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Πέμπτη 10 Μαΐου 2018

Comparative study on toxicity of methylmercury chloride and methylmercury hydroxide to the human neuroblastoma cell line SH-SY5Y

Abstract

Toxicities of methylmercury chloride (CH3HgCl) and methylmercury hydroxide (CH3HgOH) to cultured neuroblastoma cell line SH-SY5Y in vitro are evaluated. This is the comparative study between two methylmercury compounds to find out the extent of toxicity of these compounds are toxic to SH-SY5Y cell line. Both cytotoxicity and genotoxicity experiments were carried out to find out the more toxic compound. For cytotoxicity study, four staining assay methods independently with trypan blue (TB), acridine orange/ethidium bromide (AO/EB), 3-(4,5-dimethylthiazol-2-yl) 2,5-diphenyl tetrazolium bromide (MTT), and neutral red (NR) were used and the comet assay method was done for genotoxicity study. The obtained toxicity data were used for probit analysis. In cytotoxicity, CH3HgCl had minimum inhibitory concentration (MIC) value in each assay method as 3 mg/L invariably; LC25 values were in the range 7.41 to 10.23 mg/L, and LC50 values were 14.79 to 15.48 mg/L; while LC75 values were 20.89 to 26.91 mg/L. Moreover, LC100 value was 30 mg/L, known from comet assay experiments for CH3HgCl. Similarly for CH3HgOH, the MIC value in each assay method was invariably 3 mg/L, the LC25 values were in the range 12.58 to 16.59 mg/L, and LC50 values were 19.49 to 23.44 mg/L; LC75 values were 27.54 to 30.90 mg/L and LC100 value was 42 mg/L in each assay done for cytotoxicity and genotoxicity studies. Computed DNA fragmentation indices in comet assays were 98.6 ± 0.57 30 mg/L with CH3HgCl and 76 ± 5.29 30 mg/L with CH3HgOH. This study clearly indicated that methylmercury chloride is more toxic than methylmercury hydroxide to SH-SY5Y cell line. Toxicity of Hg had been quantified with in vitro cultured human neuroblastoma cell line; since it has neurotoxic effects, its neural evaluation has implications in environmental health issues.



Table of Contents



Information for Readers



Editorial Board



The multidisciplinary tumor board for the management of cutaneous neoplasms: A national survey of academic medical centers

To the Editor: The multidisciplinary tumor board (MTB) is a meeting of various medical specialties to discuss the management of patients with cancer. In lung, esophageal, and head and neck cancers, tumor boards increase adherence to national treatment guidelines, decrease treatment delays, are educational, and instill the importance of multidisciplinary care early in training.1-4 However, little is known about the MTB for cutaneous neoplasms. This study assesses the structure, goals, and participation patterns of the MTB in a nationwide sample of academic dermatology centers.

Subject index

ABC parameters

CME examination



Answers to CME examination



CME examination



June iotaderma (#292)



May iotaderma (#291)



Answers to CME examination



Should medical students follow up on skin biopsy results? When education conflicts with patient privacy

With the increased availability of EHR across clinical medicine, medical trainees are increasingly using this technology as a learning tool. Although medical students are standardly given access to patient records to carry out clinical duties, one study found that 96% of students use EHRs to follow-up on outcomes after patients have left the student's direct care.1 Of these students, 93% found the practice to be educationally beneficial.1 However, what implications does this have for a patient's right to privacy, which reflects the ethical principle of respect for patient autonomy? Autonomy represents self-governance or self-rule whereby a person is free from the control or undue influence of others.

Dermatology Calendar



JAAD Case Reports Article List



Author index∗∗January, pp. 1-236; February, pp. 237-432 and S1-S24; March, pp. 433-644 and S25-S84; April, pp. 645-838; May, pp. 839-1034; June, pp. 1035-1294.

Abanmi A (see Thiboutot et al). 2018;78:S1-23 (Supplement article)

Journal Based CME Instructions and Information



Cover Sheet for Index



In the blink of an eye

It seems like just the other day that I stood before the AAD Board of Directors to discuss my vision for the Journal of the American Academy of Dermatology (JAAD). That "other day" was actually in July 2007, and the presentation was to support my candidacy for Editor of the Journal. I simply cannot believe how quickly time has passed. As the old saying goes, "Time flies when you're having fun."

Langerhans cell histiocytosis in children

Langerhans cell histiocytosis (LCH) is an inflammatory neoplasia of myeloid precursor cells driven by mutations in the mitogen-activated protein kinase pathway. When disease involves the skin, LCH most commonly presents as a seborrheic dermatitis or eczematous eruption on the scalp and trunk. Evaluation for involvement of other organ systems is essential, because 9 of 10 patients presenting with cutaneous disease also have multisystem involvement. Clinical manifestations range from isolated disease with spontaneous resolution to life-threatening multisystem disease.

Instagram and the dermatologist: An ethical analysis

Instagram, one of the most popular social media platforms, is a mobile media sharing app that allows users to share their content with a large, diverse audience. Among the 1 million advertisers1 on Instagram are business savvy physicians who are engaging with potential patients and customers on this platform. The growing application of Instagram as a tool to connect with an audience and build a personal brand presents unique ethical dilemmas to physician users of this platform. Dr M's moral obligations as a physician may conflict with the perceived need to adapt to the changing landscape of marketing in medicine.

Chemical characterization of PM 2.5 from a southern coastal city of China: applications of modeling and chemical tracers in demonstration of regional transport

Abstract

An intensive sampling campaign of airborne fine particles (PM2.5) was conducted at Sanya, a coastal city in Southern China, from January to February 2012. Chemical analyses and mass reconstruction were used identify potential pollution sources and investigate atmospheric reaction mechanisms. A thermodynamic model indicated that low ammonia and high relative humidity caused the aerosols be acidic and that drove heterogeneous reactions which led to the formation of secondary inorganic aerosol. Relationships among neutralization ratios, free acidity, and air-mass trajectories suggest that the atmosphere at Sanya was impacted by both local and regional emissions. Three major transport pathways were identified, and flow from the northeast (from South China) typically brought the most polluted air to Sanya. A case study confirmed strong impact from South China (e.g., Pearl River Delta region) (contributed 76.8% to EC, and then this result can be extended to primary pollutants) when the northeast winds were dominant. The Weather Research Forecasting Black carbon model and trace organic markers were used to apportion local pollution versus regional contributions. Results of the study offer new insights into the atmospheric conditions and air pollution at this coastal city.



Relationship between Cough-Associated Changes in CSF Flow and Disease Severity in Chiari I Malformation: An Exploratory Study Using Real-Time MRI [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Currently no quantitative objective test exists to determine disease severity in a patient with Chiari I malformation. Our aim was to correlate disease severity in symptomatic patients with Chiari I malformation with cough-associated changes in CSF flow as measured with real-time MR imaging.

MATERIALS AND METHODS:

Thirteen symptomatic patients with Chiari I malformation (tonsillar herniation of ≥5 mm) were prospectively studied. A real-time, flow-sensitized pencil-beam MR imaging scan was used to measure CSF stroke volume during rest and immediately following coughing and relaxation periods (total scan time, 90 seconds). Multiple posterior fossa and craniocervical anatomic measurements were also obtained. Patients were classified into 2 groups by neurosurgeons blinded to MR imaging measurements: 1) nonspecific Chiari I malformation (5/13)—Chiari I malformation with nonspecific symptoms like non-cough-related or mild occasional cough-related headache, neck pain, dizziness, paresthesias, and/or trouble swallowing; 2) specific Chiari I malformation (8/13)—patients with Chiari I malformation with specific symptoms and/or objective findings like severe cough-related headache, myelopathy, syringomyelia, and muscle atrophy. The Spearman correlation was used to determine correlations between MR imaging measurements and disease severity, and both groups were also compared using a Mann-Whitney U test.

RESULTS:

There was a significant negative correlation between the percentage change in CSF stroke volume (resting to postcoughing) and Chiari I malformation disease severity (R = 0.59; P = .03). Mann-Whitney comparisons showed the percentage change in CSF stroke volume (resting to postcoughing) to be significantly different between patient groups (P = .04). No other CSF flow measurement or anatomic measure was significantly different between the groups.

