Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00306932607174,00302841026182,alsfakia@gmail.com
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Παρασκευή 8 Δεκεμβρίου 2017
Correctness of Self-Reported Task Durations: A Systematic Review
Harnessing the Power of Data in Facial Plastic and Reconstructive Surgery
Recreational Activity and Facial Trauma Among Older Adults
In Memoriam: Gary Burget, MD (1941-2017)
Teaching Photographic Nasal Analysis
Partial Cost Cartilage Harvest for Rhinoplasty
Simulation Course for Evaluation and Treatment of Facial Fractures
Teaching Rhinoplasty
Bony Batten Grafting to Correct Caudal Septal Deviation in Septoplasty
The Columella Retraction Suture
Perception of Permanent Unilateral Facial Paralysis
Review of Facial Plastic and Reconstructive Surgery
Costal Cartilage Warping Using Oblique Split vs Concentric Carving
Algorithm-Based Levator Aponeurectomy in Ptosis Surgery
Training Current and Future Residents in Facial Plastic Surgery
Complete Philtrum Reconstruction on the Partial-Thickness Cross-Lip Flap
Data Collection Integration to Optimize Clinical Outcomes Research
Electrochemical Therapy of Porcine Skin
The Twisted Nose
Lateral Crural Overlay Technique and Strength of Lower Lateral Cartilages
Interleukin-21 receptor signaling is not critically required for imiquimod-induced psoriasiform dermatitis in mice
Abstract
Psoriasis is largely mediated by interleukin (IL)-23/ T helper (Th) 17 axis, and IL-21 is a pleiotropic cytokine expressed by Th17 cells. Despite previously reported possible pathogenic roles of IL-21 in human psoriasis, we found that IL-21 receptor (IL-21R) signaling was not crucial for imiquimod-induced psoriatic inflammation, using IL-21R−/− mice. The severity of imiquimod-induced psoriatic manifestation and pro-inflammatory Th17 cytokine levels, IL-17A-producing γδ T cells and CD4+ T cells, and in vitro IL-17A production by γδ T cells after IL-23 stimulation was comparable between wild-type and IL-21R−/− mice. Collectively, IL-21R signaling was not critically involved in IMQ-induced psoriatic inflammation despite an increased IL-21 expression in the IMQ-treated mouse skin. Our data may represent the significant differences between human psoriasis and murine psoriasis model, and further studies using other models will be required to elucidate the role of IL-21 in psoriasis pathogenesis.
This article is protected by copyright. All rights reserved.
A randomized phase II study evaluating different maintenance schedules of nab-Paclitaxel in the first-line treatment of metastatic breast cancer: final results of the IBCSG 42-12/BIG 2-12 SNAP trial
Analysis of Angiogenesis Biomarkers for Ramucirumab Efficacy in Patients with Metastatic Colorectal Cancer from RAISE, a Global, Randomized, Double-Blind, Phase III Study
Title: Rituximab: A Benchmark in the Development of Chemotherapy-free Treatment Strategies for Follicular Lymphomas
Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy
Progestin-associated shift of meningioma mutational landscape
Skin Cancer Prevention Campaign in Childhood: Survey based on 3,676 children in Brazil
Abstract
Background and Objectives
Primary skin cancer prevention campaigns are essential and more effective among children, not only because of the importance of sun exposure effects during this period, but also because at this age is when individuals are developing behaviors. The Brazilian Society of Dermatology - Regional State of Sao Paulo developed and conducted, the program named "The Sun, Friend of Childhood", a school health education and disease prevention project for children and parents. Our objective was to evaluate the cognitive and behavioral effects of the children and parents before and after an education model-based intervention of sun protection.
Methods
We carried out a study on a school population of Social Service of Industry – Regional State of São Paulo, from the first to the fifth years of the regular course (6-10 years). Our educational project was planned to be based on two children's learning tools (comic magazine and a DVD cartoon). Questionnaires in relation to habits and knowledge in sun exposure where applied to the children (3,776) before and (2,748) after the intervention. A questionnaire was applied to 3,663 parents regarding personal details and habits of their children.
Results
According to the McNemar′s statistical test, all changes in the children in acquire new knowledge about good practices for sun exposure were statistically significant.
Conclusions
Educative sun exposure programs in childhood are a relevant tool to modify the history of life for next generations, to concern the skin cancer and good health practices.
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Safety and Efficacy of Apremilast Through 104 Weeks in Patients With Moderate to Severe Psoriasis Who Continued on Apremilast or Switched From Etanercept Treatment: Findings From the LIBERATE Study
Abstract
Background
Apremilast, an oral phosphodiesterase 4 inhibitor, has demonstrated efficacy in patients with moderate to severe psoriasis.
Objective
To evaluate long-term efficacy and safety of apremilast in biologic-naive patients with moderate to severe plaque psoriasis and safety of switching from etanercept to apremilast in the phase 3b LIBERATE trial.
