3D–2D registration in endovascular image-guided surgery: evaluation of state-of-the-art methods on cerebral angiograms

Abstract

Purpose

Image guidance for minimally invasive surgery is based on spatial co-registration and fusion of 3D pre-interventional images and treatment plans with the 2D live intra-interventional images. The spatial co-registration or 3D–2D registration is the key enabling technology; however, the performance of state-of-the-art automated methods is rather unclear as they have not been assessed under the same test conditions. Herein we perform a quantitative and comparative evaluation of ten state-of-the-art methods for 3D–2D registration on a public dataset of clinical angiograms.

Methods

Image database consisted of 3D and 2D angiograms of 25 patients undergoing treatment for cerebral aneurysms or arteriovenous malformations. On each of the datasets, highly accurate "gold-standard" registrations of 3D and 2D images were established based on patient-attached fiducial markers. The database was used to rigorously evaluate ten state-of-the-art 3D–2D registration methods, namely two intensity-, two gradient-, three feature-based and three hybrid methods, both for registration of 3D pre-interventional image to monoplane or biplane 2D images.

Results

Intensity-based methods were most accurate in all tests (0.3 mm). One of the hybrid methods was most robust with 98.75% of successful registrations (SR) and capture range of 18 mm for registrations of 3D to biplane 2D angiograms. In general, registration accuracy was similar whether registration of 3D image was performed onto mono- or biplanar 2D images; however, the SR was substantially lower in case of 3D to monoplane 2D registration. Two feature-based and two hybrid methods had clinically feasible execution times in the order of a second.

Conclusions

Performance of methods seems to fall below expectations in terms of robustness in case of registration of 3D to monoplane 2D images, while translation into clinical image guidance systems seems readily feasible for methods that perform registration of the 3D pre-interventional image onto biplanar intra-interventional 2D images.

Mesenchymal stromal cells modulate gut inflammation in experimental colitis

Abstract

Inflammatory bowel diseases (IBDs) affect millions of people worldwide and their frequencies in developed countries have increased since the twentieth century. In this context, there is an intensive search for therapies that modulate inflammation and provide tissue regeneration in IBDs. Recently, the immunomodulatory activity of adipose tissue-derived mesenchymal stromal cells (ADMSCs) has been demonstrated to play an important role on several immune cells in different conditions of inflammatory and autoimmune diseases. In this study, we explored the immunomodulatory potential of ADMSC in a classical model of DSS-induced colitis. First, we found that treatment of mice with ADMSC ameliorated the severity of DSS-induced colitis, reducing colitis pathological score and preventing colon shortening. Moreover, a prominent reduction of pro-inflammatory cytokines levels (i.e., IFN-γ, TNF-α, IL-6 and MCP-1) was observed in the colon of animals treated with ADMSC. We also observed a significant reduction in the frequencies of macrophages (F4/80⁺CD11b⁺) and dendritic cells (CD11c⁺CD103⁺) in the intestinal lamina propria of ADMSC-treated mice. Finally, we detected the up-regulation of immunoregulatory-associated molecules in intestine of mice treated with ADMSCs (i.e., elevated arginase-1 and IL-10). Thus, this present study demonstrated that ADMSC modulates the overall gut inflammation (cell activation and recruitment) in experimental colitis, providing support to the further development of new strategies in the treatment of intestinal diseases.

Targeting of circulating Th17 cells by β-D-mannuronic acid (M2000) as a novel medication in patients with rheumatoid arthritis

Abstract

Objective

This study aimed at investigating the inhibitory effect of β-D-mannuronic acid (M2000) on the Th17 circulating levels and IL-17 a related cytokine in rheumatoid arthritis (RA) patients.

Methods

The study included 27 patients with RA who had failed response to treatment. All patients were treated orally by M2000 at a dose of 500 mg twice daily for 12 weeks (Clinical trial identifier: IRCT2014011213739N2). The patients based on anti-tumor necrosis factor alpha (TNFα) blocker treatment were classified into two groups (conventional group and etanercept group). They were then allowed to continue their treatment excluding non-steroidal anti-inflammatory drugs (NSAIDs). The frequency of circulating Th17 cells and IL-17 serum level were determined before and 12 weeks after M2000 therapy and were compared to the healthy controls by using flow cytometry analysis and ELISA method, respectively.

Results

At baseline, higher circulating Th17 and IL-17 serum levels were significantly observed in both groups of RA patients than in the healthy controls (all P < 0.001). The frequency of Th17 cells significantly decreased in the conventional group as well as in the etanercept group after M2000 therapy but the level of reduction was higher in the conventional group compared to the etanercept group (P < 0.03 and P < 0.04, respectively). The IL-17 serum level significantly decreased in both groups after M2000 therapy (P < 0.01 and P < 0.02, respectively). Furthermore, the frequency of Th17 cells was positively correlated with Disease Activity Score (DAS28) (r = 0.34, P = 0.02).

Conclusion

M2000 shows the inhibitory effect on the frequency of circulating Th17 cells as well as in the production of IL-17 in RA patients.

Attenuation of nociceptive pain and inflammatory disorders by total steroid and terpenoid fraction of Euphorbia tirucalli Linn root in experimental in vitro and in vivo model

Abstract

The plant Euphorbia tirucalli Linn has been successfully used as a tribal folk medicine in India and Africa for the management of acute inflammatory, arthritic, nociceptive pain and asthmatic symptoms. The present study was conducted to assess the anti-inflammatory, analgesic, anti-asthmatic and anti-arthritic role of the total steroid and terpenoid rich fractions of the hydro-alcoholic extract of E. tirucalli root (STF-HAETR). STF-HAETR fraction demonstrated 71.25 ± 2.5 and 74.25 ± 5.1% protection against acetic acid-induced pain and central neuropathic pain at 75 and 100 mg/kg doses, respectively. It showed 96.97% protection against acute inflammation at 100 mg/kg with 1.6-fold better activity than the standard drug. The fraction exhibited such efficacy via inhibition of proinflammatory cytokines TNF-α, IFN-γ, by 61.12 and 65.18%, respectively, at 100 μg/mL. Inhibition of cyclooxygenase and Nitric oxide synthase in a dose-dependent manner affirms its analgesic and anti-inflammatory activity. The spectrophotometric analysis reveals that STF-HAETR induces ameliorative effect against heat-induced denaturation of Bovine serum albumin (BSA) and exhibits significant anti-proteinase activity. The plant fraction also demonstrated anti-asthmatic activity by displaying 62.45% protection against histamine induced bronchoconstriction or dyspnoea. Our findings suggest that STF-HAETR could be an effective safe therapeutic agent to treat nociceptive pain, acute inflammation, asthma, and arthritis which may authenticate its traditional use.

Erratum to: Parthood and naturalness

Lactic acid alleviates stress: good for female genital tract homeostasis, bad for protection against malignancy

Abstract

Women are unique from all other mammals in that lactic acid is present at high levels in the vagina during their reproductive years. This dominance may have evolved in response to the unique human lifestyle and a need to optimally protect pregnant women and their fetuses from endogenous and exogenous insults. Lactic acid in the female genital tract inactivates potentially pathogenic bacteria and viruses, maximizes survival of vaginal epithelial cells, and inhibits inflammation that may be damaging to the developing fetus and maintenance of the pregnancy. In an analogous manner, lactic acid production facilitates survival of malignantly transformed cells, inhibits activation of immune cells, and prevents the release of pro-inflammatory mediators in response to tumor-specific antigens. Thus, the same stress-reducing properties of lactic acid that promote lower genital tract health facilitate malignant transformation and progression.

Pre-emptive Diclofenac Versus Ketoprofen as a Transdermal Drug Delivery System: How They Face

Abstract

Aim

To compare the analgesic efficacy of Diclofenac vis-a-vis Ketoprofen transdermal patch, in the management of immediate post-operative pain following orthognathic procedures.

Material and Method

A prospective, double-blinded, randomised controlled study was conducted among 50 subjects, between 2012 and 2015. These patients were diagnosed clinically and cephalometrically as skeletal and dental class II malocclusion and underwent bi-jaw surgical procedure. In total, 25 Diclofenac and 25 Ketoprofen transdermal patches, sealed in envelopes and numbered, were administered to subjects. The patches used, contained 100 mg of either Diclofenac or Ketoprofen and administered by a nurse prior to induction. Duration of analgesia, severity of pain using Visual Analog Scale, necessity of rescue analgesia (spontaneous pain > 5 on a 10-cm scale) and any other adverse effect associated with the drug were evaluated.

Results

Mean duration of analgesia was significantly higher in the Ketoprofen group (20 h), compared to Diclofenac group (13 h) (p = 0.001). Rescue analgesia was required in 12% of subjects who received Diclofenac patch, compared to 4% in Ketoprofen group. None of the subjects showed any allergic reactions.

Conclusion

The study was designed to evaluate the efficacy of transdermal patch in reduction of post-operative pain in subjects undergoing bi-jaw surgeries. Subjects in both groups were comfortable and returned to early function. However, Ketoprofen transdermal patch had an edge over the Diclofenac transdermal patch with respect to analgesic efficacy.

Biofilm formation is determinant in tomato rhizosphere colonization by Bacillus velezensis FZB42

Abstract

In this work, the behavior in tomato rhizosphere of Bacillus velezensis FZB42 was analyzed taking into account the surfactin production, the use of tomato roots exudate as substrates, and the biofilm formation. B. velezensis FZB42 and B. amyloliquefaciens S499 have a similar capability to colonize tomato rhizosphere. Little difference in this colonization was observed with surfactin non producing B. velezensis FZB42 mutant strains. B. velezensis is able to grow in the presence of root exudate and used preferentially sucrose, maltose, glutamic, and malic acids as carbon sources. A mutant enable to produce exopolysaccharide (EPS^-) was constructed to demonstrate the main importance of biofilm formation on rhizosphere colonization. This mutant had completely lost its ability to form biofilm whatever the substrate present in the culture medium and was unable to efficiently colonize tomato rhizosphere.

