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Imiquimod cream may be used as a non-surgical treatment for lentigo maligna or as adjuvant therapy following excision to decrease the risk of recurrence. To evaluate histologic and clinical factors associated with clinical clearance of lentigo maligna treated with imiquimod. We performed a retrospective review of all patients diagnosed with lentigo maligna and treated with imiquimod between 1997 and 2019 at our academic institution. We observed clinical clearance in 93% (66/71) of participants who received adjuvant imiquimod following surgery and 79% (19/24) in the primary non-surgical treatment group over a median of 38 months of follow-up. In the adjuvant therapy group, positive surgical margins were associated with a decreased rate of clinical clearance when compared to cases with close (<1 mm) margins or background melanocytic dysplasia (83.3 vs. 100%, p =.01). The presence of an inflammatory response during treatment was associated with increased clearance (94.1 vs. 66.7%, p =.02). Adjuvant imiquimod treatment may decrease LM recurrence rates in cases with background melanocytic dysplasia or close margins. LM cases with positive surgical margins need close clinical follow-up given higher recurrence rates. [ABSTRACT FROM AUTHOR]

Analyzing the concentration of ions in aqueous solutions in real-time plays an important role in the fields of chemistry and biology. Traditional methods for measuring ion concentrations, such as concentration analysis by measuring electrical conductivity, inductively coupled plasma mass spectrometry, and ion chromatography, have been used in many research fields. However, these methods are limited in determining ion concentrations instantaneously. Fourier-transform infrared-attenuated total reflectance (ATR-FTIR) spectroscopy provides a new approach for determining ion concentrations in aqueous solutions. This allows for fast analysis without pretreatment and is scalable for real-time measurements. In this study, we present a method for measuring ion concentrations by examining ion-water interactions in the O-H stretching band of aqueous solutions using ATR-FTIR spectroscopy. Five aqueous solutions, namely LiCl + HCl, LiOH + HCl, LiOH, Li 3 PO 4 , and NaCl were used in the experiments and prepared at concentrations between 0.5-2 M. The ion concentrations in the prepared aqueous solutions were measured using ATR-FTIR spectroscopy. We observed that the difference in absorbance increased and decreased linearly with changes in concentration. The concentration of ions in the aqueous solution could be measured by validating the designed linear regression analysis function model. In this study, we proposed five linear regression analysis function models, all of which showed high coefficients of determination above 0.9, with the highest coefficient of determination reaching 0.9969. These results show that ATR-FTIR spectroscopy has the potential to be applied as a rapid and simple concentration analysis system., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (This journal is © The Royal Society of Chemistry.)

Efficient pathogen enrichment and nucleic acid isolation are critical for accurate and sensitive diagnosis of infectious diseases, especially those with low pathogen levels. Our study introduces a biporous silica nanofilms-embedded sample preparation chip for pathogen and nucleic acid enrichment/isolation. This chip features unique biporous nanostructures comprising large and small pore layers. Computational simulations confirm that these nanostructures enhance the surface area and promote the formation of nanovortex, resulting in improved capture efficiency. Notably, the chip demonstrates a 100-fold lower limit of detection compared to conventional methods used for nucleic acid detection. Clinical validations using patient samples corroborate the superior sensitivity of the chip when combined with the luminescence resonance energy transfer assay. The enhanced sample preparation efficiency of the chip, along with the facile and straightforward synthesis of the biporous nanostructures, offers a promising solution for polymer chain reaction-free detection of nucleic acids., (© 2024. The Author(s).)

