Background: Postmastectomy breast reconstruction (PMBR) is an elective, preference-sensitive decision made during a stressful, time-pressured period after a cancer diagnosis. Shared decision making (SDM) can improve decision quality about preference-sensitive choices. Stakeholders' perspectives on ways to support PMBR decision-making were explored. Methods: Forty semi-structured interviews with stakeholders (20 postmastectomy patients, 10 PMBR surgeons, 10 PMBR nurses) were conducted. Clinicians were recruited from diverse practices across the United States. Patients were recruited using purposive sampling with varying PMBR experiences, including no reconstruction. The interview guide was based on an implementation research framework. Themes were identified using grounded theory approach, based on frequency and emotive force conveyed. Results: Engagement in SDM was variable. Some patients wanted more information about PMBR from clinicians, particularly about risks. Some clinicians acknowledged highlighting benefits and downplaying risks. Many patients felt pressured to make a choice by their clinicians. Clinicians who successfully engaged patients through decisions often used outside resources to supplement conversations. Conclusions: Patient–clinician trust was critical to high-quality decisions, and many patients expressed decision regret when they were not engaged in PMBR discussions. Patients often perceived a race- or age-related bias in clinician information sharing. Interventions to support SDM may enhance decision quality and reduce decision regret about PMBR, ultimately improving patient-centered care for women with breast cancer.Κυριακή 31 Δεκεμβρίου 2017
Stakeholders’ Perspectives on Postmastectomy Breast Reconstruction: Recognizing Ways to Improve Shared Decision Making
Background: Postmastectomy breast reconstruction (PMBR) is an elective, preference-sensitive decision made during a stressful, time-pressured period after a cancer diagnosis. Shared decision making (SDM) can improve decision quality about preference-sensitive choices. Stakeholders' perspectives on ways to support PMBR decision-making were explored. Methods: Forty semi-structured interviews with stakeholders (20 postmastectomy patients, 10 PMBR surgeons, 10 PMBR nurses) were conducted. Clinicians were recruited from diverse practices across the United States. Patients were recruited using purposive sampling with varying PMBR experiences, including no reconstruction. The interview guide was based on an implementation research framework. Themes were identified using grounded theory approach, based on frequency and emotive force conveyed. Results: Engagement in SDM was variable. Some patients wanted more information about PMBR from clinicians, particularly about risks. Some clinicians acknowledged highlighting benefits and downplaying risks. Many patients felt pressured to make a choice by their clinicians. Clinicians who successfully engaged patients through decisions often used outside resources to supplement conversations. Conclusions: Patient–clinician trust was critical to high-quality decisions, and many patients expressed decision regret when they were not engaged in PMBR discussions. Patients often perceived a race- or age-related bias in clinician information sharing. Interventions to support SDM may enhance decision quality and reduce decision regret about PMBR, ultimately improving patient-centered care for women with breast cancer.
Creation of Nepal’s First Skin Bank: Challenges and Outcomes
Background: In Nepal, burn trauma causes more than 55,000 injuries each year. Burn-related mortality is high in Nepal, in part due to lack of allograft, leading to high infection rates. To address this challenge, our collaboration between Kirtipur Hospital, America Nepal Medical Foundation, Stanford University, and ReSurge International established Nepal's first skin bank. Methods: We identified 3 major tasks to create a sustainable skin banking program: 1) identify and acquire the equipment and personnel needed to collect, process, store, and graft cadaveric skin for burn injuries; 2) develop safe donation protocols and documentation tools that remain feasible for low-resource settings; and 3) develop a long-term awareness program to educate the Nepali people on skin donation, a previously foreign concept. Results: Kirtipur Hospital acquired the necessary equipment and materials for the skin bank through a combination of local and international fundraising efforts. Existing U.S. skin banking protocols were adapted for the Nepali setting and piloted on potential patients, donors, and physicians. For the first time in the hospital's history, patients with > 40% total body surface area burns were successfully treated with extensive allografts. Conclusions: It is feasible to create a skin bank in a country with no tradition of allograft skin use. Long-term sustainability now depends on spreading awareness and education in the Kathmandu Valley to overcome religious and cultural barriers that have hindered donor recruitment. Our low-cost and high-impact skin bank provides a model to expand this system to other hospitals both within Nepal and beyond.Effects of Autologous Fat and ASCs on Swine Hypertrophic Burn Scars: A Multimodal Quantitative Analysis
Background: Hypertrophic scar formation is unpredictable and poorly understood, afflicting both the pediatric and adult populations. Treatment methods with conservative and invasive approaches have low rates of compliance and high rates of morbidity. The purpose of this study was to test a reproducible scar model and investigate a new technique of scar modification through the use of adipose- derived progenitor stromal cells (ASCs). Methods: Twenty thermal deep-partial thickness contact burns were created on the dorsum of three 8-week-old domestic swine and allowed to mature for 10 weeks. Scars were then injected with 2 cc saline, expanded autologous ASCs, or 2 cc fresh lipoaspirate and sampled at 2 week intervals up to 10 weeks postinjection. Volumetric analysis with a 3-D scanner, mechanical elasticity testing through negative pressure transduction, and standardized photography evaluation with Image J was performed. RNA sequencing was performed on scar tissue samples, cultured cells, and fresh lipoaspirate to determine relevant gene transcription regulation. Immunohistochemistry was used to verify expression level changes within the scars. Results: Volumetric analysis demonstrates a reduction in average scar thickness at 6 weeks when injected with ASCs (−1.6 cc3) and autologous fat (−1.95 cc3) relative to controls (−0.121 cc3; PΣάββατο 30 Δεκεμβρίου 2017
Photodynamic Therapy Interventions in Facial Photodamage: A Systematic Review
Publication date: Available online 30 December 2017
Source:Actas Dermo-Sifiliográficas
Author(s): G. Sanclemente, V. Ruiz-Cañas, J.M. Miranda, A.P. Ferrín, P.A. Ramirez, G.N. Hernandez
IntroductionPhotodynamic therapy (PDT) involves the combination of a light source and a photosensitizing agent to induce tissue damage via the generation of singlet oxygen. Although topical PDT has been approved for other indications, its use in facial photodamage is uncertain.AimsTo assess the efficacy and safety of PDT in facial skin photoaging.MethodsAll randomized clinical trials (RCTs) evaluating the efficacy and safety of any form of topical PDT for the treatment of facial photodamage (dermatoheliosis) or photoaging in patients older than 18 years, were included. Photodynamic-therapy using any topical photosensitizing agent at any dose, and with any light-source, were considered. Comparators were chemical exfoliation, intense pulsed light (IPL), light emitting diodes (LED), dermabrasion or microdermabrasion, ablative or non-ablative lasers, injectables, surgery, placebo and/or no treatment.A systematic search in PubMed, Embase, Lilacs, Google Scholar and RCT's registry databases, was performed.ResultsSearch was conducted up to May 4th 2016. Four authors independently selected and assessed methodological quality of each RCT. According to inclusion criteria, twelve studies were included (6 aminolevulinate (ALA) trials and 6 methyl aminolevulinate (MAL) trials), but the majority of them had methodological constraints particularly in randomization description and patients/outcome assessors blindness.Discussion and conclusionsOverall results indicated that PDT either with ALA or with MAL was effective and safe for facial photodamage treatment, but high quality of evidence was found mainly for MAL studies.
Graphical abstract
Mice over-expressing placenta growth factor in the skin exhibit increased vascularization and vessel permeability independently of VEGF-A
Placenta growth factor (PlGF), a member of the vascular endothelial growth factor (VEGF) family, shows strong pro-angiogenic properties in adult pathological angiogenesis [1]. In the skin, where keratinocytes represent the major source of VEGF-A and PlGF, these two factors are contemporaneously induced [2,3]. VEGF-A is also expressed in macrophages, and at minimal levels in dermal fibroblasts and endothelial cells; PlGF is also expressed in endothelial cells, at higher levels than VEGF-A. PlGF binds to tyrosine kinase receptor VEGFR-1 (Flt-1), while VEGF-A also binds to VEGFR-2 (Flk-1), which mediates the strongest angiogenic response.