Methods
Two hundred fifty patients were randomized to placebo, apremilast 30 mg BID, or etanercept 50 mg QW through Week 16; thereafter, all patients continued or switched to apremilast through Week 104 (extension phase). Skin, scalp, and nail involvement at Weeks 16, 52, and 104 were assessed using the Psoriasis Area and Severity Index (PASI; 0–72), Scalp Physician Global Assessment (ScPGA; 0–5), and Nail Psoriasis Severity Index (NAPSI; 0–8); patient-reported outcomes (PROs) were assessed using the Dermatology Life Quality Index (DLQI; 0–32) and pruritus visual analog scale (VAS; 0–100 mm).
Results
The apremilast-extension phase (Weeks 16–104) included 226 patients in the placebo/apremilast (n=73), apremilast/apremilast (n=74), and etanercept/apremilast (n=79) groups, and at Week 104, 50.7%, 45.9%, and 51.9% of these patients, respectively, maintained ≥75% reduction from baseline in PASI score (based on last observation carried forward analysis). Across treatment groups, ScPGA 0 (clear) or 1 (minimal) was achieved by 50.0%–59.2% of patients; NAPSI mean change from baseline was −48.1% to −51.1%; DLQI score ≤5 was achieved by 66.0%–72.5% of patients; and pruritus VAS mean change from baseline was −24.4 to −32.3. AEs in ≥5% of patients (diarrhea, nausea, nasopharyngitis, upper respiratory tract infection, and headache) did not increase with prolonged apremilast exposure.
Conclusions
Apremilast demonstrated significant and sustained improvements in skin, scalp, nails, and PROs (pruritus and quality of life) over 104 weeks in patients with moderate to severe plaque psoriasis. Safety was consistent with the known safety profile of apremilast.
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Consensus on the management of patients with psoriatic arthritis in a dermatology setting
Abstract
Background
Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis (PsO). Early diagnosis and prompt therapeutic intervention are crucial for limiting PsA progression and prevention of disability. Dermatologists are in a privileged position to detect early PsA. The management of patients with PsA in the dermatology setting is widely variable.
Objective
To provide practical recommendations for the management of patients with PsA in the dermatology setting including early diagnosis and treatment.
Methods
A consensus document was written by an expert panel composed by dermatologists (n=12) and rheumatologists (n=6). Eleven highly relevant questions were selected and elaborated with answers/statements based on a narrative literature review. The resulting document was discussed in a face-to-face meeting adopting a nominal group technique to reach consensus (i.e. 100% agreement) by using the Delphi method.
Results
A consensus was achieved in defining the following: the clinical characteristics differentiating inflammatory and non-inflammatory signs and symptoms of joint disease; the most important differential diagnoses of PsA in clinical practice; the most useful screening questionnaires, serum laboratory tests and imaging techniques for the detection of early PsA; the criteria for dermatologist to refer patients with PsO to rheumatologist; the criteria for the diagnosis of PsA; the selection of the indices that the dermatologist could use for measuring the activity and severity of PsA in clinical practice; when systemic steroids and/or intra-articular steroid injections are indicated in the treatment of PsA. Finally, systemic treatments including synthetic and biological disease modifying anti rheumatic drugs to be considered for the treatment of PsA have been reported.
Conclusions
The implementations of these practical recommendations could be very helpful for the management of patients with PsA in the dermatology setting including early diagnosis and treatment.
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Early stage mycosis fungoides screening investigations: a retrospective analysis of 440 cases
Abstract
Early stages of mycosis fungoides (MF stages IA and IB) carry similar long-term life expectancies as an age-, sex-, and race- matched control population (1-3). Despite this, the ten-year disease progression risk in stage IA and IB MF has been reported to be between 10% and 39% (4); hence, investigative screening is frequently performed at presentation. We conducted a retrospective chart review of screening investigations performed on 440 patients with stage T1/IA (52%) and T2/IB (48%) MF.
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Reflectance Confocal Microscopy evaluation of Trichobacteriosis Axilaris
Abstract
We read with great interest the paper by Navarrete-Dechent et al recently published on the Journal of European Academy of Dermatology1, in which the authors detail the dermoscopic findings of trichobacteriosis and highlight the importance of dermoscopy in these cases. We present the case of a 44-year-old man, who emanated an unpleasant axilary odor during a routine check-up. Close examination of the axillary hair shafts showed soft, brown to yellow irregular masses adherent to the central segment of the hairs, suggesting the diagnosis of trichobacteriosis axilaris (TA).
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Response to “Does Stromal Vascular Fraction Supplementation Improve Facial Lipotransfer?”
Does Stromal Vascular Fraction Supplementation Improve Facial Lipotransfer?
Rejuvenating the Face: An Analysis of 100 Absorbable Suture Suspension Patients
Immunotherapy and Overall Survival in Elderly Patients With Melanoma
Practicing Safe Dermatology—Screening Out Liability
Trends in Medical Liability Claims Against Dermatologists
Optical Coherence Tomography Features of Dermatophytoma
Knowledge to Detect Scalp and Neck Melanoma
Preference-Based QOL Measures for Economic Evaluations in Early Melanoma
Topical Tacalcitol for a Family With Follicular Keratosis of the Chin
Allergen Concerns and Popular Skin Care Products—Reply
Allergen Concerns and Popular Skin Care Products
Laboratory Monitoring During Systemic Terbinafine Therapy for Pediatric Onychomycosis
Dermatologist Density and Volume and Costs of Dermatology Procedures
Allergen Concerns and Popular Skin Care Products
A NF-κB signature predicts low-grade glioma prognosis: a precision medicine approach based on patient-derived stem cells
ICON Intimidation and Predatory Behavior: From Hollywood, “to the Newsroom,” to the Halls of Congress
Violence and Gender , Vol. 0, No. 0.
