Characterization of pyrolysis bio-oil derived from intermediate pyrolysis of Aegle marmelos de-oiled cake: study on performance and emission characteristics of C.I. engine fueled with Aegle marmelos pyrolysis oil-blends

Abstract

The present research focuses on the analyzing the characteristics of bio-oil derived from intermediate pyrolysis of Aegle marmelos (AM) seed cake and its suitability for C.I. engine adaptation. Owing to the high volatile matter content of 73.69%, Aegle marmelos biomass was selected as the feedstock for this research. The intermediate pyrolysis was carried out at 600 °C in a 2-kg fixed bed type pyrolysis reactor at a heating rate of 10 °C/min and the obtained bio-oil was characterized by different analytical methods. As per American Society for Testing and Materials (ASTM) standards, physicochemical properties of the bio-oil were tested and it was observed that bio-oil is a highly viscous fluid with low calorific value. Analysis of bio-oil through FT-IR and GC-MS examination confirmed the presence of phenol, esters, alkyl, and oxygenated compounds. The performance and emission testing of direct injection diesel engine were conducted with various bio-oil blends and the results were compared with baseline diesel fuel. The experimental results showed that the addition of bio-oil decreased BTE (%) while increasing the BSEC (MJ/kW-h). At the same time, increasing the bio-oil ratio with diesel decreases dangerous emissions such as carbon monoxide and oxides of nitrogen emissions in the engine exhaust. According to engine test result, it was suggested that up to 20% of AM bio-oil (F20) can be employed as engine fuel for better engine operating characteristics.

Metals in a northern Nile Delta lake: water, suspended particulates, sediments, and biota

Abstract

Lake Edku is one of the important fishing areas in the Nile Delta. It is exposed to different quantities of serious pollutants in particular metals. To overall appraise the risk and status of metals in the lake, a comprehensive study of total concentrations of cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), and zinc (Zn) in sediments and spatial-temporal variations of these metals in the dissolved and suspended particulates, and some tissues of Tilapias niloticus, was conducted from ten sampling sites during 2016. Results showed that none of the investigated metals exceeded the limits considered as hazardous for aquatic life in water. The highest concentrations of Cd, Cu, Ni, and Zn were observed in suspended particulate matter, which may precipitate on the surface of the sediments. Potential ecological risk analysis of the majority of the investigated metals in the sediment indicated that Lake Edku posed a low ecological risk. The estimated values of all metals in tissues of Tilapia niloticus were below the international permissible limits. Moreover, the potential risk of metals to human via the consumption of Tilapia niloticus was estimated using the weekly intake levels, which was lower than the WHO's safe provisional tolerant weekly intake levels. These results prove the importance of performing measurements of contaminants in various compartments of Lake Ecosystem including sediment, biota, and suspended particulate matter for proper management.

Accumulation of heavy metals in native Andean plants: potential tools for soil phytoremediation in Ancash (Peru)

Abstract

Metal contamination is a recurring problem in Peru, caused mainly by mine tailings from a past active mining activity. The Ancash region has the largest number of environmental liabilities, which mobilizes high levels of metals and acid drainages into soils and freshwater sources, posing a standing risk on human and environmental health. Native plant species spontaneously growing on naturally acidified soils and acid mine tailings show a unique tolerance to high metal concentrations and are thus potential candidates for soil phytoremediation. However, little is known about their propagation capacity and metal accumulation under controlled conditions. In this study, we aimed at characterizing nine native plant species, previously identified as potential hyperaccumulators, from areas impacted by mine tailings in the Ancash region. Plants were grown on mine soils under greenhouse conditions during 5 months, after which the concentration of Cd, Cu, Ni, Pb, and Zn was analyzed in roots, shoots, and soils. The bioaccumulation (BAF) and translocation factor (TF) were calculated to determine the amount of each metal accumulated in the roots and shoots and to identify which species could be better suited for phytoremediation purposes. Soil samples contained high Cd (6.50–49.80 mg/kg), Cu (159.50–1187.00 mg/kg), Ni (3.50–8.70 mg/kg), Pb (1707.00–4243.00 mg/kg), and Zn (909.00–7100.00 mg/kg) concentrations exceeding national environmental quality standards. After exposure to mine tailings, concentrations of metals in shoots were highest in Werneria nubigena (Cd, 16.68 mg/kg; Cu, 41.36 mg/kg; Ni, 26.85 mg/kg; Zn, 1691.03 mg/kg), Pennisetum clandestinum (Pb, 236.86 mg/kg), and Medicago lupulina (Zn, 1078.10 mg/kg). Metal concentrations in the roots were highest in Juncus bufonius (Cd, 34.34 mg/kg; Cu, 251.07 mg/kg; Ni, 6.60 mg/kg; Pb, 718.44 mg/kg) and M. lupulina (Zn, 2415.73 mg/kg). The greatest BAF was calculated for W. nubigena (Cd, 1.92; Cu, 1.20; Ni, 6.50; Zn, 3.50) and J. bufonius (Ni, 3.02; Zn, 1.30); BCF for Calamagrostis recta (Cd, 1.09; Cu, 1.80; Ni, 1.09), J. bufonius (Cd, 3.91; Cu, 1.79; Ni, 18.36), and Achyrocline alata (Ni, 137; Zn, 1.85); and TF for W. nubigena (Cd, 2.36; Cu, 1.70; Ni, 2.42; Pb, 1.17; Zn, 1.43), A. alata (Cd, 1.14; Pb, 1.94), J. bufonius (Ni, 2.72; Zn, 1.63), and P. clandestinum (Zn, 1.14). Our results suggest that these plant species have a great potential for soil phytoremediation, given their capability to accumulate and transfer metals and their tolerance to highly metal-polluted environments in the Andean region.

