Validated Questionnaires: Solid Tools for Research

Publication date: Available online 20 November 2017
Source:Actas Dermo-Sifiliográficas (English Edition)
Author(s): N. Blázquez Sánchez

Spanish Cultural Adaptation of the Questionnaire Early Arthritis for Psoriatic Patients

Publication date: Available online 20 November 2017
Source:Actas Dermo-Sifiliográficas (English Edition)
Author(s): J. García-Gavín, L. Pérez-Pérez, I. Tinazzi, D. Vidal, D. Mc Gonagle
Introduction and objectivesThe Early Arthritis for Psoriatic patients (EARP) questionnaire is a screening tool for psoriatic arthritis. The original Italian version has good measurement properties but the EARP required translation and adaptation for use in Spain. This article describes the cultural adaptation process as a step prior to validation.Material and methodsWe used the principles of good practice for the cross-cultural adaptation of patient-reported outcomes measurement established by the International Society Pharmacoeconomics and Outcome Research. The steps in this process were preparation, forward translation, reconciliation, back-translation and review, harmonization, cognitive debriefing and review, and proofreading. During preparation the developers of the original questionnaire were asked for their permission to adapt the EARP for use in Spain and to act as consultants during the process.ResultsThe original questionnaire was translated into Spanish by native Spanish translators, who made slight changes that were approved by the questionnaire's developers. The Spanish version was then back-translated into Italian; that version was reviewed to confirm equivalence with the original Italian text. The reconciled Spanish EARP was then tested for comprehensibility and interpretation in a group of 35 patients. All the patients answered all items without making additional comments.ConclusionThis cultural adaptation of the EARP questionnaire for Spanish populations is the first step towards its later use in routine clinical practice. The application of a cross-cultural adaptation method ensured equivalence between the original and Spanish versions of the EARP. The Spanish questionnaire will be validated in a second stage.

Skin Diseases in the Emergency Department: Impact on Patient Quality of Life

Publication date: Available online 17 November 2017
Source:Actas Dermo-Sifiliográficas (English Edition)
Author(s): E. Martínez García

Erythematous Lesions on the Face and Papules on the Trunk of a Young Woman

Publication date: Available online 20 November 2017
Source:Actas Dermo-Sifiliográficas (English Edition)
Author(s): B. González-Ponce, E.C. López-Jiménez, L. Borrego-Hernando

Extracorporeal shockwave therapy as supplemental therapy for closure of large full thickness defects—Rat full-thickness skin graft model

Publication date: Available online 24 November 2017
Source:Wound Medicine
Author(s): Vlado Antonic, Bernd Hartmann, Peter Balks, Wolfgang Schaden, Christian Ottomann
Skin grafting is one of the most common treatment options for permanent replacement of lost skin. Successful healing and engraftment is destined by degree of ischemia, angiogenesis and inflammation in the graft tissue. Exrtacorporeal shockwave therapy (ESWT) has been shown to have beneficial effects in soft tissue wounds through increase in perfusion, angiogenesis and suppression of inflammation. The objective of this study was to evaluate effects of single and repeated ESWT on skin graft survival and healing.

Facial Contouring Surgery—Malarplasty

No abstract available

Review of 494 Consecutive Breast Augmentation Patients: System to Improve Patient Outcomes and Satisfaction

Background: Breast augmentation continues to be one of the most common surgical procedures performed by plastic surgeons. As implant options expand, controlling the numerous variables required for a successful result will prove increasingly challenging. The purpose of this study was to outline specific steps that can be taken during the patient consultation and during surgery to decrease complications and improve overall patient satisfaction and patient outcomes. Methods: A retrospective review of 494 consecutive patients who underwent primary augmentation mammaplasty performed by a single surgeon was undertaken. Surgical outcomes were recorded and compared with previously published results. Patient satisfaction was measured using the BREAST-Q Augmentation Module. Results: Patients were followed for an average of 6 months (range, 0–45 months). Of the 494 patients, 1.3% developed capsular contracture. Other complications included 0.6% asymmetry, 0.4% malposition, 0.2% hematoma, and 0.2% rippling. The median BREAST Q score for the patient's overall satisfaction with outcome was 86%. The median BREAST Q score for patient's satisfaction with the plastic surgeon, medical team, and office staff was 100% in each case. The median score for psychological well-being, physical well-being, and sexual well-being was 100%, 90%, and 88%, respectively. Conclusions: The system outlined in this study showed very low rates of complications and high scores for patient satisfaction. Following a system like this will become increasingly important as breast augmentation continues to become more popular, implant options continue to expand, and social media continues to be used by patients to share surgical experiences.

