An integrated fuzzy-based advanced eutrophication simulation model to develop the best management scenarios for a river basin

Abstract

Assessment of water quality status of a river with respect to its discharge has become prerequisite to sustainable river basin management. The present paper develops an integrated model for simulating and evaluating strategies for water quality management in a river basin management by controlling point source pollutant loadings and operations of multi-purpose projects. Water Quality Analysis and Simulation Program (WASP version 8.0) has been used for modeling the transport of pollutant loadings and their impact on water quality in the river. The study presents a novel approach of integrating fuzzy set theory with an "advanced eutrophication" model to simulate the transmission and distribution of several interrelated water quality variables and their bio-physiochemical processes in an effective manner in the Ganges river basin, India. After calibration, simulated values are compared with the observed values to validate the model's robustness. Fuzzy technique of order preference by similarity to ideal solution (F-TOPSIS) has been used to incorporate the uncertainty associated with the water quality simulation results. The model also simulates five different scenarios for pollution reduction, to determine the maximum pollutant loadings during monsoon and dry periods. The final results clearly indicate how modeled reduction in the rate of wastewater discharge has reduced impacts of pollutants in the downstream. Scenarios suggesting a river discharge rate of 1500 m³/s during the lean period, in addition to 25 and 50% reduction in the load rate, are found to be the most effective option to restore quality of river Ganges. Thus, the model serves as an important hydrologic tool to the policy makers by suggesting appropriate remediation action plans.

Effects of Biologic Therapy on Cardiovascular Disease in Psoriasis

Abstract

Purpose of Review

The aim of this review is to summarize the literature on the effects of biologic treatment for psoriasis on the risk of cardiovascular (CV) disease (CVD) and adverse CV outcomes.

Recent Findings

Therapy with tumor necrosis factor-alpha (TNF-α) inhibitors has been associated with reduced risk of CV events in observational studies; however, data are conflicting. Data on interleukin (IL)-17 and IL-12/23 inhibitors are limited, and primary endpoints of studies on these drugs have not been focused on CV outcomes.

Summary

Psoriasis is a chronic inflammatory skin disease that has distinct pathogenetic overlaps with that of atherosclerosis. Patients with psoriasis, in particular moderate-to-severe disease, have an increased incidence and prevalence of CV risk factors and CVD. Biologic therapies targeted for treatment of psoriasis dampen the systemic inflammation and may therefore be effective in treating not only the cutaneous manifestations of psoriasis, but may also have beneficial or detrimental CV effects depending on the particular cytokine target and mode of action. Studies on TNF-α inhibitors have suggested that these may reduce the coronary artery calcium score, improve myocardial function, and reduce the risk of adverse CV events albeit that use of these drugs may also lead to weight gain. Studies of treatment with anti-IL-12/23 agents have yielded conflicting results, but ustekinumab, the only IL-12/23 inhibitor currently approved for psoriasis, appears to be effect neutral on CV parameters. Newer drugs such as IL-17 inhibitors have not demonstrated any notable CV safety signals based on pivotal clinical trials, but long-term data from real-life studies are lacking. As new treatment modalities emerge, there is a need for well-powered long-term observational studies to firmly establish the CV safety profile of these drugs in a real-life setting.

Hydrogeochemical processes and influence of seawater intrusion in coastal aquifers south of Chennai, Tamil Nadu, India

Abstract

Seawater intrusion promotes the salinity of groundwater, and it poses a great environmental impact on a global scale. The present study was carried out to determine the hydrogeochemical processes and influence of seawater intrusion in the coastal aquifers using geophysical, geochemical, and stable isotope techniques. The true resistivity value ranges from 0.5 to 8008.5 Ω-m which has been measured using vertical electrical sounding (VES) based on the Schlumberger method. About 33 groundwater samples were collected during post-monsoon (POM) (January 2012) and pre-monsoon (PRM) (June 2012) seasons from open and bore wells and were analyzed for major ions and stable isotopes. EC, Na⁺, and Cl⁻ were high in groundwater of wells near salt pan, the Buckingham Canal, and backwater regions. Around 45% of the groundwater of this study area is of Na⁺-Cl⁻ type due to salinisation. Reverse ion exchange and silicate weathering are the dominant processes controlling the geochemistry of groundwater. Saturation indexes (SI) of halite (SI_halite) and gypsum (SI_gypsum) versus sulfate show an increasing trend line from > 0 to < 0, which implies higher dissolution of minerals and hints increasing salinization during both seasons. The value of Na⁺/Cl⁻ ranges between 0.7 and 2.4 (POM) and from 0.6 to 2.8 (PRM). The molar ratio suggested that around 25% of the groundwater samples are with values similar to those of seawater. Further, the groundwater is also affected by saline backwater, salt pan activities, and Buckingham Canal. Some locations are also are affected by anthropogenic, agricultural activities and geochemical processes. Heavy stable isotopes were found to be dominant in the coastal region due to seawater intrusion. Stable isotopes of δ¹⁸O range from − 5.6 to − 2.9‰ during both periods. About 201 km² of this area is affected by salinization. It is necessary to reduce pumping and plan for physical barriers to create freshwater ridges for controling the seawater intrusion.