CONCLUSIONS:

Our exploratory study suggests that assessment of CSF flow response to a coughing challenge has the potential to become a valuable objective noninvasive test for clinical assessment of disease severity in patients with Chiari I malformation.



Deep-Learning Convolutional Neural Networks Accurately Classify Genetic Mutations in Gliomas [ADULT BRAIN]

BACKGROUND AND PURPOSE:

The World Health Organization has recently placed new emphasis on the integration of genetic information for gliomas. While tissue sampling remains the criterion standard, noninvasive imaging techniques may provide complimentary insight into clinically relevant genetic mutations. Our aim was to train a convolutional neural network to independently predict underlying molecular genetic mutation status in gliomas with high accuracy and identify the most predictive imaging features for each mutation.

MATERIALS AND METHODS:

MR imaging data and molecular information were retrospectively obtained from The Cancer Imaging Archives for 259 patients with either low- or high-grade gliomas. A convolutional neural network was trained to classify isocitrate dehydrogenase 1 (IDH1) mutation status, 1p/19q codeletion, and O6-methylguanine-DNA methyltransferase (MGMT) promotor methylation status. Principal component analysis of the final convolutional neural network layer was used to extract the key imaging features critical for successful classification.

RESULTS:

Classification had high accuracy: IDH1 mutation status, 94%; 1p/19q codeletion, 92%; and MGMT promotor methylation status, 83%. Each genetic category was also associated with distinctive imaging features such as definition of tumor margins, T1 and FLAIR suppression, extent of edema, extent of necrosis, and textural features.

CONCLUSIONS:

Our results indicate that for The Cancer Imaging Archives dataset, machine-learning approaches allow classification of individual genetic mutations of both low- and high-grade gliomas. We show that relevant MR imaging features acquired from an added dimensionality-reduction technique demonstrate that neural networks are capable of learning key imaging components without prior feature selection or human-directed training.



Cerebral Perfusion Is Perturbed by Preterm Birth and Brain Injury [PEDIATRICS]

BACKGROUND AND PURPOSE:

Early disturbances in systemic and cerebral hemodynamics are thought to mediate prematurity-related brain injury. However, the extent to which CBF is perturbed by preterm birth is unknown. Our aim was to compare global and regional CBF in preterm infants with and without brain injury on conventional MR imaging using arterial spin-labeling during the third trimester of ex utero life and to examine the relationship between clinical risk factors and CBF.

MATERIALS AND METHODS:

We prospectively enrolled preterm infants younger than 32 weeks' gestational age and <1500 g and performed arterial spin-labeling MR imaging studies. Global and regional CBF in the cerebral cortex, thalami, pons, and cerebellum was quantified. Preterm infants were stratified into those with and without structural brain injury. We further categorized preterm infants by brain injury severity: moderate-severe and mild.

RESULTS:

We studied 78 preterm infants: 31 without brain injury and 47 with brain injury (29 with mild and 18 with moderate-severe injury). Global CBF showed a borderline significant increase with increasing gestational age at birth (P = .05) and trended lower in preterm infants with brain injury (P = .07). Similarly, regional CBF was significantly lower in the right thalamus and midpons (P < .05) and trended lower in the midtemporal, left thalamus, and anterior vermis regions (P < .1) in preterm infants with brain injury. Regional CBF in preterm infants with moderate-severe brain injury trended lower in the midpons, right cerebellar hemisphere, and dentate nuclei compared with mild brain injury (P < .1). In addition, a significant, lower regional CBF was associated with ventilation, sepsis, and cesarean delivery (P < .05).

CONCLUSIONS:

We report early disturbances in global and regional CBF in preterm infants following brain injury. Regional cerebral perfusion alterations were evident in the thalamus and pons, suggesting regional vulnerability of the developing cerebro-cerebellar circuitry.



Use of Diffusional Kurtosis Imaging and Dynamic Contrast-Enhanced MR Imaging to Predict Posttraumatic Epilepsy in Rabbits [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Finding a reliable biomarker to thoroughly assess the brain structure changes in posttraumatic epilepsy is of great importance. Our aim was to explore the value of diffusional kurtosis imaging combined with dynamic contrast-enhanced MR imaging in the evaluation of posttraumatic epilepsy.

MATERIALS AND METHODS:

A modified weight-drop device was used to induce traumatic brain injury. Rabbits were exposed to traumatic brain injury or sham injury. Diffusional kurtosis imaging and dynamic contrast-enhanced MR imaging were performed 1 day after injury. Posttraumatic epilepsy was investigated 3 months after injury. The traumatic brain injury group was further divided into 2 groups: the posttraumatic epilepsy and the non-posttraumatic epilepsy groups. Mean kurtosis and volume transfer coefficient values in the cortex, hippocampus, and thalamus were analyzed. After follow-up, the experimental animals were sacrificed for Nissl staining.

RESULTS:

The posttraumatic epilepsy group comprised 8 rabbits. In the ipsilateral cortex, the volume transfer coefficient in the traumatic brain injury group was higher than that in the sham group; the volume transfer coefficient in the posttraumatic epilepsy group was higher than that in the non-posttraumatic epilepsy group. In the ipsilateral hippocampus, the volume transfer coefficient in the posttraumatic epilepsy group was higher than that in the non-posttraumatic epilepsy and sham groups. No difference was observed between the non-posttraumatic epilepsy and sham groups. In the ipsilateral cortex, mean kurtosis in the traumatic brain injury group was lower than that in the sham group, and mean kurtosis in the posttraumatic epilepsy group was lower than that in the non-posttraumatic epilepsy group. In the ipsilateral thalamus and hippocampus, mean kurtosis in the traumatic brain injury group was lower than that in the sham group, and mean kurtosis in the posttraumatic epilepsy group was lower than that in the non-posttraumatic epilepsy group. In the contralateral thalamus, mean kurtosis in the traumatic brain injury group was lower than that in the sham group; however, no difference was observed between the posttraumatic epilepsy and non-posttraumatic epilepsy groups.

CONCLUSIONS:

Diffusional kurtosis imaging and dynamic contrast-enhanced MR imaging could be used to predict the occurrence of posttraumatic epilepsy in rabbits exposed to experimental traumatic brain injury.



MRI-Based Methods for Spinal Cord Atrophy Evaluation: A Comparison of Cervical Cord Cross-Sectional Area, Cervical Cord Volume, and Full Spinal Cord Volume in Patients with Aquaporin-4 Antibody Seropositive Neuromyelitis Optica Spectrum Disorders [SPINE]

BACKGROUND AND PURPOSE:

Measures for spinal cord atrophy have become increasingly important as imaging biomarkers in the assessment of neuroinflammatory diseases, especially in neuromyelitis optica spectrum disorders. The most commonly used method, mean upper cervical cord area, is relatively easy to measure and can be performed on brain MRIs that capture cervical myelon. Measures of spinal cord volume (eg, cervical cord volume or total cord volume) require longer scanning and more complex analysis but are potentially better suited as spinal cord atrophy measures. This study investigated spinal cord atrophy measures in a cohort of healthy subjects and patients with aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorders and evaluated the discriminatory performance of mean upper cervical cord cross-sectional area compared with cervical cord volume and total cord volume.

MATERIALS AND METHODS:

Mean upper cervical cord area, cervical cord volume, and total cord volume were measured using 3T MRIs from healthy subjects (n = 19) and patients with neuromyelitis optica spectrum disorders (n = 30). Group comparison and receiver operating characteristic analyses between healthy controls and patients with neuromyelitis optica spectrum disorders were performed.

RESULTS:

Mean upper cervical cord area, cervical cord volume, and total cord volume measures showed similar and highly significant group differences between healthy control subjects and patients with neuromyelitis optica spectrum disorders (P < .01 for all). All 3 measures showed similar receiver operating characteristic–area under the curve values (mean upper cervical cord area = 0.70, cervical cord volume = 0.75, total cord volume = 0.77) with no significant difference between them. No associations among mean upper cervical cord cross-sectional area, cervical cord volume, or total cord volume with disability measures were found.

CONCLUSIONS:

All 3 measures showed similar discriminatory power between healthy control and neuromyelitis optica spectrum disorders groups. Mean upper cervical cord area is easier to obtain compared with cervical cord volume and total cord volume and can be regarded as an efficient representative measure of spinal cord atrophy in the neuromyelitis optica spectrum disorders context.