Nematicidal potential and specific enzyme activity enhancement potential of neem ( Azadirachta indica A. Juss.) aerial parts

Abstract

Nematodes are considered as major plant parasites damaging most of the crops, and neem plant exhibits potential nematicidal and insecticidal properties. This study aimed to check nemato-toxic potential of neem (Azadirachta indica) plant using in vitro and in-planta trials against Meloidogyne incognita. The findings suggested that the neem extracts were lethal to second-stage juvenile (J₂) and egg hatching with simultaneous enhancement in treated tomato plant growth. The egg numbers of M. incognita found less sensitive to the aqueous and alcoholic extracts than those of J₂ as per LC₅₀ values. Complete mortality of J₂s was recorded at 40, 60, and 80% of neem standard extract (SE) dilutions and for undiluted SE of neem. The undiluted SE extract showed 100% inhibition of egg production. The highest reductions in the number of galls/root system, J₂ population, and egg production were observed with 80, 85, and 82% SE as compared control (untreated distilled water). The maximum 250% growth increment was observed in the length of tomato roots supplemented with neem extracts. Resistance-related enzyme [phenylalanine ammonia lyase (PAL), polyphenol oxidase (PPO), and peroxidase (POX)] activities in tomato plant have been increased significantly by supplementation with neem extracts. It appears that the aerial parts of neem (A. indica) extracts showed significant and sustainable eco-friendly nemato-toxic potential towards M. incognita growth inhibition and eradication using alcoholic extracts compared to aqueous. From this study, it was concluded that the neem aerial parts were useful for the control of M. incognita and could be a possible replacement for synthetic nematicides in crop protection with utilization in enhancement of specific enzyme activity in tomato plants.

Trace metal accumulation by Ranunculus sceleratus : implications for phytostabilization

Abstract

This study investigated the growth response of Ranunculus sceleratus to pollution and its capacity to accumulate trace metals for its use as a phytoremediator in Lake Maruit, Egypt. Three basins (main basin, fish farm, and southwestern basin) representing the natural distribution of the plant as well as the pollution loads in the lake, were chosen for collecting plant and sediment samples. In each basin ten quadrats (0.5 m × 0.5 m), distributed equally along two sites, were selected for measuring growth parameters, nutrients, and trace metal concentration. The highest biomass of the shoot and root (610 and 236 g m⁻²) was recorded in the main basin and fish farm, respectively. R. sceleratus accumulated high concentrations of Cu and Pb (27.7 and 9.9 mg kg⁻¹), while toxic concentration of Mn (2508.0 mg kg⁻¹) in their roots compared to shoots. The bioaccumulation factor (BF) for the investigated metals was greater than one, and in the decreasing order: Ni (27.1) > Zn (20.0) > Cd (16.4) > Cu (7.7) > Mn (3.9) > Pb (3.6). The translocation factor of all analyzed trace metals was less than one. The ability of R. sceleratus to accumulate Mn, Ni, Cu, and Pb in its roots indicates the potential use of this species for phytostabilization of these metals (mainly Mn) in contaminated water bodies.

Cold atmospheric plasma (CAP) activates angiogenesis-related molecules in skin keratinocytes, fibroblasts and endothelial cells and improves wound angiogenesis in an autocrine and paracrine mode

Cold atmospheric plasma (CAP) devices are currently being developed for a variety of medical applications and have already shown efficacy for the treatment of chronic and acute wounds in patients accelerating wound healing by activation of wound healing relevant growth factors and cytokines and by killing bacteria. CAP has also revealed antitumoral effects in vitro by inducing malignant cell apoptosis [1–3].

Elemental composition of PM 2.5 in the urban environment of San Juan, Argentina

Abstract

This study contributes to the current knowledge about air pollution in the province of San Juan, Argentina. Sampling was carried out to measure the fine particulate matter in the atmosphere (PM_2.5) of the city of San Juan. PM_2.5 was collected continuously during the winter and spring seasons of 2014 and 2015, and the concentrations of 14 elements (Pb, Ca, K, Cd, Ni, Cr, Mn, V, Cu, Ti, Ba, Co, Sr, and Fe) were determined in PM_2.5 filters using the technique of X-ray fluorescence by synchrotron radiation (SR-XRF). The results revealed that PM_2.5 presented annual and seasonal variations, showing a higher concentration during the winter seasons. In addition, for the elements quantified in the filters, a multivariate analysis (Positive Matrix Factorization) was performed to identify the main sources of emission of these elements in the study area, with a series of components being obtained that corresponded to their compositions, which were assigned physical meanings. The first factor, which was the most important in contribution of the sum of the measured elements (45%), was determined mainly by the elements K, Ti, V, Mn, and Fe, which came predominantly from soil particles. The second factor contributed 30% to the measured species in PM_2.5, with higher Ba and Zn content perhaps being related to emissions from vehicular traffic. Finally, the third factor, in which Pb, Cr, and Ca predominated, may be an indicator of industrial activity and contributed 25% of the sum of the measured elements of PM_2.5. The results of this study provide the first PM composition database in the province, and this can now be used in the development of mitigation and prevention programs.

