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Τρίτη 26 Δεκεμβρίου 2017

The impact of olive mill wastewater spreading on soils using integrated approach of proximal soil survey, spatial, and multivariate analyses

Abstract

Olive oil production generates a large amount of olive mill wastewater (OMW), the most difficult to treat of agro-industrial effluents. Spreading of OMW across the soilscape has become the most frequently used practice in several Mediterranean basin countries but is hotly debated because of its potential to impair soil environs. The research hypothesis states that soil deterioration is correlated strongly with the spatiotemporal rate of OMW application; thus, the spatial pattern of the soil attributes should be established in conjunction with the rate of OMW spreading. The spatial pattern was ascertained using proximal soil sensing that measures the apparent electrical conductance (ECa). Eight representative locations were identified using grouping analysis of the ECa data. The soils were analyzed for selected physical and chemical attributes known to be affected by OMW spreading as well as ancillary parameters needed for the calibration of the ECa. Discriminant analysis successfully categorized 76% of the ECa groups, selecting CEC, sand, pH, and ESP as the most powerful discriminatory variables in the grouping analysis. The correlation coefficients between the measured ECa, and the calculated ECa, and soil moisture were very high (r > 0.77, P < 0.05), suggesting that the proximal soil survey results are well calibrated. The spreading of untreated OMW over more than 7 years did not impair the soils under study. No significant changes in soil chemo-physical properties such as pH (< 7.66), electrical conductivity in saturated paste (< 3.58 dS m−1), sodium adsorption ratio (< 2.3), potassium adsorption ratio (< 0.33), exchangeable sodium percentage (< 3.85%), and unsaturated hydraulic conductivity (< 0.3 cm h−1) were found in comparison with untreated soils. The results support the premise that moderate quantities of OMW (50–70 m3 ha−1 year−1) equally spread over the soilscape will have little impact on soil health.



Itching for answers: Prevalence and severity of pruritus in psoriasis

Abstract

Background/Objectives

Pruritus is the most frequently reported complaint or symptom for psoriasis patients. Despite the morbidity associated with pruritus in psoriasis few studies have evaluated the prevalence of itch in psoriasis with the current use of biological agents.

Method

This was a multi-site cross-sectional observational study conducted in New South Wales, Australia. Psoriasis patients were approached during their outpatient clinic, phototherapy or private consultations. Data on psoriasis characteristics, severity and treatment were collected. The patients were then asked to complete a survey regarding the frequency, severity and aggravators of their psoriasis.

Results

Data were collected from 179 patients with a mean age of 52.3 years, of whom 55% were male. Altogether 63 (35%) had a psoriasis area severity index (PASI) > 10, 42 (24%) were on biological agents and 84 (47%) were receiving phototherapy. The number of patients who reported itch all the time was 40 (22%), most of the time 48 (27%), and never 19 (11%). Patients with nail psoriasis were significantly less likely to have itch all or most of the time (P = 0.01). Itch all or most of the time was significantly more likely in patients with PASI > 10 (P = 0.013). No treatment was associated with reduced itch. Itch was reported to be most frequent in the winter season.

Conclusion

Few patients with psoriasis do not suffer from pruritus. Despite their promise, biological agents are not associated with reduced itch.



Mycosis fungoides occurring at the site of previous herpes zoster eruption

Abstract

Numerous clinicopathological variants of mycosis fungoides have been described in the literature. Dermatomal or zosteriform mycosis fungoides is one reported variant but a clear aetiology has never been documented. We report a case of mycosis fungoides proved by biopsy and immunohistochemistry that developed in a 55-year-old man at the site of previous herpes zoster eruption. We also present a review of the relevant literature to add to the understanding of rare variants of mycosis fungoides and aid in the clinical recognition of zosteriform mycosis fungoides.



Canaliform median raphe cyst

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Debabrata Bandyopadhyay

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):108-108



Antihypertensives in dermatology Part I - Uses of antihypertensives in dermatology

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P. S. S. Ranugha, Jayadev B Betkerur

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):6-15

Hypertension is a global health problem. Antihypertensives are the mainstay of treatment for hypertension. Some of them were accidentally found to be useful in alopecias and infantile hemangiomas and have now become standard treatment for these conditions as well. Antihypertensives are also being studied for other dermatological indications, where they have shown promising efficacy. This review focuses on the dermatological indications for antihypertensives, discussing the drugs that have been tried, as well as their efficacy, dosage, duration of therapy, and adverse effects.

Involvement of scars in capecitabine induced hand foot syndrome

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Bhabani S. T. P. Singh, Tapaswini Tripathy, Bikash Ranjan Kar, Surabhi Singh

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):85-87



Turmeric: A condiment, cosmetic and cure

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Hima Gopinath, Kaliaperumal Karthikeyan

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):16-21

Turmeric (Curcuma longa L.) is an integral part of Asian culture and cuisine. It has been used in traditional medicine since centuries. A myriad of health benefits have been attributed to it. Curcumin, the most biologically active curcuminoid in turmeric, is being investigated in pre-clinical and clinical trials for its role in disease prevention and cure. It has antioxidant, anti-inflammatory, antineoplastic, anti-proliferative and antimicrobial effects. We review the chemistry of this plant, its cultural relevance in Indian skin care, and its uses in dermatology.

Erratum: A noncancerous variant of xeroderma pigmentosum type D associated with novel heterozygous missense ERCC2 gene mutation

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Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):122-122



Risk of venous thromboembolism in patients with bullous pemphigoid: A systematic review and meta-analysis

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Patompong Ungprasert, Karn Wijarnpreecha, Charat Thongprayoon

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):22-26

Background and Objectives: Increased risk of venous thromboembolism is observed in several autoimmune inflammatory disorders. However, data on bullous pemphigoid, one of the most common autoimmune blistering disorders, is limited. This systematic review and meta-analysis was conducted to summarize all available evidence. Methods: Two investigators independently searched published studies indexed in MEDLINE and EMBASE from inception to July 2016 using the terms for bullous pemphigoid and venous thromboembolism. The inclusion criteria were as follows: (1) cohort or case-control study evaluated the association between bullous pemphigoid and risk of venous thromboembolism, (2) effect estimates were provided as odds ratios, relative risk, hazard ratio, standardized incidence ratio with 95% confidence intervals, and (3) subjects without bullous pemphigoid were used as comparators for cohort studies, while subjects without venous thromboembolism were used as comparators for case-control studies. Point estimates and 95% confidence intervals were extracted from each study and were pooled together using the random-effect model, generic inverse variance method of DerSimonian and Laird. Cochran's Q test and the I2 statistic were used to evaluate the statistical heterogeneity. Results: Two retrospective cohort studies, one prospective cohort study, and one case-control study met the eligibility criteria and were included in the meta-analysis. The pooled odds ratio was 2.69 (95% confidence interval, 1.79–4.05). Statistical heterogeneity was high with I2 of 77%. Limitation: Limited accuracy of diagnosis of primary studies and high between-study heterogeneity. Conclusion: This meta-analysis demonstrated that patients with bullous pemphigoid have a significantly increased risk of venous thromboembolism.

Dermoscopy and scanning electron microscopy in two cases with hair shaft damage secondary to hair straightening

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Feroze Kaliyadan, BB Gosai, Walid Naief Ali Al Melhim, Hani Mohammed Al Rasasi, P Joel Kuruvilla

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):95-97



A study of the histopathology of palmo-plantar psoriasis and hyperkeratotic palmo-plantar dermatitis

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Ashwin Rao, Sujay Khandpur, M Kalaivani

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):27-33

Background and Objectives: Palmo-plantar psoriasis and dermatitis show several overlapping clinical features. We undertook this retrospective study to elucidate and compare the histological findings in these two dermatoses. Materials and Methods: Biopsies of 31 clinically diagnosed cases of palmo-plantar psoriasis and 24 cases of hyperkeratotic palmo-plantar dermatitis, with concomitant presence of representative lesions at other body sites, were retrieved and analysed. Results: Histologically, confluent parakeratosis, suprapapillary thinning and dermal edema were observed in significantly greater number of palmo-plantar psoriasis biopsies while an inflammatory infiltrate confined to the papillary dermis only, was a significant feature in palmo-plantar dermatitis. The two conditions could not be differentiated on the basis of features like focal parakeratosis, presence of neutrophils and fibrin globules in the stratum corneum, hypogranulosis, acanthosis, spongiosis, rete ridge pattern, or vascularity. Conclusion: Histopathology of palmo-plantar psoriasis and dermatitis can have several overlapping features. In our study, we found only few features as strong pointers towards psoriasis.

Phacomatosis pigmentokeratotica: A very rare twin spotting phenomenon

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Darshan R Karia, Apeksha N Solanki, Ashish G Jagati, Bela J Shah

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):120-120



Prevalence of ocular findings in a sample of Egyptian patients with psoriasis

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Salma Samir Omar, Hany Ahmed Helaly

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):34-38

Background: Psoriasis is a common disorder worldwide. The prevalence of psoriasis in Egypt, an African country with a Caucasian population, ranges 0.19–3%. Despite this relatively high prevalence of psoriasis, there are no epidemiologic data regarding the burden of associated eye affection. Determining the magnitude of the problem could help in offering better integrated health services. Aim: The purpose of this study was to evaluate eye involvement in a sample of Egyptian psoriatic patients. Patients and Methods: This case-control study included 100 patients with psoriasis and 100 age and sex matched healthy controls. Psoriasis extent and severity was graded by psoriasis area and severity index (PASI). Complete ophthalmological examination and tests for dry eye were performed to all subjects. Results: The mean age of the psoriasis group was 50.7 ± 14.3 years. Thirty eight percent of the cases were females. The mean duration of psoriasis was 10.1 ± 7.5 years. Psoriasis patients had more conjunctival injection (n = 40, P = 0.035), more pinguecula (n = 38, P = 0.048) than controls. Ocular surface disease index (OSDI), tear breakup time (TBUT), Schirmer I, and Rose Bengal staining showed statistically significant positive results in the psoriasis group. Conclusion: This is the first report on the prevalence of eye comorbidities in Egyptian psoriatic patients. Dry eyes were more common with psoriasis, particularly the erythrodermic type. Other ocular findings were not statistically significantly different except for conjunctival injection and pinguecula.

