Exploring the in situ expression of vascular endothelial growth factor and endoglin in pemphigus foliaceus variants and pemphigus vulgaris

Abstract

Background

Erythroderma is a severe manifestation of pemphigus foliaceus (PF), a blistering disease mediated by IgG autoantibodies against desmoglein-1. Increasing evidence supports the contribution of angiogenic mediators in the pathogenesis of erythroderma.

Objective

To evaluate the in situ expression of vascular endothelial growth factor (VEGF) and endoglin in PF patients with erythroderma.

Methods

Formalin-fixed paraffin-embedded skin samples obtained from patients with erythrodermic PF (n=19; 12 patients with endemic PF), non-erythrodermic PF (n=17), pemphigus vulgaris (PV; n=10), psoriasis (n=10), and healthy individuals (HI; n=10) were processed in an automated immunohistochemistry platform utilizing anti-VEGF and anti-endoglin as primary antibodies. Reactivity was evaluated both manually (0=negative; 1+=mild; 2+=intense) and through an automated microvessel analysis algorithm.

Results

VEGF expression in erythrodermic PF was higher than in non-erythrodermic PF (p=0.034) and in HI (p=0.004), and similar to psoriasis (p=0.667) and PV (p=0.667). In non-erythrodermic PF, VEGF positivity was similar to HI (p=0.247), and lower than psoriasis (p=0.049) and PV (p=0.049). Both erythrodermic and non-erythrodermic PF presented similar endoglin expression (p=0.700). In addition, endoglin positivity during erythrodermic PF was similar to psoriasis (p=0.133) and lower than PV (p=0.0009). Increased expression of in situ VEGF suggests that healing processes are triggered in response to tissue damage led by autoantibodies in PF, especially during erythroderma. Reduced endoglin positivity suggests that an unbalanced angiogenesis may occur during erythrodermic PF. Further studies may help to confirm if the regulation of VEGF and endoglin expression in patients with PF can contribute to control the healing process and enable disease remission.

Conclusion

Overexpression of VEGF in erythrodermic PF as well as in PV and psoriasis points out a dysregulated repair process in severe forms of these diseases, and suggests VEGF and endoglin could act as prognostic markers and future therapeutic targets to enable proper healing in PF.

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Reply to Happle R. And al. Koebner's sheep in Wolf's clothing: does the isotopic response exist as a distinct phenomenon?

Abstract

We read with interest the issues raised by Happle and Kluger. The Koebner phenomenon is well-established and the number of diseases apparently showing this phenomenon has grown so much that a classification of subtypes exists. The concept of locus minoris resistentiae (lmr), which helps us explain why certain disorders occur in certain locations, appears to underlie both Koebner phenomenon and Wolf isotopic response. The isotopic response was initially defined as "the occurrence of a new disorder at the site of another, unrelated and already healed skin disease". Wolf himself cited lmr as a putative explanation for the occurrence of the isotopic response. Certain questions arise from the initial definition by Wolf and the ever growing extensions of the isotopic response we see today.

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Answer to Nwabudike LC and al. Koebner's sheep in Wolf's clothing: does the isotopic response exist as a distinct phenomenon?

Abstract

We thank Dr. Nwabudike for his interest in our article. We fully agree with him that the "isotopic response" is merely a variant of Koebner reaction. In fact, all forms of Koebner reaction can be taken as variants from each other.

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Hereditary palmoplantar keratodermas. Part I. Non-syndromic palmoplantar keratodermas: classification, clinical and genetic features

Abstract

The term palmoplantar keratoderma (PPK) indicates any form of persistent thickening of the epidermis of palms and soles, and includes genetic as well as acquired conditions. We review the nosology of hereditary PPKs that comprise an increasing number of entities with different prognoses, and a multitude of associated cutaneous and extracutaneous features. On the basis of the phenotypic consequences of the underlying genetic defect, hereditary PPKs may be divided into: i. non-syndromic, isolated PPKs, which are characterized by a unique or predominant palmoplantar involvement; ii. non-syndromic PPKs with additional distinctive cutaneous and adnexal manifestations, here named complex PPKs; iii. syndromic PPKs, in which PPK is associated with specific extracutaneous manifestations. To date, the diagnosis of the different hereditary PPKs is based mainly on clinical history and features combined with histopathological findings. In recent years, the exponentially increasing use of next generation sequencing technologies has led to the identification of several novel disease genes, and thus substantially contributed to elucidate the molecular basis of such a heterogeneous group of disorders. Here, we focus on hereditary non-syndromic isolated and complex PPKs. Syndromic PPKs are reviewed in the second part of this 2-part article, where other well-defined genetic diseases, which may present PPK among their phenotypic manifestations, are also listed and diagnostic and therapeutic approaches for PPKs are summarized.

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The depth of follicular extension in actinic keratosis correlates with the depth of invasion in squamous cell carcinoma: implication for clinical treatment

Abstract

Background

Actinic keratosis (AK) may show extension down follicules, not only in cases with full-thickness epidermal atypia ("bowenoid" AK), but also in cases with atypia limited to the epidermal basalis. Previous studies have demonstrated that in bowenoid AK, follicular extension is usually superficial, being limited to the upper follicular segment. Little is known about the depth of follicular involvement in cases of iSCC arising from AK and the role of the follicle in iSCC pathogenesis.

Objective

This study investigated the relationship between follicular extension of atypical keratinocytes in an AK and the development of iSCC from the follicular wall. The depth of follicular extension was correlated with the depth invasion of iSCC. Differences between the differentiated and classical pathways of iSCC were also examined.

Methods

We performed a retrospective histologic review of 193 biopsy specimens of iSCC with an associated AK. We assessed the presence and depth of follicular extension of atypical keratinocytes in the AK, using tumor (Breslow) thickness and the follicular unit level (infundibular, isthmic and sub-isthmic), as well as iSCC being present directly adjacent to the follicular basalis.

Results

Follicular extension was present in 25.9% of the cases (50 cases), usually extending into the lower follicular segment. The iSCC was present directly adjacent to the follicular basalis in 58% of the cases (29 cases), correlating highly with the depth of follicular extension (infundibular: 3/12; isthmic: 21/33; sub-isthmic 5/5).

Conclusion

The depth of follicular extension of atypical keratinocytes in an AK correlates with the development of depth of invasion of an associated iSCC, irrespective of the pathway of origin. It is therefore important to note the presence and the depth of follicular extension when diagnosing an AK, since follicular extension likely accounts for a significant proportion of recurrent AK and the development of iSCC following superficial treatment modalities.

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Orthotopic transfer of vascularized groin lymph node flap in the treatment of breast cancer-related lymphedema: clinical results, lymphoscintigraphy findings and proposed mechanism

Publication date: Available online 28 February 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Hin-Lun Liu, Suet-Ying Pang, Chung-Ching Lee, Melody Man-Kuen Wong, Hon-Ping Chung, Yu-Wai Chan
IntroductionVascularized lymph node transfer (VLNT) has become more popular in treating secondary lymphedema. However, the mechanism has not been clearly elucidated.The purpose of this study were (1) to evaluate the outcome of vascularized groin lymph node (VGLN) transfer using axilla as a recipient site in patients with breast cancer-related lymphedema (BCRL) and (2) to provide radiological evidence of lymphangiogenesis in VLNT.MethodsBetween August 2013 and June 2016, 30 consecutive patients with a mean age of 60 years underwent VGLN transfer for BCRL. A skinless VGLN flap nourished by the superficial circumflex iliac vessels was transferred to the axillary region of lymphedematous limb. The outcomes were assessed clinically with limb circumference measurement and radiologically with lymphoscintigraphy.ResultsAt a mean follow-up of 22.11 ± 7.83 months, 21 (70%) patients had reduction in limb circumference. The mean circumference reduction rate of the lymphedematous limb was 47.06 ± 27.92% (range, 0 to 100%).Eleven (37%) patients showed radiological improvement in post-operative lymphoscintigraphy that included 7 cases of faster contrast transport and 4 cases of visualization of transplanted lymph node.ConclusionPatients with BCRL can benefit from orthotopic VGLN transfer. Lymphangiogenesis is supported by the visualization of transplanted lymph node in post-operative lymphoscintigraphy.

Morphological changes of hair melanosomes by aging

Summary

Various changes appear in hair by aging and graying is the most remarkable one. Changes in melanocytes have been well studied as the cause, however, little is known about the change of melanosomes which have a role of carrying melanin pigments into hair shafts. Using pigmented hairs of Japanese females from their age of 4 to 75, I isolated melanosomes and observed them. As a result, I found a significant change in the morphology of hair melanosomes with age. They were ellipsoidal on the whole and there was no age dependence in the major axis, while the minor axis significantly increased and its frequency distribution broadened with age. The anticipated volume of the melanosome of the oldest person hairs was about twice larger than that of child hairs. This enlargement of melanosome seems to be a cause of the age-related color change of pigmented hairs from brown to black.

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Marc Lange: Because Without Cause: Non-causal Explanations in Science and Mathematics

“This Is a White Space”: On Restorative Possibilities of Hospitality in a Raced Space

Abstract

In a restorative classroom inspired by a vision of racial equity, race consciousness is a necessity and a restorative outcome is conceptualized in terms of a sustainable interdependent right-relation, a species of racial justice. Yet, regardless of intent, the constructed space is white. Race-based inequity is reproduced as White students get more of everything from class than do students of Color. What made the space white? How might hospitality affect the restorative possibilities of and in the space? I explore these questions and reconceptualize right-relation as that which necessitates hospitality.