How tapeworm infection and consumption of a Cd and Zn hyperaccumulating plant may affect Cu, Fe, and Mn concentrations in an animal—a plant consumer and tapeworm host

Abstract

This study evaluated the effects of a hyperaccumulator plant (Arabidopsis halleri), containing surplus of cadmium (Cd) and zinc (Zn) and being an admixture to the rat feed, on concentrations of copper (Cu), iron (Fe), and manganese (Mn) in the tissues of experimental rats infected/uninfected with the tapeworm (Hymenolepis diminuta). Male Wistar rats were divided into three groups (00, P0, and PT); the P0 and PT animals were fed a standard mixture for rats (ST-1) supplemented with the plant A. halleri at a weekly Zn and Cd dosage of 123 and 1 mg, respectively. Moreover, rats from the group PT were infected with the tapeworm. The group 00 served as control animals fed only ST-1 having no tapeworm infection. Rats were euthanized after 6 weeks, and Cu, Fe, and Mn levels were determined in rat and tapeworm tissues. The results indicated that both the consumption of hyperaccumulator plant and/or presence of tapeworms did have significant effect on Cu, Fe, and Mn concentrations in the host tissues. Concentrations of all the elements were higher in the rat liver and partially kidneys than in the tapeworms, and the concentrations of Cu, Fe, and Mn were affected by the consumption of Cd/Zn hyperaccumulator plants. Particularly, Fe concentrations in all rat tissues were significantly increased by consumption of A. halleri while decreased by the presence of tapeworms. Overall, the consumption of a Cd/Zn hyperaccumulator plant and tapeworm infection cause an imbalance in Cu, Fe, and Mn concentrations in the tissues of a consumer (experimental rats).

Value of FDG-PET/CT for treatment response in tuberculosis: a systematic review and meta-analysis

Abstract

Purpose

Tuberculosis (TB) is an infectious disease with a high global incidence and substantial disease burden. Monitoring disease activity and evaluating treatment response with conventional methods such as culture or chest x-ray is time-consuming and non-specific. Active TB lesions are typically highly FDG-avid and may be assessed on whole-body 18-fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). We hypothesized that FDG-PET or FDG-PET/CT is useful for evaluation of treatment response and outcome in TB-infected patients undergoing anti-tuberculosis therapy (ATT).

Methods

PubMed and Embase databases were searched and original studies with humans infected with Mycobacterium tuberculosis receiving ATT and a minimum of one FDGPET/CT or FDG-PET scan were included. Percentage change in maximum standardized uptake value (SUVmax) from baseline was assessed with a fixed-effects model using the inverse variance method supplemented by a Forest Plot. Publication bias and heterogeneity between studies was assessed with a Funnel plot and the I squared statistic, respectively.

Results

A total of 2048 articles were identified and nine were included in the review. Four studies were included in the meta-analysis. The estimated overall percentage change in SUVmax was − 54.38% (95% confidence interval − 57.81 to − 50.96) and the heterogeneity between studies was high (I ² = 90.1%). Study design, protocol, sample size and ATT varied between studies.

Conclusion

Despite high heterogeneity there was a trend towards the usefulness of FDG-PET or FDG-PET/CT for evaluation of ATT response. Impending research is needed to further clarify the predictive value of FDG-PET/CT in tuberculous disease.

Modification of chitosan/calcium alginate/Fe 3 O 4 hydrogel microsphere for enhancement of Cu(II) adsorption

Abstract

Copper in drinking water causes a significant environmental problem. Composite material based on alginate hydrogel has been gaining attention in the field of Cu(II) adsorption. However, alginate-based hydrogel exhibits poor mechanical property and relative low adsorption capacity which limit their application. The present study is devoted to the modification of chitosan/calcium alginate/Fe₃O₄ (CAF) hydrogel microsphere by NaOH solution for enhancement of Cu(II) adsorption. Results reveal that modification of CAF via NaOH solution significantly improves the mechanical strength and Cu²⁺ adsorption capacity of pristine materials. FTIR and XRD analysis confirms that CAF and newly prepared materials (NACAF) are successfully prepared. SEM and EDX are employed to analyze the surface morphology and elemental composition, respectively, both before and after their loading with Cu²⁺. XPS study demonstrates adsorption mechanism is based on chelation and ion-exchange. Compressive stress-strain curves demonstrate NACAF has better mechanical performance than CAF. The adsorption kinetics of the two adsorbents follow a pseudo-second-order model. The equilibrium data were best described by Langmuir isotherm model, and the estimated maximum equilibrium sorption capacity, q _m,is 261.31 mg/g for the NACAF, which is larger than that of CAF (145.39 mg/g). Hence, NACAF shows excellent mechanical strength and high sorption capacity for Cu²⁺. It has great potential for Cu(II) removal in aqueous solutions.