Acral porokeratosis associated with anonychia

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Gurumoorthy Rajesh, Prakash Devan, Subramaniam Keerthi, Kaliaperumal Karthikeyan

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):81-82



Polymorphism of glutathione S-transferase M1 and T1 genes and susceptibility to psoriasis disease: A study from North India

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Daya Shankar Lal Srivastava, Vijay K Jain, Poonam Verma, Jaya P Yadav

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):39-44

Background: Increased oxidative stress and resulting inflammation has been emphasized as a factor in the pathogenesis of many diseases including psoriasis. Glutathione S-transferases (GSTs) protect against oxidative stress, inflammation, and genotoxicity. Polymorphisms in the GST genes may lead to an imbalance in pro- and antioxidant systems resulting in the increased production of reactive oxygen species that could influence the pathogenesis of psoriasis. Aim: The aim of this study was to investigate the association between GSTs (GSTM1 and GSTT1) gene polymorphism in patients with chronic plaque psoriasis as a factor in the susceptibility and development of psoriasis. Materials and Methods: We assessed 128 patients with psoriasis and 250 age- and sex-matched healthy controls. Genomic DNA was extracted from peripheral blood by the phenol chloroform method. The null GSTT1 and GSTM1 genotypes were identified by multiplex polymerase chain reaction (PCR) method. Results: The null genotype of GSTM1 and GSTT1 was seen in 45.3% and 40.6% in psoriasis patients whereas in the controls it was 34.4% and 20.0%, respectively. A significant association was seen between the null alleles of the GSTT1 (OR = 2.74) and GSTM1 (OR = 1.58) alone or in combination with tobacco use (P < 0.001) and psoriasis risk. The presence of both null genotypes of GSTM1 and GSTT1 further increased the risk of psoriasis (OR = 3.52) when compared with the positive genotypes of GSTM1 and GSTT1. Limitations: A major limitation of this study was the small sample size. A large epidemiological study is necessary to confirm these findings. Conclusions: The null genotype of GSTT1 is a strong predisposing factor for psoriasis in North India.

Leukemia cutis mimicking erythema nodosum or vice versa: A histological conundrum

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Keshavamurthy Vinay, Debajyoti Chatterjee, Uday Yanamandra, Uma Nahar Saikia, Pankaj Malhotra, Sunil Dogra

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):91-93



Mycobacterium chelonae infection complicating traumatic and surgical wounds: A case series

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Soumya Jagadeesan, V Anilkumar, Vinitha Varghese Panicker, Gopikrishnan Anjaneyan, Jacob Thomas

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):45-48

Mycobacterium chelonae is a rapidly growing non-tuberculous mycobacterium. The skin and soft tissue infections due to this organism are steadily on the rise and need to be delineated specifically as most of these are not responsive to routine antituberculosis treatment. Here, we report 3 different presentations caused by Mycobacterium chelonae in traumatic and surgical wounds. Mycobacterium chelonae can complicate surgical or traumatic wounds.This infection may also present as injection site abscesses. Diabetics on insulin injections are especially at risk. A high index of suspicion is necessary in long standing culture negative lesions for clinching the diagnosis. PCR can be helpful in confirming the diagnosis.

Successful treatment outcome with itraconazole and potassium iodide in disseminated sporotrichosis

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Binod K Khaitan, Vishal Gupta, Dinesh P Asati, Divya Seshadri, M Ramam

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):101-104



A retrospective study of the utility of targeted phototherapy in vitiligo

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Abhijit D Raghuwanshi, Minty W Jambhore, Vishalakshi Viswanath, Vinay Gopalani

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):49-53

Background: Targeted phototherapy is a recent advance in the treatment of vitiligo, involving selective treatment of vitiligo patches with no effect on surrounding areas. Although it has been in use for a few years, little data is available regarding its safety and efficacy. Aims: A retrospective study to determine efficacy and safety of targeted phototherapy in vitiligo. Methods: One hundred and thirty four patients (male: 53, female: 81) who received targeted phototherapy and completed 11 or more sittings were included. Treatment was given once a week using the Lumera phototherapy system, a broadband ultraviolet B source, starting at 150 mJ/spot and after excluding a sunburn reaction, with increments of 50 mJ every week up to a maximum of 1000 mJ/patch. Chi-square test for linear trends was used for statistical analysis. Results: The most common sites involved were the legs and a majority (70.9%) had non-segmental vitiligo. Response was mild in 78 (58.2%) patients, moderate in 50 (37.3%) and excellent in 6 (4.5%) patients. Response was directly proportional to the number of sittings with more patients showing moderate and excellent responses with an increase in the number of sittings. The most common site for an excellent response was the trunk while the lower limbs were involved in most cases with a moderate or mild response. Side effects were seen in 27 (20.2%) patients, the commonest being erythema. Limitations: This is a retrospective uncontrolled study. Further, the effects of adjuvant treatment were not assessed. Conclusions: Targeted phototherapy is a useful treatment for vitiligo with mild adverse effects, though response is mild or moderate and appears to be directly proportional to the number of treatments received.

A brief biographic sketch of Dr. Bhau Daji Lad (1822–1874): A forgotten figure of Indian dermatology

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Amiya Kumar Mukhopadhyay

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):114-116



A red, swollen and painful lesion on the right hand after local steroid injections

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Kaisheng Liao, Chienliang Fang, Chienchin Chen

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):54-56



Tufted angioma with recurrent Kasabach–Merritt phenomenon

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Neetu Bhari, Banwari Lal Jangid, Piyush Pahadiya, Sanjay Singh, Sudheer Arava, Atin Kumar, Vinod Kumar Sharma, Gomathy Sethuraman

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):121-121



Cirsoid aneurysm of scalp

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Sirisha Varala, Geeta Kiran Arakkal, Shashikant Malkud, Bhaskar Narayana

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(1):57-58



Is thoracic outlet syndrome common after nuss procedure?

We try to discuss the results of Nagasao and Colleagues, claiming thoracic outlet syndrome is not a rare complication after Nuss procedure. According to our experience, this syndrome is not common.

Re: antibiotic prophylaxis in breast reduction surgery: a systematic review and meta-analysis.

We read with interest the article by Drs. Zapata-Copete, Aguilera-Mosquera and Garcia-Perdomo recommending the use of antibiotic prophylaxis in lowering surgical site infection in breast reduction surgery1. The study, however, is open to criticism in its design and originality of outcomes.

Skin wound healing in humans and mice: challenges in translational research

Skin, the first protective barrier of all animals, has evolved and specialized differently among fish, reptiles, birds and mammals[1]. Epidermis, the outermost layer, consists of a stratified squamous epithelium of keratinocytes delimited by the basal membrane, and contains melanocytes and Langerhans and Merkel cells. Dermis, the internal layer that provides structural integrity, elasticity, and nutrition, is a connective tissue composed by fibroblasts and extracellular matrix enriched in collagen and elastic fibers[2–4], and also contains blood and lymphatic vessels, sebaceous glands, sweat glands, nerve endings, and hair follicles invaginated from epidermis [5–7].

The properties and dynamic changes of DOM subfractions during food waste and sugarcane leaves co-composting

Abstract

The purpose of this research was to evaluate the properties and dynamic changes of humic acids (HA), fulvic acids (FA), hydrophobic neutrals (HoN), and hydrophilic (Hi) fractions of dissolved organic matter (DOM) during food waste and sugarcane leaves co-composting process. The pools of HA, FA, HoN, and Hi were separated from DOM by fractionation method, and characterized using spectroscopic (UV–vis, FTIR) and pyrolysis–GC/MS analyses. The least peaks in the HA pool were found in FTIR spectra with the simple structure in HA. The highest value of SUV254 was observed in HA, indicating that the HA pool played a dominant role in aromaticity of DOM. Hydrophobic compounds (HA, FA, HoN) had higher percentages of alkanes and cyclo-alkanes at the end of composting, while lower contents in the Hi pool. Both DOM and its subfractions increased the Chinese flowering cabbage (Brassica campestris L.) seed germination rate (SGR), whereas HA had a significant effect on promoting the root growth.



A study of the influence of regional environmental expenditure on air quality in China: the effectiveness of environmental policy

Abstract

Based on the panel data model, data on environmental expenditures, the air quality index, economic aggregates, industrial structures, etc., of seven seriously polluted cities in China, from the period 2007–2015, were collected, and this paper estimates the general relationship between environmental expenditures and the air quality index. Besides, the impact of the fuel tax policy on air quality as well as on the relationship between environmental expenditure and the air quality index is tested using the method of regression discontinuity. We find that there is a long-term equilibrium relationship between environmental expenditure and air quality index as well as a 0.0507% positive effect of the former on the latter. Second, for Beijing, Taiyuan, Chongqing, and Lanzhou, a 1% increase in environmental expenditure leads to 0.0773, 0.0125, 0.0965, and 0.0912% decreases in the air quality index, respectively; however, for Shijiazhuang, Ji'nan, and Urumqi, effect of environmental expenditure on air quality is insignificant. Third, both economic growth and optimization of the industrial structure can lead to an improvement of air quality. Fourth, since the implementation of the fuel tax policy in 2009, the air quality of the sample cities has improved, and the pulling effect of environmental expenditure on the air quality index has decreased from 0.0507 to 0.0048%. Our findings cannot only clarify the effect of environmental expenditures on air quality but can also objectively judge the effectiveness of environmental policies of China to a certain extent. It may benefit Chinese government to effectively govern air pollution with fiscal tools in conjunction with economic and environmental characteristics.



Distribution of perfluorinated compounds in drinking water treatment plant and reductive degradation by UV/SO 3 2− process

Abstract

Perfluorinated compounds (PFCs), which are widely used in industrial and residential areas, have a large negative impact on the environment. This study investigated the removal efficiency of five PFCs in a drinking water treatment plant. The results indicate that the total PFC concentration in raw water is 261.51 ng L−1 and that perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) are the predominant pollutants. Among all of the treatment processes, coagulation sedimentation process had the highest removal ratio of PFCs (36.12%), and removal ratio was the least in the sand filtration process. The ozonation/activated carbon and disinfection processes increased the concentration of PFCs. Therefore, developing an effective treatment to degrade PFCs is feasible. In this study, we proposed a method using UV irradiation of SO32− at 365 nm to degrade PFCs. The SO32− concentration, pH, and initial concentration had profound impacts on the degradation of PFCs. When the PFC initial concentration was 20 mg L−1, the SO32− concentration was 2.4 g L−1, and in the presence of buffer, the degradation of PFCs was the most efficient, with the degradation ratio close to 100% after 60 min of reaction. During the degradation of PFCs, short-chain PFCs and hydrofluorinated carboxylic acid were generated. From the above, we proposed a detailed mechanism of degradation and its possible pathways.



The Ethics of Performing Non-Invasive, Reversible Gender Affirming Procedures on Transgender Adolescents



‘Transillumination Dermoscopy’ for nail bed pathology



Wood’s lamp-induced fluorescence of milia



Diagnosis and management of peristomal pyoderma gangrenosum: A systematic review

Peristomal pyoderma gangrenosum (PPG) is an uncommon subtype of pyoderma gangrenosum. PPG is a challenging condition to diagnose and treat; no evidence-based guidelines exist.

Dermatologic manifestations of solid organ transplantation-associated graft-versus-host disease: A systematic review



The Nail Hematoma Selfie



Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer

There is controversy regarding nonmelanoma skin cancer (NMSC) treatment in the very elderly, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the very elderly NMSC population has not been well-defined.

Incidence of androgenic dermatological side effects following placement of a levonorgestrel intrauterine device for menorrhagia: A survey-based study



A Split-Face, Single-Blinded, Randomized Controlled Comparison of Alexandrite 755 nm Picosecond Laser vs. Alexandrite 755 nm Nanosecond Laser in the Treatment of Acquired Bilateral Nevus of Ota-like Macules (ABNOM)

Q-switched alexandrite lasers (QSAL) have been used for the treatment of acquired bilateral nevus of Ota-like macules (ABNOM). Currently, picosecond alexandrite laser (PSAL) pulses have become available for pigmentary disorders. However, no studies have compared PSAL and QSAL in the treatment of ABNOM.

