Liver fibrosis: stretched exponential model outperforms mono-exponential and bi-exponential models of diffusion-weighted MRI

Abstract

Objectives

To compare the ability of diffusion-weighted imaging (DWI) parameters acquired from three different models for the diagnosis of hepatic fibrosis (HF).

Methods

Ninety-five patients underwent DWI using nine b values at 3 T magnetic resonance. The hepatic apparent diffusion coefficient (ADC) from a mono-exponential model, the true diffusion coefficient (D_t ), pseudo-diffusion coefficient (D_p ) and perfusion fraction (f) from a biexponential model, and the distributed diffusion coefficient (DDC) and intravoxel heterogeneity index (α) from a stretched exponential model were compared with the pathological HF stage. For the stretched exponential model, parameters were also obtained using a dataset of six b values (DDC^#, α^#). The diagnostic performances of the parameters for HF staging were evaluated with Obuchowski measures and receiver operating characteristics (ROC) analysis. The measurement variability of DWI parameters was evaluated using the coefficient of variation (CoV).

Results

Diagnostic accuracy for HF staging was highest for DDC^# (Obuchowski measures, 0.770 ± 0.03), and it was significantly higher than that of ADC (0.597 ± 0.05, p < 0.001), D_t (0.575 ± 0.05, p < 0.001) and f (0.669 ± 0.04, p = 0.035). The parameters from stretched exponential DWI and D_p showed higher areas under the ROC curve (AUCs) for determining significant fibrosis (≥F2) and cirrhosis (F = 4) than other parameters. However, D_p showed significantly higher measurement variability (CoV, 74.6%) than DDC^# (16.1%, p < 0.001) and α^# (15.1%, p < 0.001).

Conclusions

Stretched exponential DWI is a promising method for HF staging with good diagnostic performance and fewer b-value acquisitions, allowing shorter acquisition time.

Key Points

• Stretched exponential DWI provides a precise and accurate model for HF staging.

• Stretched exponential DWI parameters are more reliable than D _p from bi-exponential DWI model

• Acquisition of six b values is sufficient to obtain accurate DDC and α

Are pancreatic IPMN volumes measured on MRI images more reproducible than diameters? An assessment in a large single-institution cohort

Abstract

Objectives

To assess reproducibility of volume and diameter measurement of intraductal papillary mucinous neoplasms (IPMNs) on MRI images.

Methods

Three readers measured the diameters and volumes of 164 IPMNs on axial T2-weighted images and coronal thin-slice navigator heavily T2-weighted images using manual and semiautomatic techniques. Interobserver reproducibility and variability were assessed.

Results

Interobserver intraclass correlation coefficients (ICCs) for the largest diameter measured using manual and semiautomatic techniques were 0.979 and 0.909 in the axial plane, and 0.969 and 0.961 in the coronal plane, respectively. Interobserver ICCs for the volume measurements were 0.973 and 0.970 in axial and coronal planes, respectively. The highest intraobserver reproducibility was noted for coronal manual measurements (ICC 0.981) followed by axial manual measurements (ICC 0.969). For the diameter measurements, Bland-Altman analysis revealed the lowest interobserver variability for manual axial measurements with an average range of 95% limits of agreement (LOA) of 0.68 cm. Axial and coronal volume measurements showed similar 95% LOA ranges (8.9 cm³ and 9.4 cm³, respectively).

Conclusions

Volume and diameter measurements on axial and coronal images show good interobserver and intraobserver reproducibility. The single largest diameter measured manually on axial images showed the highest reproducibility and lowest variability. The 95% LOA may help define reproducible size changes in these lesions using measurements from different readers.

Key Points

• MRI measurements by different radiologists can be used for IPMN follow-up.

• Both diameter and volume measurements demonstrate excellent interobserver and intraobserver reproducibility.

• Manual axial measurements show the highest interobserver reproducibility in determining size.

• Axial and coronal volume measurements show similar limits of agreement.

• Manual axial measurements show the lowest variability in agreement range.

Dual-energy CT: a phantom comparison of different platforms for abdominal imaging

Abstract

Objectives

Evaluation of imaging performance across dual-energy CT (DECT) platforms, including dual-layer CT (DLCT), rapid-kVp-switching CT (KVSCT) and dual-source CT (DSCT).

Methods

A semi-anthropomorphic abdomen phantom was imaged on these DECT systems. Scans were repeated three times for CTDIvol levels of 10 mGy, 20 mGy, 30 mGy and different fat-simulating extension rings. Over the available range of virtual-monoenergetic images (VMI), noise as well as quantitative accuracy of hounsfield units (HU) and iodine concentrations were evaluated.

Results

For all VMI levels, HU values could be determined with high accuracy compared to theoretical values. For KVSCT and DSCT, a noise increase was observed towards lower VMI levels. A patient-size dependent increase in the uncertainty of quantitative iodine concentrations is observed for all platforms. For a medium patient size the iodine concentration root-mean-square deviation at 20 mGy is 0.17 mg/ml (DLCT), 0.30 mg/ml (KVSCT) and 0.77mg/ml (DSCT).

Conclusion

Noticeable performance differences are observed between investigated DECT systems. Iodine concentrations and VMI HUs are accurately determined across all DECT systems. KVSCT and DLCT deliver slightly more accurate iodine concentration values than DSCT for investigated scenarios. In DLCT, low-noise and high-image contrast at low VMI levels may help to increase diagnostic information in abdominal CT.

Key Points

• Current dual-energy CT platforms provide accurate, reliable quantitative information.

• Dual-energy CT cross-platform evaluation revealed noticeable performance differences between different systems.

• Dual-layer CT offers constant noise levels over the complete energy range.

Imaging prediction of nonalcoholic steatohepatitis using computed tomography texture analysis

Abstract

Objectives

To determine if texture analysis of non-contrast-enhanced CT (NECT) images is able to predict nonalcoholic steatohepatitis (NASH).

Methods

NECT images from 88 patients who underwent a liver biopsy for the diagnosis of suspected NASH were assessed and texture feature parameters were obtained without and with filtration. The patient population was divided into a predictive learning dataset and a validation dataset, and further divided into groups according to the prediction of liver fibrosis as assessed by hyaluronic acid levels. The reference standard was the histological result of a liver biopsy. A predictive model for NASH was developed using parameters derived from the learning dataset that demonstrated areas under the receiver operating characteristic curve (AUC) of >0.65. The resulting model was then applied to the validation dataset.

Results

In patients without suspected fibrosis, the texture parameter mean without filter and skewness with a 2-mm filter were selected for the NASH prediction model. The AUC of the predictive model for the validation dataset was 0.94 and the accuracy was 94%. In patients with suspicion of fibrosis, the mean without filtration and kurtosis with a 4-mm filter were selected for the NASH prediction model. The AUC for the validation dataset was 0.60 and the accuracy was 42%.

Conclusions

In patients without suspicion of fibrosis, NECT texture analysis effectively predicted NASH.

Key Points

• In patients without suspicion of fibrosis, NECT texture analysis effectively predicted NASH.

• The mean without filtration and skewness with a 2-mm filter were modest predictors of NASH in patients without suspicion of liver fibrosis.

• Hepatic fibrosis masks the characteristic texture features of NASH.

Endovascular interventional modalities for haemorrhage control in abnormal placental implantation deliveries: a systematic review and meta-analysis

Abstract

Objectives

To examine the evidence regarding the effectiveness and safety of endovascular interventional modalities for haemorrhage control in abnormal placentation deliveries.

Methods

MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to July 2017. Blood loss volume was regarded as the primary endpoint. Other important results are described. Random and fixed effects models were used for the meta-analysis.

Results

Of 385 studies identified, 69 (1,811 patients, mean age 32.9 years, range 23–39 years) were included. Mean gestational age at delivery was 35.1 weeks (range 27–38 weeks). Of 1,395 patients who underwent endovascular intervention, 587 (42%) had placenta accreta, 254 (18%) placenta increta and 313 (22%) placenta percreta. Prophylactic balloon occlusion of the internal iliac arteries (PBOIIA) was performed in 470 patients (33.6%), of the abdominal aorta (PBOAA) in 460 patients (33%), of the uterine artery (PBOUA) in 181 patients (13%), and of the common iliac arteries (PBOCIA) in 21 patients (1.5%). Primary embolization of the UA was performed in 246 patients (18%), of the pelvic collateral arteries in 12 patients (0.9%), and of the anterior division of the IIA in 5 patients (0.3%). Follow-up ranged from 0.5 to 42 months. Endovascular intervention was associated with less blood loss than no endovascular intervention (p < 0.001) with the lowest blood loss volume in patients who underwent PBOAA (p < 0.001). PBOAA was associated with a lower rate of hysterectomy (p = 0.030). Endovascular intervention did not result in increases in operative time or hospital stay.

Conclusions

Endovascular intervention is effective in controlling haemorrhage in abnormal placentation deliveries. PBOAA was associated with a lower rate of hysterectomy and less blood loss than other modalities.

Key points

• Endovascular intervention in abnormal placentation deliveries is effective in reducing blood loss.

• Endovascular intervention did not result in longer operative time or hospital stay.

• Prophylactic balloon occlusion of the abdominal aorta is superior to other modalities.

Intravoxel incoherent motion magnetic resonance imaging for differentiating metastatic and non-metastatic lymph nodes in pancreatic ductal adenocarcinoma

Abstract

Objectives

To evaluate the diagnostic potential of intravoxel incoherent motion (IVIM) DWI for differentiating metastatic and non-metastatic lymph node stations (LNS) in pancreatic ductal adenocarcinoma (PDAC).

Methods

59 LNS histologically diagnosed following surgical resection from 15 patients were included. IVIM DWI with 12 b values was added to the standard MRI protocol. Evaluation of parameters was performed pre-operatively and included the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f). Diagnostic performance of ADC, D, D* and f for differentiating between metastatic and non-metastatic LNS was evaluated using ROC analysis.

Results

Metastatic LNS had significantly lower D, D*, f and ADC values than the non-metastatic LNS (p< 0.01). The best diagnostic performance was found in D, with an area under the ROC curve of 0.979, while the area under the ROC curve values of D*, f and ADC were 0.867, 0.855 and 0.940, respectively. The optimal cut-off values for distinguishing metastatic and non-metastatic lymph nodes were D = 1.180 × 10⁻³ mm²/s; D* = 14.750 × 10⁻³ mm²/s, f = 20.65 %, and ADC = 1.390 × 10⁻³ mm²/s.

Conclusion

IVIM DWI is useful for differentiating between metastatic and non-metastatic LNS in PDAC.

Key Points

• IVIM DWI is feasible for diagnosing LN metastasis in PDAC.

• Metastatic LNS has lower D, D*, f, ADC values than non-metastatic LNS.

• D-value from IVIM model has best diagnostic performance, followed by ADC value.

• D* has the lowest AUC value.