Residues and health risk assessment of typical antibiotics in aquatic products from the Dongting Lake, China—“Did you eat “Antibiotics” today?”

Abstract

The contamination level of 12 antibiotics in 8 species of fish and shrimp from the Dongting Lake, China, was firstly studied. In total, the concentrations of antibiotics in fish and shrimp were lower, which were far lower than the maximum residue limits. The most abundant compound was enrofloxacin followed by sulfadiazine, sulfamethoxazole, sarafloxacin, and sulfadimidine with the highest content from 0.37 to 1.06 ng g⁻¹. The concentrations in Silurus asotus, Cyprinus carpio, and Palinuridae were higher. Concentrations in fish and shrimp from different water layers showed spatial difference, with the order of benthos and middle-lower species > middle-upper species. In addition, the antibiotic content could be affected by the diet, which showed the concentration level of antibiotics decreased in the order of carnivorous > omnivorous > phytophagous species. Human health risk assessment based on potential fish consumption indicates that main antibiotic risk factors were enrofloxacin and sarafloxacin, and main risk species were Silurus asotus and Palinuridae. The daily risk quotient of these antibiotics to rural residents was lower than townsmen. This study is the first report of antibiotic content in fish and shrimp from the Dongting Lake, which could enrich the research of emerging pollutants in aquatic products.

Performance and biofilm characteristics of biotrickling filters for ethylbenzene removal in the presence of saponins

Abstract

Saponins were applied to enhance ethylbenzene removal in biotrickling filters (BTFs), and comparison experiments were carried out to evaluate the effects of saponins on ethylbenzene removal and biofilm characteristics at various saponin concentrations. Results showed that the optimum concentration of saponins was 40 mg/L and a maximum removal efficiency (RE) of ethylbenzene reached 84.3%. When the inlet ethylbenzene concentration increased, ranging from 750 to 2300 mg/m³, the RE decreased from 92.1 to 60.8% and from 69.4 to 44.2% for BTF1 and BTF2 in which saponin was and was not added, respectively. The corresponding RE declined from 91.1 to 40.8% and from 71.5 to 35.8% with a decreased empty bed residence time ranging from 45 to 7.5 s. Additionally, significant differences existed between both BTFs not only in the contents of polysaccharide and proteins but also in the surface charge of biofilms, and the ratio of protein to polysaccharide increased with the increase of saponin concentration, which indicated the presumable effect of saponins on liquid-biofilm transfer rates of ethylbenzene. Mechanisms for the enhanced removal of hydrophobic volatile organic compounds at the presence of surfactants were also discussed.

Bioaccumulation of selected heavy metals and histopathological and hematobiochemical alterations in backyard chickens reared in an industrial area, India

Abstract

This study was carried out to determine the concentrations of four heavy metals, cadmium (Cd), lead (Pb), copper (Cu), and cobalt (Co), and histopathological lesions in tissues of chickens reared in an industrial area of West Bengal, India. In particular, Mejhia Block was selected as a heavy metal-exposed area and Vatar Block (120 km away from industrially polluted areas) as a reference site. Samples were collected from the backyard chickens in these areas. Concentrations of heavy metals in soil, water, feedstuffs, tissues (liver, kidney, spleen, lung, and muscle), and droppings were greater (p < 0.05) in the polluted site than in the reference site. The greatest tissue concentrations of Cd and Pb were noted in the kidney, followed by the liver, lung, spleen, and muscle, whereas Cu and Co concentrations accumulated in these tissues resulted in the following: liver > kidney > lung > spleen > muscle. Heavy metal concentrations were greater in older chickens (> 1 year) than in young chickens (< 1 year). Packed cell volume, total erythrocyte counts, hemoglobin, total protein, and total leucocyte counts were significantly (p < 0.01) lower in the blood picture of chickens in the exposed area. Different serum enzymes and biochemical profiles were altered due to heavy metal exposure. Histological changes revealed necrotic lesions and tubulitis in the kidney, degeneration and necrosis in liver parenchyma, and periarteriolitis, peribronchiolitis, and presence of hemosiderin pigment in the lung of chickens in the exposed site. Results indicated that backyard chickens in heavy metal-exposed site may show pathological lesions in different tissues due to accumulation of heavy metals, and thus, the consumption of chicken meat from the industrially exposed site may pose a potential health risk to local residents of polluted sites.