Possessing epistemic reasons: the role of rational capacities

Abstract

In this paper, I defend a reasons-first view of epistemic justification, according to which the justification of our beliefs arises entirely in virtue of the epistemic reasons we possess. I remove three obstacles for this view, which result from its presupposition that epistemic reasons have to be possessed by the subject: (1) the problem that reasons-first accounts of justification are necessarily circular; (2) the problem that they cannot give special epistemic significance to perceptual experience; (3) the problem that they have to say that implicit biases provide epistemic. The first problem will be overcome by introducing presentational attitudes that are not in need of justification as basic ways of possessing epistemic reasons. The latter two problems will be solved by introducing epistemic rational capacities of two different kinds, which are exercised in mental states that are ways of possessing epistemic reasons, and by distinguishing these from mental states that are not exercises of epistemic rational capacities .



The promises of microalgae—still a long way to go

Abstract
Over the past decades, interest in microalgae has grown exponentially. Especially industrial applications, such as biodiesel production from microalgae were hyped in the early 2000s. But since the first attempts to commercialise microalgae-derived products for energy applications, only a few developments made it to the market. What is hindering the full exploitation of this valuable resource for food, feed, and energy applications? This opinion paper reflects on the state of the art of industrial microalgae culturing and the knowledge gaps which still need to be filled jointly by academia and industry.

Poly(3-hydroxybutyrate) hyperproduction by a global nitrogen regulator NtrB mutant strain of Paracoccus denitrificans PD1222

Abstract
Paracoccus denitrificans PD1222 accumulates short-length polyhydroxyalkanoates, poly(3-hydroxybutyrate), under nitrogen-deficient conditions. Polyhydroxybutyrate metabolism requires the 3-ketoacyl-CoA thiolase PhaA, the acetoacetyl-CoA dehydrogenase/reductase PhaB and the synthase PhaC for polymerization. Additionally, P. denitrificans PD1222 grows aerobically with nitrate as sole nitrogen source. Nitrate assimilation is controlled negatively by ammonium through the two-component NtrBC system. NtrB is a sensor kinase that autophosphorylates a histidine residue under low-nitrogen concentrations and, in turn, transfers a phosphoryl group to an aspartate residue of the response regulator NtrC protein, which acts as a transcriptional activator of the P. denitrificans PD1222 nasABGHC genes. The P. denitrificans PD1222 NtrB mutant was unable to use nitrate efficiently as nitrogen source when compared to the wild-type strain, and it also overproduced poly(3-hydroxybutyrate). Acetyl-CoA concentration in the P. denitrificans PD1222 NtrB mutant strain was higher than in the wild-type strain. The expression of the phaC gene was also increased in the NtrB mutant when compared to the wild-type strain. These results suggest that accumulation of poly(3-hydroxybutyrate) in the NtrB mutant strain of PD1222 responds to the high levels of acetyl-CoA that accumulate in the cytoplasm as consequence of its inability to efficiently use nitrate as nitrogen source.

Biotransformation of trinitrotoluene by Citrobacter sp. YC4 and evaluation of its cyto-toxicological effects

Abstract
Trinitrotoluene (TNT) is an explosive chemical generally used for military, civil and industrial purposes. Therefore, TNT residue can be found in soil and ground water as an environmental pollutant. The environmental control of TNT pollution has become a critical issue because of its potential toxicity and carcinogenicity. The aim of this study is to evaluate the cyto-toxicological effects of TNT after bioremediation. Citrobacter sp. YC4 is able to utilize TNT as a sole nitrogen source. Citrobacter sp. YC4 cells grown in medium with TNT as the sole nitrogen source (TNT-N) were able to rapidly degrade TNT, in contrast to cells grown in Luria Bertani medium as determined by resting cell suspension. The concentration of TNT decreased from 100 to 0 ppm within 10 h in the solution containing TNT mixed with TNT-N-grown YC4. The cytotoxicity of TNT and its degradation products generated by TNT-N-grown YC4 were assessed by WST-1-based cell cytotoxicity assays. Our results showed that the cytotoxic potential of solutions containing TNT decreased almost to the level of the control after a 1-h incubation with TNT-N-grown YC4 cells. The rapid conversion of TNT into possibly less toxic products by Citrobacter sp. YC4 proposes a bioremediation prospection.

Relationship between Escherichia coli growth rate and bacterial susceptibility to ciprofloxacin

Abstract
The effect of Escherichia coli growth rate on its susceptibility to ciprofloxacin was investigated using bacteria grown on different carbon sources and harboring mutations in genes encoding tricarboxylic acid cycle enzymes. A 1-h treatment of the wild type (wt) grown on glucose, succinate, malate, α-ketoglutarate or acetate with 0.3 μg ml–1 ciprofloxacin decreased the number of surviving cells (CFU ml–1), 560, 110, 74, 62 and 5 times, respectively. Among the mutants tested, sucB strain, which grew 1.75 times slower than wt, was 7.4-fold more tolerant to 0.3 μg ml–1 of ciprofloxacin than wt. Strong inverse correlations between log(CFU ml–1) after 1-h exposure to 0.3 and 3.0 μg ml–1 ciprofloxacin and the specific growth rate prior to antibiotic treatment (r = − 0.93 and −0.96, respectively) were observed. Data from the current and previous studies on the inhibitory effect of ciprofloxacin on cultures exhibiting a wide range of growth rates (0.01–1.3 h–1) were collated. Statistical analysis revealed a significant inverse correlation between log(CFU ml–1) after exposure to 3.0 μg ml–1 of ciprofloxacin and the specific bacterial growth rate prior to antibiotic exposure (r = −0.92). These data may be used in a design of antibiotic treatment protocols.

Genomic insights into the non-histamine production and proteolytic and lipolytic activities of Tetragenococcus halophilus KUD23

Abstract
Tetragenococcus halophilus KUD23, a non-histamine producer, was isolated from a traditional Korean high-salt fermented soybean paste, doenjang. The strain was safe in terms of antibiotic susceptibility, hemolytic activity and biofilm formation. It could grow on De Man-Rogosa-Sharpe agar containing 21% (w/v) NaCl, exhibited acid production at 15% NaCl, and had strain-specific proteolytic and lipolytic activities under salt stress. Complete genome analysis of T. halophilus KUD23 and comparative genomic analysis shed light on the genetic background behind these phenotypic characteristics, including non-production of histamine and proteolytic and lipolytic activities.

Laboratory-scale photobiotechnology—current trends and future perspectives

Abstract
Phototrophic bioprocesses are a promising puzzle piece in future bioeconomy concepts but yet mostly fail for economic reasons. Besides other aspects, this is mainly attributed to the omnipresent issue of optimal light supply impeding scale-up and -down of phototrophic processes according to classic established concepts. This MiniReview examines two current trends in photobiotechnology, namely microscale cultivation and modeling and simulation. Microphotobioreactors are a valuable and promising trend with microfluidic chips and microtiter plates as predominant design concepts. Providing idealized conditions, chip systems are preferably to be used for acquiring physiological data of microalgae while microtiter plate systems are more appropriate for process parameter and medium screenings. However, these systems are far from series technology and significant improvements especially regarding flexible light supply remain crucial. Whereas microscale is less addressed by modeling and simulation so far, benchtop photobioreactor design and operation have successfully been studied using such tools. This particularly includes quantitative model-assisted understanding of mixing, mass transfer, light dispersion and particle tracing as well as their relevance for microalgal performance. The ultimate goal will be to combine physiological data from microphotobioreactors with hybrid models to integrate metabolism and reactor simulation in order to facilitate knowledge-based scale transfer of phototrophic bioprocesses.

A novel lateral flow immunoassay for the rapid detection of anti-Dsg3 IgG serum autoantibodies in pemphigus vulgaris

Abstract

Pemphigus vulgaris (PV) is a severe autoimmune blistering disease of the skin and mucous membranes. As autoantibodies play an essential role in the disease pathogenesis, the serological detection of anti-desmoglein 3 IgG represents a central tool in the diagnosis of the disease. In this study, we show the validation of a novel lateral flow immunoassay (LFIA) which rapidly detects anti-desmoglein 3 (Dsg3) IgG in human serum. In contrast to other diagnostic procedures, the assay is compact and simple to perform and delivers a fast "yes" or "no" answer within 10 min without additional hardware requirements for test evaluation. For validation a blinded collection of 200 sera including 100 sera from 14 PV patients, 75 sera from 24 bullous pemphigoid patients, and 25 sera from 6 patients with pemphigus foliaceus collected at different time points during disease was used. Presence or non-presence of anti-Dsg3 IgG within sera was confirmed using a commercially available Dsg3-ELISA. For qualitative evaluation Dsg3-LFIA test results were assessed by two independent groups of human observers. Furthermore quantitative evaluation using POCScan reader was applied. The Dsg3-LFIA demonstrated reliable test results with a sensitivity and specificity of 78.1% and 97.1%, respectively. Test results from POCScan and human observers showed a substantial agreement. The Dsg3-LFIA represents a new diagnostic tool for the immediate and reliable detection of anti-desmoglein 3 serum IgG autoantibodies that does not require additional hardware. Further prospective trials are warranted to validate the Dsg3 LFIA in pemphigus.

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Effect of Cd stress on the bioavailability of Cd and other mineral nutrition elements in broad bean grown in a loess subsoil amended with municipal sludge compost

Abstract

Municipal sludge compost (MSC) is commonly used as fertilizer or an amendment in barren soils. However, MSC-borne Cd is of great concern in food safety because of its toxicity. Loess subsoil (LS) is barren and lacks nutrients, but it has a strong ability to absorb and stabilize heavy metals. Hence, LS may be amended with MSC and may reduce the bioavailability of Cd. To simulate the dose effect of the accumulated MSC-borne Cd in amended LS, pot experiments were conducted to study the bioavailability of Cd and other mineral nutrition elements in broad bean (Vicia faba L.) under Cd stress. Plant height and dry biomass remarkably increased as the physicochemical properties of LS were significantly improved; however, they were not significantly influenced by the added Cd. The Cd in the plants grown in MSC amended-LS (P2) mainly accumulated in roots (32.12 mg kg−1) and then in stems and leaves (6.00 mg kg−1). Less Cd (0.74 mg kg−1) accumulated in the edible parts, where the Cd concentration was 53% lower than that in the edible parts of plants grown in LS (P1). The decreased Cd concentrations in the P2 beans may be due to the biomass dilution effect. Notably, the Cd concentrations in the beans exceeded the national safety limit value (0.2 mg kg−1) when the Cd treatment levels exceeded 2 mg kg−1 in LS and 6 mg kg−1 in amended LS. The MgCl2 extraction procedures can be used to assess Cd bioavailability in amended soil-plant systems. The potential antagonism of Zn and Cu against Cd toxicity in the soil-plant system may explain why this plant can tolerate higher Cd concentrations after MSC application.