Efficacy and Safety of Titanium Miniplates in Septorhinoplasty
Hybrid Cartilage-Modifying Otoplasty Technique and Outcomes
Blast SMS and Enrollment for Cleft Lip and Cleft Palate Surgery in Zimbabwe
Characteristics, Diagnosis, and Management of Ehlers-Danlos Syndromes
Opioid Use After Rhinoplasty
Glutamate residues at positions 162nd and 164th influence the beta-lactamase activity of SHV-14 obtained from Klebsiella pneumoniae
Microbial carbon dioxide fixation: new tricks for an old game
Extracellular nucleic acids of the marine bacterium Rhodovulum sulfidophilum and recombinant RNA production technology using bacteria
Rapid screening method for detecting highly pathogenic Streptococcus intermedius strains carrying a mutation in the lacR gene.
The impact of environmental factors on CO2 fixation by microalgae
Poly(3-hydroxybutyrate) hyperproduction by a global nitrogen regulator NtrB mutant strain of Paracoccus denitrificans PD1222
Relationship between Escherichia coli growth rate and bacterial susceptibility to ciprofloxacin
Biotransformation of trinitrotoluene by Citrobacter sp. YC4 and evaluation of its cyto-toxicological effects
The promises of microalgae – still a long way to go
Assessing the diversity of the g23 gene of T4-like bacteriophages from Lake Baikal with high-throughput sequencing
Mating-type switching in CBS 732T derived sub-cultures unveils potential genetic and phenotypic novelties in haploid Zygosaccharomyces rouxii
Gram-scale production of recombinant microbial enzymes in shake flasks
Growth and carotenogenesis in Rhodosporidium diobovatum IMB Y-5023: Effects of culture medium and illumination intensity
Electroactive haloalkaliphiles exhibit exceptional tolerance to free ammonia
Descriptive Error in the Text
Magnetic ethylene diamine-functionalized graphene oxide as novel sorbent for removal of lead and cadmium ions from wastewater samples
Abstract
In this paper, magnetic ethylene diamine-functionalized graphene oxide (MDFGO) as a novel sorbent was synthesized and applied for removal of Pb(II) and Cd(II) from real wastewater samples. The morphology and molecular structure of MDFGO were studied by different analytical methods. The effective parameters in adsorption efficiency of Pb(II) and Cd(II) were studied and optimized using experimental design. Under the optimal condition, the effective parameters including pH, sorbent dosage, shaking rate, and adsorption time were 6.2, 33.0 mg, 500 rpm, and 11 min, respectively. Mechanism of adsorption kinetic was investigated using the Lagergren pseudo-first-order, pseudo-second-order, and intraparticle diffusion models. It was found that adsorption of lead and cadmium ions in the MDFGO sorbent followed from pseudo-first-order and pseudo-second-order models, respectively. Thermodynamic parameters (ΔG°, ΔH°, and ΔS°) for the lead and cadmium ions uptake onto the MDFGO sorbent were calculated and indicated that the adsorption processes were spontaneous and endothermic in nature for both cations. In order to investigate the isotherm model for adsorption of Pb(II) and Cd(II), the experimental data were studied using the Langmuir, Freundlich, and Harkins–Jura isotherm models. The results fitted well with Freundlich model for both metal ions. The new sorbent (MDFGO) was applied to remove Pb(II) and Cd(II) from battery wastewater and electroplating wastewater. The removal percentage of Pb(II) and Cd(II) were 99.6±0.5 and 99.4±0.6, respectively, and demonstrated that the new sorbent was very suitable for removal of lead and cadmium ion from the real wastewater samples.
Regional Epidemiology of Methicillin-Resistant Staphylococcus aureus among Adult Intensive Care Unit Patients following State-Mandated Active Surveillance
Antibiotic resistance and the risk of recurrent bacteremia
Acute Retroviral Syndrome is Associated with High Viral Burden, CD4 Depletion, and Immune Activation in Systemic and Tissue Compartments
Advances in Serodiagnostic Testing for Lyme Disease Are at Hand
Vivax malaria chemoprophylaxis: the role of Atovaquone-proguanil, compared to other options
Randomized Controlled Trial of Daily Text Messages To Support Adherence to PrEP In At-Risk for HIV Individuals: The TAPIR Study
Endoscopic ultrasound-guided biliary drainage using a newly designed metal stent with a thin delivery system: a preclinical study in phantom and porcine models
Abstract
Purpose
This study was designed to evaluate the feasibility and safety of a newly designed self-expandable metal stent for endoscopic ultrasound-guided biliary drainage (EUS-BD) when it was delivered via three different stent delivery systems: a 7.5Fr delivery catheter with a bullet-shaped tip (7.5Fr-bullet), a 7Fr catheter with a bullet-shaped tip (7Fr-bullet), or a 7Fr catheter with a tee-shaped tip (7Fr-tee).
