Dickson Hald (verseplough65)

Single Cell Force Spectroscopy was applied to measure the single cell de-adhesion between human neural stem cells (hNSC) and gelatin methacrylate (GelMA) hydrogel with varying modulus in the range equivalent to brain tissue. The cell de-adhesion force and energy were predominately generated via unbinding of complexes formed between RGD groups of the GelMA and cell surface integrin receptors and the de-adhesion force/energy were found to increase with decreasing modulus of the GelMA hydrogel. For the softer GelMA hydrogels (160 Pa and 450 Pa) it was proposed that a lower degree of cross-linking enables a greater number of polymer chains to bind and freely extend to increase the force and energy of the hNSC-GelMA de-adhesion. In this case, the multiple polymer chains are believed to act together in parallel like 'molecular tensors' to generate tensile forces on the bound receptors until the cell detaches. Counterintuitively for softer substrates, this type of interaction gave rise to higher force loading rates,cues for regulating cell function. BACKGROUND Subcutaneous implantable cardioverter defibrillators (S-ICD) are attractive for preventing sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) as they mitigate risks of transvenous leads in young patients. However, S-ICDs may be associated with increased inappropriate shock (IAS) in HCM patients. OBJECTIVES To assess incidence and predictors of appropriate and IAS in a contemporary HCM S-ICD cohort. VX-561 mw METHODS We collected ECG and clinical data on HCM patients who underwent S-ICD implantation at 4 centers. Etiologies of all S-ICD shocks were adjudicated. We used Firth penalized logistic regression to derive adjusted odds ratios (aOR) for predictors of IAS. RESULTS Eighty-eight HCM patients received S-ICD (81 for primary and 7 for secondary prevention) with mean follow-up 2.7 years. Five patients (5.7%) had 9 IAS (3.8 IAS per 100 patient-years) most often due to sinus tachycardia and/or T-wave over-sensing. Independent predictors of IAS were taller 12-lead ECG R wave amplitude (aOR 2.55 per 1 mV; 95% CI 1.15-6.38) and abnormal T wave inversions (aOR 0.16; 95% CI 0.02-0.97). There were 2 appropriate shocks in 7 secondary prevention and none in 81 primary prevention patients, despite 96% meeting Enhanced ACC/AHA criteria, and mean European HCM-SCD risk score predicting 5.7% 5-year risk. No patients had sudden death or untreated sustained ventricular arrhythmias. CONCLUSIONS In this multi-center HCM S-ICD study, IAS were rare and appropriate shocks confined to secondary prevention patients. R wave amplitude increased IAS risk whereas T wave inversions were protective. HCM primary prevention ICD guidelines over-estimated risk of appropriate shocks in our cohort. BACKGROUND Telemedicine in a school-based setting involving partnerships between a child with asthma and health care provider can provide patients and caregivers with opportunities to better manage chronic conditions, communicate among partners, and collaborate for solutions in convenient locations. OBJECTIVE This systematic review examined outcomes for school-age children with asthma involving asthma-based telemedical education. METHODS Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we searched 4 databases with terms related to asthma, education, and pediatrics. Included articles involved a school-based setting, children and adolescents, a telemedical mechanism for training, empirical study designs, and peer review. We extracted data regarding (a) participant background, (b) research methods and purpose, and (c) outcomes. RESULTS A total of 408 articles were identified. Five met inclusion criteria. Three studies were randomized and 2 were cohort studies. In addition to clinical and educational outcomes, studies reported on satisfaction, self-management, asthma knowledge gain, and quality of life (QOL). We found support for caregiver/parent QOL and participant self-ma