Explore the vast range of titles available.

The object of this study was to discover an alternative therapeutic agent with fewer side effects against acne vulgaris, one of the most common skin diseases. Acne vulgaris is often associated with acne-related bacteria such as Propionibacterium acnes, Staphylococcus epidermidis, Staphylococcus aureus, and Pseudomonas aeruginosa. Some of these bacteria exhibit a resistance against commercial antibiotics that have been used in the treatment of acne vulgaris (tetracycline, erythromycin, and lincomycin). In the current study, we tested in vitro antibacterial effect of chitosan-phytochemical conjugates on acne-related bacteria. Three chitosan-phytochemical conjugates used in this study exhibited stronger antibacterial activity than that of chitosan (unmodified control). Chitosan-caffeic acid conjugate (CCA) showed the highest antibacterial effect on acne-related bacteria along with minimum inhibitory concentration (MIC; 8 to 256 μg/mL). Additionally, the MIC values of antibiotics against antibiotic-resistant P. acnes and P. aeruginosa strains were dramatically reduced in combination with CCA, suggesting that CCA would restore the antibacterial activity of the antibiotics. The analysis of fractional inhibitory concentration (FIC) indices clearly revealed a synergistic antibacterial effect of CCA with antibiotics. Thus, the median sum of FIC (∑FIC) values against the antibiotic-resistant bacterial strains ranged from 0.375 to 0.533 in the combination mode of CCA and antibiotics. The results of the present study suggested a potential possibility of chitosan-phytochemical conjugates in the control of infections related to acne vulgaris.

Background Effective communication between patients and healthcare providers in the emergency department (ED) is challenging due to the dynamic nature of the ED environment. This study aimed to trial a chat service enabling patients in the ED and their family members to ask questions freely, exploring the service’s feasibility and user experience. Objectives To identify the types of needs and inquiries from patients and family members in the ED that could be addressed through the chat service and to assess the user experience of the service. Methods We enrolled patients and family members aged over 19 years in the ED, providing the chat service for up to 4 h per ED visit. Trained research nurses followed specific guidelines to respond to messages from the participants. After participation, participants were required to complete a survey. Those who agreed also participated in interviews to provide insights on their experiences with the ED chat service. Results A total of 40 participants (20 patients and 20 family members) sent 305 messages (72 by patients and 233 by family members), with patients sending an average of 3.6 messages and family members 11.7. Research nurses resolved 41.4% of patient inquiries and 70.9% of family member inquiries without further healthcare provider involvement. High usability was reported, with positive feedback on communication with healthcare workers, information accessibility, and emotional support. Conclusions The ED chat service was found to be feasible and led to positive user experiences for both patients and their family members.

The increasing recidivism rate of sex offenders indicates potential problems in existing recidivism programs. The present study was conducted to determine whether the polygraph examination is a useful technique to obtain a sex offender's concealed past sexual history. We collected fifty-two sex offenders' data and analyzed it. Among the 52 participants, the court ordered 26 sex offenders to take the psychiatric evaluation and the polygraph test. The other half were prisoners at the hospital who were currently undergoing treatment. The participants in the polygraph group disclosed more deviant sexual behaviors and paraphilia interests/behaviors than the comparison group. Thus, the polygraph examination is a powerful tool that can encourage sex offenders to disclose hidden information to help create suitable psychological therapy programs for preventing recidivism in the future.

Poly(ADP-ribose) polymerase 1 (PARP-1) and p53 are two key proteins in the DNA-damage response. Although PARP-1 is known to poly(ADP-ribosyl)ate p53, the role of this modification remains elusive. Here, we identify the major poly(ADP-ribosyl)ated sites of p53 by PARP-1 and find that PARP-1-mediated poly(ADP-ribosyl)ation blocks the interaction between p53 and the nuclear export receptor Crm1, resulting in nuclear accumulation of p53. These findings molecularly link PARP-1 and p53 in the DNA-damage response, providing the mechanism for how p53 accumulates in the nucleus in response to DNA damage. PARP-1 becomes super-activated by binding to damaged DNA, which in turn poly(ADP-ribosyl)ates p53. The nuclear export machinery is unable to target poly(ADP-ribosyl)ated p53, promoting accumulation of p53 in the nucleus where p53 exerts its transactivational function.