Exposure to nanoscale and microscale particulate air pollution prior to mining development near a northern indigenous community in Québec, Canada

Abstract

This study serves as a baseline characterization of indoor and outdoor air quality in a remote northern indigenous community prior to the start of a major nearby mining operation, including measurements of nanoparticles, which has never been performed in this context before. We performed aerosol sample collection and real-time aerosol measurements at six different locations at the Cree First Nation of Waswanipi and the Montviel campsite, located 45 km west of the Cree First Nation of Waswanipi, in the south of the Nord-du-Québec region. High concentrations of airborne nanoparticles (up to 3.98 × 10⁴ ± 8.9 × 10³ cm⁻³ at 64.9-nm midpoint particle diameter) and fine particles (up to 1.99 × 10³ ± 1.6 × 10² cm⁻³ at 0.3-μm midpoint particle diameter) were measured inside a residential home, where we did not find any ventilation or air filtration systems. The most abundant particle sizes by mass were between 0.19 and 0.55 μm. The maximum concentration of analyzed heavy metals was detected at the d₅₀ cut-off particle size of 0.31 μm; and the most abundant heavy metals in the aerosol samples were Al, Ba, Zn, Cu, Hg, and Pb. We concluded that the sources of the relatively high indoor particle concentrations were likely laundry machines and cooking emissions in the absence of a sufficient ventilation system. However, the chemical composition of particles resulting from mining activities is expected to be different from that of the aerosol particles from indoor sources. Installation and proper maintenance of sufficient ventilation and air filtration systems may reduce the total burden of disease from outdoor and indoor air pollution and remediate infiltrated indoor particulate pollution from the mining sources as well.

Ecotoxicity thresholds for ametryn, diuron, hexazinone and simazine in fresh and marine waters

Abstract

Triazine and urea herbicides are two groups of photosystem II inhibiting herbicides frequently detected in surface, ground and marine waters. Yet, there are few water quality guidelines for herbicides. Ecotoxicity thresholds (ETs) for ametryn, hexazinone and simazine (triazine herbicides) and diuron (a urea herbicide) were calculated using the Australian and New Zealand method for deriving guideline values to protect fresh and marine ecosystems. Four ETs were derived for each chemical and ecosystem that should theoretically protect 99, 95, 90 and 80% of species (i.e. PC99, PC95, PC90 and PC80, respectively). For all four herbicides, the phototrophic species were significantly more sensitive than non-phototrophic species, and therefore, only the former data were used to calculate the ETs. Comparison of the ET values to measured concentrations in 2606 samples from 15 waterways that discharge to the Great Barrier Reef (2011–2015) found three exceedances of the simazine PC99, regular exceedances (up to 30%) of the PC99 in a limited number of rivers for ametryn and hexazinone and frequent (> 40%) exceedances of the PC99 and PC95 ETs in at least four waterways for diuron. There were no exceedances of the marine ETs in inshore reef areas. Further, ecotoxicity data are required for ametryn and hexazinone to fresh and marine phototrophic species, for simazine to marine phototrophic species, for tropical phototrophic species, repeated pulse exposures and long-term (2 to 12 months) exposures to environmentally relevant concentrations.