Comparative Analysis of Diffusional Kurtosis Imaging, Diffusion Tensor Imaging, and Diffusion-Weighted Imaging in Grading and Assessing Cellular Proliferation of Meningiomas [ADULT BRAIN]

BACKGROUND AND PURPOSE:

An accurate evaluation of the World Health Organization grade and cellular proliferation is particularly important in meningiomas. Our aim was to prospectively evaluate and compare diffusional kurtosis imaging, DTI, and DWI metrics in determining the grade and cellular proliferation of meningiomas.

MATERIALS AND METHODS:

Ninety-six consecutive patients with histopathologically confirmed meningiomas were included in this study. Mean kurtosis, radial kurtosis, axial kurtosis, fractional anisotropy, mean diffusivity, and ADC were semiautomatically obtained in the solid components of tumors. Each normalized diffusion value was compared between high-grade meningiomas and low-grade meningiomas using the Mann-Whitney U test. Receiver operating characteristic, multiple logistic regression, and Pearson correlation analysis were used for statistical evaluations.

RESULTS:

Diffusional kurtosis imaging metrics (mean kurtosis, radial kurtosis, and axial kurtosis) were significantly higher in high-grade meningiomas than in low-grade meningiomas (P ≤ .001). Mean diffusivity and ADC were significantly lower in high-grade meningiomas than in low-grade meningiomas (P = .003 and .002). Mean kurtosis had significantly greater area the under curve values than mean diffusivity and fractional anisotropy in differentiating high-grade meningiomas from low-grade meningiomas (P = .038 and .002). Mean kurtosis was the only variable that could be used to independently differentiate high-grade meningiomas and low-grade meningiomas (P < .001). Significant correlations were found between the Ki-67 labeling index and kurtosis metrics (P < .001), as well as for mean diffusivity and ADC (P = .004, and .007).

CONCLUSIONS:

Compared with other diffusion metrics, mean kurtosis may serve as an optimal parameter for evaluating and predicting the meningioma grade. Moreover, diffusion metrics may potentially reflect cellular proliferation.



A Qualitative and Quantitative Correlation Study of Lumbar Intervertebral Disc Degeneration Using Glycosaminoglycan Chemical Exchange Saturation Transfer, Pfirrmann Grade, and T1-{rho} [SPINE]

BACKGROUND AND PURPOSE:

Glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging allows the direct measurement and mapping of glycosaminoglycans. In this study, we aimed to evaluate the usefulness of gagCEST imaging in the quantitative assessment of intervertebral disc degeneration in a comparison with Pfirrmann grade and T1- measurements.

MATERIALS AND METHODS:

Ninety-six lumbar intervertebral discs in 24 volunteers (36.0 ± 8.5 years of age, 21 men and 3 women) were examined with both gagCEST imaging and T1- measurements. The gagCEST imaging was performed at 3T with a saturation pulse with 1.0-second duration and the B1 amplitude of 0.8 μT followed by imaging by a 2D fast spin-echo sequence. The Z-spectra were obtained at 25 frequency offsets from –3 to +3 ppm (step, 0.25 ppm). A point-by-point B0 correction was performed with a B0 map. The gagCEST signal and T1- values were measured in the nucleus pulposus in each intervertebral disc. The Pfirrmann grades were assessed on T2-weighted images.

RESULTS:

The gagCEST signal at grade I (5.36% ± 2.79%) was significantly higher than those at Pfirrmann grade II (3.15% ± 1.40%, P = .0006), grade III (0.14% ± 1.03%, P < .0001), grade IV (–1.75% ± 2.82%, P < .0001), and grade V (–1.47% ± 0.36%, P < .0001). The gagCEST signal at grade II was significantly higher than those of grade III (P < .0001), grade IV (P < .0001), and grade V (P < .0001). The gagCEST signal was significantly correlated negatively with Pfirrmann grade (P < .0001) and positively correlated with T1- (P < .0001).

CONCLUSIONS:

GagCEST imaging could be a reliable and quantitative technique for assessing intervertebral disc degeneration.



Quantitative Assessment of Normal Fetal Brain Myelination Using Fast Macromolecular Proton Fraction Mapping [PEDIATRICS]

BACKGROUND AND PURPOSE:

Fast macromolecular proton fraction mapping is a recently emerged MRI method for quantitative myelin imaging. Our aim was to develop a clinically targeted technique for macromolecular proton fraction mapping of the fetal brain and test its capability to characterize normal prenatal myelination.

MATERIALS AND METHODS:

This prospective study included 41 pregnant women (gestational age range, 18–38 weeks) without abnormal findings on fetal brain MR imaging performed for clinical indications. A fast fetal brain macromolecular proton fraction mapping protocol was implemented on a clinical 1.5T MR imaging scanner without software modifications and was performed after a clinical examination with an additional scan time of <5 minutes. 3D macromolecular proton fraction maps were reconstructed from magnetization transfer-weighted, T1-weighted, and proton density–weighted images by the single-point method. Mean macromolecular proton fraction in the brain stem, cerebellum, and thalamus and frontal, temporal, and occipital WM was compared between structures and pregnancy trimesters using analysis of variance. Gestational age dependence of the macromolecular proton fraction was assessed using the Pearson correlation coefficient (r).

RESULTS:

The mean macromolecular proton fraction in the fetal brain structures varied between 2.3% and 4.3%, being 5-fold lower than macromolecular proton fraction in adult WM. The macromolecular proton fraction in the third trimester was higher compared with the second trimester in the brain stem, cerebellum, and thalamus. The highest macromolecular proton fraction was observed in the brain stem, followed by the thalamus, cerebellum, and cerebral WM. The macromolecular proton fraction in the brain stem, cerebellum, and thalamus strongly correlated with gestational age (r = 0.88, 0.80, and 0.73; P < .001). No significant correlations were found for cerebral WM regions.

CONCLUSIONS:

Myelin is the main factor determining macromolecular proton fraction in brain tissues. Macromolecular proton fraction mapping is sensitive to the earliest stages of the fetal brain myelination and can be implemented in a clinical setting.



Extent of Microstructural Tissue Damage Correlates with Hemodynamic Failure in High-Grade Carotid Occlusive Disease: An MRI Study Using Quantitative T2 and DSC Perfusion [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Chronic hemodynamic impairment in high-grade carotid occlusive disease is thought to cause microstructural abnormalities that might be subclinical or lead to subtle symptoms including cognitive impairment. Quantitative MR imaging allows assessing pathologic structural changes beyond macroscopically visible tissue damage. In this study, high-resolution quantitative T2 mapping combined with DSC-based PWI was used to investigate quantitative T2 changes as a potential marker of microstructural damage in relation to hemodynamic impairment in patients with unilateral high-grade carotid occlusive disease.

MATERIALS AND METHODS:

Eighteen patients with unilateral high-grade ICA or MCA stenosis/occlusion were included in the study. T2 values and deconvolved perfusion parameters, including relative CBF, relative CBV, and the relative CBF/relative CBV ratio as a potential indicator of local cerebral perfusion pressure, were determined within areas with delayed TTP and compared with values from contralateral unaffected areas after segmentation of normal-appearing hypoperfused WM and cortical regions. Hemispheric asymmetry indices were calculated for all parameters.

RESULTS:

Quantitative T2 was significantly prolonged (P < .01) in hypoperfused tissue and correlated significantly (P < .01) with TTP delay and relative CBF/relative CBV reduction in WM. Significant correlations (P < .001) between TTP delay and the relative CBF/relative CBV ratio were found both in WM and in cortical areas.

CONCLUSIONS:

Quantitative T2 can be used as a marker of microstructural tissue damage even in normal-appearing GM and WM within a vascular territory affected by high-grade carotid occlusive disease. Furthermore, the extent of damage correlates with the degree of hemodynamic failure measured by DSC perfusion parameters.