Natural sharkskin features staggered-overlapped and multilayered architectures of riblet-textured anisotropic microdenticles, exhibiting drag reduction and providing a flexible yet strong armor. However, the artificial fabrication of three-dimensional (3D) sharkskin with these unique functionalities and mechanical integrity is a challenge using conventional techniques. In this study, it is reported on the facile microfabrication of multilayered 3D sharkskin through the magnetic actuation of polymeric composites and subsequent chemical shape fixation by casting thin polymeric films. The fabricated hydrophobic sharkskin, with geometric symmetry breaking, achieves anisotropic drag reduction in frontal and backward flow directions against the riblet-textured microdenticles. For mechanical integrity, hard-on-soft multilayered mechanical properties are realized by coating the polymeric sharkskin with thin layers of zinc oxide and platinum, which have higher hardness and recovery behaviors than the polymer. This multilayered hard-on-soft sharkskin exhibits friction anisotropy, mechanical robustness, and structural recovery. Furthermore, coating the MXene nanosheets provides the fabricated sharkskin with a low electrical resistance of ≈5.3 Ω, which leads to high Joule heating (≈229.9 °C at 2.75 V). The proposed magnetomechanical actuation-assisted microfabrication strategy is expected to facilitate the development of devices requiring multifunctional microtextures., (© 2023 Wiley-VCH GmbH.)

When a low-viscosity fluid displaces into a higher-viscosity fluid, the liquid-liquid interface becomes unstable causing finger-like patterns. This viscous fingering instability has been widely observed in nature and engineering systems with two adjoined fluids. Here, we demonstrate a hitherto-unrealizable viscous fingering in a single fluid-solid interface. In a single polyelectrolyte fluid on a charge selective surface, selective ion rejection through the surface initiates i) stepwise ion concentration and viscosity gradient boundaries in the fluid and ii) electroconvective vortices on the surface. As the vortices grow, the viscosity gradient boundary pushes away from the surface, resulting viscous fingering. Comparable to conventional one with two fluids, i) a viscosity ratio ([Formula: see text]) governs the onset of this electroconvective viscous fingering, and ii) the boundary properties (finger velocity and rheological effects) - represented by [Formula: see text], electric Rayleigh ([Formula: see text]), Schmidt ([Formula: see text]), and Deborah ([Formula: see text]) numbers - determine finger shapes (straight v.s. ramified, the onset length of fingering, and relative finger width). With controllable onset and shape, the mechanism of electroconvective viscous fingering offers new possibilities for manipulating ion transport and dendritic instability in electrochemical systems., (© 2023. The Author(s).)

Exposure of a conducting porous material to an electric field in electrolytes induces an electric dipole, which results in capacitive charging of cations and anions at opposite poles. In this letter, we investigate a novel desalination method using this induced-charge capacitive deionization (ICCDI). To do this, we devise a microscale ICCDI platform that can visualize in situ ion concentrations, pH shifts, and fluid flows, and study ion transport dynamics and desalination performances compared to conventional CDI with unipolar / bipolar connections. Similar ion concentration and fluid flow characteristics were observed in Ohmic, limiting, and over-limiting regimes, but variations in desalination performance trends were noted based on the number of stacks. In a single cell, ICCDI generates a higher electric field at the opposite poles of porous electrodes than simple conducted electrodes in CDIs with unipolar/bipolar connections, leading to superior salt removal and/or lower ionic current at a given applied voltage. This marks a clear contrast from CDI with bipolar connection, which lacks any advantage over CDI with unipolar connection in a single cell. These metrics of ICCDI however deteriorated as the stack number increased, likely due to short-circuiting between the dipoles. As a result, ICCDI in current form shows higher desalination efficient than conventional CDIs with low stack numbers (< 6), so we offer the scale-up module by repeating 4-stack ICCDI units. Our study enhances comprehension of ion transport dynamics and desalination performance in ICCDI, and the results could aid in the development of ICCDI for energy/cost-efficient desalination., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Competing Interests: Conflicts of interest None disclosed.