Efficient degradation of triclosan by an endophytic fungus Penicillium oxalicum B4

Abstract

Triclosan (TCS), a widely used antimicrobial and preservative agent, is an emerging contaminant in aqueous and soil environment. Microbial degradation of TCS has not been reported frequently because of its inhibition of microbe growth. To explore the new microbial resources for TCS biodegradation, fungal endophytes were isolated and screened for the degradation potential. The endophytic strain B4 isolated from Artemisia annua L. showed higher degradation efficiency and was identified as Penicillium oxalicum based on its morphology and ITS sequences of ribosomal DNA. In both medium and synthetic wastewater, TCS (5 mg/L) was almost completely degraded within 2 h by the strain B4. The high capacity of TCS uptake (127.60 ± 8.57 mg/g dry weight, DW) of fungal mycelium was observed during the first 10 min after TCS addition. B4 rapidly reduced initial content (5.00 mg/L) of TCS to 0.41 mg/L in medium in 10 min. Then, the accumulation of TCS in mycelium was degraded from 0.45 to 0.05 mg/g DW after 1-h treatment. The degradation metabolites including 2-chlorohydroquinone, 2, 4-dichloropheno, and hydroquinone were found to be restrained in mycelia. The end products of the biodegradation in medium showed no toxicity to Escherichia coli. The new characteristics of high adsorption, fast degradation, and low residual toxicity highlight the potential of endophytic P. oxalicum B4 in TCS bioremediation.

Variability and reliability of POP concentrations in multiple breast milk samples collected from the same mothers

Abstract

Risk assessment of infant using a realistic persistent organic pollutant (POP) exposure through breast milk is essential to devise future regulation of POPs. However, recent investigations have demonstrated that POP levels in breast milk collected from the same mother showed a wide range of variation daily and monthly. To estimate the appropriate sample size of breast milk from the same mother to obtain reliable POP concentrations, breast milk samples were collected from five mothers living in Japan from 2006 to 2012. Milk samples from each mother were collected 3 to 6 times a day through 3 to 7 days consecutively. Food samples as the duplicated method were collected from two mothers during the period of breast milk sample collection. Those were employed for POP (PCBs, DDTs, chlordanes, and HCB) analysis. PCB concentrations detected in breast milk samples showed a wide range of variation which was maximum 63 and 60% of relative standard deviation (RSD) in lipid and wet weight basis, respectively. The time course trend of those variations among the mothers did not show any typical pattern. A larger amount of PCB intake through food seemed to affect 10 h after those concentrations in breast milk in lipid weight basis. Intraclass correlation coefficient (ICC) analyses indicated that the appropriate sample size for good reproducibility of POP concentrations in breast milk required at least two samples for lipid and wet weight basis.

Consensus Recommendations for Treatment Strategies in Indians Using Botulinum Toxin and Hyaluronic Acid Fillers

Background: Indians constitute one of the largest population groups in the world. Facial anthropometry, morphology, and age-related changes in Indians differ from those of other ethnic groups, necessitating a good understanding of their facial structure and the required aesthetic treatment strategies. However, published recommendations specific to Indians are few, particularly regarding combination treatment. Methods: The Indian Facial Aesthetics Expert Group (19 dermatologists, plastic surgeons, and aesthetic physicians with a mean 15.5 years' aesthetic treatment experience) met to develop consensus recommendations for the cosmetic facial use of botulinum toxin and hyaluronic acid fillers, alone and in combination, in Indians. Treatment strategies and dosage recommendations (agreed by ≥ 75% of the group) were based on results of a premeeting survey, peer-reviewed literature, and the experts' clinical experience. Results: The need for combination treatment increases with age. Tear trough deficiency is the most common midface indication in Indian women aged 20–40 years. In older women, malar volume loss and jowls are the most common aesthetic concerns. Excess medial soft tissue on a relatively smaller midface precedes age-related sagging. Hence, in older Indians, fillers should be used peripherally to achieve lift and conservatively in the medial zones to avoid adding bulk medially. The shorter, wider lower face requires 3-dimensional correction, including chin augmentation, to achieve increased facial height and the oval shape desired by most Indian women. Conclusions: These recommendations give physicians treating Indians worldwide a better understanding of their unique facial characteristics and provide treatment strategies to achieve optimal aesthetic outcomes.