Sulfate supply enhances cadmium tolerance in Vicia faba L. plants

Abstract

Sulfur deficiency and cadmium (Cd) pollution are two ubiquitous constraints affecting plant growth in agricultural soils. However, facing the situation of sulfur deficiency, whether surplus sulfate supply can affect Cd toxicity in plants is still unclear. Therefore, in the present study, experiments with deficient, sufficient, and excess sulfate levels under Cd stress were conducted in faba bean plants hydroponically. We found that sulfate supply significantly increased biomass of Cd-stressed plants when compared with deficient sulfate treatment. Intriguingly, sulfate application also increased Cd concentrations in leaves. Based on increased Cd concentrations without retarding plant growth, we conclude that sulfate supply enhances Cd tolerance in faba bean plants. Sulfate application increased CdSO₄⁰ proportion in the growth medium which is partially related to the increase of Cd in plants because the diffusion of CdSO₄⁰ is faster than Cd²⁺ in plants. Further study on Cd localization showed that this heavy metal was prone to accumulate in the epidermis of leaves as affected by sulfate which might contribute to enhancement of Cd tolerance. Oxidative stress induced by Cd toxicity was alleviated by surplus sulfate supply compared with deficient sulfate. Although capacities of total antioxidants were increased by sulfate in Cd-stressed plants, phenolic compounds as one kind of important antioxidants were unchanged, suggesting that sulfate has no effect on phenolic compounds for scavenging ROS under Cd stress. Taken together, sulfate accelerates Cd accumulation in the epidermis of leaves in faba bean giving rise to higher Cd tolerance.

PAR2 Pepducin-Based Suppression of Inflammation and Itch in Atopic Dermatitis Models

Characteristics and source apportionment of winter black carbon aerosols in two Chinese megacities of Xi’an and Hong Kong

Abstract

Black carbon (BC) aerosols were observed over Xi'an (XA) and Hong Kong (HK) to better compare its properties and sources in two geographically separate regions in China. High-BC (7.9 ± 3.3 μg·m⁻³) and -PM_2.5 (182 ± 80.5 μg·m⁻³) concentrations were observed in XA, and these were much higher than those in HK (BC, 3.2 ± 0.9 μg·m⁻³; PM_2.5, 34.5 ± 9.3 μg·m⁻³). The contribution of BC to PM_2.5 in HK reached 10.7%, which was ~ 1.5 times than that in XA (7.6%). The results emphasized that BC played an important role in HK PM_2.5. The diurnal distribution of HK BC was highly correlated with vehicle emissions during the daytime; it peaked during heavy traffic times. Whereas XA BC exhibited flat distribution owing to stable BC sources. It is not markedly driven by traffic patterns. Additionally, the potential source contribution function (PSCF) analysis showed that XA BC mainly originated from local emissions while nearly half of the HK BC originated from distant sources, such as industrial emissions from northeastern regions and ship emissions from marine regions. These anthropogenic BC sources were found to be regional in nature based on multilinear engine (ME-2) analysis. Specifically, the XA BC sources were dominated by three factors: 22.5% from coal burning, 19.6% from biomass burning, and 32.9% from vehicle emissions. In HK, the majority of BC contributions originated from vehicle and ship emissions (78.9%), while only 14.5% and 1.5% originated from coal and biomass burning from residential combustion, as well as industrial and power plants in inland China.

Trends in the Incidence and Survival of Eccrine Malignancies in the United States: A SEER Population-Based Study

More than keratitis, ichthyosis, and deafness: multisystem effects of lethal GJB2 mutations

Infant death in KID syndrome is recognized; its association with specific genotypes and pathophysiology is inadequately understood.

Lower Socioeconomic Status is Associated with Delayed Access to Care for Infantile Hemangioma, a Cohort Study

What is already known on this topic: Children with Medicaid face greater barriers of access-to-care. Delayed management of complicated infantile hemangiomas compromises outcomes. What this article adds to our knowledge. Lower socioeconomic status is associated with delayed care for infantile hemangioma, but not among children with institutional care-management services. How this information impacts clinical practice and/or changes patient care. Institution-facilitated managed-care programs may moderate socioeconomic disparities in accessing timely specialty care and improve outcomes.

