Performance and microbial characteristics of biomass in a full-scale aerobic granular sludge wastewater treatment plant

Abstract

By modification of the operational conditions of batch reactors, a municipal wastewater treatment plant was upgraded from activated sludge to aerobic granular sludge (AGS) technology. After upgrading, the volume of the biological reactors was reduced by 30%, but the quality of the effluent substantially improved. The concentration of biomass in the reactors increased twofold; the average biomass yield was 0.6 g MLVSS/g COD, and excess granular sludge was efficiently stabilized in aerobic conditions. Canonical correspondence analysis based on the results of next-generation sequencing showed that the time of adaptation significantly influenced the microbial composition of the granules. In mature granules, the abundance of ammonium-oxidizing bacteria was very low, while the abundance of the nitrite-oxidizing bacteria Nitrospira sp. was 0.5 ± 0.1%. The core genera were Tetrasphaera, Sphingopyxis, Dechloromonas, Flavobacterium, and Ohtaekwangia. Bacteria belonging to these genera produce extracellular polymeric substances, which stabilize granule structure and accumulate phosphorus. The results of this study will be useful for designers of AGS wastewater treatment plants, and molecular data given here provide insight into the ecology of mature aerobic granules from a full-scale facility.

Does non-contact low-frequency ultrasound (NLFU) therapy contribute to wound healing at the molecular level?

Abstract

Non-contact low frequency ultrasound (NLFU) is used to treat various types of chronic wounds including venous, diabetic and pressure ulcers. The objective for this sub study of the IN BALANCE RCT VLU trial was to characterize and compare the NLFU treatment group and patients receiving standard of care (SOC) with respect to the effect of the assigned study treatment on content/quantity of inflammatory cytokines and fibrinogen as well as bacteria. Higher mean wound area reduction was observed in the NLFU treatment group (67.0%) compared to the SOC group (41.6%, p<0.05). Hypertension, diabetes type II, coronary artery disease, and anaemia were identified as the most common co-morbidities of the CVLU patients included in the study. Pseudomonas, Corynebacterium, and unclassified Enterobacteriaceae were dominant in the highest number of samples. Anaerococcus, Peptoniphilus, and Finegoldia, had the highest median proportion in the samples overall. Peptoniphilus abundance decreased more in the NLFU treatment group relative to SOC; similar trends were observed for Anaerococcus and Finegoldia. Progression of mediators like TNF-alpha, IL-1beta, IL-6, IL-8, and IL-10 as well as PF4, TGF-beta, and fibrinogen was monitored and trends for several of the mediators were identified. Fibrinogen amounts were significantly reduced over time in the NLFU treatment group (p<0.05). IL-8 levels declined in wound fluid from NLFU responders as well as SOC responders. Bacterial load (total bacterial abundance) determined local parameters of ulcer inflammation. If a bioburden of ≥ 10E⁵ was found compared to < 10E⁵, levels of IL-1beta, IL-8, and TNF-alpha were significantly higher. In conclusion, NLFU treatment is an effective adjuvant tool for CVLU therapy. This study demonstrates that it improves wound healing by equally inhibiting abundant levels of pro-inflammatory cytokines as well as by reducing the overall bacterial burden. This article is protected by copyright. All rights reserved.

Advanced scoring method of eco-efficiency in European cities

Abstract

This paper analyzes a set of selected German and French cities' performance in terms of the relative behavior of their eco-efficiencies, computed as the ratio of their gross domestic product (GDP) over their CO₂ emissions. For this analysis, eco-efficiency scores of the selected cities are computed using the data envelopment analysis (DEA) technique, taking the eco-efficiencies as outputs, and the inputs being the energy consumption, the population density, the labor productivity, the resource productivity, and the patents per inhabitant. Once DEA results are analyzed, the Malmquist productivity indexes (MPI) are used to assess the time evolution of the technical efficiency, technological efficiency, and productivity of the cities over the window periods 2000 to 2005 and 2005 to 2008. Some of the main conclusions are that (1) most of the analyzed cities seem to have suboptimal scales, being one of the causes of their inefficiency; (2) there is evidence that high GDP over CO₂ emissions does not imply high eco-efficiency scores, meaning that DEA like approaches are useful to complement more simplistic ranking procedures, pointing out potential inefficiencies at the input levels; (3) efficiencies performed worse during the period 2000–2005 than during the period 2005–2008, suggesting the possibility of corrective actions taken during or at the end of the first period but impacting only on the second period, probably due to an increasing environmental awareness of policymakers and governors; and (4) MPI analysis shows a positive technological evolution of all cities, according to the general technological evolution of the reference cities, reflecting a generalized convergence of most cities to their technological frontier and therefore an evolution in the right direction.

Grupo Español de Dermatología en las Enfermedades Autoinmunes y Sistémicas (GEDEAS): un nuevo grupo de trabajo

Publication date: November 2017
Source:Actas Dermo-Sifiliográficas, Volume 108, Issue 9
Author(s): I. Bielsa Marsol

Rinotilexomanía

Publication date: Available online 2 November 2017
Source:Actas Dermo-Sifiliográficas
Author(s): C. Martín-Callizo, M. Sacristà, Y. Fortuño, R.M. Penín, M.J. Tribó

Terapias no quirúrgicas para el carcinoma basocelular: revisión

Publication date: November 2017
Source:Actas Dermo-Sifiliográficas, Volume 108, Issue 9
Author(s): S. Ariza, S. Espinosa, M. Naranjo
El carcinoma basocelular (CBC) es el tumor maligno más frecuente en seres humanos, y tiene la capacidad de causar una significativa morbilidad asociada a su potencial de destrucción local. El tratamiento del CBC demanda altos costes de atención para los sistemas de salud, por la gran incidencia de esta enfermedad, especialmente en pacientes mayores. El tratamiento estándar para la mayoría de los CBC consiste en la resección quirúrgica con márgenes y control histológico de los bordes de sección, o mediante cirugía micrográfica de Mohs. Sin embargo, en algunos pacientes con contraindicación para cirugía, que tienen comorbilidades importantes o altas expectativas estéticas, existen en la actualidad nuevas alternativas terapéuticas no quirúrgicas, con las cuales se puede lograr muy buen control local, preservar la función y obtener un excelente resultado cosmético.Basal cell carcinoma (BCC) is the most prevalent malignant tumor in humans and the local destruction of tissue that can result from excision has a significant impact on well-being. Treating BCC is costly for health care systems given the high incidence of this tumor, especially in older patients. Standard treatment involves either resection with histologic assessment of margins or Mohs micrographic surgery. Surgery is sometimes contraindicated, however, due to the presence of significant comorbidity or high cosmetic expectations. For such patients, nonsurgical treatments have become available. These alternatives can offer good local control of disease, preserve function, and achieve excellent cosmetic results.

Graphical abstract

Provokationstest mit Medikamenten: Tun oder lassen?

Süßes für die Schwangere, Asthma fürs Kind?

Zu viel Zucker in der Schwangerschaft schadet auch dem Nachwuchs. Laut einer britischen Studie könnte der häufiger Atopien und allergisches Asthma entwickeln.

Beeinflusst Impfen das Allergierisiko?

BCG-Impfung wohl doch nicht atopieprotektiv

Einer Antituberkuloseimpfung mit Bacillus Calmette-Guérin werden unspezifisch immunmodulierende Effekte zugeschrieben. Eine kontrollierte Studie untersuchte nun prospektiv den atopiepräventiven Effekt einer BCG-Neugeborenen-Impfung.

Reges Interesse und heiße Diskussionen

Am diesjährigen 12. Deutschen Allergiekongress im malerischen Kurhaus in Wiesbaden haben sich die Junior Members der Deutschen Gesellschaft für Allergologie und klinische Immunologie wie gewohnt mit einem Junior-Member-Symposium und einer speziell für die Junioren ausgerichteten ePoster-Session am Programm beteiligt. Trotz kleiner technischer Pannen begeisterten die Vorträge und deren Themen das Publikum.

Fetuin-A: Outcome-Prädiktorkandidat für die spezifische Immuntherapie

Biomarker für einen wahrscheinlich erfolgreichen Abschluss einer spezifischen Immuntherapie gibt es bisher nicht. Ein Kandidat ist Fetuin-A, ein Blutprotein, das nun im Rahmen von funktionellen Tests und einer Therapiestudie näher untersucht wurde.

Allergiekongress mit überwältigender Resonanz

Bei schwerer Reaktion auf Nahrungsmittel auch an FPIES denken

Ein Vierteljahrhundert Allergo Journal

Inhaltsverzeichnis

Elektronische Abstracteinreichung Schritt für Schritt

Präambel für die Evidenztabelle der SIT-Leitlinie

SLIT: Real-Life-Daten sprechen für asthmapräventive Effekte

Kontrollierte Studien zur asthmapräventiven Wirkung einer allergenspezifischen Immuntherapie sind aufwendig. Weniger aufwendig zu generieren sind longitudinale Real-Life-Datenanalysen. Eine solche Untersuchung liegt jetzt speziell für die Gräserpollen-SLIT vor.

Interdisziplinärer Rundumschlag

Ist ein Provokationstest zur Abklärung einer Medikamentenüberempfindlichkeit unverzichtbar oder überflüssig? Wie häufig sind Impfstoff-induzierte anaphylaktische Reaktionen? Welche Optionen bleiben bei einem schweren refraktären Asthma? Diese und weitere interdisziplinäre Fragen wurden im Rahmen des 12. Deutschen Allergiekongresses, der vom 5. bis 7. Oktober in Wiesbaden stattfand, diskutiert.

Atopische Dermatitis: endlich gezielt antientzündlich behandeln?

Einladung DGAKI-Frühjahrstagung

Maßgeschneiderte Therapie bei schwerem Asthma in Sicht?

Atopische Dermatitis: ARNE-Schulungsprogramm unterstützt speziell Erwachsene

In Deutschland wurde jetzt ein multiprofessionelles strukturiertes Trainingsmodul für erwachsene Patienten mit einer atopischen Dermatitis multizentrisch untersucht.

12. Deutscher Allergiekongress — ein Rückblick in Bildern

Nichts ist so beständig wie der Wandel

Sie sind allergologisch tätig und eine Wirtschaftlichkeitsprüfung steht ins Haus? Dann kommt es ganz darauf an, in welchem Bundesland Sie leben. Denn in manchen KV-Bezirken werden Allergologen belohnt, in anderen bestraft. Der Ärzteverband Deutscher Allergologen muss oft beratend eingreifen und konnte schon so manchen Regress abwenden.

Hemodynamic Changes Caused by Multiple Stenting in Vertebral Artery Fusiform Aneurysms: A Patient-Specific Computational Fluid Dynamics Study [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

The multiple stent placement technique has largely improved the long-term outcomes of intracranial fusiform aneurysms, but the hemodynamic mechanisms remain unclear. In this study, we analyzed the hemodynamic changes caused by different stent-placement strategies in patient-specific models using the computational fluid dynamics technique, aiming to provide evidence for clinical decision-making.

MATERIALS AND METHODS:

Ten vertebral artery fusiform aneurysms were included, and their patient-specific computational fluid dynamics models were reconstructed. A fast virtual stent placement technique was used to simulate sequential multiple stent placements (from a single stent to triple stents) in the vertebral artery fusiform aneurysm models. Hemodynamic parameters, including wall shear stress, pressure, oscillatory shear index, relative residence time, and flow pattern, were calculated and compared among groups with different numbers of stents.