Monobloc Reconstruction of Dome, Medial Crura, and Columella with Gamma-Shaped Costal Cartilage Graft

Summary: In severe nasal deformities, the original cartilages are removed, or they become unusable because of previous operations. Costal cartilage (CC) is one of the most important tools for the replacement of deficient nasal osteocartilaginous framework. In 4 secondary and 1 tertiary rhinoplasty cases with severe deformities of medial and lateral crura of the lower lateral cartilages, we have prepared a long strut graft from a CC and then split the graft tip 5–6 mm vertically into 2 equal halves to create a gamma (υ)-shaped strut graft. We have sutured the base of this graft to the nasal spine and/or the bases of the medial crural remnants. Then, we have prepared lateral crural grafts and secured the grafts over lateral crural remnants. Then we curved the split tip winglets of the υ-shaped strut graft to both sides and sutured them to lateral crural grafts in order to create a new dome. Splitting of the CC strut graft reduces the need for extensive suturing at the tip, obtains smoother contours and ensures graft economy, and provides an original and stable dome shape. The bending capacity of the CC is limited in middle-aged patients. Costal allografts from a young cadaver can be a good alternative. υ-shaped costal crural graft is useful for medial crural and domal monobloc reconstruction in secondary and tertiary cases.

The Superiorly Based Partial Rectus Abdominis and External Oblique Flap: A New Technique for Breast Asymmetry Reconstruction

Summary: Breast asymmetry has a wide spectrum of presentations with several employable strategies for surgical correction. Historically, the external oblique muscle has proven to be a versatile flap option for the reconstruction of both local and distant defects. It has also been described for use in breast reconstruction for coverage of the lower pole of implant prostheses. The external oblique muscle flap can be harvested in several ways to capture overlying fat and skin. In this study, we describe the use of a superiorly based partial rectus and external oblique flap for surgical correction of lower pole breast hypoplasia. This flap provides vascularized autologous volume to the lower pole of the breast with minimal donor morbidity. Other advantages of this flap are that it can increase the nipple to inframammary fold distance and lower the inframammary fold. This technique represents an evolution of an under-utilized flap and is the first study describing the use of the external oblique flap in the management of breast asymmetry.

Selective IKK2 inhibitor IMD0354 disrupts NF-κB signaling to suppress corneal inflammation and angiogenesis

Abstract

Corneal neovascularization is a sight-threatening condition caused by angiogenesis in the normally avascular cornea. Neovascularization of the cornea is often associated with an inflammatory response, thus targeting VEGF-A alone yields only a limited efficacy. The NF-κB signaling pathway plays important roles in inflammation and angiogenesis. Here, we study consequences of the inhibition of NF-κB activation through selective blockade of the IKK complex IκB kinase β (IKK2) using the compound IMD0354, focusing on the effects of inflammation and pathological angiogenesis in the cornea. In vitro, IMD0354 treatment diminished HUVEC migration and tube formation without an increase in cell death and arrested rat aortic ring sprouting. In HUVEC, the IMD0354 treatment caused a dose-dependent reduction in VEGF-A expression, suppressed TNFα-stimulated expression of chemokines CCL2 and CXCL5, and diminished actin filament fibers and cell filopodia formation. In developing zebrafish embryos, IMD0354 treatment reduced expression of Vegf-a and disrupted retinal angiogenesis. In inflammation-induced angiogenesis in the rat cornea, systemic selective IKK2 inhibition decreased inflammatory cell invasion, suppressed CCL2, CXCL5, Cxcr2, and TNF-α expression and exhibited anti-angiogenic effects such as reduced limbal vessel dilation, reduced VEGF-A expression and reduced angiogenic sprouting, without noticeable toxic effect. In summary, targeting NF-κB by selective IKK2 inhibition dampened the inflammatory and angiogenic responses in vivo by modulating the endothelial cell expression profile and motility, thus indicating an important role of NF-κB signaling in the development of pathologic corneal neovascularization.