Overall and Subgroup Prevalence of Acne Vulgaris Among Patients with Hidradenitis Suppurativa

This analysis augments the significantly literature establishing the link between acne vulgaris and hidradenitis suppurativa. Understanding the burden of acne vulgaris among patients with hidradenitis suppurativa may support evaluation and optimization of management for both conditions.

Association between atopic dermatitis and autoimmune disorders in US adults and children: A cross-sectional study

•The present study found increased risk of autoimmune disorders of the skin, endocrine, gastrointestinal, hematologic and musculoskeletal systems in both adults and children, with a predilection for females, young age, Asian race/ethnicity and those without asthma.•Clinicians should consider increased screening for autoimmune disorders in atopic dermatitis patients.

Trends in utilization of topical medications for treatment of rosacea in the United States (2005-2014) – a cohort analysis

Bullae for You: The Increasing Importance and Implications of Drug-induced Bullous Pemphigoid

Correction

Acne Disparities in Native Americans

Evaluating the cost-effectiveness of teldermatology

Cost Analysis of a Store and Forward Teledermatology Consult System in Philadelphia

When conducted appropriately, store and forward teledermatology can be cost saving by reducing unnecessary office-based dermatology clinic and emergency room visits. With engagement of stakeholders and proper planning, patients can obtain improved access to high-quality sustainable dermatologic care, in the setting of teledermatology reimbursement.

Guideline-Based Medicine Grading based upon the Guidelines of Care for Ambulatory Atopic Dermatitis Treatment in the United States

Although atopic dermatitis practice guidelines are published, how doctors adhere to these guidelines is unknown. Using a grading system analogous to the United States A to F system, healthcare providers receive a grade of B or C in their atopic dermatitis management, suggesting that physicians may benefit from reviewing guidelines of care

A systematic review and meta-analysis of the regional and age-related differences of atopic dermatitis clinical characteristics

•This study identified considerable heterogeneity of atopic dermatitis, with seventy eight different signs and symptoms identified, and notable differences by study region and age-group.•These phenotypical differences should be incorporated into the diagnosis and severity assessment of atopic dermatitis patients.

Prognostic value of the Breslow/diameter ratio in cutaneous melanoma

"Treatment of male pattern alopecia with platelet-rich plasma: a double blind controlled study with analysis of platelet number and growth factor levels"

Platelet rich plasma (PRP) has shown promise for androgenetic alopecia. We found PRP injections significantly increased hair growth compared to placebo, but response was not correlated with platelet or the measured growth factors in PRP

Opioid Prescribing for Acute Postoperative Pain After Cutaneous Surgery

Nonopioid interventions should be used for patients in pain; patients who need opioids should also receive nonopioid therapy. Among patients requiring opioids, 36-hour supply is generally adequate. Requests for refill beyond expected duration of need should require return visit.

Infertility and Teratogenicity after Paternal Exposure to Systemic Dermatologic Medications: A Systematic Review

Many systemic dermatologic medications can cause teratogenicity after maternal exposure. Some of these medications can cause infertility and may have teratogenic effects after paternal exposure; however, teratogenicity is understudied. Information on fertility effects or teratogenicity risk should guide discussions with male patients using these medications and looking to conceive.

The role of TERT promoter mutations in differentiating recurrent nevi from recurrent melanomas: a retrospective, case-control study

Repigmentation at previous biopsy sites pose a significant diagnostic dilemma given clinical and histologic similarities between recurrent nevi and locally recurrent melanoma. While common in melanoma, the role of TERT promoter mutations (TPMs) in recurrent nevi is unknown.

Gabor-Domain Optical Coherence Tomography to Aid in Mohs Resection of Basal Cell Carcinoma

Beyond JAAD January 2019

Body Contouring After Massive Weight Loss

Body contouring after weight loss has become a growing niche in plastic surgery. Over the past decade, the rise in worldwide obesity has led to evolving trends in bariatric surgery that have a direct impact on the practice of plastic surgery. From banding procedures, to stomach plication, balloons, and sleeve procedures, there is a constant array of surgical and nonsurgical treatments aimed to combat the obesity epidemic. A major pitfall of massive weight loss is the significant skin relaxation that occurs afterwards.

