Body dysmorphic disorder: diagnosis and approach

Body dysmorphic disorder is a psychiatric disease that can be frequently encountered in an aesthetic practice. Body dysmorphic disorder is characterized by a preoccupation with a minimal or nonexistent appearance defect and causes significant distress and interferes with the social life of the patient. The perceived physical anomaly may involve the shape and size of the whole body or may be centered around single units. Body dysmorphic disorder patients are known to request multiple aesthetic procedures that leave them unsatisfied. Only a timely diagnosis will enable the surgeon and staff to adequately address the patient's needs. Body dysmorphic disorder patients cannot be cured with surgery. Diagnostic techniques such as patient interview and observation are presented in this article. With this, the plastic surgeon should be able to diagnose body dysmorphic disorder preoperatively. Using the presented algorithm to approach body dysmorphic disorder patients will avoid disappointment for patients and surgeons alike.     

Identification of novel uracil derivatives incorporating benzoic acid moieties as highly potent Dipeptidyl Peptidase-IV inhibitors

Dipeptidyl Peptidase-IV (DPP-4) is a validated therapeutic target for type 2 diabetes. Aiming to interact with both residues Try629 and Lys554 in S₂′ site, a series of novel uracil derivatives 1a–l and 2a–i incorporating benzoic acid moieties at the N₃ position were designed and evaluated for their DPP-4 inhibitory activity. Structure-activity relationships (SAR) study led to the identification of the optimal compound 2b as a potent and selective DPP-4 inhibitor (IC₅₀?=?1.7?nM). Docking study revealed the additional salt bridge formed between the carboxylic acid and primary amine of Lys554 has a key role in the enhancement of the activity. Furthermore, compound 2b exhibited no cytotoxicity in human hepatocyte LO2 cells up to 50?μM. Subsequent in vivo evaluations revealed that the ester of 2b robustly improves the glucose tolerance in normal mice. The overall results have shown that compound 2b has the potential to a safe and efficacious treatment for T2DM.     

Single-Cell Analysis Reveals a Hair Follicle Dermal Niche Molecular Differentiation Trajectory that Begins Prior to Morphogenesis

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Structural insight into how the human helicase subunit MCM2 may act as a histone chaperone together with ASF1 at the replication fork

MCM2 is a subunit of the replicative helicase machinery shown to interact with histones H3 and H4 during the replication process through its N-terminal domain. During replication, this interaction has been proposed to assist disassembly and assembly of nucleosomes on DNA. However, how this interaction participates in crosstalk with histone chaperones at the replication fork remains to be elucidated. Here, we solved the crystal structure of the ternary complex between the histone-binding domain of Mcm2 and the histones H3-H4 at 2.9 Å resolution. Histones H3 and H4 assemble as a tetramer in the crystal structure, but MCM2 interacts only with a single molecule of H3-H4. The latter interaction exploits binding surfaces that contact either DNA or H2B when H3-H4 dimers are incorporated in the nucleosome core particle. Upon binding of the ternary complex with the histone chaperone ASF1, the histone tetramer dissociates and both MCM2 and ASF1 interact simultaneously with the histones forming a 1:1:1:1 heteromeric complex. Thermodynamic analysis of the quaternary complex together with structural modeling support that ASF1 and MCM2 could form a chaperoning module for histones H3 and H4 protecting them from promiscuous interactions. This suggests an additional function for MCM2 outside its helicase function as a proper histone chaperone connected to the replication pathway.     

PET Index of Bone Glucose Metabolism (PIBGM) Classification of PET/CT Data for Fever of Unknown Origin Diagnosis

Objectives

Fever of unknown origin (FUO) remains a challenge in clinical practice. Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is helpful in diagnosing the etiology of FUO. This paper aims to develop a completely automatic classification method based on PET/CT data for the computer-assisted diagnosis of FUO.

Methods

We retrospectively analyzed the FDG PET/CT scan of 175 FUO patients, 79 males and 96 females. The final diagnosis of all FUO patients was achieved through pathology or clinical evaluation, including 108 normal patients and 67 FUO patients. CT anatomic information was used to acquire bone functional information from PET images. The skeletal system of FUO patients was classified by analyzing the standardized uptake value (SUV) and the PET index of bone glucose metabolism (PIBGM). The SUV distributions in the bone marrow and the bone cortex were also studied in detail.

Results

The SUV and PIBGM of the bone marrow only slightly differed between the FUO patients and normal people, whereas the SUV of whole bone structures and the PIBGM of the bone cortex significantly differed between the normal people and FUO patients. The method detected 43 patients from 67 FUO patients, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 64.18%, 95%, 93.48%, 72.73%, and 83.33%, respectively.

Conclusion

The experimental results demonstrate that the study can achieve automatic classification of FUO patients by the proposed novel biomarker of PIBGM, which has the potential to be utilized in clinical practice.     