Supplementing living kidney transplantees’ medical records with donor- and recipient-narratives

Abstract

Norway provides total social welfare coverage for organ transplantations, including free immunosuppressive medication and prepaid life-long follow up for both recipients and donors. Despite these benefits the proportion of living kidney donors (LKD) has in recent years declined from around 40% (2011) of all kidney transplantations to 24% (2016). This study suggests harnessing patient- and donor-narratives as a tool for addressing the current fall in donation rates. The hospital records of 18 recipient/donor dyads were compared with patient and donor accounts elicited in semi-structured interviews. Narratives afford a pertinent supplement to the primarily biomedical and technical information stored in medical records. Even in condensed form, the messages embedded in narratives contribute to a 'thicker' understanding of the complexity of living kidney donation (LKD)-decisions. Narratives represent a source of education for referring-nephrologists wishing to deepen their evaluation skills and avoid making decisions based on insufficient insight into patients' and potential donors' values and life-situation. Recipients' and donors' unedited accounts of their motivations, worries, doubts and expectations afford a revealing and edifying supplement to the primarily biomedical and technical information stored in medical records. In narratives, the predicaments and dilemmas surrounding LKD become visible and debatable and can serve as support for future donors, recipients and the nephrologists responsible for evaluation–conclusions. Generating narratives raises a number of practical, epistemic and normative challenges.

Callitriche cophocarpa (water starwort) proteome under chromate stress: evidence for induction of a quinone reductase

Abstract

Chromate-induced physiological stress in a water-submerged macrophyte Callitriche cophocarpa Sendtn. (water starwort) was tested at the proteomic level. The oxidative stress status of the plant treated with 1 mM Cr(VI) for 3 days revealed stimulation of peroxidases whereas catalase and superoxide dismutase activities were similar to the control levels. Employing two-dimensional electrophoresis, comparative proteomics enabled to detect five differentiating proteins subjected to identification with mass spectrometry followed by an NCBI database search. Cr(VI) incubation led to induction of light harvesting chlorophyll a/b binding protein with a concomitant decrease of accumulation of ribulose bisphosphate carboxylase (RuBisCO). The main finding was, however, the identification of an NAD(P)H-dependent dehydrogenase FQR1, detectable only in Cr(VI)-treated plants. The FQR1 flavoenzyme is known to be responsive to oxidative stress and to act as a detoxification protein by protecting the cells against oxidative damage. It exhibits the in vitro quinone reductase activity and is capable of catalyzing two-electron transfer from NAD(P)H to several substrates, presumably including Cr(VI). The enhanced accumulation of FQR1 was chromate-specific since other stressful conditions, such as salt, temperature, and oxidative stresses, all failed to induce the protein. Zymographic analysis of chromate-treated Callitriche shoots showed a novel enzymatic protein band whose activity was attributed to the newly identified enzyme. We suggest that Cr(VI) phytoremediation with C. cophocarpa can be promoted by chromate reductase activity produced by the induced quinone oxidoreductase which might take part in Cr(VI) → Cr(III) bioreduction process and thus enable the plant to cope with the chromate-generated oxidative stress.

Pollution and ecological risk assessment of nutrients associated with deposited sediments collected from roof and road surfaces

Abstract

Surface-deposited sediment in urban areas is an essential environmental medium for assessing nutrient contamination. The total nitrogen (TN) and total phosphorus (TP) pollution associated with surface-deposited sediments can be transported into urban water bodies by runoff and can cause eutrophication of those water bodies. By analyzing the samples collected on roof surfaces and road surfaces, this study provides a comparison of the differences in TN and TP pollution loading in sediments on these two different impervious surface materials. Also, an assessment of the ecological risk of nutrients in surface-deposited sediments with respect to grain size fraction was performed. The results indicate that the TN and TP pollution loading in both road-deposited sediments and roof-deposited sediments indicated an asymmetric "W" trend along with grain size fraction, and both road-deposited sediments and roof-deposited sediments had the highest TN and TP pollution contribution when the particle size is between 250 and 500 μm. TN in roof-deposited sediments has high ecological risk when the particle size is less than 250 μm. These findings help to provide guidance for the management of surface-deposited sediment pollution.

Pilot study of serial FLT and FDG-PET/CT imaging to monitor response to neoadjuvant chemoradiotherapy of esophageal adenocarcinoma: correlation with histopathologic response

Abstract

Objective

The aim of this prospective pilot study was to investigate the potential of serial FLT-PET/CT compared to FDG-PET/CT to provide an early indication of esophageal cancer response to concurrent neoadjuvant chemoradiation therapy.