Exploitation of olive oil mill wastewaters and molasses for ethanol production using immobilized cells of Saccharomyces cerevisiae

Abstract

An alcoholic fermentation process is described, involving molasses, the main by-product of the sugar industry, blended with crude olive oil mill wastewaters (OOMWs) and immobilized Saccharomyces cerevisiae cells on delignified cellulosic material (DCM). For comparison, fermentations with free cells were also carried out. Initially, the optimum blending mixture for molasses dilution was sought after, while at a second step repeated batch fermentations at a temperature range 5–30 °C were performed to monitor the operational stability of the system. A 1/1 ratio of OOMWs/tap water blending mixture and cell immobilization resulted in higher fermentation parameters. Ethanol concentration and daily productivity values recorded at temperatures ≥ 20 °C (up to 67.8 g L−1 and 67.6 g L−1 d−1, respectively) could be adopted by the industrial sector, although the decline in fermentation efficiency observed, probably due to the toxicity effects of OOMWs. Finally, the potential of OOMWs treatment for ethanol production is highlighted and assessed.



Toxic and essential elements in seafood from Mausund, Norway

Abstract

In annual surveys conducted during the period 2012–2015, concentrations of the toxic or essential elements B, Se, Cd, Sn, Cs, Hg, Pb, Al, Cr, Mn, Fe, Ni, Cu, Zn, and As were analyzed in brown meat of edible crab (Cancer pagurus), and filets of cod (Gadus morhua) and halibut (Hippoglossus hippoglossus) in one of the most important commercial crab fishing areas in Norway, at Mausund in Frøya municipality in Sør-Trøndelag, Norway. Concentrations of the elements were analyzed in sediments in 2015. Several salmon farms are located in this area. Samples were extracted by HNO3 and analyzed using inductively coupled plasma mass spectroscopy (ICP-MS). Crab, cod, and halibut were caught in a total of five locations. One of these locations was in the proximity of a salmon farm. In edible crabs, the mean ranks were significantly different between two locations only for Sn (p = 0.034). When all data were pooled, the mean ranks statistics showed significant difference between all years for the elements Se (p = < 0.001), Cs (p = 0.005), Mn (p = 0.002), Zn (p = 0.006), and As (p = 0.001) in edible crab. The study showed elevated levels of Cd in edible crabs in 2012, 2013, 2014, and 2015, with the highest levels in 2015. In cod, there were significant differences between locations for the elements B (p = 0.003), and Pb (p = 0.04), as well as between the years for the elements B, Sn, Cs, Hg, Cr, and As (p = < 0.01). The study showed elevated level of Pb in cod in 2013. Halibut showed no significant differences between years or locations for any elements. The Cd, Hg, and Pb values of the sediments in this study indicate that local geogenic sources cannot be considered a major cause of high values in local biota.



An insertion mutation in HOXC13 underlies pure hair and nail ectodermal dysplasia with lacrimal duct obstruction

Abstract

Pure hair and nail ectodermal dysplasia (PHNED; MIM 602032, 614929, and 614931) is an autosomal recessive ED that is characterized by hypotrichosis and nail dystrophy only, without further ectodermal or non-ectodermal alterations. To date, homozygous mutations in three genes have been reported to cause PHNED: KRT85 (MIM 602767), encoding keratin, type II cuticular Hb5 like; KRT74 (MIM 608248), encoding keratin, type II cytoskeletal 74; and HOXC13 (MIM 142976), encoding Homeobox C13. Here, we studied the genetic basis of PHNED in an Iranian kindred, displaying double consanguinity (Fig. 1a-g).



Response to: ‘Human orf complicated by epidermolysis acquisita’

Abstract

Dear editor, we read with great interest the article 'Human orf complicated by epidermolysis bullosa acquisita' by Zeulgaray and colleagues.1 Recently, a Moroccan patient who contracted orf (fig. 1a) after slaughtering a sheep during Eid Al-Adha was admitted to our hospital and developed a similar pruritic vesiculobullous eruption predominantly on the hands and forearms (fig. 1b). Hematoxylin and eosin staining of punch biopsies from areas of the vesicullobullous eruption showed spongiotic dermatitis with eosinophilia, most consistent with an id reaction.

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Aberrant DNA methylation is associated with aggressive clinicopathological features and poor survival in cutaneous melanoma

Abstract

Background

Promoter methylation of tumor suppressor genes (TSGs) has recently been implicated in the pathogenesis of several types of cancer. Regarding melanoma, over a hundred genes that contribute to its pathogenesis have been identified to be aberrantly hypermethylated. This is a retrospective observational study that aims to analyze the prevalence of CpG island methylation in a series of primary melanoma, to identify the associations with the main clinicopathological features, and to explore the prognostic significance of methylation in melanoma survival.

Materials and Methods

DNA methylation was analyzed using methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) in a series of 170 melanoma formalin-fixed paraffin embedded (FFPE) tumor samples. The relationship between the methylation status, known somatic mutations and clinicopathological features was evaluated. Disease-free survival (DFS) and overall survival (OS) were displayed by the Kaplan-Meier method.

Results

In the entire cohort, one or more genes were detected to be methylated in 55% of the patients. The most prevalent methylated genes were RARB 31%, PTEN 24%, APC 16%, CDH13 16%, ESR1 14%, CDKN2A 6%, and RASSF1 5%. An association between aberrant methylation and aggressive clinicopathological features was observed (older age, increased Breslow, presence of mitosis and ulceration, fast-growing melanomas, advancing stage, and TERT mutations). Furthermore, Kaplan-Meier survival analysis showed a correlation of methylation and poorer DFS and overall survival OS.

Conclusions

Aberrant methylation of TSGs is a frequent event in melanoma. It is associated to aggressive clinicopathological features and poorer survival. Epigenetic alterations may represent a significant prognostic marker with utility in routine practice.

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A possible association between BP230-type bullous pemphigoid and dementia: report of two elderly cases

Bullous pemphigoid (BP) is the most common autoimmune blistering disease, and it features itchy oedematous erythemas and tense bullae on the whole body most commonly in the elderly. BP180 is the most common autoantigens of BP, and BP230 is the only target of autoantibodies in approximately 8% of patients with BP1. It has been reported that elderly patients with BP sometimes have comorbidities associated with neurological disease (ND) including dementia2. BP antigens and their isoforms can be identified in skin as well as in neuronal tissues, suggesting that exposure of the neuronal antigen may lead to an immune reaction against the epithelial isoform3. Here, we describe two elderly cases of BP with dementia in which the autoantibodies reacted to BP230 but not to BP180 (BP230-BP).

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Point mutation in p14ARF-specific exon 1β of CDKN2A causing familial melanoma and astrocytoma

Abstract

Rarely, melanoma is dominantly inherited, with CDKN2A mutations accounting for >85% of mutation-positive families (1). CDKN2A encodes two, non-homologous proteins, p16 and p14ARF, with individually unique first exons (1α and 1β, respectively) and alternative reading frames. Over 95% of the CDKN2A mutations in familial melanoma occur in the p16 transcript (1).



Legionella feeleii: an unusual organism associated with cutaneous infection in an immunocompromised patient

Summary

We report a 23-year-old immunocompromised woman who, following cardiac transplantation, presented with an unusual cutaneous eruption. She developed a widespread pustular rash, systemic symptoms and a high temperature with raised inflammatory markers. The diagnosis was reached when a skin biopsy was cultured onto Legionella agar (buffered charcoal yeast extract) and Legionella feeleii was isolated. The patient was treated with 6 weeks of moxifloxacin and her cutaneous lesions gradually resolved. Cutaneous Legionella infections are uncommon and usually affect immunocompromised patients.



Morphoea profunda and its relationship to eosinophilic fasciitis

Summary

In this small case series, all eight patients were women in their fifth and sixth decades. This is similar to the female predominance in morphoea and less in keeping with eosinophilic fasciitis (EF). All cases had diffuse induration of their limbs with both proximal and distal patterns of distribution, and five of the patients exhibited peau d'orange skin. All patients had diffuse induration of the lower limbs and half had restricted ankle movements. Six patients had concomitant superficial morphoea. This group of patients demonstrated a unique subtype of the morphoea spectrum with some features overlapping with EF. However, there appear to be points of distinction, and we propose that some previously reported cases labelled as EF would be better described as having morphoea profunda (MP). Methotrexate may be a useful treatment for MP, hence it is important to distinguish this from EF, as management may differ.



Recurrent chilblains in a child with neurological impairment



Recessive epidermolytic ichthyosis results from loss of keratin 10 expression, regardless of the mutation location

Summary

Epidermolytic ichthyosis (EI) is a rare skin disorder caused by mutations in the genes KRT1 and KRT10, and is usually inherited in an autosomal dominant fashion. Only five recessive mutations causing EI have been described, all of which are located in the central region of the KRT10 gene. In the current study, we aimed to identify the genetic defect underlying EI in a 12-year-old patient. Direct sequencing of the patient's genomic DNA revealed a novel homozygous nonsense mutation residing within the proximal part KRT10 first exon. The mutation was found to co-segregate with the disease phenotype in an autosomal recessive fashion. Using real-time quantitative PCR, we found an almost two-fold decrease in KRT10 expression in the patient's skin compared with the skin of healthy controls. Western blot analysis showed complete absence of keratin 10 protein in the patient's skin, suggesting early protein degradation.



A protective role for FADD dominant negative (FADD-DN) mutant in trinitrochlorobenzene (TNCB)-induced murine contact hypersensitivity reactions

Summary

Background

Fas-associated protein with death domain (FADD) is a classic adaptor protein in apoptosis. Increasing evidence has shown that FADD is also implicated in T-cell development, activation and proliferation. The role of FADD in inflammatory disorders remains largely unexplored.

Aim

To assess the role of FADD in inflammatory disorders.

Methods

We established an experimental model of contact hypersensitivity (CHS) by using 2,4,6-trinitrochlorobenzene (TNCB) on transgenic mice expressing a dominant negative mutant of FADD (FADD-DN),

Results

CHS responses were clearly attenuated in FADD-DN mice compared with control mice. In the retroauricular lymph nodes, the ratio of CD8+ T cells was also decreased.

Conclusion

FADD-DN appears to play a protective role in TNCB-induced CHS reactions.



Rare case of multicentric reticulohistiocytosis presenting as epidermotropic papular xanthoma and double primary cancers



Survival and prognostic factors for patients with melanoma brain metastases in the era of modern systemic therapy

Abstract

Historically, the prognosis of patients with melanoma brain metastases is poor, with median overall survival (OS) of 4-6 months. Little is known of OS in the era of modern systemic therapies and local therapy with stereotactic radiosurgery (SRS) or surgery. Patients diagnosed with melanoma brain metastases at Melanoma Institute Australia from January 2011 to December 2014 were included. OS and prognostic factors were analysed using Cox regression and Kaplan-Meier survival analyses.355 patients were included. The median OS was 7.1 months (95% confidence interval [CI] 6.0-8.1). Median OS differed by treatment modality: systemic therapy and SRS and/or surgery 14.9 months (95% CI 10.7-19.0), SRS and/or surgery with or without whole brain radiotherapy (WBRT) 6.4 months (95% CI 5.4-7.5), systemic therapy 5.4 months (95% CI 3.1-7.7), systemic therapy and WBRT 5.2 months (95% CI 4.1-6.4), WBRT 4.4 months (95% CI 2.4-6.3), and best supportive care 1.8 months (95% CI 1.2-2.3). OS for patients with melanoma brain metastases appears improved in the modern era, particularly for patients who are candidates for systemic therapy with SRS and/or surgery.