RESULTS:

Virtual stents were deployed in all 10 cases successfully, consistent with the real stent configuration. Wall shear stress decreased progressively by 7.2%, 20.6%, and 25.8% as the number of stents increased. Meanwhile, relative residence time and pressure increased on average by 11.3%, 15.4%, and 45.0% and by 15.7%, 21.5%, and 28.2%. The oscillatory shear index showed no stable variation trend. Flow patterns improved by weakening the intensity of the vortices and displacing the vortex center from the aneurysmal wall.

CONCLUSIONS:

Stent placement modifies hemodynamic patterns in vertebral artery fusiform aneurysms, which might favor thrombosis formation in the aneurysmal sac. This effect is amplified with the number of stents deployed. However, a potential risk of rupture or recanalization exists and should be considered when planning to use the multiple stent placement technique in vertebral artery fusiform aneurysms.

Gadolinium DTPA Enhancement Characteristics of the Rat Sciatic Nerve after Crush Injury at 4.7T [SPINE]

BACKGROUND AND PURPOSE:

Traumatic peripheral nerve injury is common and results in loss of function and/or neuropathic pain. MR neurography is a well-established technique for evaluating peripheral nerve anatomy and pathology. However, the Gd-DTPA enhancement characteristics of acutely injured peripheral nerves have not been fully examined. This study was performed to determine whether acutely crushed rat sciatic nerves demonstrate Gd-DTPA enhancement and, if so, to evaluate whether enhancement is affected by crush severity.

MATERIALS AND METHODS:

In 26 rats, the sciatic nerve was crushed with either surgical forceps (6- to 20-N compressive force) or a microvascular/microaneurysm clip (0.1–0.6 N). Animals were longitudinally imaged at 4.7T for up to 30 days after injury. T1WI, T2WI, and T1WI with Gd-DTPA were performed.

RESULTS:

Forceps crush injury caused robust enhancement between days 3 and 21, while clip crush injury resulted in minimal-to-no enhancement. Enhancement after forceps injury peaked at 7 days and was seen a few millimeters proximal to, in the region of, and several centimeters distal to the site of crush injury. Enhancement after forceps injury was statistically significant compared with clip injury between days 3 and 7 (P < .04).

CONCLUSIONS:

Gd-DTPA enhancement of peripheral nerves may only occur above a certain crush-severity threshold. This phenomenon may explain the intermittent observation of Gd-DTPA enhancement of peripheral nerves after traumatic injury. The observation of enhancement may be useful in judging the severity of injury after nerve trauma.

Brain Structural Changes following HIV Infection: Meta-Analysis [ADULT BRAIN]

BACKGROUND:

Numerous studies have used structural neuroimaging to measure HIV effects on brain macroarchitecture. While many have reported changes in total brain volume, gray matter volume, white matter volume, CSF volume, and basal ganglia volume following HIV infection, quantitative inconsistencies observed across studies are large.

PURPOSE:

Our aim was to evaluate the consistency and temporal stability of serostatus effects on a range of structural neuroimaging measures.

DATA SOURCES:

PubMed, reference lists, and corresponding authors.

STUDY SELECTION:

The meta-analysis included 19 cross-sectional studies reporting HIV effects on cortical and subcortical volume from 1993 to 2016.

DATA ANALYSIS:

Random-effects meta-analysis was used to estimate individual study standardized mean differences and study heterogeneity. Meta-regression was used to examine the effects of the study publication year.

DATA SYNTHESIS:

Meta-analysis revealed standardized mean differences related to the serostatus of –0.65 (P = .002) for total brain volume, –0.28 for gray matter volume (P = .008), –0.24 (P = .076) for white matter volume, and 0.56 (P = .001) for CSF volume. Basal ganglia volume differences related to serostatus were not significant. Nevertheless, estimates of between-study heterogeneity suggested that much of the observed variance was between studies. Publication year was associated with recent reductions in many neurostructural effects.

LIMITATIONS:

Many studies pooled participants with varying durations of treatment, disease, and comorbidities. Image-acquisition methods changed with time.

CONCLUSIONS:

While published studies of HIV effects on brain structure had substantial variations that are likely to result from changes in HIV treatment practice during the study period, quantitative neurostructural measures can reliably detect the effects of HIV infection during treatment, serving as reliable biomarkers.

The Anesthesiologist, Rather Than the Anesthesia, May Influence the Outcomes following Stroke Thrombectomy [LETTERS]

Spatial Correlation of Pathology and Perfusion Changes within the Cortex and White Matter in Multiple Sclerosis [ADULT BRAIN]

BACKGROUND AND PURPOSE:

The spatial correlation between WM and cortical GM disease in multiple sclerosis is controversial and has not been previously assessed with perfusion MR imaging. We sought to determine the nature of association between lobar WM, cortical GM, volume and perfusion.

MATERIALS AND METHODS:

Nineteen individuals with secondary-progressive multiple sclerosis, 19 with relapsing-remitting multiple sclerosis, and 19 age-matched healthy controls were recruited. Quantitative MR perfusion imaging was used to derive CBF, CBV, and MTT within cortical GM, WM, and T2-hyperintense lesions. A 2-step multivariate linear regression (corrected for age, disease duration, and Expanded Disability Status Scale) was used to assess correlations between perfusion and volume measures in global and lobar normal-appearing WM, cortical GM, and T2-hyperintense lesions. The Bonferroni adjustment was applied as appropriate.

RESULTS:

Global cortical GM and WM volume was significantly reduced for each group comparison, except cortical GM volume of those with relapsing-remitting multiple sclerosis versus controls. Global and lobar cortical GM CBF and CBV were reduced in secondary-progressive multiple sclerosis compared with other groups but not for relapsing-remitting multiple sclerosis versus controls. Global and lobar WM CBF and CBV were not significantly different across groups. The distribution of lobar cortical GM and WM volume reduction was disparate, except for the occipital lobes in patients with secondary-progressive multiple sclerosis versus those with relapsing-remitting multiple sclerosis. Moderate associations were identified between lobar cortical GM and lobar normal-appearing WM volume in controls and in the left temporal lobe in relapsing-remitting multiple sclerosis. No significant associations occurred between cortical GM and WM perfusion or volume. Strong correlations were observed between cortical-GM perfusion, normal appearing WM and lesional perfusion, with respect to each global and lobar region within HC, and RRMS and SPMS patients (R² ≤ 0.96, P < .006 and R² ≤ 0.738, P < .006).

CONCLUSIONS:

The weak correlation between lobar WM and cortical GM volume loss and perfusion reduction suggests the independent pathophysiology of WM and cortical GM disease.

On the tracks of sandarac, review and chemical analysis

Abstract

The sandarac resin (Tetraclinis articulata) has been long used for its properties, mostly as a varnish component. Called juniper resin until the nineteenth century, the real botanical origin of sandarac is still unclear. The first approach to this issue is the review of the evolution of the etymology, terminology, and botanical description of sandarac through time. It seems that sandarac was mainly coming from T. articulata but the use of some juniper resins before the twentieth century is not to be excluded. The second approach is a chemical one; we used gas chromatography coupled to mass spectrometry to characterise the resin. As sandarac was the main component of the famous Italian varnish Vernice liquida, its characterisation is important for old paintings studies. However, although we could hope to differentiate sandarac, Juniperus communis and Juniperus oxycedrus resins by looking at their chemical composition, it appears that these resins are very similar. Besides, we notice a lack of old varnishes containing sandarac which complicates our work.

Genotoxicity of carbon tetrachloride and the protective role of essential oil of Salvia officinalis L. in mice using chromosomal aberration, micronuclei formation, and comet assay

Abstract

The present work was conducted to evaluate the genotoxic effect of carbon tetrachloride (CCl₄) in mouse bone marrow and male germ cells. The safety and the modulating activity of sage (Salvia officinalis L.) essential oil (SEO) against the possible genotoxic effect of CCl₄ were also evaluated. A combination of in vivo mutagenic endpoints was included: micronucleus (MN), apoptosis using dual acridine orange/ethidium bromide (AO/EB) staining, comet assay, chromosomal aberrations (CAs), and sperm abnormalities. Histological examination of testis tissues was also studied. The extracted SEO was subjected to gas chromatography-mass spectrometry (GC-MS) for identifying its chemical constituents. Safety/genotoxicity of SEO was determined after two consecutive weeks (5 days/week) from oral treatment with different concentrations (0.1, 0.2, and 0.4 mL/kg). For assessing genotoxicity of CCl₄, both acute (once) and subacute i.p. treatment for 2 weeks (3 days/week) with the concentrations 1.2 mL/kg (for acute) and 0.8 mL/kg (for subacute) were performed. For evaluating the protective role of SEO, simultaneous treatment with SEO plus CCl₄ was examined. In sperm abnormalities, mice were treated with the subject materials for five successive days and the samples were collected after 35 days from the beginning of treatment. Based on GC-MS findings, 22 components were identified in the chromatogram of SEO. The results demonstrated that the three concentrations of SEO were safe and non-genotoxic in all the tested endpoints. Negative results were also observed in bone marrow after acute and subacute treatment with CCl_4. In contrast, CCl₄ induced testicular DNA damage as evidenced by a significant increase of CAs in primary spermatocytes, sperm abnormalities, and histological distortion of testis. A remarkable reduction in these cells was observed in groups treated with SEO plus CCl₄ especially with the two higher concentrations of SEO. In conclusion, SEO is safe and non-genotoxic under the tested conditions and can modulate genetic damage and histological alteration induced by CCl₄ in the testes.

Chlorination disinfection by-products and comparative cost analysis of chlorination and UV disinfection in sewage treatment plants: Indian scenario

Abstract

Apart from numerous other well-known drawbacks of chlorination, viz. on-site operational hazards and residual chlorine toxicity, trihalomethane (THM) formation is the major factor that came into limelight in the last 40 years, primarily in drinking water treatment industry. Treated effluent from wastewater treatment plants is also chlorinated and then discharged, indirectly coming in human contact, so there is need to consider THM as a potable as well as wastewater parameter. In this study, THMs were identified in seven sewage treatment plants (STPs) in North India. STPs were selected based on treatment technology employed, viz., up-flow anaerobic sludge blanket (UASB), activated sludge process (ASP), sequential batch reactor (SBR), and oxidation pond (OP). THM concentrations obtained at all the seven STPs were below BIS standards of drinking water (0–40 μg L⁻¹). UASB plant shows considerably higher concentration of THM. UV followed by chlorination is suggested as an alternative to chlorination. Per million liter per day (MLD) capital and operation and maintenance (O&M) costs of UV disinfection were analyzed revealing decreasing per MLD capital cost of UV with increasing plant capacity. The comparative annual O&M cost analysis of chlorination, dechlorination, and UV disinfection shows that there is up to 63% reduction of the total annual O&M cost by UV in comparison to chlorination, whereas in the case of chlorination followed by dechlorination, total reduction is 71%.