Assessment of reactive nitrogen mitigation potential of different nitrogen treatments under direct-seeded rice and wheat cropping system

Abstract

The reactive nitrogen (Nr) pollution is a serious environmental problem. A wise application of nitrogen fertilizer is important for mitigating Nr loss. Field experiments were undertaken during the direct-seeded rice and winter-wheat growing seasons from 2014 to 2015 in Nanjing, one of the typical rice-wheat rotation regions in China, to evaluate the potential of different nitrogen fertilizers for mitigating Nr (N2O, NH3 emissions, and NO3 leaching) losses. Seven different fertilizer treatments were included in this study: a no fertilizer treatment (NF), conventional fertilizer (CF), urea-ammonium mixed nitrogen fertilizer (UA), stabilized urea (UHD; urea + hydroquinone + dicyandiamide), sulfur-coated urea (SCU), urea formaldehyde (UF) and organic fertilizer (OF). In comparison with the CF, all the fertilizer treatments except for UA decreased NH3 volatilization by 14.5–36.0% (p < 0.05), while none of the N fertilizers had an obvious mitigation effect on N2O emissions and NO3 leaching during the rice and wheat seasons. Further analyses showed that the UHD, UF and OF treatments reduced the yield-scaled Nr loss (NLI) by 32.6–42.5% for the rice season and by 15.5–34.5% for the wheat season as compared to the CF; other treatments relative to CF had no obvious effect with regard to lowering the NLI. UHD, UF and OF could be adopted as an effective mitigation alternative to reduce Nr loss and maintain crop yield in future rice/wheat production.

Graphical abstract



Low-temperature co-purification of NO x and Hg 0 from simulated flue gas by Ce x Zr y Mn z O 2 /r-Al 2 O 3 : the performance and its mechanism

Abstract

In this study, series of Cex Zry Mnz O2/r-Al2O3 catalysts were prepared by impregnation method and explored to co-purification of NOx and Hg0 at low temperature. The physical and chemical properties of the catalysts were investigated by XRD, BET, FTIR, NH3-TPD, H2-TPR, and XPS. The experimental results showed that 10% Ce0.2Zr0.3Mn0.5O2/r-Al2O3 yielded higher conversion on co-purification of NOx and Hg0 than the other prepared catalysts at low temperature, especially at 200–300 °C. 91% and 97% convert rate of NOx and Hg0 were obtained, respectively, when 10% Ce0.2Zr0.3Mn0.5O2/r-Al2O3 catalyst was used at 250 °C. Moreover, the presence of H2O slightly decreased the removal of NOx and Hg0 owing to the competitive adsorption of H2O and Hg0. When SO2 was added, the removal of Hg0 first increased slightly and then presented a decrease due to the generation of SO3 and (NH4)2SO4. The results of NH3-TPD indicated that the strong acid of 10% Ce0.2Zr0.3Mn0.5O2/r-Al2O3 improved its high-temperature activity. XPS and H2-TPR results showed there were high-valence Mn and Ce species in 10% Ce0.2Zr0.3Mn0.5O2/r-Al2O3, which could effectively promote the removal of NOx and Hg0. Therefore, the mechanisms of Hg0 and NOx removal were proposed as Hg (ad) + [O] → HgO (ad), and 2NH3/NH4+ (ad) + NO2 (ad) + NO (g) → 2 N2 + 3H2O/2H+, respectively.

Graphical abstract



Analyzing the uncertainty of diffusive gel-based passive samplers as tools for evaluating the averaged contamination of surface water by organic pollutants

Abstract

Agarose gel-based passive samplers are nowadays one of the most effective sampling devices able to provide a quantitative evaluation of water contamination level for a broad range of organic contaminants. These devices show significant improvements in comparison to the previous passive samplers dedicated to hydrophilic compounds because they tend to reduce the effect of hydrodynamic flow conditions on the uptake rate of compounds and thus subsequently to improve their accuracy. However, albeit their effects minimized, hydrodynamic water flow and temperature are reported as variables likely to change the uptake rate of compounds that may lead to some inaccuracy if they are not adequately taken into account. This work aims to investigate the magnitude of effects of such uncorrected variables on the bias of the deduced water contamination level. The analysis of the error structure shows that the uncertainty on the diffusivity of contaminants in agarose gel and its dependency on temperature are the most inferring factors. At 8 °C, these factors are, respectively, responsible of 34 and 33% of the squared uncertainty on the final deduced contamination level. The overall uncertainty for a single exposed passive sampler is in the order of 39% and drops to 23% if threesamplers are co-exposed (at 8 °C). Despite this uncertainty, we present results for a set of pesticides and personal care products throughout a field monitoring conducted over a 4-month period, which show the potential of passive samplers to allow assessing the temporal trend of water contamination.



Accelerated carbonation of wood combustion ash for CO 2 removal from gaseous streams and storage in solid form

Abstract

In this work, ash generated by the combustion of wood in a central heating plant was used to remove and permanently store by accelerated carbonation CO2 contained in a gas mixture simulating biogas. The process was studied as an alternative treatment to the ones currently available on the market for biogas upgrading. The process was investigated at laboratory scale by setting up a facility for directly contacting the wood ash and the synthetic biogas in a fixed bed reactor. The process was able to completely remove CO2 during its initial phase. After about 30 h, CO2 started to appear again in the outlet stream and its concentration rapidly increased. The specific CO2 uptake achieved in solid carbonate form was of about 200 g/kg of dry wood ash. This value is an order of magnitude higher than the ones found for waste incineration bottom ash carrying out similar experiments. The difference was ascribed to the physicochemical properties of the ash, characterized by a fine particle size (d50 < 0.2 mm) and high content of reactive phases with CO2 (e.g., Ca hydroxides). The leaching behavior of the wood ash was examined before and after the accelerated carbonation process showing that the release of several elements was lower after the treatment; Ba leaching in particular decreased by over two orders of magnitude. However, the release of the critical elements for the management of this type of residues (especially Cr and sulfates) appeared not to be significantly affected, while V leaching increased.



Dynamic filtration and static adsorption of lead ions in aqueous solution by use of blended polysulfone membranes with nano size MCM-41 particles coated by polyaniline

Abstract

MCM-41 mesopore was prepared by hydrothermal method and used for synthesis of polyaniline/MCM-41 nanocomposite via in situ polymerization. The nanocomposite was blended with polysulfone to prepare mixed matrix membrane in different content of nanocomposite by phase inversion method. Structural and surface properties of the samples were characterized by SEM, XRD, FTIR, AFM, TGA, BET, and zeta potential measurements. Effect of the nanocomposite content on the hydrophilicity, porosity, and permeability of the membrane was determined. Membrane performance was evaluated for removal of lead ions in dynamic filtration and static adsorption. The membranes were found as effective adsorptive filters for removal of lead ions via interactions between active sites of nanocomposite in membrane structure and lead ions during filtration. Results of batch experiments proved adsorptive mechanism of membranes for removal of lead ions with the maximum adsorption capacity of 19.6 mg/g.



Clinical Characteristics of Asymmetric Bilateral Gynecomastia: Suggestion of Desirable Surgical Method Based on a Single-Institution Experience

Abstract

Background

Asymmetric bilateral gynecomastia (ABGM) is uncommon, and reports on its characteristics are rare. In the present study, we investigated the clinical characteristics and surgical treatment of ABGM.

Methods

We conducted a retrospective study of 1159 patients with gynecomastia who underwent subcutaneous mastectomy with liposuction at Damsoyu Hospital from January 2014 to February 2016. We then analyzed differences in the characteristics and operative results between two groups of patients: those with asymmetric and symmetric gynecomastia. Asymmetric gynecomastia was defined as gynecomastia meeting both of the following criteria: (1) upon physical examination, the size of the palpable mass below the nipple–areolar complex was twice as large as the smaller one, and (2) upon ultrasonography, the depth of the glandular tissue under the nipple-areolar complex was twice as large as the smaller one.

Results

Fifty-four patients were diagnosed with asymmetric gynecomastia. Among them, 51 had ABGM and three had unilateral gynecomastia. In the asymmetric group, more patients had a larger left than right breast (33 patients, 64.7%). The incidence of true-type (entirely glandular) breasts was significantly higher in the asymmetric group (84.3%) than in the symmetric group (p < 0.001). The asymmetry ratios in the asymmetric and symmetric groups were 1.87 ± 2.07 and 0.20 ± 0.16, respectively (p < 0.001).

Conclusion

Bilateral mastectomy provided an acceptable and symmetric cosmetic outcome in patients with ABGM.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.