Monilethrix: A case report imaged by trichoscopy, reflectance confocal microscopy and histopathology

Statistical Controversies in Clinical Research: Limitations of open-label studies assessing antiangiogenic therapies with regard to evaluation of vascular adverse drug events. A meta-analysis

Abstract

Background

Previous meta-analyses have shown paradoxical increased risk of bleeding and thrombotic events in patients receiving antiangiogenics (AA) that may be simply explained by the studies design included. By a meta-epidemiological approach, we aim to investigate the impact of double-blind (DB) and open-label study designs on the risks of bleeding, venous thrombotic events (VTE) and arterial thrombotic events (ATE) in cancer patients treated with AA.

Materials and Methods

We searched Medline, Cochrane, ClinicalTrials.gov databases, and proceedings of major oncology congresses for clinical trials published from January 2003 to January 2016. Randomized clinical trials that assigned patients with solid cancers to AA or control groups were eligible for inclusion. Combined odds ratios (OR) for the risks of bleeding events, VTE and ATE were calculated for open and DB trials. Estimation bias of the treatment effect was determined by the ratio of odds ratio (ROR), by dividing the OR values obtained in open-label trials by those obtained in DB trials.

Results

The literature-based meta-analysis included 166 trials (72,024 patients). For bleeding events, comparison of AA versus control yielded an overall OR of 2.41 (95% CI 2.12-2.73; P <0.001), but this risk was overestimated by 1.68 (95% CI 1.33-2.13) in open-label studies. Concerning VTE, the OR was 1.19 (95% CI 1.04-1.35; P =0.012) overall with AA, but this effect disappears when considering only DB trials (OR 0.99, 95% CI, 0.83-1.17). The corresponding ROR showed a significant overestimation of 1.53 (95% CI 1.19-1.96) in open-label trials. For ATE, an OR of 1.59 (95% CI 1.30-1.94; P <0.001) was observed, associated with a significant overestimation of 1.65 (95% CI 1.13-2.43) in open-label trials.

Conclusions

Open-label studies overestimated the risk of vascular adverse events with AA by at least 50%. Meta-analyses assessing adverse drug events should therefore be restricted to DB randomized trials.

EXPRESSION III: Patient´s Expectations and Preferences regarding Physician–Patient Relationship and Clinical Management. Results of the International NOGGO/ENGOT-ov4-GCIG study in 1,830 Ovarian Cancer Patients from European countries.

Abstract

Backround

The primary aim of this study was to investigate information needs and treatment preferences of patients with ovarian cancer, focusing especially on physician-patient relationship and treatment

Patients and methods

A questionnaire was developed based on the experiences of the national German survey Expression II, and was provided to patients with ovarian cancer either at initial diagnosis or with recurrent disease via Internet (online-version) or as print-out-version.

Results

From December 2009 to October 2012, a total of 1,830 patients with ovarian cancer from eight European countries (Austria, Belgium, France, Germany, Italy, Poland, Romania, Spain) participated, 902 (49.3%) after initial diagnosis and 731 (39.9%) with recurrent ovarian cancer. The median age was 58 years (range 17–89). Nearly all patients (96.2%) had experienced upfront surgery followed by first-line chemotherapy (91.8%). The majority of patients were satisfied with the completeness and comprehensibility of the explanation about the diagnosis and treatment options. The 3 most important aspects, identified by patients to improve the treatment for ovarian cancer included: "the therapy should not induce alopecia" (42%), "there must be more done to counter fatigue" (34.5%), and "the therapy should be more effective" (29.7%). Out of 659 (36%) patients, who were offered participation in a clinical trial, 476 (26%) were included.

Conclusion

This study underlines the high need of patients with ovarian cancer for all details concerning treatment options irrespective of their cultural background, the stage of disease and the patient's age. Increased information requirements regarding potential side effects and treatment alternatives were recorded. Besides the need for more effective therapy, alopecia and fatigue are the most important side effects of concern to patients.

Developing Androgen Receptor Targeting for Salivary Gland Cancers

Phase 1-2 trial designs: how early should efficacy guide the dose recommendation process?

Nivolumab versus docetaxel in previously treated advanced non-small cell lung cancer (CheckMate 017 and CheckMate 057): 3-year update and outcomes in patients with liver metastases

Abstract

Background

Long-term data with immune checkpoint inhibitors in non-small cell lung cancer (NSCLC) are limited. Two phase III trials demonstrated improved overall survival (OS) and a favorable safety profile with the anti–programmed death-1 antibody nivolumab versus docetaxel in patients with previously treated advanced squamous (CheckMate 017) and non-squamous (CheckMate 057) NSCLC. We report results from ≥3 years' follow-up, including subgroup analyses of patients with liver metastases, who historically have poorer prognosis among patients with NSCLC.

Patients and methods

Patients were randomized 1:1 to nivolumab (3 mg/kg every 2 weeks) or docetaxel (75 mg/m² every 3 weeks) until progression or discontinuation. The primary endpoint of each study was OS. Patients with baseline liver metastases were pooled across studies by treatment for subgroup analyses.

Results

After 40.3 months' minimum follow-up in CheckMate 017 and 057, nivolumab continued to show an OS benefit versus docetaxel: estimated 3-year OS rates were 17% (95% confidence interval [CI], 14–21%) versus 8% (95% CI, 6–11%) in the pooled population with squamous or non-squamous NSCLC. Nivolumab was generally well tolerated, with no new safety concerns identified. Of 854 randomized patients across both studies, 193 had baseline liver metastases. Nivolumab resulted in improved OS compared with docetaxel in patients with liver metastases (hazard ratio, 0.68; 95% CI, 0.50–0.91), consistent with findings from the overall pooled study population (hazard ratio, 0.70; 95% CI, 0.61–0.81). Rates of treatment-related hepatic adverse events (primarily grade 1–2 liver enzyme elevations) were slightly higher in nivolumab-treated patients with liver metastases (10%) than in the overall pooled population (6%).

Conclusions

After 3 years' minimum follow-up, nivolumab continued to demonstrate an OS benefit versus docetaxel in patients with advanced NSCLC. Similarly, nivolumab demonstrated an OS benefit versus docetaxel in patients with liver metastases, and remained well tolerated.

Clinical trial registration

CheckMate 017: NCT01642004; CheckMate 057: NCT01673867

CHK1 Inhibition in Soft-Tissue Sarcomas: Biological and Clinical Implications

Abstract

Background

Inhibition of ChK1 appears as a promising strategy for selectively potentiate the efficacy of chemotherapeutic agents in G1 checkpoint-defective tumor cells such as those that lack functional p53 protein. The p53 pathway is commonly dysregulated in soft-tissue sarcomas (STS) through mutations affecting TP53 or MDM2 amplification. GDC-0575 is a selective ATP-competitive inhibitor of CHK1.

Methods

We have performed a systematic screening of a panel of 10 STS cell lines by combining the treatment of GDC-0575 with chemotherapy. Cell proliferation, cell death and cell cycle analysis were evaluated with high throughput assay. In vivo experiments were performed by using TP53-mutated and TP53 wild-type patient-derived xenograft models of STS. Clinical activity of GDC-0575 combined with chemotherapy in patients with TP53-mutated and TP53 wild-type STS was also assessed.

Results

We found that GDC-0575 abrogated DNA damage-induced S and G2–M checkpoints, exacerbated DNA double-strand breaks and induced apoptosis in STS cells. Moreover, we observed a synergistic or additive effect of GDC-0575 together with gemcitabine in vitro and in vivo in TP53-proficient but not TP53-deficient sarcoma models. In a phase 1 study of GDC-0575 in combination with gemcitabine, two patients with metastatic TP53-mutated STS had an exceptional, long-lasting response despite administration of a very low dose of gemcitabine whereas one patient with wild-type TP53 STS had no clinical benefit. Genetic profiling of samples from a patient displaying secondary resistance after 1 year showed loss of one preexisting loss-of-function mutation in the helical domain of DNA2.

Conclusion

We provide the first pre-clinical and clinical evidence that potentiation of chemotherapy activity with a CHK1 inhibitor is a promising strategy in TP53-deficient STS and deserves further investigation in the phase 2 setting.

Molecular detection and genotypic characterization of enteric adenoviruses in a hospital wastewater

Abstract

Hospital wastewater (HWW) represents a major source of the diffusion of many antibiotics and some toxic pathogenic microorganisms in the aquatic environment. Sanitation services play a critical role in controlling transmission of numerous waterborne pathogens, especially enteric human adenoviruses (HAdVs) that can cause acute gastroenteritis. This study intended to evaluate the human adenoviruses (HAdVs) detection rates, to determine the genotype of these viruses and to assess the efficiency of HAdVs removal in hospital pilot wastewater treatment plant (PWWTP) in Tunis City, Tunisia. Therefore, hospital wastewater samples (n = 102) were collected during the study year from the two biological wastewater treatment techniques: natural oxidizing ponds and the rotating biological disks or biodisks. Nested polymerase chain reaction (Nested PCR) was used to evaluate the HAdVs detection rates. The genotype of HAdVs positive samples was achieved by the sequencing of the PCR products. HAdVs were detected in 64% (65/102) of positive wastewater samples. A substantial increase in the frequencies of HAdVs was observed at the exit of the two wastewater treatment techniques studied. The typing of HAdVs species F showed the occurrence of only HAdVs type 41. This data acquired for the first time in Tunisia showed high persistence and survival of HAdVs in the two biological wastewater treatment techniques experienced, and mainly highlighted the poor virological quality of the treated wastewater intended for recycling, agriculture reuse, and discharges into the natural receiving environments. Consequently, tertiary wastewater treatment appeared necessary in this case to decrease the load of enteric viruses flowing in the water environment.

Lichen sclerosus on the face

Subcutaneous methotrexate in patients with moderate to severe psoriasis: a critical appraisal

Summary

Aim

Warren et al¹ set out to assess the effect of an intensified dosing schedule of subcutaneous methotrexate in patients with moderate to severe chronic plaque psoriasis.

Setting and design

This is a prospective, double-blind, randomised (3:1), placebo-controlled study, conducted across 16 centres in Germany, France, the Netherlands, and the UK.

Study exposure

Methotrexate-naïve adults with a diagnosis of moderate to severe chronic plaque psoriasis for at least 6 months before baseline were randomly assigned to receive weekly subcutaneous injections of either methotrexate at a starting dose of 17.5 mg, or placebo for 16 weeks (first phase).Dose escalation to 22.5 mg/week was implemented after 8 weeks if patients did not achieve PASI 50. Treatment was combined with folic acid 5 mg/week. The first phase of the study was followed by an open-label period from 16-52 weeks (second phase), in which both groups received weekly methotrexate injections. At week 24, dose escalation to 22.5 mg/week was possible in patients not achieving PASI 50.

Outcomes

Psoriasis severity was measured using the PASI (Psoriasis Area and Severity Index). The authors also used two other psoriasis severity measures and two quality of life measures, looked at safety indices and performed a sub-study analysing paired skin biopsies at baseline and week 16 (histopathology, immunohistochemistry and expression of interleukin (IL)17A, interferon-γ and tumour necrosis factor-α).

Primary outcome measures

The primary outcome was the proportion of patients reaching PASI 75 at week 16.

Results

120 patients were included in this trial, most of whom were middle-aged white men with longstanding psoriasis and a mean BMI of 30.1 kg/m². PASI 75 was achieved in 41% of patients receiving methotrexate vs. 10% of patients receiving placebo (RR 3.93, 95% CI 1.31–11.81; p=0.0026) at week 16. Subcutaneous methotrexate was generally well tolerated, with no serious adverse events related to this treatment over the 52-week study.