Dynamics of phosphorus content and the activity of phosphatase in forest soil in the sustained nitrogen compounds emissions zone

Abstract

This paper summarizes research work on the seasonal and profile dynamics of phosphorus content and the activity of phosphatase in soil next to the nitrogen industry. The results are presented of the total phosphorus (TP) and available phosphorus (AP) content and the alkaline phosphatase (AlP) and acid phosphatase (AcP) against the basic physicochemical properties (clay, pH, total organic carbon, total nitrogen). Three soil profiles were sampled from Brunic Arenosols 0.8, 2.0, and 2.5 km away from the nitrogen plant. The control profile was taken from the Tuchola Forest. The soil was collected in both spring and autumn. The results showed that the total phosphorus content was higher in spring than in autumn (the value of index of changes in time TI < 0) contrary to available phosphorus (TI > 0) and in both seasons in surface soils, the lowest, in profile I. Both total and available phosphorus decreased with depth along the soil profiles. The distribution index (DI) calculated for total phosphorus in surface soils demonstrated a rather moderate accumulation, while DI value for available phosphorus for profile III, a considerable accumulation. The availability factor (AF) for all the soil samples was above the threshold of phosphorus load (2%) in the two seasons in this study (from 2.00 to 10.13% for spring and from 3.92 to 21.19% for autumn), suggesting that the transformation rate from TP to AP was high, and AP supply for plant growth was sufficient. The correlation analysis showed a significant and positive correlation of available phosphorus with soil properties such as total organic carbon (r = 0.577), total nitrogen (r = 0.512), and clay (r = 0.493); however, there was no correlation with the activity of phosphatases.

Early onset of efficacy with erenumab in patients with episodic and chronic migraine

Subcutaneous erenumab reduced monthly migraine days and increased the likelihood of achieving a ≥ 50% reduction at all monthly assessment points tested in 2 pivotal trials in episodic migraine (EM) and chronic...

Contributing effect of lymphatic disruption in trapdoor deformity in nasolabial flaps—superiorly based vs. inferiorly based flap: A case report

Abstract

The nasolabial flap is well suited for reconstruction of the lower third of the nose. In one-stage reconstruction used as transposition flap, complications can be caused by blunting of the normal concavity of the nasofacial sulcus, but also by trapdoor formation. Various theories have attempted to explain this phenomenon of bulging tissue occurring in transposition flaps. The contributing effect of lymphatic dysfunction is not clear. In our case performed after excision of basal cell carcinoma, both lower thirds of the nose of a 77-year-old patient were reconstructed with a nasolabial transposition flap using an inferior base on one and a superior base on the other side. A follow-up showed greater trapdoor deformity on the superiorly based transposition flap. Assuming that the inferiorly based flap has better drainage than the superiorly based due to intact vertical lymphatics, our case suggests that lymphatic disruption may significantly contribute to the development of trapdoor deformity.

Level of Evidence: Level V, risk/prognostic study.

Simultaneous Nipple–Areola Complex Reconstruction Technique: Combination Nipple Sharing and Tattooing

Abstract

Background

Nipple–areola complex (NAC) reconstruction is the final critical process used to achieve breast symmetry, patient satisfaction, and overall reconstruction completeness. Here, we introduce our simplified simultaneous NAC reconstruction approach with nipple sharing and tattooing that resulted in minimal morbidity, high patient satisfaction, and a shortened total reconstructive period.

Methods

Patients who underwent simultaneous nipple sharing and tattooing between July 2012 and December 2017 after the final operative procedure or adjuvant therapy were included. We retrospectively evaluated breast reconstruction type, interval between breast and NAC reconstruction, mean operation time for simultaneous nipple sharing and tattooing, and postoperative complications. Overall patient satisfaction and willingness to undergo simultaneous NAC reconstruction again were assessed.

Results

The mean interval between the final operative procedure or adjuvant therapy and NAC reconstruction was 4.4, 4.4, and 6.7 months in non-adjuvant patients, those who underwent chemotherapy, and those who underwent radiotherapy, respectively. The mean operation time for simultaneous NAC reconstruction was 46 min. No major complications such as infection or total nipple loss were observed regardless of breast reconstruction type at least 6 months postoperatively. The average overall satisfaction was 8.0 on a 10-point scale, and 96.9% of patients indicated that they would undergo this simultaneous NAC reconstruction again.

Conclusions

Our simplified technique of simultaneous nipple sharing and tattooing is safe and reliable and features high patient satisfaction rates. Additionally, it can be performed in the clinical setting and is convenient for patients and surgeons alike since it features a decreased total reconstruction period.

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 www.springer.com/00266.

Lowering of the High Eyelid Crease in Revision Upper Eyelid Surgery

Abstract

Background

High placement of the lid crease is a common complication in upper eyelid surgery. Correction of the high crease by revision surgery is challenging and has not been well-reported.

Methods

This is a retrospective interventional study of patients who underwent revision eyelid surgery with lowering of the lid crease from 2008 to 2016 at a tertiary institution. Main outcome measures were pretarsal show (PTS) distance, lid crease symmetry, margin reflex distance 1 (MRD1), and lid height symmetry. Lid crease symmetry was graded as symmetrical, mild asymmetry (PTS difference ≤ 0.5 mm), moderate asymmetry (PTS difference > 0.5 mm but ≤ 1 mm), or obvious asymmetry (PTS difference > 1 mm). Lid height symmetry was graded as symmetrical, mild asymmetry (MRD1 difference ≤ 1 mm), moderate asymmetry (MRD1 difference > 1 mm but ≤ 2 mm), or obvious asymmetry (MRD1 difference > 2 mm).