Source apportionments of PM 2.5 organic carbon during the elevated pollution episodes in the Ordos region, Inner Mongolia, China

Abstract

The Ordos region in the southwestern part of Inner Mongolia experiences frequent PM concentrations in excess of the national PM_2.5 air quality standards. In order to determine the key sources of PM_2.5 contributing to these pollution episodes, the main sources of PM_2.5 OC during elevated PM episodes in the Inner Mongolia were analyzed and compared with non-polluted days. This will provide insight to the main sources of particulate matter pollution during the high-pollution episodes and the effective seasonal strategies to control sources of particulate matter during months and with the highest PM concentrations that need to be controlled. The PMF source contributions to OC demonstrated that the industrial/coal combustion (4762.77 ± 1061.54 versus 2726.49 ± 469.75 ng/m³; p < 0.001) and mobile source factors (4651.14 ± 681.82 versus 2605.55 ± 276.50 ng/m³; p value < 0.001) showed greater contributions to the elevated concentrations during the episode. The spatial analysis of secondary organic carbon (SOC) factors, regional biomass burning, and biogenic sources did not show significant difference in the pollution episodes and the non-polluted months. In addition, the bivariate polar plots and CWT maps of the industrial/coal combustion and mobile illustrated a regional long-range transport patterns from the external sources to the study area, however, adjacent areas were mostly controlling the contributions of these factors during the PM elevated episodes. The SOC sources, regional biomass burning, and biogenic sources illustrated a regional long-range transport with similar locations found during the elevated pollution episodes compared to the normal situations.

Evaluating gas chromatography with a halogen-specific detector for the determination of disinfection by-products in drinking water

Abstract

The occurrence of disinfection by-products (DBPs) in drinking water has become an issue of concern during the past decades. The DBPs pose health risks and are suspected to cause various cancer forms, be genotoxic, and have negative developmental effects. The vast chemical diversity of DBPs makes comprehensive monitoring challenging. Only few of the DBPs are regulated and included in analytical protocols. In this study, a method for simultaneous measurement of 20 DBPs from five different structural classes (both regulated and non-regulated) was investigated and further developed for 11 DBPs using solid-phase extraction and gas chromatography coupled with a halogen-specific detector (XSD). The XSD was highly selective towards halogenated DBPs, providing chromatograms with little noise. The method allowed detection down to 0.05 μg L⁻¹ and showed promising results for the simultaneous determination of a range of neutral DBP classes. Compounds from two classes of emerging DBPs, more cytotoxic than the "traditional" regulated DBPs, were successfully determined using this method. However, haloacetic acids (HAAs) should be analyzed separately as some HAA methyl esters may degrade giving false positives of trihalomethanes (THMs). The method was tested on real water samples from two municipal waterworks where the target DBP concentrations were found below the regulatory limits of Sweden.

Enhanced algae removal by Ti-based coagulant: comparison with conventional Al- and Fe-based coagulants

Abstract

The water eutrophication caused by cyanobacteria seasonally proliferates, which is a hot potato to be resolved for water treatment plants. This study firstly investigated coagulation performance of titanium tetrachloride (TiCl₄) for Microcystis aeruginosa synthetic water treatment. Results show complete algal cell removal by TiCl₄ coagulation without damage to cell membrane integrity even under harsh conditions; 60 mg/L TiCl₄ was effective in removing the microcystins up to 85%. Furthermore, besides having stronger UV₂₅₄ removal capability and the higher removal of fluorescent substances over Al- and Fe-based coagulants, TiCl₄ coagulant required more compact coagulation and sedimentation tanks due to its significantly improved floc growth and sedimentation speed. Meanwhile, its' short hydraulic retention time avoided algal cell breakage and subsequent algal organic matter release. Microcystin concentrations were kept at a low level during sludge storage period, indicating that the TiCl₄ flocs could prevent algal cells from natural lysis. To facilitate water recycling without secondary contamination, the algae-containing sludge after TiCl₄ coagulation ought to be disposed within 12 days at 20 °C and 8 days at 35 °C.

Anoxic conditions are beneficial for abiotic diclofenac removal from water with manganese oxide (MnO 2 )

Abstract

This is the first study examining pharmaceutical removal under anoxic conditions with MnO₂. This study compares the abiotic removal of seven pharmaceuticals with reactive MnO₂ particles in the presence of oxygen (oxic conditions) and in the absence of oxygen (anoxic conditions). Due to the novelty of pharmaceutical removal under anoxic conditions, the influence of phosphate buffer, pH, and MnO₂ morphologies is also examined. Results show that over 90% of diclofenac is removed under anoxic conditions. Additionally, we found that (1) anoxic conditions are beneficial for diclofenac removal with MnO₂, (2) phosphate buffer affects the pharmaceutical removal efficiencies, (3) higher pharmaceutical removal is obtained at acidic pH compared to that at neutral or alkaline conditions, and (4) amorphous MnO₂ removes pharmaceuticals better than crystalline MnO₂. The pharmaceutical molecular structure and properties, MnO₂ properties especially reactive sites of the MnO₂ surface, are important for degradation kinetics. This study provides a fundamental basis towards understanding pharmaceutical degradation with MnO₂ under anoxic conditions, and development of a cost-effective, sustainable technology for removal of pharmaceuticals from water.

Impact of Previous Biologic Use on Efficacy and Safety of Brodalumab and Ustekinumab in Patients with Moderate-to-Severe Plaque Psoriasis: Integrated Analysis of AMAGINE-2 and AMAGINE-3

Abstract

Background

Biologics used increasingly used for treating moderate-to-severe psoriasis. Efficacy may differ in patients with previous biologics exposure.

Objective

To investigate the impact of previous biologic exposure on efficacy and safety of brodalumab and ustekinumab in moderate-to-severe plaque psoriasis.

Methods

Two placebo- and ustekinumab-controlled phase 3 clinical trials. Initial 12-week induction phase where patients were treated with brodalumab (210mg Q2W or 140mg Q2W), ustekinumab or placebo. Efficacy endpoints included: Psoriasis Area and Severity Index (PASI 75) and Physician's Global Assessment (sPGA 0/1) versus placebo, PASI 100 versus ustekinumab, Dermatology Life Quality Index (DLQI) and Psoriasis Symptom Inventory (PSI). Adverse events were monitored throughout.

Results

493 patients (334 [27%] brodalumab 210 mg Q2W and 159 [26%] ustekinumab) received prior biologics exposure; 150 (12%) and 62 (10%) reporting previously failed biologic. Brodalumab efficacy in patients with or without previous biologics exposure was statistically equivalent; 40.9% and 39.5% of bio-naïve and -experienced patients achieved PASI 100 at Week 12, compared with 21.1% and 17.0% with ustekinumab (both P<0.001). In patients where prior biologics had been successful or failed, 41.7% and 32.0% achieved PASI 100, compared with 21.1% and 11.3% with ustekinumab. Tolerability was similar, and did not appear to be influenced by previous biologic treatment.

Conclusions

Efficacy of brodalumab 210 mg Q2W was similar regardless of prior biologic therapy (P=0.31, 0.32 and 0.64 for PASI 75, 90, and 100 respectively). Almost twice as many patients achieved PASI 100 or complete clearance at Week 12 compared with ustekinumab; differences most noticeable where previous biologics had failed. Both treatments were well tolerated.

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Comparing Data from the Poisons Information Centre with Employers’ Accident Reports Reveal Under-Recognized Hazards at the Workplace

Abstract

Records of injuries and incidents provide an important basis for injury prevention related to hazardous substances at the workplace. The present study aimed to review available data on injuries and incidents involving hazardous substances and investigate how data from the Poisons Information Centre could complement the records of the Swedish Work Environment Authority. We found two major obstacles for using injury/incident data based on employers' mandatory reporting. First, it was not possible to quickly and reliably identify injuries caused by hazardous substances, and second, data identifying substances or products are not systematically included. For two out of five investigated injuries with lost working days likely due to chemical injuries, we could not identify substances and/or products involved. The records based on calls to the Poisons Information Centre allow better understanding of chemical hazards and products. Besides the large share of unidentified chemical hazards in the injury statistics, the most striking difference was found for cleaning agents. Cleaning agents were implicated in one-third of the occupational cases that the consulting Poisons Information Centre expert judged to pose a major risk and in need of immediate healthcare. Only one in 10 injuries with lost days reported by employers was related to this type of product. The identification of exposures and symptoms by the Poisons Information Centre allow recognition of chemicals with problematic occupational uses. Hence, these records may serve as an important complement to official injury statistics related to incidents with hazardous substances at work.