Virus and Antibody Dynamics in Travelers With Acute Zika Virus Infection
Abstract
Background
To improve our understanding of the natural history of Zika virus (ZIKV) infection in humans, we described the dynamics of ZIKV RNA shedding in different body fluids and antibody responses in patients with acute infection. Methods
Twenty-nine adults with travel-associated infection and 1 case of sexual transmission were enrolled and followed up with weekly ZIKV RNA testing in blood, urine, saliva, and semen samples and antibody testing. Results
ZIKV RNA was detected in plasma, urine, and saliva of 57%, 93.1%, and 69.2% of participants, with estimated median times to clearance of 11.5 days (interquartile range [IQR] 6–24 days), 24 days (IQR, 17–34), and 14 days (IQR, 8–31), respectively. In 2 pregnant women, ZIKV RNA persisted in blood until delivery of apparently healthy infants. ZIKV RNA was detected in semen of 5 of 10 tested men; median time to clearance was 25 days (IQR 14–29), and the longest time of shedding in semen was 370 days. In flavivirus-naive patients, the median times to detection of ZIKV nonstructural protein 1 (NS1)–specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies were estimated as 8 days (IQR, 5–15 days) and 17 days (IQR, 12–26 days), respectively. ZIKV NS1 IgM antibodies were undetectable in patients with previous dengue. Conclusions
Prolonged viremia and ZIKV RNA shedding in urine, saliva, and semen occur frequently in patients with acute ZIKV infection. At the time of diagnosis, about half of patients are ZIKV IgM negative. ZIKV NS1 IgM antibodies remain undetectable in patients with previous dengue. Estimates of the times to viral clearance and seroconversion are useful to optimize diagnostic algorithms.Evidence for Mother-to-Child Transmission of Zika Virus Through Breast Milk
Abstract
Zikavirus (ZIKV) is an emerging viral pathogen that continues to spread throughout different regions of the world. Herein we report a case that provides further evidence that ZIKV transmission can occur through breastfeeding by providing a detailed clinical, genomic, and virological case-based description.Impact of Dengue Vaccination on Serological Diagnosis: Insights From Phase III Dengue Vaccine Efficacy Trials
Abstract
Background
We previously reported that vaccination with the tetravalent dengue vaccine (CYD-TDV; Dengvaxia) may bias the diagnosis of dengue based on immunoglobulin M (IgM) and immunoglobulin G (IgG) assessments. Methods
We undertook a post hoc pooled analysis of febrile episodes that occurred during the active surveillance phase (the 25 months after the first study injection) of 2 pivotal phase III, placebo-controlled CYD-TDV efficacy studies that involved ≥31000 children aged 2–16 years across 10 countries in Asia and Latin America. Virologically confirmed dengue (VCD) episode was defined with a positive test for dengue nonstructural protein 1 antigen or dengue polymerase chain reaction. Probable dengue episode was serologically defined as (1) IgM-positive acute- or convalescent-phase sample, or (2) IgG-positive acute-phase sample and ≥4-fold IgG increase between acute- and convalescent-phase samples. Results
There were 1284 VCD episodes (575 and 709 in the CYD-TDV and placebo groups, respectively) and 17673 other febrile episodes (11668 and 6005, respectively). Compared with VCD, the sensitivity and specificity of probable dengue definition were 93.1% and 77.2%, respectively. Overall positive and negative predictive values were 22.9% and 99.5%, respectively, reflecting the much lower probability of correctly confirming probable dengue in a population including a vaccinated cohort. Vaccination-induced bias toward false-positive diagnosis was more pronounced among individuals seronegative at baseline. Conclusions
Caution will be required when interpreting IgM and IgG data obtained during routine surveillance in those vaccinated with CYD-TDV. There is an urgent need for new practical, dengue-specific diagnostic algorithms now that CYD-TDV is approved in a number of dengue-endemic countries.Arbovirus Diagnostics: From Bad to Worse due to Expanding Dengue Virus Vaccination and Zika Virus Epidemics
dengueZikadiagnosticsserologyarbovirus
Improved survival and cure rates with concurrent treatment for MDR-TB/HIV co-infection in South Africa
Abstract
Background
The global epidemic of multidrug-resistant tuberculosis (MDR-TB) threatens gains in TB and HIV outcomes over the past two decades. Mortality in MDR-TB/HIV co-infection has historically been high, but most studies predated the availability of antiretroviral therapy (ART). We prospectively compared survival and treatment outcomes in MDR-TB/HIV co-infected patients on ART to those in patients with MDR-TB alone. Methods
This prospective, observational study enrolled culture-confirmed MDR-TB patients, with and without HIV co-infection, in South Africa between 2011–2013. Participants received standardized MDR-TB and HIV regimens and were followed monthly for treatment response, adverse events, and adherence. The primary outcome was survival. Results
Among 206 participants, 150 were HIV-infected, 131 (64%) were female, and the median age was 33 years (IQR 26-41). Of the 191 participants with a final MDR-TB outcome, 130 (73%) were cured or successfully completed treatment, which did not differ by HIV status (p=0.50). After two years, the median CD4 count was 386 cells/mm3 (IQR 219-510), an increase of 140 cells/mm3 from baseline (p=0.005), and 64% had an undetectable HIV viral load. HIV-infected and HIV-uninfected participants had high rates of survival (86% and 94%, respectively; p=0.34). The strongest risk factor for mortality was having a CD4 count ≤100 cells/mm3 (aHR 15.6, 95%CI 4.4-55.6). Conclusions
Survival and treatment outcomes among MDR-TB/HIV individuals receiving concurrent ART were improved, approaching those of HIV-uninfected MDR-TB patients. The greatest risk of death was among HIV-infected individuals with CD4 counts ≤100 cells/mm3. These findings provide critical evidence to support concurrent treatment of MDR-TB and HIV.Dolutegravir plus lamivudine maintain HIV-1 suppression through week 48 in a pilot randomized trial
Abstract
In this randomized pilot clinical trial, dolutegravir plus lamivudine was non-inferior to continuation of standard three-drug maintenance therapy in virologically-suppressed HIV-1 infected individuals. There was no emergence of drug resistance in the participant with virologic failure on dolutegravir plus lamivudine.Impact of Culture-Independent Diagnostic Testing on Recovery of Enteric Bacterial Infections
Abstract
Background
Culture-independent diagnostic tests (CIDT) are increasingly used to identify enteric pathogens. However, foodborne illness surveillance systems have relied upon culture confirmation to estimate disease burden and identify outbreaks through molecular subtyping. This study examined the impacts of CIDT and estimated costs for culture verification of Shigella, Salmonella, Shiga-Toxin producing E. coli (STEC), and Campylobacter at the Tennessee Department of Health Public Health Laboratory (PHL). Methods
This observational study included laboratory and epidemiological surveillance data collected between years 2013-2016 from patients with the reported enteric illness. We calculated pathogen recovery at PHL based on initial diagnostic test type reported at the clinical laboratory. Adjusted prevalence ratios (PR) and 95% confidence intervals (CI) were estimated with Modified Poisson Regression. Estimates of cost were calculated for pathogen recovery from CIDT positive specimens compared to recovery from culture-derived isolates. Results
During the study period, PHL received 5553 specimens from clinical laboratories from patients with the enteric illness. Pathogen recovery was 57% (984/1713) from referred CIDT positive stool specimens and 95% (3662/3840) from culture-derived isolates (PR=0.61, 95% CI: 0.56-0.66). Pathogen recovery from CIDT-positive specimens varied based on pathogen type: Salmonella (72%), Shigella (64%), STEC (57%) and Campylobacter (26%). Compared to stool culture-derived isolates, the cost to recover pathogens from 100 CIDT positive specimens was higher for Shigella ($6,192), Salmonella ($18,373) and STEC ($27,783). Conclusions
Pathogen recovery was low from CIDT positive specimens for enteric bacteria. This has important implications for the current enteric disease surveillance system, outbreak detection and costs for public health programs.Busting the Myth of “Static vs. Cidal”: A Systemic Literature Review
Abstract
We sought to determine if clinical data validate the dogma that bactericidal antibiotics are more clinically effective than bacteriostatic agents. We performed a systematic literature review of published, randomized controlled trials that compared a bacteriostatic agent to a bactericidal agent in the treatment of clinical, bacterial infections. From among a total of 56 identified trials, 49 found no significant difference in efficacy between bacteriostatic and bactericidal agents. Six trials found that the bacteriostatic agent was superior in efficacy to the bactericidal agent. Only one trial found that the bactericidal agent was superior; in this case, the inferiority of the static agent was explainable by under-dosing of the drug based on pharmacokinetic-pharmacodynamic analysis. Thus, virtually all available data from high quality, randomized controlled trials demonstrate no intrinsic superiority of bactericidal compared to bacteriostatic agents. Other drug characteristics, such as optimal dosing, pharmacokinetics, and tissue penetration, may be more important efficacy drivers.Characteristics and outcomes of influenza-associated encephalopathy cases among children and adults in Japan, 2010-2015
Abstract
Background
Influenza-associated encephalopathy (IAE) can result in severe neurologic disease with high mortality. Most IAE cases have been reported among children worldwide; understanding of IAE among adults is limited. Methods
Data were collected on IAE cases reported through the National Epidemiological Surveillance of Infectious Diseases database in Japan during 2010 through 2015. IAE cases were stratified by age category and analyzed using descriptive statistics to assess differences in characteristics and outcomes. Results
Among 385 reported IAE cases, median age at diagnosis was 7 years (range 0-90), and 283 (74%) were children aged <18 years. The mean seasonal incidence of IAE cases among children and adults (≥18 years) was 2.83 and 0.19 cases per 1,000,000 population, respectively. IAE incidence did not vary by predominant influenza A virus subtype. The frequency of IAE was highest in school-aged (5-12 years) children (38%), followed by young children aged 2-4 years (21%) and adults aged 18-49 years (11%). The proportion of cases with seizures was more common in pediatric IAE cases. There were more cases with cerebrospinal fluid pleocytosis among adults than in children (p<0.01), especially among those aged 18-49 (17%) and 50-64 (19%) years. Case fatality proportion was highest in those aged 40-64 (17%) and ≥65 (20%) years. Conclusions
We identified differences in the characteristics of IAE patients between adults and children in Japan. Although IAE cases were more frequently reported among children, mortality was higher in adults. Further efforts are needed to prevent and improve survival of patients with IAE, especially in adults.The limits of non-standard contingency
Abstract
Gideon Rosen has recently sketched an argument which aims to establish that the notion of metaphysical modality is systematically ambiguous. His argument contains a crucial sub-argument which has been used to argue for Metaphysical Contingentism, the view that some claims of fundamental metaphysics are metaphysically contingent rather than necessary. In this paper, Rosen's argument is explicated in detail and it is argued that the most straight-forward reconstruction fails to support its intended conclusion. Two possible ways to save the argument are rebutted and it is furthermore argued that the crucial sub-argument only supports a rather particular variant of Metaphysical Contingentism.
Evaluation of 1-Nitropyrene as a Surrogate Measure for Diesel Exhaust
Abstract
We investigated the viability of particle bound 1-nitropyrene (1-NP) air concentration measurements as a surrogate of diesel exhaust (DE) exposure, as compared with industry-standard elemental carbon (EC) and total carbon (TC) measurements. Personal exposures are reported for 18 employees at a large underground metal mine during four different monitoring campaigns. Full-shift personal air exposure sampling was conducted using a Mine Safety and Health Administration (MSHA) compliant diesel particulate matter (DPM) impactor cassette downstream of a GS-1 cyclone pre-selector. Each DPM filter element was analyzed for EC and organic carbon (OC) using NIOSH Method 5040. After EC and OC analysis, the remaining portion of each DPM filter was analyzed for 1-NP using liquid chromatography tandem mass spectrometry (LC/MS/MS). We observed high correlations between the quantiles of 1-NP and EC exposures across 10 different work shift task groups (r = 0.87 to 0.96), and a linear relationship with a slope between 6.0 to 6.9 pg 1-NP per µg EC. However, correlation between 1-NP and EC was weak (r =0.34) for the 91 individual sample pairs due to low EC concentrations and possible heterogeneity of DE composition. While both 1-NP and EC differentiated between high and low exposure groups categorized by job location, measurements of 1-NP, but not EC further differentiated between specific job activities. Repeated measurements on individual subjects verified the relationship between 1-NP and EC and demonstrated substantial within-subject variability in exposure. The detection limit of TC air concentration ranged between 18 and 28 µg m−3 and was limited by OC contamination of the quartz filters in the MSHA compliant DPM samplers.Molecular signature of nitric oxide on major cancer hallmarks of colorectal carcinoma
Abstract
Colorectal cancer (CRC) is the one of the most important diseases throughout the world. Several aetiological risk factors, viz. sedentary life style, smoking, alcohol intake, less physical activity, red meat, and microbiota, are associated with the development of CRC. Molecular pathophysiology of CRC implies inflammation, metastasis, apotosis and angiogenesis. Inflammation involves interaction between various immune cells, inflammatory cells, chemokines, cytokines, and pro-inflammatory mediators, such as cyclooxygenase (COX) and lipoxygenase (LOX) pathways, which may lead to signalling towards, tumour cell proliferation, growth, and invasion whereas nitric oxide (NO) has been associated with metastasis, apoptosis, and angiogenesis. Therefore, this review emphasises on the potential molecular mechanisms associated with NO with alteration of cancer biomarkers during development of colorectal carcinogenesis.
Introduction: Antibody-Mediated Therapy Special Issue Part 2
Antibodies have been used therapeutically for well over a century but the breadth and depth of their applications are increasing so rapidly and successfully that clinical studies are informing mechanistic questions while basic research continues to interrogate how antibodies are made and function, so their properties can be further refined. The first part of this Special Issue comprised five review articles (1); this second part includes four more reviews. Once again, we thank the authors for their excellent contributions. This issue also includes an original research article that builds on observations from patients with hyper-IgM syndrome to further define the mechanism for antibody class-switch recombination (CSR).