Historical trends of trace metals in muddy deposit along the Zhejiang coast, East China Sea: response to economic development and hypoxia

Abstract

One sediment core spanning approximately 138 years was taken from the muddy deposits along the Zhejiang coast of the East China Sea, which is located in a hypoxic zone south of the Yangtze River estuary. When the sources of the trace metals in the core were analyzed, the three geochemical sources were identified as lithogenic, anthropogenic, and reductive deposits based on both principal component analysis and the ratios of terrigenous elements. The temporal distribution of the enrichment factor of copper in the sediment core matches the timeline of economic development and national policy in China. The rapid increase in human activity and economic development in the Yangtze River catchment accounts for the enrichment of copper in the sediment core. Based on the vertical distribution of arsenic concentration, the hypoxic zone south of the Yangtze River estuary may have not only existed, but worsened since 1875.

Identification and characterization of key circadian clock genes of tobacco hairy roots: putative regulatory role in xenobiotic metabolism

Abstract

The circadian clock is an endogenous system that allows organisms to daily adapt and optimize their physiology and metabolism. We studied the key circadian clock gene (CCG) orthologs in Nicotiana tabacum seedlings and in hairy root cultures (HRC). Putative genes involved in the metabolism of xenobiotic compounds (MXC) were selected and their expression profiles were also analyzed. Seedlings and HRC displayed similar diurnal variations in the expression profiles for the CCG examined under control conditions (CC). MXC-related genes also showed daily fluctuations with specific peaks of expression. However, when HRC were under phenol treatment (PT), the expression patterns of the clock and MXC-related genes were significantly affected. In 2-week-old HRC, PT downregulated the expression of NtLHY, NtTOC1, and NtPRR9 while NtFKF1 and NtGI genes were upregulated by phenol. In 3-week-old HRC, PT also downregulated the expression of all CCG analyzed and NtTOC1 was the most affected. Following PT, the expression of the MXC-related genes was upregulated or displayed an anti-phasic expression profile compared to the expression under CC. Our studies thus provide a glimpse of the circadian expression of clock genes in tobacco and the use of HRC as a convenient system to study plant responses to xenobiotic stresses.

Water quality and resource management in the dairy industry

Abstract

Food industry is one of the most important and fastest growing sectors of economy in Poland. This sector is also characterized by high demand for the resources, particularly for water. Polish food industrial plants consumed 793 hm³ of water in 2014. Dairy branch had a combined 35% share of the above consumption. As shown by the data obtained from the Polish Central Statistical Office, the majority of dairy plants use its own source of water, so this branch is also important water producer in Poland. Water used for dairy industry should meet the requirements of at least drinking water quality, so the factories need to treat the water. This paper analyses the correlations between selected technical process, equipment profiles and water quality, and consumption in two types of dairy factories (DF). The first one DF-1 processes approx. 50,000 L of milk, and the second, DF-2 processes approx. 330,000 L of milk per day. The water taken from the wells needs to be pre-treated because of iron and manganese concentration and due to specific requirements in various industrial processes. As a result of this work, we have managed to propose technological solutions in the context of water consumption rationalization. The proposed solutions aim at improving water and wastewater management by reducing the amount of consumed water by industry.

Integrating water quality responses to best management practices in Portugal

Abstract

Nutrient nonpoint pollution has a significant impact on water resources worldwide. The main challenge of this work was to assess the application of best management practices in agricultural land to comply with water quality legislation for surface waters. The Hydrological Simulation Program—FORTRAN was used to evaluate water quality of Ave River in Portugal. Best management practices (infiltration basin) (BMP) were applied to agricultural land (for 3, 6, 9, 12, and 15% area) with removal efficiencies of 50% for fecal coliforms and 30% for nitrogen, phosphorus, and biochemical oxygen demand. The inflow of water quality constituents was reduced for all scenarios, with fecal coliforms achieving the highest reduction between 5.8 and 28.9% and nutrients and biochemical oxygen demand between 2 and 13%. Biochemical oxygen demand and orthophosphates concentrations achieved a good water quality status according to the European Legislation for scenarios of BMP applied to 3 and 12% agricultural area, respectively. Fecal coliform levels in Ave River basin require further treatment to fall below the established value in the abovementioned legislation. This study shows that agricultural watersheds such as Ave basins demand special attention in regard to nonpoint pollution sources effects on water quality and nutrient loads.

CORRECTION

Isotretinoin treatment for acne and risk of depression: A systematic review and meta-analysis

Evidence for the formal development of trauma subspecialty within plastic surgery in the united kingdom.

The Royal College of Surgeons working group on trauma recently recommended the reorganization of Plastic surgery training to incorporate a trauma subspeciality as a means to provide a sustainable workforce for trauma care provision nationally. The aim of this work was to gauge trainee opinion and aspiration in order to advice and shape the future of trauma training to meet this potential need. An online survey was conducted of UK Plastic surgical trainees to assess their interest in subspecialisiing in trauma.

Targeted muscle reinnervation for pain control in an elective transradial amputation

Targeted muscle reinnervation (TMR) is primarily used to transfer residual nerves of the amputated upper limb to reinnervate alternate target muscle groups, for intuitive control of a myoelectric prosthesis. Furthermore, TMR can significantly reduce the incidence of neuropathic and neuroma-related pain compared with conventional amputation techniques, by providing each nerve 'somewhere to go and something to do'.We report the use of TMR in a case of elective transradial amputation for intractable severe chronic post-traumatic and end neuroma limb pain (constant VAS pain score 10/10), 2 years following a severe crush injury to his left hand.

The liquid facelift: first hands-on experience with facial water jet-assisted liposuction as an additive technique for rhytidectomy - a case series of 25 patients

Recently, water jet-assisted liposuction (WAL) was successfully applied by several other authors to remove fat and induce skin contraction in non-facial body areas. Extending the range of indications for this new method, the authors of this article report on their first experience with its use in facial contouring, fat harvesting, and hydrodissection of the facial skin flap in rhytidectomy in a case series of 25 patients.

Rapidly growing mycobacteria infections among “cosmetic tourists” returning to the netherlands

Medical tourism for cosmetic surgery is becoming increasingly popular1. Most cosmetic tourists travel to developing parts of the world, such as Latin America and South Asia.2 Cosmetic surgery abroad has advantages such as shorter waiting lists, anonymity and lower costs, combined with a vacation.1-2 Although this seems appealing, it also carries risks.

3D graphene-based nanostructured materials as sorbents for cleaning oil spills and for the removal of dyes and miscellaneous pollutants present in water

Abstract

Oil spills over seawater and dye pollutants in water cause economic and environmental damage every year. Among various methods to deal oil spill problems, the use of porous materials has been proven as an effective strategy. In recent years, graphene-based porous sorbents have been synthesized to address the shortcomings associated with conventional sorbents such as their low uptake capacity, slow sorption rate, and non-recyclability. This article reviews the research undertaken to control oil spillage using three-dimensional (3D) graphene-based materials. The use of these materials for removal of dyes and miscellaneous environmental pollutants from water is explored and the application of various multifunctional 3D oil sorbents synthesized by surface modification technique is presented. The future prospects and limitations of these materials as sorbents are also discussed.

Prolonged and localized sweat stimulation by iontophoretic delivery of the slowly-metabolized cholinergic agent carbachol

Eccrine sweat has recently been gaining significant attention as a non-invasive method to access many electrolyte, molecule, and protein analytes found in blood [1]. Such attention builds on established commercial use of sweat for cystic fibrosis testing [2] and testing for metabolites of drugs of abuse [3,4]. The recent surge of interest in sweat biosensing has been caused by a demand for wearable technology that can continuously measure chemical analytes, and because sweat has several inherent advantages compared to other non-invasive biofluids [5–9].

Resolvin D1 attenuates imiquimod-induced mice psoriasiform dermatitis through MAPKs and NF-κB pathways

Psoriasis is a common, immune-mediated, chronic inflammatory skin disease of man. The prevalence ranges from 0% to 8.5%. The occurrence of psoriasis varies according to age and geographic region [1–3]. Psoriasis is characterized by hyperproliferative keratinocytes, parakeratosis, hyperkeratosis, and massive infiltration of inflammatory leukocytes into the dermis and epidermis. The disease severely affects quality of life. The typical histological traits encompass hyperkeratosis of the epidermis, acanthosis, elongation of dermal capillary vessels, and infiltration of inflammatory leukocytes into the dermis and epidermis, which are clinically reflected by erythema, scaling, and thickening.

What Neurotoxins Have Taught Us About the Brow: The Reintroduction and Review of the Transpalpebral Browpexy

Abstract

Introduction

The use of neuromodulators has grown substantially in our society, particularly in the temporary treatment of brow ptosis. This study revisits the use of the transpalpebral browpexy for upper face and brow rejuvenation in the context of what has been learned from neuromodulators.

Methods

A retrospective review of 97 subjects was conducted who had transpalpebral browpexy performed for lateral brow ptosis. Qualitative degree of brow elevation after the procedure was determined by examining before and after photographs for each patient.

Results

Out of 97 patients, 95 (98%) experienced aesthetically optimal brow elevation for their respective gender. Two patients required surgical revision, both of which experienced extenuating circumstances. Two patients experienced edema and one patient experienced periodic eruptions of chalazia along the upper eyelid.

Conclusion

Transpalpebral browpexy is a reliable, minimally invasive surgical procedure that effectively emulates the results of neuromodulator injections for a much longer period of time. While it cannot replace traditional brow-lifting techniques, transpalpebral browpexy does have solid indications with proven long-lasting results, which can be effective in a significant portion of patients with brow ptosis.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://ift.tt/18t7xNj.

Enzymatic dynamics into the Eisenia fetida (Savigny, 1826) gut during vermicomposting of coffee husk and market waste in a tropical environment

Abstract

Epigeic worms modify microbial communities through their digestive processes, thereby influencing the decomposition of organic matter in vermicomposting systems. Nevertheless, the enzyme dynamics within the gut of tropically adapted earthworms is unknown, and the enzymes involved have not been simultaneously studied. The activities of 19 hydrolytic enzymes within three different sections of the intestine of Eisenia fetida were determined over a fasting period and at 24 h and 30, 60, and 90 days of vermicomposting, and data were evaluated by multivariate analyses. There were found positive correlations between the maximal activity of glycosyl hydrolases and one esterase with the anterior intestine (coincident with the reduction of hemicellulose in the substrate) and the activity of the protease α-chymotrypsin with posterior intestine. The results suggest that activities of enzymes change in a coordinated manner within each gut section, probably influenced by selective microbial enzyme enrichment and by the availability of nutrients throughout vermicomposting.

Ovarian growth impairment after chronic exposure to Roundup Ultramax® in the estuarine crab Neohelice granulata

Abstract

Adult females of the estuarine crab Neohelice granulata were exposed to the glyphosate formulation Roundup Ultramax® during the entire 3-month pre-reproductive period. At the end of the assay, a significant higher increment of glycemia was noted at both glyphosate concentrations assayed (0.01 and 0.2 mg/L, acid equivalent). Although no differences were observed in the gonadosomatic index, a significantly higher proportion of reabsorbed vitellogenic oocyte was observed at the highest glyphosate concentration, together with a significant decrease of vitellogenin content in the ovary. In addition, some in vitro assays were carried out by co-incubating small pieces of ovary with or without the addition of Roundup; at both concentrations tested (same as those used in vivo), a decrease in the ovarian vitellogenin content was observed, whereas the ovarian protein synthesis was significantly inhibited by glyphosate at 0.2 mg/L in the Roundup formulation used.