Control Banding Tools for Engineered Nanoparticles: What the Practitioner Needs to Know

Abstract

Control banding (CB) has been widely recommended for the selection of exposure controls for engineered nanomaterials (ENMs) in the absence of ENM-specific occupational exposure limits (OELs). Several ENM-specific CB strategies have been developed but have not been systematically evaluated. In this article, we identify the data inputs and compare the guidance provided by eight CB tools, evaluated on six ENMs, and assuming a constant handling/use scenario. The ENMs evaluated include nanoscale silica, titanium dioxide, silver, carbon nanotubes, graphene, and cellulose. Several of the tools recommended the highest level of exposure control for each of the ENMs in the evaluation, which was driven largely by the hazard banding. Dustiness was a factor in determining the exposure band in many tools, although most tools did not provide explicit guidance on how to classify the dustiness (high, medium, low), and published data are limited on this topic. The CB tools that recommended more diverse control options based on ENM hazard and dustiness data appear to be better equipped to utilize the available information, although further validation is needed by comparison to exposure measurements and OELs for a variety of ENMs. In all CB tools, local exhaust ventilation was recommended at a minimum to control exposures to ENMs in the workplace. Generally, the same or more stringent control levels were recommended by these tools compared with the OELs proposed for these ENMs, suggesting that these CB tools would generally provide prudent exposure control guidance, including when data are limited.

Understanding disability civil rights non-categorically: The Minority Body and the Americans with disabilities act

Abstract

A persistent paradox apparently infects disability civil rights claims. On the one hand, these rights claims are often understood to apply only to those who are sufficiently impaired in body or in mind to qualify for them because of the disadvantage they endure. On the other hand, asserting significant impairments threatens to undermine the plausibility of these claims as civil rights rather than as welfare for those who are dependent and in need of extra help. Behind this paradox lies a type of categorical understanding of disability civil rights: that disability civil rights are only for those who fall into a category of disability and that this category should be defined in a particular way, in terms of disadvantaging disablement. In this article, I dispel this paradox by deploying a critical analysis of Elizabeth Barnes's account of physical disability in her recent book, The Minority Body (2016). In her book, Barnes makes the important critical point that disability is not "bad" difference. Instead, she argues that physical disability is a physical condition that the disability rights community is working to promote justice for. I argue that this account fails as a project of ameliorative social metaphysics because it fails to understand the role of impairment in the construction of disability antidiscrimination law. I also argue that her account risks privileging physical disability and is thus problematic as a starting place for examining disability justice.

Knowledge of objective modality

Abstract

The epistemology of modality has focused on metaphysical modality and, more recently, counterfactual conditionals. Knowledge of kinds of modality that are not metaphysical has so far gone largely unexplored. Yet other theoretically interesting kinds of modality, such as nomic, practical, and 'easy' possibility, are no less puzzling epistemologically. Could Clinton easily have won the 2016 presidential election—was it an easy possibility? Given that she didn't in fact win the election, how, if at all, can we know whether she easily could have? This paper investigates the epistemology of the broad category of 'objective' modality, of which metaphysical modality is a special, limiting case. It argues that the same cognitive mechanisms that are capable of producing knowledge of metaphysical modality are also capable of producing knowledge of all other objective modalities. This conclusion can be used to explain the roles of counterfactual reasoning and the imagination in the epistemology of objective modality.

Risk of intraocular and other extracutaneous involvement in patients with cutaneous juvenile xanthogranuloma

Abstract

Background/Objectives

Cutaneous juvenile xanthogranuloma is an uncommon, usually benign disease affecting infants and young children. Ocular and other systemic involvement have been reported, but their incidence is unclear, and the utility of routine screening is not well established. Our aim was to characterize the risk of ocular and systemic complications in children with cutaneous juvenile xanthogranuloma.

Methods

In this retrospective study, we reviewed the medical charts of children with cutaneous juvenile xanthogranuloma seen at Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois, between January 2000 and December 2015. A comprehensive literature review was also performed.

Results

Of 338 children with cutaneous juvenile xanthogranuloma, 76 (median age 6 months, 51% female) met inclusion criteria. The most frequently involved site was the head and neck region (40%). In 39 patients (51%), there was a single lesion. Multiple lesions (>5) were evident in 20 patients (26%). Most cutaneous juvenile xanthogranulomas were micronodular (77%). None of the patients had ocular involvement. One patient had multiple asymptomatic hepatic nodules on imaging that regressed spontaneously within several months. Literature review of pediatric cutaneous juvenile xanthogranuloma series, including our cohort, revealed that the incidence of ocular manifestations is 0.24% (7/2949) and of systemic manifestations is 0.75% (22/2949).

Conclusion

Cutaneous juvenile xanthogranulomas are generally limited to the skin. Because eye involvement is rare, a routine eye examination is of low yield and probably not warranted in children with no ocular or visual symptoms. New recommendations for systemic screening could not be drawn from this study.

Familial papular epidermal nevus with “skyline” basal cell layer and multiple pilomatricomas: A new association?

Abstract

Papular epidermal nevus with "skyline" basal cell layer is a newly described keratinocytic nevus. Recently, papular epidermal nevus with "skyline" basal cell layer has been reported in association with extracutaneous involvement, and the term papular epidermal nevus with "skyline" basal cell layer syndrome is used to indicate a neurocutaneous syndrome characterized by the presence of papular epidermal nevus with "skyline" basal cell layer and different neurologic symptoms that seem to improve during infancy and adolescence. Multiple pilomatricomas have been reported in association with various syndromes. We report herein papular epidermal nevus with "skyline" basal cell layer associated with multiple pilomatricomas in two members of a family with the aim of drawing attention to this peculiar epidermal nevus to improve our knowledge of the syndrome.

Color Atlas of Oral Diseases, Diagnosis and Treatment Edited by G. Laskaris Fourth edition Stuttgart, Germany: Thieme, 2017. ISBN 9783137170044

Acquired perforating collagenosis in a non-diabetic patient with advanced prostate carcinoma: A review of perforating dermatosis associated with malignancy

HLA-DRB1*04:05 in two cases of Vogt–Koyanagi–Harada disease-like uveitis developing from an advanced melanoma patient treated by sequential administration of nivolumab and dabrafenib/trametinib therapy

Abstract

Although uveitis is reported as a rare adverse event (AE) associated with dabrafenib/trametinib therapy or nivolumab, the occurrence of severe uveitis is extremely rare. We describe two cases of Vogt–Koyanagi–Harada (VKH)-like uveitis developing after the sequential administration of nivolumab and dabrafenib/trametinib therapy. Interestingly, both cases had HLA-DRB1*04:05, which is strongly associated with VKH disease, and achieved biologically complete remission after the treatment for uveitis. Our cases suggest a possible correlation between VKH-like uveitis as an AE and the clinical outcomes of sequential administration of nivolumab and dabrafenib/trametinib therapy for the treatment of advanced melanoma.

Unusual association between digital mucous cyst and acquired ungual fibrokeratoma: A case report

Case of pyoderma gangrenosum-like sporotrichosis caused by Sporothrix globosa in a patient with ulcerative colitis

Mechanisms of copper stress alleviation in Citrus trees after metal uptake by leaves or roots

Abstract

Nutritional disorders caused by copper (Cu) have affected citrus orchards. Since Cu is foliar sprayed as a pesticide to control citrus diseases, this metal accumulates in the soil. Thereby, we evaluated the effects of Cu leaf absorption after spray of different metal sources, as well as roots absorption on growth, nutritional status, and oxidative stress of young sweet orange trees. Two experiments were carried out under greenhouse conditions. The first experiment was set up with varying Cu levels to the soil (nil Cu, 0.5, 2.0, 4.0 and 8.0 g of Cu per plant as CuSO₄.5H₂O), whereas the second experiment with Cu application via foliar sprays (0.5 and 2.0 g of Cu per plant) and comparing two metal sources (CuSO₄.5H₂O or Cu(OH)₂). Copper was mainly accumulated in roots with soil supply, but an increase of oxidative stress levels was observed in leaves. On the other hand, Cu concentrations were higher in leaves that received foliar sprays, mainly as Cu(OH)₂. However, when sulfate was foliar sprayed, plants exhibited more symptoms of injuries in the canopy with decreased chlorophyll contents and increased hydrogen peroxide and lipid peroxidation levels. Copper toxicity was characterized by sap leakage from the trunk and twigs, which is the first report of this specific Cu excess symptom in woody trees. Despite plants with 8.0 g of Cu soil-applied exhibiting the sap leakage, growth of new plant parts was more vigorous with lower oxidative stress levels and injuries compared to those with 4.0 g of Cu soil-applied (without sap leakage). With the highest level of Cu applied via foliar as sulfate, Cu was eliminated by plant roots, increasing the rhizospheric soil metal levels. Despite citrus likely exhibiting different mechanisms to reduce the damages caused by metal toxicity, such as responsive enzymatic antioxidant system, metal accumulation in the roots, and metal exclusion by roots, excess Cu resulted in damages on plant growth and metabolism when the metal was taken up either by roots or leaves.

Melanoma risk prediction using a multi-locus genetic risk score in the Women’s Health Initiative cohort

Single-nucleotide polymorphisms (SNPs) associated with melanoma have been identified though genome-wide association studies (GWASs). However, the combined impact of these SNPs on melanoma development remains unclear, particularly in post-menopausal women who carry lower melanoma risk.

The Risk of Cardiovascular Events in Psoriasis Patients Treated with Tumor Necrosis Factor-alpha Inhibitors versus Phototherapy: An Observational Cohort Study

Psoriasis is a risk factor for cardiovascular events.

Dermatologists are the primary treating physicians of skin cancer in the United States Medicare population

Dermatology and climate change

Title: Opioid, Alcohol, and Cannabis Misuse Among Patients with Hidradenitis Suppurativa: a population-based analysis in the United States

Patients with hidradenitis suppurativa (HS) experience chronic pain and have significant physical, emotional and psychological disease impact. These patients may be at risk for substance abuse.