Methods

Five patients with biopsy-proven esophageal adenocarcinomas underwent neoadjuvant chemoradiation (Tx) prior to minimally invasive esophagectomy. The presence of residual tumor was classified histologically using the Mandard et al. criteria, categorizing patients as pathologic responders and non-responders. Participants underwent PET/CT imaging 1 h after intravenous administration of FDG and of FLT on two separate days within 48 h of each other. Each patient underwent a total of 3 scan "pairs": (1) pre-treatment, (2) during treatment, and (3) post-treatment. Image-based response to therapy was measured in terms of changes in SUVmax (ΔSUV) between pre- and post-therapeutic FLT- and FDG-PET scans. The PET imaging findings were correlated with the pathology results after surgery.

Results

All tumors were FDG and FLT avid at baseline. Lesion FLT uptake was lower than with FDG. Neoadjuvant chemoradiation resulted in a reduction of tumor uptake of both radiotracers in pathological responders (n = 3) and non-responders (n = 2). While the difference in the reduction in mean tumor FLT uptake during Tx between responders (ΔSUV = − 55%) and non-responders (ΔSUV = − 29%) was significant (P = 0.007), for FDG it was not, [responders had a mean ΔSUV = − 39 vs. − 31% for non-responders (P = 0.74)]. The difference in the reduction in tumor FLT uptake at the end of treatment between responders (ΔSUV = − 62%) and non-responders (ΔSUV = − 57%) was not significant (P = 0.54), while for FDG there was a trend toward significance [ΔSUV of responders = − 74 vs. − 52% in non-responders (P = 0.06)].

Conclusion

The results of this prospective pilot study suggest that early changes in tumor FLT uptake may be better than FDG in predicting response of esophageal adenocarcinomas to neoadjuvant chemoradiation. These preliminary results support the need to corroborate the value of FLT-PET/CT in a larger cohort.

A rare case of topical methazolamide ophthalmic solution causing death due to toxic epidermal necrolysis

Comparative study of selenium and selenium nanoparticles with reference to acute toxicity, biochemical attributes, and histopathological response in fish

Abstract

Recent studies have demonstrated that selenium (Se) and selenium nanoparticles (Se-NPs) exhibited toxicity at a higher concentration. The lethal concentration of Se and Se-NPs was estimated as 5.29 and 3.97 mg/L at 96 h in Pangasius hypophthalmus. However, the effect of different definite concentration of Se (4.5, 5.0, 5.5, and 6.0 mg/L) and Se-NPs (2.5, 3.0, 3.5, and 4.0 mg/L) was decided for acute experiment. Selenium and Se-NPs alter the biochemical attributes such as anti-oxidative status [catalase (CAT), superoxide dismutase (SOD), and glutathione-S-transferase (GST) activities], neurotransmitter enzyme, cellular metabolic enzymes, stress marker, and histopathology of P. hypophthalmus in a dose- and time-dependent manner. CAT, SOD, and GST were significantly elevated (p < 0.01) when exposed to Se and Se-NPs, and similarly, a neurotransmitter enzyme (acetylcholine esterase (AChE)) was significantly inhibited in a time- and dose-dependent manner. Further, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and malate hydrogenase were noticeably (p < 0.01) affected by Se and Se-NPs from higher concentration to lower concentration. Stress markers such as cortisol and HSP 70 were drastically enhanced by exposure to Se and Se-NPs. All the cellular metabolic and stress marker parameters were elevated which might be due to hyperaccumulation of Se and Se-NPs in the vital organ and target tissues. The histopathology of liver and gill was also altered such as large vacuole, cloudy swelling, focal necrosis, interstitial edema, necrosis in liver, and thickening of primary lamellae epithelium and curling of secondary lamellae due to Se and Se-NP exposure. The study suggested that essential trace element in both forms (inorganic and nano) at higher concentration in acute exposure of Se and Se-NPs led to pronounced deleterious alteration on histopathology and cellular and metabolic activities of P. hypophthalmus.

Issue Information

Influences for gender disparity in dermatology in North America

Abstract

Background

Despite constituting half the population, women represent a minority of active physicians and hold a small proportion of faculty leadership positions in North America. However, dermatology is one of the few specialties where women comprise a substantial portion of the workforce. This study explores extent and contributors to gender disparity in academic dermatology faculty positions, leadership, and research.

Methods

We collected data on academic faculty including leadership from the websites of accredited U.S. and Canadian dermatology faculties. We used PubMed and SCOPUS to collect faculty research information including h-index, number of publications, citations, and years of active research.