Predicting Forearm Physical Exposures During Computer Work Using Self-Reports, Software-Recorded Computer Usage Patterns, and Anthropometric and Workstation Measurements

Abstract

Objectives

Alternative techniques to assess physical exposures, such as prediction models, could facilitate more efficient epidemiological assessments in future large cohort studies examining physical exposures in relation to work-related musculoskeletal symptoms. The aim of this study was to evaluate two types of models that predict arm-wrist-hand physical exposures (i.e. muscle activity, wrist postures and kinematics, and keyboard and mouse forces) during computer use, which only differed with respect to the candidate predicting variables; (i) a full set of predicting variables, including self-reported factors, software-recorded computer usage patterns, and worksite measurements of anthropometrics and workstation set-up (full models); and (ii) a practical set of predicting variables, only including the self-reported factors and software-recorded computer usage patterns, that are relatively easy to assess (practical models).

Methods

Prediction models were build using data from a field study among 117 office workers who were symptom-free at the time of measurement. Arm-wrist-hand physical exposures were measured for approximately two hours while workers performed their own computer work. Each worker's anthropometry and workstation set-up were measured by an experimenter, computer usage patterns were recorded using software and self-reported factors (including individual factors, job characteristics, computer work behaviours, psychosocial factors, workstation set-up characteristics, and leisure-time activities) were collected by an online questionnaire. We determined the predictive quality of the models in terms of R² and root mean squared (RMS) values and exposure classification agreement to low-, medium-, and high-exposure categories (in the practical model only).

Results

The full models had R² values that ranged from 0.16 to 0.80, whereas for the practical models values ranged from 0.05 to 0.43. Interquartile ranges were not that different for the two models, indicating that only for some physical exposures the full models performed better. Relative RMS errors ranged between 5% and 19% for the full models, and between 10% and 19% for the practical model. When the predicted physical exposures were classified into low, medium, and high, classification agreement ranged from 26% to 71%.

Conclusion

The full prediction models, based on self-reported factors, software-recorded computer usage patterns, and additional measurements of anthropometrics and workstation set-up, show a better predictive quality as compared to the practical models based on self-reported factors and recorded computer usage patterns only. However, predictive quality varied largely across different arm-wrist-hand exposure parameters. Future exploration of the relation between predicted physical exposure and symptoms is therefore only recommended for physical exposures that can be reasonably well predicted.

Toenail Manganese: A Sensitive and Specific Biomarker of Exposure to Manganese in Career Welders

Abstract

Manganese (Mn) is an essential trace metal. It is also a component of welding fume. Chronic inhalation of manganese from welding fume has been associated with decreased neurological function. Currently, there is not a universally recognized biomarker for Mn exposure; however, hair and toenails have shown promise. In a cohort of 45 male welders and 35 age-matched factory control subjects, we assessed the sensitivity and specificity of toenail Mn to distinguish occupationally exposed subjects from unexposed controls. Further we examined the exposure time window that best correlates with the proposed biomarker, and investigated if non-occupational exposure factors impacted toenail Mn concentrations. Toenail clippings were analyzed for Mn using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Exposure to respirable Mn-containing particles (<4 µm) was estimated using an exposure model that combines personal air monitoring, work history information, and dietary intake to estimate an individual's exposure to Mn from inhalation of welding fume. We assessed the group differences in toenail concentrations using a Student's t-test between welders and control subjects and performed a receiver operating characteristic (ROC) curve analysis to identify a threshold in toenail concentration that has the highest sensitivity and specificity in distinguishing welders from control subjects. Additionally, we performed mixed-model regressions to investigate the association between different exposure windows and toenail Mn concentrations. We observed that toenail Mn concentrations were significantly elevated among welders compared to control subjects (6.87 ± 2.56 versus 2.70 ± 1.70 µg g⁻¹; P < 0.001). Our results show that using a toenail Mn concentration of 4.14 µg g⁻¹ as cutoff allows for discriminating between controls and welders with 91% specificity and 94% sensitivity [area under curve (AUC) = 0.98]. Additionally, we found that a threshold of 4.66 µg g⁻¹ toenail Mn concentration enables a 90% sensitive and 90% specific discrimination (AUC = 0.96) between subjects with average exposure above or below the American Conference of Governmental Industrial Hygienist (ACGIH) Threshold Limit Value (TLV) of 0.02 mg m⁻³ during the exposure window of 7–12 months prior to the nail being clipped. Investigating which exposure window was best reflected by toenail Mn reproduced the result from another study of toenail Mn being significantly (P < 0.001) associated with exposure 7–12 months prior to the nail being clipped. Lastly, we found that dietary intake, body mass index, age, smoking status, and ethnicity had no significant effect on toenail Mn concentrations. Our results suggest that toenail Mn is a sensitive, specific, and easy-to-acquire biomarker of Mn exposure, which is feasible to be used in an industrial welder population.