Conclusions

Warren et al conclude that the 52-week risk-benefit profile of subcutaneous methotrexate is favourable in patients with psoriasis.

This article is protected by copyright. All rights reserved.

Oral retinoids and depression

Abstract

We are concerned about the content and possible misinterpretation of a research letter by Le Moigne et al. published on 19 June 2017 in the British Journal of Dermatology online.[1]

We share the concern expressed by the authors about possible psychiatric effects of oral retinoids. However, case reports rank low in the hierarchy of evidence, as a result of their inherent limitations, including publication bias and a lack of control groups.

This article is protected by copyright. All rights reserved.

A new mobile learning module using smartphone wallpapers in identification of medical fungi for medical students and residents

Abstract

Introduction

Medical students and residents will encounter many cutaneous fungal infections in medical practice. However, the training for identification of medical fungi has been insufficient due to limited lecture-based courses. The objective of this study was to evaluate the impact of using smartphone-based wallpapers in learning the microscopic morphology and colony characteristics of medical fungi for medical students and residents.

Methods

A smartphone-based wallpaper learning module using a wallpaper-changing software application (app) was introduced in this 3-week training course. Twenty-six participants were enrolled and divided into two groups: nondermatology trainees, including medical students and postgraduate year one (PGY-1) doctors who have not yet specialized, and dermatology trainees (dermatology residents). All of the participants completed a 3-week training course, and the effectiveness of the module was evaluated by pre- and post-course multiple-choice examinations.

Results

Both nondermatology and dermatology trainees scored significantly higher in post-course examinations than pre-course examinations (P < 0.001). The dermatology trainees performed better than nondermatology trainees in the pre-course examinations (P < 0.001). In the post-course examinations, no significant difference in scores was noted between dermatology and nondermatology trainees (P = 0.573).

Discussion

The smartphone-based wallpaper learning module was effective in helping medical students and residents learn and memorize morphologic characteristics of fungi. In comparison to conventional lecture-based learning, this new mobile module was more readily accessible and convenient for learners to engage in learning.

Disseminated actinomycetoma due to Nocardia wallacei

Abstract

Background

Actinomycetoma caused by Nocardia usually responds well to antibiotics. Emerging species of Nocardia, such as N. wallacei, can be a therapeutic challenge.

Aims

Confirm the therapeutic effectivity of linezolid in multidrug resistant Nocardia Wallacei actinomycetoma.

Materials and Methods

We evaluated the medical management of an 18-year-old man with multidrug resistant actinomycetoma of the left leg caused by N. transvalensis complex treated 17 years ago with linezolid 1200 mg a day. This bacteria was recently reclassified as Nocardia Wallacei by specific molecular biology technique.

Results

The infection was cured after 3 months of treatment; the patient remained asymptomatic for the past 17 years. No adverse effects were found.

Discussion

Frequently, strains of N. transvalensis complex have aminoglycoside resistance; in this case, we highlight the effectiveness of linezolid for the successful medical management of multidrug resistant actinomycetoma.

Conclusion

Linezolid can be an alternative for the treatment of multidrug resistant Nocardia Wallacei.

Treatment response to omalizumab in patients with refractory chronic spontaneous urticaria

Abstract

Background

Previous clinical trials have demonstrated the efficacy and safety of the anti-IgE monoclonal antibody omalizumab in chronic spontaneous urticaria (CSU) not responding to antihistamine treatment. The primary aim of our study was to describe the response patterns of patients with refractory CSU treated with omalizumab in a real-world clinical setting.

Methods

A retrospective analysis of medical records of 20 patients with refractory CSU was performed. Demographic, clinical, and laboratory features were retrieved and analyzed in correlation with treatment data.

Results

Mean age of our patient population was 54.5 years, while the majority were females (15/20 cases, 75%). Mean disease duration prior to omalizumab administration was 21.8 months. All patients had a history of chronic urticaria, refractory to high antihistamine and corticosteroid treatment, and responded favorably to omalizumab after administration of 1–5 doses of omalizumab; complete response was observed in 17/20 patients (85%) and well-controlled disease in the remaining 3/20 patients (15%). In a subset of cases (6/20, 30%), best response to omalizumab was achieved after interval administration of a 9-day course of methylprednisolone (total dose of 188 mg). Late response to omalizumab (after three-month treatment) was significantly correlated (P = 0.026) with shorter disease duration before initiation of omalizumab.

Conclusion

In the present series, omalizumab, either alone or in combination with a short-term course of corticosteroids, was highly effective in resolution of refractory CSU. Furthermore, disease duration prior to omalizumab had a significant effect on timing of response.

Occupational allergic contact dermatitis caused by antibiotics in healthcare workers – relationship with non-immediate drug eruptions

Summary

Background

Occupational allergic contact dermatitis (ACD) in healthcare workers (HCWs) is common, but systemic antibiotics are rarely reported as the cause.

Objectives

Characterize occupational ACD by handling systemic antibiotics.

Method

A retrospective analysis was performed of ACD caused by systemic antibiotics among HCWs patch tested between 2010 and 2016 with a series of systemic antibiotics.

Results

We studied 4 female nurses aged 28–47 years who developed ACD while working in surgical departments. They had eczema of the hands, and forearms or face, and 1 patient, who previously had exanthema caused by flucloxacillin, also developed a generalized rash following airborne exposure to systemic antibiotics. Patch tests showed positive reactions to ampicillin and cefazolin in 1 patient, to cefotaxime and ceftriaxone in 2 patients, and to several penicillins in another patient. Three patients also reacted to rubber allergens, fragrances, and/or preservatives. All patients admitted having direct and sporadic exposure to systemic antibiotic solutions. Avoidance resulted in a significant improvement of ACD, but 1 patient had to change job.

Conclusions

Occupational ACD caused by β-lactam antibiotics, particularly cephalosporins, is significant in HCWs. Cross-reactions between β-lactams are similar to those described in non-immediate drug eruptions. A relationship between systemic delayed drug hypersensitivity and ACD, as observed in 1 case, suggests that patients should avoid future use of the antibiotic to which they are sensitized.

Textile contact dermatitis caused by octylisothiazolinone in compression stockings

Toying with the Toolbox: How Metaphysics Can Still Make a Contribution

Abstract

Current analytic metaphysics has been claimed to be, at best, out of touch with modern physics, at worst, actually in conflict with the latter (Callender, in: French, Saatsi (eds) The continuum companion to the philosophy of science, Continuum, London, 2011; Ladyman and Ross Every thing must go: metaphysics naturalized, Oxford University Press, Oxford, 2007). While agreeing with some of these claims, it has been suggested that metaphysics may still be of service by providing a kind of 'toolbox' of devices that philosophers of science can access in order to help provide an interpretation of theories in fundamental physics (French and McKenzie in Eur J Anal Philos 8:42–59, 2012; see also French and McKenzie, in: Bigaj, Wuthrich (eds) Metaphysics in contemporary physics, Rodopi, Amsterdam, 2015). In this context it has been argued that 'standard' forms of dispositionalism simply cannot be sustained in the context of modern physics but that certain 'non-standard' views may provide the resources to help explicate the sense in which physics may be regarded as 'modally informed'. Here that suggestion will be further extended in order to consider the implications both with regard to the overall relevance of metaphysics given advances in science and for the prospects of a naturalised metaphysics more generally. In particular, this paper will focus on three concerns: (1) that the particular tools identified are not, in fact, 'scientifically disinterested' and thus that the distinction between 'naturalised' and 'non-naturalised' metaphysics is at best vague or poorly drawn; (2) that the usefulness of such tools depends on their being shaped to fit the relevant physics and thus the latter 'guts' metaphysics; (3) that if metaphysics does prove to be useful in this sense then we have no reason to scorn non-naturalised metaphysics to begin with.

Social Science as a Guide to Social Metaphysics?

Abstract

If we are sympathetic to the project of naturalising metaphysics, how should we approach the metaphysics of the social world? What role can the social sciences play in metaphysical investigation? In the light of these questions, this paper examines three possible approaches to social metaphysics: inference to the best explanation from current social science, conceptual analysis, and Haslanger-inspired ameliorative projects.

Phase 1/2 study assessing the safety and efficacy of dabrafenib and trametinib combination therapy in Japanese patients with BRAF V600 mutation-positive advanced cutaneous melanoma

Abstract

The combination of dabrafenib and trametinib demonstrated encouraging antitumor activity and tolerability, at initial analysis, in Japanese patients with BRAF V600 mutant advanced melanoma warranting further investigation. This study evaluated the safety and tolerability, pharmacokinetics (PK) and preliminary efficacy of dabrafenib 150 mg b.i.d. plus trametinib 2 mg q.d. in Japanese patients with BRAF V600E/K mutant solid tumors (phase 1) and melanoma (phase 2). Phase 1 was primarily intended to assess safety and tolerability as assessed by adverse events (AE), and the primary end-point in phase 2 was to assess confirmed overall response rate (ORR). The secondary end-points in phase 1 included PK, confirmed/unconfirmed ORR and duration of response (DOR). The secondary end-points in phase 2 were PK, unconfirmed ORR, DOR, safety and tolerability. A total of 12 cutaneous melanoma patients were enrolled in the study (six in phase 1 and six in phase 2) and received the combination therapy of dabrafenib and trametinib. Common AE (≥50.0%) included pyrexia (75%), increased aspartate aminotransferase (67%), peripheral edema (50%) and nasopharyngitis (50%). The investigator-assessed ORR was reported in five patients (83%) in phase 1 and was also reported in five patients (83%; 95% confidence interval, 35.9–99.6; P < 0.0001) in phase 2. Plasma concentrations of both dabrafenib and trametinib seemed to a reach steady state by week 3. Overall, efficacy and PK properties for the dabrafenib plus trametinib combination in Japanese patients were comparable with those seen in global studies.

Efficacy of oral cholecalciferol on rhododendrol-induced vitiligo: A blinded randomized clinical trial

Abstract

Rhododendrol (RD), 4-(4-hydroxyphenyl)-2-butanol, inhibits melanin synthesis and has been used for skin-whitening cosmetic products. RD has been very effective in lightening skin pigmentation, but some persons have developed so-called RD vitiligo, in which vitiligo starts on the face, neck and hands where topical RD has been applied and even extended over skin areas where RD has not been applied. RD vitiligo lesions in some patients have lasted for years and have been resistant to conventional vitiligo treatments. We examined the effects of cholecalciferol on RD vitiligo in a blinded randomized clinical trial. Forty-eight female RD vitiligo patients were recruited for the trial and were randomized into two groups: the vitamin D (VD)-intervention group that received daily 5000 IU cholecalciferol for 5 months and the control group. Three blinded investigators scored vitiligo improvement by comparing photographic images of baseline and at 5-month observation. Serum 25(OH)D3 of RD vitiligo patients was not significantly different from age-matched healthy volunteers. Twenty-two in the VD-intervention group and 23 in the control group completed the 5-month observation. Serum 25(OH)D3 levels were significantly increased after the 5-month VD intervention, while the control group did not change. The improvement scores were significantly higher in the VD-intervention group than the control group. The improvement scores were positively correlated with the serum 25(OH)D3 levels after the 5-month intervention period but not before the treatment. This blinded randomized clinical trial showed favor in administrating 5000 IU cholecalciferol daily to RD vitiligo patients.