Methods
This experimental study utilized a porcine model of biliary dilatation involving ten pigs. In the animal study, technical feasibility and clinical outcomes of the stent when placed with each of the delivery systems were examined. In addition, a phantom model was used to measure the resistance of these delivery systems to advancement.
Results
Phantom experiments showed that, compared with 7Fr-bullet, 7Fr-tee had less resistance force to the advancement of the stent delivery system. EUS-BD was technically successful in all ten pigs. Fistulous tract dilation was necessary in 100% (2/2), 75% (3/4), and 0% (0/4) of the pigs that underwent EUS-BD using 7.5Fr-bullet, 7Fr-bullet, and 7Fr-tee, respectively. There were no procedure-related complications.
Conclusion
Our newly designed metal stent may be feasible and safe for EUS-BD, particularly when delivered by 7Fr-tee, because it eliminates the need for fistulous tract dilation.
Chrysophyllum cainito (apple-star): a fruit with gastroprotective activity in experimental ulcer models
Abstract
The gastroprotective potential of the methanolic extracts from peels (MEPe), seeds (MESe) and pulp (MEPu) of Chrysophyllum cainito L. (Sapotaceae) fruits was evaluated in mice using ethanol/HCl- and indomethacin-induced ulcer, as well as the antiulcer effect of the juice and flour from this fruit. The lowest oral gastroprotective dose of MEPe, MESe and MEPu against ethanol/HCl was 3, 3 and 10 mg/kg, respectively. Moreover, all extracts increased mucin secretion at 176, 198 and 193%. Intraperitoneal administration of MEPe (0.3 mg/kg), MESe (0.3 mg/kg) and MEPu (1 mg/kg) also promoted gastroprotection against ethanol/HCl. In addition, MEPe (3 mg/kg, p.o), MESe (3 mg/kg, p.o) and MEPu (10 mg/kg, p.o) reduced indomethacin-induced gastric ulcer in mice by 78, 70 and 50%, respectively. Regarding the mode of action, the gastroprotective effect of MEPe was decreased by the pre-administration of N-ethylmaleimide (NEM, a sulfhydryl group chelator, 10 mg/kg, i.p), glibenclamide (a potassium channel blocker, 10 mg/kg, i.p), yohimbine (10 mg/kg, i.p, an alpha-adrenergic receptor antagonist, 10 mg/kg, i.p) and indomethacin (a cyclooxygenase inhibitor, 10 mg/kg, i.p). The gastroprotective effect of MESe was reduced by the pre-administration of NEM, glibenclamide, N-Nitro-l-arginine methyl ester (L-NAME, a nitric oxide synthase inhibitor, 70 mg/kg, i.p) and yohimbine, while MEPu had the gastroprotective effect decreased in animals pretreated with NEM and L-NAME. However, the extracts did not reduce gastric acid secretion. The supplementation with the flour from C. cainito fruit at 10% by 7 days, but not the juice intake, displayed gastroprotective potential, evidencing the fruit as a promising functional food. Together, the antiulcer effect of extracts of the C. cainito fruit in different experimental models was confirmed by the favoring of mucosal protective mechanisms among different, but complementary, modes of action. In parallel, the gastroprotective effects of the flour from C. cainito fruit were also described.
CFD modeling of hydro-biochemical behavior of MSW subjected to leachate recirculation
Abstract
The most commonly used method of operating landfills more sustainably is to promote rapid biodegradation and stabilization of municipal solid waste (MSW) by leachate recirculation. The present study is an application of computational fluid dynamics (CFD) to the 3D modeling of leachate recirculation in bioreactor landfills using vertical wells. The objective is to model and investigate the hydrodynamic and biochemical behavior of MSW subject to leachate recirculation. The results indicate that the maximum recirculated leachate volume can be reached when vertical wells are set at the upper middle part of a landfill (H W/H T = 0.4), and increasing the screen length can be more helpful in enlarging the influence radius than increasing the well length (an increase in H S/H W from 0.4 to 0.6 results in an increase in influence radius from 6.5 to 7.7 m). The time to reach steady state of leachate recirculation decreases with the increase in pressure head; however, the time for leachate to drain away increases with the increase in pressure head. It also showed that methanogenic biomass inoculum of 1.0 kg/m3 can accelerate the volatile fatty acid depletion and increase the peak depletion rate to 2.7 × 10−6 kg/m3/s. The degradation-induced void change parameter exerts an influence on the processes of MSW biodegradation because a smaller parameter value results in a greater increase in void space.