Results

There were a total of 69 patients and 100 eyes. The majority (n = 42, 60.9%) of patients were females. The mean age was 38.3 ± 17.3 years, and mean follow-up was 16 months. Mean PTS decreased from 3.1 mm pre-surgery to 2.0 mm 2 years post-surgery. The proportion of patients with moderate or severe lid crease asymmetry decreased from 81.1% pre-surgery to 6.7% 2 years post-surgery. The mean MRD1 difference decreased from 1.54 mm pre-surgery to 0.23 mm 1 year post-surgery. The proportion of patients with moderate or severe lid height asymmetry improved from 64.5% preoperatively to 4.5% 1 year postoperatively.

Conclusion

Revision eyelid surgery to correct a high crease is a challenging procedure. We present a technique that is effective in correcting the high lid crease, while simultaneously improving the lid height and lid crease symmetry.

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 www.springer.com/00266.

Smooth Muscle Alpha Actin Immunoexpression (α-Sma) and CD-117 Antibody (C-Kit) in Capsules Formed by Polyurethane Foam-Coated Silicone Implants and with Textured Surface: A Study on Rats

Abstract

Background

One of the undesirable complications that might occur after breast augmentation with silicone implants is capsular contracture. In its etiology, the relations between mast cells and myofibroblasts play an important role in collagen synthesis. Mast cells are able to activate fibroblasts into myofibroblasts, through paracrine secretions, inducing collagen production. The objectives of this study were to analyze the myofibroblast concentration through the α-SMA immunomarker and evaluate the intensity of mast cell expression against the C-Kit immunomarker.

Material and Method

Sixty-four Wistar rats were used, divided into two groups (polyurethane foam and textured surface) with 32 animals in each. The animals received silicone implants on the back, below the panniculus carnosus, and after the determined period, they were killed and the capsules formed around the implants were studied. The capsules were analyzed employing the immunohistochemical technique, with the α-SMA and C-Kit immunomarkers in subgroups of 30, 50, 70 and 90 days.

Results

The myofibroblast concentration was higher in the polyurethane group when compared to the textured group (30 days p = 0.105; 50 days p = 0.247; 70 days p = 0.014 and 90 days p = 0.536). The intensity of mast cell expression was more pronounced in the polyurethane group when compared to the textured group (30 days p = 0.798; 50 days p = 0.537; 70 days p = 0.094 and 90 days p = 0.536).

Conclusions

Polyurethane-coated implants induced higher concentrations of myofibroblasts and higher expression of mast cells, when compared to the textured surface implants.

No Level Assigned

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 www.springer.com/00266.

Combined Iron Oxide Nanoparticle Ferumoxytol and Gadolinium Contrast Enhanced MRI Defines Glioblastoma Pseudo-progression

Abstract

Background

Noninvasively differentiating therapy-induced pseudo-progression from recurrent disease in patients with glioblastoma is prospectively difficult due to the current lack of a biologically specific imaging metric. Ferumoxytol iron oxide nanoparticle MRI contrast characterizes innate immunity mediated neuroinflammation; therefore, we hypothesized that combined ferumoxytol and gadolinium enhanced MRI could serve as a biomarker of glioblastoma pseudo-progression.

Methods

In this institutional review board approved, retrospective study, we analyzed ferumoxytol and gadolinium contrast enhanced T₁-weighted 3T MRI in 45 patients with glioblastoma over multiple clinical time points. IDH-1 mutational status was characterized by exome sequencing. Sum of products diameter measurements were calculated according to RANO criteria from both gadolinium and ferumoxytol enhanced sequences. Enhancement mismatch was calculated as the natural log of the ferumoxytol to gadolinium sum of products diameter ratio. Analysis of variance and Students t-test assessed differences in mismatch ratios. P-value < 0.05 indicated statistical significance.

Results

With the development of pseudo-progression we observed a significantly elevated mismatch ratio when compared to disease recurrence (P< 0.01) within IDH-1 wild type patients. Patients with IDH-1 mutation demonstrated significantly reduced mismatch ratio with the development of pseudo-progression when compared to disease recurrence (P< 0.01). Receiver operator curve analysis demonstrated 100% sensitivity and specificity for the use of mismatch ratios as a diagnostic biomarker of pseudo-progression.

Conclusion

Our study suggests that ferumoxytol to gadolinium contrast mismatch ratios are a MRI biomarker for the diagnosis of pseudo-progression in patients with glioblastoma. This may be due to the unique characterization of therapy-induced neuroinflammation.