Sensory neurons generate spike patterns upon receiving external stimuli and encode key information to the spike patterns, enabling energy-efficient external information processing. Herein, we report an epifluidic electronic patch with spiking sweat clearance using a sensor containing a vertical sweat-collecting channel for event-driven, energy-efficient, long-term wireless monitoring of epidermal perspiration dynamics. Our sweat sensor contains nanomesh electrodes on its inner wall of the channel and unique sweat-clearing structures. During perspiration, repeated filling and abrupt emptying of the vertical sweat-collecting channel generate electrical spike patterns with the sweat rate and ionic conductivity proportional to the spike frequency and amplitude over a wide dynamic range and long time (> 8 h). With such 'spiking' sweat clearance and corresponding electronic spike patterns, the epifluidic wireless patch successfully decodes epidermal perspiration dynamics in an event-driven manner at different skin locations during exercise, consuming less than 0.6% of the energy required for continuous data transmission. Our patch could integrate various on-skin sensors and emerging edge computing technologies for energy-efficient, intelligent digital healthcare., (© 2022. The Author(s).)

Competing Interests: Conflicts of interest None disclosed.

Purpose: The physician voice is crucial to shaping health policy and public health guidelines, particularly during COVID-19. However, there are gaps in health policy and advocacy education within graduate medical education. This study sought to characterise the impact of a virtual COVID-19 focused advocacy day among medical trainees in Massachusetts., Study Design: The half-day event featured speakers drawn from government relations experts, physician advocates, and state and federal legislators as well as breakout discussions among attendees. A 25-question Redcap survey and list of resources/opportunities for continued advocacy was administered to all participants at event's conclusion on 19 May 2020., Results: There were 60 responses from 141 participants (43% response rate). One-third reported no prior formal health policy instruction, and over half reported getting information from news publications, social media and peers. 58% believed physician involvement in advocacy to be 'extremely important' prior to COVID-19; 83% believed the same after onset of COVID-19 (p<0.0001). The most common barriers to advocacy engagement were lack of time and knowledge. Most attendees felt participation increased their knowledge and likelihood to engage in the COVID-19 response, imparted useful skills/knowledge for continued advocacy, increased their interest in future similar events, and that such events should be available to all trainees., Conclusions: Trainees recognise the importance of health policy and advocacy and value opportunities to gain the necessary skills/knowledge to effect tangible change. Virtual advocacy days can be replicated nationwide to help trainees learn about advocacy efforts and find their legislative voices during COVID-19 and beyond., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: The potential of DNA methylation alterations in early pancreatic cancer (PC) detection among pancreatic tissue cell-free DNA seems promising. This study investigates the diagnostic capacity of the 4-gene methylation biomarker panel, which included ADAMTS1, BNC1, LRFN5, and PXDN genes, in a case-control study., Methods: A genome-wide pharmacoepigenetic approach identified ADAMTS1, BNC1, LRFN5, and PXDN genes as putative targets. Tissue samples including stage I-IV PC (n = 44), pancreatic intraepithelial neoplasia (n = 15), intraductal papillary mucinous neoplasms (n = 24), and normal pancreas (n = 8), and cell-free DNA, which was acquired through methylation on beads technology from PC (n = 22) and control patients (n = 10), were included. The 2-∆ct was the outcome of interest and underwent receiver operating characteristic analysis to determine the diagnostic accuracy of the panel., Results: Receiver operating characteristic analysis revealed an area under the curve of 0.93 among ADAMTS1, 0.76 among BNC1, 0.75 among PXDN, and 0.69 among LRFN5 gene. The combination gene methylation panel (ADAMTS1, BNC1, LRFN5, and PXDN) had an area under the curve of 0.94, with a sensitivity of 100% and specificity of 90%., Conclusions: This methylation-based biomarker panel had promising accuracy for PC detection and warranted further validation in prospective PC surveillance trials., Competing Interests: N.A. receives research grant funding from Astex Inc and the Van Andel Research Institute. She is a consultant for and has licensed methylation biomarkers to Cepheid (patent # 10167513). N.A. has also served as a consultant to Johnson and Johnson, an advisor to Celgene, and a member of the Scientific Advisory Council to the No Stomach for Cancer Foundation. N.A. also serves as PI on NIH grants 5P30CA016359-42 and 7R01CA185357-05. This work was supported by the NIH grant 7R01CA185357-05. All authors have read the journal's policy on disclosure of potential conflicts of interest, and none of the authors have financial or personal relationship with organizations that could potentially be perceived as influencing the described research., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Major changes in climate resulting in mass migrations have unique dermatologic implications for global vulnerable populations. Dermatologic manifestations commonly accompany the infectious and communicable diseases that proliferate in the settings of confinement, crowding, and limited sanitation associated with mass migration. Ectoparasitic infestations abound in refugee camps, and poor nutrition, hygiene, and compromised immunity put refugees at an increased risk for more dangerous infectious diseases carried by these ectoparasites. Climate change also profoundly affects the worldwide distribution of various vector-borne illnesses, thereby leading to the emergence of various communicable diseases in previously nonendemic areas. Natural disasters not only disrupt important lifesaving treatments, but also challenge various infectious disease control measures that are critical in preventing rapid transmission of highly infectious diseases. This article reviews the infectious diseases commonly found in these scenarios and provides an in-depth discussion of important implications for the dermatologist., (© 2020 Published by Elsevier Inc. on behalf of Women's Dermatologic Society.)