Case of atopic dermatitis concurrent with idiopathic thrombocytopenic purpura, whose serum thymus and activation-regulated chemokine level remained undetectable

Abstract

We report a 9-year-old Japanese female patient with atopic dermatitis associated with idiopathic thrombocytopenic purpura. She demonstrated high serum immunoglobulin (Ig)E and IgE specific to several environmental allergens, but extremely low serum thymus and activation-regulated chemokine (TARC) levels regardless of the disease progression. This case suggests platelets as the main source of serum TARC.

A novel image processing workflow for the in vivo quantification of skin microvasculature using dynamic optical coherence tomography

Abstract

Background

Currently, imaging technologies that can accurately assess or provide surrogate markers of the human cutaneous microvessel network are limited. Dynamic optical coherence tomography (D-OCT) allows the detection of blood flow in vivo and visualization of the skin microvasculature. However, image processing is necessary to correct images, filter artifacts, and exclude irrelevant signals. The objective of this study was to develop a novel image processing workflow to enhance the technical capabilities of D-OCT.

Materials and methods

Single-center, vehicle-controlled study including healthy volunteers aged 18-50 years. A capsaicin solution was applied topically on the subject's forearm to induce local inflammation. Measurements of capsaicin-induced increase in dermal blood flow, within the region of interest, were performed by laser Doppler imaging (LDI) (reference method) and D-OCT.

Results

Sixteen subjects were enrolled. A good correlation was shown between D-OCT and LDI, using the image processing workflow. Therefore, D-OCT offers an easy-to-use alternative to LDI, with good repeatability, new robust morphological features (dermal-epidermal junction localization), and quantification of the distribution of vessel size and changes in this distribution induced by capsaicin. The visualization of the vessel network was improved through bloc filtering and artifact removal. Moreover, the assessment of vessel size distribution allows a fine analysis of the vascular patterns.

Conclusion

The newly developed image processing workflow enhances the technical capabilities of D-OCT for the accurate detection and characterization of microcirculation in the skin. A direct clinical application of this image processing workflow is the quantification of the effect of topical treatment on skin vascularization.

Editor's Choice

Editorial board

Horizontal and vertical sections of scalp biopsy specimens from dermatomyositis patients with scalp involvement

Scalp involvement in dermatomyositis manifests as a pruritic eruption with erythema and scaling associated with nonscarring alopecia. We characterized the histologic features of scalp dermatomyositis using horizontal and vertical sections. Characteristic findings of scalp dermatomyositis include preserved follicular architecture, hair counts consistent with chronic telogen effluvium, telangiectasia and mucin.

Skin in the Game: Existing and Upcoming Physician Payment Models in Dermatology

Efficacy and Safety of Topical Oxymetazoline Cream 1.0% for Treatment of Persistent Facial Erythema Associated With Rosacea: Findings From the Two Phase 3, 29-Day, Randomized, Controlled REVEAL Trials

Most rosacea treatments targeting inflammatory lesions do not improve persistent facial erythema.Topical oxymetazoline hydrochloride cream 1.0% effectively reduced erythema versus vehicle in patients with moderate to severe persistent facial erythema of rosacea, with favorable tolerability.Topical oxymetazoline represents a new treatment option for patients with persistent erythema of rosacea.

Consultative Teledermatology in the Emergency Department and Inpatient Wards: A Survey of Potential Referring Providers.

Surgical treatment of axillary bromhidrosis by combining suction-curettage with subdermal undermining through a miniature incision

The suction-curettage technique has been widely applied in the treatment of axillary bromhidrosis. However, it can only moderately eradicate the malodor. From 2011 to 2013, we performed the suction-curettage procedure alone in 91 patients with primary axillary bromhidrosis (group A). From 2014 to 2016, we refined the suction-curettage technique by performing wide subdermal scissors undermining through a miniature incision in 80 patients (group B). Through a miniature incision at the inferior pole of the central axillary crease, the entire subcutaneous tissues containing apocrine glands were initially dissected with scissors within the axillary area and then the undermined apocrine glands were removed by suction-curettage.

Quality of life improvement after chest wall masculinization in female-to-male transgender patients: a prospective study using the BREAST-Q and body uneasiness test

Background: Chest reconstruction in many female-to-male (FTM) transgender individuals is an essential element of treatment for their gender dysphoria. In existing literature, there are very few longitudinal studies utilizing validated survey tools to evaluate patient reported outcomes surrounding this surgery. The purpose of our study is to prospectively evaluate patient reported satisfaction, improvement in body image, and quality of life following FTM chest wall reconstruction. Methods: Our study was a prospective analysis of FTM patients who underwent chest reconstruction by a single surgeon (C.A.) between April 2015 and June 2016.

Gasdermin C is Induced by Ultraviolet Light and Contributes to MMP-1 Expression via Activation of ERK and JNK Pathways

Matrix metalloproteinases (MMPs) comprise a family of zinc-dependent endopeptidases that are able to degrade extracellular matrix proteins [1–3]. MMP family members can be categorized into four different subfamilies: collagenases, stromelysins, gelatinases, and membrane-type MMPs [3–5]. MMPs play important roles in various physiological and pathological processes including developmental morphogenesis, tissue repair, skin aging, and tumor invasion. Expressions of some MMPs are regulated by diverse extracellular stimuli including UV, proinflammatory cytokines, and growth factors [4,6–9].

Diversity of circulating tumor cells in peripheral blood: Detection of heterogeneous BRAF mutations in a patient with advanced melanoma by single-cell analysis

Therapies targeting the MAPK signal pathway have been used to improve survival of patients with advanced melanoma [1]. However, many patients exhibit a short response and recurrence within several months after therapy, possibly related to heterogeneity arising due to genetic and epigenetic instability in melanoma cells. Circulating tumor cells (CTCs) released from primary or metastatic tumors are a non-invasive tool that could be used to characterize changes in tumors over time. Assuming that the CTC population represents the distributed tumor burden, characterization of these cells could provide a complementary sample for monitoring of tumor characteristics [2].

Coverage of the dorsal surface of a digit based on a pedicled free-style perforator flap concept

Reconstruction of the finger and thumb dorsum has been considered difficult due to the need for a thin and flexible flap, and the surrounding tissue is sometimes insufficient for a local flap. The purpose of this report is to describe our concept for finger and thumb dorsum reconstruction with free-style perforator flaps and our clinical experience with transfer of various perforator flaps.

“Reply - preventing the cheese-wire effect by combining steri-strips” and sutures for the management of lacerations in thin-skinned individuals. january 2017 volume 70, issue 1, pages 134-136.”

We read with interest the experimental results attaining to the technical tip of using the Steri-Strip/Suture combination. This method is indeed a useful technique in helping prevention of the cheese-wiring seen in frail skinned individuals although the application of this can be sometimes difficult, particularly if the wound is moist. The application of Steri-Strips can be quite problematic in the actively, or prone to, bleeding wound and in this instance, we would advocate the simple adjunct of using tincture of benzoin as a topical adhesive agent.

Improved photosynthetic efficacy of maize (Zea mays) plants with arbuscular mycorrhizal fungi (AMF) under high temperature stress

Publication date: Available online 4 February 2018
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Sonal Mathur, Mahaveer P. Sharma, Anjana Jajoo
In this study, pot experiments were performed to investigate the effects of high temperature stress (44 °C) in maize plants colonized with and without arbuscular mycorrhizal fungi (AMF). Various parameters characterizing photosynthetic activity were measured in order to estimate the photosynthetic efficiency in maize plants. It was observed that density of active reaction centers of PSII, quantum efficiency of photosystem II (PSII), linear electron transport, excitation energy trapping, performance index, net photosynthesis rate increased in AMF (+) plants at 44 °C ± 0.2 °C. Efficiency of primary photochemical reaction (represented as Fv/Fo) increased in AMF (+) plants as compared to AMF (−) plants. AMF seems to have protected water splitting complex followed by enhanced primary photochemistry of PSII under high temperature. Basic morphological parameters like leaf width, plant height and cob number increased in AMF (+) plants as compared to AMF (−) plants. AMF (+) plants grew faster than AMF (−) plants due to larger root systems. Chl content increased in AMF (+) plants as compared to AMF (−) maize plants. AMF hyphae likely increased Mg uptake which in turn increased the total chlorophyll content in AMF (+) maize plants. This subsequently led to a higher production in photosynthate and biomass. Thus AMF (+) plants have shown better photosynthesis performance as compared to AMF (−) maize plants under high temperature stress.

Annonalide and derivatives: Semisynthesis, cytotoxic activities and studies on interaction of annonalide with DNA

Publication date: February 2018
Source:Journal of Photochemistry and Photobiology B: Biology, Volume 179
Author(s): Ricardo A. Marques, Akenaton O.C.V. Gomes, Maria V. de Brito, Ana L.P. dos Santos, Gladyane S. da Silva, Leandro B. de Lima, Fátima M. Nunes, Marcos C. de Mattos, Fátima C.E. de Oliveira, Cláudia do Ó Pessoa, Manoel O. de Moraes, Ângelo de Fátima, Lucas L. Franco, Marina de M. Silva, Maria Dayanne de A. Dantas, Josué C.C. Santos, Isis M. Figueiredo, Edeíldo F. da Silva-Júnior, Thiago M. de Aquino, João X. de Araújo-Júnior, Maria C.F. de Oliveira, A.A. Leslie Gunatilaka
The cytotoxic activity of the pimarane diterpene annonalide (1) and nine of its semisynthetic derivatives (2–10) was investigated against the human tumor cell lines HL-60 (leukemia), PC-3 (prostate adenocarcinoma), HepG2 (hepatocellular carcinoma), SF-295 (glioblastoma) and HCT-116 (colon cancer), and normal mouse fibroblast (L929) cells. The preparation of 2–10 involved derivatization of the side chain of 1 at C-13. Except for 2, all derivatives are being reported for the first time. Most of the tested compounds presented IC50s below 4.0 μM, being considered potential antitumor agents. The structures of all new compounds were elucidated by spectroscopic analyses including 2D NMR and HRMS. Additionally, the interaction of annonalide (1) with ctDNA was evaluated using spectroscopic techniques, and the formation of a supramolecular complex with the macromolecule was confirmed. Competition assays with fluorescent probes (Hoechst and ethidium bromide) and theoretical studies confirmed that 1 interacts preferentially via DNA intercalation with stoichiometric ratio of 1:1 (1:ctDNA). The ΔG value was calculated as −28.24 kJ mol⁻¹, and indicated that the interaction process occurs spontaneously. Docking studies revealed that van der Walls is the most important interaction in 1-DNA and EB-DNA complexes, and that both ligands (1 and EB) interact with the same DNA residues (DA6, DA17 and DT19).