Enhanced activity and stability of La-doped CeO 2 monolithic catalysts for lean-oxygen methane combustion
Abstract
Effective utilization of coal bed methane is very significant for energy utilization and environment protection. Catalytic combustion of methane is a promising way to eliminate trace amounts of oxygen in the coal bed methane and the key to this technology is the development of high-efficiency catalysts. Herein, we report a series of Ce1-xLaxO2-δ (x = 0–0.8) monolithic catalysts for the catalytic combustion of methane, which are prepared by citric acid method. The structural characterization shows that the substitution of La enhance the oxygen vacancy concentration and reducibility of the supports and promote the migration of the surface oxygen, as a result improve the catalytic activity of CeO2. M-Ce0.8La0.2O2-δ (monolithic catalyst, Ce0.8La0.2O2-δ coated on cordierite honeycomb) exhibits outstanding activity for methane combustion, and the temperature for 10 and 90% methane conversion are 495 and 580 °C, respectively. Additionally, Ce0.8La0.2O2-δ monolithic catalyst presents excellent stability at high temperature. These Ce1-xLaxO2-δ monolithic materials with a small amount of La incorporation therefore show promises as highly efficient solid solution catalysts for lean-oxygen methane combustion.
Graphical abstract
Against the perceptual model of utterance comprehension
Abstract
What accounts for the capacity of ordinary speakers to comprehend utterances of their language? The phenomenology of hearing speech in one's own language makes it tempting to many epistemologists to look to perception for an answer to this question. That is, just as a visual experience as of a red square is often taken to give the perceiver immediate justification for believing that there is a red square in front of her, perhaps an auditory experience as of the speaker asserting that p gives the competent hearer immediate justification for believing that the speaker has asserted that p. My aim here is to offer reasons for resisting this temptation. I argue that the perceptual model cannot adequately account for the hearer's justification in many cases. The arguments here also allow us to draw certain further morals about the role of phenomenology in the epistemology of perception.
Wound healing activity of Streptocaulon juventas root ethanolic extract
ABSTRACT
Streptocaulon juventas is a well-known plant that has antimicrobial activity, in vitro antiplasmodial activity, anti-proliferative activity, and antioxidant activity. In this study, we showed experimental evidence that proved that Streptocaulon juventas root ethanolic extract has wound healing activities. First, in a mouse excision wound model, Streptocaulon juventas root ethanolic extract at a dose of 100 mg/kg/day significantly reduced the wound closure time. After 7 days, the wound granulation tissue in mice treated with the extract exhibited a 2.3-fold decrease in inflammatory cells, a 1.7-fold increase in fibroblasts and enhanced angiogenesis. Molecular analysis also revealed that after wounds were treated with Streptocaulon juventas root ethanolic extract, TNF-α and NF-κB1 gene expression were down-regulated by 4.7 and 3.7 times, respectively. In contrast, TGF-β1 and VEGF gene expression were up-regulated by 1.9 and 6.5 times, respectively. Taken together, our experimental data strongly demonstrate that the ethanolic extract from Streptocaulon juventas root displays remarkable wound healing activity. This article is protected by copyright. All rights reserved.
Survival study of treatment adherence by patients given oral oxibutynin for hyperhidrosis
Abstract
Introduction
In recent years, increasing use has been made of oral anticholinergics such as oxybutynin for the management of hyperhidrosis. The primary aim of this study is to determine the variables associated with adherence to this treatment, and secondarily to obtain data on its effectiveness, safety and adverse effects.
Material and methods
Prospective study of patients with hyperhidrosis, at any location, receiving treatment with oral oxybutynin in the period 2007-2016. Epidemiological variables, treatment details, effectiveness and adverse effects were recorded. Effectiveness was determined according to the Hyperhidrosis Disease Severity Scale (HDSS) at baseline, at 3 and 12 months and in successive visits. A descriptive analysis was performed, and Cox's bivariate and multivariate regressions were calculated to determine the variables associated with treatment adherence.
Results
201 patients (140 women) with a mean age of 34 years were included. The mean initial HDSS score was 3.8 and the median follow-up period was 29 months. At 3 months, 84.57% of the patients had responded to treatment (excellent response: 72.94%), but adverse effects were reported by 68.2%. At 12 months, 54.23% had responded (excellent response: 79.82%), with adverse effects in 75.2%. The main variable associated with greater adherence was affected areas: palms of the hands and soles of the feet. The following variables were associated with poorer adherence: onset of hyperhidrosis in adolescence, failure to provide an incrementally increasing, individualised dose, initial HDSS score of 3, and partial initial response. The multivariate analysis confirmed the association between the onset of hyperhidrosis during adolescence, the failure to provide a progressively increasing dose, and palmar affectation.
Discussion
This study was conducted to identify the variables associated with adherence to treatment by hyperhidrosis patients treated with oral oxybutynin. This information would facilitate selection of patients for this treatment and enhance our understanding of the biological behaviour of such anticholinergics when used to treat hyperhidrosis.
This article is protected by copyright. All rights reserved.
Testing the role of fiscal policy in the environmental degradation: the case of Turkey
Abstract
This study introduces a new research topic that investigates the relationship between fiscal development and carbon emissions in Turkey through testing Environmental Kuznets Curve (EKC) hypothesis. Annual data covering the period, 1960–2013, has been used and in addition to gross domestic product and energy consumption, fiscal policy variables have been regressed on the level of carbon emissions in Turkey. Results reveal that fiscal policies and carbon emissions are in long-term equilibrium relationship in Turkey; carbon dioxide emission level converges towards long-term paths as contributed by fiscal policy. The effects of fiscal aggregates on the level of carbon dioxide emissions are negatively significant revealing that growth in fiscal aggregates leads to declines on the levels of carbon emissions. This proves that as far as environmental effects are concerned, fiscal policies regarding energy sector is successful in Turkey. Thus, the major finding of this study confirmed the validity of the fiscal policy-induced EKC hypothesis in the case of Turkey.