A pro-inflammatory role of Fcα/μR on marginal zone B cells in sepsis
Abstract
Fc receptors play important roles for a wide array of immune responses. In contrast to the well-defined Fcγ and Fcε receptors, the molecular and functional characteristics of Fc receptors for IgA and IgM have remained incompletely understood for years. Recent progress has unveiled the characteristics of Fc receptors for IgA and IgM, including Fcα/μ receptor (Fcα/μR) (CD351), polymeric immunoglobulin receptor (poly-IgR), Fcα receptor (FcαRI) (CD89) and Fcμ receptor (FcμR). In this review, we summarize the molecular and functional characteristics of Fcα/μR in comparison with poly-IgR, FcμR and FcαRI, and focus particularly on the pro-inflammatory function of Fcα/μR expressed on marginal zone B cells in sepsis.Depletion of recombination-specific cofactors by the C-terminal mutant of the activation-induced cytidine deaminase causes the dominant negative effect on class switch recombination
Abstract
Activation-induced cytidine deaminase (AID) is essential for class-switch recombination (CSR) and somatic hypermutation (SHM) of immunoglobulin genes. Studies on in vitro mutagenized AID as well as its mutations in human patients with hyper-IgM (HIGM)-syndrome type II revealed that C-terminal AID mutations were defective in CSR whereas their DNA cleavage and SHM activities remained intact. The C-terminal mutants of AID were speculated to exert the dominant negative effect on wild-type (WT) AID whereas its mechanism remains unknown. We generated the JP41 (R190X) mutation in one allele and a null mutation on the other allele in a mouse B cell line (CH12F3-2A) using CRISPR/Cas9 genome-editing tools and studied the effect of JP41 expression on the function of exogenously introduced WT AID fused with estrogen receptor (AIDER) in AIDJP41/∆/AIDER CH12F3-2A cells. We found that JP41 expression strongly suppressed not only CSR but also Igh/c-Myc chromosomal translocations by AIDER. We showed that the dominant negative effect is not evident at the DNA cleavage step but obvious at both deletional and inversional recombination steps. We also confirmed the dominant negative effect of other C-terminal mutants, JP8Bdel (R183X) and P20 (34-aa insertion at residue 182) in AID-deficient spleen B cells. Finally, we showed that the expression of JP41 reduced the binding of AIDER with its cofactors (hnRNP L, SERBP1 and hnRNP U). Together, these data indicate that dominant negative effect of JP41 on CSR is likely due to the depletion of the CSR-specific RNA-binding proteins from WT AID.Targeted antibody therapy and relevant novel biomarkers for precision medicine for rheumatoid arthritis
Abstract
Over the past two decades, the management of rheumatoid arthritis (RA) has progressed remarkably, encompassing the development of new diagnostic tools and efficacious biological agents, such as monoclonal antibodies against inflammatory cytokines and surface markers on immune cells. In addition to the significant efficacy of these biological agents, biomarkers for RA are under consideration for their potential to classify heterogeneous patients into several groups based on clinical and immunological phenotypes for the prediction of clinical course and prognosis and the facilitation of appropriate and precise treatment with the appropriate therapeutic monoclonal antibodies. Biomarkers, particularly those for the prediction and monitoring of the responses to therapeutic monoclonal antibodies for RA, are in demand, with many approaches examined in recent years. In this article, we have summarized the background research on biomarkers and introduced recent topics in the field that enable the possible clinical applications of biomarkers, especially those related to pathogenic cytokines, to guide the treatment of RA.Sweet SIGNs: IgG glycosylation leads the way in IVIG-mediated resolution of inflammation
Abstract
A hallmark of many chronic inflammatory and autoimmune diseases is that there is an impaired resolution of inflammation and return to the steady state. The infusion of high doses of pooled serum IgG preparations from thousands of donors [intravenous immunoglobulin (IVIG) therapy] has been shown to induce resolution of inflammation in a variety of chronic inflammatory and autoimmune diseases, suggesting that IgG molecules can instruct the immune system to stop inflammatory processes and initiate the return to the steady state. The aim of this review is to discuss how insights into the mechanism of IVIG activity may help to understand the molecular and cellular pathways underlying resolution of inflammation. We will put a special emphasis on pathways dependent on the IgG FC domain and IgG sialylation, as several recent studies have provided new insights into how this glycosylation-dependent pathway modulates innate and adaptive immune responses through different sets of C-type or I-type lectins.IVIG-mediated effector functions in autoimmune and inflammatory diseases
Abstract
Intravenous immunoglobulin (IVIG) is a pooled preparation of normal IgG obtained from several thousand healthy donors. It is widely used in the immunotherapy of a large number of autoimmune and inflammatory diseases. The mechanisms of action of IVIG are complex and, as discussed in this review, experimental and clinical data provide an indicator that the therapeutic benefit of IVIG therapy is due to several mutually non-exclusive mechanisms affecting soluble mediators as well as cellular components of the immune system. These mechanisms depend on Fc and/or F(ab′)2 fragments. A better understanding of the effector functions of IVIG should help in identification of biomarkers of responses to IVIG in autoimmune patients.The impacts of the axial-to-radial airflow quantity ratio and suction distance on air curtain dust control in a fully mechanized coal face
Abstract
To understand the impacts of the axial-to-radial airflow quantity ratio (denoted as R) and the suction distance (denoted as Ds) on air curtain dust control in a fully mechanized coal face, the 3down610 coal face in Jiangzhuang coal mine was numerically simulated in this study. A mathematic model was established to describe the airflow migration and dust diffusion in a coal face, and a scaled physical model was constructed. The comparison between simulation results and field measurements validated the model and the parameter settings. Furthermore, the airflow migration and dust diffusion at various R and Ds are analyzed using Ansys CFD. The results show that a reduction of R and Ds is conducive to the formation of an effective axial dust control air curtain; the dust diffusion distance decreases with the decrease of both R and Ds. By analyzing the simulation results, the optimal parameter for air curtain dust control in the 3down610 coal face and those faces with similar production conditions is determined as R = 1/9 and Ds = 2 m. Under the optimal parameter condition, the high-concentration dust can be confined in front of the mining driver within a space 5.8 m away from the coal face.
Removal mechanism of di- n -butyl phthalate and oxytetracycline from aqueous solutions by nano-manganese dioxide modified biochar
Abstract
In this work, nano-manganese dioxide (nMnO2)-modified biochar (BC) was synthesized in order to improve BC's adsorption capacity for di-n-butyl phthalate (DBP) and oxytetracycline (OTC). The results showed that nMnO2 on the BC surface exhibited a poor crystallinity and oxidation state (Mn (IV)). Sorption experiments showed that, compared to BC, DBP sorption capacity of nMnO2-BC (1:20) and OTC sorption capacity of nMnO2-BC (1:10) were 0.0364 and 0.0867 mmol/g, respectively, which are significantly higher than that of BC (0.0141 and 0.0151 mmol/g). Kinetics and isotherm experiments indicated that physical adsorption and chemical interactions have both exerted their impacts on the adsorption process. Further X-ray photoelectron spectroscopy (XPS) analysis showed that part of the Mn (IV) in nMnO2-BC was reduced to Mn (III) and Mn (II) after DBP or OTC adsorption. Therefore, we suggest the nMnO2 also acted as an oxidizer on modified BC, which may accelerate the degradation of DBP and OTC.
Hyo-neck lift evolution: Neck lift with fixation of the platysma to the deep cervical fascia
Publication date: Available online 29 December 2017
Source:Annales de Chirurgie Plastique Esthétique
Author(s): C. Le Louarn
The aim of any neck lift obviously includes the restoration of an acute cervicomandibular angle. The hyo neck lift, first published in April 2016, did proposed a new technique of neck lift with a sub-cutaneous neck dissection and suture of the platysma to the hyoid through this sub-cutaneous approach. To enhance results and efficiency, a major change of the hyo neck lift technique is herein proposed with a vertical anterior sub-platysmal and sub-platysmal fat opening and dissection. This anterior dissection ensures a precise and efficient fixation of the platysma to the deep cervical fascia on direct visual control. This permits to create an horizontal and posterior vector of tension on both platysma and skin, which induces flattening of the submental area and consequently creates or recreates an acute cervicomandibular angle. The sub-cutaneous dissection is no more necessary at the hyoid level. In addition, the posterior border of the anterior platysmal flap is suspended to the mastoid fascia. If necessary, the submandibular gland, through this lateral approach, can be partially excised inside it's capsule, after strong bipolar coagulation. A botulinum toxin injection, realized in early post-op, will definitively stabilize the platysma to deep cervical fascia fixation. Fifteen patients underwent the new technique of neck lift with fixation of the platysma to the deep cervical fascia and suspension of the lateral platysma (Platysma Fixation Platysma Suspension: PF PS) and were evaluated at one year post-op and compared to the results obtained with the first preliminary prospective study "hyo neck lift technique" published in April 2016. As now subcutaneous dissection is limited, recovery is faster. No transient nerve damage happened because dissection planes are designed to be far from nerve branches.ConclusionsThe simplest way to obtain an acute cervicomandibular angle is to reattach the platysma to the deep cervical fascia along the platysma cords. The new neck lift with fixation of the anterior platysma to the deep cervical fascia and suspension of the lateral platysma, is faster to perform, induces a faster recovery and is safer and more efficient than the subcutaneous hyo neck lift and other described types of anterior platysma plasties.
The effect of flurbiprofen oral spray and ibuprofen versus ibuprofen alone on postoperative tonsillectomy pain: an open randomised controlled trial
Abstract
Objective
This prospective clinical study was carried out to evaluate the analgesic efficacy and safety of oral spray form of flurpiprofen in the treatment of postoperative pain in tonsillectomy patients.
Study Design
Open randomised controlled clinical study.
Setting
Tertiary care training and research hospital.
Participants
One hundred (53 males, 47 females) with an age range of 18-53 years old (mean 27.4 ± 9.3 SD) undergoing tonsillectomy were enrolled to this prospective controlled study.
Main outcome measures
Patients receiving oral ibuprofen and flurbiprofen as spray form were enrolled as study group (53) whereas patients receiving only oral ibuprofen were enrolled as control group (47) in postoperative period. Postoperative pain was evaluated through visual analog scale on 12th hour, first, third and seventh days after surgery.
Results
The mean maximal pain score of patients who have received flurbiprofen spray and ibuprofen was 3.36 ± 1.93 SD that was statistically lower than the mean maximal pain score of patients who were medicated with only ibuprofen which was 4.06 ± 1.29 SD on postoperative seventh day (p=0.013).
Conclusion
This study revealed that addition of flurbiprofen spray to oral ibuprofen is effective in the management of postoperative pain in tonsillectomy patients with no notable complications.
This article is protected by copyright. All rights reserved.
Cold/Cold vs. Bipolar Dissection Tonsillectomy: A Surgeon-Controlled Study of 400 Cases
Abstract
Surgeon controlled study of 200 cold/cold and 200 hot/hot tonsillectomy cases in one institution
Hot/hot resulted in higher overall rates of early and late post-tonsillectomy haemorrhage and return-to-theatre when compared to cold/cold methods.
Bipolar diathermy tonsillectomy resulted in a statistically significant higher rate of secondary post-tonsillectomy haemorrhage than cold-steel of nearly three times.