Removal of Polyacrylamide Gel (Aquamid ® ) from the Lip as a Solution for Late-Onset Complications: Our 8-Year Experience

Abstract

Background

The polyacrylamide hydrogel Aquamid® has been used as a permanent filler to enhance facial soft tissue volume and correct wrinkles since 2001. Various long-term studies have proved the safety of the product. Nonetheless, if complications such as migration occur, they can be difficult to treat.

Methods

Eleven patients suffering from late-onset complications after taking Aquamid® injections in the lips underwent product removal and subsequent labial reconstruction between 2009 and 2017. The reconstruction was performed using a modified bikini reduction technique combined, in eight cases, with immediate autologous fat grafting.

Results

In all the patients, general fibrosis and a diffused distribution of the product within all three layers of the lips resulted in the need for labial reconstruction. Migration, as far as in the mucosa and perioral skin, accounted for macroscopically visible yellowish accumulations. In ten out of eleven cases, an individually modified bikini reduction technique, with or without any combination of autologous fat grafting, led to an esthetically satisfying result. One patient developed a severe upper lip necrosis.

Conclusion

Contradictory to several previous studies attesting to the lack of migration after Aquamid® application to the lips, capsule formation around the product is impaired, allowing for migration even years after the injection. Product aspiration is not possible in these cases, thus necessitating complex lip reconstruction. Bikini reduction and fat grafting are valuable tools for labial reconstruction. Product residuals within the mucosa have to be accepted. Special care has to be taken while treating smokers.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.



Reply to Commentaries on: Management of Tuberous Breast Deformities—Review of Long-Term Outcomes and Patient Satisfaction with Breast-Q



Education on the Business of Plastic Surgery During Training: A Survey of Plastic Surgery Residents

Abstract

Background

Entrepreneurial skills are important for physicians, especially plastic surgeons. Nevertheless, these skills are not typically emphasized during residency training.

Objective

Evaluate the extent of business training at plastic surgery residency programs as well as means of enhancing business training.

Methods

A 6-question online survey was sent to plastic surgery program directors for distribution to plastic surgery residents. Responses from residents at the PGY2 level and above were included for analysis. Tables were prepared to present survey results.

Results

Hundred and sixty-six residents including 147 PGY2 and above residents responded to our survey. Only 43.5% reported inclusion of business training in their plastic surgery residency. A majority of residents reported they do not expect on graduation to be prepared for the business aspects of plastic surgery. Additionally, a majority of residents feel establishment of a formal lecture series on the business of plastic surgery would be beneficial.

Conclusions

Results from our survey indicate limited training at plastic surgery programs in necessary business skills. Plastic surgery residency programs should consider incorporating or enhancing elements of business training in their curriculum.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.



The Cartilage Warp Prevention Suture

Abstract

Background

Costal cartilage graft warping can challenge rhinoplasty surgeons and compromise outcomes. We propose a technique, the "warp control suture," for eliminating cartilage warp and examine outcomes in a pilot group.

Methods

The warp control suture is performed in the following manner: Harvested cartilage is cut to the desired shape and immersed in saline to induce warping. A 4-0 or 5-0 PDS suture, depending the thickness of the cartilage, is passed from convex to concave then concave to convex side several times about 5–6 mm apart, finally tying the suture on the convex side with sufficient tension to straighten the cartilage. First an ex vivo experiment was performed in 10 specimens from 10 different patients. Excess cartilage was sutured and returned to saline for a minimum of 15 min and then assessed for warping compared to cartilage cut in the identical shape also soaked in saline. Then, charts of nine subsequent patients who received the warp control suture on 16 cartilage grafts by the senior author (BG) were retrospectively reviewed. Inclusion of study subjects required at least 6 months of follow-up with standard rhinoplasty photographs. Postoperative complications and evidence of warping were recorded.

Results

In the ex vivo experiment, none of the 10 segments demonstrated warping after replacement in saline, whereas all the matching segments demonstrated significant additional warping. Clinically, no postoperative warping was observed in any of the nine patients at least 6 months postoperatively. One case of minor infection was observed in an area away from the graft and treated with antibiotics. No warping or other complications were noted.

Conclusion

The warp control suture technique presented here effectively straightens warped cartilage graft and prevents additional warping.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.



Comments on “Opinions on the Treatment Strategy after Breast Augmentation by Polyacrylamide Hydrogel Injection”



Spontaneous Regression and Resolution of Breast Implant-Associated Anaplastic Large Cell Lymphoma: Implications for Research, Diagnosis and Clinical Management

Abstract

Background

First described in 1997, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) was recognised by the World Health Organisation in 2016 as a specific disease. It typically presents as a late seroma-containing atypical, monoclonal T cells which are CD30+ and anaplastic lymphoma kinase negative. Until recently, it was thought that the disease was very rare. However, it is being diagnosed increasingly frequently with 56 cases confirmed in Australia by September 2017 and the estimated incidence revised from 1 in 300,000 to between 1 in 1000 and 1 in 10,000 patients with bilateral implants. There is debate about the spectrum of BIA-ALCL. According to the current WHO classification, BIA-ALCL is a cancer in all cases. Treatment guidelines require that it is treated urgently with a minimum of bilateral removal of implants and capsulectomies. Whilst acknowledging the disease has been under diagnosed in the past, with some notable exceptions the BIA-ALCL literature has given scant attention to the epidemiological evidence. Now that it is known that the disease may occur in up to 1 in 1000 patients with a median of 7.5 years from implantation to diagnosis, understanding it in its epidemiological context is imperative. The epidemiology of cancer and lymphoma in women with breast implants strongly suggests that most patients do not have a cancer that will inevitably progress without treatment but instead a self-limiting lympho-proliferative disorder. Although the possibility of spontaneous regression has been raised and the observation made that treatment delay did not seem to increase the risk of spread, the main objection to the lympho-proliferative hypothesis has been the lack of documented cases of spontaneous regression or resolution. Because all cases currently are considered malignant and treated urgently, only case report evidence, interpreted in the proper epidemiological context, is likely to be available to challenge this thinking.

Methods and Results

New observations and interpretation of the epidemiology of BIA-ALCL are made. These are supported by the presentation of two cases, which to the best of our knowledge comprise the first documented evidence of spontaneous regression and spontaneous resolution of confirmed BIA-ALCL.

Conclusions

The epidemiology of the disease strongly suggests that the vast majority of cases are not a cancer that will inevitably progress without treatment. The findings presented in the manuscript provide supportive clinical evidence. Consequently, an alternative view of BIA-ALCL with implications for research, diagnosis and clinical management needs to be considered.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.



The cytotoxic effects of propolis on breast cancer cells involve PI3K/Akt and ERK1/2 pathways, mitochondrial membrane potential, and reactive oxygen species generation

Abstract

Propolis has been extensively used to improve health and prevent inflammatory diseases. Different types of Cuban propolis (red, brown and yellow) have been documented. The purpose of this research was to investigate the cytotoxic effects of Cuban red propolis (CP) on MDA MB-231 cell line, since breast cancer is considered one of the most common causes of mortality among women. Antiproliferative and cytotoxic activity of CP against MDA MB-231 cells were determined by the 3-[4,5-dimethylth-iazol-2-yl]-2,5-diphenyl tetrazoliumbromide (MTT) and lactate dehydrogenase (LDH) assays. Apoptosis/necrosis, involvement of PI3K/Akt and ERK1/2 pathways, mitochondrial membrane potential and expression of genes were investigated. CP extract exhibited antiproliferative and cytotoxic effects on MDA MB-231 cells, what may be probably related to PI3K/Akt and ERK1/2 pathways. A decreased expression of apoptosis-related genes (TP53, CASP3, BAX and P21) was seen, whereas the expressions of BCL-2, BCL-XL, NOXA and PUMA were unaffected. CP extract induced mitochondrial dysfunction and LDH release, what indicated cell necrosis associated with reactive oxygen species production and decreased cell migration. Our findings provide a basis for future investigation of chemopreventive and/or therapeutic studies against apoptosis-resistant breast cancer, in animals and humans.



The M–Y Axilloplasty After Massive Weight Loss: Analysis of 159 Consecutive Patients

Abstract

Background

Brachioplasties often culminate in unsightly scars that are a source of disappointment to patients. We aimed to evaluate the results of M–Y axilloplasty following massive weight loss.