Adaptive Mesh Expansion Model (AMEM) for Liver Segmentation from CT Image

This study proposes a novel adaptive mesh expansion model (AMEM) for liver segmentation from computed tomography images. The virtual deformable simplex model (DSM) is introduced to represent the mesh, in which the motion of each vertex can be easily manipulated. The balloon, edge, and gradient forces are combined with the binary image to construct the external force of the deformable model, which can rapidly drive the DSM to approach the target liver boundaries. Moreover, tangential and normal forces are combined with the gradient image to control the internal force, such that the DSM degree of smoothness can be precisely controlled. The triangular facet of the DSM is adaptively decomposed into smaller triangular components, which can significantly improve the segmentation accuracy of the irregularly sharp corners of the liver. The proposed method is evaluated on the basis of different criteria applied to 10 clinical data sets. Experiments demonstrate that the proposed AMEM algorithm is effective and robust and thus outperforms six other up-to-date algorithms. Moreover, AMEM can achieve a mean overlap error of 6.8% and a mean volume difference of 2.7%, whereas the average symmetric surface distance and the root mean square symmetric surface distance can reach 1.3 mm and 2.7 mm, respectively.     

Lithium–Iron (III) Fluoride Battery with Double Surface Protection

Lithium–metal fluoride batteries promise significantly higher energy density than the state‐of‐the‐art lithium‐ion batteries and lithium–sulfur batteries. Unfortunately, commercialization of metal fluoride cathodes is prevented by their high resistance, irreversible structural change, and rapid degradation. In this study, a substantial boost in metal fluoride (MF) cathode stability by designing nanostructure with two layers of protective shells—one deposited ex situ and the other in situ is demonstrated. Such methodology achieves over 90% capacity retention after 300 charge–discharge cycles, producing the first report on FeF₃ as a cathode material, where a very high capacity utilization in combination with excellent stability is approaching the level needed for practical applications of FeF₃. The cathode solid electrolyte interphase (CEI) containing lithium oxalate and B? F bond containing anions is found to effectively protect the cathode material from direct contact with electrolytes, thus greatly suppressing the dissolution of Fe. Quantum chemistry and molecular dynamics calculations provide unique insights into the mechanisms of CEI layer formation. As a result, this work not only demonstrates unprecedented performance, but also provides the reader with a better fundamental understanding of electrochemical behavior of MF cathodes and the positive impact observed with the application of a lithium bis(oxalato)borate salt in the electrolyte.     

Compact 3D Copper with Uniform Porous Structure Derived by Electrochemical Dealloying as Dendrite‐Free Lithium Metal Anode Current Collector

The development of lithium (Li) metal anodes Li metal batteries faces huge challenges such as uncontrolled Li dendrite growth and large volume change during Li plating/stripping, resulting in severe capacity decay and high safety hazards. A 3D porous copper (Cu) current collector as a host for Li deposition can effectively settle these problems. However, constructing a uniform and compact 3D porous Cu structure is still an enormous challenge. Herein, an electrochemical etching method for Cu–Zinc (Zn) alloy is reported to precisely engrave a 3D Cu structure with uniform, smooth, and compact porous network. Such a continuous structure endows 3D Cu excellent mechanical properties and high electrical conductivity. The uniform and smooth pores with a large internal surface area ensures well dispersed current density for homogeneous Li metal deposition and accommodation. A smooth and stable solid electrolyte interphase is formed and meanwhile Li dendrites and dead Li are effectively suppressed. The Li metal anode conceived 3D Cu current collector can stably cycle for 400 h under an Li plating/stripping capacity of 1 mA h cm^?2 and a current density of 1 mA cm^?2. The Li@3D Cu||LiFePO₄ full cells present excellent cycling and rate performances. The electrochemical dealloying is a robust method to construct 3D Cu current collectors for dendrite‐free Li metal anodes.     

Protective Effect of Dehydroepiandrosterone Against Copper-Induced Lipid Peroxidation in the Rat

This study investigates the effectiveness and multitargeted activity of dehydroepiandrosterone (DHEA) as antioxidant in vivo. A single dose of DHEA was given IP to male rats. Liver and brain microsomes, and plasma low density lipoprotein (LDL), were isolated from rats sacrified 17 h later. Liver and brain microsomes were challenged with CuSO₄ and, as index of lipid peroxidation, the production of thiobarbituric acid reactive substances (TBARS) was measaured. Also, plasma low-density lipoprotein (LDL) were challenged with copper and the time course of lipid peroxidation was evaluated following the formation of conjugated dienes. The onset of TBARS generation induced by copper was marked delayed in both liver and brain microsomes from DHEA-treated animals. Also, the resistance of LDL to oxidation, expressed by the duration of the lag-phase of the kinetic curve, was significantly enhanced in DHEA-treated rats. Results indicate that in vivo DHEA supplementation makes subcellular fractions isolated from different tissues and plasma constituents (LDL) more resistant to lipid peroxidation triggered by copper. The antioxidant effect on plasma LDL might be of special relevance to the proposed antiatherogenic activity of DHEA. Moreover, multitargeted antioxidant activity of DHEA might protect tissues from oxygen radicals damage. © 1997 Elsevier Science Inc.