Trainee surgeons performed better in bipolar haemostasis than cold-steel dissection with regard to post-operative morbidity.
With continued use of cold-steel tonsillectomy methods in both junior and senior surgeons, it is hoped that the rates of PTH and RTT will continue to improve.
This article is protected by copyright. All rights reserved.
Double Suspension Sutures: a simple Surgical Technique for Selected Cases of obstructive Sleep Apnea: our experience with twenty two patients
Abstract
This work aimed at presenting a simple modification of expansion pharyngoplasty using bilateral double palatal suspension sutures for the treatment of selected cases of snoring and OSA.
Between Marsh 2013 and August 2017, twenty- two patients underwent the double suspension sutures technique as a treatment for retropalatal collapse of obstructive sleep apnea.
Postoperatively, the mean AHI and the mean lowest oxygen saturation level showed highly significant improvement. Both the retropalatal and interpillar distances were increased significantly.
No persistent postoperative complications were reported. Snoring disappeared in 86.4% of patients.
The procedure is simple, well-tolerated by patients and reversible. It is an economic and less traumatic maneuver. It could be applied as a part of multilevel surgery.
This article is protected by copyright. All rights reserved.
Effect of fresh human amniotic membrane on radiation-induced wounds in a murine experimental model
Abstract
Background
Radiation-induced wounds are extremely difficult to treat. They may lead to severe infections and can even be life-threatening. Wound dressings, negative pressure wound treatment, hyperbaric oxygen therapy, and antibiotics are the main treatment modalities for radiation-induced wounds. Amniotic membrane is the innermost surface of the placenta. It has been shown that amniotic membrane induces re-epithelization, regulates angiogenesis, and decreases inflammation and fibrosis. Our proposed theory was that amniotic membrane can have a role in treating radiation-induced wounds by inducing epithelization and increasing wound tensile strength.
Methods
Out of 24 rats, 3 groups were composed. In group A, 21 days after one session of radiotherapy, a 2-cm incision was made on the gluteal region then an amniotic membrane was placed under the skin flaps. In group B, 21 days after one session of radiotherapy, a 2-cm incision made on the gluteal region and wound is sutured back after 2 × 2 cm of area was undermined. In group C, no radiotherapy is given. We just made an incision and sutured it back again with the same size of area undermined. Three weeks after these surgeries, wound regions were excised en bloc and taken out for biomechanical and histopathological assessments.
Results
The end results in amniotic membrane group (group A) were statistically higher than those in the other groups in the terms of wound healing and biomechanical measurements.
Conclusions
After biomechanical and histopathological evaluation, amniotic membrane, with its antimicrobial, anti-inflammatory, angiogenic, and epithelial-inductive effects, was found to be affective in post-radiation wound treatment. Due to the features of amniotic membrane mentioned above, it can be an option in treatment of patients which received neoadjuvant radiotherapy to prevent future wounds. It can also be used for the care and treatment of post-radiation wounds.
Level of Evidence: Not ratable
Rhinoplasty in elderly patients: analysis of outcomes and patient’s satisfaction following 20 years experiences
Abstract
Background
Rhinoplasty is one of the most complex procedures in plastic surgery. In patients over 65, the procedure is even more demanding because of the coexistence of multiple complicating psychological and anatomical factors. The aims of our study were to analyze the necessity of rhinoplasty in elderly patients, to analyze the perception of patients before and after procedures and compare these patients with younger population, to review all cases done in our department over the past 20 years, and to summarize all procedures.
Methods
We designed a retrospective study of patients that had submitted to primary rhinoplasty by the same surgical team from 1997 to 2017. The inclusion criteria were as follows: Italian national patients of either sex over 65 years old who underwent primary rhinoplasty in our department. The exclusion criteria were as follows: psychiatric disorder, abuse of alcohol or drugs, patients who had undergone secondary rhinoplasty, or patients with previous trauma. Our final sample was 125 patients. We submitted FACE-Q rhinoplasty module to 25 patients comparing the results with a control group of younger patients.
Results
Of 1703 patients who underwent primary rhinoplasty in our Department of Plastic Surgery from 1997 to 2017, only 125 were over 65 years old. The average age was 68 years old, with 72 male and 53 female patients. From June 2016 to May 2017, the Italian version of FACE-Q rhinoplasty module was given to 25 elderly patients pre- and postoperatively and to 25 younger patients (control group), for comparison. All patients answered the postoperative module 6 months after their procedure. The most noticeable result was in tip perception, in fact in the > 65 years old group. Two surgeons reviewed and summarized all 125 cases and procedures, which were 89 open approach, 36 closed approach, 17 reduction rhinoplasty, 108 augmentation rhinoplasty, 47 dorsum grafts, 159 tip grafts, 9 alar region grafts, and 5 other grafts.
Conclusions
The tip of the nose is the focus of attention for older patients who want to undergo this surgery and require surgical procedures for increased projection and support. Augmentation rhinoplasty plays a fundamental role in the remodeling of the nose in patients over 65 years old.
Level of Evidence: Level III, risk/prognostic study.
MAPK pathway inhibitors rescue lethal phenotypes in a BRAF gain-of-function Drosophila melanogaster model
Abstract
Mutant BRAF is the leading oncogene in melanoma and is found in close to 50% of all melanoma patients (Cancer_Genome_Atlas_Network, 2015). The oncogenic capacity of the BRAFV600E mutation has also been demonstrated in a murine melanoma model (Dankort et al., 2009). This mutation causes the activation of the mitogen-activated protein kinase (MAPK) pathway, which involves BRAF kinase and downstream mitogen-activated extracellular signal-regulated kinases 1/2 (MEK1/2) and extracellular signal-regulated kinases 1/2 (ERK1/2).
This article is protected by copyright. All rights reserved.
Παρασκευή 29 Δεκεμβρίου 2017
Does heavy metal exposure affect the condition of Whitethroat ( Sylvia communis ) nestlings?
Abstract
Anthropogenic pollution results in high concentrations of heavy metals in the environment. Due to their persistence and a high potential for bioaccumulation, metals are a real threat for birds breeding in industrial areas. The aim of the present study has been to explore the contents of heavy metals (arsenic As, cadmium Cd, chromium Cr, copper Cu, iron Fe, nickel Ni, lead Pb and zinc Zn) in the excreta of Whitethroat (Sylvia communis) nestlings living in polluted environment and to investigate the relationship between these contents and the nestlings' condition. Excrement samples contained all the studied elements. The contents of arsenic, cadmium, copper and zinc in the excreta of nestlings from nests located close to a slag dump were several times higher than in the soil near the dump, which suggested accumulation in food consumed by the birds. Condition parameters (body mass and haemoglobin concentration) were not related to heavy metal concentrations in the nestlings' excreta, except of Zn. It is possible that Whitethroats are able to detoxicate heavy metals to a certain extent. Detailed, multi-element analysis of the environment, food and bird tissues or excreta should be performed to explore relations between different chemicals and bird condition.
Effect of injection pressure on performance, emission, and combustion characteristics of diesel–acetylene-fuelled single cylinder stationary CI engine
Abstract
In this paper, the effect of injection pressure on the performance, emission, and combustion characteristics of a diesel-acetylene fuelled single cylinder, four-stroke, direct injection (DI) diesel engine with a rated power of 3.5 kW at a rated speed of 1500 rpm was studied. Experiments were performed in dual-fuel mode at four different injection pressures of 180, 190, 200, and 210 bar with a flow rate of 120 LPH of acetylene and results were compared with that of baseline diesel operation. Experimental results showed that highest brake thermal efficiency of 27.57% was achieved at injection pressure of 200 bar for diesel-acetylene dual-fuel mode which was much higher than 23.32% obtained for baseline diesel. Carbon monoxide, hydrocarbon, and smoke emissions were also measured and found to be lower, while the NOx emissions were higher at 200 bar in dual fuel mode as compared to those in other injection pressures in dual fuel mode and also for baseline diesel mode. Peak cylinder pressure, net heat release rate, and rate of pressure rise were also calculated and were higher at 200 bar injection pressure in dual fuel mode.
El futuro del tratamiento de las malformaciones capilares
Publication date: Available online 29 December 2017
Source:Actas Dermo-Sifiliográficas
Author(s): R. del Río
Removal of macro-pollutants in oily wastewater obtained from soil remediation plant using electro-oxidation process
Abstract
Electro-oxidation process by niobium boron-doped diamond (Nb/BDD) electrode was used to treat non-biodegradable oily wastewater provided from soil leachate contaminated by hydrocarbons. Firstly, the diffusion current limit and mass transfer coefficient was experimentally measured (7.1 mA cm−2 and 14.7 μm s−1, respectively), in order to understand minimum applied current density. Later on, the oxidation kinetic model of each pollutant was investigated in different current densities ranged between 3.8 and 61.5 mA cm−2. It was observed that direct oxidation was the main removal mechanism of organic and inorganic carbon, while the indirect oxidation in higher current density was responsible for nitrogen oxidation. Hydrocarbon in the form of colloidal particles could be removed by electro-flotation. On the other hand, electro-decomposition on the surface of cathode and precipitation by hydroxyl ions were the utmost removal pathway of metals. According to the initial experiments, operating condition was further optimized by central composite design model in different current density, treatment time, and electrolyte addition, based on the best responses on the specific energy consumption (SEC), chemical oxygen demand (COD), and total organic carbon (TOC) removal efficiency. Unde r optimum operating condition (current density = 23.1 mA cm−2, time = 120 min, Ti/Pt as a cathode, and Nb/BDD as the anode), electro-oxidation showed the following removal efficiencies: COD (84.6%), TOC (68.2%), oil and grease (99%), color (87.9%), total alkalinity (92%), Ntot (18%), NH4+ (31%), Ca (66.4%), Fe (71.1%), Mg (41.4%), Mn (78.1%), Ptot (75%), S (67.1%), and Si (19.1%).
Graphical abstract
Environmental significance statement
Soil treatment facilities are rapidly grown throughout the world, especially in North America due to its intense industrialization. High water content soil in humid area like Canada produces significant amount of leachate which is difficult to remove by physical and biological processes. Current treatment facility was modified by applying the electro-chemical oxidation process. The kinetic models of each macro-pollutant included carbon, nitrogen, phosphorous, and metals were developed to investigate their oxidation mechanism (graphical abstract). The efficiency of treatment was monitored in order to optimize the decisive operating parameters of electro-oxidation process. The result of this article could pave the way of future investigation on efficient treatment of variety of oily wastewater.