Results

Although women constitute almost half of all dermatologists in the U.S. and Canada (47.9%), only one-fourth (26.1%) of all faculty heads are women. Furthermore, the proportion of women in higher faculty ranks (Assistant Professor, Associate Professors, and Professors) is much lower than males. Female dermatologists also have fewer publications, citations, and years of active research. Interestingly, having a female in a leadership position is associated with a higher proportion of female dermatologists in the faculty.

Conclusions

Gender disparity exists in academic dermatology, and the current academics fail to account for the enormous social challenges that women face, which may put them at a disadvantage to career advancement. Among other factors, better representation of female leadership may encourage and inspire women joining academic faculties in the future.

Teaching & Learning Tips 4: Motivation and emotion in learning

Abstract

Challenge: Trainees' motivational and emotional states can influence their learning and career decisions, but historically these "affective" learning factors have received little attention in medical education. In this "Tips" piece, we outline strategies to positively influence trainees' intrinsic motivation and emotion toward their training to ultimately enhance their overall learning experience.

Gender-specific risk factors for androgenetic alopecia in the Korean general population: Associations with medical comorbidities and general health behaviors

Abstract

Background

The relationships between androgenetic alopecia (AGA) and various factors related to metabolic syndrome have been demonstrated in previous studies. However, it remains unclear because of inconsistent results. We investigated the associations between AGA and various risk factors related to metabolic syndrome according to gender.

Methods

We conducted a population-based cross-sectional survey of 2028 Koreans (1050 men, 978 women). The basic and specific (BASP) classification was used for diagnosis of AGA. We collected information on risk factors though questionnaires and medical records.

Results

AGA was significantly associated with age, family history of AGA, hypertension, diabetes mellitus, and waist circumference in both genders. Female subjects with AGA were more likely to have cerebrovascular disease, dyslipidemia, and obesity; however, these associations were not observed in the male subjects. When multiple regression analysis was applied, there was a significant relationship between hypertension and AGA in male subjects. However, there was no statistically significant association in female subjects.

Conclusion

The different results according to gender might arise from different mechanisms of AGA. There was a significant relationship between hypertension and AGA in male subjects. Evaluation of blood pressure in male patients with AGA might facilitate interventions for hypertension.

To avoid a misleading genetic diagnosis of epidermolysis bullosa

Host responses to intestinal nematodes

Abstract

Helminth infection remains common in developing countries, where residents who suffer from the consequences of such infections can develop serious physical and mental disorders and often persist in the face of serious economic problems. Intestinal nematode infection induces the development of T_h2-type immune responses including the B cell IgE response; additionally, this infection induces an increase in the numbers and activation of various types of effector cells, such as mast cells, eosinophils and basophils, as well as the induction of goblet cell hyperplasia, antimicrobial peptide production and smooth muscle contraction, all of which contribute to expel nematodes. Innate immunity is important in efforts to eliminate helminth infection; cytokines, including IL-25, IL-33 and thymic stromal lymphopoietin, which are products of epithelial cells and mast cells, induce T_h2 cells and group 2 innate lymphoid cells to proliferate and produce T_h2 cytokines. Nematodes also facilitate chronic infection by suppression of immune reactions through an increased number of regulatory T cells. Immunosuppression by parasite infection may ultimately be beneficial for the host animals; indeed, a negative correlation has been found between parasite infection and the prevalence of inflammatory disease in humans.

Notes on Contributors

CHRISTIAN FOLDE is a PhD student at the University of Hamburg, and a member of the Phlox Research Group. His research in aesthetics focuses on truth, interpretation, and the logic of fiction. He has recently published articles in the BJA, the Journal of Aesthetics and Art Criticism, and the Journal of Literary Theory.

A Bad Theory of Truth in Fiction

Abstract

William D'Alessandro has recently argued that there are no implicit truths in fiction. According to the view defended by D'Alessandro, which he terms explicitism, the only truths in fiction are the ones explicitly expressed therein. In this essay, I argue that explicitism is incorrect on multiple counts. Not only is the argument D'Alessandro gives for it invalid, but explicitism as a theory of truth in fiction fails drastically to account for a number of phenomena that are crucial to our understanding and interpretation of fiction, such as pragmatic implicatures and speech acts occurring in fiction, psychological profiles of fictional characters, and fictional truths determined by literary conventions.