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Classes, why and how

Abstract

This paper presents a new approach to the class-theoretic paradoxes. In the first part of the paper, I will distinguish classes from sets, describe the function of class talk, and present several reasons for postulating type-free classes. This involves applications to the problem of unrestricted quantification, reduction of properties, natural language semantics, and the epistemology of mathematics. In the second part of the paper, I will present some axioms for type-free classes. My approach is loosely based on the Gödel–Russell idea of limited ranges of significance. It is shown how to derive the second-order Dedekind–Peano axioms within that theory. I conclude by discussing whether the theory can be used as a solution to the problem of unrestricted quantification. In an appendix, I prove the consistency of the class theory relative to Zermelo–Fraenkel set theory.



Δευτέρα 25 Δεκεμβρίου 2017

Dual slag filters for enhanced phosphorus removal from domestic waste water: performance and mechanisms

Abstract

The phosphorus (P) removal of five combinations of dual filters consisting of blast furnace slag (BFS), argon oxygen decarburisation slag (AOD) and electric arc furnace slag (EAF) was evaluated in column experiments with domestic waste water. The columns were fed with waste water for 24 days. The column with only EAF had the best P removal performance (above 93% throughout the experiment). The speciation of the bound P was evaluated by P K-edge X-ray absorption near-edge structure (XANES) spectroscopy. In all five columns, the main P species of the slag packed in the outlet chamber was amorphous calcium phosphate (ACP). In samples from the inlet chambers, the contributions from crystalline Ca phosphates, P adsorbed on gibbsite and P adsorbed on ferrihydrite were usually much greater, suggesting a shift of P removal mechanism as the waste water travelled from the inlet to the outlet. The results provide strong evidence that P was predominantly removed by the slags through the formation of ACP. However, as the pH decreased with time due to the progressively lower dissolution of alkaline silicate minerals from the slag, the ACP was rendered unstable and hence redissolved, changing the P speciation. It is suggested that this process strongly affected the lifespan of the slag filters. Of the slags examined, EAF slag had the best P removal characteristics and BFS the worst, which probably reflected different dissolution rates of alkaline silicates in the slags.



Comparing the effects of 3 different pressure ulcer prevention support surfaces on the structure and function of heel and sacral skin: An exploratory cross-over trial

Special support surfaces are key in pressure ulcer prevention. The aim of this study was to measure the effects of 3 different types of mattresses (reactive gel, active alternating air, basic foam) on skin properties of the sacral and heel skin after 2 hours loading. Fifteen healthy females (median age 66 years) were included. Transepidermal water loss, skin surface temperature, erythema, stratum corneum hydration, epidermal hydration, skin extensibility, elastic function, and recovery as well as skin roughness parameters were measured under controlled room conditions before loading, immediately after loading, and 20 minutes post-loading in the supine position on the different mattresses. The highest increases in transepidermal water loss, skin temperature, and erythema were observed for the foam mattress after loading, indicating higher deformation and occlusion. Cutaneous stiffness decreased in all 3 groups, indicating structural changes during loading. There was a substantial decrease of mean roughness at the heel skin in the foam group, leading to a flattening of the skin surface. Study results indicate that the type of support surface influences skin structure and function during loading. The gel and air mattress appeared to be more protective compared with the foam mattress, but the differences between the gel and air were minor.



Predicting delayed healing: The diagnostic accuracy of a venous leg ulcer risk assessment tool

The aim of this study was to validate a newly developed tool that can predict the risk of failure to heal of a venous leg ulcer in 24 weeks. The risk assessment tool was validated, and performance of the tool was assessed using Area Under the Receiver Operating Characteristic Curve (AUC) analysis. Retrospective and prospective validation was conducted through multi-site, longitudinal studies. In the retrospective study (n = 318), 30% of ulcers did not heal within 24 weeks, with the tool demonstrating an AUC of 0.80 (95% CI, 0.68-0.93, P < .001) for the total score. In the prospective study across 10 clinical sites (n = 225), 31% (n = 68) of ulcers did not heal within 24 weeks. Participants were classified with the RAT at enrolment as being at low risk (27%), moderate risk (53%) or high risk (20%) of delayed healing; the proportion of wounds unhealed at 24 weeks was 6%, 29% and 59%, respectively. Validation results of the total score indicated good discrimination and goodness of fit with an AUC of 0.78 (95% CI, 0.71-0.85, P < .001). Validation of this risk assessment tool offers assurance that realistic outcomes can be predicted for patients, and scores can guide early decisions on interventions to address specific risk factors for failing to heal, thus promoting timely healing.



Pseudomonas infection following total contact cast application



Efficacy and safety of fosmidomycin-piperaquine as non-artemisinin-based combination therapy for uncomplicated falciparum malaria - A single-arm, age-de-escalation proof of concept study in Gabon

Abstract
Background
Fosmidomycin-piperaquine is being developed as non-artemisinin-based combination therapy to meet the challenge of emerging artemisinin resistance.
Methods
The study was a phase 2 single arm open label proof of concept study of the efficacy, tolerability and safety of fosmidomycin-piperaquine for the treatment of uncomplicated Plasmodium falciparum mono-infection in Gabon. Adults and children of both sexes with initial parasite counts between 1,000 and 150,000/µL were eligible for oral treatment with fosmidomycin (twice daily doses of 30mg/kg), and piperaquine (once daily dose of 16mg/kg) for three days and followed-up for 63 days. The primary efficacy endpoint was the per protocol PCR-corrected Day 28 adequate clinical and parasitological response (ACPR).
Results
100 patients were enrolled. The PCR-corrected Day 28 ACPR rate was 83/83 or 100% (95% CI: 96-100). Fourteen patients had asexual parasitaemia between Day 28 and Day 63; all were typed by PCR as new infections. Fosmidomycin-piperaquine therapy led to rapid parasite clearance (median: 36h; IQR: 6-60) and fever clearance time (median: 12h; IQR: 6-48). The electrocardiogram assessments showed two subjects with QT corrected from the formula of Bazett (QTcB) >500msec following study drug administration. The majority of adverse events affected the gastrointestinal and respiratory tracts and were transient and mild to moderate in severity.
Conclusions
This is the first report of the use of the combination fosmidomycin-piperaquine, a non-artemisinin-based combination therapy in clinical development. The combination appeared to have high efficacy, to be safe and well tolerated despite observed transient changes in electrocardiogram with prolongation of the QT interval.

A Simple Symptom Score for Acute HIV Infection in a San Diego Community Based Screening Program

Abstract
Background
Treatment of acute HIV infection (AHI) decreases transmission and preserves immune function, but AHI diagnosis remains resource-intensive. Risk-based scores predictive for AHI have been described for high-risk groups, however symptom-based scores could be more generalizable across populations.
Methods
Adults who tested either positive for AHI (antibody-negative, HIV nucleic acid test [NAT]-positive) or HIV NAT-negative with the community-based Early Test HIV screening program in San Diego were retrospectively randomized 2:1 into a derivation and validation set. In the former, symptoms significant for AHI in a multivariate logistic regression model were assigned a score value (the odds ratio rounded to the nearest integer). The score was assessed in the validation set using receiver operating characteristics and areas under the curve (AUC). An optimal cut-off score was found using Youden's index.
Results
Of 998 participants (including 737 men who have sex with men (MSM), 149 non-MSM men, 109 ciswomen and 3 trans women), 113 had AHI (including 109 MSM). Compared to HIV-negative cases, AHI cases reported more symptoms (median 4 vs 0, p<0.01). Fever, myalgia and weight loss were significantly associated with AHI in the multivariate model and corresponded to 11, 8 and 4 score points, respectively. The summed score yielded AUC of 0.85 (95%CI 0.77-0.93). A score of ≥11 was 72% sensitive, 96% specific with diagnostic odds ratio of 70.27 (95%CI 28.14-175.93).
Conclusions
A 3-symptom score accurately predicted AHI in a community based screening program and may inform allocation of resources in settings that do not routinely screen for AHI.

Atypical Skeletal Muscle Profiles in HIV+ Asymptomatic Middle-Aged Adults

Abstract
Background
Human immunodeficiency virus (HIV)-infected individuals are at increased risk of age-associated functional impairment, even with effective antiretroviral therapy (ART). A concurrent characterization of skeletal muscle, physical function, and immune phenotype in aviremic middle-aged HIV+ adults represents a knowledge gap in prognostic biomarker discovery.
Methods
We undertook a prospective observational study of 170 middle-aged, HIV-infected ambulatory men and women with CD4+ T-cell counts of at least 350 per microliter and undetectable plasma viremia while on effective antiretroviral therapy, and uninfected control participants. We measured biomarkers for inflammation and immune activation, fatigue, the Veterans Aging Cohort Study (VACS) mortality index, and physical function. A subset also received a skeletal muscle biopsy and computerized tomography scan.
Results
Compared to the uninfected, HIV+ participants displayed increased immune activation (P<0·001), inflammation (P=0·001) and fatigue (P=0·010), and in a regression model adjusting for age and sex displayed deficits in stair climb power (P<0.001), gait speed (P=0.036) and predicted metabolic equivalents (P=0.019). Skeletal muscle displayed reduced nuclear PGC-1alphapositive myonuclei (P=0·006) and increased internalized myonuclei (P<0·001) that correlated with immune activation (P=0·003) and leukocyte infiltration (P<0·001). Internalized myonuclei improved a model for HIV discrimination, increasing the C-statistic from 0·84 to 0·90.
Conclusions
Asymptomatic HIV-infected middle-aged adults display atypical skeletal muscle profiles, subclinical deficits in physical function and persistent inflammation and immune activation. Identifying biomarker profiles for muscle dysregulation and risk for future functional decline in the HIV-infected population will be key to developing and monitoring preventative interventions.
Trial Registration
This protocol is registered with ClinicalTrials.gov (NCT03011957).

CDC Yellow Book 2018: Health Information for International Travel

CDC Yellow Book 2018: Health Information for International Travel Edited by BrunetteGary WKozarskyPhyllis. Oxford University Press, 2017. 704 pp. £49.95 (paperback). ISBN: 9780190628611.