Use of Lymph Node Ultrasound Prior to Sentinel Lymph Node Biopsy in 384 Patients with Melanoma: A Cost-Effectiveness Analysis

Publication date: Available online 2 November 2017
Source:Actas Dermo-Sifiliográficas (English Edition)
Author(s): D. Olmedo, M. Brotons-Seguí, C. del Toro, M. González, C. Requena, V. Traves, A. Pla, I. Bolumar, D. Moreno-Ramírez, E. Nagore
Background and objectivesLocoregional lymph node ultrasound is not typically included in guidelines as part of the staging process prior to sentinel lymph node biopsy (SLNB). The objective of the present study was to make a clinical and economic analysis of lymph node ultrasound prior to SLNB.Materials and methodsWe performed a retrospective study of 384 patients with clinical stage I-II primary melanoma who underwent locorregional lymph node ultrasound (with or without ultrasound-guided biopsy) prior to SLNB between 2004 and 2015. We evaluated the reliability and cost-effectiveness of the strategy.ResultsUse of locorregional lymph node ultrasound avoided SLNB in 23 patients (6%). Ultrasound had a sensitivity of 46% and specificity of 76% for the detection of metastatic lymph nodes that were not clinically palpable. False negatives were significantly more common in patients aged over 60 years and in tumors with a thickness of less than 2mm. The staging process using SLNB and ultrasound with ultrasound-guided biopsy produced an increase of €16.30 in the unit price. Our cost-effectiveness analysis identified the staging protocol with ultrasound and SLNB as the dominant strategy, with a lower cost-effectiveness ratio than the alternative, consisting of SLNB alone (8,095.24 vs €28,605.00).ConclusionsUltrasound with ultrasound-guided biopsy for the diagnostic staging of melanoma prior to SLNB is a useful and cost-effective tool. This procedure does not substitute SLNB, though it does allow to avoid SLNB in a not insignificant proportion of patients.

Optimizing donor site closure following bilateral breast reconstruction with abdominal-based free flaps

Publication date: Available online 1 November 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Noelle M. Messina, Kristie Rossi, Lisa M. Wetherhold, Matthew J. Wetherhold, Samuel Litwin, Neal S. Topham, Eric I. Chang

Rapidly growing mycobacteria infections among “cosmetic tourists” returning to the netherlands

Publication date: Available online 2 November 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Zachri Ovadja, Heleen Sluijmer, Esther Moerman, Marc van Ogtrop, Oren Lapid

The liquid facelift: first hands-on experience with facial water jet-assisted liposuction as an additive technique for rhytidectomy - a case series of 25 patients

Publication date: Available online 2 November 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Kai O. Kaye, Sonja Kaestner, Felix J. Paprottka, Phillipp Gonser
ObjectiveRecently, water jet-assisted liposuction (WAL) was successfully applied by several other authors to remove fat and induce skin contraction in non-facial body areas. Extending the range of indications for this new method, the authors of this article report on their first experience with its use in facial contouring, fat harvesting, and hydrodissection of the facial skin flap in rhytidectomy in a case series of 25 patients.MethodsTwenty-five patients (median age: 56 years) had facelift surgery under sedation, and the WAL technique was used for facial contouring, fat harvesting face-to-face lipotransfer, and hydrodissection of the facial skin flap. Patients were monitored for discomfort during the procedure. Complications such as bleeding, postoperative swelling, and hematoma formation were observed during a 1-week follow-up period, and intensity was rated by two independent surgeons using a special grading system. Furthermore, a patient survey (FACE-Q) was performed to analyze the patients' satisfaction and perception of the postsurgical esthetic results.ResultsThe WAL technique can be applied under intravenous sedation without causing any discomfort in all treated patients [mean 1.16, standard deviation (SD) 0.31]. Intraoperative bleeding during WAL-assisted facial dissection was judged as not present at all times (mean 1.3, SD 0.32). Postoperative swelling (day 1: mean 1.82, SD 0.28; day 7: mean 1.18, SD 0.28) and hematoma formation following surgery (day 1: mean 1.58, SD 0.34; day 7: mean 1.18, SD 0.31) were judged as minor in all cases. Overall, no skin necrosis was detected. There was no need for revision surgery. More than half of our treated patients (n=13) answered the FACE-Q questionnaire, verifying a high satisfaction rate with beneficial treatment results without the occurrence of any major complications.ConclusionsThe WAL technique seems to offer a safe and efficient treatment approach for facial contouring, facial fat harvesting, and simultaneous facial flap hydrodissection with only minor postoperative swelling and hematoma formation. Therefore, the authors believe that the WAL technique is a powerful and useful tool and should be used in modern facial plastic surgery.

Evidence for the formal development of trauma subspecialty within plastic surgery in the united kingdom.

Publication date: Available online 2 November 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): R.M.T. Staruch, H. Lloyd-Hughes, A. Shiatis, S.P. Hettiaratchy
The Royal College of Surgeons working group on trauma recently recommended the reorganization of Plastic surgery training to incorporate a trauma subspeciality as a means to provide a sustainable workforce for trauma care provision nationally. The aim of this work was to gauge trainee opinion and aspiration in order to advice and shape the future of trauma training to meet this potential need. An online survey was conducted of UK Plastic surgical trainees to assess their interest in subspecialisiing in trauma. A total of 98 trainees responded to the survey. Eighty three percent of trainees are interested in gaining from experience in the management of trauma. Whilst sixty five percent would be interested in undertaking formal roles in trauma as a subspeciality. This survey has documented and highlighted the desire of UK trainees to play a significant role in the management of acute trauma.

Distally based sural neuro-fasciocutaneous perforator flap for foot and ankle reconstruction: surgical modifications for flap pedicle and donor site closure without skin graft

Publication date: Available online 1 November 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Zhenglin Chi, Yiheng Chen, Tinggang Chu, Weiyang Gao, Zhijie Li, Hede Yan, Yonghuan Song
BackgroundThe conventional procedure of the sural neuro-fasciocutaneous flap enables the supply of blood and venous drainage by increasing the width of the adipofascial tissue and preserving tiny venous return routes. Moreover, skin graft is a common method for donor site closure, which may lead to some complications and influence the aesthetic appearance. We report modifications for a distally based sural neuro-fasciocutaneous perforator flap and a relaying flap for donor site closure without skin graft.MethodsTwelve patients undergoing the modified flap for foot and ankle reconstruction were included in this study between 2014 and 2016. A peroneal-based perforator, a superficial vein, and the vascular axis of the sural nerve were included in the pedicle. A Z-shape skin incision was performed to explore the perforator vessels and a relaying island perforator flap was used to close the donor site.ResultsAll flaps survived completely without necrosis. The area of the flaps ranged from 16×8 cm to 30×15 cm. The diameter width of the pedicle ranged from 1.0 to 2.0 cm. A relaying perforator island flap was used in 10 cases for donor site closure and no skin graft was performed. There were no serious donor site complications. All patients were satisfied with the aesthetic outcome postoperatively at the final follow-up.ConclusionsThe distally based sural neuro-fasciocutaneous perforator flap is considered a reliable method for foot and ankle reconstruction. The modification for flap pedicle and donor site closure method without skin graft should be recommended.

Rectus femoris branch: an alternative blood supply for a distally based anterolateral thigh flap

Publication date: Available online 1 November 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Shanshan Li, Yuanbo Liu, Mengqing Zang, Shengji Yu, Wei Guo, Rongli Yang
Successful raising of a distally-based anterolateral thigh (dALT) flap mainly depends on a well-developed lateral circumflex femoral artery (LCFA) descending branch and an intact vascular connection between the descending branch and the vascular network of the knee. However, in some clinical scenarios, the descending branch is hypoplastic or the vascular connection of the knee is compromised. We present six cases of using dALT flaps in soft tissue defect reconstruction of the knee with either of the above-mentioned conditions. In these cases, the flaps relied on the reverse blood flow through the rectus femoris branch and showed complete survival postoperatively. We believe the reverse flow from the rectus femoris branch could be an alternative blood supply for the dALT flap in the presence of hypoplasia of the LCFA descending branch or compromise of the vascular connection between the descending branch and the articular geniculate network.

Rethinking the Wrongness Constraint on Criminalisation

Abstract

Orthodox thought holds that criminalisation should be subject to a wrongness constraint: that is, that conduct may be criminalised only if it is wrongful. This article argues that this principle is false, at least as it is usually understood. On the one hand, the wrongness constraint seems to rest on solid foundations. To criminalise conduct is to facilitate its condemnation and punishment; to coerce citizens against it; and to portray it as wrongful. All of these actions are presumptively impermissible when the conduct that they target is not wrongful. On the other hand, the article argues that the wrongness constraint is nevertheless unsound. Although it is presumptively impermissible to criminalise non-wrongful conduct, this might yet be permissible, given sufficient countervailing reasons. Moreover, there are realistic cases – specifically, some cases of over-inclusive criminalisation – in which such countervailing reasons exist.

Abhinavagupta on the Kashmirian Gītā

Abstract

This paper announces the first critical edition of Abhinavagupta's commentary (entitled Gītārthasaṃgraha) on the Bhagavadgītā in its Kashmirian recension, based on one Kashmirian Devanāgarī and seven Śāradā manuscripts in addition to two existing non-critical editions. The volume will also include a new edition of the Kashmirian recension of the Bhagavadgītā and a full French translation. After a short presentation of Abhinavagupta's commentary and a discussion of previous work on the subject, the manuscripts used are listed and briefly described. The question and importance of the Kashmirian recension of the Bhagavadgītā and problems of its edition are discussed in detail, with several textual examples. In order to give a sample of the Gītārthasaṃgraha's contents, some of Abhinavagupta's remarkable interpretations are also highlighted, in particular tantric or esoteric ones. An Appendix deals with the closely related question of Bhāskara the Vedāntin, his date, his provenance and the Gītā recension he probably used for his commentary.

Identification of intraplaque haemorrhage in carotid artery by simultaneous non-contrast angiography and intraPlaque haemorrhage (SNAP) imaging: a magnetic resonance vessel wall imaging study

Abstract

Objectives

To investigate the usefulness of Simultaneous Non-contrast Angiography and intraPlaque haemorrhage (SNAP) imaging in characterising carotid intraplaque haemorrhage (IPH) compared with magnetisation-prepared rapid acquisition gradient-echo (MP-RAGE) sequence.

Methods

Fifty-four symptomatic patients (mean age: 63.1 ± 5.7 years, 38 males) with carotid atherosclerosis were recruited and underwent carotid MR imaging. The presence and area of IPH on SNAP and MP-RAGE images were determined. The agreement in identifying IPH and its area between SNAP and MP-RAGE was analysed.

Results

Of 1368 slices with acceptable image quality in 54 patients, 13% and 22.6% were found to have IPH on MP-RAGE and SNAP images, respectively. There was moderate agreement between MP-RAGE and SNAP sequences in identifying IPH (κ = 0.511, p = 0.029). The area of IPH on SNAP images was significantly larger than that on MP-RAGE images (17.9 ± 18.2 mm² vs. 9.2 ± 10.5 mm², p < 0.001). For IPHs detected by SNAP imaging, the area of IPHs also detected by the MP-RAGE sequence was significantly larger than that of IPHs not detected by the MP-RAGE sequence (17.9 ± 19.2 mm² vs. 6.4 ± 6.2 mm², p < 0.001).

Conclusion

Compared with the MP-RAGE sequence, SNAP imaging detects more IPHs, particularly for smaller IPHs, suggesting that SNAP imaging might be a more sensitive tool for identification of carotid haemorrhagic plaques.