Surgical Pearl: Video chat to prevent wrong site surgery

Similar survival of patients with multiple vs. single primary melanomas based on Utah SEER data (1973-2011)

Survival data are mixed comparing patients with multiple primary melanomas (MPM) to those with single primary melanomas (SPM).

Routine Pathologic Evaluation of Plastic Surgery Specimens: Are We Wasting Time and Money?

Background: Recent health care changes have encouraged efforts to decrease costs. In plastic surgery, an area of potential cost savings includes appropriate use of pathologic examination. Specimens are frequently sent because of hospital policy, insurance request, or habit, even when clinically unnecessary. This is an area where evidence-based guidelines are lacking and significant cost-savings can be achieved. Methods: All specimen submitted for pathologic examination at two hospitals between January and December of 2015 were queried for tissue expanders, breast implants, fat, skin, abdominal pannus, implant capsule, hardware, rib, bone, cartilage, scar, and keloid. Specimens not related to plastic surgery procedures were excluded. Pathologic diagnosis and cost data were obtained. Results: A total of 759 specimens were identified. Of these, 161 were sent with a specific request for gross examination only. There were no clinically significant findings in any of the specimens. There was one incidental finding of a seborrheic keratosis on breast skin. The total amount billed in 2015 was $430,095. Conclusions: The infrequency of clinically significant pathologic examination results does not support routine pathologic examination of all plastic surgery specimens. Instead, the authors justify select submission only when there is clinical suspicion or medical history that warrants evaluation. By eliminating unnecessary histologic or macroscopic examination, significant cost savings may be achieved.

Reply: Facial Nerve Supply to the Orbicularis Oculi around the Lower Eyelid Anatomy and Its Clinical Implications

No abstract available

So, You Want to Be a Success? Aspire, Inspire, and Perspire—A Lot!

No abstract available

Sifting through the Evidence: A Comprehensive Review and Analysis of Neurotization in Breast Reconstruction

Background: An untoward outcome following breast reconstruction is diminished or complete loss of sensation. As the reconstructive paradigm continues to evolve, sensory restoration following reconstruction remains a research focus. Despite the multitude of published outcomes, there is marked heterogeneity across studies, thus confounding published outcomes. This study critically appraises the literature to summarize outcomes and establish a framework to guide clinical practice and future research. Methods: A literature review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in an effort to perform a meta-analysis. The Ovid MEDLINE, PubMed, Embase, Scopus, Cochrane, and ClinicalTrials.gov online databases were queried to capture all publications between 1990 and 2017 that investigated postreconstruction breast sensation. The primary outcome of interest was breast sensation following both implant-based and autologous reconstruction with or without neurotization. Secondary outcomes of interest included time to sensory testing and patient-reported outcomes. Results: Overall, 503 titles were screened, from which 37 articles were ultimately included for analysis, accounting for 1299 patients. There was major methodologic variability and inconsistent measurable outcomes across studies. It can be deduced that postoperative sensation returns spontaneously and unpredictably, neurotization enhances the magnitude and rapidity of sensory restoration when compared to nonneurotized reconstruction, and a sensate reconstruction improves patient-reported outcomes. Conclusions: Significant study design discrepancies exist, making it difficult to combine data and assess results. To effectively study breast sensation and the impact of neurotization, future investigation will depend on standardizing the way in which breast sensation is measured.

Reply: Population Health Implications of Medical Tourism

No abstract available

Is the Right Research Being Conducted to Advance Knowledge about Breast Reconstruction? An Analysis of the Research Pipeline

Background: It has been estimated that up to 85 percent of research is of limited value or wasted, in part because of the wrong research questions being addressed. In this study, the authors identified research gaps for breast reconstruction using guideline recommendations based on low-quality or no evidence. The authors then evaluated whether research was currently being conducted to fill these gaps. Methods: The authors extracted grade C and D options, which are based on limited evidence, from the American Society of Plastic Surgeon's clinical practice guideline for breast reconstruction. For each option, the authors created Participants, Intervention, Comparator, Outcome questions and search strings using a systematic process. Searches were conducted of ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform to locate new and ongoing studies. The authors also catalogued studies on breast reconstruction funded by the Plastic Surgery Foundation. Results: Of the 10 research gaps, only six were being addressed by new and ongoing research. Timing of reconstruction (immediate or delayed) and use of acellular dermal matrix were most frequently studied. Preoperative referral of a plastic surgeon before mastectomy, complications associated with preoperative breast size, effects of hormone therapy on postoperative outcomes, and methods for detecting local recurrence after mastectomy were not being addressed by new research. Studies funded by the Plastic Surgery Foundation showed a similar pattern. Conclusions: Of the areas identified, some have received more attention than others. Gaps remain. The authors' results should spark interest in conducting research on these topics and, by so doing, strengthen the clinical practice guideline recommendations.

Reply: Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution

No abstract available

Where Do We Look? Assessing Gaze Patterns in Breast Reconstructive Surgery with Eye-Tracking Technology

Background: Aesthetics plays a large role in determining a successful outcome in plastic and reconstructive surgery. As such, understanding perceptions of favorable aesthetics is crucial for optimizing patient satisfaction. Eye-tracking technology offers an unbiased way of measuring how viewers evaluate breast reconstructions. Methods: Twenty-nine raters with varied plastic surgery experience were shown 20 images of breast reconstruction at various stages. Breasts were divided into those with nipples and no reconstruction scars, those with nipples and reconstruction scars, and those with reconstruction scars and no nipples. Raters viewed each image for 8 seconds to evaluate aesthetic outcomes. Eye-tracking equipment and software were used to track raters' gaze and analyze the distribution of attention. Results: In breasts with reconstruction scars and no nipples, viewers spent 53.9 percent of the view time examining scars, whereas viewers' attention was divided evenly in breasts with both reconstruction scars and nipples, spending 27.5 percent and 27.7 percent of view time examining the nipples and reconstruction scars, respectively. When examining complete reconstructions, viewers spent more time scanning the entire image before fixating on scars and spent less time on single-site fixation. Conclusions: Complete reconstructions, which notably include the final nipple-areola complex, appear to play an important role in restoring normal viewing parameters. In essence, completed breast reconstructions with nipple-areola complexes divert attention from extraneous surgical scars and lead viewers to assess the breasts more holistically. Eye-tracking technology provides a powerful link between objective gaze and viewer attention that may potentially be used to predict subjective aesthetic preferences.

Reply: Predictors of Autologous Free Fat Graft Retention in the Management of Craniofacial Contour Deformities

No abstract available

The Effect of Radiation on Quality of Life throughout the Breast Reconstruction Process: A Prospective, Longitudinal Pilot Study of 200 Patients with Long-Term Follow-Up

Background: Despite well-established correlation of postmastectomy radiotherapy and surgical complications in breast reconstruction, its impact on patient reported outcomes is less clear. We sought to determine the effect of postmastectomy radiotherapy on patient reported outcomes throughout the breast reconstruction process. Methods: Patients undergoing prosthetic and autologous breast reconstruction from November 2010 to June 2013 were prospectively followed with BREAST-Q surveys (preoperatively, after expander placement, and 6 and 12 months after final reconstruction). Paired t test, Wilcoxon rank sum test, and multiple linear regression were used to determine the effect of radiation on patient reported outcomes. Results: Two hundred patients were included in the study, of which 51 (25.5 percent) received postmastectomy radiotherapy. Prosthetic reconstruction was performed in 75 patients (37.5 percent), autologous reconstruction was performed in 118 (59 percent), and pure fat grafting was performed in seven (3.5 percent). At one-year follow-up, the nonirradiated group reported higher BREAST-Q scores when compared with the irradiated group, in Satisfaction with Breasts (p = 0.003), Psychosocial Well-being (p = 0.003), Sexual Well-being (p

Intraoperative Nerve Blocks Fail to Improve Quality of Recovery after Tissue Expander Breast Reconstruction: A Prospective, Double-Blinded, Randomized, Placebo-Controlled Clinical Trial

Background: The authors' study represents the first level I evidence to assess whether intraoperative nerve blocks improve the quality of recovery from immediate tissue expander/implant breast reconstruction. Methods: A prospective, randomized, double-blinded, placebo-controlled clinical trial was conducted in which patients undergoing immediate tissue expander/implant breast reconstruction were randomized to either (1) intraoperative intercostal and pectoral nerve blocks with 0.25% bupivacaine with 1:200,000 epinephrine and 4 mg of dexamethasone or (2) sham nerve blocks with normal saline. The 40-item Quality of Recovery score, pain score, and opioid use in the postoperative period were compared statistically between groups. Power analysis ensured 80 percent power to detect a 10-point (clinically significant) difference in the 40-item Quality of Recovery score. Results: Forty-seven patients were enrolled. Age, body mass index, laterality, mastectomy type, and lymph node dissection were similar between groups. There were no statistical differences in quality of recovery, pain burden as measured by visual analogue scale, opioid consumption, antiemetic use, or length of hospital stay between groups at 24 hours after surgery. Mean global 40-item Quality of Recovery scores were 169 (range, 155 to 182) for the treatment arm and 165 (range, 143 to 179) for the placebo arm (p = 0.36), indicating a high quality of recovery in both groups. Conclusion: Although intraoperative nerve blocks can be a safe adjunct to a comprehensive postsurgical recovery regimen, the authors' results indicate no effect on overall quality of recovery from tissue expander/implant breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.