Glucose-6-phosphate dehydrogenase inhibition attenuates acute lung injury through reduction in NADPH oxidase derived reactive oxygen species

Abstract

Acute lung injury (ALI) is a heterogeneous disease with the hallmarks of alveolar capillary membrane injury, increased pulmonary edema and pulmonary inflammation. The commonest direct etiological factor for ALI is usually parenchymal lung infection or hemorrhage. Reactive oxygen species (ROS) generated by NADPH oxidase (NOX2) are thought to play an important role in the pathophysiology of ALI. Glucose-6-phosphate dehydrogenase (G6PD) plays an important role both in production of ROS as well as their removal through supply of NADPH. However, how G6PD modulation affects NOX2-mediated ROS in the airway epithelial cells (AECs) during acute lung injury has not been explored earlier. Therefore, we investigated the effect of G6PD inhibitor, 6-aminonicotinamide on G6PD activity, NOX2 expression, ROS production and enzymatic antioxidants in AECs in a mouse model of ALI induced by lipopolysaccharide (LPS). ALI led to increased G6PD activity in the AECs with concomitant elevation of NOX2, ROS, SOD1, and nitrotyrosine. G6PD inhibitor led to reduction of LPS-induced airway inflammation, bronchoalveolar lavage fluid protein concentration as well as NOX2-derived ROS and subsequent oxidative stress. On the other hand, ALI led to decreased glutathione reductase activity in AECs which was normalized by G6PD inhibitor. These data show that activation of G6PD is associated with enhancement of oxidative inflammation in during ALI. Therefore, inhibition of G6PD might be a beneficial strategy during ALI to limit oxidative damage and ameliorate airway inflammation. This article is protected by copyright. All rights reserved.



Carbon Monoxide Off-Gassing From Bags of Wood Pellets

Abstract
Wood pellets are increasingly used for space heating in the United States and globally. Prior work has shown that stored bulk wood pellets produce sufficient carbon monoxide (CO) to represent a health concern and exceed regulatory standards for occupational exposures. However, most of the pellets used for residential heating are sold in 40-pound (18.1 kg) plastic bags. This study measured CO emission factors from fresh, bagged-wood pellets as a function of temperature and relative humidity. CO concentrations increased with increasing temperature and moisture in the container. CO measurements in a pellet mill warehouse with stored pallets of bagged pellets had 8-h average CO concentrations up to 100 ppm exceeding occupational standards for worker exposure. Thus, manufacturers, distributors, and home owners should be aware of the potential for CO in storage areas and design facilities with appropriate ventilation and CO sensors.

Κυριακή 24 Δεκεμβρίου 2017

Differentiation of severe fever with thrombocytopenia syndrome from scrub typhus

Abstract
We developed a severe fever with thrombocytopenia syndrome (SFTS) differentiation score in the cohort including 21 patients with SFTS and 91 patients with scrub typhus. This scoring using criteria (score > 1) of altered mental status, leukopenia, prolonged aPTT, and normal CRP provided 100% sensitivity and 97% specificity for SFTS.

Effect of concomitant positive HBsAg on the risk of liver metastasis: a retrospective clinical study of 4033 consecutive cases of newly diagnosed colorectal cancer

Abstract
Aims
To evaluate the effect of chronic hepatitis B infection on the risk of synchronous colorectal liver metastasis (synCRLM).
Methods
A total of 4033 consecutive, newly diagnosed colorectal cancer (CRC) patients with hepatitis B test were enrolled. The prevalence of synCRLM was compared between hepatitis B surface antigen (HBsAg) positive and negative patients; significant predictors for synCRLM were analyzed by logistic regression analysis; a fibrosis index based on the four factors (FIB-4), an aspartate aminotransferase-to-platelet ratio index (APRI) and hepatitis B e antigen (HBeAg) status were compared between patients with or without synCRLM.
Results
The prevalence of synCRLM was significantly higher in the HBsAg+ patients than that in the HBsAg- patients (15.57% vs. 8.60%, P<0.001, χ2 test). A logistic regression analysis indicated that HBsAg+ showed the highest hazard ratio (HR, 2.317; 95% CI: 1.406-3.820) for synCRLM. Both FIB-4 and APRI were significantly higher in those with HBsAg+ but no synCRLM compared to those with HBsAg+ and synCRLM [FIB-4: 1.23 (0.92-1.88) vs. 1.09 (0.74~1.51), P=0.045; APRI: 0.23 (0.227~0.387) vs. 0.18 (0.171~0.309), P=0.023; median (P25~P75), Mann-Whitney test]; HBeAg positivity was detected in 26.32% of those with positive HBsAg and synCRLM compared to 18.45% of those with positive HBsAg but no synCRLM, the difference was not statistically significant.
Conclusions
Concomitant chronic HBV infection significantly increases the risk of CRLM, and for HBsAg + CRC patients, elevated FIB-4/APRI may be anti-metastatic. Further study is needed to determine whether active HBV replication is pro-metastatic.

Σάββατο 23 Δεκεμβρίου 2017

Coagulation behavior of kaolin-anionic surfactant simulative wastewater by polyaluminum chloride-polymer dual coagulants

Abstract

In this study, polyaluminum chloride (PAC) and cationic polymers were used to treat kaolin suspension in the presence of sodium dodecyl benzene sulfonate (SDBS). Effects of PAC dosage, pH, and rotation rate on the coagulation efficiency and floc properties were studied. And the interaction of chemicals and kaolin-SDBS was discussed. Results showed that dual coagulants could decrease the influence of SDBS on the turbidity removal compared with PAC. PAC + polyacrylamide dual coagulant showed superior performance, and the maximal removal ratios of turbidity and dissolved organic carbon were 98.5 and 42.2%, respectively. Optimal coagulation performance was achieved at pH 5–7, where charge neutralization of Al hydrolysates and bridging of polyacrylamide were the primary mechanisms. And flocs with compact structure and small size were formed. Flocs coagulated by PAC were prone to be broken at the pH of raw water after introducing high rotation rate. After dosing polyacrylamide, floc size was enhanced under alkaline condition. Meanwhile, flocs showed stronger recoverability and an open structure because the regeneration mechanism was mainly the bridging effect of polyacrylamide.



Analysis of the transmission characteristics of China’s carbon market transaction price volatility from the perspective of a complex network

Abstract

Research on the price fluctuation transmission of the carbon trading pilot market is of great significance for the establishment of China's unified carbon market and its development in the future. In this paper, the carbon market transaction prices of Beijing, Shanghai, Tianjin, Shenzhen, and Guangdong were selected from December 29, 2013 to March 26, 2016, as sample data. Based on the view of the complex network theory, we construct a price fluctuation transmission network model of five pilot carbon markets in China, with the purposes of analyzing the topological features of this network, including point intensity, weighted clustering coefficient, betweenness centrality, and community structure, and elucidating the characteristics and transmission mechanism of price fluctuation in China's five pilot cities. The results of point intensity and weighted clustering coefficient show that the carbon prices in the five markets remained unchanged and transmitted smoothly in general, and price fragmentation is serious; however, at some point, the price fluctuates with mass phenomena. The result of betweenness centrality reflects that a small number of price fluctuations can control the whole market carbon price transmission and price fluctuation evolves in an alternate manner. The study provides direction for the scientific management of the carbon price. Policy makers should take a positive role in promoting market activity, preventing the risks that may arise from mass trade and scientifically forecasting the volatility of trading prices, which will provide experience for the establishment of a unified carbon market in China.



Combining Follicular Unit Extraction and Scalp Micropigmentation for the Cosmetic Treatment of Alopecias

imageTwo relatively new modalities, follicular unit extraction (FUE) and scalp micropigmentation have changed the treatment of hair loss, to reduce the number of procedures and the total costs of the hair restoration process. These 2 modalities augment each other when treating patients with thinning hair and balding. The explosion of FUE procedures (which reflected 52.6% of the hair transplant procedures performed in 2016, up from 48.5%) and the appearance of more and more new physicians offering hair restoration technologies employing FUE have caused a 20% annual growth in this industry over the past few years. This article reviews the use of FUE and scalp micropigmentation when used in combination.

Enhanced photocatalytic activity using GO/TiO 2 catalyst for the removal of DCA solutions

Abstract

This work aimed to optimize high-performance photocatalysts based on graphene oxide/titanium dioxide (GO/TiO2) nanocomposites for the effective degradation of aqueous pollutants. The catalytic activity was tested against the degradation of dichloroacetic acid (DCA), a by-product of disinfection processes that is present in many industrial wastewaters and effluents. GO/TiO2 photocatalysts were prepared using three different methods, hydrothermal, solvothermal, and mechanical, and varying the GO/TiO2 ratio in the range of 1 to 10%. Several techniques were applied to characterize the catalysts, and better coupling of GO and TiO2 was observed in the thermally synthesized composites. Although the results obtained for DCA degradation showed a coupled influence of the composite preparation method and its composition, promising results were obtained with the photocatalysts compared to the limited activity of conventional TiO2. In the best case, corresponding to the composite synthesized via hydrothermal method with 5% of GO/TiO2 weight ratio, an enhancement of 2.5 times of the photocatalytic degradation yield of DCA was obtained compared to bare TiO2, thus opening more efficient ways to promote the application of photocatalytic remediation technologies.



Growth, extracellular alkaline phosphatase activity, and kinetic characteristic responses of the bloom-forming toxic cyanobacterium, Microcystis aeruginosa , to atmospheric particulate matter (PM 2.5 , PM 2.5–10 , and PM >10 )

Abstract

Atmospheric particulate matter (APM), commonly seen and widely excited in environment, appears great enough to influence the biochemical processes in aquatic microorganisms and phytoplankton. Understanding the response of cyanobacteria to various factors is fundamental for eutrophication control. To clarify the response of cyanobacteria to APM, the effects of PM2.5, PM2.5–10, and PM>10 on Microcystis aeruginosa were researched. Variabilities in cell density, chlorophyll a, soluble protein, malondialdehyde, extracellular activity, and kinetic parameters of alkaline phosphatase were evaluated by lab-cultured experiments. Results showed that the PM2.5 had a slight stimulation impact on the growth and enhanced both of the 48- and 72-h extracellular alkaline phosphatase activity (APA), the affinity of alkaline phosphatase for substrate, and the 72-h maximum enzymatic reaction velocity (Vmax). Moreover, the stimulations in extracellular APA and Vmax enhanced with the increasing exposure concentrations. We also found there were no obvious distinctions on the effects of growth and alkaline phosphatase in M. aeruginosa between PM2.5–10 and PM>10 exposure groups. Obviously, inhibitory effects on growth existed in 4.0 and 8.0 mg/L PM2.5–10 and 8.0 mg/L PM>10 at 120 h. Furthermore, PM2.5–10 and PM>10 exerted inhibitory effects on the extracellular APA during the 72-h exposure. Simultaneously, the Vmax was notably inhibited and the affinity of alkaline phosphatase for substrate was more inseparable compared with control in PM2.5–10 and PM>10 treatments. Nevertheless, the inhibitors in extracellular APA and kinetic parameters were unrelated to PM2.5–10 and PM>10 exposure concentrations. Two-way ANOVA results revealed that there were significant interactions between exposure concentration and diameter of APM on the 120-h cell density, soluble protein content, APA, and 72 h APA of M. aeruginosa. These results in our study would be meaningful to further researches on relationships between APM deposition and cyanobacterial bloom.