Combined effects of binary antibiotic mixture on growth, microcystin production, and extracellular release of Microcystis aeruginosa : application of response surface methodology

Abstract

The interactive effects of binary antibiotic mixtures of spiramycin (SP) and ampicillin (AMP) on Microcystis aeruginosa (MA) in terms of growth as well as microcystin production and extracellular release were investigated through the response surface methodology (RSM). SP with higher 50 and 5% effective concentrations in MA growth was more toxic to MA than AMP. RSM model for toxic unit approach suggested that the combined toxicity of SP and AMP varied from synergism to antagonism with SP/AMP mixture ratio decreasing from reversed equitoxic ratio (5:1) to equitoxic ratio (1:5). Deviations from the prediction of concentration addition (CA) and independent action (IA) model further indicated that combined toxicity of target antibiotics mixed in equivalent ratio (1:1) varied from synergism to antagonism with increasing total dose of SP and AMP. With the increase of SP/AMP mixture ratio, combined effect of mixed antibiotics on MA growth changed from stimulation to inhibition due to the variation of the combined toxicity and the increasing proportion of higher toxic component (SP) in the mixture. The mixture of target antibiotics at their environmentally relevant concentrations with increased total dose and SP/AMP mixture ratio stimulated intracellular microcystin synthesis and facilitated MA cell lysis, thus leading to the increase of microcystin productivity and extracellular release.

Isolation and characterization of culturable bacteria present in the spent nuclear fuel pool water

Abstract

A spent nuclear fuel (SNF) pool is a key facility for safe management of nuclear waste, where spent nuclear fuel rods are stored in a water pool. The spent fuel rods carry a significant amount of radioactivity; they are either recycled or stored for further processing. Pool water acts as a heat sink as well as a shield against the radiation present in spent/burned fuel rods. The water used in these pools is filtered by an ultra-filtration process which makes certain the purity of water. As the life span of these pools is approximately 20 to 40 years, the maintenance of pure water is a big challenge. A number of researchers have shown the presence of bacterial communities in this ultrapure water. The bacterial types present in SNF pool water is of increasing interest for their potential bioremediation applications for radioactive waste. The present study showed the isolation of six bacterial species in the SNF pool water samples, which had significant radio-tolerance (D₁₀ value 248 Gy to 2 kGy) and also biofilm-forming capabilities. These strains were also investigated for their heavy metal removal capacity. Maximum biofilm-mediated heavy metal (Co and Ni) removal (up to 3.8 μg/mg of biomass) was observed by three isolates (FPB1, FPB4, and FPB6). The ability of these bacterial isolates to survive in radioactive environments can be of great interest for remediation of radioactive contaminants.

Prokaryotic community profiling of local algae wastewaters using advanced 16S rRNA gene sequencing

Abstract

Algae biomass-fed wastewaters are a promising source of lipid and bioenergy manufacture, revealing substantial end-product investment returns. However, wastewaters would contain lytic pathogens carrying drug resistance detrimental to algae yield and environmental safety. This study was conducted to simultaneously decipher through high-throughput advanced Illumina 16S ribosomal RNA (rRNA) gene sequencing, the cultivable and uncultivable bacterial community profile found in a single sample that was directly recovered from the local wastewater systems. Samples were collected from two previously documented sources including anaerobically digested (AD) municipal wastewater and swine wastewater with algae namely Chlorella spp. in addition to control samples, swine wastewater, and municipal wastewater without algae. Results indicated the presence of a significant level of Bacteria in all samples with an average of approximately 95.49% followed by Archaea 2.34%, in local wastewaters designed for algae cultivation. Taxonomic genus identification indicated the presence of Calothrix, Pseudomonas, and Clostridium as the most prevalent strains in both local municipal and swine wastewater samples containing algae with an average of 17.37, 12.19, and 7.84%, respectively. Interestingly, swine wastewater without algae displayed the lowest level of Pseudomonas strains < 0.1%. The abundance of some Pseudomonas species in wastewaters containing algae indicates potential coexistence between these strains and algae microenvironment, suggesting further investigations. This finding was particularly relevant for the earlier documented adverse effects of some nosocomial Pseudomonas strains on algae growth and their multidrug resistance potential, requiring the development of targeted bioremediation with regard to the beneficial flora.

Macroinvertebrate communities in riverine systems of buffer areas of protected wildland, rangeland and city areas: implications for conservation of riverine systems on urbanising watersheds

Abstract

Riverine systems in developing countries continue to be degraded by anthropogenic pressures such as urbanisation. The responses of biota in watersheds surrounding a drainage divide may provide critical information that is required to protect the ecological condition of riverine systems. This study assessed the spatial variation of selected environmental variables together with macroinvertebrate communities in upper reaches of riverine systems across different land use categories of the Bulawayo region. Based on an a priori selection criterion, studied sites were grouped following an urban-wastewater disturbance gradient comprising of (i) heavily polluted city sites, (ii) moderately disturbed rangeland sites and (iii) less disturbed sites of the buffer areas of protected wildland. Most of the studied environmental variables and the macroinvertebrate community assemblages were significantly (ANOVA, p < 0.05) different and degraded within the city areas. In this study, the variance of environmental variables known to be associated with organic pollution like increased nutrients, embeddedness by particulates, salinity, COD, conductivity, turbidity and reduced dissolved oxygen was found to be related with the variation of macroinvertebrate communities across the studied sites. Besides affirming the effectiveness of macroinvertebrate-based bioassessment approaches, the results of our study demonstrate that an aggressive riverine protection policy that prohibits the discharge of poor-quality urban effluents and preservation of the less disturbed riverine systems needs to be part of the larger urban planning and regulatory framework in urbanising watersheds.

Relay cropping of wheat ( Triticum aestivum L.) in cotton ( Gossypium hirsutum L.) improves the profitability of cotton-wheat cropping system in Punjab, Pakistan

Abstract

Delayed sowing of wheat (Triticum aestivum L.) in cotton-based system reduces the productivity and profitability of the cotton-wheat cropping system. In this scenario, relay cropping of wheat in standing cotton might be a viable option to ensure the timely wheat sowing with simultaneous improvement in wheat yields and system profitability. This 2-year study (2012–2013 and 2013–2014) aimed to evaluate the influence of sowing dates and relay cropping combined with different management techniques of cotton sticks on the wheat yield, soil physical properties, and the profitability of the cotton-wheat system. The experiment consisted of five treatments viz. (S1) sowing of wheat at the 7th of November by conventional tillage (two disc harrows + one rotavator + two plankings) after the removal of cotton sticks, (S2) sowing of wheat at the 7th of November by conventional tillage (two disc harrows + two plankings) after the incorporation of cotton sticks in the field with a rotavator, (S3) sowing of wheat at the 7th of November as relay crop in standing cotton with broadcast method, (S4) sowing of wheat at the 15th of December by conventional tillage (two disc harrows + one rotavator + two plankings) after the removal of cotton sticks, and (S5) sowing of wheat at the 15th of December by conventional tillage (two disc harrows + two plankings) after the incorporation of cotton sticks in the field with a rotavator. The highest seed cotton yield was observed in the S5 treatment which was statistically similar with the S3 and S4 treatments; seed cotton yield in the S1 and S2 treatments has been the lowest in both years of experimentation. However, the S2 treatment produced substantially higher root length, biological yield, and grain yield of wheat than the other treatments. The lower soil bulk density at 0–10-cm depth was recorded in the S2 treatment which was statistically similar with the S5 treatment during both years of experimentation. The volumetric water contents, net benefit, and benefit-cost ratio were the highest in the S3 treatment during both years of experimentation. Thus, relay cropping of wheat in standing cotton might be a viable option to improve the soil physical environment and profitability of the cotton-wheat cropping system.

Assessing watercourse quality: challenges in implementing European and Swiss legal frameworks

Abstract

Hydro-climatic changes and the increasing release of pollutants into rivers by human activities tend to affect the quality of watercourses, to alter aquatic ecosystems and to reduce the amount of useable water. The ecological and chemical states of rivers and their evolution is thus of growing concern. In Europe and Switzerland, water policies are progressively shifting towards a holistic approach of river systems. The European Commission notably established a framework to highlight rivers' ecological deficits and to enhance regional or local water management plans. In Switzerland, a similar framework is currently under development. In this paper, both procedures are compared and implemented in a Swiss catchment dominated by agricultural activities. The aim is to define the challenges that still need to be addressed to assess and sustain river health. The hydromorphological, ecological, and ecotoxicological quality of the river was evaluated. Both frameworks highlighted the fact that no section of the river can currently be classified as being in a good environmental state and that the state deteriorates as tributaries and wastewater discharge flow into the main riverbed. Chemical issues and water quality changes due to hydro-climatic variations and management strategies were also pinpointed. Both frameworks are thus useful tools to survey changes in rivers quality in space and over time. However, challenges remain regarding the appropriate strategies to monitor and analyze chemicals, the definition of target values and conditions, the evaluation and integration of human-induced pressures, and the overall evaluation of the state of a river. The development of integrated indicators or of ecosystem services approaches is considered as a potential solution to explore river health and to define efficient restoration measures by water managers.