New insight of hybrid membrane to degrade Congo red and Reactive yellow under sunlight
Publication date: February 2018
Source:Journal of Photochemistry and Photobiology B: Biology, Volume 179
Author(s): A. Rajeswari, E. Jackcina Stobel Christy, Anitha Pius
A study was carried out to investigate the degradation of organic contaminants (Congo red and Reactive yellow - 105) using cellulose acetate - polystyrene (CA-PS) membrane with and without ZnO impregnation. Scanning electron microscope (SEM), electron dispersive analysis of X-rays (EDAX), Fourier transform infrared spectrometer (FTIR), atomic force microscope (AFM) and thermogravimeric analysis (TG-DTA) analysis were carried out to characterize bare and ZnO impregnated CA-PS membranes. Membrane efficiency was also tested for pure water flux and antifouling performance. The modified membrane showed almost 85% water flux recovery. Blending of ZnO nanoparticles to CA-PS matrix could decrease membrane fouling and increase permeation quality of the membrane with above 90% of photocatalytic degradation efficiency for dyes. The rate of degradation of dyes was observed using UV–Vis spectrometer. Reusability of CA-PS-ZnO membrane was studied and no significant change was noted in the degradation efficiency until fourth cycle. Langmuir-Hinshelwood kinetic model well describes the photo degradation capacity and the degradation of dyes CR and RY – 105 exhibited pseudo-first order kinetics. The regression coefficient (R) of CR and RY - 105 found to be 0.99. The novelty of the prepared CA-PS-ZnO membrane is that it has better efficiency and high thermal stability than our previously reported material. Therefore, ZnO impregnated CA-PS membrane had proved to be an innovative alternative for the degradation of CR and RY - 105 dyes.
Graphical abstract
Surgical damage to the lymphatic system promotes tumor growth via impaired adaptive immune response
Both lymph nodes (LNs) and lymphatic channels from primary sites to regional LNs are critical for initiation of adaptive immunity. However, as LNs are common metastatic sites in skin cancers, LN biopsies or dissections are frequently performed. In addition, reconstructive skin flaps after tumor resection may damage lymphatic flow from primary sites to regional LNs.
Regulatory mechanisms of collagen expression by interleukin-22 signaling in scleroderma fibroblasts
Systemic sclerosis (SSc) is an autoimmune disease characterized by irreversible and intractable tissue fibrosis of the skin and internal organs [1]. Previous findings indicate that inflammation, immune response and vascular damage lead to the activation of dermal fibroblasts, and then thickened dermis is resulted from uncontrolled excessive production of extracellular matrix (ECM) by the activated fibroblasts in the skin [2]. Although the mechanism of fibroblast activation in SSc is still unknown, many researchers have suggested that TGF-β1 may play a key role [3–5].
Skin cancer in the military: a systematic review of melanoma and non-melanoma skin cancer incidence, prevention, and screening among active duty and veteran personnel
Occupational sun exposure is a well-studied risk factor for skin cancer development, but more work is needed to assess melanoma and non-melanoma skin cancer risk among U.S. military personnel to improve education and screening efforts in this population.
Applicability of EULAR/ACR Classification Criteria for Dermatomyositis to Amyopathic Disease
Existing classification systems for idiopathic inflammatory myopathies (IIM) fail to classify and/or diagnose patients with amyopathic dermatomyositis (ADM).
SPF 100+ sunscreen is more protective against sunburn than SPF 50+ in actual-use: Results of a randomized, double-blind, split-face, natural sunlight exposure, clinical trial
The value of additional photoprotection provided by use of high SPF sunscreens is controversial and limited clinical evidence exists.
Use of Indocyanine Green for Sentinel Lymph Node Biopsy: Case Series and Methods Comparison
Introduction: Sentinel lymph node biopsy is indicated for patients with biopsy-proven thickness melanoma greater than 1.0 mm. Use of lymphoscintigraphy along with vital blue dyes is the gold standard for identifying sentinel lymph nodes intraoperatively. Indocyanine green (ICG) has recently been used as a method of identifying sentinel lymph nodes. We herein describe a case series of patients who have successfully undergone ICG-assisted sentinel lymph node biopsy for melanoma. We compare 2 imaging systems that are used for ICG-assisted sentinel lymph node biopsy. Methods: Fourteen patients underwent ICG-assisted sentinel lymph node biopsy for melanoma using the SPY Elite system (Novadaq, Mississigua, Canada) and the Hamamatsu PDE-Neo probe system (Mitaka USA, Park City, Utah). We analyzed costs for 2 systems that utilize ICG for sentinel lymph node biopsies. Results: Intraoperative use of ICG for sentinel lymph node biopsies was successful in correctly identifying sentinel lymph nodes. There was no difference between the Hamamatsu PDE-Neo probe and SPY Elite systems in the ability to detect sentinel lymph nodes; however, the former was associated with a lower operating cost and ease of use compared with the latter. Conclusion: ICG-assisted sentinel lymph biopsy using the SPY Elite or the Hamamatsu PDE-Neo probe systems for melanoma are comparable in terms of sentinel node detection. The Neo probe system delivers pertinent clinical data with the advantages of lower cost and ease of operation.UCS protein function is partially restored in the Saccharomyces cerevisiae she4 mutant with expression of the human UNC45-GC, but not UNC45-SM
Abstract
A dedicated UNC45, Cro1, She4 (UCS) domain-containing protein assists in the Hsp90-mediated folding of the myosin head. Only weak sequence conservation exists between the single UCS protein of simple eukaryotes (She4 in budding yeast) and the two UCS proteins of higher organisms (the general cell and striated muscle UNC45s; UNC45-GC and UNC45-SM, respectively). In vertebrates, UNC45-GC facilitates cytoskeletal functions, whereas the 55% identical UNC45-SM assists assembly of the contractile apparatus of cardiac and skeletal muscles. A Saccharomyces cerevisiae she4Δ mutant, totally lacking any UCS protein, was engineered to express as its sole Hsp90 either the Hsp90α or the Hsp90β isoforms of human cytosolic Hsp90. A transient induction of the human UNC45-GC, but not UNC45-SM, could rescue the defective endocytosis in these she4Δ cells at 39 °C, irrespective of whether they possessed Hsp90α or Hsp90β. UNC45-GC-mediated rescue of the localisation of a Myo5-green fluorescent protein (GFP) fusion to cortical patches at 39 °C was more efficient in the yeast containing Hsp90α, though this may relate to more efficient functioning of Hsp90α as compared to Hsp90β in these strains. Furthermore, inducible expression of UNC45-GC, but not UNC45-SM, could partially rescue survival at a more extreme temperature (45 °C) that normally causes she4Δ mutant yeast cells to lyse. The results indicate that UCS protein function has been most conserved—yeast to man—in the UNC45-GC, not UNC45-SM. This may reflect UNC45-GC being the vertebrate UCS protein that assists formation of the actomyosin complexes needed for cytokinesis, cell morphological change, and organelle trafficking—events also facilitated by the myosins in yeast.
The Effect of the Removal of User Fees for Delivery at Public Health Facilities on Institutional Delivery in Urban Kenya
Abstract
Objectives In 2013, Kenya removed delivery fees at public health facilities in an effort to promote equity in access to health services and address high maternal mortality. This study determines the effect of the policy to remove user fees on institutional delivery in a population-based sample of women from urban Kenya. Methods Longitudinal data were collected from a representative sample of 8500 women from five cities in Kenya in 2010 with a follow-up interview in 2014 (response rate 58.9%). Respondents were asked about their most recent birth since 2008 at baseline and 2012 at endline, including the delivery location. Multinomial logistic regression is used, controlling for the temporal time trend and background characteristics, to determine if births which occurred after the national policy change were more likely to occur at a public facility than at home or a private facility. Results Multivariate findings show that women were significantly more likely to deliver at a public facility as compared to a private facility after the policy. Among the poor, the results show that poor women were significantly more likely to deliver in a public facility compared to home or a private facility after policy change. Conclusions for Practice These findings show Kenya's progress towards achieving universal access to delivery services and meeting its national development targets. The removal of delivery fees in the public sector is leading to increased use of facilities for delivery among the urban poor; this is an important first step in reducing maternal death.
Arsenic and/or copper caused inflammatory response via activation of inducible nitric oxide synthase pathway and triggered heat shock protein responses in testis tissues of chicken
Abstract
The aim of this study is to investigate the effects of arsenic (As) and copper (Cu) on the inflammatory response, and the protective roles of heat shock proteins (Hsps) in chicken testes. Seventy-two 1-day-old male Hy-line chickens were treated with 30 mg/kg feed of arsenic trioxide (As2O3) and/or 300 mg/kg feed of copper sulfate (CuSO4) for 4, 8, and 12 weeks. The histological changes, inducible nitric oxide synthase (iNOS) activity, and the expressions of Hsps and inflammatory cytokines were detected. The results showed that slight histology changes were obvious in the testis tissue exposure to treatment groups. The activity and the protein level of iNOS were increased compared to the control group. The mRNA levels of proinflammatory cytokines and inflammatory factors were increased as a whole. However, anti-inflammatory cytokines were inhibited. The mRNA and protein levels of Hsp60, Hsp70, and Hsp90 were upregulated. These results suggested that sub-chronic exposure to As and/or Cu induced testicular poisoning in chickens. Increased Hsps tried to protect chicken testis tissues from tissues damage caused by inflammation. In conclusion, testicular poisoning induced by As and/or Cu caused inflammatory response and heat shock protein response in chicken testis tissues.
Biogenic synthesis of silver nanoparticles using Piper betle aqueous extract and evaluation of its anti-quorum sensing and antibiofilm potential against uropathogens with cytotoxic effects: an in vitro and in vivo approach
Abstract
Urinary tract infections are the utmost common bacterial infections caused by Proteus mirabilis, Pseudomonas aeruginosa, Escherichia coli, and Serratia marcescens. These uropathogens resist the action of several antibiotics due to their ability to form biofilms. Most of these bacterial pathogens use the quorum sensing (QS) machinery to co-ordinate their cells and regulate several virulence factors and biofilm formation. On the other hand, the anti-quorum sensing (anti-QS) and antibiofilm potential of silver nanoparticles have been well reported against certain bacterial pathogens, but to the best of our knowledge, no report is available against the pathogenicity of uropathogens in particular S. marcescens and P. mirabilis. Therefore, the present study is primarily focused on the anti-QS and antibiofilm potential of Piper betle-based synthesized silver nanoparticles (PbAgNPs) against S. marcescens and P. mirabilis. Initially, the silver nanoparticles were synthesized by the aqueous extract of P. betle and characterized by UV-absorbance spectroscopy, XRD, FT-IR, SEM, TEM, and DLS. The synthesized silver nanoparticles were assessed for their anti-QS activity and the obtained results revealed that the PbAgNPs inhibited the QS-mediated virulence factors such as prodigiosin, protease, biofilm formation, exopolysaccharides and hydrophobicity productions in uropathogens. The gene expression analysis divulged the downregulation of fimA, fimC, flhD, and bsmB genes in S. marcescens and flhB, flhD, and rsbA genes in P. mirabilis, respectively. The in vivo Caenorhabditis elegans assays revealed the non-toxic and anti-adherence efficiency of PbAgNPs. Furthermore, the non-toxic effect of PbAgNPs was also confirmed through peripheral blood mononuclear cells and normal lung epithelial cells. Therefore, the contemporary study demonstrates the use of PbAgNPs as a possible alternative toward conventional antibiotics in controlling QS and biofilm-related uropathogen infections.