Graphical abstract

LuAG:Pr3+-porphyrin based nanohybrid system for singlet oxygen production: Toward the next generation of PDTX drugs

Publication date: February 2018
Source:Journal of Photochemistry and Photobiology B: Biology, Volume 179
Author(s): Kseniya Popovich, Kateřina Tomanová, Václav Čuba, Lenka Procházková, Iveta Terezie Pelikánová, Ivo Jakubec, Eva Mihóková, Martin Nikl
A highly prospective drug for the X-ray induced photodynamic therapy (PDTX), LuAG:Pr³⁺@SiO2-PpIX nanocomposite, was successfully prepared by a three step process: photo-induced precipitation of the Lu3Al5O12:Pr³⁺ (LuAG:Pr³⁺) core, sol–gel technique for amorphous silica coating, and a biofunctionalization by attaching the protoporphyrin IX (PpIX) molecules. The synthesis procedure provides three-layer nanocomposite with uniform shells covering an intensely luminescent core. Room temperature radioluminescence (RT RL) spectra as well as photoluminescence (RT PL) steady-state and time resolved spectra of the material confirm the non-radiative energy transfer from the core Pr³⁺ ions to the PpIX outer layer. First, excitation of Pr³⁺ ions results in the red luminescence of PpIX. Second, the decay measurements exhibit clear evidence of mentioned non-radiative energy transfer (ET). The singlet oxygen generation in the system was demonstrated by the 3′-(p-aminophenyl) fluorescein (APF) chemical probe sensitive to the singlet oxygen presence. The RT PL spectra of an X-ray irradiated material with the APF probe manifest the formation of singlet oxygen due to which enhanced luminescence around 530 nm is observed. Quenching studies, using NaN3 as an ¹O2 inhibitor, also confirm the presence of ¹O2 in the system and rule out the parasitic reaction with OH radicals. To summarize, presented features of LuAG:Pr³⁺@SiO2-PpIX nanocomposite indicate its considerable potential for PDTX application.

Graphical abstract

Predicted environmental concentration and fate of the top 10 most dispensed Australian prescription pharmaceuticals

Abstract

A basic environmental risk assessment was carried out for the top 10 dispensed pharmaceuticals in Melbourne, Australia, in contrast to the more commonly assessed measure of the most used drugs by physical mass. This allowed for the evaluation of compounds that had not previously been the subject of risk assessment. Estimations of the possible fate and behaviour of the target pharmaceuticals in sewage treatment plants were also made. The predicted removal rates of most drugs within standard sewage treatment were expected to be low, with the exception of the statins, which had high removal rates. Each pharmaceutical was predicted to be present in Melbourne wastewater at the nanogram per litre range or lower. All compounds were predicted to be of low toxicity risk, although it was not possible to model mixture effects. Atorvastatin and Irbesartan were also found to possess the potential to possibly bioaccumulate in the aquatic food chain but not to the extent that would require regulation or labelling.

Aqueous aggregation and stability of graphene nanoplatelets, graphene oxide, and reduced graphene oxide in simulated natural environmental conditions: complex roles of surface and solution chemistry

Abstract

Graphene-family nanomaterials (GFNs) exhibit universal applications and consequently will inevitably enter aquatic systems. However, both the fate and behavior of GFNs in aquatic environments have not been completely explored at field relevant conditions. Herein, we have systematically investigated the aqueous aggregation and stability of graphene nanoplatelets (GNPs), graphene oxide (GO), and reduced graphene oxide (RGO) under varied solution chemistry parameters (pH, divalent cations, and dissolved organic carbon (DOC)) during 21 days of incubation in simulated natural environmental conditions. Results indicate that pH values from 6 to 9 had a notable impact on the aqueous behaviors of the three GFNs. Divalent cations (Ca²⁺ and Mg²⁺) at the concentrations of 2.5 and 10 mM remarkably increased the extent of aggregation of the three GFNs and resulted in severe sedimentation, independently of surface chemical functionalization. The presence of only DOC ranging from 0.5 to 2 mg C/L significantly elevated the dispersion stability of GNPs and RGO in a dose-dependent manner, whereas no effects were observed on GO. Furthermore, DOC at the studied concentrations and surface functionality were insufficient to counterbalance the impact of the divalent cations. Direct visual and in situ observations further supported the conclusions on the effects of divalent cations or/and DOC. These findings further underline that the environmental behaviors of GFNs are controlled by the complex interplay between water chemistry parameters and GFN surface properties.

Organisms in wall ecosystems as biomonitors of metal deposition and bioavailability in urban environments

Abstract

Vegetated walls are common structures in urban environments, and aiming to test the hypothesis that the biogenic crusts and plant and animal communities inhabiting these vertical surfaces can be more reliable indicators of atmospheric metal deposition than plants or animals inhabiting urban soils, we analyzed the chemical composition of the wall crusts, moss cushions (Tortula muralis) and the shells, soft tissues and feces of the stonework snail Papillifera papillaris collected in three small towns in Tuscany (Central Italy). Crusts and mosses from the same stones or bricks indicated that Cd, Pb, and Zn are the main pollutants released by vehicular traffic, while Hg and Cu probably originate from other sources. The soft tissues of P. papillaris (purged of the gut contents) showed as well higher Cd, Pb, and Zn and lower Hg concentrations at more traffic-affected sites, while data from shells and feces suggested that this species probably ingests large amounts of Al, Cr, Fe, Mn, and Pb, and avoids eating mosses. Most lithophilic elements and Pb are scarcely absorbed in the snail digestive tract and soft tissues mainly accumulate Cd and essential elements such as Cu and Mn. This study definitively confirms the extraordinary Mn bioaccumulation in P. papillaris soft tissues and reports extraordinary Mn levels also in the shell. The shells also contain unusually high Cu, Fe, and Zn concentrations and this bioaccumulation likely remains after death, potentially providing a historical record of the snail exposure to metals over lifetime.

Targeted muscle reinnervation: advances and opportunities

It is with interest, and some concern, that we read the recent letter from Messrs Nikkhah et al. (1). Targeted muscle reinnervation (TMR) is a surgical development for the rehabilitation community with enormous potential to improve the quality of life for amputees. However, their letter fails to clarify exactly what TMR is, and how it can benefit amputees. There are two aspects to TMR. Kuiken's first aim was to improve the control of a myoelectric prostheses and secondly to strive for "intuitive" manipulation of a prosthesis (2,3).

The split hypoglossal nerve versus the cross-face nerve graft to supply the free functional muscle transfer for facial reanimation: a comparative study

Long-standing cases of facial paralysis are currently treated with free functional muscle transfer. Several nerves are mentioned in the literature to supply the free muscle transfer. The aim of this study is to compare the split hypoglossal nerve and the cross-face nerve graft to supply the free functional muscle transfer in facial reanimation.Of 94 patients with long-standing, unilateral facial palsy, 49 were treated using the latissimus dorsi muscle supplied by the split hypoglossal nerve, and 45 patients were treated using the healthy contralateral buccal branch of the facial nerve.

Biochar alleviates the toxicity of imidacloprid and silver nanoparticles (AgNPs) to Enchytraeus albidus (Oligochaeta)

Abstract

The present study investigated the use of biochar for the alleviation of the toxic effects of a nanosilver colloidal dispersion and a chloronicotinyl insecticide. The survival and reproduction of the potworm Enchytraeus albidus were assessed after exposure to imidacloprid and silver nanoparticles (AgNPs). E. albidus was exposed to 0, 25, 50, 100, 200, and 400 mg imidacloprid/kg and 0, 5, 25, 125, and 625 mg Ag/kg for 21 days in 10% biochar amended and non-biochar amended OECD artificial soil. In both exposure substrates, the effects of imidacloprid on survival were significant in the two highest treatments (p < 0.01). No biochar effect was observed as survival was statistically similar in both soils after exposure to imidacloprid. In the case of AgNPs, significant mortality was only observed in the highest AgNP treatments in both the amended and non-amended soils (p < 0.05). Nevertheless, statistically greater survival occurred in the biochar-amended treatment (p < 0.05). Reproduction results showed a more pronounced biochar effect with an EC₅₀ = 22.27 mg imidacloprid/kg in the non-amended soil and a higher EC₅₀ = 46.23 mg imidacloprid/kg in the biochar-amended soil. This indicated a 2-fold decrease in imidacloprid toxicity due to biochar amendment. A similar observation was made in the case of AgNPs where a reproduction EC₅₀ = 166.70 mg Ag/kg soil in the non-amended soil increased to an EC₅₀ > 625 mg Ag/kg soil (the highest AgNP treatment) in the amended soil. This indicated at least a 3.7-fold decrease in AgNPs toxicity due to biochar amendment. Although more studies may be needed to optimize the easing effects of biochar on the toxicity of these chemicals, the present results show that biochar could be useful for the alleviation of the toxic effects of imidacloprid and silver nanoparticles in the soil.

Toxicity comparison of the shoreline cleaners Accell Clean® and PES-51® in two life stages of the grass shrimp, Palaemonetes pugio

Abstract

Oil spills are a significant source of coastal pollution. Shoreline cleaners, used to remove oil from surfaces during spill response and remediation, may also act as toxins. Adult and larval grass shrimp, Palaemonetes pugio, were tested for lethal and sublethal impacts from two shoreline cleaners, Accell Clean SWA® and PES-51®, alone and in combination with crude oil using Chemically Enhanced Water Accommodated Fractions (CEWAFs). Median lethal toxicity values determined for the individual cleaners were similar. However, when tested in mixture with oil as CEWAFs, Accell Clean SWA resulted in greater hydrocarbon concentrations in the water column and greater toxicity than PES-51. Increased glutathione levels were observed for adult shrimp exposed to Accell Clean SWA, and glutathione was elevated in shrimp exposed to both CEWAFs. Larval shrimp development was delayed after exposure to both CEWAFs. These findings may have implications for managing and mitigating oil spills.

Sleeping Beauty Goes to the Lab: The Psychology of Self-Locating Evidence

Abstract

Analyses of the Sleeping Beauty Problem are polarised between those advocating the "1/2 view" ("halfers") and those endorsing the "1/3 view" ("thirders"). The disagreement concerns the evidential relevance of self-locating information. Unlike halfers, thirders regard self-locating information as evidentially relevant in the Sleeping Beauty Problem. In the present study, we systematically manipulate the kind of information available in different formulations of the Sleeping Beauty Problem. Our findings indicate that patterns of judgment on different formulations of the Sleeping Beauty Problem do not fit either the "1/2 view" or the "1/3 view." Human reasoners tend to acknowledge self-locating evidence as relevant, but discount its weight significantly. Accordingly, self-locating information may trigger more cautious judgments of confirmation than familiar kinds of statistical evidence. We also discuss how these results can advance the debate by providing a more nuanced and empirically grounded account or explication of the evidential impact of self-locating information.