Key Points

• Moderate agreement was found between SNAP and MP-RAGE in identification of IPH

• SNAP imaging might be a more sensitive tool to detect carotid IPHs

• Compared with the MP-RAGE sequence, SNAP imaging can detect carotid IPHs with smaller size

• SNAP imaging can help clinicians to optimise the treatment strategy

Cost-effectiveness of Bezlotoxumab Compared With Placebo for the Prevention of Recurrent Clostridium difficile Infection

Abstract

Background

Clostridium difficile infection (CDI) is the most commonly recognized cause of recurrent diarrhea. Bezlotoxumab, administered concurrently with antibiotics directed against C. difficile (standard of care [SoC]), has been shown to reduce the recurrence of CDI, compared with SoC alone. This study aimed to assess the cost-effectiveness of bezlotoxumab administered concurrently with SoC, compared with SoC alone, in subgroups of patients at risk of recurrence of CDI.

Methods

A computer-based Markov health state transition model was designed to track the natural history of patients infected with CDI. A cohort of patients entered the model with either a mild/moderate or severe CDI episode, and were treated with SoC antibiotics together with either bezlotoxumab or placebo. The cohort was followed over a lifetime horizon, and costs and utilities for the various health states were used to estimate incremental cost-effectiveness ratios (ICERs). Both deterministic and probabilistic sensitivity analyses were used to test the robustness of the results.

Results

The cost-effectiveness model showed that, compared with placebo, bezlotoxumab was associated with 0.12 quality-adjusted life-years (QALYs) gained and was cost-effective in preventing CDI recurrences in the entire trial population, with an ICER of $19824/QALY gained. Compared with placebo, bezlotoxumab was also cost-effective in the subgroups of patients aged ≥65 years (ICER of $15298/QALY), immunocompromised patients (ICER of $12597/QALY), and patients with severe CDI (ICER of $21430/QALY).

Conclusions

Model-based results demonstrated that bezlotoxumab was cost-effective in the prevention of recurrent CDI compared with placebo, among patients receiving SoC antibiotics for treatment of CDI.

Trends in the San Francisco HIV Epidemic in the “Getting to Zero” Era

Abstract

Background

San Francisco (SF) has launched interventions to reduce new HIV infections and HIV-associated morbidity and mortality during the SF "Getting to Zero (GTZ)" era. We measured recent changes in HIV care indicators to assess the success of these interventions.

Methods

SF residents newly HIV-diagnosed from 2009-2014 were included. We measured temporal changes from HIV diagnosis to a) linkage to care ≤ 3 months, b) initiation of antiretroviral therapy (ART) ≤12 months, c) viral suppression (VS) ≤12 months, d) development of AIDS ≤3 months, e) death ≤12 months and f) retention in care 6-12 months after linkage. Kaplan-Meier analyses stratified by year of HIV diagnosis measured time from diagnosis to linkage, ART initiation, VS, AIDS and death.

Results

Overall, new diagnoses declined from 473 in 2009 to 329 in 2014. The proportion of new diagnoses among men (p=0.005), Latinos and Asian/Pacific Islanders (p=0.02), and men who have sex with men (p=0.003) increased. ART initiation and VS ≤12 months of diagnosis increased (P<0.001) while the proportion who were diagnosed with AIDS ≤3 months of HIV diagnosis declined (P<0.001). Time to ART initiation and time to VS were significantly shorter in more recent years of diagnosis (P<0.001). Time from HIV to AIDS diagnosis was significantly longer in more recent years (P<0.001). Retention in care did not significantly change.

Conclusions

In SF new HIV diagnoses have declined and HIV care indicators have improved during the "GTZ" era. Continued success requires attention to vulnerable populations and monitoring to adjust programmatic priorities.

Carbapenem-resistant Enterobacteriaceae (CRE) detection practices in California: What are we missing?

Abstract

Background

The Clinical and Laboratory Standards Institute (CLSI) revised carbapenem breakpoints for the Enterobacteriaceae in 2010. The number of hospitals that adopted revised CLSI breakpoints and the clinical impact of delayed adoption has not been previously explored.

Methods

We performed a cross-sectional, voluntary survey of microbiology laboratories that serve California acute care hospitals and long-term acute care hospitals (LTAC) to determine use of revised CLSI breakpoints. CRE clinical isolates from a single tertiary care hospital from 2013 to 2017 were examined. All isolates with an elevated minimum inhibitory concentration (MIC) (≥ 2 µg/mL) to imipenem or meropenem were tested for the presence of a carbapenemase gene by PCR.

Results

We received responses from 128 laboratories that serve 264/393 (67%) of hospitals and LTACs. Current CLSI carbapenem breakpoints for Enterobacteriaceae were used by 92/128 (72%) laboratories. Among laboratories using current breakpoints, time to implementation varied from 0 – 68 months (mean, 41 months, median, 55 months). Application of historical breakpoints to isolates in with a carbapenemase gene detected by PCR resulted in susceptibility rates of 8.9%, 18.6%, and 18.6% to ertapenem, imipenem, and meropenem, respectively. By current breakpoints, <1% of these isolates were susceptible to ertapenem or imipenem and 2.6% to meropenem.

Conclusion

Clinicians and epidemiologists should be aware that use of outdated MIC breakpoints for Enterobacteriaceae remains common and can result in reports of false susceptibility to carbapenems and missed identification of carbapenemase producers. This misclassification could have consequences for patient care and infection control efforts to address carbapenemase-producing Enterobacteriaceae.

Reply to Ceccarelli, et al.

Achieving 90-90-90 HIV targets will not be enough to achieve the HIV incidence reduction target in Australia

Abstract

Background

We estimated the HIV incidence reduction in Australia corresponding to achieving the UNAIDS 90-90-90 targets by 2020 and extended targets of 95-95-95 by 2030, in combination with various scale-ups of HIV testing, primary prevention and pre-exposure prophylaxis (PrEP) among high-risk men who have sex with men (MSM). These projections were evaluated against the target of achieving a 90% reduction in HIV incidence by 2030 compared with 2010 levels.

Methods

A mathematical model was used to project annual HIV incidence for combinations of HIV care cascade targets, testing frequencies, primary prevention coverages and levels of PrEP scale-up.

Results

Achieving 90-90-90 by 2020 was estimated to reduce incidence by 10% from 2010 levels. Achieving 95-95-95 by 2030 was estimated to reduce incidence by 17% from 2010 levels, with the first 95 being achievable by testing low-/high-risk MSM two/four times per year respectively. This was improved to a 34% reduction by including a five-year scale-up of PrEP to 30% coverage among high-risk MSM; and to 45% by also increasing MSM condom use from 42% to 60%. However, even with 95-95-95, two/four tests per year for low-/high-risk MSM, 100% high-risk MSM PrEP coverage and 100% MSM condom use, only an 80% reduction in incidence was possible by 2030.

Conclusion

Many countries, particularly those with low HIV prevalence, will struggle to achieve a 90% reduction in HIV incidence by 2030 even if UNAIDS targets are met. Most will require substantially higher levels of prevention coverage and higher testing frequencies to reach this target.

Toward the identification of a genetic risk signature for pulmonary aspergillosis in COPD

January 15 2018 News feature

Reply to Cunha et al

Low Monitoring Rates of Healthcare-associated Infection in Japanese Hospitals

Follow-Up Blood Cultures: A 2.0 Diagnostic Tool in Patients with Gram-Negative Bacteremia and Septic Thromboplhebitis

Repairing Bronchoesophageal Tube Fistula Using A Contralateral Latissimus Dorsi Musculocutaneous Flap

Summary:A postoperative aerodigestive fistula is one of the rare but critical complications after esophagectomy, and management is challenging. The essential keys to successful treatment of these fistula are thorough debridement and complete closure followed by separation of the respiratory and digestive tract. We present a case of a recurrent bronchoesophageal fistula between the left main bronchus and neo esophagus, which was successfully treated through a contralateral approach. The fistula was debrided and closed primarily through a right thoracotomy, and the interposition of a pedicled latissimus dorsi musculocutaneous flap from the right side was carried out. The patient was able to resume oral feeding at 16th postoperative day.

Oxidative stress and cell cycle arrest induced by short-term exposure to dustfall PM 2.5 in A549 cells

Abstract

It was reported that in vitro short-term exposure to PM_2.5 caused different lung diseases through inflammatory response, immune toxicity, oxidative stress, and genetic mutations. However, the complex molecular biological mechanism for its toxicity had not been fully elucidated. Therefore, the present study investigated the cytotoxicity, oxidative damage, mitochondria damage, apoptosis, and cell cycle arrest of NX and QH PM_2.5 in A549 cells. Further, cell cycle arrest-related gene levels in PM_2.5-induced A549 cells were also detected. Our results suggested that PM_2.5 reduced the cell viability in A549 cells. Simultaneously, excessive ROS decreased MMP levels and damaged mitochondrial membrane integrity and induced mitochondrial oxidative damage through the oxygen-dependent killer route, resulting in mitochondrial damage and cell apoptosis. Besides, the results also showed that PM_2.5 induced A549 cell cycle alteration in G2/M phase after co-culture for 24 h. G2/M phase arrest was induced by upregulation of p53 and p21 and downregulation of CDK1 mRNA expression. In addition, lncRNA Sox2ot might play an important role as the specific oncogenes and it participated in G2/M phase arrest by regulating the expression of EZH₂.

Cost-effectiveness analysis of herpes zoster vaccine in adults above 50 in Singapore

Publication date: Available online 2 November 2017
Source:Dermatologica Sinica
Author(s): JiunYit Pan, Tun-Ying Hsu, Kelly D. Johnson, Ruifeng Xu, Camilo J. Acosta, Kosuke Kawai
Background/ObjectivesIncidence of herpes zoster (HZ) increases with age. The vaccine to prevent HZ is available for those who are 50 and older. This study aims to investigate the cost-effectiveness of HZ vaccine on population older than 50 years old from a societal perspective in Singapore.MethodsThe established decision analytic (Markov) model was utilized to simulate the results of vaccination for adults who were older than 50 years of age, compared to those without vaccination. The total number of HZ cases, postherpetic neuralgia (PHN) cases, total direct cost of treatment and indirect cost due to productivity loss were estimated based on the characteristics of population, and treatment costs were collected from a local institute in Singapore. The public health consensus for the ICER benchmark in Singapore was S$65,000.ResultsOne million individuals were simulated in this health economics analysis. Vaccination would reduce 48% of HZ cases and 33% of PHN cases over their life time. When a vaccination strategy for adults who are 50 years old and older was compared to a strategy with no vaccination, incremental cost-effectiveness ratio (ICER) was S$49,023 per quality adjusted life years (QALY) gained from the societal perspective.ConclusionThe herpes zoster vaccination is likely to be cost-effective in societal perspective for adult over 50 years of age in Singapore.

Acute kidney injury in patients with nephrotic syndrome undergoing contrast-enhanced CT for suspected venous thromboembolism: a propensity score-matched retrospective cohort study

Abstract

Objectives

To determine whether intravenous iodinated contrast material administration increases the risk of acute kidney injury (AKI) in patients with nephrotic syndrome undergoing contrast-enhanced CT.