Predicting Cu and Zn sorption capacity of biochar from feedstock C/N ratio and pyrolysis temperature
Abstract
Biochars have been proposed for remediation of metal-contaminated water due to their low cost, high surface area and high sorption capacity for metals. However, there is a lack of understanding over how feedstock material and pyrolysis conditions contribute to the metal sorption capacity of biochar. We produced biochars from 10 different organic materials by pyrolysing at 450 °C and a further 10 biochars from cedar wood by pyrolysing at 50 °C intervals (250–700 °C). Batch sorption experiments were conducted to derive the maximum Cu and Zn sorption capacity of each biochar. The results revealed an exponential relationship between Cu and Zn sorption capacity and the feedstock C/N ratio and a sigmoidal relationship between the pyrolysis temperature and the maximum Cu and Zn sorption capacity. FTIR analysis revealed that as temperature increased, the abundance of functional groups reduced. We conclude that the high sorption capacity of high temperature biochars is due to an electrostatic attraction between positively charged Cu and Zn ions and delocalised pi-electrons on the greater surface area of these biochars. These findings demonstrate a method for predicting the maximum sorption capacity of a biochar based on the feedstock C/N ratio and the pyrolysis temperature.
Labour Market Segregation and Gender Differences in Sickness Absence: Trends in 2005–2013 in Finland
Abstract
Objectives
Women have higher sickness absence rate than men, but less is known of changes in this difference over time. We examined gender differences in sickness absence trends focusing on gender segregation in the labour market. Methods
We used large nationwide register data on Finnish wage earners aged 25–59 and generalized estimation equations based on repeated logistic regression to estimate the annual risk of sickness absence lasting at least 2 weeks. Results
Between 2005 and 2013, the age-adjusted proportion (%) of employees with all-cause sickness absence decreased from the initial levels of 10.6 among men and 15.1 among women by 16.7 and 13.6%, respectively. Among both genders, the largest decrease in sickness absence coincided with the peak of the economic recession in 2009. In sickness absence due to all causes and musculoskeletal diseases, also the excess decrease among men mainly occurred in 2009, and in sickness absence due to mental disorders 2 years later. In sickness absence due to all causes and musculoskeletal diseases, the increasing gender difference was mainly attributable to a larger decrease in sickness absence at the time of the recession in male-dominated groups, such as in manual and manufacturing work, than in other sectors and occupational classes. In mental disorders, the increasing gender difference was partly attributable to a later smaller decrease in sickness absence among female-dominated lower non-manual and lower income employment groups. The increasing gender differences did not result from differential distributional changes in employment or sociodemographic factors among the employed male and female populations. In fact, widening of the gender gap in sickness absence due to all causes and musculoskeletal diseases would have been even larger without faster increase among women in the educational level and in non-manual employment. Conclusions
Sickness absence decreased especially in male-dominated employment groups, resulting in a larger decrease in absences among men compared with women. More research is needed to ascertain whether these differential changes are attributable, for example, to reduced willingness to seek medical advice or increased presenteeism in male-dominated groups, or to increased work pressures in female-dominated groups. Selection mechanisms, i.e. men's increased ill-health-related exit from work through other routes than sickness absence, also cannot be ruled out.Pityriasis rubra pilaire
Publication date: Available online 28 December 2017
Source:Annales de Dermatologie et de Vénéréologie
Author(s): S. Quenan, E. Laffitte
Le pityriasis rubra pilaire est une dermatose hétérogène rare qui associe trois éléments sémiologiques à divers degrés : une papule cornée folliculaire, une kératodermie palmoplantaire orangée et des lésions érythématosquameuses parfois très étendues, avec des intervalles de peau saine. L'origine est peu claire, avec dans la majorité des cas des facteurs déclenchants traumatiques ou infectieux, probablement sur un terrain prédisposé. Dans d'autres cas, on retrouve une association à des désordres immunologiques ou bien dans des cas familiaux des anomalies génétiques de la kératinisation proches d'une ichtyose. Devant la grande variabilité sémiologique, plusieurs classifications ont été proposées, sur des critères cliniques et évolutifs. L'évolution est variable en fonction des formes cliniques. La prise en charge thérapeutique est mal codifiée et il n'y a pas d'essai thérapeutique disponible du fait de la rareté de la maladie. Les meilleurs résultats semblent cependant être obtenus avec les rétinoïdes oraux, avec en seconde ligne le méthotrexate et la ciclosporine. Les nouveaux inhibiteurs du tumor necrosis factor et les anti-interleukines 12/23 semblent changer la stratégie thérapeutique.Pityriasis rubra pilaris is a rare heterogeneous dermatosis associating three clinical signs to different degrees: follicular corneal papules, reddish-orange palmoplantar keratoderma and erythematosquamous lesions that may in some cases be very extensive, interspersed with patches of healthy skin. The aetiology is unclear, and in most cases, the trigger factors consist of trauma or infection, probably in subjects with an existing predisposition. In other cases, the condition is associated with immunological disorders or, in familial cases, genetic keratinisation abnormalities similar to ichthyosis. Given the widely varying signs, several classifications have been proposed, based on clinical criteria and outcomes. The outcome varies in accordance with the clinical forms involved. Therapeutic approaches are poorly qualified and there have been no clinical trials due to the rarity of the disease. However, the best results appear to have been obtained using oral retinoids, with second-line therapy comprising methotrexate and cyclosporine. The landscape of therapeutic strategy seems to be changing with the advent of new anti-tumour necrosis factor and anti-interleukin-12/23 antibodies.
Troubles de kératinisation : toujours du nouveau !
Publication date: Available online 28 December 2017
Source:Annales de Dermatologie et de Vénéréologie
Author(s): O. Dereure
Anaplastic Kaposi's sarcoma: 5 cases of a rare and aggressive type of Kaposi's sarcoma
Publication date: Available online 28 December 2017
Source:Annales de Dermatologie et de Vénéréologie
Author(s): M. Chapalain, G. Goldman-Lévy, N. Kramkimel, A. Carlotti, N. Franck, C. Lheure, V. Audard, M.-F. Avril, A.-G. Marcelin, D. Damotte, B. Terris, S. Aractingi, N. Dupin
BackgroundAnaplastic Kaposi's sarcoma (KS) is a rare form of KS characterized clinically by the development of a tumour mass with unusual local aggressiveness and histologically by a specific architecture and cytological morphology. A very small number of limited series in endemic countries have established characteristics common to these anaplastic forms of KS. We present five patients with an anaplastic form in a context of KS ongoing for several years in a non-endemic country.Materials and methodsWe collected 5 cases of anaplastic KS followed in our department over a period of 20years. We describe the main developmental, clinical, virological and histological features.ResultsThe cases involved 4 men and 1 woman whose mean age at diagnosis of anaplastic KD was 70years, with an average time of 25years between initial diagnosis of KD and anaplastic transformation. Our patients were all treated with chemotherapy and/or radiotherapy (RT) prior to diagnosis of anaplastic transformation. All patients had a tumour mass of the lower limbs developing in classically indolent KS with associated chronic lymphoedema. Progression was very aggressive locally with deep invasion of the soft tissues as well as osteoarticular involvement, without visceral dissemination. At present, three patients are dead, one patient is showing partial response, and one patient is in locoregional progression. Diagnosis of the disease was based on histopathological findings. The tumour cells were undifferentiated, pseudo-cohesive, and chiefly organized in sheets. The mitotic count was high (27 mitoses per 10 fields at high magnification). Necrosis was constant.DiscussionTo our knowledge, this is the first series describing anaplastic Kaposi's sarcoma in a non-endemic country. The severity of the prognosis, despite the absence of visceral dissemination, is related to the local aggressiveness of anaplastic KS and to its resistance to radiotherapy and chemotherapy, with amputation being required in certain cases.
On Educating While Hoping for the Impossible: Gabriel Marcel’s Absolute Hope as a Rejection of Educational Instrumentalism
Abstract
Over the last 20 years, there has been an increase in philosophical inquiries of hope both in philosophy of mind and of virtue as well as in the philosophy of education. This paper wishes to add to this discussion by presenting the analysis of hope by French existentialist philosopher and theologian Gabriel Marcel and examining its possible contribution to educational practices and beliefs. As one of the very few modern, systematic accounts of hope, Marcel's provocative conception of it and his critique of its common "technical" use could prove promising when applied to educational theory and practice. Following Marcel, I argue that in hope we find a complex and possibly contradictory view of the future: as a result of planning and technical problem-solving on one hand, and on the other, as an inclination towards the mysterious and radically unexpected. I suggest that maintaining educational hope within the tension between the planned and the unexpected, and specifically rejecting a complete disenchantment of the educational act, could help in securing education from being reduced to instrumental training and socializing, opening it up to new and unimaginable possibilities.
Hyperbaric oxygen therapy: An alternative treatment for radiation-induced cutaneous ulcers
Abstract
Radiotherapy is a widely recognised treatment for non-melanoma skin cancer. We report three cases of radiation-induced skin ulcers in which hyperbaric oxygen therapy was administered in 90-min sessions, 5 days a week at 2.4 absolute atmospheres in a multiplace hyperbaric chamber. Hyperbaric oxygen therapy is an outpatient treatment that does not displace other classical treatments and may be used as an adjunct therapy.
Reducing the Risk of Postpartum Depression in a Low-Income Community Through a Community Health Worker Intervention
Abstract
Objectives To clarify the effectiveness of perinatal social support interventions in reducing postpartum depression among minority, low-income women. Methods The Transdisciplinary Research Consortium for Gulf Resilience on Women's Health supported a community-based participatory research project to improve perinatal health among low-income, first-time pregnant women living in a vulnerable Gulf Coast region. Community health workers (CHWs) were partnered with recruited women, and used a mix of mobile technology and home visits to develop a supportive relationship during the perinatal period. Results Women enrolled in the CHW-led intervention had lower (F: 2.38, p = 0.04) average postpartum depression scores (EPDS) 6 months postpartum than a comparison population. The difference, however, was not seen among women in the intervention group who reported relatively poor relationships with their CHWs. Conclusions for Practice Results reinforce the evidence that perinatal social support can affect postpartum depression outcomes. CHWs are increasingly utilized by public programs to reach at-risk populations. We discuss the potential efficacy of CHW programs, but also, the need to pair outreach with effective monitoring and evaluation of the relationship development between CHW and clients.
Does a History of Gestational Diabetes Mellitus Affect Key Outcomes in Women Participating in a Diabetes Prevention Program?
Abstract
Objectives To evaluate lifestyle change outcomes among women with and without a history of gestational diabetes mellitus (GDM) enrolled in the Montana Diabetes Prevention Program (DPP). Methods Participation, self-monitoring behavior, weight loss, and cardiometabolic risk reduction were compared among 5091 women at high-risk for type 2 diabetes, with and without a history of GDM, enrolled in the Montana DPP between 2008 and 2015. Results Women with a history of GDM (6% of enrolled women, n = 283) were significantly younger than women without GDM. No significant differences in participation, self-monitoring fat intake, achievement of the physical activity goal, or weight loss were found among women with and without a history of GDM. Overall, women lost an average of 5.0 kg (± 6.5), and 45 and 29% of women achieved 5 and 7% weight loss, respectively. Both groups lost significant and comparable amounts of weight. After adjusting for age and other factors, no differences were found in achievement of ≥ 5% weight loss (AOR 0.84; 95% CI 0.61–1.16) or the ≥ 7% weight loss goal (AOR 1.04; 95% CI 0.73–1.47) among women with and without a history of GDM. Conclusions for Practice Our findings suggest that women with and without a history of GDM successfully participate in and achieve significant weight loss in the DPP. Health care providers should identify and refer women with risk factors for type 2 diabetes, including a history of GDM, to a DPP within their community.