Contamination of estuaries from failing septic tank systems: difficulties in scaling up from monitored individual systems to cumulative impact

Abstract

Aquaculture in many coastal estuaries is threatened by diffuse sources of runoff from different land use activities. The poor performance of septic tank systems (STS), as well as runoff from agriculture, may contribute to the movement of contaminants through ground and surface waters to estuaries resulting in oyster contamination, and following their consumption, impacts to human health. In monitoring individual STS in sensitive locations, it is possible to show that nutrients and faecal contaminants are transported through the subsurface in sandy soils off-site with little attenuation. At the catchment scale however, there are always difficulties in discerning direct linkages between failing STS and water contamination due to processes such as effluent dilution, adsorption, precipitation and vegetative uptake. There is often substantial complexity in detecting and tracing effluent pathways from diffuse sources to water bodies in field studies. While source tracking as well as monitoring using tracers may assist in identifying potential pathways from STS to surface waters and estuaries, there are difficulties in scaling up from monitored individual systems to identify their contribution to the cumulative impact which may be apparent at the catchment scale. The processes which may be obvious through monitoring and dominate at the individual scale may be masked and not readily discernible at the catchment scale due to impacts from other land use activities.

Different calcification responses of two hermatypic corals to CO 2 -driven ocean acidification

Abstract

Understanding how calcification is influenced by the enhanced dissolution of CO₂ in the oceans is the key to evaluating the effects of ocean acidification (OA) on coral reefs. In this study, two branching hermatypic corals widely distributed in the South China Sea, Pocillopora damicornis and Seriatopora caliendrum, were used to study the calcification responses to CO₂-driven OA (7.77 ± 0.07 vs. 8.15 ± 0.12). Our results showed that the calcification rate (0.17 ± 0.04%/day to 0.21 ± 0.12%/day) in P. damicornis remained unchanged in the acidified seawaters, but that in S. caliendrum decreased significantly (0.62 ± 0.21%/day to 0.44 ± 0.11%/day). Our results suggested that reef corals with high calcification rates may be more susceptible to the enhanced dissolution of CO₂. Differential calcified response to elevated CO₂ may be closely attributed to coralline capacity of the upregulation at their site of calcification in acidified seawater.

LETTER TO THE EDITOR: Predictors of internal mammary vessel diameter: A computed tomographic angiography-assisted anatomic analysis. J Plast Reconstructive & Aesthetic Surgery 2016: 69:1340-8. Cook JA, Tholpady SS, Momeni A, Chu MW

We would like to congratulate Dr Cook and colleagues on their publication entitled "Predictors of internal mammary vessel diameter: A computed tomographic angiography-assisted anatomic analysis" 1 and take this opportunity to contrast their experience with ours. Our comments are based on a prospectively collected database of consecutive abdominal microvascular breast reconstructions performed by a single surgeon (CMM) using the total rib preservation technique of internal mammary vessel exposure.

Using the internal mammary artery as recipient artery in cervicofacial reconstruction by fibular flap

This study was designed to investigate the anatomy of the internal mammary to its use for mandibular reconstruction using a fibula free flap for patients without other recipient vessels in the neck. This technique could be an alternative to venous grafts in vascular desert cases.We dissected the internal mammary artery in 6 cadavers from the clavicle down to the 5th rib.The length of the artery once released was 11 to 13 cm, its distal diameter of 2 to 3 mm.We measured the distance separating the distal end of the liberated artery with the hyoid anatomical landmark for the vascular anastomoses of the mandibular fibula flap reconstructions, this distance varies from 0 to 15 mm, theoretically allowing the use of the internal mammary artery for complexes mandibular reconstructions.

Liposuction-assisted four pedicle based breast reduction (LAFPBR): A new safer technique of breast reduction for elderly patients

As older people increasingly care for their body image and remain active longer, the demand for reduction mammaplasty is increasing in this population. Only a few studies of reduction mammaplasty have specifically focussed on the outcomes in elderly women. We developed a new breast reduction technique: the Liposuction-Assisted Four Pedicles - Based Breast Reduction (LAFPBR) that is especially indicated for elderly patients.The aim of this paper was to describe the LAFPBR technique and to determine whether it could be considered a safer option for elderly patients compared to the superomedial pedicle (SMP) technique.

Influence of dressing application time after breast augmentation on cutaneous colonization: a randomized clinical trial

Concepts regarding the best way to treat a surgical wound vary, in literature, ranging from no dressing use to dressing maintenance for 24 to 48 hours or until suture removal. This study aimed to evaluate the influence of the length of dressing maintenance after breast augmentation with implants on cutaneous colonization and surgical site infection. This is a two-arm parallel group randomized clinical trial. Eighty patients who were candidates for augmentation mammoplasty with silicone implants were randomly allocated to two groups, in which the dressing was removed on postoperative day 1 (group A, n=40) or postoperative day 6 (group B, n=40).

Intraoperative imaging of lymphatic vessel using ultra high-frequency ultrasound

Lymphaticovenular anastomosis (LVA) is effective and minimally invasive treatment for refractory lymphedema.1-4 The lymphatic vessels become sclerotic over time after lymph flow obstruction, and lose their function to drain lymph fluid in peripheral lymphedema patient.2 Anastomosing the severely sclerotic lymphatic vessels leads to minimum therapeutic effect in LVA. Therefore, identification of functional lymphatic vessels is important for LVA.3,4 Hayashi et al. reported non-invasive ultrasound visualization of lymphatic vessels in a region masked by dermal backflow pattern of indocyanine green (ICG) lymphography.

Invited commentary on jpras-d-17-00269

This article describes the development of a breast reduction guideline. This is a major achievement, which represents the culmination of a large body of work: multiple systematic reviews, consensus building, and recommendation generation. It has the potential to provide considerable benefit if developed appropriately, and if it gains traction with its target audience.

Routine closure of the donor site with a second dorsal metacarpal artery flap to avoid the use of a skin graft after harvest of a first dorsal metacarpal artery flap

Closure of the donor site on the index finger after raising a first dorsal metacarpal artery (DMA) flap harvest is challenging. The conventional choice is to use a full-thickness skin graft. However, this procedure is associated with several complications and a second donor site to harvest the skin graft is inevitable. The aim of this study was to design a modified incision to allow harvest of a first DMA flap without skin graft.

USB Dermatoscope as an Oculoscopy tool

Demographics and Outcomes of Stage I-II Merkel Cell Carcinoma Treated with Mohs Micrographic Surgery Compared with Wide Local Excision in the National Cancer Data Base

The optimal surgical approach (wide local excision (WLE) vs. Mohs micrographic surgery (MOHS)) for treating Merkel cell carcinoma (MCC) is yet to be determined.

Use of Sterile Urine Cups as Sharps Containers During Mohs Stages

Using smooth forceps for assisting incision and drainage of an infected epidermoid cyst

Autoinflammatory keratinization diseases: an emerging concept encompassing various inflammatory keratinization disorders of the skin

Among the myriad diseases affecting the skin are a subset of disorders whose main pathobiology is inflammation, predominantly in the epidermis and the superficial dermis, that leads to hyperkeratosis, manifesting clinically as thickened scaly skin. These are designated as "inflammatory keratinization disorders". The category includes many conditions that are poorly defined, although some, including psoriasis and lichen planus, are better categorized.

A prospective study comparing patients with early and late relapsing pemphigus treated with rituximab

Rituximab (RTX) is an effective therapy for patients with pemphigus. However it does not prevent relapse.

Efficacy and Safety of Oxymetazoline Cream 1.0% for Treatment of Persistent Facial Erythema Associated With Rosacea: Findings From the 52-Week Open Label REVEAL Trial

Limited treatments are available for persistent erythema of rosacea.

Prognostic value of sentinel lymph node biopsy according to Breslow thickness for cutaneous melanoma

Sentinel lymph node biopsy (SLNB) is widely performed for melanoma of certain histologic parameters and offers important prognostic and staging information. Breslow thickness (BT) by itself also provides meaningful prognostic information.

Psoriasis and cardiovascular disease risk factors. The HUNT Study, Norway

Abstract

Background

Studies have examined the associations between psoriasis and cardiovascular diseases and their risk factors, but the results are conflicting, especially in the general population.

Objectives

To investigate the association of psoriasis, and in particular psoriasis severity, with objectively measured cardiovascular disease risk factors and cardiovascular morbidity in a large population-based cross-sectional study.

Methods

We linked data on 50 245 persons in the HUNT3 Study, Norway with information from the National Prescription Database to obtain information on use of psoriasis medication. A total of 2 894 persons reported to have psoriasis; 2 643 were classified as mild and 251 as moderate/severe psoriasis. We used linear and logistic regression to estimate adjusted associations with 95% confidence intervals (CIs) between psoriasis and cardiovascular disease risk factors and morbidity.

Results

We observed a positive association between psoriasis and objective measures of body mass index (BMI), waist circumference and high-sensitivity C-reactive protein (hsCRP), but no clear association with blood pressure and blood lipids. People with moderate/severe psoriasis had an odds ratio for being overweight of 1.94 (95% CI 1.42, 2.67), whereas the odds ratio for metabolic syndrome was 1.91 (95% CI 1.47, 2.49). Psoriasis was also positively associated with self-reported diabetes, myocardial infarction and angina pectoris.

Conclusions

In this population-based study we found that psoriasis was positively associated with measures of adiposity, as well as with a clustering of cardiovascular disease risk factors. Overall, these associations were strongest for people with moderate/severe psoriasis.

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Sensitive skin in france: a study on prevalence, relationship with age and skin type and impact on quality of life

Abstract

Background

Many epidemiological studies have been performed, but a potential increase in the prevalence of sensitive skin as well as its relationship with age and skin type and the impact of sensitive skin on quality of life are still debated.

Objective

To answer these unresolved questions

Methods

An opinion poll was conducted on a representative French 5000-person sample.

Results

Fifty-nine percent of the people declared very sensitive or fairly sensitive skin (together: sensitive skin), and women (66%) declared sensitive skin more frequently than men (51.9%). The results also showed that sensitive skin is more common (more than 60%) in younger people (<35 years old), and there was a decrease in the following age groups. The univariate analysis demonstrated that sensitive skin was more likely to be reported by people with fair skin (OR=1.83) and by people with an atopic predisposition (OR=2.51). The risk of sensitive skin is higher for people with dry skin (OR= 6.18 compared with normal skin), but sensitive skin can occur in other skin types (OR=2.45 for mixed skin and OR=2.16 for greasy skin). Quality of life was clearly altered in patients with sensitive skin, as assessed by SF-12 and DLQI.

Conclusion

This large study demonstrates that sensitive skin can alter quality of life and is more common in young people and in women as well as patients with dry skin or fair skin or an atopic predisposition. It also suggests that there is an increase in the prevalence of sensitive skin.

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Hereditary palmoplantar keratodermas. Part II. Syndromic palmoplantar keratodermas. Diagnostic algorithm and principles of therapy

Abstract

Hereditary palmoplantar keratodermas (PPKs) comprise a large and heterogeneous group of disorders characterized by persistent thickening of the epidermis at palmar and plantar surfaces. Clinical and genetic features of isolated and complex PPKs have been reviewed in part I of this 2-part review. Here we focus on clinical and molecular classification of syndromic PPKs which are recognized by additional extracutaneous manifestations, in particular deafness, specific mucosal lesions, cardiomyopathy, inborn errors of metabolism, involvement of internal organs or disorders of sexual development. Other genetic diseases which may show palmoplantar involvement, such as selected subtypes of hereditary epidermolysis bullosa, various hereditary ichthyoses and other keratinization disorders, several ectodermal dysplasias and some multisystem genetic disorders, are also briefly summarized. PPK diagnosis is based on inheritance pattern, age at onset, morphology, distribution and severity of hyperkeratosis, pattern of additional dermatological and systemic manifestations and laboratory findings. Molecular analysis is at present the gold standard to confirm the diagnosis in PPK forms due to mutations in known causative genes. No specific and curative therapy is currently available for PPKs which highly impair patients' quality of life. Topical treatments are symptomatic and offer only temporary relief. Among systemic treatments, retinoids improve disease symptoms in the majority of patients.