Effect of zero-valent iron and trivalent iron on UASB rapid start-up

Abstract

In order to realize the rapid start-up of upflow anaerobic sludge blanket (UASB) reactor, the iron ion in different valence state was added to UASB. The results indicated that the start-up time of R3 (FeCl₃) was 48 h faster than that of R2 (zero-valent iron (ZVI)). It was because the FeCl₃ could rapidly promote granulation of sludge as a flocculant. However, ZVI released Fe²⁺ through corrosion slowly, and then the Fe²⁺ increased start-up speed by enhancing enzyme activity and enriching methanogens. In addition, the ZVI and FeCl₃ could promote hydrolysis acidification and strengthen the decomposition of long-chain fatty acids. The detection of iron ions showed that iron ions mainly existed in the sludge. Because the high concentration of Fe²⁺ could inhibit anaerobic bacteria activity, excess Fe³⁺ could be changed into iron hydroxide precipitation to hinder the mass transfer process of anaerobic bacteria under the alkaline condition. The FeCl₃ was suitable to be added at the initial stage of UASB start-up, and the ZVI was more fitted to be used in the middle stage of reactor start-up to improve the redox ability.

210 Po and 210 Pb bioaccumulation and possible related dose assessment in parasol mushroom ( Macrolepiota procera )

Abstract

Presented are results of a study on accumulation and distribution of ²¹⁰Po and ²¹⁰Pb in the fruitbodies of parasol mushroom (Macrolepiota procera) and risk to human consumer due to exposure from highly radiotoxic decay particles emitted by both radionuclides. Mushrooms were collected from 16 forested places in central and northern regions of Poland. Activity concentrations of ²¹⁰Po and ²¹⁰Pb were determined after radiochemical separation of nuclides and subsequent measurement using validated method and alpha spectrometer. Results showed on spatially heterogeneous distribution of the ²¹⁰Po and ²¹⁰Po activity concentrations in M. procera and two interpolation maps were prepared. Activity concentrations of nuclides in dried caps of M. procera were in the range from 3.38 ± 0.41 to 16.70 ± 0.33 Bq∙²¹⁰Po ∙kg⁻¹ and from 5.11 ± 0.21 to 13.42 ± 0.30 Bq∙²¹⁰Pb ∙kg⁻¹. Consumption of M. procera foraged in central and northern Poland should not contribute significantly to the annual effective radiation doses from ²¹⁰Po and ²¹⁰Pb due to amount of both nuclides accumulated by fungus in caps.

Photocatalytic degradation of organic pollutant aldicarb by non-metal-doped nanotitania: synthesis and characterization

Abstract

The current study focused on pollution control by titania through photocatalytic degradation of aldicarb pesticide in aqueous medium. Titania, which is an efficient photocatalyst, can bring about degradation of aqueous organic pollutants under UV and visible light irradiation. Here, we prepared titania by sol-gel method from titanium tetraisopropoxide and doped non-metals like N and S from sources such as urea and thiourea, respectively. The prepared catalyst was characterized by XRD, UV-Vis.DRS, TEM, XPS, etc. Photocatalytic activity of the catalyst was evaluated from extend of degradation of aldicarb pesticide by measuring its concentration with the help of HPLC. It was found that the modified catalyst showed better photocatalytic degradation than pure titania in visible light.

Multivariate curve resolution of organic pollution patterns in mangrove forest sediment from Qeshm Island and Khamir Port—Persian Gulf, Iran

Abstract

Straight-chain alkanes (n-alkanes) have been proposed as biomarkers to assess petroleum pollution sources in marine environments. In this work, three sampling sites were selected along Iranian-protected mangrove forests in the Persian Gulf. Sample sites were chosen to represent different compositions and sources of n-alkanes in surface sediments (0–5 cm) from different locations in the Khamir Port, in the middle part of the Gulf, and in the Qeshm Island. Samples were analyzed by gas chromatography-mass spectrometry (GC–MS), and the obtained n-alkanes concentrations were analyzed by principal component analysis (PCA) and multivariate curve resolution alternating least squares (MCR-ALS) to deduce their possible sources and distribution patterns. Results revealed that n-alkanes have a dominant biogenic source in marginal Qeshm Island stations, which changed from biogenic to petrogenic sources in the Khamir Port areas. Sediment samples from the Khamir Port showed the significant presence of oil pollution due to transportation. These samples are being exposed to basic Persian Gulf currents entering from the Hormuz Strait causing oil pollution spread over the entire Gulf area. Sediment samples of the Middle Part stations located between two other sites show a combined condition of the two previous sections, with petrogenic and biogenic contributions. The present study demonstrates that the Hara Protected Area was already contaminated by background oil pollution as a result of continuous oil spills and war conflicts in the Persian Gulf.

Additionally, the MCR-ALS method is shown to be a powerful chemometric tool for the investigation, resolution, identification, and description of pollution patterns distributed over a particular geographical area and environmental compartment. They can be used as well as parameters like unresolved to resolved ratio (U/R), pristane to phytane (Pr/Ph), n-C₁₇/Pr, n-C₁₈/Ph, and unresolved complex mixture (UCM) to assess petroleum pollution sources in the sediments.

Corn industrial wastewater (nejayote): a promising substrate in Mexico for methane production in a coupled system (APCR-UASB)

Abstract

In Mexico, the corn tortilla is a food of great economic importance. Corn tortilla production generates about 1500–2000 m³ of wastewater per 600 tons of processed corn. Although this wastewater (also known as nejayote) has a high organic matter content, few studies in Mexico have analyzed its treatment. This study presents fresh data on the potential methane production capacity of nejayote in a two-phase anaerobic digestion system using an Anaerobic-Packed Column Reactor (APCR) to optimize the acidogenic phase and an up-flow anaerobic sludge blanket (UASB) reactor to enhance the methanogenic process. Results indicate that day 8 was ideal to couple the APCR to the UASB reactor. This allowed for a 19-day treatment that yielded 96% COD removal and generated a biogas containing 84% methane. The methane yield was 282 L kg⁻¹ of COD_removed. Thus, two-phase anaerobic digestion is an efficient process to treat nejayote; furthermore, this study demonstrated the possibility of using an industrial application by coupling the APCR to the UASB reactor system, in order to assess its feasibility for biomethane generation as a sustainable bioenergy source.

Occurrence of multi-class surfactants in urban wastewater: contribution of a healthcare facility to the pollution transported into the sewerage system

Abstract

Healthcare facility discharges, by their nature, are often considered as non-domestic effluent, which can provide significant pollution comparatively to other domestic sources. In this context, a total of 12 monthly sampling campaigns were collected from a healthcare facility as well as the output of a sewerage system of Site Pilote de Bellecombe (SIPIBEL) observatory. This study focuses more specifically on 12 surfactants and biocides: four anionics, four cationic, two non-ionic, one zwitterionic, and one dispersive agent, among the most commonly used commercial surfactants. Particular attention was also provided to routine wastewater quality parameters. Both effluents were heavily contaminated by most anionic surfactants; they displayed median concentrations up to 1 to 2 mg/L for linear alkylbenzene sulfonates and between 10 and 100 μg/L for other sodium sulfate congeners (lauryl and laureth). Overall, for the majority of surfactants, the healthcare facility contribution to the total flux reaching the wastewater treatment plant ranges between 5 and 9%.

Environmental impact assessment of municipal solid waste management options using life cycle assessment: a case study

Abstract

The goal of this study is to use life cycle assessment (LCA) tool to assess possible environmental impacts of different municipal solid waste management (MSWM) scenarios on various impact categories for the study area Dhanbad City, India. The scenarios included in the present study are collection and transportation (denoted as S1); baseline scenario consisting of recycling, open burning, open dumping, and finally unsanitary landfilling without energy recovery (denoted by S2); composting and landfilling (denoted by S3); and recycling and composting followed by landfilling of inert waste without energy recovery (denoted by S4). One ton of municipal solid waste (MSW) was selected as the functional unit. The primary data were collected through sampling, surveys, and literatures. Background data were obtained from Eco-invent data of SimaPro 8.1 libraries. The scenarios were compared using the CML 2 baseline 2000 method, and the results indicated that the scenario S1 had the highest impact on marine aquatic ecotoxicity (1.86E + 04 kg 1,4-DB eq.) and abiotic depletion (2.09E + 02 kg Sb eq.). S2 had the highest impact on global warming potential (9.42E + 03 kg CO₂ eq.), acidification (1.15E + 01 kg SO₂ eq.), eutrophication (2.63E + 00 kg PO₄³⁻ eq.), photochemical oxidation (2.12E + 00 kg C₂H₄ eq.), and human toxicity (2.25E + 01 kg 1,4-DB eq.). However, S3 had the highest impact on abiotic depletion (fossil fuels) (2.71E + 02 MJ), fresh water aquatic ecotoxicity (6.54E + 00 kg 1,4-DB eq.), terrestrial ecotoxicity (3.36E − 02 kg 1,4-DB eq.), and ozone layer depletion (2.73E − 06 kg CFC-11 eq.). But S4 did not have the highest impact on any of the environmental impact categories due to recycling of packaging waste and landfilling of inert waste. Landfilling without energy recovery of mixed solid waste was found as the worst disposal alternative. The scenario S4 was found as the most environmentally suitable technology for the study area and recommended that S4 should be considered for strategic planning of MSWM for the study area.

Purification of Hg 0 from flue gas by wet oxidation method and its mechanism: a review

Abstract

The vast majority of Hg²⁺ can be removed while elemental mercury (Hg⁰) can hardly be removed due to its characteristic of high volatility and insolubility in water. Till now, how to oxidize Hg⁰ to Hg²⁺ is the key for the purification of Hg⁰, especially when there are others pollutants, such as HCl, SO₂, and NOx. In this review, the method and mechanism of Hg⁰ purification from flue gas by H₂O₂, KMnO₄, NaClO₂, and O₃ are reviewed comprehensively. It is concluded that the oxidation of Hg⁰ mainly depends on the electronic supply efficiency from the solution. The Fenton reagent, composed of H₂O₂ and metal cations, is superior to O₃ and the solution of KMnO₄ and NaClO₂. Moreover, HCl, SO₂, and NOx in the flue gas can influence the oxidation and purification mechanism of Hg⁰. It is found that HCl in flue gas had obvious auxo-action on the oxidation of mercury, and SO₂ and NOx have different effects on the oxidation of Hg⁰ with the change of compositions and concentration of pollutants in the flue gas. In general, SO₂ and NOx can slightly promote the oxidation of Hg⁰ due to the synergistic effect.