Patients

We performed a retrospective assessment of our technique for brachioplasty with an M–Y axilloplasty in 159 female patients after massive weight loss. This retrospective study covered a study period of 10 years.

Method

After substantial lipoaspiration, the incision is placed on the internal side of the arm, with an M-shaped axilloplasty.

Results

The satisfaction rate was 154/159 (97%) and 120/159 (75.5%) being happy with their esthetic results. Nineteen percent (30/159) of the patients had complications and 12/159 (7.5%) underwent a surgical revision.

Conclusion

M–Y axilloplasty for brachioplasty is an effective procedure for treating women who are unhappy with their upper arms after massive weight loss. The satisfaction rate is high, and the result leaves no excess skin on the chest.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.



A weak-light-responsive TiO 2 /g-C 3 N 4 composite film: photocatalytic activity under low-intensity light irradiation

Abstract

A TiO2/g-C3N4 composite photocatalytic film was prepared by in situ synthesis method and its photocatalytic capability under weak-visible-light condition was studied. The co-precursor with different ratio of melamine and TiO2 sol-gel precursor were treated using ultrasonic mixing, physical deposition, and co-sintering method to form the smooth, white-yellow, and compact TiO2/g-C3N4 composite films. The prepared TiO2/g-C3N4 materials were characterized by SEM, TEM, EDS, XRD, BET, VBXPS, and UV-vis diffuse reflectance spectra. The results of composite showed that TiO2 and g-C3N4 have close interfacial connections which are favorable to charge transfer between these two semiconductors with suitable band structure, g-C3N4 retard the anatase-to-rutile phase transition of TiO2 significantly, the specific surface area were increased with g-C3N4 ratio raised. Under weak-light irradiation, composite films photocatalytic experiments exhibited RhB removal efficiency approaching 90% after three recycles. Powders suspension degradation experiments revealed the removal efficiency of TiO2/g-C3N4 (90.8%) was higher than pure TiO2 (52.1%) and slightly lower than pure g-C3N4 (96.6%). By control experiment, the enhanced photocatalysis is ascribed to the combination of TiO2 and g-C3N4, which not only produced thin films with greater stability but also formed heterojunctions that can be favorable to charge transfer between these two semiconductors with suitable band structure. This study presents the potential application of photocatalytic film in the wastewater treatment under weak-light situation.



Electric bicycle cost calculation models and analysis based on the social perspective in China

Abstract

Electric bicycles (EBs) are increasingly popular around the world. In April 2014, EB ownership in China reached 181 million. While some aspects of the impact of EBs have been studied, most of the literature analyzing the cost of EBs has been conducted from the buyer's point of view and the perspective of social cost has not been covered, which is therefore the focus of this paper. From the consumer's point of view, only the costs paid from purchase until retirement are included in the cost of EBs, i.e., the EB acquisition cost, battery replacement cost, charging cost, and repair and maintenance cost are included. Considered from the perspective of the social cost (including impact on the environment), costs that are not paid directly by consumers should also be included in the cost of EBs, i.e., the lead-acid battery scrap processing cost, the cost of pollution caused by wastewater, and the traffic-related costs. Data are obtained from secondary sources and surveys, and calculations demonstrate that in the life cycle of an EB, the consumer cost is 6386.2 CNY, the social cost is 10,771.2 CNY, and the ratio of consumer to social cost is 1:1.69. By comparison, the ratio for motor vehicles is 1:1.06, so that the share of the life cycle cost of EBs that is not borne by the consumer is much higher than that for motor vehicles, which needs to be addressed.



Correction to: Soluble delta-like 1 homolog (DLK1) stimulates angiogenesis through Notch1/Akt/eNOS signaling in endothelial cells

In the original publication of the article, there is an error in one of the citations in the Discussion section.



Omitted Medical Illustrator Credit

In the Original Investigation titled "The Multivector Gracilis Free Functional Muscle Flap for Facial Reanimation," published online March 22, 2018, there was an ommision of credit for the medical illustrator for Figure 2A. The following statement should have been included in the Figure caption: "Image copyright www.dnaillustrations.com." This article was corrected online.

Treatment of Frontal Secondary Headache Attributed to Nerve Entrapment

This cohort study compares treatment outcomes of oral medication, botulinum toxin type A injections, and endoscopic decompression surgery in patients with frontal secondary headache attributed to supratrochlear nerve and supraorbital nerve entrapment.

Diagnostic and Therapeutic Management of Nasal Airway Obstruction

This review summarizes advances in diagnosis and treatment of patients with nasal airway obstruction as reported in studies published within the past 5 years.

Heavy metal and δ 13 C value variations and characterization of dissolved organic matter (DOM) during vermicomposting of pig manure amended with 13 C-labeled rice straw

Abstract

In this work, a mixture of pig manure and 13C-labeled rice straw was vermicomposted with Eisenia fetida for 40 days. The results showed that after they acclimated to the vermicomposting environment, the earthworms helped to degrade the substrate residues. After 40 days, the vermicomposting led to much higher pH, EC, C/N, available K, available P, available Zn, and CEC values but much lower available N and available Cu values in the substrate residues compared to the initial values. The earthworms accumulated 13C, Cu, and Zn with a heavy metal enrichment capacity in the order of Cu > Zn. Furthermore, the correlation analysis showed that the Cu and Zn content in the DOM was mainly controlled by the Cu and Zn content in the pig manure. The earthworms accumulated Cu and Zn by feeding on the substrate residues, but the DOM from the 13C-labeled rice straw helped to extract Zn from the substrate residues and promoted the migration of Zn into the earthworm tissues and/or DOM. Moreover, the characterization of the DOM extracted from the substrate residues revealed a decrease in the content of the aliphatic alcohols or polysaccharide-like substances and an increase in the aromatic compounds and fulvic or humic acid-like substances in the DOM as the vermicomposting time increased. This indicated that the higher humification degree in the DOM caused by vermicomposting contributed to the increased mobility of Zn in the substrate residues and helped Zn migrate into the earthworms or DOM.



The linkage of CO 2 emissions for China, EU, and USA: evidence from the regional and sectoral analyses

Abstract

As economic integration in the world continues to advance, energy consumption and carbon emissions in various regions have also become increasingly interdependent. In order to better understand the regional interaction of carbon emissions, this paper employs a three-region input-output approach to explore the linkage of CO2 emissions among China, EU, and USA. Based on the world input-output table and environment account of World Input-Output Database (WIOD) in 2009, we calculate the carbon emission multiplier effect, spillover effect, and feedback effect and carry out the analysis from the regional and sectoral levels. The results show that, first of all, the carbon emission multiplier effect of each region is larger than the spillover and feedback effects. Second, EU and USA have higher carbon emission spillover effect on China than China's carbon emission spillover effect on them. Finally, the carbon multiplier effects in different sectors have different characteristics.



Synthesis and characterisation of stable and efficient nano zero valent iron

Abstract

Nano zero valent iron (nZVI) is an excellent adsorbent/reductant with wide applicability in remediation of persistent contaminants in soil, water and groundwater aquifers. There are concerns about its environmental fate, agglomeration, toxicity and stability in the air. Several modification methods have applied chistosan, green tea, carboxyl methyl cellulose and other coating substances to ensure production of nZVI with excellent air stability and effectiveness. The synthesis of a novel green nZVI (gNZVI) with Harpephyllum caffrum leaf extracts was successfully executed in the current study. Production of gNZVI involved the simultaneous addition of an optimum amount of the NaBH4 and H. caffrum extract to FeCl3 in an inert environment (Nitrogen). The solution was stirred for 30 min, washed with dilute ethanol (50%) and freeze dried. This procedure offered the best option for the synthesis of gNZVI in terms of nontoxic and inexpensive choice of stabiliser/reductant. Systematic characterisations using TGA, TEM, SEM, XRD, FT-IR and XPS confirmed the synthesis of crystalline, stable, reactive, well-dispersed and predominantly 50 nm diameter sized gNZVI compared to the conventionally synthesised nZVI which is 65 nm. The activity testing using Orange II sodium salt (OR2) confirmed the effectiveness of the synthesised gNZVI as an excellent Fenton catalyst with 65% degradation of 20 ppm OR2 dye in 1 h reaction time.