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Sorption and recovery of platinum from simulated spent catalyst solution and refinery wastewater using chemically modified biomass as a novel sorbent

Abstract

In this study, Lagerstroemia speciosa biomass modified by polyethylenimine (PEI-LS) was developed as a potential biosorbent for sorption and recovery of platinum(II) from platinum bearing waste solutions. Batch experiments were conducted to study the effect of various parameters on the sorption and recovery of platinum(II) using PEI-LS. The equilibrium time for platinum(II) sorption process was found to be 6 h. Both the sorption kinetics and sorption isotherm data fits pseudo second-order kinetic model and Langmuir isotherm, respectively. The maximum sorption capacity of platinum(II) onto PEI-LS at pH 2 for the studied temperature range (25–45 °C) is in the range of 122–154 mg/g. Evaluation of thermodynamic parameters suggests that the platinum(II) sorption is spontaneous and endothermic in nature. The regeneration of PEI-LS can be achieved using acidic thiourea as an eluent for recovery of platinum from the biosorbent. Fourier transform infrared (FT-IR) analysis suggests many functional groups were involved in platinum(II) sorption onto PEI-LS. Both the scanning electron microscope/energy dispersive spectroscopy (SEM/EDS) and X-ray photoelectron spectroscopy (XPS) analysis suggest a successful modification of raw biomass with PEI. The XPS analysis further concludes that platinum(II) sorption is governed by ion-exchange and co-ordination reaction. Finally, the PEI-LS was shown to recover ≥ 90% of platinum from two simulated solutions: the acid-leached spent catalyst solution and refinery wastewater. The biosorbent developed in this study is a low-cost and eco-friendly media that can be effectively used for platinum recovery from industrial wastewater.

Need of life cycle thinking for effective utilisation of resources based on developed and developing countries: a scenario for future generation

Alteration of adaptive behaviors of progeny after maternal mobile phone exposure

Abstract

Exposure of pregnant women to radiofrequency (RF) devices raises questions on their possible health consequences for their progeny. We examined the hazard threshold of gestational RF on the progeny's glial homeostasis, sensory-motor gating, emotionality, and novelty seeking and tested whether maternal immune activation would increase RF toxicity. Pregnant dams were daily restrained with loop antennas adjoining the abdomen (fetus body specific absorption rates (SAR): 0, 0.7, or 2.6 W/kg) and received three lipopolysaccharide (LPS) intra-peritoneal injections (0 or 80 μg/kg). Scores in the prepulse startle inhibition, fear conditioning, open field, and elevated plus maze were assessed at adolescence and adulthood. Glial fibrillary acidic protein (GFAP) and interleukines-1β (ILs) were quantified. LPS induced a SAR-dependent reduction of the prepulse startle inhibition in adults. Activity in the open field was reduced at 2.6 W/kg at adolescence. GFAP and ILs, emotional memory, and anxiety-related behaviors were not modified. These data support the hypothesis that maternal immune activation increased the developmental RF exposure-induced long-term neurobiological impairments. These data support the fact that fetuses who receive combined environmental exposures with RF need special attention for protection.

Essential oils from Foeniculum vulgare Miller as a safe environmental insecticide against the aphid Myzus persicae Sulzer

Abstract

Aphids are an important agricultural pest that not only damage plants by suction, but can also transmit a number of economically important plant viruses. Protection against aphids is based on the use of synthetic insecticides. However, these products can be dangerous for non-target organisms. Therefore, it is important to develop new, environmentally safe plant protection methods.

In this study, we have tested an essential oil (EO) obtained from Foeniculum vulgare for the mortality of Myzus persicae, an important polyphagous pest, its natural predator Harmonia axyridis, and Eisenia fetida as a representative of soil organisms. The EO, with its major compounds trans-anethole (67.9%) and fenchone (25.5%), was found to provide excellent efficacy against M. persicae (LC₅₀ = 0.6 and LC₉₀ = 2.4 mL L⁻¹) while not causing any significant mortality of the tested non-target organisms. On the contrary, application of an insecticide based on the active substance alpha-cypermethrin not only caused mortality in the aphids, but also had a fatal negative effect on both the non-target organisms we tested, resulting in their high mortality.

Our results indicate very high prospects for using the essential oil from F. vulgare in the development of environmentally safe botanical insecticides designed for plant protection against aphids.

Evaluating the Risk of Noise-Induced Hearing Loss Using Different Noise Measurement Criteria

Abstract

Objectives

This article examines whether the Occupational Safety and Health Administration's (OSHA) average noise level (L_AVG) or the National Institute of Occupational Safety and Health's (NIOSH) equivalent continuous average (L_EQ) noise measurement criteria better predict hearing loss.

Methods

A cohort of construction workers was followed for 10 years (2000–2010), during which time their noise exposures and hearing threshold levels (HTLs) were repeatedly assessed. Linear mixed models were constructed with HTLs as the outcome, either the OSHA (L_AVG) or NIOSH (L_EQ) measurement criteria as the measure of exposure, and controlling for age, gender, duration of participation, and baseline HTLs (as both a covariate or an additional repeated measure). Model fit was compared between models for HTLs at 0.5, 1, 2, 3, 4, 6, and 8 kHz using the Akaike information criterion (AIC). The 10th, 50th, and 90th percentiles of hearing outcomes predicted by these models were then compared with the hearing outcomes predicted using the ISO 1999:2013 model.

Results

The mixed models using the L_EQ were found to have smaller AIC values than the corresponding L_AVG models. However, only the 0.5, 3, and 4 kHz models were found to have an AIC difference greater than 2. When comparing the distribution of predicted hearing outcomes between the mixed models and their corresponding ISO outcomes, it was found that L_EQ generally produced the smallest difference in predicted hearing outcomes.

Conclusions

Despite the small difference and high correlation between the L_EQ and L_AVG, the L_EQ was consistently found to better predict hearing levels in this cohort and, based on this finding, is recommended for the assessment of noise exposure in populations with similar exposure characteristics.

Characterization of the Selective Recording of Workplace Exposure Measurements into OSHA’s IMIS Databank

Abstract

Objectives

The Integrated Management Information System (IMIS) is the largest multi-industry source of exposure results available in North America. In 2010, the Occupational Safety and Health Administration (OSHA) released the Chemical Exposure Health Data (CEHD) that contains analytical results of samples collected by OSHA inspectors. However, the two databanks only partially overlap, raising suspicion of bias in IMIS data. We investigated the factors associated with selective recording of CEHD results into the IMIS databank.

Methods

This analysis was based on personal exposure measurements of 24 agents from 1984 to 2009. The association between nine variables (level of exposure coded as detected versus non-detected (ND), whether a sampling result was part of a panel of chemicals, duration of sampling, issuance of a citation, presence of other detected levels during the same inspection, year, OSHA region, amount of penalty, and establishment size) and a CEHD sampling result being reported in IMIS was analyzed using modified Poisson regression.

Results

A total of 461900 CEHD sampling results were examined. The proportion of CEHD sampling results recorded into IMIS was 38% (51% for detected and 28% for ND measurements). In the models, the detected sampling results were associated with a higher probability of recording into IMIS than ND sampling results, and this difference was similar for panel versus non-panel samples. Probability of recording remained constant from 1984 to 2009 for sampling results measured on panels but increased for sampling results of single determinations of an agent. Some OSHA regions had probability of recording two times higher than others. No other variables that we examined were associated with a CEHD sampling result being reported in IMIS.

Conclusions

Our results indicate that the under-reporting of sampling results in IMIS is differential: ND results (especially those determined from the panels) seem less likely to be recorded in IMIS than other results. It is important to consider both IMIS and CEHD data in order to reduce bias in evaluation of exposures in workplaces inspected by OSHA.

Parity, prospects, and predominance

Abstract

Let's say that you regard two things as on a par when you don't prefer one to other and aren't indifferent between them. What does rationality require of you when choosing between risky options whose outcomes you regard as on a par? According to Prospectism, you are required to choose the option with the best prospects, where an option's prospects is a probability-distribution over its potential outcomes. In this paper, I argue that Prospectism violates a dominance principle—which I call The Principle of Predominance—because it sometimes requires you to do something that's no better than the alternatives and might (or even likely) be worse. I argue that this undermines the strongest argument that's been given in favor of Prospectism.

Management of tannery wastewater for improving growth attributes and reducing chromium uptake in spinach through citric acid application

Abstract

The use of chromium (Cr)-contaminated tannery wastewater for irrigation is a common practice, especially in developing countries like Pakistan. This practice is due to the shortage of good quality irrigation water for crop growth as well as the issue of tannery wastewater disposal. The current study was done to evaluate the effect of citric acid (CA) (0, 1.0, and 2.0 mM) on the growth and Cr uptake by spinach irrigated with different mixtures of tap water and tannery wastewater (100:0, 50:50, and 0:100 tap water to wastewater ratio). Plants were grown for 8 weeks under ambient conditions. Results showed that 50:50% tap water and wastewater increased plant height, dry weights of shoots and roots, total chlorophyll contents, and gas exchange attributes than the plants treated with only tap water or only wastewater. Increasing wastewater ratio increased electrolyte leakage (EL) in plants and enhanced the leaf key antioxidant enzyme activities as well as increased Cr contents. Foliar application of CA increased the plant dry weights, photosynthesis, and enzyme activities, whereas reduced the EL and Cr concentrations in plants than respective treatments without CA application. It can be concluded that 50:50 tap water and wastewater irrigation along with foliar CA application might be an effective strategy for increasing vegetable growth with reduced metal concentrations.

Acute and single repeated dose effects of low concentrations of chlorpyrifos, diuron, and their combination on chicken

Abstract

This study investigated the acute and single repeated dose effects of low concentrations of chlorpyrifos, diuron, and their mixture to chicken. The effects were determined as biological response (chicken behavior); physiological response (body weight, gaining weight); and biochemical response such as reduction of acetylcholine esterase activity (ACHE), changes in liver biomarkers, such as (1) alkaline phosphatase (ALP), (2) aspartate aminotransferase (AST), and (3) alanine aminotransferase (ALP), and effects on kidney biomarkers such as total protein, creatinine, uric acid, and urea. Results showed abnormal behavior on chicken received 5 μg/g and above from the tested compounds. A reduction in growth weight was observed in chicken received a single repeated dose of diuron and mixture. Enlargements in the liver and heart were observed in chicken received a single repeated dose of diuron. Percentage of serum ACHE inhibition increased linearly as the concentration of the tested compounds increased. The tested low concentration showed tremendous effects on liver enzymes and kidney functions. Similarly, a single repeated dose of the tested compounds caused severe inhibition on serum ACHE and affected the liver enzyme activities and kidney functions. It can be concluded that the low concentrations are not safe and may cause severe damage to the liver, heart, or kidney and disturb the life.