Existing forms and changes of nitrogen inside of horizontal subsurface constructed wetlands

Abstract

Horizontal zeolite subsurface constructed wetland system (HZCWs) and horizontal limestone subsurface constructed wetland system (HLCWs) were applied to the removal of nitrogen in lightly polluted wastewater, and the existing forms, changes, and removal mechanism of nitrogen in the constructed wetlands were analyzed. The results indicated that compared with HLCWs, HZCWs exhibited better nitrogen removal effect, and the maximum removal rates of ammonia nitrogen and total nitrogen could reach 96.97 ± 5.29 and 93.12 ± 3.35%, respectively. Besides, analysis of the removal effect on nitrogen in different existing forms on different substrate heights in the constructed wetlands showed that variation of nitrogen removal efficiency had certain regularities, which were related to the interior construction features of the wetland systems, and agreed with the regularities in the changes of the influential factors such as DO inside of the wetlands. In addition, degradation mechanism of pollutions was also analyzed, and the results indicated that the quantity of microorganisms and enzymes, including FDA, catalase, and urease, on the surface of the substrates had significant influence on the removal regularities and effects of the major pollutions in constructed wetlands.

Heavy metal and nutrient uptake in plants colonizing post-flotation copper tailings

Abstract

Copper ore mining and processing release hazardous post-flotation wastes that are difficult for remediation. The studied tailings were extremely rich in Cu (1800 mg kg⁻¹) and contaminated with Co and Mn, and contained very little available forms of P, Fe, and Zn. The plants growing in tailings were distinctly enriched in Cu, Cd, Co, Ni, and Pb, and the concentration of copper achived the critical toxicity level in shoots of Cerastium arvense and Polygonum aviculare. The redundancy analysis demonstrated significant relationship between the concentration of available forms of studied elements in substrate and the chemical composition of plant shoots. Results of the principal component analysis enabled to distinguish groups of plants which significantly differed in the pattern of element accumulation. The grass species Agrostis stolonifera and Calamagrostis epigejos growing in the tailings accumulated significantly lower amounts of Cu, but they also had the lowest levels of P, Fe, and Zn in comparison to dicotyledonous. A. stolonifera occurred to be the most suitable species for phytostabilization of the tailings with regard to its low shoot Cu content and more efficient acquisition of limiting nutrients in relation to C. epigejos. The amendments improving texture, phosphorus fertilization, and the introduction of native leguminous species were recommended for application in the phytoremediation process of the tailings.

The impact of foreign direct investment on CO 2 emissions in Turkey: new evidence from cointegration and bootstrap causality analysis

Abstract

Pollution haven hypothesis (PHH), which is defined as foreign direct investment inducing a raising impact on the pollution level in the hosting country, is lately a subject of discussion in the field of economics. This study, within the scope of related discussion, aims to look into the potential impact of foreign direct investments on CO₂ emission in Turkey in 1974–2013 period using environmental Kuznets curve (EKC) model. For this purpose, Maki (Econ Model 29(5):2011–2015, 2012) structural break cointegration test, Stock and Watson (Econometrica 61:783–820, 1993) dynamic ordinary least square estimator (DOLS), and Hacker and Hatemi-J (J Econ Stud 39(2):144–160, 2012) bootstrap test for causality method are used. Research results indicate the existence of a long-term balance relationship between FDI, economic growth, energy usage, and CO₂ emission. As per this relationship, in Turkey, (1) the potential impact of FDI on CO₂ emission is positive. This result shows that PHH is valid in Turkey. (2) Moreover, this is not a one-way relationship; the changes in CO₂ emission also affect FDI entries. (3) The results also provide evidence for the existence of the EKC hypothesis in Turkey. Within the frame of related findings, the study concludes several polities and presents various suggestions.

High HIV incidence and prevalence and associated factors among adolescent sexual minority males, 3 cities, 2015

Abstract

Background

Much has been written about the impact of HIV among young (13-24) sexual minority men (SMM). Evidence for concern is substantial for emerging adult (18-24) SMM. Data documenting the burden and associated risk factors of HIV among adolescent SMM (<18) remains limited.

Methods

Adolescent SMM aged 13–18 years were recruited in three cities (Chicago; New York City; Philadelphia) for interview and HIV testing. We used chi-square tests for percentages of binary variables and one-way ANOVA for means of continuous variables to assess differences by race-ethnicity in behaviors. We calculated estimated annual HIV incidence density (number of HIV infections/100 person-years [PY] at risk). We computed Fisher's exact tests to determine differences in HIV prevalence by selected characteristics.

Results

Of 415 sexually active adolescent SMM with a valid HIV test result, 25 (6%) had a positive test. Estimated annual HIV incidence density (ID) was 3.4/100PY; ID was highest for blacks, followed by Hispanics, then whites (4.1, 3.2 and 1.1/100PY). Factors associated with higher HIV prevalence included black race; ≥4 male partners, condomless anal sex, and exchange sex in the past 12 months; a recent partner that was older, black, HIV-positive, or had ever been in jail or prison (p<0.05).

Conclusions

HIV-related risk behaviors, prevalence and estimated incidence density for adolescent SMM were high, especially for minority SMM. Our findings suggest that initiating intervention efforts early may be helpful in combating these trends.

Outbreak of invasive infections from subtype emm26.3 group A Streptococcus among homeless adults—Anchorage, Alaska, 2016–2017

Abstract

Background

In 2016, we detected an outbreak of group A Streptococcus (GAS) invasive infections among the estimated 1000 persons experiencing homelessness (PEH) in Anchorage, Alaska. We characterized the outbreak and implemented a mass antibiotic intervention at homeless service facilities.

Methods

We identified cases through the Alaska GAS laboratory-based surveillance system. We conducted emm-typing, antimicrobial susceptibility testing, and whole genome sequencing (WGS) on all invasive isolates and compared medical record data of patients infected with emm26.3 and other emm types. In February 2017, we offered PEH at six facilities in Anchorage a single dose of 1 gram of azithromycin. We collected oropharyngeal and non-intact skin swabs on a subset of participants concurrent with the intervention and 4 weeks afterward.

Results

From July 2016–April 2017, we detected 42 invasive emm26.3 cases in Anchorage, 35 of which were in PEH. The emm26.3 isolates differed on average by only 2 single nucleotide polymorphisms. Compared to other emm types, infection with emm26.3 was associated with cellulitis (odds ratio [OR] 2.5, p=0.04) and necrotizing fasciitis (OR 4.4, p=0.02). We dispensed antibiotics to 391 PEH. Colonization with emm26.3 decreased from 4% of 277 at baseline to 1% of 287 at follow-up (p=0.05). Invasive GAS incidence decreased from 1.5 cases per 1000 PEH/week in the 6 weeks prior to the intervention to 0.2 cases per 1000 PEH/week in the 6 weeks after (p=0.01).

Conclusions

In an invasive GAS outbreak in PEH in Anchorage, mass antibiotic administration was temporally associated with reduced invasive disease cases and colonization prevalence.

Breast implant Q fever as a source of in hospital transmission

Abstract

Herein, we describe the first case of mammary implant infection caused by Coxiella burnetii, resulting in delayed diagnosis and treatment and an in-hospital cross transmission of Q-fever to medical personnel.

Influenza Antiviral Prescribing for Outpatients with an Acute Respiratory Illness and at High Risk for Influenza-Associated Complications during Five Influenza Seasons—United States, 2011–2016

Abstract

Background

Influenza causes millions of illnesses annually; certain groups are at higher risk for influenza-associated complications. Early antiviral treatment can reduce the risk of complications and is recommended for outpatients at increased risk. We describe antiviral prescribing among high-risk outpatients for 5 influenza seasons and explore factors that may influence prescribing.

Methods

We analyzed antiviral prescription and clinical data for high-risk outpatients aged ≥ 6 months with an acute respiratory illness (ARI) and enrolled in the US Influenza Vaccine Effectiveness Network during the 2011–2012 to 2015–2016 influenza seasons. We obtained clinical information from interviews and electronic medical records and tested all enrollees for influenza with rRT-PCR. We calculated the number of patients with ARI that must be treated to treat 1 patient with laboratory-confirmed influenza.

Results

Among high-risk outpatients with ARI who presented to care within two days of symptom onset (early), 15% (718/4861) were prescribed an antiviral medication, including 472/1292 (37%) of those with rRT-PCR-confirmed influenza. Less than half (40%) of high-risk outpatients with influenza presented to care early. Earlier presentation to care was associated with antiviral treatment (OR: 4.1, CI: 3.5–4.8), as was fever (OR: 3.2, CI: 2.7–3.8), although 25% of high-risk outpatients with influenza were afebrile. Empiric treatment of 4 high-risk outpatients with ARI was needed to treat 1 patient with laboratory-confirmed influenza.

Conclusion

Influenza antiviral medications were infrequently prescribed for high-risk outpatients with ARI who would benefit most from treatment. Efforts to increase appropriate antiviral prescribing are needed to reduce influenza-associated complications.

Improving Delivery of Early Treatment to Influenza Infected Patients

Gender, alcohol use and fibrosis in HIV-HCV co-infected individuals

Safety Evaluation of Efavirenz in Children: Don’t Forget the Central Nervous System

Detection of influenza C viruses among outpatients and patients hospitalized for severe acute respiratory infection, Minnesota, 2013-2016

Abstract

Background

Existing literature suggests that influenza C typically causes mild respiratory tract disease. However, clinical and epidemiological data are limited.