Essence, necessity, and definition
Abstract
What is it for something to be essential to an item? For some time, it was standard to think that the concept of necessity alone can provide an answer: for something to be essential to an item is for it to be strictly implied by the existence of that item. We now tend to think that this view fails because its analysans is insufficient for its analysandum. In response, some argue that we can supplement the analysis in terms of necessity with a further condition. In this paper I argue that this view is untenable in its current form. I then provide a glimmer of hope to those who think that essence is at least partially analyzable in terms of necessity.
Modulation of collagen population under honey assisted wound healing in diabetic rat model
Publication date: Available online 7 December 2017
Source:Wound Medicine
Author(s): Satarupa Sarkar, Amrita Chaudhary, Tanmoy Kumar Saha, Amit Kumar Das, Jyotirmoy Chatterjee
BackgroundDiabetic wound with impaired healing attributes owing to inappropriate synthesis and alignment of collagen fibrils with aberrant post translational modifications impose substantial economic burden. Honey: a recognized natural collagen pro-synthetic healing agent; stimulates rapid healing with its anti-inflammatory and anti-scarring approach. Present study investigates the effect of honey on collagen population in diabetic wound model.MethodologyFull thickness wound was created on rat and divided into three groups: normal saline treated group (N), diabetic honey treated group (H), diabetic povidone iodine treated group (PI). Biopsies were collected from wound edges for collagen characterization.Main findingsHistological attributes of collagen fibers in N and H group biopsy displayed proximity. Ultrastructure analysis using scanning electron microscope (SEM) revealed that the D-Spacing and collagen diameter under honey treatment were in close resemblance to normal skin collagen. FTIR spectra confirmed secondary structure of collagen with a greater peak height in PI group exhibiting excessive glycation than H group. Nano-indentation profiling showed decreased displacement in PI samples resulting from increased rigidity when compared to honey treated ones. Molecular expression of collagen I and III exhibited optimum ratio in H group similar to N group.ConclusionsBased on these findings, it might be opined that honey predominantly helps in regulating synthesis, glycation and deposition followed by mechanical quality of collagen alike normal skin and its application also accelerated diabetic healing process.
Dapsone for Recalcitrant Eosinophilic Annular Erythema: A Case Report and Literature Review
Abstract
Eosinophilic annular erythema (EAE) is a rare entity of unknown etiology that is possibly related to a hypersensitivity reaction and presents as annular erythematous plaques with tissue eosinophilia. It is classified as a figurate erythema with a controversial relationship to Wells syndrome (WS) in the literature, where it is generally considered a separate entity or subset based on clinical and histopathologic differences. EAE typically presents with recurrent, erythematous, arcuate, and annular plaques on the trunk and proximal extremities. The course of the disease is often chronic, recurrent, and relapsing. Responses to treatment are variable but are typically best with systemic steroids and antimalarials. We report a patient refractory to other therapies who had a striking response to dapsone.
Protective effects of fucoxanthin and fucoxanthinol against tributyltin-induced oxidative stress in HepG2 cells
Abstract
Tributyltin (TBT) is a biocide extremely toxic to a wide range of organisms, which has been used for decades for industrial purposes. Fucoxanthin is a natural carotenoid that is isolated from seaweed, and fucoxanthinol is a major primary metabolite of fucoxanthin. Although fucoxanthin and fucoxanthinol have been reported to possess anti-oxidant activities in vitro, little is known as to whether they protect against TBT-induced oxidative stress in cultured cells. In the present study, the protective effect of fucoxanthin and fucoxanthinol against oxidative stress induced by TBT was investigated. The data showed that incubation of HepG2 cells with 0.2 μM TBT significantly increased cell apoptosis, whereas treatment with fucoxanthin or fucoxanthinol (3 μM) significantly recovered cell viability. In addition, fucoxanthinol treatment significantly decreased the intracellular reactive oxygen species (ROS) and malondialdehyde (MDA) in HepG2 cells incubated with TBT. Moreover, fucoxanthin and fucoxanthinol markedly increased the expression level of Bcl-2/Bax. These results demonstrated that both fucoxanthin and fucoxanthinol effectively prevented cytotoxicity in HepG2 cells treated with TBT, and the protective effect was likely associated with decreased intracellular ROS and MDA and increased Bcl-2/Bax levels.