BRAF mutations might be more common than supposed in vulvar melanomas

Ethanolic extract of fenugreek seeds moderates dimethoate-induced pancreatic damage in male rats

Abstract

Dimethoate is a widely used organophosphate insecticide known to be toxic to the pancreas. The aim of this study is to detect the possible protective effects of the fenugreek seed ethanolic extract on the biochemical, histological, and ultra-structural abnormalities induced by dimethoate chronic exposure in the pancreas of adult male rats. The study was conducted on 50 adult male albino rats that were divided equally into 5 groups: (group I) negative control, (group II) vehicle control group, (group III) fenugreek-treated group that was given 400 mg/kg ethanolic fenugreek seed extract once daily, (group IV) dimethoate group received 20 mg/kg/day dimethoate, and (group V) dimethoate- + fenugreek-treated group received a combination of dimethoate and fenugreek in the same previous doses. Dimethoate treatment caused a significant increase in serum glucose, amylase, and lipase levels and a significant decrease in serum insulin. A significant increase in lipid peroxidation and pro-fibrotic cytokine (TGF-β1) together with a significant reduction of the antioxidant {reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD)} activities and the anti-inflammatory (IL-4) in pancreatic tissues was also recorded. There was a histological and ultra-structural evidence of pancreatic acinar and islet cell injury. The recorded abnormalities were reversed in dimethoate+fenugreek treated group indicating that fenugreek ethanolic extract can serve as an antidote for dimethoate-induced pancreatic insult.

Development of an efficient viral aerosol collector for higher sampling flow rate

Abstract

Viral aerosol infection through cough generates large amounts of viral aerosol and can result in many adverse health effects such as influenza flu and severe acute respiratory syndrome (SARS). To characterize the coughed viral aerosol, the sampler needs to sample at higher flow rate and possess high physical collection efficiency as well as high viral preservation. However, most current inertia-based high flow bioaerosol samplers are not suited for viral aerosol sampling since the viability will be lost doing the sampling process. Current condensation growth methods only have good physical collection efficiency and viral preservation at low flow rate (< 10 LPM). In this study, we developed a viral aerosol sampling system using a cooler and steam-jet aerosol collector (SJAC) for bioaerosol collection for the first time. The system is based on mixing condensation growth method and has high viral preservation at a higher flow rate (12.5 LPM). We control the inlet aerosol flow temperature and the SJAC mixing reservoir temperature to improve the physical collection efficiency and viability preservation of the viral aerosol. Results indicate that the physical collection efficiency is 70–99% for aerosol 30–100 nm when the aerosol flow and mixing reservoir temperature was 19 and 50 °C, respectively. In addition, the system was 7 and 22 times more efficient for viability preservation of MS2 bacteriophage than the commonly used All Glass Impinger 30 (AGI-30) and BioSampler®, respectively. Finally, the system can be applied to sample at a lower concentration (10⁵ PFU/m³), and results shows the system was 4.7 times more efficient for viability preservation than using AGI-30 alone. The developed viral collection system will improve our understanding of the characteristics of coughed aerosol and can be used for future evaluation of respiratory protective equipment and environmental sampling.

Successful treatment of chromoblastomycosis of 10-year duration due to Fonsecaea nubica

Abstract

We report a case of chromoblastomycosis due to presence of large plaque and verrucous hyperplasia lesions on the left upper limb, with elbow abnormal activities, in a 56-year-old male. The diagnosis of chromoblastomycosis was based on gross and microscopic morphologies, histopathological examination and clinical manifestation. Molecular tools were applied to identifying the causative agent: Fonsecaea nubica, which is rarely reported to be associated with chromoblastomycosis. The patient was initially treated orally with terbinafine (250 mg/day) and itraconazole (200 mg/day), subsequently patient received thermotherapy (45-50 °C, 3 hours/day) for one month. The patient was successfully cured. A literature review was performed to assess general features, treatment and outcome of chromoblastomycosis due to Fonsecaea nubica. All the five reviewed patients were male, over 30-years-old, and their lesions were occurred after traumatic inoculation.

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Isavuconazole shortens the QTc interval

Abstract

Background

Isavuconazole is a novel antifungal drug, approved for treatment of adults with invasive aspergillosis and mucormycosis. While azoles as a class effect are known to prolong QTc interval, clinical trials have shown that isavuconazole administration may cause shortening in a dose-related manner. Here, we assessed the effects of isavuconazole on the length of QTc interval.

Objectives

To describe changes of the QTc interval induced by isavuconazole treatment.

Patients/Methods

A total of 26 adult patients from seven hospitals were included. Patients received isavuconazole for treatment of invasive fungal infection and, in one case, for prophylaxis due to QTc prolongation under fluconazole. 12-channel electrocardiograms were performed before and during treatment.