Methods

Patients with nephrotic syndrome undergoing contrast-enhanced CT were retrospectively identified (n = 701). Control group consisted of patients with nephrotic syndrome receiving non-contrast CT (n = 1053). Two different 1:1 propensity score matching models using three or 10 variables were developed for each estimated glomerular filtration (eGFR) subgroup. Incidence of post-CT AKI for the two groups was assessed and compared by standard AKI criteria and Acute Kidney Injury Network (AKIN) criteria.

Results

After matching with three variables, the AKI incidence in the contrast-enhanced CT and non-contrast CT groups was 2.7% vs 2.5% (standard AKI criteria) and 4.2% vs. 6.7% (AKIN criteria) (p = 1.00 and 0.05), respectively. After matching with 10 variables, AKI incidences were 3.1% vs. 2.6% (standard AKI criteria) and 4.1% vs. 7.4% (AKIN criteria) (p = 0.72 and 0.03), respectively. AKI incidences of each eGFR subgroup in the contrast-enhanced CT group were not higher than in the non-contrast CT group (lowest p = 0.46).

Conclusion

Intravenous contrast material administration during CT was not found to be a risk factor for AKI in this large cohort of patients with nephrotic syndrome.

Key points

• AKI incidence of contrast-enhanced CT and non-contrast CT had no difference.

• AKI incidences of eGFR subgroup in contrast-enhanced CT were not increased.

• Studies without a non-contrast CT control group may overestimate CIN incidence.

Ästhetische Psychodermatologie

High concentrations of perfluorooctane sulfonate in mucus of tiger puffer fish Takifugu rubripes : a laboratory exposure study

Abstract

Distribution of perfluorooctane sulfonate (PFOS) was investigated in tissues (plasma, blood clot, mucus, skin, liver, muscle, and gonad) of tiger puffer fish Takifugu rubripes. A single dose of PFOS was intraperitoneally injected at 0.1 mg/kg body weight with samples taken over a 14-day period. The highest concentration of PFOS was found in the plasma, 861 ng/mL at 14 days, followed by the mucus, liver, blood clot, gonads, muscles, and skin of fish. A gradual upward trend in PFOS concentration was observed in the mucus and liver whereas there was no change in the plasma, blood clot, gonad, muscle, and skin after the initial increase in PFOS concentrations following injection. No significant trend for estimated total PFOS content in whole body was observed during the experimental period. Relatively high concentrations of PFOS (690 ng/g ww after 14 days) were detected in body surface mucus that continuously oozes from the skin. These results may suggest that mucus is one of the elimination pathways of PFOS in tiger puffer fish.

Resistance of black soldier fly (Diptera: Stratiomyidae) larvae to combined heavy metals and potential application in municipal sewage sludge treatment

Abstract

Treating municipal sewage sludge (MSS) sustainably and economically in China remains a challenge because of risks associated with the heavy metals it contains. In this study, black solider fly larvae (BSFL) were used for MSS treatment. The resistance of larvae to combined heavy metals and their potential use in conversion of MSS were investigated. The results indicated that seven MSS samples contained large amounts of heavy metals, with the lead and nickel contents of several samples exceeding Chinese national discharge standards. BSFL were highly tolerant to an artificial diet spiked with combined heavy metals. Principal component analysis revealed that high concentrations of lead, nickel, boron, and mercury potentially interfered with larval weight gain, while zinc, copper, chromium, cadmium, and mercury slightly reduced larval survival. The addition of chicken manure and wheat bran as co-substrates improved the conversion process, which was influenced by the nature and amount of added co-substrate and especially the quantity of nitrogen added. With the amended substrate, the BSFL accumulated heavy metals into their bodies but not into extracted larval oil. The heavy metal content of the treatment residue was lower than that considered safe for organic-inorganic compound fertilizers standards in China and the harvested larvae could be used as a source of oil for industrial application.

Breast compression parameters and mammographic density in the Norwegian Breast Cancer Screening Programme

Abstract

Objectives

To investigate possible associations between breast compression parameters, including compression force, pressure and compressed breast thickness, and mammographic density assessed by an automated software.

Methods

We obtained data on breast compression parameters, breast volume, absolute and percentage dense volume, and body mass index for 14,698 women screened with two-view (craniocaudal, CC, and mediolateral oblique, MLO) digital mammography, in the Norwegian Breast Cancer Screening Programme, 2014–2015. The Spearman correlation coefficient (ρ) was used to measure correlation between breast compression parameters, breast volume and absolute and percentage dense volume. Linear regression was used to examine associations between breast compression parameters and absolute and percentage dense volume, adjusting for breast volume, age and BMI.

Results

A fair negative correlation was observed between compression pressure and absolute dense volume (ρ = − 0.37 for CC and ρ = − 0.34 for MLO). A moderate negative correlation was identified for compressed breast thickness and percentage dense volume (ρ = − 0.56 for CC and ρ = − 0.62 for MLO). These correlations were corroborated by the corresponding associations obtained in the adjusted regression analyses.

Conclusions

Results from this study indicate that breast compression parameters may influence absolute and percentage dense volume measured by the automated software.

Key points

• A fair correlation was identified between compression pressure and absolute dense volume

• A moderate correlation was identified between compressed breast thickness and percentage dense volume

• Breast compression may influence automated density estimates

A New Method for Photocephalometry

This Research Letter presents a simple technique for obtaining pre- and postoperative cephalometric measurements from digital facial photographs using an adhesive ruler affixed to sunglasses.

Cranioplasty Using a Mixture of Biologic and Nonbiologic Agents

This study describes a cranioplasty technique that combines biologic autologous bone and nonbiologic allograft materials.

YWHAE is a novel interaction partner of Helicobacter pylori CagA

Abstract

CagA, an important virulence factor of Helicobacter pylori, targets and interacts with a series of host proteins to activate signaling factors involved in many functions, such as development, cytoskeleton rearrangement, and inflammatory molecule release. Despite extensive efforts, the relationship between CagA and gastric cancer is far from completely understood. Here, the GAL4 yeast two-hybrid system was used to screen cellular proteins for binding to CagA, and five cellular proteins, including tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein, epsilon (YWHAE), were identified. The CagA-YWHAE interaction was further verified not only in vitro by a glutathione S-transferase pull-down assay but also in vivo by immunolocalization and co-immunoprecipitation assays. In SGC7901 and AGS cells, overexpression of the YWHAE protein promoted the activation of NF-κB by CagA; conversely, knockdown of the YWHAE protein inhibited the activation of NF-κB by CagA. These results indicate that CagA enhances the YWHAE-mediated transactivation of NF-κB, providing a new clue to the molecular mechanisms of H. pylori-associated tumorigenesis mediated by CagA.

Paid Maternity Leave in the United States: Associations with Maternal and Infant Health

Abstract

Objectives The United States is one of only three countries worldwide with no national policy guaranteeing paid leave to employed women who give birth. While maternity leave has been linked to improved maternal and child outcomes in international contexts, up-to-date research evidence in the U.S. context is needed to inform current policy debates on paid family leave. Methods Using data from Listening to Mothers III, a national survey of women ages 18–45 who gave birth in 2011–2012, we conducted multivariate logistic regression to predict the likelihood of outcomes related to infant health, maternal physical and mental health, and maternal health behaviors by the use and duration of paid maternity leave. Results Use of paid and unpaid leave varied significantly by race/ethnicity and household income. Women who took paid maternity leave experienced a 47% decrease in the odds of re-hospitalizing their infants (95% CI 0.3, 1.0) and a 51% decrease in the odds of being re-hospitalized themselves (95% CI 0.3, 0.9) at 21 months postpartum, compared to women taking unpaid or no leave. They also had 1.8 times the odds of doing well with exercise (95% CI 1.1, 3.0) and stress management (95% CI 1.1, 2.8), compared to women taking only unpaid leave. Conclusions for Practice Paid maternity leave significantly predicts lower odds of maternal and infant re-hospitalization and higher odds of doing well with exercise and stress management. Policies aimed at expanding access to paid maternity and family leave may contribute toward reducing socio-demographic disparities in paid leave use and its associated health benefits.

Toxicity profile of organic extracts from Magdalena River sediments

Abstract

The Magdalena River, the main river of Colombia, receives contaminated effluents from different anthropogenic activities along its path. However, the Magdalena River is used as drinking water source for approximately 30 million inhabitants, as well as a major source of fish for human consumption. Only a few studies have been conducted to evaluate the environmental and toxicological quality of the Magdalena River. To evaluate sediment toxicity, wild-type and GFP transgenic Caenorhabditis elegans were exposed to methanolic extracts, and effects on lethality, locomotion, growth, and gene expression were determined based on fluorescence spectroscopy. These biological and biochemical parameters were correlated with measured pollutant concentrations (PAHs and trace elements), identifying patterns of toxicity along the course of the river. Effects on lethality, growth, and locomotion were observed in areas influenced by industrial, gold mining, and petrochemical activities. Changes in gene expression were evident for cyp-34A9, especially in the sampling site located near an oil refinery, and at the seaport, in Barranquilla City. Body bend movements were moderately correlated with Cr and As concentrations. The expression of mtl-1, mtl-2, hsp-6, and hsp-70 were significantly associated with Pb/U, Pb, Sr, and As/Sr/Pb/U, respectively. Interestingly, toxicity of methanolic as well as aqueous extracts were more prone to be dependent on Cd, Zn, and Th. In general, ecological risk assessment showed sediments display low environmental impact in terms of evaluated metals and PAHs. Different types of waste disposal on the Magdalena River, as a result of mining, domestic, agricultural, and industrial activities, incorporate toxic pollutants in sediments, which are capable of generating a toxic response in C. elegans.

Antifungal activity of essential oils on two Venturia inaequalis strains with different sensitivities to tebuconazole

Abstract

The antifungal activity of seven essential oils (eucalyptus, clove, mint, oregano, savory, tea tree, and thyme) was studied on Venturia inaequalis, the fungus responsible for apple scab. The composition of the essential oils was checked by gas chromatography-mass spectrometry. Each essential oil had its main compound. Liquid tests were performed to calculate the IC₅₀ of essential oils as well as their majority compounds. The tests were made on two strains with different sensitivities to tebuconazole: S755, the sensitive strain, and rs552, the strain with reduced sensitivity. Copper sulfate was selected as the reference mineral fungicidal substance. IC₅₀ with confidence intervals were calculated after three independent experiments. The results showed that all essential oils and all major compounds had in vitro antifungal activities. Moreover, it was highlighted that the effectiveness of four essential oils (clove, eucalyptus, mint, and savory) was higher than copper sulfate on both strains. For each strain, the best activity was obtained using clove and eucalyptus essential oils. For clove, the IC₅₀ obtained on the sensitive strain (5.2 mg/L [4.0–6.7 mg/L]) was statistically lower than the IC₅₀ of reduced sensitivity strain (14 mg/L [11.1–17.5 mg/L]). In contrast, for eucalyptus essential oil, the IC₅₀ were not different with respectively 9.4–13.0 and 12.2–17.9 mg/L for S755 and rs552 strains. For mint, origano, savory, tea tree, and thyme, IC₅₀ were always the best on rs552 strain. The majority compounds were not necessarily more efficient than their corresponding oils; only eugenol (for clove) and carvacrol (for oregano and savory) seemed to be more effective on S755 strain. On the other hand, rs552 strain seemed to be more sensitive to essential oils than S755 strain. In overall, it was shown that essential oils have different antifungal activities but do not have the same antifungal activities depending on the fungus strain used.