Risk assessment of heavy metals in Vembanad Lake sediments (south-west coast of India), based on acid-volatile sulfide (AVS)-simultaneously extracted metal (SEM) approach

Abstract

Contamination of estuarine system due to heavy metals is a severe issue in tropical countries, especially in India. For the evaluation of the risk due to heavy metals, the current study assessed spatial and temporal variation of acid-volatile sulfide (AVS), simultaneously extracted metal (SEM), and total metal concentration as toxicity indicator of aquatic sediments in Vembanad Lake System (VLS), India. Surface sediment samples collected from 12 locations from the northern portion of VLS for 4 years during different seasons. The results suggest, in post-monsoon season, 91% of the sampling locations possessed high bioavailability of metals and results in toxicity to aquatic biota. The average seasonal distribution of SEM during the period of observations was in the order post-monsoon > pre-monsoon > monsoon (1.76 ± 2.00 > 1.35 ± 0.60 > 0.80 ± 0.54 μmol/g). The concentration of individual metals on ∑SEM are in the order SEM Zn > SEM Cu> SEM Cd ≈ SEM Pb > SEM Hg. Considering annual ΣSEM/AVS ratio, 83% of the sites cross the critical value of 'One,' reveals that active sulfide phase of the sediment for fixing the metals is saturated. The molar ratio (differences between SEM and AVS) and its normalized organic carbon ratio reveals that in the post-monsoon season, about 42% of the sites are in the category of adverse effects are possible. The study suggests the toxicity and mobility of the metals largely depend on the available AVS, and the current situation may pose harm to benthic organisms.



Paraben degradation using catalytic ozonation over volcanic rocks

Abstract

Parabens are widely used as antimicrobial and preservatives in pharmaceutical and personal care products and are continuously reaching the water streams. Conventional wastewater treatments are proven inefficient on the removal of this kind of contaminants from wastewater. Therefore, catalytic ozonation appears as a suitable option, due to the oxidant power of ozone and its high capacity of hydroxyl radical generation in the presence of a suitable catalyst. The main drawback of catalytic ozonation is related with the choice of stable and active catalysts at low cost. On this way, two volcanic rocks were tested to enhance the removal of a mixture of parabens by ozonation, improving their degradation. Indeed, catalytic ozonation with volcanic rock allowed total paraben degradation using a transferred ozone dose (TOD) of 55 mg/L which corresponds to a reduction of about threefold the amount of TOD comparatively with single ozonation (170 mg/L of TOD). Due to the presence of semiconductors on volcanic rock composition, the effect of UVA irradiation on paraben degradation was analyzed. The neutral and basic conditions enhanced catalytic ozonation comparatively to acid conditions. Higher pH values allowed a total methylparaben degradation with 35 mg O3/L, whereas for low pH values, 55 mg O3/L was required. The use of a radical scavenger proven that hydroxyl radicals are the main responsible for paraben degradation with catalytic ozonation. This was confirmed through the analysis of the by-products, where 4-hydroxybenzoic acid, 3,4-dihydroxybenzoic acid (3,4-diHBA), 2,4-dihydroxybenzoic acid, and hydroquinone were quantified.



A Novel Adjustable Concept for Permeable Gas/Vapor Protective Clothing: Balancing Protection and Thermal Strain

Abstract
Armed forces typically have personal protective clothing (PPC) in place to offer protection against chemical, biological, radiological and nuclear (CBRN) agents. The regular soldier is equipped with permeable CBRN-PPC. However, depending on the operational task, these PPCs pose too much thermal strain to the wearer, which results in a higher risk of uncompensable heat stress. This study investigates the possibilities of adjustable CBRN-PPC, consisting of different layers that can be worn separately or in combination with each other. This novel concept aims to achieve optimization between protection and thermal strain during operations. Two CBRN-PPC (protective) layers were obtained from two separate manufacturers: (i) a next-to-skin (NTS) and (ii) a low-burden battle dress uniform (protective BDU). In addition to these layers, a standard (non-CBRN protective) BDU (sBDU) was also made available. The effect of combining clothing layers on the levels of protection were investigated with a Man-In-Simulant Test. Finally, a mechanistic numerical model was employed to give insight into the thermal burden of the evaluated CBRN-PPC concepts. Combining layers results in substantially higher protection that is more than the sum of the individual layers. Reducing the airflow on the protective layer closest to the skin seems to play an important role in this, since combining the NTS with the sBDU also resulted in substantially higher protection. As expected, the thermal strain posed by the different clothing layer combinations decreases as the level of protection decreases. This study has shown that the concept of adjustable protection and thermal strain through multiple layers of CBRN-PPC works. Adjustable CBRN-PPC allows for optimization of the CBRN-PPC in relation to the threat level, thermal environment, and tasks at hand in an operational setting.

How to Quantitatively Assess Dermal Exposure to Volatile Organic Compounds

Creta et al. (2017) present a method to assess dermal exposure to volatile organic compounds (VOCs) using activated charcoal cloth (ACC Perma-TecTM pads). They clearly demonstrate that in a controlled environmental chamber charcoal cloth patches adsorb vapour in the same way as organic vapour monitors (3MTM 3500). There was a high degree of linearity between the response of the two measurement systems when tested against 181 different VOCs. However, the authors did not undertake any field tests of their system and, surprisingly for a sampler designed to measure dermal exposure, they did not test it using a liquid challenge. They also do not report the mass of VOC required to saturate the adsorbent—a key issue for effective quantification of dermal exposure. Finally, they did not consider how their measurements might relate to dermal uptake, which presumably is the purpose of the sampling system.

Phosphorylation of intracellular signaling molecules in peripheral blood cells from psoriasis patients on originator or biosimilar infliximab

Abstract

Background

Psoriasis vulgaris is a chronic, inflammatory skin disease characterized by a dysregulated immune response and it is associated with substantial systemic comorbidities. Biological drugs like tumor necrosis factor (TNF) inhibitors can ameliorate the disease but are expensive. Biosimilar drugs have the same amino acid sequence as the originator, but differences in manufacturing can affect biological activity, efficacy and tolerability.

Objectives

We aimed to explore potential differences in intracellular phosphorylation of signaling molecules in peripheral blood cells from TNF inhibitor infliximab treated psoriasis patients compared to healthy controls, and to investigate if the phosphorylation pattern was influenced by switching from originator infliximab to biosimilar CT-P13.

Methods

By flow cytometry, we measured phosphorylation of NF-κB, ERK1/2, p38 MAPK and STAT3 before and after TNF stimulation in monocytes and T, B, natural killer and CD3+CD56+ cells from 25 psoriasis patients treated with infliximab and 19 healthy controls.

Results

At inclusion, phosphorylation levels of peripheral blood mononuclear cells were increased in psoriasis patients compared to healthy controls, even though clinical remission had already been achieved. Phosphorylation levels declined in both patients on originator and biosimilar infliximab during continued treatment. No significant differences were detected between the two medications after 12 months.

Conclusions

Psoriasis patients on infliximab have higher activation levels of PBMC than healthy controls, possibly reflecting systemic inflammation. Switching from originator infliximab to biosimilar CT-P13 did not affect phosphorylation levels or clinical parameters, suggesting that CT-P13 is a non-inferior treatment alternative to originator infliximab.

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The role of adult attachment orientation and coping in psychological adjustment to living with skin conditions

Abstract

Background

Skin conditions can be associated with significant psychological distress. Investigation of attachment orientation and associated use of coping strategies is a promising perspective from which to investigate psychological adjustment to skin conditions.

Objectives

To examine the role of adult attachment orientation, conceptualised as two dimensions: attachment avoidance and attachment anxiety, in psychological adjustment (appearance related distress and skin related quality of life) and the mediating role of two coping strategies: defeatism and activity.

Methods

Attachment avoidance and attachment anxiety (ECR), use of coping strategies (COPE), appearance related distress (DAS 24) and skin related quality of life (Skindex-16) were assessed through a cross-sectional online survey in 207 adults with skin conditions. Multiple mediation analyses were performed using PROCESS path analysis.

Results

Overall, higher attachment avoidance and higher attachment anxiety were associated with higher appearance related distress and greater impact on emotions and functioning aspects of quality of life. For attachment anxiety, the relationship was fully explained by more frequent use of defeatism coping. For attachment avoidance, the relationship was partially explained by more frequent use of defeatism coping (and in the case of appearance related distress also more frequent use of activity coping), and higher attachment avoidance was also associated with poorer psychological adjustment in a way that could not be explained by use of assessed coping strategies.

Conclusions

Insecure attachment orientation (high attachment avoidance or high attachment anxiety) is linked to poorer adjustment. People with insecure attachment might benefit from psychological interventions that target underlying attachment orientation.

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Lymphoedema in Lentigo Maligna patients treated with imiquimod, a long term adverse effect

Abstract

Lentigo Maligna (LM) is a potential precursor lesion of Lentigo Maligna Melanoma (LMM). It is treated to prevent progression to LMM. A recent epidemiological study reports a progression rate of 2.0-2.6% over a course of 25 years1. The gold standard of treatment is surgical excision with 5 mm margin2. Topical application of imiquimod cream is an off-label alternative.

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Efficacy of anti-PD-1 on skin carcinomas and melanoma metastases in an Xeroderma Pigmentosum patient

Abstract

Xeroderma pigmentosum is an orphan disease of poor prognosis. We report one case of parallel efficacy with anti-PD-1 antibody on both melanoma and skin carcinoma in a xeroderma pigmentosum patient.

A 17-year old patient presented with metastatic melanoma and multiple non melanoma skin cancers. He was treated with pembrolizumab, a monoclonal anti-PD-1 antibody, at the dose of 2mg/Kg 3 weeks apart. Parallel therapeutic efficacy of anti-PD1 was observed in metastatic melanoma and skin carcinomas, and maintained at week 24.

This observation suggests anti-PD1 may be considered in patients with XP and metastatic melanoma as well as advanced non melanoma skin cancer.

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Novel POFUT1 mutation associated with hidradenitis suppurativa-Dowling Degos Disease firm up a role for Notch signalling in the pathogenesis of this disorder

Abstract

We read with great interest the article by Pavlovsky et al;1 describing PSENEN mutations associated with hidradenitis suppurativa-Dowling Degos Disease (HS-DDD) and suggesting a role for Notch signalling in the pathogenesis of this disorder. The literature also describes mutations in the POFUT1 gene as causative genetic defects in Dowling Degos Disease.2 Decreased Notch activity is associated with mutations in POFUT1.

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Effects of Photobiomodulation on SOFAT, a T-cell-derived Cytokine, May Explain Accelerated Orthodontic Tooth Movement

Abstract

Orthodontic tooth movement is based on mechanical forces inducing bone remodeling and several methods have been proposed to increase tooth movement, including photobiomodulation. This study evaluated, in an animal model, the effects of photobiomodulation on SOFAT – a secreted osteoclastogenic factor of activated T cells and RANK-L during tooth movement. The results showed that tooth displacement, RANK-L and SOFAT levels were significantly greater compared to control group. SOFAT may play an important role in bone remodeling during orthodontic movement, possibly increasing the osteoclast cells at the compression area and bone remodeling activity.

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Identification of dihydrogambogic acid as a matrix metalloproteinase 1 inhibitor by high-throughput screening.