Methods

Four outpatient clinics and three hospitals submitted clinical data and respiratory specimens through a surveillance network for acute respiratory infection (ARI) during May 2013 through December 2016. Specimens were tested using multi-target nucleic acid amplification tests (NAAT) for 19-22 respiratory pathogens, including influenza C.

Results

Influenza C virus was detected among 59 of 10,202 (0.58%) hospitalized SARI cases and 11 of 2,282 (0.48%) outpatients. Most detections occurred from December to March, with 73% during the 2014-2015 season. Influenza C detections occurred among patients of all ages, with similar rates between inpatients and outpatients. The highest rate of detection occurred among children aged 6 to 24 months (1.2%). Among hospitalized cases, seven required intensive care. Medical co-morbidities were reported in 58% of hospitalized cases and all who required intensive care. At least one other respiratory pathogen was detected in 40 (66%) cases, most commonly rhinovirus/enterovirus (25%) and respiratory syncytial virus (RSV) (20%). The hemagglutinin-esterase-fusion (HEF) gene was sequenced in 37 specimens, and both C/Kanagawa and C/Sao Paulo lineages were detected in inpatients and outpatients.

Conclusions

We found seasonal circulation of influenza C with year-to-year variability. Detection was most frequent among young children, but occurred in all ages. Some cases positive for influenza C, particularly those with co-morbid conditions, had severe disease, suggesting a need for further study of the role of influenza C virus in the pathogenesis of respiratory disease.

Reply to van de Wijer et. al.

The impact of pneumococcal vaccination on bacterial and viral pneumonia in Western Australian children: record linkage cohort study of 469,589 births (1996–2012)

Abstract

Background

Pneumococcal conjugate vaccine (PCV) was included in Australia's National Immunisation Program for all children from 2005. We assessed the impact of PCV on all-cause and pathogen-specific pneumonia hospitalisations in Western Australian (WA) children aged ≤16 years.

Methods

All hospitalisations with pneumonia-related ICD-10AM diagnosis codes occurring in WA-born children (1996–2012) were linked to pathology records. Age-specific incidence rate ratios and temporal trends for all-cause and pathogen-specific pneumonia hospitalisations were calculated pre- and post-PCV introduction.

Results

469,589 births had 15,175 pneumonia-related hospitalisations. Hospitalisation rates were 6.7 (95%CI:6.4–6.9) times higher in Aboriginal than in non-Aboriginal children. Following PCV introduction, all-cause pneumonia hospitalisations showed significant declines across all age groups. A pathogen was identified in 2785 (41.6%) of 6693 pneumonia hospitalisations that linked to a pathology record. Respiratory syncytial virus (RSV) was most frequently identified with RSV-associated pneumonia hospitalisation rates of 89.6/100,000 child-years in Aboriginal and 26.6/100,000 child-years in non-Aboriginal children. The most common bacterial pathogen was Streptococcus pneumoniae in Aboriginal children (32.9/100,000) and Mycoplasma pneumoniae in non-Aboriginal children (8.4/100,000). Viral pneumonia rates declined in all children following PCV introduction, with the greatest declines seen in non-Aboriginal children; declines in bacterial pneumonia were observed in non-Aboriginal children.

Conclusions

Based on our ecological analyses, PCV seems to have had an impact on hospitalisations for pneumonia suggesting that the pneumococcus is likely to play a role in both bacterial and viral pneumonia. Respiratory viruses remain an important pathogen in childhood pneumonia. Vaccines targeting respiratory viruses are needed to combat the residual burden of childhood pneumonia.

HIVMA Pain Management Guidelines Needed to Curb Opioid Epidemic

Isolation and identification of R. raoultii in human cases: a surveillance study in three medical centers in China

Abstract

Background

Rickettsia raoultii was frequently detected in multiple tick species, while human infection remained scarcely studied.

Methods

A surveillance study was performed at 3 sentinel hospitals in China, to recruit participants with suspected tick exposure. R. raoultii infection was identified through PCR followed by sequencing and confirmed serologically. Isolation by cell culture was performed and the isolates were genome sequenced.

Results

Twenty-six subjects with R. raoultii infection was determined, including 7 with asymptomatic infection, 15 with mild to moderate illness, and 4 with severe illness. Common nonspecific manifestations in the 19 patients included fever (100%), malaise (95%), myalgia (58%), lymphadenopathy (53%), and nausea (42%). Only 5% of them had rash and 16% had eschar. Scalp eschar and neck lymphadenopathy after a tick bite syndrome was only seen in 2 patients. Of the 4 patients with severe complications, 3 developed pulmonary oedema, and 1 developed clouding of consciousness and lethargy. Frequent abnormalities of laboratory testing included leukopenia, thrombocytopenia, lymphopenia, neutropenia, hypoproteinemia, and elevated levels of total bilirubin, hepatic aminotransferases, lactate dehydrogenase, and creatine kinase. All the 19 patients recovered without sequelae after receiving doxycycline treatment. Two R. rauoltii strains were isolated, and a significantly less degraded genome was observed than other more virulent Rickettsia strains, indicating a low pathogenicity of the current strain.

Conclusions

Human infection with R. raoultii has a wide clinical spectrum that ranged from subclinical infection to severe complications. Physicians need to be aware of the high potential and clinical complexity of R. raoultii infection, to ensure appropriate testing and treatment in endemic regions.

Dermatitis de contacto alérgica aerotransportada por aceite de neem

Publication date: Available online 23 October 2017
Source:Actas Dermo-Sifiliográficas
Author(s): A. Sánchez-Gilo, A. Nuño González, M. Gutiérrez Pascual, F.J. Vicente Martín

Púrpura bullonecrótica de distribución esporotricoide por Scedosporium apiospermum

Publication date: Available online 23 October 2017
Source:Actas Dermo-Sifiliográficas
Author(s): J. Company-Quiroga, C. Martínez-Morán, A. Moreno, J. Borbujo

Siringocistadenocarcinoma papilífero, descripción de un caso y revisión de la literatura

Publication date: Available online 23 October 2017
Source:Actas Dermo-Sifiliográficas
Author(s): A.D. Agulló Pérez, B. Bonaut Iriarte, A. Córdoba Iturriagagoitia, A. Valcayo Peñalba

Nevo azul con satelitosis que simula melanoma maligno

Publication date: Available online 23 October 2017
Source:Actas Dermo-Sifiliográficas
Author(s): A. Sardoy, M.B. Bidabehere, M.L. Gubiani, B.A. Pinardi

FR-La linfadenectomía inmediata tras la afectación tumoral del ganglio centinela no aumenta la supervivencia en el melanoma cutáneo

Publication date: Available online 23 October 2017
Source:Actas Dermo-Sifiliográficas
Author(s): D. Morgado-Carrasco, A. Combalia, X. Fustà-Novell, L. Ferrandiz

Vasculopatía livedoide tratada con rivaroxabán. Potenciales usos de los nuevos anticoagulantes orales para el dermatólogo

Publication date: Available online 23 October 2017
Source:Actas Dermo-Sifiliográficas
Author(s): D. Jiménez-Gallo, I. Villegas-Romero, M.E. Rodríguez-Mateos, M. Linares-Barrios

CLARENCE CARNOT EVANS II, MD: A Statesman for Dermatology

Erratum

Integrative and Comparative Biology; doi:10.1093/icb/icx053.

Bipedicled conchal bowl composite sling flap for reconstruction of the upper third of the ear

A 70-year-old male underwent Mohs micrographic surgery to remove an advanced squamous cell carcinoma from his right ear. After extirpation of the tumor resulted in amputation of the superior third of the auricle, the patient worried about his appearance and ability to wear sensory aids.

Autophagy and Apoptosis: who regulates whom?

By Christina Towers, PhD

Apoptosis, or programmed cell death, is the result of an intricate cascade of signaling events that is initiated by extrinsic (death receptor mediated) and intrinsic (mitochondrial mediated) stimuli.  Extrinsic apoptosis is initiated by ligand binding to death receptors followed by signaling cascades that activate caspase-8, also known as the initiator caspase.  The effector caspase-3 can be activated by caspase-8, but is usually activated downstream of the intrinsic pathway, and often the extrinsic pathway will converge on the intrinsic for more efficient programmed cell death. Intrinsic signaling takes place on the mitochondrial membrane, where BH-3 only proteins activate mitochondrial outer membrane permeabilization (MOMP) and the release of mitochondrial proteins like cytochrome c.  Subsequently, the apoptosome is formed by a complex of proteins that include cytochrome c to activate caspase-9, leading to the eventual activation of caspase-3. In contrast, autophagy is another tightly regulated cellular process that degrades damaged cytoplasmic material and recycles necessary building blocks that fuel metabolism.  Stress can often induce autophagy, and cancer cells in particular can utilize this process to generate necessary nutrients in scant environments to promote survival. Apoptosis and autophagy are seemingly juxtaposed processes and it is often assumed that one inhibits the other, however, many studies suggest it is much more complicated than that¹.

The two pathways share BH3-only proteins that play intricate roles during intrinsic apoptosis signaling on the mitochondrial membrane, but also play critical roles during the initiation step of autophagy.  For example under basal conditions anti-apoptotic BH3 proteins (BCL-2, BCL-XL, MCL-1) inhibit  pro-apoptotic family members (BID, BAX).  These same anti-apoptotic proteins play an inhibitory role in the autophagy initiating BECN1 complex.  Moreover, pro-apoptotic proteins including PUMA, NOXA and others, disrupt these inhibitory interactions in the BECN1 complex². To add complexity, autophagy regulates the constitutive levels of the pro-apoptotic protein, PUMA: an example of how autophagy can protect cells from stimuli induced apoptosis³.  