Microbial Evaluation in Capsular Contracture of Breast Implants: Correction

No abstract available

Vertical Skin Paddle Orientation for the Latissimus Dorsi Flap in Breast Reconstruction: A Modification to Simultaneously Correct Inferior Pole Constriction and Improve Projection

Summary: The latissimus dorsi myocutaneous flap is a reliable and frequently used option to bring vascularized skin and soft tissue to improve the stability and aesthetic result in breast reconstruction. Standard techniques with skin paddle inset in a horizontal or oblique fashion preferentially improve anterior projection (when inset at the mastectomy scar) or lower pole and inframammary fold constriction (when inset into the inframammary fold). Here, the authors describe a modification for inset of the latissimus dorsi myocutaneous flap that improves both anterior projection and lower pole/inframammary fold constriction, and also allows the latissimus muscle to fan out and provide complete implant coverage. The vertical inset modification brings new skin and soft tissue into both the inferior pole and the central mastectomy scar, allowing simultaneous improvement in both areas and full use of the latissimus muscle to cover the implant or expander. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Reply: Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution

No abstract available

Evaluation of Preoperative and Postoperative Patient Satisfaction and Quality of Life in Patients Undergoing Rhinoplasty: A Systematic Review and Meta-Analysis

Background: Improvement of nasal aesthetics by means of rhinoplasty is a highly sought-after procedure and leads to increased patient confidence. The aim of the study was to provide a quantitative synthesis of existing data regarding the ability of cosmetofunctional rhinoplasty to improve patient satisfaction and quality of life measured by the Rhinoplasty Outcomes Evaluation scale. Methods: Electronic databases were searched for studies evaluating quality of life following aesthetic rhinoplasty. Study results were pooled and analyzed using a random effects model. Effect size was estimated using standardized mean difference at a 95 percent confidence interval. Heterogeneity and benefit were assessed and reported using the I2 and standard mean difference. Subgroup analyses were performed based on follow-up period and age group segregation. Results: A total of 377 articles were retrieved, of which eight studies were included in the final analysis. Overall, patient satisfaction analyzed by pooling eight observational studies improved following cosmetofunctional rhinoplasty (standard mean difference, 5.87; 95 percent CI, 3.55 to 8.19; I2 = 100 percent). In addition, further subgroup analyses revealed that maximum benefit was derived by younger patients (standard mean difference, 6.69; 95 percent CI, 3.65 to 9.74; I2 = 99 percent) compared with older patients (standard mean difference, 3.48; 95 percent CI, 3.01 to 3.96; I2 = 0 percent). Postoperative patient satisfaction levels showed maximum improvement during a follow-up period of 6 to 12 months (standard mean difference, 11.07; 95 percent CI, −8.79 to 32.12; I2 = 100 percent). Conclusion: Cosmetofunctional rhinoplasty improves patients' quality of life as evidenced by an improvement in Rhinoplasty Outcomes Evaluation scores. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Reply: Safety of Outpatient Circumferential Body Lift Evidence from 42 Consecutive Cases

No abstract available

Thread-Lift Sutures: Still in the Lift? A Systematic Review of the Literature

Background: In 2006, Villa et al. published a review article concerning the use of thread-lift sutures and concluded that the technique was still in its infancy but had great potential to become a useful and effective procedure for nonsurgical lifting of sagged facial tissues. As 11 years have passed, the authors now performed again a systematic review to determine the real scientific current state of the art on the use of thread-lift sutures. Methods: A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PubMed database and using the Medical Subject Headings search term "Rhytidoplasty." "Rhytidoplasty" and the following entry terms were included by this Medical Subject Headings term: "facelift," "facelifts," "face Lift," "Face Lifts," "Lift," "Face," "Lifts," "Platysmotomy," "Platysmotomies," "Rhytidectomy," "Rhytidectomies," "Platysmaplasty," "and "Platysmaplasties." The Medical Subject Headings term "Rhytidoplasty" was combined with the following search terms: "Barbed suture," "Thread lift," "APTOS," "Suture suspension," "Percutaneous," and "Silhouette suture." RefWorks was used to filter duplicates. Three of the authors (H.A.G., B.C., and B.L.) performed the search independently. Results: The initial search with all search terms resulted in 188 articles. After filtering the duplicates and the articles about open procedures, a total of 41 articles remained. Of these, the review articles, case reports, and letters to the editor were subsequently excluded, as were reports dealing with nonbarbed sutures, such as Vicryl and Prolene with Gore-Tex. This resulted in a total of 12 articles, seven additional articles since the five articles reviewed by Villa et al. Conclusions: The authors' review demonstrated that, within the past decade, little or no substantial evidence has been added to the peer-reviewed literature to support or sustain the promising statement about thread-lift sutures as made by Villa et al. in 2006 in terms of efficacy or safety. All included literature in the authors' review, except two studies, demonstrated at best a very limited durability of the lifting effect. The two positive studies were sponsored by the companies that manufacture the thread-lift sutures.

Reply: The Efficacy of Perforator Flaps in the Treatment of Chronic Osteomyelitis

No abstract available

Comparing Efficacy and Costs of Four Facial Fillers in Human Immunodeficiency Virus–Associated Lipodystrophy: A Clinical Trial

Background: The objective of this study was to evaluate and compare the safety and effectiveness of four different dermal fillers in the treatment of facial lipoatrophy secondary to human immunodeficiency virus. Methods: The authors conducted a clinical trial including 147 patients suffering from human immunodeficiency virus–induced lipoatrophy treated with Sculptra (poly-L-lactic acid), Radiesse (calcium hydroxylapatite), Aquamid (polyacrylamide), or autologous fat. Objective and subjective changes were evaluated during a 24-month follow-up. Number of sessions, total volume injected, and overall costs of treatment were also analyzed. A comparative cost-effectiveness analysis of the treatment options was performed. Results: Objective improvement in facial lipoatrophy, assessed by the surgeon in terms of changes from baseline using the published classification of Fontdevila, was reported in 53 percent of the cases. Patient self-evaluation showed a general improvement after the use of facial fillers. Patients reported being satisfied with the treatment and with the reduced impact of lipodystrophy on their quality of life. Despite the nonsignificant differences observed in the number of sessions and volume, autologous fat showed significantly lower costs than all synthetic fillers (p

ASPS/PSF Sponsored Symposia and Workshops

No abstract available

Combined toxicities of copper nanoparticles with carbon nanotubes on marine microalgae Skeletonema costatum

Abstract

To investigate the combined toxicities of copper nanoparticles (nano-Cu) with carbon nanotubes (CNTs) on marine microalgae Skeletonema costatum, algal growth inhibition tests were carried out. Toxicities of nano-Cu with CNTs and without CNTs on microalgae were determined, respectively. Chlorophyll content and photosynthetic efficiency (ΦPSII) were determined to compare negative effects of nano-Cu with CNTs and without CNTs on photosynthesis. The concentration of Cu²⁺ released by nano-Cu into the medium was determined, and interactions between nano-Cu and CNTs were analyzed to study toxic mechanisms of combined toxicities of nano-Cu with CNTs. It was found that both nano-Cu and CNTs could inhibit the growth of the microalgae; however, the toxicity of CNTs on the microalgae was far lower than that of nano-Cu. The maximum growth inhibition ratio (IR) of nano-Cu on the microalgae was 86% appearing at 96 h under 1.0 mg/L nano-Cu treatment, while the maximum IR of CNTs on the microalgae was 58% at 96 h under 200 mg/L CNT treatment. CNTs could reduce the toxicity of nano-Cu on the microalgae in processes of growth and photosynthesis. Adsorption of Cu²⁺ on CNTs and aggregate between Cu and CNTs in the medium were main reasons for attenuation of toxicity of nano-Cu with adding CNTs.

Books Received

ALEXANDER, ZEYNEP ÇELIK. Kineasthetic Knowing: Aesthetics, Epistemology, and Modern Design. (Chicago: University of Chicago Press). 2017. pp. 311. £40.54 (hbk).

Journals Received

JTLA, Journal of the Faculty of Letters, The University of Tokyo: Aesthetics.

Notes on Contributors

CHRISTOPHER BARTEL is an Associate Professor in Philosophy at Appalachian State University. His research interests primarily lie within aesthetics with a special focus on philosophy of music and philosophy of video games. He has published essays on the ontology of musical works, the ethics of video games, and historical inaccuracies in works of fiction. His essays have appeared in the British Journal of Aesthetics, Ethics and Information Technology, the European Journal of Philosophy, and the Journal of Aesthetics and Art Criticism.

Nahlowsky’s Psychological Aesthetics

Abstract

My article aims to revisit the aesthetic thought of the Austrian psychologist and philosopher Joseph Wilhelm Nahlowsky (1812–1885), as expounded in his formerly famous monograph Das Gefühlsleben. I show that although Nahlowsky was a direct heir of Herbart, his ideas were in keeping with both the contemporary debate about form and content and the then-emerging paradigm of psychological aesthetics. I describe his developments on aesthetic feelings and his remarkable attempt to elaborate a general psycho-affective theory on the experience of the aesthetic object. I also discuss the importance of the notion of form, inherited from Herbart, in his psychological aesthetics. Finally, I demonstrate that, in addition to having marked an 'affective' turn in Herbartianism, Nahlowsky was a key actor in the evolution of ideas in psychological aesthetics in the second half of the nineteenth century.