Phytotoxic effects of silver nanoparticles in tobacco plants
Abstract
The small size of nanoparticles (NPs), with dimensions between 1 and 100 nm, results in unique chemical and physical characteristics, which is why they are implemented in various consumer products. Therefore, an important concern is the potential detrimental impact of NPs on the environment. As plants are a vital part of ecosystem, investigation of the phytotoxic effects of NPs is particularly interesting. This study investigated the potential phytotoxicity of silver nanoparticles (AgNPs) on tobacco (Nicotiana tabacum) plants and compared it with the effects of the same AgNO3 concentrations. Accumulation of silver in roots and leaves was equally efficient after both AgNP and AgNO3 treatment, with predominant Ag levels found in the roots. Exposure to AgNPs did not result in elevated values of oxidative stress parameters either in roots or in leaves, while AgNO3 induced oxidative stress in both plant tissues. In the presence of both AgNPs and AgNO3, root meristem cells became highly vacuolated, which indicates that vacuoles might be the primary storage target for accumulated Ag. Direct AgNP uptake by root cells was confirmed. Leaf ultrastructural studies revealed changes mainly in the size of chloroplasts of AgNP-treated and AgNO3-treated plants. All of these findings indicate that nano form of silver is less toxic to tobacco plants than silver ions.
Changes to tetracyclines and tetracycline resistance genes in arable soils after single and multiple applications of manure containing tetracyclines
Abstract
The influence of manure containing tetracyclines (TCs) on the prevalence of antibiotic resistance genes in soils remains poorly understood. Here, three different TCs (oxytetracycline (OTC), tetracycline (TC), and chlortetracycline (CTC)) were mixed respectively with unpolluted manure to fertilize arable soil. The soil received either a single application of 0 μg kg−1, 300 μg kg−1 (TC and CTC), or 700 μg kg−1 (OTC) or multiple applications every 14 days for 140 days. Four tetracycline resistance genes (TRGs), including tet(A), tet(L), tet(M), and tet(Q), were monitored. Although the abundances of the four TRGs in the single application treatment initially increased rapidly, they decreased over time and were significantly lower than those of the repeated treatments after day 112. All additions of TCs stopped on day 140, but we continued to assess the long-term accumulation of TRGs. Most of the TRGs were detected even after the TC-containing manures had not been applied for more than 15 months. The abundance of the TRGs after ceasing fertilization with the TC-containing manures was higher in the repeated application treatments than in the single application treatments. Therefore, more attention should be paid to repeated applications of antibiotic-containing manure to arable soils.
Pyoderma gangrenosum récidivant du post-partum et cardiomyopathie fatale
Source:Annales de Dermatologie et de Vénéréologie
Author(s): I. Naciri, M. Meziane, L. Benzekri, M. Ghaouti, K. Senouci, B. Hassam
IntroductionNous rapportons l'observation d'un pyoderma gangrenosum (PG) récidivant du post-partum, associé à une cardiomyopathie du post-partum (CMPP).ObservationUne femme de 23 ans signalait avoir eu un abcès du sein gauche lors de sa quatrième grossesse. Cette lésion avait évolué, après drainage chirurgical, vers une ulcération inflammatoire traitée par des soins locaux atraumatiques. Lors de sa cinquième grossesse, la patiente développait une ulcération large et douloureuse en regard d'une cicatrice de césarienne, malgré l'introduction d'une antibiothérapie à large spectre. Les prélèvements bactériologiques étaient négatifs. L'examen histologique était en faveur d'un PG. Une semaine après l'introduction d'une corticothérapie générale, elle présentait brutalement des signes d'insuffisance cardiaque. L'échocardiographie trans-thoracique permettait de retenir le diagnostic de CMPP, dont l'évolution était fatale.DiscussionCette observation soulève la question de la relation entre PG et grossesse, et décrit l'association d'un PG et d'une CMPP. La survenue du PG lors de la grossesse est rare ; elle pourrait être induite par l'élévation des taux de G-CSF constatée chez les femmes enceintes. L'association à une CMPP chez notre patiente pourrait être expliquée par le développement d'un climat anti-angiogénique en fin de grossesse, auquel s'ajouterait une agression myocardique inflammatoire neutrophilique en lien avec le PG.BackgroundWe report a case of recurrent post-partum pyoderma gangrenosum (PG) complicated by post-partum cardiomyopathy (PPCM).Patients and methodsA 23-year-old woman presented with a previous medical history of aseptic abscess of the left breast in her fourth pregnancy, which developed after surgical drainage of an inflammatory ulceration treated by atraumatic topical care. During her fifth pregnancy, the patient presented a large and painful ulceration in relation to the scar of the Caesarean section, despite the introduction of broad-spectrum antibiotic therapy. Bacteriological samples were negative. Histological examination militated in favor of PG. One week after initiation of corticosteroid therapy, the patient suddenly showed signs of heart failure. Based on trans-thoracic echocardiography PPCM was diagnosed, and the outcome was fatal.DiscussionThis observation raises the question of the relationship between PG and pregnancy and describes the association of PG and PPCM. PG occurs rarely during pregnancy and it may be induced by the rise in G-CSF levels found in pregnant women. The association with PPCM seen in our patient could have been due to the development of an anti-angiogenic climate at the end of pregnancy, together with inflammatory myocardial aggression linked to the PG.
An advanced simulator for orthopedic surgical training
Abstract
Purpose
The purpose of creating the virtual reality (VR) simulator is to facilitate and supplement the training opportunities provided to orthopedic residents. The use of VR simulators has increased rapidly in the field of medical surgery for training purposes. This paper discusses the creation of the virtual surgical environment (VSE) for training residents in an orthopedic surgical process called less invasive stabilization system (LISS) surgery which is used to address fractures of the femur.