Biomonitoring of polychlorinated biphenyls in Bavaria/Germany—long-term observations and standardization
Abstract
In the 1980s, it was demonstrated that semi-volatile organic compounds (SVOCs) like polychlorinated biphenyls (PCBs) accumulate in plant leaves. Plants are at the base of the food chain, and therefore a starting point for transfer of PCBs to animals and related human exposure. For two decades, the Environment Agency of the German federal state of Bavaria (LfU) has been operating long-term monitoring stations to measure the impact of organic air pollutants. Standardized ryegrass, curly kale, and spruce needles are used as bioindicators for the atmospheric entries of PCBs into vegetation. From the end of 1990s to 2009, there was a marked decline in the concentrations of indicator PCBs (i-PCBs) and a minor decline in PCB-TEQ levels. After 2009, the concentrations leveled off. In rural areas, the median concentrations of Σ6 i-PCB in ryegrass and curly kale were about 3 and 4 μg/kg dm in 2000, and have been about 0.5 and 1 μg/kg dm since 2009, respectively. Concentrations in spruce needles fell from 0.9 to 0.4 μg/kg dm. Median PCB-TEQ concentrations in the bioindicator plants ranged from 0.05 to 0.23 ng/kg dm between 2002 and 2009 and from 0.15 to 0.05 ng/kg dm after 2009. Indicator PCB and PCB-TEQ concentrations were several times higher at the urban station in Munich than at the rural areas, reflecting the emissions from in-use PCB stocks in the building sector. The likely reason of the slower decrease of PCB-TEQ compared to i-PCBs is the formation of PCB-126 by dechlorination of industrial PCBs in open applications.
Efficient removal of Hg 2+ in aqueous solution with fishbone charcoal as adsorbent
Abstract
The Hg2+ removal performance of fishbone charcoal prepared from discarded fishbone has been investigated in this work. The XRD, FTIR, and BET results demonstrated that the main composition of fishbone charcoal was hydroxyapatite and the specific surface area was 117 m2/g. The adsorption experiments indicated that fishbone charcoal had an extremely high adsorption capacity for Hg2+ (243.77 mg/g). The excellent Hg2+ adsorption capacity might be ascribed to the ion exchange of Hg2+ to the Ca2+ in the structure of fishbone charcoal, complexation of Hg2+ with ≡Ca(OH)2+ on the surface of fishbone charcoal, as well as electrostatic interaction between electronegative fishbone charcoal surface and cation Hg2+. This work transformed kitchen garbage (i.e., fishbone) into an effective mercury adsorbent with considerable capacity, giving a perspective sight for the utilization of solid waste.
Persistent organochlorine pesticides in aquatic environments and fishes in Taiwan and their risk assessment
Abstract
Organochlorine pesticides (OCPs) are ubiquitous contaminants with high bioaccumulation and persistence in the environment; they can have adverse effects in humans and animals. This study examined residual concentrations in water, sediments, and fishes as well as the association between the health risks of OCPs and fish consumption in the Taiwanese population. Various water and sediment samples from Taiwanese aquaculture and fish samples from different sources were collected and analyzed through gas chromatography tandem mass spectrometry to determine the concentrations of 20 OCPs, namely, aldrin; cis-chlordane; trans-chlordane; dieldrin; endrin; alpha-endosulfan; beta-endosulfan; heptachlor; hexachlorobenzene; alpha-hexachlorocyclohexane; beta-hexachlorocyclohexane; lindane; mirex; pentachlorobenzene; o,p′-dichlorodiphenyltrichloroethane (DDT); p,p′-DDT; and DDT metabolites (o,p'-dichlorodiphenyldichloroethane [DDD]; p,p'-DDD; o,p'-dichlorodiphenyldichloroethylene [DDE]; and p,p'-DDE). None of the analyzed samples was positive for OCP contamination, suggesting no new input pollution from the land through washing into Taiwanese aquaculture environments. However, OCP residues were detected in fishes caught along the coast, namely, skipjack tuna and bigeye barracuda, and in imported fishes, such as codfish and salmon. DDT was the predominant pesticide. The contamination pattern of persistent organic pollutants was as follows: dieldrin > cis-chlordane > hexachlorobenzene, with average concentrations ranging from 0.09 to 2.74 ng/g. The risk was assessed in terms of the estimated daily intake (EDI) for potential adverse indices; the EDI of OCP residues was lower than 1% of the acceptable daily intake established by the Food and Agriculture Organization of the United Nations and World Health Organization. The assessed risk was negligible and considered to be at a safe level, suggesting no association between fish consumption and risks to human health in Taiwan. However, a continuous monitoring program for OCP residues in fishes is necessary to further assess the possible effects on human health.
Complex upper arm reconstruction using an antero-lateral thigh free flap after an extravasation of Yttrium-90-ibritumomab Tiuxetan: A case report and literature review
Source:Annales de Chirurgie Plastique Esthétique
Author(s): A. Baus, C. Keilani, C.-S. Bich, F. Entine, M. Brachet, P. Duhamel, J.-C. Amabile, J.V. Malfuson, E. Bey
Yttrium-90-Ibritumomab Tiuxetan (Zevalin®) is used in the treatment of non- Hodgkin's lymphoma. Extravasation is an iatrogenic complication that is fortunately rare. However, the treatment of this complication is often complex due to the risk of extensive skin necrosis and unpredictable evolution of localized irradiation. This vesicant drug requires emergency management when extravasation occured. Radiations burns have specificities. Therefore, wound coverage involves specific plastic surgical techniques. Here, we report the case of a man presenting a chronic and extensive skin necrosis of upper arm treated with an antero-lateral thigh free flap. Moreover, we compare our experience of Zevalin® extravasation management to other past publications and propose recommendations to prevent this unacceptable complication.
Melasma, a photoaging disorder
Summary
Melasma is a common hyperpigmentary disorder. The impact on the quality of life of affected individuals is well demonstrated, demanding new therapeutic strategies. However, the treatment of melasma remains highly challenging. Melasma is often considered as the main consequence of female hormone stimulation on a predisposed genetic background. Although these two factors do contribute to this acquired pigmentary disorder, the last decade has revealed several other key players and brought new pieces to the complex puzzle of the pathophysiology of melasma. Here, we summarize the latest evidence on the pathophysiology of melasma and we suggest that melasma might be a photoaging skin disorder affecting genetically predisposed individuals. Such data must be taken into consideration by clinicians as they could have a profound impact on the treatment and the prevention of melasma.
This article is protected by copyright. All rights reserved.
Using single-cell multiple omics approaches to resolve tumor heterogeneity
It has become increasingly clear that both normal and cancer tissues are composed of heterogeneous populations. Genetic variation can be attributed to the downstream effects of inherited mutations, environment...
Microfocused ultrasound in combination with diluted calcium hydroxylapatite for improving skin laxity and the appearance of lines in the neck and décolletage
Summary
Background
Skin laxity and wrinkling on the neck and décolletage reveal age as reliably as the face.
Objective
To evaluate the combined use of microfocused ultrasound with visualization (MFU-V; Ultherapy®) and diluted calcium hydroxylapatite (CaHA; Radiesse®) for treating the neck and décolletage.
Methods
Subjects with moderate-to-severe lines on the neck and/or décolletage were retrospectively enrolled. MFU-V was applied using 7 and 10 MHz transducers followed by subdermal injection of CaHA diluted 1:1 with lidocaine solution. Photographs at baseline and 90 days were assessed by two independent, blinded evaluators using three scales: Merz Aesthetics décolleté wrinkles, Fabi-Bolton chest wrinkle, and Allergan transverse neck lines scales.
Results
A total of 47 subjects were treated as follows: 29 (neck only), five (décolletage only), and 13 (both areas). Mean neckline score improved from 2.6 (moderate-to-severe lines) at baseline to 1.3 (mild lines) 90 days after treatment (P < .001). Mean décolletage scores improved from 2.6 and 3.3 (moderate-to-severe wrinkles) on the Merz Aesthetics and Fabi-Bolton scales, respectively, to 1.1 and 1.8 (mild wrinkles), respectively, after treatment (both P < .001). Both procedures were well tolerated with high subject satisfaction.
Conclusions
Combining MFU-V with 1:1 diluted CaHA is effective for improving the appearance of neck and décolletage lines and wrinkles.
Axially Decorated SiIV-phthalocyanines Bearing Mannose- or Ammonium-conjugated Siloxanes: Comparative Bacterial Labelling and Photodynamic Inactivation
Abstract
Herein we present a comparative study about the photoinactivation of Staphylococcus aureus (Gram-positive model) and Escherichia coli (Gram-negative model) employing a neutral and a dicationic axially functionalized SiIV phthalocyanine. Depending on the charge of the siloxane moiety (neutral monosaccharide or cationic ammonium salt), different interactions with the bacteria were observed and a differential photoinactivation was facilitated. The intensity of the fluorescence labelling correlated with the photoinactivation of the two types of bacteria: while the neutral species only significantly affected the Gram-positive cells, we observed that the positively charged photosensitizer interacted both with the Gram-positive and with the Gram-negative models. The dicationic photosensitizer labelled both models with a characteristic deep-red fluorescence and photoinactivated both classes of prokaryotes. In general, our study clearly demonstrates that axially ammoniumsiloxane-functionalized Si(IV) phthalocyaninates constitute excellent photosensitizers due to their weak aggregation in aqueous environments. In particular, we also show that charge-based targeting with axial ammonium groups leads towards broad spectrum SiIV phthalocyanines for photodynamic inactivation of bacteria.
This article is protected by copyright. All rights reserved.
Πέμπτη 28 Δεκεμβρίου 2017
Correction to: The mineralization of oxalic acid and bio-treated coking wastewater by catalytic ozonation using nickel oxide
Abstract
In Table 1, "SO2-4" and "NO-3" should be corrected to " \( \mathrm{S}{\mathrm{O}}_4^{2-} \) " and " \( \mathrm{N}{\mathrm{O}}_3^{-} \) ", respectively. The original article was corrected.
Fouling mitigation and cleanability of TiO 2 photocatalyst-modified PVDF membranes during ultrafiltration of model oily wastewater with different salt contents
Abstract
In the present study, TiO2-coated ultrafiltration membranes were prepared and used for oily water filtration (droplet size < 2 μm). The aim of this work was to investigate the effect of different salt contents on fouling and filtration properties of neat and TiO2-coated membranes during oil-in-water emulsion filtration. The effect of the TiO2 coating on the flux, surface free energy, and retention values was measured and compared with the neat membrane values. The cleanability of the fouled TiO2-coated membranes by UV irradiation was also investigated by measuring flux recovery and contact angles, and the chemical changes during cleaning were characterized by ATR-IR. It was found that increasing the salt content of the model wastewaters, oil-in-water emulsions, increased the zeta potential and the size of the droplets. The presence of the TiO2 coating decreases the membrane fouling during oily emulsion filtration compared to the neat membrane, due to the hydrophilicity of the coating regardless of the salt content of the emulsions. The neat and coated membrane oil retention was similar, 96 ± 2%. The coated membrane can be effectively cleaned with UV irradiation without additional chemicals and a significant flux recovery can be achieved. Monitoring of the cleaning process by following the membrane surface wettability and ATR-IR measurements showed that the recovery of flux does not mean the total elimination of the oil layer from the membrane surface.