Results

24 out of 26 patients showed shortening of QTc interval. In patients with QTc shortening, QTc during isavuconazole treatment showed a mean decrease of 7.4 ± 5.8% [(36.5 ± 38.8 ms, range 7 to 202; p=0.004), compared to pre-isavuconazole ECG. One patient with available long-term follow-up showed further decrease in QTc on day 55 and 110.

Conclusion

Apart from one case report, these are the first data outside controlled clinical trials showing QTc shortening. Knowledge about cardiac effects of isavuconazole will serve to better manage the use of concomitant medications.

Visualization of dendritic cells’ responses in atopic dermatitis: Preventing effect of emollient

Comparative bioleaching of metals from pulverized and non-pulverized PCBs of cell phone charger: advantages of non-pulverized PCBs

Abstract

Sample inhomogeneity is a severe issue in printed circuit boards especially when we are comparing the bioleaching efficiency. To avoid the ambiguous results obtained due to inhomogeneity in PCBs, 12 similar cell phone chargers (of renowned company) having same make and batch number were collected from scrap market. PCBs obtained from them were used in present studies. Out of these 12, three PCBs were used separately for chemical analysis of PCBs with prior acid digestion in aqua regia. It was found that, 10.8, 68.0, and 710.9 mg/l of Zn, Pb, and Cu were present in it, respectively. Six PCBs were used for bioleaching experiment with two variations, pulverized and non-pulverized. Though the pulverized sample have shown better leaching than non-pulverized one, former has some disadvantages if overall recycling of e-waste (metallic and nonmetallic fraction) is to be addressed. At the end of leaching experiments, copper was recovered using a simple setup of electrodeposition and 92.85% recovery was attained. The acidophiles involved in bioleaching were identified by culture dependent and culture independent techniques such as DGGE and species specific primers in PCR.

Strength and microstructure characteristics of the recycled rubber tire-sand mixtures as lightweight backfill

Abstract

The disposal of scrap rubber tires has induced critical environmental issue worldwide due to the rapid increase in the number of vehicles. Recycled scrap tires as a construction material in civil engineering have significant environmental benefits from a waste management perspective. A systematic study that deals with strength and microstructure characteristics of the rubber-sand mixtures is initiated, and mechanical response of the mixtures is discussed in this investigation. Experiments were conducted to evaluate the effects of rubber fraction on the basic properties including mass density (ρ), stress-strain characteristics, shear strength, and unconfined compression strength (q _u) of the rubber-sand mixtures. Additionally, scanning electron microscopy (SEM) was carried out to reveal the microstructure characteristics of the mixtures with various rubber fractions. A discussion on the micromechanics of the mixtures also was conducted. This study demonstrates that the ρ, friction angle, and q _u decrease linearly with an increase in rubber fraction, whereas shear strain at peak increases. The stress-strain characteristics of the rubber-sand mixtures shift from brittle to ductile as the rubber fraction increase. These changes are attributed to remarkably lower stiffness and higher compressibility of the rubber particle compared with those of the conventional mineral aggregates. With an increase in the rubber fraction, the mechanical response of rubber-sand mixtures exhibits two types: sand-like material and rubber-like material. Rubber particle possesses the capacity to prevent the contacted sand particles from sliding at lower rubber fraction, whereas it transmits the applied loadings as the rubber fraction increased. This outcome reinforces the practicability of using recycled rubber tire-sand mixtures as a lightweight backfill in subbase/base applications.

Michel Alhadeff-Jones, Time and the Rhythms of Emancipatory Education: Rethinking the Temporal Complexity of Self and Society . Routledge, 2017

Correction to: Certolizumab Pegol in the Treatment of Psoriasis and Psoriatic Arthritis: Preliminary Real-Life Data

Abstract

In the original publication, part Fig. 3b and c were interchanged. The correct versions are given below.

An exploratory study into measuring the cortical bone thickness from CT in the presence of metal implants

Abstract

Purpose

The aim of this study was to develop and evaluate a method for measuring the cortical bone thickness from computed tomography (CT) scans with metallic implants and to assess the benefits of metal artefact removal software.

Methods

A previously validated technique based on the fitting of a cortical model was modified to also model metal structures when required. Cortical thickness measurements were taken over intact bone segments and compared with the corresponding contralateral bone segment. The evaluation dataset includes post-operative CT scans of a unipolar hemi-arthroplasty, a dynamic hip screw fixation, a bipolar hemi-arthroplasty, a fixation with cannulated screws and a total hip arthroplasty. All CT scans were analysed before and after processing with metal artefact removal software.

Results

Cortical thickness validity and accuracy were improved through the use of a modified metalwork-optimised model and metal artefact removal software. For the proximal femoral segments of the aforementioned cases, the cortical thickness was measured with a mean absolute error of 0.55, 0.39, 0.46, 0.53 and 0.69 mm. The hemi-pelvis produced thickness errors of 0.51, 0.52, 0.52, 0.47 and 0.67 mm, respectively.