N2M2 (NOA20) phase I/II trial of molecularly matched targeted therapies plus radiotherapy in patients with newly diagnosed non-MGMT hypermethylated glioblastoma

Abstract

Background

Patients with glioblastoma without O6-methyl guanine O6-methylatransferase (MGMT) promoter hypermethylation are unlikely to benefit from alkylating chemotherapy with temozolomide (TMZ). Trials aiming at replacing TMZ with targeted agents in unselected patient populations have failed to demonstrate any improvement of survival. Advances in molecular understanding and diagnostic precision enable identification of key genetic alterations in a timely manner and in principle allow treatments with targeted compounds based on molecular markers.

Methods and analysis

The NCT Neuro Master Match (N²M²) trial is an open label multicenter phase I/IIa umbrella trial for patients with newly diagnosed isocitrate dehydrogenase (IDH) wildtype glioblastoma without MGMT promoter hypermethylation to show safety, feasibility and preliminary efficacy of treatment with targeted compounds in addition to standard radiotherapy based on molecular characterization. N²M² is formally divided in a DISCOVERY and a TREATMENT part. DISCOVERY includes broad molecular neuropathological diagnostics to detect predefined biomarkers for targeted treatments. Molecular diagnostics and bioinformatic evaluation are performed within four weeks, allowing a timely initiation of postoperative treatment. Stratification for TREATMENT takes place in five subtrials, including alectinib, idasanutlin, palbociclib, vismodegib and temsirolimus as targeted therapies, according to the best matching molecular alteration. Patients without matching alterations are randomized between subtrials without strong biomarkers using atezolizumab and asinercept (APG101), and the standard of care, TMZ. For the phase I parts, a Bayesian criterion is used for continuous monitoring of toxicity. In the phase II trials, progression-free survival at six months is used as endpoint for efficacy.

TERT, the target?

Since 2013, when 2 hotspot point mutations were identified in the telomerase reverse transcriptase (TERT) promoter in melanomas, this genetic event was found to be among the most common point mutations in several tumor entities.^1–5 Thus, TERT is in the research focus of many scientists in different branches of oncology. For neuro-oncology, it is of pivotal interest due to its high frequencies in several brain tumors, most notably glioblastoma and oligodendroglioma.^4,6

Absence of potential gadolinium toxicity symptoms following 22,897 gadoteric acid (Dotarem®) examinations, including 3,209 performed on renally insufficient individuals

Abstract

Objectives

Recent safety concerns regarding gadolinium-based contrast agents (GdCAs) concluded with the suspension of some agents from the European market, yet a clinical consequence remains unknown. We used electronic health records to investigate the incidence of potential toxicity to gadoteric acid (Dotarem®) within our local population, including those with renal insufficiency (RI).

Methods

Data for patients who underwent contrast-enhanced MRI were identified, stratified by renal function at time of scan and retrospectively followed using routinely collected health data. Searches performed were: records of hypersensitivity reactions; diagnoses of nephrogenic systemic fibrosis (NSF); onset of chronic pain, a symptom that has been associated with NSF and the theorised gadolinium deposition disease (GDD); and post-contrast acute kidney injury (PC-AKI). Comparisons were made between patients and controls (those who underwent non-contrast scans) via chi-square and ANOVA statistical tests.

Results

Of the 22,897 contrast-enhanced MRI scans performed locally from 2004–2016 (adult, n = 22,325 and paediatric, n = 572), 14% were performed on patients with RI (30 ≤ eGFR < 60, n = 2,622; 15 ≤ eGFR < 30, n = 464; eGFR < 15, n = 123). Two adult patients (0.01%) suffered hypersensitivity reactions. Zero cases of NSF were reported, with an average follow-up time of 6.0 ± 2.5 years (range, 8 months–15 years). Analysis failed to highlight statistically higher rates of chronic pain onset post-MRI (adult: p = 0.777, paediatric: p = 0.578), or PC-AKI (adult: p = 0.566, paediatric: p = 0.841), in the patient groups compared to controls.

Conclusions

These data indicate that administration of gadoteric acid to RI patients does not result in a higher rate of signs or symptoms that may be associated with gadolinium toxicity when compared to controls.

Key Points

• Following 22,897 administrations of gadoteric acid to a local population, there was no association with symptoms that may be associated with gadolinium toxicity.

• Zero cases of nephrogenic systemic fibrosis were reported following 3,209 gadoteric acid administrations to a cohort of renally insufficient patients.

• A low number of hypersensitivity reactions were observed (0.01%) and no higher rate of chronic pain or post-contrast acute kidney injury were noted when compared with a control cohort of non-contrast-enhanced examinations.

Objectively Measured Physical Activity, Sedentary Behavior, and Metabolic Syndrome in Adults: Systematic Review of Observational Evidence

Metabolic Syndrome and Related Disorders, Ahead of Print.