Binding of Cu, Co, and Cs to fluorescent components of natural organic matter (NOM) from three contrasting sites

Abstract

Aqueous natural organic matter (NOM) contains different types of functional groups (carboxylic, phenolic, sulfidic, etc.), and hence could change the speciation of metals in environmental systems. This work is a proof-of-concept study on the interaction of three metals (Cu, Co, and Cs) with NOM using fluorescence spectroscopy. The specific aim was to determine the conditional stability constants for these three metals with NOM optical components, obtained from the quenching of fluorescence signals. Three contrasting water types were sampled in Northern Ontario: a pristine source (Cross Rd.), an urban-impacted source (Junction Creek), and an industrially impacted creek (Copper Cliff creek). In this investigation, Cu2+ was used as a benchmark, whereas Co2+ and Cs+ analyses were novel applications of this technique. Humic-like (H-like; terrestrial and microbial), fulvic-like (F-like), and protein-like (P-like) fluorescence components were found in various proportions at the three sampling sites. For these samples, the fluorescence signals of the H-, F-, and P-like components were quenched upon additions of Cu2+. The computed conditional stability constants (as log Kc) ranged from 4.46 to 6.06. In contrast, Kc values with Co2+ were measurable only for the two H-like components of the pristine sample (log Kc 3.02–4.05). Cesium (Cs+) induced quenching only for the P-like component at the industrial-impacted site (log Kc 4.82–5.03). While this study corroborates earlier reports that Cu2+-NOM interactions can be measured by fluorescence, we are showing for the first time a direct chemical interaction of Co2+ and Cs+ with specific NOM components, as reported by fluorescence quenching.



Hexavalent chromium removal from aqueous solution using functionalized chitosan as a novel nano-adsorbent: modeling and optimization, kinetic, isotherm, and thermodynamic studies, and toxicity testing

Abstract

Hexavalent chromium is a highly toxic metal that can enter drinking water sources. Chitosan, which contains amino and hydroxyl functional groups, is considered an appropriate candidate to remove heavy metals through absorption. In this study, a novel adsorbent, magnetic nanoparticles of chitosan modified with polyhexamethylene biguanide (Ch-PHMB NPs) was synthesized and was used to successfully remove chromium from aqueous solution. Quadratic models with independent variables including pH, adsorbent dosage, time, and the initial concentration of chromium were proposed through RSM to describe the behavior of both magnetic chitosan (M-Ch) and Ch-PHMB NPs in Cr(VI) removal. Optimized models with adjusted R2 values of 0.8326 and 0.74 for M-Ch and Ch-PHMB NPs were developed. Cr(VI) removal from aqueous solution by both absorbents followed pseudo-second-order kinetics. The experimental data were best fitted to the Temkin and Freundlich models for M-Ch and Ch-PHMB NPs, respectively. M-Ch and Ch-PHMB NPs can effectively remove the hexavalent chromium from aqueous solution with pH above 7. Ch-PHMB NPs have higher removal efficiency than M-Ch, removing up to 70% of Cr(VI) from aqueous solution. However, toxicity evaluation on Daphnia magna revealed that Ch-PHMB NPs was more toxic than M-Ch nanoparticles.



Yang DD, Krasnova A, Nead KT et al. Androgen deprivation therapy and risk of rheumatoid arthritis in patients with localized prostate cancer



Latest clinical evidence and further development of PARP inhibitors in ovarian cancer

Abstract
Background
For several decades, the systemic treatment of ovarian cancer has involved chemotherapy, with the relatively recent addition of anti-angiogenic strategies given with chemotherapy and in the maintenance setting. In the past decade, numerous poly(ADP-ribose) polymerase (PARP)-inhibiting agents have been assessed.
Design
We review key trials that have led to the approval of three PARP inhibitors – olaparib, niraparib and rucaparib – as maintenance therapy for platinum-sensitive recurrent ovarian cancer. We discuss the efficacy and safety of these agents in the populations studied in clinical trials. We then provide an overview of the numerous avenues of ongoing research for PARP inhibitors in different treatment settings: as treatment rather than maintenance strategies and in combination with other anti-cancer approaches, including anti-angiogenic and immunotherapeutic agents.
Results
Three phase III trials (NOVA, SOLO2 and ARIEL3) demonstrated remarkable improvement in progression-free survival (PFS) with PARP inhibitors given as maintenance therapy in patients with complete or partial response after platinum-based therapy for platinum-sensitive ovarian cancer. Differences in trial design and patient populations influence the conclusions that can be drawn from these trials. Overall survival data are pending and there is a limited experience regarding long-term safety.
Conclusions
PARP inhibitors have transformed the management of ovarian cancer and have changed the course of disease for many patients. Although recent approvals are irrespective of BRCA mutation or homologous repair deficiency status, genetic profiles, as well as dosing schedules, tolerability and affordability, may influence patient selection and the setting in which PARP inhibitors are used. The development and evolution of PARP inhibitors continue, with new agents, strategies, combinations and indications under intensive evaluation.

Insufficiency Fractures After Radiation Therapy: An Update

Abstract

Purpose of Review

Radio therapy, alone or in combination with surgery and/or chemotherapy, is commonly used to treat a variety of neoplasms, resulting in effective local tumor control. Unfortunately radiation therapy can also change the structure of the skeletal system, leading to edema, vascular congestion, areas of hemorrhage, loss of cellularity, focal bone marrow changes, fatty transformation, osteitis, hematopoietic marrow regeneration, osteolysis of symphysis pubis or sacroiliac joints, avascular necrosis, insufficiency fractures, osteoradionecrosis, and radiation-induced neoplasms.

Recent Findings

The various radiotherapy effects can be studied and diagnosed by analyzing MR signal intensity, CT attenuation, and FDG-PET activity.

Summary

In this review, we report a complete analysis of side effects of radiotherapy on bones, focusing on the spine, chest wall, and pelvis.



Hip Fractures: A Practical Approach to Diagnosis and Treatment

Abstract

Purpose of Review

To summarize relevant anatomy, imaging, and treatment of hip fractures, and to synthesize a treatment-based approach for description and classification of hip fractures.

Recent Findings

Hip fractures are predominantly seen in the elderly, where they are increasing in incidence, and can substantially reduce healthy life-years. The osseous and vascular anatomy of the proximal femur can help to understand the clinical implications of various types of hip fracture. Radiographs are the principal imaging modality for assessment of hip fracture, although there is a clear role for CT and MRI for assessment of radiographically occult fractures. There are multiple classifications of hip fractures in the orthopedic literature; however, these are not commonly used in clinical practice due to complexity, poor reported inter-observer agreement, and relatively few methods of surgical fixation.

Summary

A simplified anatomic and treatment-based approach to hip fractures can help guide image interpretation and clinical management.



Emerging Trends in Emergent Stroke Neuroimaging

Abstract

Purpose of Review

Various imaging techniques used in stroke evaluation have complementary, evolving roles. This article reviews recent updates in emergent stroke neuroimaging.

Recent Findings

Multiple recent randomized trials showing benefit of endovascular therapy in strokes with confirmed large-vessel occlusion emphasize need for vessel imaging, typically CTA, in addition to unenhanced head CT. In addition, because recent trials published in 2018 showed efficacy of mechanical thrombectomy at up to 24 h from symptom onset in stroke patients with favorable ischemic core and/or penumbra assessments, imaging techniques to define viable and infarcted tissue, such as DWI or CT/MR perfusion imaging, have an increasing role in emergent stroke assessment. Other studies contributing to new AHA/ASA stroke guidelines are also discussed.

Summary

Neuroimaging remains crucial to emergent stroke evaluation, with CTA, MRI, and perfusion studies playing an increasing role in identifying patients likely to benefit from treatment.



Blunt Chest Trauma: A Radiologic Approach and Review

Abstract

Blunt chest trauma, a frequent component of trauma admissions, is the second leading cause of death in motor-vehicle accidents. Additionally, it may be associated with significant morbidity in those who survive. Radiography, ultrasonography, and computed tomography (CT) have a widespread role in evaluating blunt chest trauma, importantly aiding in the diagnosis and management of injury. Herein, we discuss the most common salient injuries, imaging protocol considerations and imaging findings associated with acute blunt chest trauma.



Imaging of Acute Traumatic Aortic Injury

Abstract

Purpose of Review

This article aims to review the key aspects of the imaging evaluation of acute traumatic aortic injury (ATAI) with an emphasis on factors that affect management of these patients.