Method
The overall methodology included first obtaining an understanding of the LISS plating process through interactions with expert orthopedic surgeons and developing the information centric models. The information centric models provided a structured basis to design and build the simulator. Subsequently, the haptic-based simulator was built. Finally, the learning assessments were conducted in a medical school.
Results
The results from the learning assessments confirm the effectiveness of the VSE for teaching medical residents and students. The scope of the assessment was to ensure (1) the correctness and (2) the usefulness of the VSE. Out of 37 residents/students who participated in the test, 32 showed improvements in their understanding of the LISS plating surgical process. A majority of participants were satisfied with the use of teaching Avatars and haptic technology. A paired t test was conducted to test the statistical significance of the assessment data which showed that the data were statistically significant.
Conclusion
This paper demonstrates the usefulness of adopting information centric modeling approach in the design and development of the simulator. The assessment results underscore the potential of using VR-based simulators in medical education especially in orthopedic surgery.
Levels, dietary intake, and health risk of potentially toxic metals in vegetables, fruits, and cereal crops in Pakistan
Abstract
Food safety is a major concern worldwide and human beings are frequently exposed to potentially toxic metals (PTMs) through consumption of vegetables, fruits, and cereal crops grown in contaminated areas. The present study investigates the concentrations of PTMs such as chromium (Cr), nickel (Ni), zinc (Zn), arsenic (As), cadmium (Cd), and lead (Pb) in the foodstuffs (fruits, vegetables, and cereals) collected from different markets of Khyber Pakhtunkhwa, Pakistan. Samples of fruits (banana, tangerine, apple, and guava), vegetables (tomato, onion, potato, pea, and lady finger), and cereals (rice, kidney beans, and chick peas) were acid-extracted and analyzed using ICP-MS. The concentrations of Cr, Zn, Pb, As, and Cd in fruits (54, 50, 50, 45, and 4% samples, respectively), vegetables (53, 43, 63, 80, and 46%), and cereals (37, 62, 25, 70, and 25%) exceeded their respective permissible limits set by FAO/WHO (2001). The results showed that the highest mean concentration was observed for Ni (14.95 mg/kg), Pb (0.57 mg/kg), and Cd (0.27 mg/kg) in vegetables followed by fruits and cereals. However, the highest mean concentration of As (0.44 mg/kg) was observed in cereal crops followed by vegetables and fruits. The individual health risk of PTMs via consumption of fruits, vegetables, and cereals were found within safe limits for adults and children. Nevertheless, the total HRI values (fruits + vegetables + cereals) for Ni, As, and Cd for both adults and children were observed > 1 and may posed potential risk for the community consuming these foodstuffs on a daily basis.
Graphical abstract
Municipal solid waste compost as a novel sorbent for antimony(V): adsorption and release trials at acidic pH
Abstract
The ability of two municipal solid waste composts (MSW-Cs) to sorb antimony(V) in acidic conditions (pH 4.5) was investigated. Sorption isotherms and kinetics showed that both MSW-Cs could sorb antimony(V), even if in different amounts (~ 0.18 and 0.24 mmol g−1 of Sb(V) by MSW-C1 and MSW-C2, respectively). These differences were ascribed to the chemical composition of composts, as well as to the total acidity of their humic substances. The Sb(V) sorption by both MSW-Cs followed a pseudo-second-order kinetic model, while the sorption isotherms data fitted the Freundlich model better than the Langmuir one. The humic acids extracted from composts contributed to 4.26 and 8.24% of Sb(V) sorption by MSW-C1 and MSW-C2 respectively. SEM-EDX spectra of the MSW-C+Sb(V) systems showed a certain association of Ca(II) with Sb(V), while sequential extraction procedures indicated that more than 80% of the Sb(V) sorbed was strongly retained by MSW-Cs. On the other hand, treatment with oxalic acid at pH 4.5 favored the release of more than 98 and 65% of the Sb(V) sorbed by MSW-C1 and MSW-C2 respectively, supporting a possible role of calcium in Sb(V) retention. The results from this study suggest that MSW-Cs could be used as amendments for the in-situ immobilization of Sb(V) in acidic-polluted soils.
Responsibility for scientific misconduct in collaborative papers
Abstract
This paper concerns the responsibility of co-authors in cases of scientific misconduct. Arguments in research integrity guidelines and in the bioethics literature concerning authorship responsibilities are discussed. It is argued that it is unreasonable to claim that for every case where a research paper is found to be fraudulent, each author is morally responsible for all aspects of that paper, or that one particular author has such a responsibility. It is further argued that it is more constructive to specify what task responsibilities come with different roles in a project and describe what kinds of situations or events call for some kind of action, and what the appropriate actions might be.
Πέμπτη 7 Δεκεμβρίου 2017
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A Case of Diprosopus Tetraophthalmos: Ocular Findings and Surgical Treatment of Exposure KeratopathyDiprosopus is a rare variation of conjoined twinning. In this report, ophthalmic findings in an infant with diprosopus tetraophthalmos are p...