Hybrid UV-C/microfiltration process in membrane photoreactor for wastewater disinfection

Abstract

A novel hybrid UV-C/microfiltration process for water disinfection is presented, and its application in continuous mode operation to the removal of different pathogen germs (Escherichia coli, Enterococcus faecalis, and Candida albicans) present in urban wastewater. The membrane photoreactor is based on porous stainless steel membranes coated with a TiO₂ layer and illuminated by a UV-C lamp (254 nm). A valve actuator in the outlet of the UV-C stream allows operation of the system under conditions of constant transmembrane pressure (TMP) keeping the UV-C contact time in few seconds, significantly lower than the typical irradiation time employed in TiO₂ photocatalytic processes. An E. coli removal of up to 4-log in the permeate stream and up to 2-log in the UV-C outlet was achieved with a 0.2 μm membrane operating with a TMP of 0.5 bar and a UV-C contact time as low as 8 s. The microbial balance data from the cells recovered from the membrane confirmed that 96–98% of the removed microorganisms died due to the UV-C action over the membrane surface. Modification of the membrane with a TiO₂ layer has been also shown to be a suitable way to improve both the UV-C inactivation and the filtration efficiency. The results reported in this work constitute a proof of concept of the synergy between UV-C and filtration that can be achieved in a hybrid UV-C/microfiltration system, being a good example of process intensification where two products of different quality can be simultaneously obtained.

Interactions between oil prices and financial sectors’ performances: empirical evidence from Amman Stock Exchange

Abstract

The present study searches the effects of international oil prices on the performance of financial sector firms in the Amman Stock Exchange (ASE). Using the daily data which range from July 3, 2006 to April 12, 2018, we found that financial performance of the ASE firms is downturn during this data period and oil prices do not impact on these performances. It is found that downward movement of financial performances in the ASE is totally independent of the movements in international oil prices.

CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2011–2015

Schmerztherapie bei Darmkrebspatienten

Zusammenfassung

Hintergrund

Die adäquate Behandlung von Schmerzen ist ein wichtiger Bestandteil in der Versorgung von Krebspatienten, doch mangelt es bisher an Studien, die den Gebrauch von Schmerzmitteln bzw. adjuvanten Schmerztherapeutika bei Krebspatienten systematisch untersuchen.

Ziel

Die Quantifizierung des Gebrauchs von Schmerzmitteln und adjuvanten Schmerztherapeutika wird am Beispiel von Darmkrebspatienten in verschiedenen Zeiträumen vor und nach Diagnose beschrieben.

Material und Methoden

Für die Studie wurde die pharmakoepidemiologische Forschungsdatenbank GePaRD (German Pharmacoepidemiological Research Database) verwendet, die Abrechnungsdaten von 4 gesetzlichen Krankenkassen enthält. Darmkrebspatienten mit Erstdiagnose im Jahr 2010 wurden mittels ICD-Kodes (C18-C20) identifiziert und über 5 Jahre nachbeobachtet. Die Autoren berechneten für verschiedene Zeiträume vor und nach Diagnose jeweils den Anteil an Patienten, die Opioide, nichtopioide Schmerzmittel, bestimmte adjuvante Schmerztherapeutika (Antidepressiva und die Antikonvulsiva Pregabalin und Gabapentin) und Benzodiazepine erhielten (Verordnungsprävalenz) und ermittelten für die Arzneimittelgruppen die am häufigsten verordneten Wirkstoffe. Je nach Schweregrad der Erkrankung bei Diagnose bzw. Metastasenbildung im Verlauf wurde zwischen 3 Patientengruppen unterschieden.

Ergebnisse

Insgesamt wurden 9596 Patienten mit inzidentem Darmkrebs im Jahr 2010 eingeschlossen. Für Opioide stieg die Verordnungsprävalenz von ~8 % vor Diagnose auf maximal 31 % bei Patienten mit Metastasenbildung. Auf schwach wirksame Opioide entfielen bei Patienten mit fortgeschrittenem Darmkrebs bzw. Metastasenbildung etwa ein Drittel der Tagesdosen, bei den übrigen Patienten zwei Drittel. Die Verordnungsprävalenzen für nichtopioide Schmerzmittel stiegen von ~35 % vor Diagnose auf bis zu 56 % nach Diagnose, für Antidepressiva von ~9 % auf maximal 18 %, für Pregabalin und Gabapentin von 2 % bis maximal 9 % und für Benzodiazepine von 5 % auf maximal 14 %.

Diskussion

Vergleicht man die Ergebnisse mit der verfügbaren Literatur, könnten diese tendenziell auf einen zurückhaltenden Einsatz von Opioiden bei (Darm‑)Krebspatienten hindeuten. In Anbetracht der hohen Verordnungsprävalenz von Arzneimitteln, deren gleichzeitige Gabe schwerwiegende Konsequenzen haben kann, ist bei dieser Patientengruppe hinsichtlich Arzneimittelinteraktionen besondere Vorsicht geboten.