The cAMP response element-binding protein (CREB) and CREB-regulated transcription coactivators (CRTCs) cooperate in the transcriptional activation of microphthalmia-associated transcription factor subtype M (MITF-M) that is a master regulator in the biogenesis, pigmentation and transfer of melanosomes at epidermal melanocytes. Here, we propose the targeting of phosphorylation circuits on CREB and CRTCs in the expression of MITF-M as the rationale to prevent skin hyperpigmentation by elucidating the inhibitory activity and mechanism of yakuchinone A (Yaku A) on facultative melanogenesis. We employed human epidermal melanocyte cell, mouse skin, and mouse melanoma cell, and applied Western blotting, reverse transcription-polymerase chain reaction, immunoprecipitation and confocal microscopy to conduct this study. This study suggested that α-melanocyte stimulating hormone (α-MSH)-induced melanogenic programs could switch on the axis of protein kinase A-salt inducible kinases (PKA-SIKs) rather than that of PKA-AMP activated protein kinase (PKA-AMPK) during the dephosphorylation of CRTCs in the expression of MITF-M. SIK inhibitors rather than AMPK inhibitors stimulated melanin production in melanocyte cultures in the absence of extracellular melanogenic stimuli, wherein SIK inhibitors increased the dephosphorylation of CRTCs but bypassed the phosphorylation of CREB for the expression of MITF-M. Treatment with Yaku A prevented ultraviolet B (UV-B)-irradiated skin hyperpigmentation in mice and inhibited melanin production in α-MSH- or SIK inhibitor-activated melanocyte cultures. Mechanistically, Yaku A suppressed the expression of MITF-M via dually targeting the i) cAMP-dependent dissociation of PKA holoenzyme at the upstream from PKA-catalyzed phosphorylation of CREB coupled with PKA-SIKs axis-mediated dephosphorylation of CRTCs in α-MSH-induced melanogenic programs, and ii) nuclear import of CRTCs after SIK inhibitor-induced dephosphorylation of CRTCs. Taken together, the targeting phosphorylation circuits on CREB and CRTCs in the expression of MITF-M could be a suitable strategy to prevent pigmentary disorders in the skin.

Listeria monocytogenes (LM) is an important food borne pathogen responsible for listeriosis. Further, LM is an etiological agent associated with life threatening conditions like meningitis and encephalitis. Biofilm forming and drug resistant LM may potentially become difficult to treat infections and hence effective controlling measures are required to prevent LM infections. In view of this, the present study evaluated an anti-listerial potential of edible brown seaweed, Eisenia bicyclis, by disc diffusion and micro-dilution methods. The results of the present study suggested that the anti-listerial activity of various phlorotannins isolated form E. bicyclis were in the range of 16–256 µg/ml. Among the phlorotannins isolated, fucofuroeckol-A (FAA) exhibited the highest anti-listerial potential (MIC range 16–32 µg/ml) against LM strains tested. Further, in checker board synergy assays, FFA-streptomycin combination exhibited significant synergy (fractional inhibitory concentration index, ∑FIC < 0.5) against aminoglycoside resistant clinical strains of LM. The results of the present study suggested the potential use of edible seaweed E. bicyclis as a source of natural phlorotannins to control food borne pathogenic infections.

This work examines the process of admission to a hospital’s intensive care unit (ICU). ICUs currently lack systematic admission criteria, largely because the impact of ICU admission on patient outcomes has not been well quantified. This makes evaluating the performance of candidate admission strategies difficult. Using a large patient-level data set of more than 190,000 hospitalizations across 15 hospitals, we first quantify the cost of denied ICU admission for a number of patient outcomes. We use hospital operational factors as instrumental variables to handle the endogeneity of the admission decisions and identify important specification issues that are required for this approach to be valid. Using the quantified cost estimates, we then provide a simulation framework for evaluating various admission strategies' performance. By simulating a hospital with 21 ICU beds, we find that we could save about $1.9 million per year by using an optimal policy based on observables designed to reduce readmissions and hospital length of stay. We also discuss the role of unobserved patient factors, which physicians may discretionarily account for when making admission decisions, and show that including these unobservables could result in a more than threefold increase in benefits compared to just optimizing the policy over the observable patient factors. This paper was accepted by Serguei Netessine, operations management.

Providing patients with timely care from the appropriate unit involves both correct clinical evaluation of patient needs and making admission decisions to effectively manage a unit with limited capacity in the face of stochastic patient arrivals and lengths of stay. We study human decision behavior in the latter operations management task. Using behavioral models and controlled experiments in which physicians and MTurk workers manage a simulated hospital unit, we identify cognitive and environmental factors that drive systematic admission decision bias. We report on two main findings. First, seemingly innocuous “occupancy information hurdles” (e.g., having to type a password to view current occupancy) can cause a chain of events that leads physicians to maintain systematically lower unit utilization. Specifically, these hurdles cause physicians to make most admission decisions without checking the current unit occupancy. Then—between the times that they do check—physicians underestimate the number of available beds when occupancy increases from admissions are more salient than occupancy decreases from discharges. Second, decision-related random error or “noise” leads to higher- or lower-than-optimal utilization of hospital units in predictable patterns, depending on the system parameters. We provide evidence that these patterns are due to some settings providing more opportunity for physicians to mistakenly admit patients and other settings that provide more opportunity to mistakenly reject patients. These findings help identify when and why clinicians are likely to make inefficient decisions because of human cognitive limitations and suggest mitigation strategies to help hospital units improve their capacity management. This paper was accepted by Charles Corbett, operations management.

[This corrects the article DOI: 10.1371/journal.pone.0239046.].[This corrects the article DOI: 10.1371/journal.pone.0239046.].