Related Articles

Identification of dihydrogambogic acid as a matrix metalloproteinase 1 inhibitor by high-throughput screening.

Clin Cosmet Investig Dermatol. 2017;10:499-502

Authors: Li Y, Voorhees JJ, Fisher GJ

PMID: 29270028 [PubMed]



Appearance and History: the Autographic/Allographic Distinction Revisited

Abstract
Nelson Goodman notoriously distinguished between autographic works, whose instances should be identified by taking history of production into account, and allographic works, whose instances can be identified independently of history of production. Scholars such as Jerrold Levinson, Flint Schier, and Gregory Currie have criticized Goodman's autographic/allographic distinction arguing that all works are such that their instances should be identified by taking history of production into account. I will address this objection by exploiting David Davies' distinction between e-instances and p-instances of a work, thereby restating the autographic/allographic distinction. Then, I will show that this way of restating this distinction leads us to effective accounts of relevant related phenomena such as forgery, plagiarism, and digital technologies. Finally, I will show the theoretical advantages of my account of the autographic/allographic distinction in comparison with an alternative account recently proposed by Jason D'Cruz and P.D. Magnus.

Impact of homologous recombination deficiency biomarkers on outcomes in patients with triple-negative breast cancer treated with doxorubicin-based adjuvant chemotherapy (SWOG S9313)

Abstract
Background
Homologous recombination deficiency (HRD) causing alterations have been reported in triple-negative breast cancer (TNBC). We hypothesized that TNBCs with HRD alterations might be more sensitive to anthracycline plus cyclophosphamide-based chemotherapy and report on HRD status and BRCA1 promoter methylation (PM) as prognostic markers in TNBC patients treated with adjuvant doxorubicin (A) and cyclophosphamide (C) in SWOG9313.
Patients and Methods
425 TNBC patients were identified from S9313. HRD score, tumor BRCA1/2 sequencing and BRCA1 PM, were performed on DNA isolated from FFPE tissue. Positive HRD status was defined as either a deleterious tumor BRCA1/2 (tBRCA) mutation and/or a pre-defined HRD score ≥ 42. Markers were tested for prognostic value on DFS and OS using Cox regression models adjusted for treatment assignment and nodal status.
Results
HRD status was determined in 89% (379/425) of cases. Of these, 67% were HRD-positive (27% with tBRCA mutation, 40% tBRCA negative but HRD score ≥42). HRD-positive status was associated with a better DFS (HR = 0.72; 95% CI 0.51– 1.00; p=0.049) and non-significant trend towards better OS (HR = 0.71; 95% CI 0.48– 1.03; p=0.073). High HRD score (≥42) in tBRCA-negative patients (n=274) was also associated with better DFS (HR = 0.64; 95% CI 0.43-0.94; p=0.023) and OS (HR = 0.65; 95% CI 0.42-1.00; p=0.049). BRCA1 PM was evaluated successfully in 82% (348/425) and detected in 32% of cases. The DFS HR for BRCA1 PM was similar to that for HRD, but did not reach statistical significance (HR = 0.79; 95% CI 0.54-1.17; p=0.25).
Conclusions
HRD positivity was observed in two-thirds of TNBC patients receiving adjuvant AC and was associated with better DFS. HRD status may identify TNBC patients who receive greater benefit from AC based chemotherapy and should be evaluated further in prospective studies.
Clinical Trials Number
Int0137 (The trial pre-dates Clinicaltrial.Gov website establishment)

Safety of an anti-PD-1 immune checkpoint inhibitor in a liver transplant recipient

anti-PD-1liver transplantation

CNS response to osimertinib in patients with T790M-positive advanced NSCLC: pooled data from two Phase II trials

Background
Central nervous system (CNS) metastases are common in patients with non-small-cell lung cancer (NSCLC). Osimertinib has shown systemic efficacy in patients with CNS metastases and early clinical evidence shows efficacy in the CNS. To evaluate osimertinib activity further, we present a pre-specified subgroup analysis of CNS response using pooled data from two Phase II studies: AURA extension (NCT01802632) and AURA2 (NCT02094261).
Patients and methods
Patients with T790M-positive advanced NSCLC, who had progressed following prior epidermal growth factor receptor-tyrosine kinase inhibitor treatment, received osimertinib 80 mg once daily (n = 411). Patients with stable, asymptomatic CNS metastases were eligible for enrolment; prior CNS treatment was allowed. Patients with ≥1 measurable CNS lesion (per RECIST 1.1) on baseline brain scan by blinded independent central neuroradiology review (BICR) were included in the evaluable for CNS response set (cEFR). The primary outcome for this CNS analysis was CNS objective response rate (ORR) by BICR; secondary outcomes included CNS duration of response (DoR), disease control rate (DCR) and progression-free survival (PFS).
Results
Of 128 patients with CNS metastases on baseline brain scans, 50 were included in the cEFR. Confirmed CNS ORR and DCR were 54% (27/50; 95% confidence interval [CI] 39, 68), and 92% (46/50; 95% CI 81, 98), respectively. CNS response was observed regardless of prior radiotherapy to the brain. Median CNS DoR (22% maturity) was not reached (range: 1–15 months); at 9 months, 75% (95% CI 53, 88) of patients were estimated to remain in response. Median follow up for CNS PFS was 11 months; median CNS PFS was not reached (95% CI 7, not calculable). The safety profile observed in the cEFR was consistent with the overall patient population.
Conclusions
Osimertinib demonstrated clinically meaningful efficacy against CNS metastases, with a high DCR, encouraging ORR, and safety profile consistent with that previously reported.
ClinicalTrials.gov number
NCT01802632; NCT02094261

Bioinformatics for dermatology – why we should learn about code

Abstract

The era of high throughput sequencing (HTS; otherwise known as next-generation sequencing) has revolutionised dermatological research. New publications describing successful translational research based on interpretation of omics data from dermatological sources appear each month. Bioinformatics refers to the tools used to collect, classify and analyse such datasets.

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Case of femoral pseudarthrosis due to Scedosporium apiospermum in an immunocompetent patient with successful conservative treatment and review of literature

Summary

Scedosporium apiospermum is a ubiquitous filamentous fungus, commonly found in soil, sewage, and polluted waters. It is rarely pathogenic but can cause a broad spectrum of clinical diseases, which can be localized or disseminate to distant organs. The disseminated form of the disease is mostly seen among immunocompromised patients. However, some rare cases of disseminated disease have been reported in immunocompetent individuals. Treatment of these infections is challenging because of their natural resistance to many antifungal agents.

Here, we report the case of a 57-year-old immunocompetent patient diagnosed with femoral pseudarthrosis due to Scedosporium apiospermum, despite having no obvious clinical sign of infection. Previously, the patient had undergone four iterative femoral surgeries following a road traffic accident which occurred 20 years before. During its last surgery for pseudarthrosis, no clinical or biological signs of infection were present. Per operative samples tested positive for S. apiospermum. The patient was successfully treated with oral voriconazole during 6 months with an excellent tolerance.

We also provide a review of literature on bone and joint infections due to Scedosporium spp. (S. apiospermum, S. boydii and S. aurantiacum), discussing the evolution of their management and outcome which seems to improve since the use of voriconazole.

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Interactions between Candida albicans and Candida glabrata in biofilms: influence of the strain type, culture medium and glucose supplementation

Summary

The relationship among Candida species may be influenced by several factors. Thus, this study evaluated the interactions between Candida albicans and Candida glabrata in biofilms, varying the strain type, culture medium and glucose supplementation. Biofilms were formed for 48 h in SDB or RPMI 1640, supplemented with 0, 1 or 5% glucose. Each strain of C. albicans was combined with two strains of C. glabrata, generating 4 biofilm associations, which were quantified by colony-forming units (CFUs), total biomass and metabolic activity. Data were analyzed by ANOVA and Tukey's HSD test (α = 0.05). For CFUs, all associations were classified as indifferent for biofilms formed in RPMI 1640, while for SDB the interactions were antagonistic for C. albicans and indifferent for C. glabrata. The association of reference strains resulted in a dual-species biofilm with biomass significantly higher than that observed for each single biofilm developed in SDB. The metabolic activity of dual-species biofilms did not significantly differ from that found for single ones, except for co-culture of the reference strains. Glucose supplementation and culture media had a significant influence on all parameters. In conclusion, the type strain, culture medium and glucose supplementation influenced the interactions between C. albicans and C. glabrata.

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Autopsy and biopsy study of Paracoccidioidomycosis and Neuroparacoccidioidomycosis with and without HIV coinfection

Abstract

Background

Paracoccidioidomycosis (PCM) is a systemic mycosis prevalent among immunocompetent patients in Latin America.

Objective

This study aimed to describe the frequency, demographics, and clinical characteristics of central nervous system PCM (NPCM) and PCM in an endemic region, and the impact of human immunosuppression virus (HIV) co-infection.

Patients/Methods

This was a retrospective study of autopsy and biopsy reports from the Medical Pathology Section of the Hospital de Clinicas, UFPR, Curitiba, Southern Brazil, between 1951 and 2014.

Results

PCM was present in 0.1% of 378,323 cases examined, with 5.7% being NPCM. Infection was prevalent in working-age men, agricultural workers, and rural residents. Numbers of HIV autopsy cases increased over time, while those of PCM cases decreased. Prevalence of co-infection of HIV/PCM and HIV/NPCM was 1.6%, and 0.4%, respectively. Adrenals were affected more frequently in the NPCM group compared with the PCM group. Mortality was higher on NPCM group.

Conclusion

The clinical course of PCM in HIV patients resembles an acute/subacute infection. Association of NPCM and HIV is rare, and while diagnosis of NPCM is difficult, it should be considered a differential diagnosis in HIV patients who live in, or have visited, endemic areas and present with neurological symptoms.

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Παρασκευή 22 Δεκεμβρίου 2017

Clinical response to PD-1 blockade correlates with a sub-fraction of peripheral central memory CD4+ T cells in patients with malignant melanoma

Abstract
Cancer immunotherapy that blocks immune checkpoint molecules, such as PD-1/PD-L1, unleashes dysfunctional antitumor T-cell responses and has durable clinical benefits in various types of cancers. Yet its clinical efficacy is limited to a small proportion of patients, highlighting the need for identifying biomarkers that can predict the clinical response by exploring antitumor responses crucial for tumor regression. Here we explored T-cell responses associated with clinical benefits using peripheral blood mononuclear cells (PBMCs) from patients with malignant melanoma treated with anti-PD-1 monoclonal antibody (mAb). Pre- and post-treatment samples were collected from two different cohorts (discovery set and validation set) and subjected to mass cytometry assays that measured the expression levels of 35 proteins. Screening by high dimensional clustering in the discovery set identified increases in three micro-clusters of CD4+ T cells, a subset of central memory CD4+ T cells harboring CD27+FAS-CD45RA-CCR7+ phenotype, after treatment in long-term survivors, but not in non-responders. The same increase was also observed in clinical responders in the validation set. We propose that increases in this subset of central memory CD4+ T cells in peripheral blood can be potentially used as a predictor of clinical response to PD-1 blockade therapy in patients with malignant melanoma.