Reference intervals for B-esterases in gull, Larus michahellis (Nauman, 1840) from Northwest Spain: influence of age, gender, and tissue

Abstract

Over the last years, cholinesterase (ChE) and carboxylesterase (CbE) activities have been increasingly used in environmental biomonitoring to detect the exposure to anticholinesterase insecticides such as organophosphorates (OPs) and carbamates (CBs). The aim of this study was to determine ChE and CbE enzymatic activities present in liver and muscle of yellow-legged gulls (Larus michahellis), a seabird species considered suitable to monitor environmental pollution. In order to provide reference data for further biomonitoring studies, the influence of different factors, such as gender, age, sampling mode, and tissue, was considered in the present study. Our data report a statistically significant difference in CbE enzymatic activity comparing liver and muscle samples (P < 0.05) along with an age-related CbE activity in liver samples (P < 0.05). Moreover, according to our results, capture method might influence CbE and ChE activity in both liver and muscle samples (P < 0.05). These findings underline the importance to assess basal levels of ChE and CbE activity considering, among other factors, gender-, age- and organ-related differences and confirm the suitability of Larus michahellis as a sentinel species especially within an urban environment.

A novel Fe(II)-Ca synergistic phosphorus removal process: process optimization and phosphorus recovery

Abstract

Phosphorus removal from wastewater is an important means to control eutrophication and to recover phosphorus from wastewater. In this study, a novel Fe(II)-Ca synergistic phosphorus removal process is developed using the complex of ferrous and calcium salts. The results showed that ferrous and calcium had an antagonistic effect at Fe(II)/Ca molar ratio of lower than 1:4, but a synergistic effect at Fe(II)/Ca molar ratio of higher than 1:4, with the strongest synergistic effect at Fe(II)/Ca molar ratio of 7:3. The optimal parameters of this novel process were as follows: Fe(II)/Ca = 3:1, ferrous-calcium complex/phosphorous (M/P) ≥ 1.5:1, pH = 7.0–8.0, and fast mixing speed (FMS) = 100–150 rpm. The cost of phosphorus removal agents was US$1.024 (kg P)⁻¹, reduced by 30.39% compared with that of the traditional phosphorus removal process. The phosphorus content (by P₂O₅) in the precipitate produced in the new process was 32.70%, which had a high recycling value.

A review of shampoo surfactant technology: Consumer benefits, raw materials and recent developments

Abstract

Surfactants form the core of all shampoo formulations, and contribute to a wide range of different benefits including cleansing, foaming, rheology control, skin mildness and the deposition of benefit agents to the hair and scalp. The purpose of this review is to assist the design of effective, modern, shampoo surfactant technologies. The mechanisms through which surfactants help deliver their effects are presented, along with the appraisal techniques through which surfactant options can be tested and screened for product development. The steps that should be taken to select the most appropriate blend of surfactants are described, and useful information on the most widely used surfactants is provided. The review concludes with an examination of recent developments in 'greener' surfactants, 'sulphate-free' technologies and structured liquid phases for novel sensory properties and for suspending benefit agents.

This article is protected by copyright. All rights reserved.

Programme des posters

Publication date: Available online 1 November 2017
Source:Annales de Dermatologie et de Vénéréologie

TOP 12 des juniors

Publication date: Available online 1 November 2017
Source:Annales de Dermatologie et de Vénéréologie

Silymarin mitigates lung impairments in a rat model of acute respiratory distress syndrome

Abstract

Acute respiratory distress syndrome (ARDS) is a deadly disease and lacks effective treatments. Inflammation and oxidative stress play key roles in ARDS development. We aimed to evaluate the efficacy of pretreatment of silymarin, which has capacities of anti-inflammatory and anti-oxidative stress, in ARDS. We used lipopolysaccharide (LPS) to generate an ARDS rat model, which was pretreated with silymarin. Lung wet/dry ratio and broncho-alveolar lavage fluid (BALF) analyses were performed. Histological changes of the lungs were evaluated using hematoxylin and eosin staining. Cells and proteins in BALF were determined. Protein levels in the lungs were assessed using immunoblotting. LPS administration significantly caused an increased lung wet/dry ratio, an elevated protein level in BALF, and an impaired pulmonary function in the rats. Silymarin mitigated these changes in a dose-dependent manner. Silymarin ameliorated LPS-induced histological changes of the lungs, and reduced infiltration of lymphocytes, macrophages, and neutrophils. Consistently, concentrations of pro-inflammatory cytokines such as interferon-γ, interleukin (IL)-6, and tumor necrosis factor (TNF)-α were increased, while that of anti-inflammatory cytokine IL-10 was decreased in BALF. Additionally, silymarin pretreatment partially inactivated multiple mitogen-activated protein kinase signaling pathways in the lungs. Silymarin mitigated LPS-induced lung impairments by down-regulating inflammation in a rat model.

Mesoporous silica for drug delivery: Interactions with model fluorescent lipid vesicles and live cells

Publication date: January 2018
Source:Journal of Photochemistry and Photobiology B: Biology, Volume 178
Author(s): Munmun Bardhan, Anupa Majumdar, Sayantan Jana, Tapas Ghosh, Uttam Pal, Snehasikta Swarnakar, Dulal Senapati
Formulated mesoporous silica nanoparticle (MSN) systems offer the best possible drug delivery system through the release of drug molecules from the accessible pores. In the present investigation, steady state and time resolved fluorescence techniques along with the fluorescence imaging were applied to investigate the interactions of dye loaded MSN with fluorescent unilamellar vesicles and live cells. Here 1,2-dimyristoyl-sn-glycero-3-phospocholine (DMPC) was used to prepare Small Unilamellar Vesicles (SUVs) as the model membrane with fluorescent 1,6-diphenyl-1,3,5-hexatriene (DPH) molecule incorporated inside the lipid bilayer. The interaction of DPH incorporated DMPC membrane with Fluorescein loaded MSN lead to the release of Fluorescein (Fl) dye from the interior pores of MSN systems. The extent of release of Fl and spatial distribution of the DPH molecule has been explored by monitoring steady-state fluorescence intensity and fluorescence lifetime at physiological condition. To investigate the fate of drug molecule released from MSN, fluorescence anisotropy has been used. The drug delivery efficiency of the MSN as a carrier for doxorubicin (DOX), a fluorescent chemotherapeutic drug, has also been investigated at physiological conditions. The study gives a definite confirmation for high uptake and steady release of DOX in primary oral mucosal non-keratinized squamous cells in comparison to naked DOX treatment.

Graphical abstract

Synthesis, DNA binding and cytotoxic activity of pyrimido[4′,5′:4,5]thieno(2,3-b)quinoline with 9-hydroxy-4-(3-diethylaminopropylamino) and 8-methoxy-4-(3-diethylaminopropylamino) substitutions

Publication date: January 2018
Source:Journal of Photochemistry and Photobiology B: Biology, Volume 178
Author(s): Hulihalli N. KiranKumar, Heggodu G. RohitKumar, Gopal M. Advirao
Two new derivatives of pyrimido[4′,5′;4,5]thieno(2,3-b)quinoline (PTQ), 9-hydroxy-4-(3-diethylaminopropylamino)pyrimido[4′,5′;4,5]thieno(2,3-b)quinoline (Hydroxy-DPTQ) and 8-methoxy-4-(3-diethylaminopropylamino)pyrimido[4′,5′;4,5]thieno(2,3-b)quinoline (Methoxy-DPTQ) were synthesized and their DNA binding ability was analyzed using spectroscopy (UV–visible, fluorescence and circular dichroism), ethidium bromide dye displacement assay, melting temperature (Tm) analysis and computational docking studies. The hypochromism in UV–visible spectrum and increased fluorescence emission of Hydroxy-DPTQ and Methoxy-DPTQ in the presence of DNA suggested the molecule-DNA interaction. The association constants calculated from UV–visible and spectral titrations were of the order 10⁴ to 10⁶M⁻¹. Circular dichroism studies corroborated the induced conformational changes in DNA upon addition of molecules. The change in the ellipticity was observed both in negative and positive peak of DNA, thus, suggesting the intercalation of molecules. The observed displacement of ethidium bromide from the DNA and increased Tm, upon addition of DNA confirmed the intercalative mode of binding. This was further validated by computational docking, which showed clear intercalation of molecules into the d(GpC)-d(CpG) site of the receptor DNA. Anticancer activities of these molecules are evaluated by using MTT assay. Both molecules showed antiproliferative activity against all the three cancer cells studied, with Hydroxy-DPTQ being more potential molecule among the two. IC50 value of Hydroxy-DPTQ and Methoxy-DPTQ were in the range of 3–5μM and 130–250μM, respectively.

Spontaneous chondroma formation in CD2-Cre-driven Erk-deficient Mice

Abstract

Lineage-specific Cre Tg mice are widely used to delineate the functions of genes in a tissue-specific manner. Several T cell-specific promoter cassettes have been developed, however, the activities of those promoters in non-T cells have not been investigated extensively. Here, we report that CD2-Cre-mediated deletion of Erk proteins by generating CD2-Cre × Erk1^–/–Erk2^flox/flox (Erk^∆CD2-Cre) mice results in abnormal cartilage hyperplasia. Histological analysis revealed that this abnormality is caused by aberrant hyperplasia of chondrocytes. The presence of Erk-deficient T cells is not required for this chondroma formation, as it was similarly observed in the absence of T cells in CD3-deficient background. In addition, adoptive transfer of bone marrow cells from Erk^∆CD2-Cre mice to WT recipients did not cause chondroma formation, suggesting that Erk-deficient non-immune cells are responsible for this abnormality. By tracing Cre-expressed tissues using a ROSA26-STOP-RFP allele, we found that the chondroma emitted RFP fluorescence, indicating that functional Cre is expressed in hyperplastic chondrocytes in Erk^∆CD2-Cre mice. Furthermore, RFP⁺ chondrocytes were also found in Erk-sufficient background, albeit without aberrant growth. These results suggest that unexpected expression of CD2-driven Cre in chondrocytes generates Erk-deficient chondrocytes, resulting in hyperplastic cartilage formation. Recently, two independent reports showed that CD4-Cre-mediated Ras-Erk signaling ablation led to similar abnormal cartilage formation (Guittard, et al, Front. Immunol., 2017; Wehenkel, et al, Front. Immunol., 2017). Together with these reports, our study suggests that an unexpected link exists between T cell and chondrocyte lineages during ontogeny.

Flexible fate commitment of E2-2 high common DC progenitors implies tuning in tissue microenvironments

Abstract

The basic helix-loop-helix transcription factor E2-2 is essential for the development of plasmacytoid dendritic cells (pDCs) but not conventional DCs (cDCs). Here, we generated E2-2 reporter mice and demonstrated that an E2-2^high fraction among common DC progenitors (CDPs), which are a major source of pDCs and cDCs in the steady state, strictly gave rise to pDCs in the presence of Flt3 ligand ex vivo or in the secondary lymphoid organs when transferred in vivo. However, in the small intestine, some of these E2-2^high progenitors differentiated into cDCs that produced retinoic acid. This transdifferentiation was driven by signaling via the common β receptor, a receptor for the cytokines IL-3, IL-5 and GM-CSF, which are abundant in the gut. In the presence of GM-CSF and Flt3 ligand, E2-2^high-progenitor-derived cDCs consistently induced Foxp3⁺ regulatory T cells ex vivo. Our findings reveal the commitment and flexibility of E2-2^high progenitor differentiation, and imply that pertinent tuning machinery is present in the gut microenvironment.