It is generally thought that once MOMP is initiated, the cells are committed to undergo apoptosis, however, recent studies have identified a small population of mitochondria that undergo MOMP without initiating the full signaling cascade resulting in death; a phenomenon known as incomplete MOMP.    Cells with elevated autophagy can sustain incomplete MOMP while knockdown of core autophagy genes inhibits cell survival once MOMP has initiated.   The level of autophagy within distinct cell populations can dictate the cellular response to different death receptor signaling, i.e. cells with high levels of autophagy are sensitive to FAS ligand induced apoptosis yet resistant to TRAIL induced apoptosis⁴.  While these provide examples of how autophagy can regulate apoptosis, the converse is also true and apoptosis can directly affect autophagy.  For example, there are two caspase-3 cleavage sites in BECN1, resulting in decreased autophagy and increased apoptosis⁵.  ATG13 and AMBRA1, two other core autophagy genes, can also be substrates for caspase cleavage mediated by caspase-3 and caspase-8, respectively^6,7.  Although these two pathways have been intensely studied individually, the cross-play between the two is just now being illuminated, and the complex story that is unfolding is only the tip of the iceberg. 

New Apoptosis Research Area Pages

1. Fitzwalter, B. E. & Thorburn, A. Recent insights into cell death and autophagy. FEBS J 282, 4279-4288, doi:10.1111/febs.13515 (2015).
2. Pattingre, S. et al. Bcl-2 antiapoptotic proteins inhibit Beclin 1-dependent autophagy. Cell 122, 927-939, doi:10.1016/j.cell.2005.07.002 (2005).
3. Thorburn, J. et al. Autophagy controls the kinetics and extent of mitochondrial apoptosis by regulating PUMA levels. Cell Rep 7, 45-52, doi:10.1016/j.celrep.2014.02.036 (2014).
4. Gump, J. M. et al. Autophagy variation within a cell population determines cell fate through selective degradation of Fap-1. Nature cell biology 16, 47-54, doi:10.1038/ncb2886 (2014).
5. Zhu, Y. et al. Beclin 1 cleavage by caspase-3 inactivates autophagy and promotes apoptosis. Protein Cell 1, 468-477, doi:10.1007/s13238-010-0048-4 (2010).
6. Oral, O. et al. Cleavage of Atg3 protein by caspase-8 regulates autophagy during receptor-activated cell death. Apoptosis 17, 810-820, doi:10.1007/s10495-012-0735-0 (2012).
7. Gu, W. et al. Ambra1 is an essential regulator of autophagy and apoptosis in SW620 cells: pro-survival role of Ambra1. PloS one 9, e90151, doi:10.1371/journal.pone.0090151 (2014).

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Reaction engineering analysis of the autotrophic energy metabolism of Clostridium aceticum

Abstract

Acetogenesis with CO₂:H₂ or CO via the reductive acetyl-CoA pathway does not provide any net ATP formation in homoacetogenic bacteria. Autotrophic energy conservation is coupled to the generation of chemiosmotic H⁺ or Na⁺ gradients across the cytoplasm membrane using either a ferredoxin:NAD⁺ oxidoreductase (Rnf), a ferredoxin:H⁺ oxidoreductase (Ech) or substrate-level phosphorylation via cytochromes. The first isolated acetogenic bacterium Clostridium aceticum shows both cytochromes and Rnf-complex putting it into an outstanding position. Autotrophic batch processes with continuous gas supply were performed in fully controlled stirred-tank bioreactors to elucidate energy metabolism of C. aceticum. Varying the initial Na⁺ concentration in the medium showed sodium dependent growth of C. aceticum with a growth optimum between 60–90 mM Na⁺. The addition of the Na⁺-selective ionophore ETH2120 or the protonophore CCCP or the H⁺/cation-antiporter monensin revealed that a H⁺ gradient is used as primary energy conservation mechanism, which strengthens the exceptional position of C. aceticum as acetogenic bacterium showing a H⁺ dependent energy conservation mechanism as well as Na⁺ dependent growth.

Erythematous and hypopigmented streaks of thinned dermis along Blaschko's lines

Prolidase deficiency in two sisters with recurrent ulcerations of the lower extremities

Social cognition, Stag Hunts, and the evolution of language

Abstract

According to the socio-cognitive revolution (SCR) hypothesis, humans but not other great apes acquire language because only we possess the socio-cognitive abilities required for Gricean communication, which is a pre-requisite of language development. On this view, language emerged only following a socio-cognitive revolution in the hominin lineage that took place after the split of the Pan-Homo clade. In this paper, I argue that the SCR hypothesis is wrong. The driving forces in language evolution were not sweeping biologically driven changes to hominin social cognition. Our LCA with non-human great apes was likely already a Gricean communicator, and what came with evolution was not a raft of new socio-cognitive abilities, but subtle tweaks to existing ones. It was these tweaks, operating in conjunction with more dramatic ecological changes and a significant increase in general processing power, that set our ancestors on the road to language.

Ecthyma gangrenosum, an important cutaneous infection to recognize in the immunosuppressed patient

Itching for nail fashion: chronic urticaria and chronic hand dermatitis secondary to acrylate and methacrylate allergy in gel nail varnish

Summary

Allergic contact dermatitis (ACD) secondary to acrylates and methacrylates is a well- described occurrence, particularly in those who wear or handle gel nail varnish. Management involves avoidance of the identified allergen. The cause of chronic urticaria (CI) is often not identified, and CU is not known to be associated with acrylates or methacrylates. We report a case of a 50-year-old woman who initially presented with hand dermatitis exacerbated by gel nail varnish on a background of CU. Avoiding all nail varnishes because of her ACD also resulted in improvement of her CU. To our knowledge, this is the first documented case of CU secondary to the acrylates and methacrylates found in nail cosmetics.

Treatment of molluscum contagiosum with hydrogen peroxide

Localized cluster of nodules in childhood

A congenital naevus in a blaschkoid distribution

Painful, violaceous plaques in a patient with pruritus

Genetic immunization with mouse thyrotropin hormone receptor plasmid breaks self-tolerance for a murine model of autoimmune thyroid disease and Graves' orbitopathy

Abstract

Experimental models of Graves' hyperthyroid disease accompanied by Graves' orbitopathy (GO) can be efficiently induced in susceptible inbred strains of mice by immunization by electroporation of heterologous human TSH receptor (TSHR) A-subunit plasmid. In this study, we report on the development of a bona fide murine model of autoimmune Graves' disease induced with homologous mouse TSHR A-subunit plasmid. Autoimmune thyroid disease in the self-antigen model was accompanied by GO and characterized by histopathology of hyperplastic glands with large thyroid follicular cells. Examination of orbital tissues showed significant inflammation in extraocular muscle with an accumulation of T cells and macrophages together with the substantial deposition of adipose tissue. Notably, increased levels of brown adipose tissue were present in the orbital tissue of animals undergoing experimental GO. Further analysis of inflammatory loci by ¹⁹F-magnetic resonance imaging showed inflammation to be confined to orbital muscle and optic nerve, but orbital fat showed no difference in inflammatory signs in comparison to control ß-Gal immunized animals. Pathogenic antibodies induced to mouse TSHR were specific for the self-antigen, with minimal cross-reactivity to human TSHR. Moreover, compared to other self-antigen models of murine Graves' disease induced in TSHR knock out mice, the repertoire of autoantibodies to mouse TSHR generated following the breakdown of thymic self-tolerance is different to those that arise when tolerance is not immunologically breached as in the knock out models. Overall, we show mouse TSHR A-subunit plasmid immunization by electroporation overcomes tolerance to self-antigen to provide a faithful model of Graves' disease and GO. This article is protected by copyright. All rights reserved.

T cell suppression in the bone marrow of visceral leishmaniasis patients: Impact of parasite load

Summary

Visceral leishmaniasis (VL) is a disseminated and lethal disease of reticulo-endothelial system caused by protozoan parasites Leishmania donovani and Leishmania infantum, which are known to induce host T cell suppression. To understand the impact of parasite load on T cell function, the present study was focussed on parasite load with T cell function in bone marrow of twenty-six (26) VL patients. We observed significant enrichment of Foxp3⁺ (p = 0.0003) and IL-10⁺ Foxp3⁺ T-regulatory (Treg) cells (p = 0.004) in the BM of patients with high parasite load (HPL) as compared with low parasite load (LPL). Concordantly, T effector cells producing IFN-γ (p = 0.005) and IL-17A (p = 0.002) were reduced in the BM of HPL. Blocking of Treg cell derived suppressive cytokines (IL-10 and TGF-β) rescued the effector T cells and their functions. However, it was observed that TGF-β levels were dominant favouring Treg cell differentiation. Furthermore, the low ratio of IL-6/TGF-β favours the suppressive milieu in HPL patients. Here we show the change in levels of various cytokines with the parasitic load during active VL, which could be helpful in devising newer immunotherapeutic strategies against this disease. This article is protected by copyright. All rights reserved.

ANALYSIS OF THE REGULATORY FUNCTION OF NK CELLS FROM PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

ABSTRACT

Natural Killer cells (NK cells) participates in the regulation of the immune response. However, the immunomodulatory function of NK cells in systemic lupus erythematosus (SLE) is not well understood. The aim of this study was to evaluate the regulatory function of NK cells in SLE patients and to identify the NK cells involved in the pathogenesis of this complex disease. We analyzed the expression of NK receptors and costimulatory molecules in peripheral NK cells (CD3-CD56+) from SLE patients as well as the numbers of HLA-DR/CD11c+ NK cells. In addition, NK cell regulatory function was assessed by the detection of NK cell-mediated DC lysis. We found that SLE patients showed increased numbers of ILT2+, CD86+ and CD134+ NK cells. Furthermore, NK cells from SLE patients induced higher levels of DC lysis. We were able to identify a new subset of NK cells co-expressing CD11c and HLA-DR. Furthermore, these atypical NK cells were increased in SLE patients when compared with controls.