Effects of Spirulina platensis on DNA damage and chromosomal aberration against cadmium chloride-induced genotoxicity in rats

Abstract

Todays, bioactive compounds extracted from Spirulina platensis have been intensively studied for their therapeutical values. Therefore, in the present study, we aimed to evaluate the effects of S. platensis extract on DNA damage and chromosomal aberrations induced by cadmium in rats. Four groups of male albino rats (n = 7 rats) were used. The first group served as a control group and received distilled water. The second group was exposed intraperitoneally to cadmium chloride (CdCl₂) (3.5 mg/kg body weight dissolved in 2 ml distilled water). The third group included the rats that were orally treated with S. platensis extract (1 g/kg dissolved in 5 ml distilled water, every other day for 30 days). The fourth group included the rats that were intraperitoneally and orally exposed to cadmium chloride and S. platensis, respectively. The experiment in all groups was extended for 60 days. The results of cadmium-mediated toxicity revealed significant genetic effects (DNA fragmentation, deletion or disappearance of some base pairs of DNA, and appearance of few base pairs according to ISSR-PCR analysis). Moreover, chromosomes showed structural aberrations such as reduction of chromosomal number, chromosomal ring, chromatid deletions, chromosomal fragmentations, and dicentric chromosomes. Surprisingly, S. platensis extract plus CdCl₂-treated group showed less genetic effects compared with CdCl₂ alone. Further, S. platensis extract upon CdCl₂ toxicity was associated with less chromosomal aberration number and nearly normal appearance of DNA fragments as indicated by the bone marrow and ISSR-PCR analysis, respectively. In conclusion, the present novel study showed that co-treatment with S. platensis extract could reduce the genotoxic effects of CdCl₂ in rats.

Agricultural technologies and carbon emissions: evidence from Jordanian economy

Abstract

Theoretically, agriculture can be the victim and the cause of climate change. Using annual data for the period of 1970–2014, this study examines the interaction between agriculture technology factors and the environment in terms of carbon emissions in Jordan. The results provide evidence for unidirectional causality running from machinery, subsidies, and other transfers, rural access to an improved water source and fertilizers to carbon emissions. The results also reveal the existence of bidirectional causality between the real income and carbon emissions. The variance error decompositions highlight the importance of subsidies and machinery in explaining carbon emissions. They also show that fertilizers, the crop and livestock production, the land under cereal production, the water access, the agricultural value added, and the real income have an increasing effect on carbon emissions over the forecast period. These results are important so that policy-makers can build up strategies and take in considerations the indicators in order to reduce carbon emissions in Jordan.

Detoxification of textile effluent by fungal treatment and its performance in agronomic usages

Abstract

Globally, scarcity of contaminant free water usages is increasing gradually; it might be solved after generation of any sustainable technology to detoxify contaminated waters. An attempt was undertaken to detoxify textile effluent with fungal strains Trichoderma harzianum and Mucor hiemalis. Fungal detoxified effluent and its performance on three crops (wheat, mungbean, and mustard) seed germination in petri dishes and seedlings establishment of mustard in polythene bag were evaluated. Fungal strains significantly detoxified textile effluent by removal of 76% total solids, 91.35% COD, 77.34% absorbance against optical density, and increased 87.31% DO. Studied heavy metals were reduced significantly (P ≤ 0.05) in treated effluent by both fungal strains but superior performance was achieved by Mucor hiemalis. Maximum 92.5, 88.7, 83, and 100% removal of Mn, Zn, Cu, and Fe were monitored in fungal-treated effluent, respectively. Seeds germination and seedling growth by fungal treated effluents were similar and insignificant with the results achieved in tap water but which was significant over raw textile effluent. Eighty and above percent seed germination in petri dishes was recorded at 48 h by Mucor hiemalis-treated textile effluent but conversely at the same period it was below 10% in raw effluent. Significant achievement of seedling establishment was noticed in poly bag with fungal-treated effluent. The applied technique might be a prospective way to detoxify and recycle the industrial effluents for beneficial purpose in the future.

Temperature modulation of the health effects of particulate matter in Beijing, China

Abstract

Particulate matter (PM) has been proven to cause health risks and may result in hospital emergency room visits (ERVs), which might be complicated by extreme temperature events. However, it remains unclear how temperature modulates the effect of different-sized particles on ERVs. This study used three separate time series analyses (2009–2011) to explore such temperature modulation effect in Beijing, China. The analytical approaches included a bivariate response surface model, a non-stratification parametric model, and a stratification parametric model. Results showed that the average daily concentrations of PM₁₀ and PM_2.5 in Beijing were 110.16 and 67.89 μg/m³, respectively, during the study period, which were higher than in most Western countries. Our findings indicated that the temperature modulation effects of PM_2.5 were more evident than that of PM₁₀. The effects of PM on morbidity depend on temperature. The effects were estimated for the increases in total, respiratory, and cardiovascular ERVs per 10 μg/m³ increase in PM_2.5 and PM₁₀ concentrations at high temperature level (> 28 °C). The estimated increases in the three types of ERVs for PM_2.5 were 0.15, 0.35, and 0.34%, respectively. For PM₁₀, the increases were 0.12, 0.08, and 0.14%, respectively. In addition, the results showed that the elderly (age ≥ 65) and women are more vulnerable to PM at high temperatures. These findings may have implications for the health impact associated with both air pollution and global climate change.

Removal of chlorpyrifos, thiamethoxam, and tebuconazole from water using green synthesized metal hexacyanoferrate nanoparticles

Abstract

The low-cost and highly efficient pesticides are largely used in residential, agricultural, and commercial applications. Their prevalent occurrence, bioaccumulation, and chronic toxicity to living beings have raised environmental concern and call for their whole eradication, especially from water. By virtue of semiconducting nature and high surface area, nanomaterials have become efficient adsorbent and photocatalyst in removal of toxins. To confirm this, the potential of highly crystalline metal hexacyanoferrates (MHCFs) of Zn, Cu, Co, and Ni was evaluated in deprivation of selected hazardous pesticides, viz., chlorpyrifos (CP), thiamethoxam (TH), and tebuconazole (TEB). Sharp nanocubes of ZnHCF (~ 100 nm), distorted nanocubes of CuHCF (~ 100 nm), and nanospheres of CoHCF and NiHCF (< 10 nm) were synthesized via green route using Sapindus mukorossi (raw ritha). At 50 mg L⁻¹ of pesticide, 15 mg of MHCF photocatalyst, neutral pH and sunlight irradiation, selected agrochemicals were degraded to maximum extent (91–98%) by ZnHCF followed by CuHCF (85–91%), NiHCF (73–85%), and CoHCF (70–83%). This might be because of highest zeta potential and BET surface area of ZnHCF. The highest adsorption of CP (83–98%) followed by TH (76–95%) and TEB (70–91%) on acidic surface of catalysts might be related to access of free electrons in their structures. On treatment with MHCF photocatalyst, targets underwent mineralization along with formation of some minor and non-toxic by-products such as (Z) but-2-enal, 3-aminopropanoic acid, and pyridin-3-ol, identified after mass spectrometric analysis of reaction mixture. Based on them, degradation pathways have been proposed to reveal the potential of MHCF for solar photocatalytic removal of organic pollutants in environment.

Adult-onset acne: prevalence, impact, and management challenges

PSII as an in vivo molecular catalyst for the production of energy rich hydroquinones - A new approach in renewable energy

Publication date: Available online 3 February 2018
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Sai Das, Soumen K. Maiti
One of the pertinent issues in the field of energy science today is the quest for an abundant source of hydrogen or hydrogen equivalents. In this study, phenyl-p-benzoquinone (pPBQ) has been used to generate a molecular store of hydrogen equivalents (phenyl-p-hydroquinone; pPBQH2) from thein vivo splitting of water by photosystem II of the marine cyanobacterium Synechococcus elongatus BDU 70,542. Using this technique, 10.8 μmol of pPBQH2 per mg chlorophyll a can be extracted per minute, an efficiency that is orders of magnitude higher when compared to the techniques present in the current literature. Moreover, the photo-reduction process was stable when tested over longer periods of time. Addition of phenyl-p-benzoquinone on an intermittent basis resulted in the precipitation of phenyl-p-hydroquinone, obviating the need for costly downstream processing units for product recovery. Phenyl-p-hydroquinone so obtained is a molecular store of free energy preserved through the light driven photolysis of water and can be used as a cheap and a renewable source of hydrogen equivalents by employing transition metal catalysts or fuel cells with the concomitant regeneration of phenyl-p-benzoquinone. The cyclic nature of this technique makes it an ideal candidate to be utilized in mankind's transition from fossil fuels to solar fuels.

Somatic NRAS mutation in patient with generalized lymphatic anomaly

Abstract

Generalized lymphatic anomaly (GLA or lymphangiomatosis) is a rare disease characterized by a diffuse proliferation of lymphatic vessels in skin and internal organs. It often leads to progressive respiratory failure and death, but its etiology is unknown. Here, we isolated lymphangiomatosis endothelial cells from GLA tissue. These cells were characterized by high proliferation and survival rates, but displayed impaired capacities for migration and tube formation. We employed whole exome sequencing to search for disease-causing genes and identified a somatic mutation in NRAS. We used mouse and zebrafish model systems to initially evaluate the role of this mutation in the development of the lymphatic system, and we studied the effect of drugs blocking the downstream effectors, mTOR and ERK, on this disease.

Glomerular endothelial cell maturation depends on ADAM10, a key regulator of Notch signaling

Abstract

The principal function of glomeruli is to filter blood through a highly specialized filtration barrier consisting of a fenestrated endothelium, the glomerular basement membrane and podocyte foot processes. Previous studies have uncovered a crucial role of endothelial a disintegrin and metalloprotease 10 (ADAM10) and Notch signaling in the development of glomeruli, yet the resulting defects have not been further characterized nor understood in the context of kidney development. Here, we used several different experimental approaches to analyze the kidneys and glomeruli from mice lacking ADAM10 in endothelial cells (A10ΔEC mice). Scanning electron microscopy of glomerular casts demonstrated enlarged vascular diameter and increased intussusceptive events in A10ΔEC glomeruli compared to controls. Consistent with these findings, genes known to regulate vessel caliber (Apln, AplnR and Vegfr3) are significantly upregulated in A10ΔEC glomeruli. Moreover, transmission electron microscopy revealed the persistence of diaphragms in the fenestrae of A10ΔEC glomerular endothelial cells, which was corroborated by the elevated expression of the protein PLVAP/PV-1, an integral component of fenestral diaphragms. Analysis of gross renal vasculature by light sheet microscopy showed no major alteration of the branching pattern, indicating a localized importance of ADAM10 in the glomerular endothelium. Since intussusceptions and fenestrae with diaphragms are normally found in developing, but not mature glomeruli, our results provide the first evidence for a crucial role of endothelial ADAM10, a key regulator of Notch signaling, in promoting the development and maturation of the glomerular vasculature.

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