Dermoscopic ‘Chaos and Clues’ in the diagnosis of melanoma in situ

Abstract

Background/Objective

To describe the dermoscopic features of melanoma in situ using the Chaos and Clues method.

Method

Histologically proven primary melanoma in situ (MIS) diagnosed through a specialist teledermoscopy clinic were reviewed by three dermatologists. By consensus they agreed on the global dermoscopic pattern, colours, presence of chaos (asymmetry of colour and structure and more than one pattern), and each of the nine clues described for malignancy.

Results

One hundred MIS in 92 patients of European ethnicity (45 males) were assessed. Mean age was 67.3 years (range 20–95). The mean dimensions of the lesions were 11.1 × 12.0 mm (range 2.5–31.3 × 2.3–32.3 mm). Using pattern analysis, 82% of the lesions had three or more patterns (multicomponent) and the rest had 2 patterns. Colours included light brown (100%), dark brown (98%) and grey (75%). All MIS demonstrated chaos. The most prevalent clues were thick lines (88%), eccentric structureless areas (88%), and grey or blue structures (75%).

Conclusion

Dermoscopy can be very helpful in the early diagnosis of melanoma and MIS. The Chaos and Clues method is simple to use. Its unambiguous descriptors can be successfully used to describe MIS. The presence of chaos and clues to malignancy (including thick lines, eccentric structureless areas, and blue/grey structures) should raise a red flag and lead to referral or excision.

Indolent, Waxing and Waning Cutaneous Presentation of HTLV-1 Associated Adult T-cell Leukemia/Lymphoma in an HIV-1 Positive Patient

Abstract

It is well known that patients infected with human immunodeficiency virus type I (HIV-1) are more likely to develop malignancies such as Kaposi sarcoma, non-Hodgkin lymphoma, and anal and cervical carcinomas.

Towards living within my body and accepting the past: a case study of embodied narrative identity

Abstract

This narrative case study, created from several qualitative sources, portrays a young woman's life experiences and an eight yearlong therapy process with Norwegian Psychomotor Physiotherapy (NPMP). It is analyzed retrospectively from an analytical angle, where NPMP theory is expanded with Løgstrup's phenomenology of sensation and Ricoeur's narrative philosophy. Understanding Rita's narrative through this window displayed some foundational phenomena in a singular way, illuminating embodied experiences in inter-subjective relationships in movement, sensation and time entwined. It illustrates how traumatic life experiences may cause pain, suffering and ruptured narratives with fragmented physical and sensuous reactions, chaos and loss of temporal coherence with consequences for a person's sense of identity. Rita's narrative also illuminates how intersubjective interaction has healing potentials when there is time and space for trust to emerge and to support new bodily-based experiences. Embodied sensuous experiences in present time may help clarify past and present and support chronology in narration and the sense of identity. With this exemplary case study, we argue that Løgstrup's and Ricoeur's thinking may add valuable perspectives to understanding suffering and healing processes in the field of embodied therapies like NPMP.

Tailored botulinum toxin type A injections in aesthetic medicine: consensus panel recommendations for treating the forehead based on individual facial anatomy and muscle tone.

Related Articles

Tailored botulinum toxin type A injections in aesthetic medicine: consensus panel recommendations for treating the forehead based on individual facial anatomy and muscle tone.

Clin Cosmet Investig Dermatol. 2017;10:413-421

Authors: Anido J, Arenas D, Arruabarrena C, Domínguez-Gil A, Fajardo C, Mira M, Murillo J, Ribé N, Rivera H, Ruiz Del Cueto S, Silvestre H, Tirado M

Abstract
BACKGROUND: Facial lines and wrinkles are strongly influenced by individual differences in anatomy and muscle activity and no single injection protocol will suit all patients. However, there is only limited information in the published literature on how to develop a tailored approach to botulinum toxin treatment.
METHODS: An expert panel of physicians was convened to establish a consensus on developing an individualized approach to treatment of the forehead with incobotulinumtoxinA. Separate treatment protocols were developed for men and women and subdivided by background level of muscle activity: kinetic, hyperkinetic, and hypertonic. Each muscle tone category was then further subdivided to take account of individual characteristics that can influence treatment.
RESULTS: Consensus members describe how to perform a dynamic assessment to optimize the dose and injection technique for each patient. A tailored treatment protocol is described for men and women with a wide range of forehead presentations. For each presentation, units of toxin as well as the precise location of injection points were defined by creating a 12-zone map of the forehead.
CONCLUSION: These recommendations depart from traditional consensus documents by providing detailed incobotulinumtoxinA injection protocols for the forehead based on the major parameters that differ between patients, including muscular anatomy, size, and tone. It is expected that the use of this document will lead to more satisfactory, natural, and individualized aesthetic outcomes for patients.

PMID: 29089780 [PubMed]

Regional decomposition analysis of electric carbon productivity from the perspective of production and consumption in China

Abstract

This study is concerned with the impact factors of electric carbon productivity change in China. Some influencing factors are identified by examining the time series decomposition of electric carbon productivity based on data from 2003 to 2015, where the usual Logarithmic Mean Divisia Index (LMDI) method is used but with the regional dimension taken into consideration. Moreover, this study analyzes the driving factors of electric carbon productivity change from the perspective of production and consumption in China's power industry, where the influences of power transfers among provinces, imports and exports, and transmission losses are considered. Based on the decomposition analysis of existing data in 30 provinces (including province-level municipalities), from the perspective of production, regional actual electric carbon productivity, and per capita GDP are the main influencing forces for the growth of electric carbon productivity, and the reciprocal of per capita electric carbon emissions, energy intensity, and energy emission intensity play dominate roles in the decline of electric carbon productivity. From the perspective of consumption, the main impact factors to improve electric carbon productivity are power transfers among provinces, imports and exports, the reciprocal of emission intensity of power consumption and regional electric carbon productivity, and the impact of energy consumption on thermal power generation, the proportion of thermal power to total electricity generation, and the effect of transmission losses. Finally, several conclusions are drawn that might be meaningful for the Chinese government to improve China's electric carbon productivity.

PRMT5 as a druggable target for glioblastoma therapy

Abstract

Background

In spite of standard multi modal therapy consisting of surgical resection followed by radiation and concurrent chemotherapy prognosis for GBM patients remains poor. The identification of both differentiated and undifferentiated "stem cell like" populations in the tumor highlights the significance of finding novel targets that affect the heterogenous tumor cell population. Protein arginine methyltransferase (PRMT5) is one such candidate gene whose nuclear expression correlates with poor survival and has been reported to be required for survival of differentiated GBM cells and self-renewal of undifferentiated GBM cells. In the current study we screened the specificity and efficacy of four novel PRMT5 inhibitors in the treatment of GBM.

Methods

Efficacies of these inhibitors were screened using in vitro GBM neurosphere model and in vivo intracranial zebrafish model of glioma. Standard molecular biology methods were employed to investigate changes in cell cycle, growth, and senescence.

Results

In vitro and In vivo studies revealed that among the four PRMT5 inhibitors, treatment of GBM cells with compound 5 (CMP5) mirrored the effects of PRMT5 knock down wherein it led to apoptosis of differentiated GBM cells, and drove undifferentiated primary patient derived GBM cells into a non replicative senescent state.

Conclusion

In vivo antitumor efficacy combined with the specificity of CMP5 underscores the importance of developing it for translation.

Observer-Blind Randomized Controlled Study of a Cosmetic Blend of Safflower, Olive and Other Plant Oils in the Improvement of Scar and Striae Appearance

Abstract

Objective

The normal process of skin tissue repair following injury invariably results in visual scarring. It is known that topical treatment with hydrophobic cosmetics high in silicone and mineral oil content can improve the appearance of scars and striae. Given lifestyle preferences of many cosmetic consumers towards so-called natural treatments, the objective of this controlled randomized study was to investigate the efficacy of a plant body oil rich in oleic and linoleic acids (Bio Skin Oil^®) for improving the appearance of scars and striae.

Methods

A panel of 80 volunteers with non-hypertrophic scars (40) or stretch marks (40) not older than 3 years applied a cosmetic face and body oil for 8 weeks. Compared to an untreated scar/stretch-mark region a blinded investigator as well as volunteer assessments with given observed parameters demonstrated the efficacy of the oil under test.

Results

On the Observer Scar Assessment Scale (OSAS) the mean score was reduced on the product treated area by approximately 5% (p = 0.006). The untreated area remained unchanged. Observed effects by volunteers were more pronounced - Patient Scar Assessment Scale (PSAS) giving a reduction of approximately 20% on the treated area, and on the control untreated area a reduction of approximately 6%. The overall product effect of 14% was shown to be clearly significant (p = 0.001). All statements relating to product traits achieved higher frequencies of agreements than of non-agreements and were therefore assessed positively by the volunteers. Highest frequencies of agreements occurred in statements that the test product provides a long lasting, soft and supple skin feeling (93%); caring effect (87%) and quick absorbance (84%). Agreement was also found for statements that the product improves the skin appearance (61%) and that scars / striae appear less pronounced (51%). Only 17% of volunteers felt the oil had no benefit to the appearance of their scars/striae.

Conclusions

The oil blend under test is effective in improving the appearance of non-keloid scars and striae. Further work is required to understand the mechanisms of how plant oil fatty acids ameliorate scar and striae appearance.

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Disparities in rate, triggers, and management in pediatric and adult cases of suspected drug-induced anaphylaxis in Canada

Abstract

Introduction

Data is sparse on drug-induced anaphylaxis (DIA) and there have not been studies assessing the differences in clinical characteristics and management of DIA between adults and children.

Objective

We assessed the percentage, diagnosis, and management of DIA among all anaphylaxis visits in three pediatric and one adult emergency departments (ED) across Canada.

Methods

Children presenting to the Montreal Children's Hospital (MCH), British Columbia Children's Hospital (BCCH), and Children's Hospital at London Health Sciences Center and adults presenting to Hôpital du Sacré-Coeur with anaphylaxis were recruited as part of the Cross-Canada Anaphylaxis Registry. A standardized data form documenting the reaction and management was completed and patients were followed annually to determine assessment by allergist and use of confirmatory tests.

Results

From June 2012 to May 2016, 51 children were recruited from the pediatric centers and 64 adults from the adult center with drug-induced anaphyalxis. More than half the cases were prospectively recruited. The percentage of DIA among all cases of anaphylaxis was similar in all three pediatric centers but higher in the adult center in Montreal. Most reactions in children were triggered by non-antibiotic drugs, and in adults, by antibiotics. The majority of adults and a third of children did not see an allergist after the initial reaction. In those that did see an allergist, diagnosis was established by either a skin test or an oral challenge in less than 20% of cases.

Conclusions

Our results reveal disparities in rate, culprit, and management of DIA in children versus adults. Further, most cases of suspected drug allergy are not appropriately diagnosed. Guidelines to improve assessment and diagnosis of DIA are required.

Data is sparse on drug-induced anaphylaxis and there have not been studies assessing the differences in clinical characteristics and management of drug-induced anaphylaxis between adults and children. The percentage of drug-induced anaphylaxis among all cases of anaphylaxis was similar in all three pediatric centers but higher in the adult center in Montreal. The majority of adults and a third of children did not see an allergist after the initial reaction, revealing that most cases of suspected drug allergy are not appropriately diagnosed.