Conclusions

The proposed method was shown to measure cortical bone thickness in the presence of metalwork at a sub-millimetre accuracy. This new technique might be helpful in assessing fracture healing near implants or fixation devices, and improve the evaluation of periprosthetic bone after hip replacement surgery.

Expert subjective comparison of haptic models for bone–drill interaction

Abstract

Purpose

A haptic algorithm to simulate the interaction between a surgical drill and bone using a constraint-based algorithm has been previously demonstrated. However, there has been no blinded study to determine whether this algorithm is preferred by professionals who commonly use this type of system

Methods

Fourteen otologic surgeons were presented with a spring–damper model and a constraint-based model of drill–bone interaction rendered on a low-cost haptic device with only linear feedback. The participants were blinded as to what algorithm they were using. They then answered survey questions about their opinions of the models.

Results

The surgeons overwhelmingly preferred the constraint-based model. They generally preferred the constraint-based model in the individual questions as well.

Conclusions

Follow-up work can be done to fine-tune the parameters in the model, but this study shows that a sophisticated algorithm can make a significant difference even on a low-fidelity haptic device.

Validation of a method for retroperitoneal tumor segmentation

Abstract

Purpose

In 2005, an application for surgical planning called AYRA \({\textregistered }\) was designed and validated by different surgeons and engineers at the Virgen del Rocío University Hospital, Seville (Spain). However, the segmentation methods included in AYRA and in other surgical planning applications are not able to segment accurately tumors that appear in soft tissue. The aims of this paper are to offer an exhaustive validation of an accurate semiautomatic segmentation tool to delimitate retroperitoneal tumors from CT images and to aid physicians in planning both radiotherapy doses and surgery.

Methods

A panel of 6 experts manually segmented 11 cases of tumors, and the segmentation results were compared exhaustively with: the results provided by a surgical planning tool (AYRA), the segmentations obtained using a radiotherapy treatment planning system (Pinnacle \(^{\textregistered }\) ), the segmentation results obtained by a group of experts in the delimitation of retroperitoneal tumors and the segmentation results using the algorithm under validation.

Results

11 cases of retroperitoneal tumors were tested. The proposed algorithm provided accurate results regarding the segmentation of the tumor. Moreover, the algorithm requires minimal computational time—an average of 90.5% less than that required when manually contouring the same tumor.

Conclusion

A method developed for the semiautomatic selection of retroperitoneal tumor has been validated in depth. AYRA, as well as other surgical and radiotherapy planning tools, could be greatly improved by including this algorithm.

Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps

Abstract

Background

Flap coverage is the gold standard in treating pressure sores, and due to the high recurrence rate, the possibility of multiple surgical procedures should be considered during flap selection. The gluteal thigh (GT) flap has become a workhorse for ischiatic pressure sore treatment at our hospital. Follow-up revealed a group of patients presenting recurrence of the pressure sore that needed a second flap. The inferior gluteal artery perforator (IGAP) flap was chosen in this series. The positive experience with both flaps raised the question of which flap should be the first option for the treatment of ischiatic and perineal pressure sores.

Methods

IGAP and GT flaps were dissected in 21 fresh human cadavers to allow comparison of anatomical features. In a series of 60 patients, the authors used both the gluteal thigh and the IGAP flap to cover 76 ischiatic and perineal ulcers.

Results

The IGAP flap was found to be wider and thicker than the gluteal thigh, but presented a shorter pedicle. All flaps healed uneventfully. Recurrent ulcers were treated successfully with both flaps.

Conclusions

Both flaps are suitable for coverage ischiatic and perineal sores. Due to its anatomical features, the IGAP flap should be considered the first choice of treatment for ischiatic ulcers. The gluteal thigh flap should be used in the recurrent sores.

Level of Evidence: Level IV, therapeutic study.

A statistician’s perspective on digital epidemiology

Abstract

We address the question "does digital epidemiology represent an epistemic shift in infectious disease epidemiology" from a statistician's viewpoint. Our main argument is that infectious disease epidemiology has not changed fundamentally as it always has been data-driven. However, as the data aspect has become more prominent, we discuss the statistical toolbox of the modern epidemiologist and argue that problem solving in the digital age, more than ever requires an interdisciplinary quantitative approach.

Impact of collaboration between psychologists and dermatologists: UK hospital system example

There is a strong known link between the mind and the skin, with studies indicating that some individuals who live with skin disorders can exhibit high levels of psychological distress. Historically, the psychological impact of skin conditions has often been disregarded by health professionals, friends, and family members. However, more recently, clinicians are becoming aware of the benefits of combining medical and psychological treatment for these patients. Within the United Kingdom, this is becoming more popular within dermatology due to a recent study that measured clinical utility and cost savings.