Visual Narrative and Jargon Minimization Underpin Anatomy Teaching to Animation/VFX Industry Professionals and Health Professions Students

Abstract

Whether diagrammatic or deeply detailed, most anatomical illustration adheres to established archetypes - identical views of similar dissections, exhibiting neither variability nor originality. These conventional views are replicated from one generation of anatomy textbooks, atlases and now digital sources, with little modification or reference to original dissection. In this paper, I argue that more effective communication in the field of anatomy requires rethinking conventional anatomical images and avoiding over-reliance on anatomic terminology. The ubiquity and emphasis on the image in the emerging digital learning ecosystem challenges science educators to revisit their use of the conventional visuals. The tools of narrative creating engaging science communication can also be used in constructing better images. After brief review of the role of anatomical jargon and its discontents, I present several examples of "readable" images. These examples have been refined in the course of communicating detailed anatomy and movement for two decades to medical and other health professions students, as well as to character designers, modelers, riggers and animators in the animation and gaming industries. That "reading an image" promotes understanding without jargon is both anecdotally self-evident and yet scientifically largely untested. Rather than subsisting on images of convenience, the intersection of narrative tools and anatomical imagery provides the opportunity to structure images with intentionality and ultimately evaluate their impact. Such key images and their stories will ultimately require testing to validate the extensive anecdotal evidence that visual stories promote learning.

Remodeling ancestral phenotypic plasticity in local adaptation: A new framework to explore the role of genetic compensation in the evolution of homeostasis

Abstract

Phenotypic plasticity is not universally adaptive. In certain cases, plasticity can result in phenotypic shifts that reduce fitness relative to the un-induced state. A common cause of such maladaptive plasticity is the co-option of ancestral developmental and physiological response systems to meet novel challenges. Because these systems evolved to meet specific challenges in an ancestral environment (e.g. localized and transient hypoxia), their co-option to meet a similar, but novel, stressor (e.g. reductions in ambient pO₂ at high elevation) can lead to misdirected responses that reduce fitness. In such cases, natural selection should act to remodel phenotypic plasticity to suppress the expression of these maladaptive responses. Because these maladaptive responses reduce the fitness of colonizers in new environments, this remodeling of ancestral plasticity may be among the earliest steps in adaptive walks towards new local optima. Genetic compensation has been proposed as a general form of adaptive evolution that leads to the suppression of maladaptive plasticity to restore the ancestral trait value in the face of novel stimuli. Given their central role in the regulation of basic physiological functions, we argue that genetic compensation may often be achieved by modifications of homeostatic regulatory systems. We further suggest that genetic compensation to modify homeostatic systems can be achieved by two alternative strategies that differ in their mechanistic underpinnings; to our knowledge, these strategies have not been formally recognized by previous workers. We then consider how the mechanistic details of these alternative strategies may constrain their evolution. These considerations lead us to argue that genetic compensation is most likely to evolve by compensatory physiological changes that safeguard internal homeostatic conditions to prevent the expression of maladaptive portions of conserved reaction norms, rather than direct evolution of plasticity itself. Finally, we outline a simple experimental framework to test this hypothesis. Our goal is to stimulate research aimed at providing a deeper mechanistic understanding of whether and how phenotypic plasticity can be remodeled following environmental shifts that render ancestral responses maladaptive, an issue with increasing importance in our current era of rapid environmental change.

Septoplasty versus non‐surgical management for nasal obstruction due to a deviated nasal septum in adults: a modeling study of cost‐effectiveness

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

The use of Bone Conduction Hearing Implants (BCHI) in Paediatric Chronic Otitis Media: An audit of outcomes of 32 devices in 22 patients

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.

Reversibility of alexithymia with effective treatment of moderate to severe psoriasis: longitudinal data from EPIDEPSO

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.

Fatigue in systemic lupus erythematosus and other autoimmune skin diseases

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.

Downregulation of miR‐145‐5p contributes to hyperproliferation of keratinocytes and skin inflammation in psoriasis

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.

Dramatic response to brentuximab vedotin in a refractory non‐transformed CD30‐negative mycosis fungoides allowing allogeneic stem cells transplantation and long‐term complete remission

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.

Issue Information

Experimental Dermatology, Volume 27, Issue 10, Page 1065-1066, October 2018.

Clinical Snippets

Experimental Dermatology, Volume 27, Issue 10, Page i-i, October 2018.

FRT—Fondation Rene Touraine

Experimental Dermatology, Volume 27, Issue 10, Page 1179-1189, October 2018.

Issue Information

Clinical &Experimental Immunology, Volume 194, Issue 1, October 2018.

Lactic and lactobionic acids as typically moisturizing compounds

International Journal of Dermatology, EarlyView.

Pathway dysregulation analysis of the nucleotide excision repair mechanisms reveals it is not a common feature of melanomas

Pigment Cell &Melanoma Research, Volume 0, Issue ja, -Not available-.

Eccrine porocarcinoma of the nose: A case report and literature review

Australasian Journal of Dermatology, EarlyView.