When a charge selective surface consumes or transports only cations or anions in the electrolyte, biased ion rejection initiates hydrodynamic instability, resulting in vortical fluid motions called electroconvection. In this Letter, we describe the first laboratory observation of three-dimensional electroconvection on a charge selective surface. Combining experiment and scaling analysis, we successfully categorized three distinct patterns of 3D electroconvection according to [(Ra&#95;{E})/(Re^{2}Sc)] [electric Rayleigh number (Ra&#95;{E}), Reynolds number (Re), Schmidt number (Sc)] as (i) polygonal, (ii) transverse, or (iii) longitudinal rolls. If Re increases or Ra&#95;{E} decreases, pure longitudinal rolls are presented. On the other hand, transverse rolls are formed between longitudinal rolls, and two rolls are transformed as polygonal one at higher Ra&#95;{E} or lower Re. In this pattern selection scenario, Sc determines the critical electric Rayleigh number (Ra&#95;{E}^{*}) for the onset of each roll, resulting in Ra&#95;{E}^{*}∼Re^{2}Sc. We also verify that convective ion flux by electroconvection (represented by an electric Nusselt number Nu&#95;{E}) is fitted to a power law, Nu&#95;{E}∼[(Ra&#95;{E}-Ra&#95;{E}^{*})/(Re^{2}Sc)]^{α&#95;{1}}Re^{α&#95;{2}}Pe^{α&#95;{3}} [Péclet number (Pe)], where each term represents the characteristics of electroconvection, shear flow, and ion transport.

Electrodeionization (EDI) is membrane-based desalination utilizing ion exchange membranes and ion exchange resins. By combining Electrodialysis and Ion exchanger, EDI can produce ultrapure water in a continuous-flow manner. Although its theoretical mechanisms are well documented, there is no experimental platform that can provide microscopic details inside of the system. In this paper, we present microscale EDI that can visualize in situ ion concentration, pH, and fluid flows. The platform was fabricated by filling ion exchange resins as a monolayer in a transparent polydimethylsiloxane channel between cation and anion exchange membranes. According to operating voltages (0-15V), distinct behaviors of ion concentration profile, pH shift, and fluid flows were observed in Ohmic, limiting, and overlimiting regimes. It is noteworthy that overlimiting regimes can be sub-categorized as water-splitting and electroconvection regimes. In the early stage (4-8V), water-splitting is dominant with pH change near the membranes and resins; under a higher voltage (8-15V), electroconvection starts to occur even water-splitting tries to suppress the development of the extended space charge layer and corresponding electroconvective instability. Accelerated ionic migration by electroconvection can improve current efficiency up to 80%. This is a clear departure from overlimiting dynamics in electrodialysis (with electroconvection only), ion exchanger (with no distinct regime), and even from that in previous EDI experiments (with water splitting only)., (Copyright © 2019 Elsevier Ltd. All rights reserved.)