The Value of Fidelity in Adaptation

The adaptation of literary works into films has been almost completely neglected as a philosophical topic. I discuss two questions about this phenomenon:

• What do we mean when we say that a film is faithful to its source?
• Is being faithful to its source a merit in a film adaptation?

Appearance and History: the Autographic/Allographic Distinction Revisited

Abstract

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

Body Aesthetics

Body AestheticsIrvinSherri (ed.)OUP. 2016. pp. 352. £40.00 (hbk).

‘Nothing but Nonsense’: A Kantian Account of Ugliness1

Abstract

What does it mean for something to be judged ugly? On Kant's account of aesthetic judgment, an object judged beautiful brings about a 'free play of the imagination and the understanding', and is thus given as though 'purposive without purpose'; but ugliness, Kant claims, is the 'contrary to beauty'. Assuming Kant is correct on all counts, we would have to conclude that the object judged ugly would bring about a dynamic that is contrary to this ' free play', but that is nevertheless not its mere absence—since its absence is what is exhibited in usual cognitive, non-aesthetic judgment. Likewise, an ugly object is one that would have to be given as though contrapurposive, yet without running counter to any specific end of ours. In this essay, I try to clear up what this can mean, in order to clarify the judgment of ugliness.

‘It’s Just a Story’: Pornography, Desire, and the Ethics of Fictive Imagining

Abstract

Is it ever morally wrong for a consumer to imagine something immoral? Brandon Cooke has recently argued that it cannot be. On Cooke's account, fictive imagining is immune to moral criticism because such cases of imagining do not amount to the consumer's endorsement of the immoral content, nor do they imply that the authors of such fictions necessarily endorse their contents. We argue against Cooke that in fact fictively imagining something immoral can be morally blameworthy for the consumer, specifically in cases where fictive imagining is engaged in the service of immoral desires. Taking one potent case—namely, rape-fantasy pornography—we argue that the proper engagement with pornography requires the engagement of the consumer's desires, and that consumers often engage with works of pornography as a way of 'trying on' desires. Insofar as it is morally wrong to desire something immoral, then it is also morally wrong to cultivate an immoral desire; and for some consumers, fictive imagining is a means of cultivating immoral desires. In this restricted sense, we argue that it can be morally wrong for a consumer to engage in fictively imagining immoral things.

Eat this Book: A Carnivore’s ManifestoTaste as Experience. The Philosophy and Aesthetics of Food

Eat This Book: A Carnivore's ManifestoLestelDominique, Trans. Gary Steiner.Columbia University Press. 2016. pp. 160. £14.95 (pbk).

Strange Tools: Art and Human Nature

Strange Tools: Art and Human NatureNoëAlvaHill and Wang. 2015. pp. 304. £;21.81 (hbk).

Excellent Beauty: The Naturalness of Religion and the Unnaturalness of the World

Excellent Beauty: The Naturalness of Religion and the Unnaturalness of the WorldDietrichEricColumbia University Press. 2015. pp. xvi + 191xvi + 191. £25.00 (hbk).

Emotional Intimacy in Literature BSA Prize Essay, 2016

Abstract

When reading literature, we might have an emotional connection with the author, or at least what appears to be such, even when that literature is a work of fiction. But it is unclear how a work of fictional literature could supply the resources for such an experience. It is, after all, a work of fiction, not a report of the author's experience, as with memoir or autobiography. The task of this paper is twofold: first, to explain the nature and value of this emotional experience; second, to argue that a fictional literary work can supply the resources for such an experience.

Cerebrospinal fluid γδ T cell frequency is age-related: a case control study of 435 children with inflammatory and non-inflammatory neurologic disorders

Summary

Studies of cerebrospinal fluid (CSF) γδ T cells in children are limited, especially due to the lack of control data. In adults, gamma/delta T cells (TCR-γδ) residing in the intrathecal space are sometimes involved in neuroinflammation. To evaluate the possible role of γδ T cells in pediatric neuroinflammation, we immunophenotyped CSF and blood lymphocytes using flow cytometry in a case-control study of 100 children with non-inflammatory neurologic disorders (NIND), 312 with opsoclonus-myoclonus (OMS), and 23 with other inflammatory neurologic disorders (OIND). In NIND, the negative correlation between CSF γδ T cell frequency and patient age was striking: median frequency 27% in infants, 3.3% in teens. Inter-individual variations were largest in the youngest. There was no gender effect. In all OMS, after correcting for age, only a small effect of OMS severity remained. Measurement of markers for γδ T cell activation (HLA-DR), maturation (CD45RA, CD45RO), or intracellular cytokine staining (IL-4, IFN-γ) failed to discriminate OMS and NIND groups. Of 7 OMS immunotherapies/combinations, none significantly altered the frequency of total CSF γδ T cells or subsets. In OIND, the CSF γδ T cell frequency was <10% for single samples of other paraneoplastic disorders (ANNA-1, ANNA-2, teratoma-associated syndrome), cerebellar ataxia (post-infectious, ataxia-telangiectasia), acute disseminated encephalomyelitis, neuroborreliosis, and encephalitis. This study provides new insights into CSF γδ T cells in the pediatric population. Though their role in CSF remains elusive, the negative age correlation, resistance to immunotherapy, and our age cut-off references for NIND are important findings for the design of future pediatric studies. This article is protected by copyright. All rights reserved.

Sunscreen habits and skin cancer rates in patients with vitiligo in Australia

Use of oral immunosuppressive drugs in the treatment of atopic dermatitis in the Netherlands

Abstract

Background

Although atopic dermatitis (AD) is a very common skin disease, data on the percentage of patients with really difficult to treat AD are scarce. From socio-economic perspective it is important to have more insight in these numbers, as new very effective, but expensive, treatment options will be available in the near future for difficult to treat AD. Estimating the number of AD patients using oral immunosuppressive drugs can give an impression of the percentage of difficult to treat patients in the total AD population.

Objective

To give an overview of the use of oral immunosuppressive drugs in patients with AD in the Netherlands.

Methods

Prescription data of oral immunosuppressive drugs in the Netherlands were extracted from a pharmaceutical database (NControl) containing data of 557 million prescriptions and 7.2 million patients. An algorithm, based on the WHO Anatomical Therapeutic Chemical (ATC) codes, was used to identify patients with AD. The prescription of oral immunosuppressive drugs in patients with AD between January 1^st 2012 and January 1^st 2017 was evaluated.

Results

Based on the algorithm, 65 943 patients with AD were selected. 943 AD patients (1.4%) used cyclosporine A, methotrexate, azathioprine or mycophenolic acid. Methotrexate was most commonly used, followed by azathioprine and cyclosporine A. A switch in medication was rarely seen. In the evaluation period a decrease in the prescription of cyclosporine A was seen, together with an increase of the prescription of methotrexate. In 31% of the patients who stopped treatment, the discontinuation took place within the first months of treatment.

Conclusion

In this study population, 1.4% of the AD patients used oral immunosuppressive drugs for their eczema in a five year period. Methotrexate was the most commonly used systemic drug in the Netherlands for the treatment of AD.

This article is protected by copyright. All rights reserved.

Surgical treatment of hidradenitis suppurativa: an analysis of postoperative outcome, cosmetic results and quality of life in 255 patients

Abstract

Background

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with increasing incidence. Severe disease stages are seen as a therapeutic challenge and pose the threat of significant restrictions in patients' life quality.

Objectives

We evaluated postoperative outcome after wide local excision for HS as well as postoperative course, cosmetic results, disease recurrence and quality of life.

Methods

All patients receiving radical surgical treatment for HS (Hurley III) between 2006-2015 were identified and received a letter-based survey. They were asked about postoperative course, cosmetic results, recurrence and life quality.

Results

255 patients (103 men, 152 women) answered the questionnaire. 95% of patients reported disease-specific restrictions in everyday life. 72% of patients did not experience any postoperative adverse events, however, postoperative pain with need for analgesics was reported in 38%. The majority of patients (80%) were very satisfied or satisfied after surgery, 85% of patients would recommend surgery to other affected persons.

Limitations

The retrospective design of the study was a limitation.

Conclusions

The well-known negative psychological and social effects are a relevant part of HS and emphasize the importance of immediate therapy. Since long-lasting local disease-control can be achieved, surgery should be considered as first-line therapy.

This article is protected by copyright. All rights reserved.

Thumb necrotic ulcers caused by weeverfish. Case report and review of the literature

Abstract

a 59-year-old Caucasian man presented to our department with a three weeks history of erythema and edema of the left hand, and a necrotic ulcer of the left thumb, after a holiday in Greece, associated with extreme pain. No other skin or mucosal lesions were present. Systemic symptoms such as nausea, vomiting, hypotension, seizures, cardiac arrhythmias, or paralysis were denied. The local erythematous reaction started after fishing, during which the patient was attacked by a weeverfish (Fig. 1A); the wound was treated with topical antiseptics and antibioticum ointments, and seemed to granulate, but in the following week massive edema of the left hand developed (Fig. 1B), together with a rapidly progressive necrotic ulceration of the left thumb (Fig. 1C).