Recent Findings

In the setting of trauma, the chest radiograph typically serves as the initial imaging evaluation and can be useful in detecting signs of mediastinal hematoma. In the current era, definitive diagnosis of ATAI is made with computed tomography (CT), where indirect and direct findings of ATAI can enable a confident diagnosis. Knowledge of potential technical and anatomic CT imaging pitfalls can prevent misdiagnosis of ATAI.

Summary

Diagnosis of ATAI in the setting of blunt or penetrating trauma relies heavily on timely and accurate imaging interpretation. Once the diagnosis is made, a meaningful report including appropriate descriptors of the characteristics and location of ATAI should be generated by the radiologist to help direct management.



Tip of the Iceberg Findings: Subtle Radiographic Abnormalities Indicating Significant Pathology in the Knee

Abstract

Purpose of Review

Knee injuries are common and radiographs remain the first line of study in the majority of cases. In many instances, subtle or small radiographic findings actually represent significant underlying pathology that requires expeditious diagnosis and treatment.

Recent Findings

By using a mechanistic search strategy, one that applies a comprehensive search for avulsions at ligamentous/tendinous/connective tissue attachments and potential sites of impaction, one may maximize the diagnostic accuracy of radiographic interpretation.

Summary

This article will provide a review of important indicators of ligament, tendon, and osseous injuries with an emphasis on their mechanism of injury.



An orthotopic glioblastoma animal model suitable for high-throughput screenings

Abstract
Background
Glioblastoma (GBM) is an aggressive form of brain cancer with poor prognosis. Although murine animal models have given valuable insights into the GBM disease biology, they cannot be used in high-throughput screens to identify and profile novel therapies. The only vertebrate model suitable for large-scale screens, the zebrafish, has proven to faithfully recapitulate biology and pathology of human malignancies and clinically relevant orthotopic zebrafish models have been developed. However, currently available GBM orthotopic zebrafish models do not support high-throughput drug discovery screens.
Methods
We transplanted both GBM cell lines as well as patient-derived material into zebrafish blastulas. We followed the behavior of the transplants with time-lapse microscopy and real-time in vivo light-sheet microscopy.
Results
We found that GBM material transplanted into zebrafish blastomeres robustly migrated into the developing nervous system, establishing an orthotopic intracranial tumor already 24 hours after transplantation. Detailed analysis revealed that our model faithfully recapitulates the human disease.
Conclusion
We have developed a robust, fast and automatable transplantation assay to establish orthotopic GBM tumors in zebrafish. In contrast to currently available orthotopic zebrafish models, our approach does not require technically challenging intracranial transplantation of single embryos. Our improved zebrafish model enables transplantion of thousands of embryos per hour, thus providing an orthotopic vertebrate GBM model for direct application in drug discovery screens.

Nanocomposite Au NP/TiO 2 thin film in the efficient remediation of aqueous solutions contaminated with emerging micro-pollutants

Abstract

The present communication specifically aims to synthesize novel nanocomposite material Au NPs/TiO2 in a simple template process using the polyethylene glycol as filler media. The thin film of the nanocomposite material was characterized by the advanced analytical tools. The surface morphology was obtained by the scanning electron microscopic (SEM) and transmission electron microscopic (TEM) images of solids. Similarly, the surface topography and roughness of solid were obtained by the atomic force microscopic (AFM) image of thin film. X-ray diffraction (XRD) data enabled to confirm that the TiO2 was predominantly present with its anatase phase. The specific surface area and pore size of the solid were obtained using the N2 adsorption/desorption data. Nanocomposite Au NP/TiO2 thin film was employed in the photocatalytic removal of sulfamethoxazole and triclosan from aqueous solutions using less harmful UV-A light (λmax = 330 nm). Various physicochemical parametric studies enabled to deduce the mechanism involved in the degradation process. The degradation kinetics as a function of pH (pH 4.0–10.0) and micro-pollutant concentrations (0.5–15.0 mg/L) was extensively studied. The mineralization of these pollutants was obtained using the non-purgeable organic carbon (NPOC) data. The stability of thin film was assessed by the repeated operations, and presence of several co-existing ions simulates the studies to real matrix treatment. Further, the presence of scavengers enabled to pin point the radical-induced degradation of sulfamethoxazole and triclosan from aqueous solutions.



Efficacy of a shower cream and a lotion with skin‐identical lipids in healthy subjects with atopic dry skin

Journal of Cosmetic Dermatology, EarlyView.


Implications of the Propensity Score Matching Paradox in Pharmacoepidemiology

Abstract
Recent work demonstrated that propensity score matching may lead to increased covariate imbalance, even with the corresponding decrease in propensity score distance between matched units. The extent to which this paradoxical phenomenon might harm causal inference in real epidemiologic studies has not been explored. We evaluated the effect of this phenomenon using insurance claims data from the Pharmaceutical Assistance Contract for the Elderly (1999–2002) and Medicaid Analytic eXtract (2000–2007) databases. For each dataset, we created several 1:1 propensity score-matched datasets by manipulating the size of the covariate set used to generate propensity scores, the index exposure prevalence in the pre-matched dataset and the matching algorithm. We matched all index units, then progressively pruned matched sets in order of decreasing propensity score distance, calculating covariate imbalance after each pruning. Although covariate imbalance sometimes increased after progressive pruning of matched sets, the application of commonly-used propensity score calipers for defining an acceptable match stopped pruning near the lowest region of the imbalance trend and resulted in an improvement over the imbalance in the pre-matched dataset. Thus, propensity score matching does not appear to induce increased covariate imbalance when standard propensity score calipers are applied in these types of pharmacoepidemiologic studies.

Capacity and mechanism of arsenic adsorption on red soil supplemented with ferromanganese oxide–biochar composites

Abstract

Two ferromanganese oxide–biochar composites (FMBC1 and FMBC2) were prepared by an impregnation method to promote the adsorption of As on red soil. Maximum adsorption capacities (Qm ) of 0.687 and 0.712 mg g−1 were observed for FMBC1 and FMBC2, respectively, corresponding to increases of 104 and 111% relative to the control treatment (Qm  = 0.337 mg g−1). Treatment with FMBC1 increased the pH of red soil, whereas a reverse trend was observed for FMBC2. A variety of analytical techniques were used to explain the differences between FMBC1 and FMBC2, revealing that the oxidation of As(III) to As(V) by Mn and Fe oxides was aided by interactions with the oxygen-containing functional groups of the ferromanganese oxide–biochar composites. Thus, red soil supplemented with the ferromanganese oxide–biochar composites mainly adsorbed As by chemisorption, thereby projecting ferromanganese oxide–biochar composites as potential absorbents for effectively remediating As-polluted red soil.



Descriptions and non-doxastic attitude ascriptions

Abstract

This paper addresses a certain objection to the quantificational theory of definite descriptions. According to this objection, the quantificational account cannot provide correct interpretations of definite descriptions embedded in the non-doxastic attitude ascriptions and therefore ought to be rejected. In brief, the objection says that the quantificational theory is committed to the view that a sentence of the form "The F is G" is equivalent to the claim that there is a unique F and it is G, while the ascription such as, e.g., "S wants the F to be G" is not equivalent to the statement that S wants there to be a (unique) F and for it to be G. I argue that this objection is invalid as it rests on a false assumption concerning the substitutivity of the relative clauses in the non-doxastic attitude ascriptions.



Erratum to: New data on the representation of women in philosophy journals: 2004–2015



The objects of moral responsibility

Abstract

It typically taken for granted that agents can be morally responsible for such things as, for example, the death of the victim and the capture of the murderer in the sense that one may be blameworthy or praiseworthy for such things. The primary task of a theory of moral responsibility, it is thought, is to specify the appropriate relationship one must stand to such things in order to be morally responsible for them. I argue that this common approach is problematic because it attempts to explain the way in which an agent can be morally responsible for something that is external to her, the agent. Since, I argue, everything that matters for moral responsibility is internal to the agent, the accounts that emerge from this approach are committed to a particular form of moral luck. Instead, we should reject this form of moral luck, and with it, the possibility of moral responsibility for objects external to the agent. We are, I argue, morally responsible only for our inner willings. Thus, a form of internalism about moral responsibility is defended.