Tinea faciei in a central Portuguese hospital: A 9-year survey
Summary
Tinea faciei is a relatively uncommon dermatophytosis that affects the glabrous skin of the face. The aim of this study was to analyse the epidemiologic, clinical and mycological features of tinea faciei cases diagnosed at the Dermatology and Venereology Department of Hospital Santo António dos Capuchos (Lisbon, Portugal). Consecutive cases diagnosed between 2008 and 2016 were studied retrospectively. A total of 72 tinea faciei cases have been diagnosed, involving 37 male and 35 female, aged between 8 months and 86 years. The majority were observed in patients younger than 12 years of age (59.72%). Anthropophilic isolates (mainly Microsporum audouinii, Trichophyton soudanense and Trichophyton rubrum) accounted for 75.7% of the identified dermatophytes. One quarter of the patients were also affected by dermatophytosis in other areas, such as the scalp. Only 10 cases were previously treated with topical steroids due to misdiagnosis. Most patients were treated with topical and systemic antifungal therapy with total resolution of skin lesions, without relapse or side effects. In contrast to other European studies, anthropophilic dermatophytes were the main causative agents of tinea faciei. As previously described to tinea capitis, this result is probably due to changes in the epidemiology of dermatophytes worldwide.
Association of the CYP17 MSP AI (T-34C) and CYP19 codon 39 (Trp/Arg) polymorphisms with susceptibility to acne vulgaris
Summary
The aim of this study was to detect the association of the cytochrome P450 (CYP) 17 T-34C and CYP19 T<C polymorphisms with the risk of acne vulgaris (AV). The study enrolled 198 patients with AV (mild, moderate and severe) and 195 unrelated age-matched healthy controls from western Iran who had Kurdish ethnic background. The presence of the CYP17 TC genotype significantly increased the risk of mild, moderate and severe AV by 2.68, 2.28 and 2.94 times, respectively, while the presence of the CYP19 TC genotype significantly elevated the risk of overall AV and mild AV by 2.1 and 3.2 times, respectively. There was a synergy between the CYP 17 TC and CYP19 TT genotypes, which increased the risk of AV by 2.45-fold (P < 0.001). To our knowledge, this is the first study showing that the CYP17 T-34C and CYP19 T<C variants and their synergy are associated with susceptibility to AV in an Iranian population.
Association but not Recognition: an Alternative Model for Differential Imitation from 0 to 2 Months
Abstract
Skepticism toward the existence of neonatal differential imitation is fostered by views that assign it an excessive significance, making it foundational for social cognition. Moreover, a misleading theoretical framework may generate unwarranted expectations about the kinds of findings experimentalists are supposed to look for. Hence we propose a theoretical analysis that may help experimentalists address the empirical question of whether early differential imitation really exists. We distinguish three models of early imitation. The first posits automatic visuo-motor links evolved for sociocognitive functions and we call it Genetically Programmed Direct Matching (GPDM). The second is Meltzoff and Moore's Active Intermodal Matching (AIM), which postulates a comparison between the acts of self and other. The third is the alternative we propose and we call it "Association by Similarity Theory" (AST), as it relies on the tacit functioning of this domain-general process. AST describes early imitation merely as the differential induction or elicitation of behaviors that already tend to occur spontaneously. We focus on the contrast between AIM and AST, and argue that AST is preferable to AIM for two reasons. First, AST is more parsimonious and more plausible, especially because it does not require infants to be able to recognize self-other similarities. Second, whereas the extant findings tend to disqualify AIM, AST can account for them adequately. Furthermore, we suggest that AST has the potential to give new impulse to empirical research because it discriminates promising lines of inquiry from unproductive ones.
Evaluation of topical liposome incorporated clove oil in the treatment of idiopathic palmar hyperhidrosis: Single-blinded placebo-controlled study
Summary
Introduction
Palmar hyperhidrosis is of great concern to patients because of its physical, occupational, and psychological impact on quality of life. Topical clove oil has been used in many conditions due to its major component Eugenol that exerts blocking effect on nerve transmission.
Aim of the work
To assess the efficacy of topical liposome incorporated clove oil in decreasing the rate of sweating among patients with idiopathic palmar hyperhidrosis.
Patients and method
Forty patients with palmar hyperhidrosis were treated with clove oil 45% in liposome and another twenty patients were treated as a control group with 0.9% saline solution and evaluation was carried out before and after treatment through gravimetry testing and hyperhidrosis disease severity scale (HDSS).
Result
The gravimetry testing among clove oil-treated group showed that the mean sweating rate before treatment was 80.5 ± 41.85 (SD) mg/min which decreased significantly after treatment to 52.98 ± 37.94(SD) mg/min (P value < .001). On the other hand, the placebo-treated group,(control) the mean sweating rate before treatment was 77.40 ± 29.29(SD) which did not show significant improvement after placebo application 77.35 ± 28.29(SD; P value = .957).
Conclusion
The topical application of 45% clove oil in liposome twice daily for 2 weeks showing promising result evidenced by declining in the rate of palmar sweating among patients with idiopathic palmar hyperhidrosis.
Tattoos: Evaluation of knowledge about health complications and their prevention among students of Tricity universities
Summary
Introduction
Tattooing is a very popular form of body modification among young people. However, this kind of procedure entails the risk of various health complications. The objective of the study was to evaluate the students' knowledge about contraindications, complications, and health risks that skin tattooing may cause. Additionally, the purpose of the study was to assess how the profile of education (medical vs nonmedical) impacts on the knowledge of the respondents.
Methods
We surveyed a group of 1199 people, of which 326 (27%) had tattoos. The base of the study is an anonymously filled, author's online survey consisting of 25 questions.
Results
Eighty six percent of the students from the Medical University of Gdańsk indicated the risk of HCV virus infection during tattooing, while only 34% of students from other Tricity universities were aware of this danger. Sixty seven percent of people with tattoos felt that having them does not affect any diagnostic and therapeutic procedures. Most of respondents mentioned the tattoo artist (79%) and the Internet (73%) as a source of information before having a tattoo, while only 5% and 8% respondents asked a doctor or read medical literature about it. Fourty nine percent of respondents reported that before the procedure, tattooist failed to ask them about their health condition and medications.
Conclusions
Knowledge of students about safety, contraindications, and complications associated with the performance of tattooing is insufficient. As a result, a need for a better education on the topic for both people who are getting tattoos and tattooists appears evident.
MR Imaging Criteria for the Detection of Nasopharyngeal Carcinoma: Discrimination of Early-Stage Primary Tumors from Benign Hyperplasia [HEAD & NECK]
BACKGROUND AND PURPOSE:
MR imaging can detect nasopharyngeal carcinoma that is hidden from endoscopic view, but for accurate detection carcinoma confined within the nasopharynx (stage T1) must be distinguished from benign hyperplasia of the nasopharynx. This study aimed to document the MR imaging features of stage T1 nasopharyngeal carcinoma and to attempt to identify features distinguishing it from benign hyperplasia.
MATERIALS AND METHODS:MR images of 189 patients with nasopharyngeal carcinoma confined to the nasopharynx and those of 144 patients with benign hyperplasia were reviewed and compared in this retrospective study. The center, volume, size asymmetry (maximum percentage difference in area between the right and left nasopharyngeal halves), signal intensity asymmetry, deep mucosal white line (greater contrast enhancement along the deep tumor margin), and absence/distortion of the adenoidal septa were evaluated. Differences were assessed with logistic regression and the 2 test.
RESULTS:The nasopharyngeal carcinoma center was lateral, central, or diffuse in 134/189 (70.9%), 25/189 (13.2%), and 30/189 (15.9%) cases, respectively. Nasopharyngeal carcinomas involving the walls showed that a deep mucosal white line was present in 180/183 (98.4%), with a focal loss of this line in 153/180 (85%) cases. Adenoidal septa were absent or distorted in 111/111 (100%) nasopharyngeal carcinomas involving the adenoid. Compared with benign hyperplasia, nasopharyngeal carcinoma had a significantly greater volume, size asymmetry, signal asymmetry, focal loss of the deep mucosal white line, and absence/distortion of the adenoidal septa (P < .001). Although size asymmetry was the most accurate criterion (89.5%) for nasopharyngeal carcinoma detection, use of this parameter alone would have missed 11.9% of early-stage T1 nasopharyngeal carcinomas.
CONCLUSIONS:MR imaging features can help distinguish stage T1 nasopharyngeal carcinoma from benign hyperplasia in most cases.
Clinical and Radiologic Characteristics of Deep Lumbosacral Dural Arteriovenous Fistulas [SPINE]
BACKGROUND AND PURPOSE:
Spinal dural arteriovenous fistulas located in the deep lumbosacral region are rare and the most difficult to diagnose among spinal dural arteriovenous fistulas located elsewhere in the spinal dura. Specific clinical and radiologic features of these fistulas are still inadequately reported and are the subject of this study.
MATERIALS AND METHODS:We retrospectively evaluated all data of patients with spinal dural arteriovenous fistulas treated and/or diagnosed in our institution between 1990 and 2017. Twenty patients with deep lumbosacral spinal dural arteriovenous fistulas were included in this study.
RESULTS:The most common neurologic findings at the time of admission were paraparesis (85%), sphincter dysfunction (70%), and sensory disturbances (20%). Medullary T2 hyperintensity and contrast enhancement were present in most cases. The filum vein and/or lumbar veins were dilated in 19/20 (95%) patients. Time-resolved contrast-enhanced dynamic MRA indicated a spinal dural arteriovenous fistula at or below the L5 vertebral level in 7/8 (88%) patients who received time-resolved contrast-enhanced dynamic MRA before DSA. A bilateral arterial supply of the fistula was detected via DSA in 5 (25%) patients.
CONCLUSIONS:Clinical symptoms caused by deep lumbosacral spinal dural arteriovenous fistulas are comparable with those of spinal dural arteriovenous fistulas at other locations. Medullary congestion in association with an enlargement of the filum vein or other lumbar radicular veins is a characteristic finding in these patients. Spinal time-resolved contrast-enhanced dynamic MRA facilitates the detection of the drainage vein and helps to localize deep lumbosacral-located fistulas with a high sensitivity before DSA. Definite detection of these fistulas remains challenging and requires sufficient visualization of the fistula-supplying arteries and draining veins by conventional spinal angiography.
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Publication date: Available online 25 July 2018 Source: Journal of Photochemistry and Photobiology B: Biology Author(s): Marco Ballestr...
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Editorial AJR Reviewers: Heartfelt Thanks From the Editors and Staff Thomas H. Berquist 1 Share + Affiliation: Citation: American Journal...
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Publication date: Available online 28 September 2017 Source: Actas Dermo-Sifiliográficas Author(s): F.J. Navarro-Triviño