We have identified an expanded new subset of NK cells in SLE patients. This is the first study, which demonstrates that NK cells in SLE patients have an altered phenotype with a high expression of receptors characteristic of dendritic cells. Our results suggest that the impairment in the regulatory function of NK cells, together with the increased number of DC-like NK cells could play an important role in the development of SLE and highlight the importance of NK cells as a future therapeutic target. This article is protected by copyright. All rights reserved.

Correction to: Altered oscillation of Doppler-derived renal and renal interlobar venous flow velocities in hypertensive and diabetic patients

In the original publication of this paper the legend of Fig. 1 should read as: Fig. 1 Pulsed Doppler flow velocity recordings of the aorta (a), right renal artery (b), right renal interlobar artery (c), inferior vena cava (d), right renal vein (e), and right renal interlobar vein (f). PSV peak systolic velocity, EDV end-diastolic velocity, V _MAX maximum velocity, V _MIN minimum velocity

Optical coherence tomography for margin definition of basal cell carcinoma before micrographic surgery—recommendations regarding the marking and scanning technique

Abstract

Background/purpose

Mohs Micrographic Surgery (MMS) is the preferred therapeutic treatment for high-risk basal cell carcinoma (BCC). Optical Coherence Tomography (OCT) is a non-invasive imaging technique that enables the diagnosis of BCC. We thought to determine the margins of BCCs with OCT, prior to MMS, to reduce the number of surgical steps.

Methods

Different permanent markers were tested on the skin regarding line width, resistance against disinfection and brightness in the OCT image. The visible tumor margins of BCCs were defined by dermoscopy, adding a safety margin of 2 mm and labeled using the selected pen, causing a signal shadow in OCT. Scans of the center and of entire margin were performed. If parts of the BCC were visible outside the margin, another 2 mm were added and the scan was repeated until the tissue outside the labeling looked tumor free.

Results

Eight out of ten BCCs were totally excised in a single stage when margin delineation was done by OCT. Macroscopic margins were enlarged after OCT scanning in four patients, saving further stages of MMS.

Conclusion

OCT may help to better define the microscopic dimensions of BCCs and therefore reduce the number of stages of MMS.

The relationship between skin function, barrier properties, and body-dependent factors

Abstract

Background

Skin is a multilayer interface between the body and the environment, responsible for many important functions, such as temperature regulation, water transport, sensation, and protection from external triggers.

Objectives

This paper provides an overview of principal factors that influence human skin and describes the diversity of skin characteristics, its causes and possible consequences. It also discusses limitations in the barrier function of the skin, describing mechanisms of absorption.

Methods

There are a number of in vivo investigations focusing on the diversity of human skin characteristics with reference to barrier properties and body-dependent factors.

Results

Skin properties vary among individuals of different age, gender, ethnicity, and skin types. In addition, skin characteristics differ depending on the body site and can be influenced by the body-mass index and lifestyle. Although one of the main functions of the skin is to act as a barrier, absorption of some substances remains possible.

Conclusions

Various factors can alter human skin properties, which can be reflected in skin function and the quality of everyday life. Skin properties and function are strongly interlinked.

Optical coherence tomography: An efficient imaging method for the visualization of human epidermis orientation

Abstract

Recently, it has been shown that epidermal sheets taken from suction blisters are very appropriate skin samples for Multi-Photon (MP) microscopy. However, we observed that image quality was much better when the sample was visualized through the basale side. Thus, the epidermis orientation needs to be controlled before MP imaging. We observed that the use of standard laboratory binoculars led to a high rate of false results. In this context, we showed that optical coherence tomography provided clear images of the epidermis orientation without loss of sample integrity and thus represents an effective technique before slide sealing and MP analysis.

Thickness and morphology assessment of nail polishes applied on nails by high-definition optical coherence tomography

Degradation of atenolol via heterogeneous activation of persulfate by using BiOCl@Fe 3 O 4 catalyst under simulated solar light irradiation

Abstract

Efficient oxidative degradation of pharmaceutical pollutants in aquatic environments is of great importance. This study used magnetic BiOCl@Fe₃O₄ catalyst to activate persulfate (PS) under simulated solar light irradiation. This degradation system was evaluated using atenolol (ATL) as target pollutant. Four reactive species were identified in the sunlight/BiOCl@Fe₃O₄/PS system. The decreasing order of the contribution of each reactive species on ATL degradation was as follows: h⁺ ≈ HO^· > O₂^·− > SO₄^·−. pH significantly influenced ATL degradation, and an acidic condition favored the reaction. High degradation efficiencies were obtained at pH 2.3–5.5. ATL degradation rate increased with increased catalyst and PS contents. Moreover, ATL mineralization was higher in the sunlight/BiOCl@Fe₃O₄/PS system than in the sunlight/BiOCl@Fe₃O₄ or sunlight/PS system. Nine possible intermediate products were identified through LC-MS analysis, and a degradation pathway for ATL was proposed. The BiOCl@Fe₃O₄ nanomagnetic composite catalyst was synthesized in this work. This catalyst was easily separated and recovered from a treated solution by using a magnet, and it demonstrated a high catalytic activity. Increased amount of the BiOCl@Fe₃O₄ catalyst obviously accelerated the efficiency of ATL degradation, and the reusability of the catalyst allowed the addition of a large dosage of BiOCl@Fe₃O₄ to improve the degradation efficiency.

Pemphigus vegetans with the manifestations of acrodermatitis continua: A rare variant

Presymptomatic genetic diagnosis of two siblings with hereditary angioedema, presenting with unusual normal levels of serum C4

Pigmented Bowen disease: A challenging dermoscopic feature due to a traumatic disfigurement

CD1a-positive cutaneous mastocytosis: Electron microscopic evidence of pleomorphic mast cell proliferation

Generalized eruptive keratoacanthoma with vitiligo followed by the development of prurigo nodularis: A case report and published work review

Abstract

Herein, we report a unique case of generalized eruptive keratoacanthoma (GEKA) in a 47-year-old Chinese man presenting with extensive pruritic papules and nodules accompanied by oral lesions. He also had a 2-year history of vitiligo and long-term experience of working outdoors. Biopsies were consistent with keratoacanthoma . Interestingly, prurigo nodularis (PN) was found in histopathology at 1-year follow up. To our knowledge, this is the first report describing a case of GEKA with oral lesions complicated with vitiligo and developed with PN.

Dyskeratosis congenita associated with congenital hypothyroidism

Increase of programmed death ligand 1 in non-small cell lung cancers with chronic hepatitis B

Programmed death ligand 1Chronic hepatitis Bnon-small cell lung cancer

Naming disease states for clinical utility in prostate cancer: a rose by any other name might not smell as sweet

A novel pretherapeutic gene expression based risk score for treatment guidance in gastric cancer

Background

Perioperative chemotherapy is an established treatment for advanced gastric cancer patients. Treatment selection is based on clinical staging (cT). We aimed to establish and validate a prognostic score including clinical and molecular factors, to optimize treatment decisions for these patients.

Patients and methods

We analyzed 626 carcinomas of the stomach and of the gastro-oesophageal junction from two academic centers including primarily resected and pre-/perioperatively treated patients. Patients were divided into a training (N = 269) and validation (N = 357) set. Expression of11 target genes was measured by quantitative PCR in resected tumors. A risk score to predict overall survival (OS) was generated and validated. Intra-tumoral heterogeneity was assessed by analysing 50 tumor areas from 10 patients.

Results

A risk score including the expression of CCL5, CTNNB1, EXOSC3 and LZTR1 and the clinical parameters cT, tumor localization and histopathological type suggested two groups with a significant difference in OS (hazard ratio [HR], 0.30; 95% confidence interval [CI], 0.17-0.52). The risk score was successfully validated in an independent cohort (HR, 0.32; 95% CI, 0.21-0.51; P < 0.001) as well as in subgroups of primarily resected (HR, 0.30; 95% CI, 0.17-0.54; P < 0.001) and pre-/perioperatively treated patients (HR, 0.37; 95% CI, 0.17-0.81; P = 0.009). A significant difference in OS of high and low risk patients was also found in primarily resected patients with intestinal (HR: 0.45; 95% CI, 0.23-0.90;P = 0.020) and non-intestinal type carcinomas (HR: 0.1; 95% CI 0.02-0.42; P < 0.001). Intra-tumor heterogeneity analysis indicated a classification reliability of 95% for a supposed analysis of three biopsies.

Conclusion

The identified risk score could substantially contribute to an improved management of gastric cancer patients in the context of perioperative chemotherapy.

Fever reaction and haemophagocytic syndrome induced by immune checkpoint inhibitors.

Haemophagocytic syndromeImmune-related adverse eventInfusion related reactionAnti-Programmed Death 1Anti-Programmed Death Ligand 1Anti-CTLA4

Differential binding affinity of mutated peptides for MHC class I is a predictor of survival in advanced lung cancer and melanoma

Abstract

BackgroundCancer mutations generate novel (neo-) peptides recognised by T-cells, but the determinants of recognition are not well characterised. The difference in predicted class I MHC (MHC-I) binding affinity between wildtype and corresponding mutant peptides (differential agretopicity index; DAI) may reflect clinically relevant cancer peptide immunogenicity. Our aim was to explore the relationship between DAI, measures of immune infiltration and patient outcomes in advanced cancer.Patients and methodsCohorts of patients with advanced non-small cell lung cancer (NSCLC; LUAD, n=66) and melanoma (SKCM, n=72) were obtained from the Cancer Genome Atlas. Three additional cohorts of immunotherapy treated patients with advanced melanoma (total n=131) and NSCLC (n=31) were analysed. Neopeptides and their clonal status were defined using genomic data. MHC-I binding affinity was predicted for each neopeptide and DAI values summarised as the sample mean DAI. Correlations between mean DAI and markers of immune activity were evaluated using measures of lymphocyte infiltration and immune gene expression.ResultsIn univariate and multivariate analyses, mean DAI significantly correlated with overall survival in 3/5 cohorts, with evidence of superiority over nonsynonymous mutational and neoantigen burden. In these cohorts, the effect was seen for mean DAI of clonal but not subclonal peptides. In SKCM, the association between mean DAI and survival bordered significance (p = 0.068), reaching significance in an immunotherapy treated melanoma cohort (p = 0.003). Mean DAI but not mutational nor neoantigen burden was positively correlated with independently verified markers of immune infiltration in both SKCM (p=0.027) and LUAD (p=0.024).ConclusionsThe association between mean DAI, survival and measures of immune activity support the hypothesis that DAI is a determinant of cancer peptide immunogenicity. Investigation of DAI as a marker of immunologically relevant peptides in further datasets and future clinical studies of neoantigen based immunotherapies is warranted.