This article is protected by copyright. All rights reserved.

Imiquimod anal tampons treatment of anal intraepithelial neoplasia

Abstract

The prevalence of Human Papillomavirus (HPV) in men who have sex with men (MSM) is high, reaching 85-93% prevalence in HIV-positive men. High-risk HPV are strongly associated with development of high degrees of anal intraepithelial neoplasia (AIN) which, later on, can develop in anal squamous carcinoma. The growing incidence of anal cancer during last years is particularly important in MSM and HIV-positive patients, in which the coexistence of multiple serotypes of HPV reduces the probability of eliminating the AIN. The treatments for anal dysplasia have shown limited effectiveness. Imiquimod (1-[2-methylpropyl]-1H-imidazo-[4,5-c]-quinolin-4-amine) has been successfully used for different neoplasia.

This article is protected by copyright. All rights reserved.

Insulin resistance in hidradenitis suppurativa: a case-control study

Abstract

Background

The association between chronic inflammatory diseases, such as rheumatoid arthritis and psoriasis, and insulin resistance (IR) has been well established. Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disease that affects the apocrine gland-bearing areas of the body.

Objective

We aimed to determine the prevalence of IR in patients with HS.

Methods

This cross-sectional, case-control study enrolled 137 subjects, 76 patients with HS and 61 age- and gender-matched controls. Demographic data, clinical examination of HS patients, anthropometric measures, cardiovascular risk factors and laboratory studies were recorded. The homeostasis model assessment of IR (HOMA-IR) was calculated in all participants by measuring fasting plasma glucose and insulin levels.

Results

The median (IQR) HOMA-IR value in HS patients was significantly higher [2.0 (1.0-3.6)] than in controls [1.5(0.9-2.3)] (p=0.01). The prevalence of IR was significantly higher in cases (43.4%) compared with controls (16.4%) (p=0.001). In the linear regression multivariable analysis after adjusting for age, sex and body mass index (BMI), HS remained as a significant factor for a higher HOMA-IR [2.51(0.18) vs 1.92(0.21); p=0.04]. The HOMA-IR value and the prevalence of IR did not differ significantly among HS patients grouped by severity of the disease.

Conclusion

Our results show an increased frequency of IR in HS. Thus, we suggest HS patients to be evaluated for IR and managed accordingly.

This article is protected by copyright. All rights reserved.

Commentary on the paper: “efficacy of a novel strategy for poststernotomy deep sternal infection after thoracic aorta replacement using a prosthetic graft”

Publication date: Available online 26 February 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Raymund E. Horch

Effect of atopic skin stressors on natural moisturizing factors and cytokines in healthy adult epidermis

Abstract

Background

Epidermal deficiency of filaggrin, and the derived natural moisturizing factors (NMF), is associated with increased risk of atopic dermatitis (AD). While filaggrin gene mutations cause filaggrin deficiency, there is limited insight in causative environmental factors.

Objective

To explore the effect of selected exogenous skin stressors on NMF and skin cytokines levels in healthy adult epidermis.

Material and methods

40 healthy volunteers (18-49 years) were exposed to hard, soft, and chlorinated water, 0.5% SLS, house dust mite, cat allergen, staphylococcal enterotoxin B (SEB), cooling and histamine. Participants were tape-stripped and biophysiological measurements were performed. NMF was determined after 24 and 48 hours, while skin cytokines were measured after 24 hours for selected exposures.

Results

At 24 hours, a significant decrease in NMF was observed for soft (0.51±0.19) and hard water (0.61±0.32) compared to occlusion alone (0.71±0.18). Hard water led to increased levels of IL-4, IFN-ɣ and IL-10. Exposure to house dust mite and SEB led to a significant decrease in NMF after 24 hours (0.77 ±0.28 and 0.80±0.28, respectively) compared to occlusion alone (1.00±0.42). House dust mite led to an increase in IFN-ɣ, IL-2 and IL-4, as compared to the non-occluded control site.

Conclusion

Based on experimental exposure to selected atopic skin stressors such as different water types, allergens and SEB, we conclude that NMF levels are decreased along with increased secretion of various skin cytokines in healthy individuals. Our data highlight environmental factors that might play a role in AD pathophysiology, but needs confirmation in AD patients.

This article is protected by copyright. All rights reserved.

Globular adiponectin acts as a melanogenic signal in human epidermal melanocytes

Summary

Background

Adiponectin is an adipocyte-derived cytokine which circulates as a full-length protein and a fragment containing the globular domain of adiponectin (gAd). A recent study has reported the anti-melanogenic effects of full-length adiponectin.

Objectives

To examine the involvement of gAd in melanogenesis and its action mechanisms.

Methods

The effects of gAd on melanogenesis and its mechanism of action were investigated in human epidermal melanocytes and reconstructed epidermis, and they included the levels of melanin content, cellular tyrosinase activity, cAMP production and protein kinase A (PKA) activity, expression and phosphorylation of signaling molecules.

Results

Exogenous gAd increased the melanin content, and the mRNA levels of microphthalmia-associated transcription factor (MITF) and its downstream genes tyrosinase and tyrosinase-related protein (TRP)-1, but not TRP-2, were increased by gAd. However, cAMP production and PKA activity were not affected by gAd. Moreover, attempts to elucidate the underlying mechanism behind the gAd-mediated effect revealed that gAd could regulate melanogenesis by upregulating MITF through phosphorylation of the cAMP response element-binding protein (CREB). In addition, upregulation of MITF was mediated through activation of adenosine monophosphate-activated protein kinase (AMPK)-p38MAPK signaling. Taken together, these findings indicate that promotion of melanogenesis by gAd occurs through increased expression of the MITF gene, which is mediated by activation of the AMPK-p38MAPK-CREB pathway.

Conclusions

These findings suggest that gAd contributes to epidermal homeostasis via its effect on melanocyte biology, and products of adipose tissue could affect epidermal biology.

This article is protected by copyright. All rights reserved.

Nonlinear Optical Microscopy for Melanoma: Challenges, Tools, and Opportunities

Abstract

The natural pigments known as melanins are thought to play a role in the etiology and progression of melanoma, but many of their roles are currently not well understood. While quantification of melanins have, up until now, have been performed in bulk, new imaging technologies have unlocked the means to visualize and quantify melanins. The nonlinear imaging methods known as Pump-Probe, Coherent Raman, and Sum Frequency Absorption microscopies, provide subcellular resolution imaging of melanins, enabling label-free, longitudinal quantification of both eumelanin and pheomelanin in situ and in vivo. These nonlinear imaging toolkits have been well proven in both animal models and human samples, moving them tantalizingly close to clinical application. Future efforts integrating these tools into practical, mobile imaging systems will provide immense benefit both to clinical research and practice.

This article is protected by copyright. All rights reserved.

Annual Ambient UVB at Wavelengths that Induce Vitamin D Synthesis is Associated with Reduced Oesophageal and Gastric Cancer Risk: a Nested Case-Control Study

Abstract

Vitamin D has been shown to be beneficial at reducing the risk of cancer, however studies examining oesophageal and gastric cancer have been scarce and findings inconsistent. The UK Biobank cohort was used for this nested case-control study (N=3,732). Primary, incident oesophageal and gastric cancer cases diagnosed after recruitment were identified via linkage to National Cancer Registries. Tropospheric emissions monitoring internet service database was used to calculate ambient annual UVB dose (D-UVB). Conditional logistic regression was used to investigate the relationship between annual ambient D-UVB and risk of oesophageal and gastric cancer and odds ratios (OR) are reported. In total, 373 oesophageal and 249 gastric cancer cases and 3,110 age- and gender-matched controls were included in the study. We found a strong inverse association between annual ambient UVB and odds of developing oesophageal or gastric cancer: compared to the lowest tertile, OR for the highest tertile was 0.64 (95%CI:0.51-0.79) in adjusted analysis. The association was strengthened when restricted to oesophageal cancer (OR=0.60;95%CI:0.45-0.80), and oesophageal adenocarcinoma cases (OR=0.48;95%CI:0.34-0.68). Similar results were found in unadjusted and stratified analysis. In conclusion, ambient UVB radiation is inversely associated with the development of oesophageal and gastric cancer, even in a high latitude country.

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UV-irradiated 2-methyl-4′-(methylthio)-2-morpholinopropiophenone-containing injection solution produced frameshift mutations in the Ames mutagenicity assay

Abstract

In previous studies, we detected the photoinitiators 1-hydroxycyclohexyl phenyl ketone (1-HCHPK), methyl 2-benzoylbenzoate (MBB), and 2-methyl-4′-(methylthio)-2-morpholinopropiophenone (MTMP) in intravenous injection solutions. In addition, we reported that 1-HCHPK, MBB, and MTMP exhibited cytotoxicity towards normal human peripheral blood mononuclear cells. A previous in vitro study reported that a free-radical photoinitiator introduced covalently bound purine residues into DNA. However, little is known about the in vitro mutagenicity of 1-HCHPK, MBB, and MTMP. In the present in vitro study, we evaluated the mutagenicity of 1-HCHPK, MBB, and MTMP using the Ames test. We found that untreated 1-HCHPK, MBB, and MTMP were not mutagenic in S. typhimurium strain TA97, TA98, TA100, TA102, or TA1535, regardless of the presence/absence of S9 activation. However, ultraviolet (UV) light-irradiated MTMP exhibited mutagenicity in S. typhimurium strain TA97 in the absence of S9 activation. In conclusion, we suggest that exposure to UV-irradiated MTMP, including in intravenous injection solutions, can result in frameshift mutations.