Corrigendum: In Other Shoes: Music, Metaphor, Empathy, Existence

In Other Shoes: Music, Metaphor, Empathy, Existence

The Missing Person Found. Part II: Feelings for Pictures

Abstract

According to Dominic Lopes, expressiveness in pictures should be analyzed solely in terms of "expression looks" of various sorts, namely the look of a figure, a scene and/or a design. But, according to this view, it seems puzzling that expressive pictures should have any emotional effect on their audiences. Yet Lopes explicitly ties his "contour theory" of expression in pictures to empathic responses in spectators. Thus, despite his deflationary account of pictorial expression, he claims that pictures can give us practice in various "empathic skills." I argue that Lopes's account of empathic responses to pictures, while interesting and enlightening, nevertheless ignores the most important way in which pictures exercise and enhance our empathic skills, namely, by giving us practice in taking the emotional perspective of another person.

‘Call Me Ishmael’: Fiction and Direct Reference

Abstract

Whereas it appears that direct, or causal, theories dominate philosophy's theories of reference, and it is widely held that they present an insuperable obstacle for a fictional character's name to refer, I attempt to show not only that they can be easily made compatible with such theories, but that reference to the fictional fits rather smoothly into the distinctive articles of current theories of direct reference. However, the issues about reference to fictional characters goes well beyond those points, so its compatibility with direct referential theories is not a demonstration that names of fictional things in fact refer. This essay argues only that certain popular objections to fictional reference are unsound. Moreover, if those references were to occur, it would remove a serious self-inflicted conundrum over negative existentials, one from which those raising it seem unable to extract themselves credibly.

In Defence of the One-Act View: Reply to Guyer

Abstract

I defend my 'one-act' interpretation of Kant's account of judgments of beauty against recent criticisms by Paul Guyer. Guyer's text-based arguments for his own 'two-acts' view rely on the assumption that a claim to the universal validity of one's pleasure presupposes the prior existence of the pleasure. I argue that pleasure in the beautiful claims its own universal validity, thus obviating the need to distinguish two independent acts of judging. The resulting view, I argue, is closer to the text and more phenomenologically plausible than Guyer's two-acts alternative.

Non-Fictional Narrators in Fictional Narratives

Abstract

This paper is about non-fictional objects in fictions and their role as narrators. Two central claims are advanced. In part 1 it is argued that non-fictional objects such as you and me can be part of fictions. This commonsensical idea is elaborated and defended against objections. Building on it, it is argued in part 2 that non-fictional objects can be characters and narrators in fictional narratives. As a consequence, three fundamental and popular claims concerning narrators are rejected. In particular, it is shown that some fictional narratives have non-fictional internal narrators, some have no internal fictional narrator, and, most controversially, that the author of a fictional narrative can be identical to its internal narrator.

How Pictures Complete Us

How Pictures Complete UsPAUL CROWTHER Stanford University Press. 2016. pp. 192. £16.99.

Erratum

Book Review

One Act or Two? Hannah Ginsborg on Aesthetic Judgement

Abstract

Hannah Ginsborg rejects my 'two-acts' interpretation of Kant's conception of aesthetic judgement as untrue to Kant's text and as philosophically problematic, especially because it entails that every object must be experienced as beautiful. I reject her criticisms, and argue that it is her own 'one-act' interpretation that is liable to these criticisms. But I also suggest that her emphasis on Kant's 'transcendental explanation' of pleasure as a self-maintaining mental state suggests an alternative to the common view that pleasure is a distinctive feeling, even if Ginsborg herself does not draw that conclusion.

Aestheticism: Deep Formalism and the Emergence of Modernist Aesthetics

Aestheticism: Deep Formalism and the Emergence of Modernist AestheticsMICHALLE GAL Peter Lang.2015. pp. 164. £37.00 (pbk).

In Other Shoes: Music, Metaphor, Empathy, Existence

In Other Shoes: Music, Metaphor, Empathy, ExistenceKENDALL L. Walton Oup. 2015. pp. 320. £68.00 (hbk)

Time in Fiction

Time in FictionCRAIG BOURNE AND EMILY CADDICK BOURNE Oup. 2016. pp. 261. £40 (hbk).