A fatal allo and immune-mediated thrombocytopenia with a PD-L1 inhibitor

auto-immune thrombocytopeniacheck point inhibitor

Phase II study of nab-paclitaxel in refractory small bowel adenocarcinoma and CpG island methylator phenotype (CIMP)-high colorectal cancer

Abstract

Background

Hypermethylation of promoter CpG islands (CIMP) represents a unique pathway for the development of colorectal cancer (CRC), characterized by lack of chromosomal instability and a low rate of adenomatous polyposis coli (APC) mutations, which have both been correlated with taxane resistance. Similarly, small bowel adenocarcinoma (SBA), a rare tumor, also has a low rate of APC mutations. This phase II study evaluated taxane sensitivity in SBA and CIMP-high CRC.

Patients and Methods

The primary objective was Response Evaluation Criteria in Solid Tumors version 1.1 response rate. Eligibility included Eastern Cooperative Oncology Group performance status 0/1, refractory disease, and SBA or CIMP-high metastatic CRC. nab-paclitaxel was initially administered at a dose of 260 mg/m² every 3 weeks but was reduced to 220mg/m² owing to toxicity.

Results

A total of 21 patients with CIMP-high CRC and 13 with SBA were enrolled from November 2012 to October 2014. The efficacy-evaluable population (patients who received at least three doses of the treatment) comprised 15 CIMP-high CRC patients and 10 SBA patients. Common grade 3 or 4 toxicities were fatigue (12%), neutropenia (9%), febrile neutropenia (9%), dehydration (6%), and thrombocytopenia (6%). No responses were seen in the CIMP-high CRC cohort and two partial responses were seen in the SBA cohort. Median progression-free survival was significantly greater in the SBA cohort than in the CIMP-high CRC cohort (3.2 months compared with 2.1 months, P = 0.03). Neither APC mutation status nor CHFR methylation status correlated with efficacy in the CIMP-high CRC cohort. In vivo testing of paclitaxel in an SBA patient-derived xenograft validated the activity of taxanes in this disease type.

Conclusion

Although preclinical studies suggested taxane sensitivity was associated with chromosomal stability and wild-type APC, we found that nab-paclitaxel was inactive in CIMP-high metastatic CRC. nab-paclitaxel may represent a novel therapeutic option for SBA.

Development of leptomeningeal carcinomatosis during a marked response of brain metastases to pembrolizumab in a patient with non–small cell lung cancer

A Prospective Genome-Wide Study of Prostate Cancer Metastases Reveals Association of Wnt Pathway Activation and Increased Cell Cycle Proliferation with Primary Resistance to Abiraterone Acetate-Prednisone

Abstract

Background

Genomic aberrations have been identified in metastatic castration-resistant prostate cancer (mCRPC), but molecular predictors of resistance to abiraterone acetate/prednisone (AA/P) treatment are not known.

Patients and Methods

In a prospective clinical trial, mCRPC patients underwent whole exome sequencing (n = 82) and RNA-sequencing (n = 75) of metastatic biopsies before initiating AA/P with the objective of identifying genomic alterations associated with resistance to AA/P. Primary resistance was determined at 12-weeks of treatment using criteria for progression that included serum PSA measurement, bone and CT imaging and symptom assessments. Acquired resistance was determined using the endpoint of time to treatment change (TTTC), defined as time from enrollment until change in treatment from progressive disease. Associations of genomic and transcriptomic alterations with primary resistance were determined using logistic regression, Fisher's exact test, single and multivariate analyses. Cox regression models were utilized for determining association of genomic and transcriptomic alterations with TTTC.

Results

At 12-weeks, 32 patients in the cohort had progressed (non-responders). Median study follow up was 32.1 months by which time 58 patients had switched treatments due to progression. Median TTTC was 10.1 months (IQR: 4.4 to 24.1). Genes in the Wnt/β-catenin pathway were more frequently mutated and negative regulators of Wnt/β-catenin signaling were more frequently deleted or displayed reduced mRNA expression in non-responders. Additionally, mRNA expression of cell cycle regulatory genes was increased in non-responders. In multivariate models increased cell cycle proliferation scores (≥ 50) were associated with shorter TTTC (HR = 2.11, 95% CI: 1.17-3.80; P = 0.01).

Conclusions

Wnt/β-catenin pathway activation and increased cell cycle progression scores can serve as molecular markers for predicting resistance to AA/P therapy.

Clinical Snippets

Issue Information

The promise of marine molecules as cosmetic active ingredients

Abstract

The marine environment represents an underexploited resource for the discovery of novel products, despite its high level of biological and chemical diversity. With increasing awareness of the harmful effects of chronic ultraviolet exposure, and a universal desire to improve cosmetic appearance, the market for new cosmetic ingredients is growing, and current trends have generated a greater demand for products sourced from the environment. A growing number of novel molecules from marine flora and fauna exhibit potent and effective dermatological activities. Secondary metabolites isolated from macroalgae, including carotenoids and polyphenols, have demonstrated antioxidant, antiaging and anti-inflammatory activities. In addition, marine extremophilic bacteria have recently been shown to produce bioactive exopolymeric molecules, some of which have been commercialised. Available data on their activities show significant antioxidant, moisturising and antiaging activities, but a more focussed investigation into their mechanisms and applications is required. This review surveys the reported biological activities of an emerging and growing portfolio of marine molecules that show promise in the treatment of cosmetic skin problems including ultraviolet damage, aging and cutaneous dryness.

This article is protected by copyright. All rights reserved.

Prediction of a nail polish colour applied on a nail

Abstract

Objective

The colour of a nail polish varies according to the nail on which it is applied. The objective of this study was to predict the colour of the nail polish on a given nail and to study how the colour varies depending on the nail polish thickness.

Methods

Six nail polishes were applied in one, two and three layers on the nails of one subject, thus forming eighteen samples. The spectral reflectances of the eighteen nail polishes applied on the nails with different thicknesses were obtained by spectrophotometry. The spectral reflectances of the nails without polish were also measured by using the same technique. The thicknesses of nail polishes were measured by High Definition Optical Coherence Tomography (HD-OCT). Then, in order to determine the physical parameters of the nail polish itself, we applied the six nail polishes on an opacity drawdown chart and we measured the spectral reflectance and the thickness of each patch using spectrophotometry and HD-OCT, respectively. The Kubelka-Munk theory was used to get the predicted spectral reflectance of the nail polish applied on the nail according to the polish thickness by knowing the parameter of the polish itself and the spectral reflectance of the nail. The predicted spectral reflectances were finally compared with those measured directly on the nails.

Results

The predicted spectral reflectances were rather close to measured ones. Consequently, knowing the colour of the nail without polish and the optical parameters of the nail polish itself, we can estimate the colour of the nail polish applied on the nail depending on its thickness.

Conclusion

Our study showed that the Kubelka-Munk theory can be used to predict the nail polish colour. The ability to predict the real colour of a nail polish applied on a nail could help a nail polish manufacturer to improve his polish formulae in order to obtain a precise colour.

This article is protected by copyright. All rights reserved.

Successful treatment of refractory cholinergic urticaria with omalizumab

A 71-year-old man with a hemorrhagic vesicular eruption

Psoriasis and small intestine bacterial overgrowth

Dermoscopic features of Orf disease

Support needs of people living with Mycobacterium ulcerans (Buruli ulcer) disease in a Ghana rural community: a grounded theory study

Abstract

Introduction/Background

Mycobacterium ulcerans (also known as Buruli ulcer) disease is a rare skin disease which is prevalent in rural communities in the tropics mostly in Africa. Mortality rate is low, yet morbidity and consequent disabilities affect the quality of life of sufferers.

Aims

The aim of this paper is to use the grounded theory method to explore the support needs of people living with the consequences of Buruli ulcer in an endemic rural community in Ghana.

Methods

We used the grounded theory research approach to explore the experiences of people living with Mycobacterium ulcerans in a rural district in Ghana and provide a basis to understand the support needs of this group.

Results

The key support needs identified were: functional limitations, fear and frequency of disease recurrence, contracture of limbs and legs, loss of sensation and numbness in the affected body area, lack of information from health professionals about self-care, feeling tired all the time, insomnia, lack of good diet, lack of access to prostheses, having to walk long distances to access health services, and loss of educational opportunities.

Discussions

The study discusses how the systematically derived qualitative data has helped to provide a unique insight and advance our understanding of the support needs of people living with BU and how they live and attempt to adapt their lives with disability. We discuss how the availability of appropriate interventions and equipment could help them self-manage their condition and improve access to skin care services.

Conclusions

The support needs of this vulnerable group were identified from a detailed analysis of how those living with BU coped with their lives. A key issue is the lack of education to assist self-management and prevent deterioration. Further research into the evaluation of interventions to address these support needs is necessary including self-management strategies.