Necrobiotic xanthogranuloma associated with chronic lymphocytic leukemia

Two cases of seborrheic keratosis of the external ear canal: involvement of PIK3CA and FGFR3 genes

Abstract

Background

Seborrheic keratosis (SK) of the outer ear canal is rarely described in literature. Etiological risk factors involved in SK such as exposure to human papillomavirus (HPV) and ultraviolet (UV) light are established but must still be confirmed. In recent years, new insights into the pathogenesis of SKs occurred in the area of molecular pathogenesis. Fibroblast growth factor receptor 3 (FGFR3) gene and p110α subunit of phosphoinositide 3-kinase (PIK3CA) oncogene mutations are known to be involved.

Methods

We describe two cases of SK of the outer ear canal. We conducted a review of literature and examined the role of etiological risk factors involved in our cases. The lesions were primarily treated with surgical resection. Postoperatively, in both patients, the lesions recurred after a considerably long disease-free interval. We tested both FGFR3 and PIK3CA genes for mutations, in the primary and recurrent lesions.

Results

We did not find any mutations in both genes in all samples.

Conclusion

Additional research is needed to further establish possible etiological risk factors and to clarify the involvement of PIK3CA and FGFR3 genes in the pathogenesis of seborrheic keratosis of the outer ear canal. These cases underscore the need for meticulous diagnosis, treatment, and sufficient long-term follow-up.

Review of Reconstructing ‘Education’ Through Mindful Attention: Positioning the Mind at the Center of Curriculum and Pedagogy , Oren Ergas

Abstract

This paper provides a review of Reconstructing 'Education' through Mindful Attention: Positioning the Mind at the Center of Curriculum and Pedagogy by Oren Ergas. The review examines the central argument of the book, namely that present educational theory and practice avoids substantial self-inquiry, paying lip service to reflective practice but stopping short of any real encounter with the complex dynamics of the self. In Ergas' bold inquiry, we are invited to attend and to see for ourselves by considering perspectives and practices rooted in contemplative traditions. The educational context becomes clear as attention to the self entails formation of the self. However, I argue that it is not clear why contemplative traditions (or mindful attention defined by the text) are best placed to engage in such formation. I suggest that a central problem with the book is the conflation here of education and socialisation, and that more systematic treatment of educational questions might obviate some of the troubling issues around the failures of what is called the inner curriculum.

Out-of-pocket expenditure on maternity care for hospital births in Uttar Pradesh, India

The studies measured Out-of-Pocket Expenditure (OOPE) for hospital births previously suffer from serious data limitations. To overcome such limitations, we designed a hospital-based study for measuring the lev...

In vivo characterization of pustules in Malassezia Folliculitis by reflectance confocal microscopy and optical coherence tomography. A case series study

Abstract

Background and objective

Malassezia Folliculitis (MaF) is an inflammatory condition of hair follicles caused by Malassezia yeast. Optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) are imaging technologies enabling in vivo visualization of superficial skin layers. This study explores morphology of pustules in MaF imaged by OCT and RCM.

Methods

Patients with microscopically verified MaF were included in this case series. Morphology was evaluated qualitatively with RCM and OCT, focusing on shape, border and content of selected pustules.

Results

Nine patients with MaF were included. Clinically, six patients presented monomorphic MaF with multiple superficial pustules, while three patients showed more polymorph MaF appearance. In total 13 pustules were investigated by RCM and OCT. In RCM images, pustules varied from having a well-defined border with homogenous content to ill-defined borders with heterogeneous content. A distinct black halo was occasionally observed around pustules as were dilated vessels. In OCT images, pustules appeared polymorphic, showing both well- and ill-defined structures with oval or irregular shape and more or less homogenous content. Malassezia fungi were not discernible by either RCM or OCT. Specific morphological image features in RCM and OCT did not reflect different clinical manifestations of MaF.

Conclusion

RCM and OCT images identify morphological aspects of MaF pustules, and confirm that MaF is a folliculitis with clinical as well as morphological variance.

Superficial Inferior Epigastric Artery Flap Salvage Technique Using Deep Inferior Epigastric Artery Graft

Summary: Superficial inferior epigastric artery (SIEA) flap salvage remains challenging, particularly in cases of arterial insufficiency due to vessel spasm, pedicle kinking, or thrombosis. The already small, short SIEA pedicle, in addition to its inherent tendency toward spasm, renders the SIEA flap more difficult to manage when anastomotic revision is required. Furthermore, arterial thrombosis will cause dilation of the internal mammary artery, exacerbating vessel mismatch. In our previously published experience with 145 SIEA flaps, no flap with postoperative arterial thrombosis was salvageable. Following this experience, a new salvage technique using deep inferior epigastric artery grafts has been utilized and is described here.

Evaluation of nanoparticle emissions from a laser printer in an experimental chamber and estimation of the human particle dose

Abstract

The aim of this study was to evaluate the nanoparticle emissions from a laser printer in a chamber in conjunction with emissions from printers in a print room (PR) and to characterize the processes that lead to increased nanoparticle concentrations, as well as to estimate the human particle dose of the printers' users. Measurements were conducted in a small stainless steel environmental chamber under controlled conditions, where the evolution of particle size distributions (PSDs) with time and printed pages was studied in detail. Printer was generating nanoparticles (vast majority ˂ 50 nm with mode on ~ 15 nm) primarily during cold startup. Previously, 1-week sampling was also done in a PR at the Technical University of Crete, where the tested laser printer is installed along with three other printers. Similarly, as it was observed in the chamber study, printers' startup on any given day was characterized by a sharp increase in particle number (PN) concentrations. Average measured PN concentrations during printing hours in PR (5.4 × 10³ #/cm³) is similar to the one observed in chamber measurements (6.7 × 10³ #/cm³). The ExDoM2 dosimetry model was further applied to calculate the deposition of particles in the human respiratory tract. More precisely, the increase in particle dose for an adult Caucasian male was 14.6- and 24.1-fold at printers' startup, and 1.2- and 5.2-fold during printing in the PR and experimental chamber, respectively, compared to the exposure dose at background concentrations (BCs).

The influencing factors of CO 2 emission intensity of Chinese agriculture from 1997 to 2014

Abstract

In China, agriculture produces the greatest chemical oxygen demand (COD) emissions in wastewater and the most methane (CH₄) emissions. It is imperative that agricultural pollution in China be reduced. This study investigated the influencing factors of the CO₂ emission intensity of Chinese agriculture from 1997 to 2014. We analyzed the influencing factors of the CO₂ emission intensity through the first-stage least-square regression. We also analyzed determinants of innovation through the second-stage least-square regression. We found that innovation negatively affected the CO₂ emission intensity in the model of the nation. FDI positively affected innovation in China. It is important to enhance indigenous innovation for green agriculture through labor training and collaboration between agriculture and academia.

Depth treatment of coal-chemical engineering wastewater by a cost-effective sequential heterogeneous Fenton and biodegradation process

Abstract

In this study, a sequential Fe⁰/H₂O₂ reaction and biological process was employed as a low-cost depth treatment method to remove recalcitrant compounds from coal-chemical engineering wastewater after regular biological treatment. First of all, a chemical oxygen demand (COD) and color removal efficiency of 66 and 63% was achieved at initial pH of 6.8, 25 mmol L⁻¹ of H₂O₂, and 2 g L⁻¹ of Fe⁰ in the Fe⁰/H₂O₂ reaction. According to the gas chromatography-mass spectrometer (GC-MS) and gas chromatography-flame ionization detector (GC-FID) analysis, the recalcitrant compounds were effectively decomposed into short-chain organic acids such as acetic, propionic, and butyric acids. Although these acids were resistant to the Fe⁰/H₂O₂ reaction, they were effectively eliminated in the sequential air lift reactor (ALR) at a hydraulic retention time (HRT) of 2 h, resulting in a further decrease of COD and color from 120 to 51 mg L⁻¹ and from 70 to 38 times, respectively. A low operational cost of 0.35 $ m⁻³ was achieved because pH adjustment and iron-containing sludge disposal could be avoided since a total COD and color removal efficiency of 85 and 79% could be achieved at an original pH of 6.8 by the above sequential process with a ferric ion concentration below 0.8 mg L⁻¹ after the Fe⁰/H₂O₂ reaction. It indicated that the above sequential process is a promising and cost-effective method for the depth treatment of coal-chemical engineering wastewaters to satisfy discharge requirements.

Intravesicular taxane-induced dermatotoxicity in a 78-year-old man with urothelial carcinoma and primary cutaneous anaplastic large cell lymphoma

Patients treated with intravesical bacillus Calmette-Guerin therapy for urothelial carcinoma often become refractory and experience recurrent disease, thus necessitating alternative intravesical treatment modalities if the patient is to be spared the morbidities associated with radical cystectomy. Intravesical treatment with taxane-based chemotherapy, such as docetaxel, has gained traction in urologic oncology, proving to be an effective salvage therapy in such patients. Systemic taxane-based chemotherapeutic regimens have long been used in several advanced malignancies, and their systemic side effects and associated histologic correlates have been extensively documented. In contrast to adverse effects associated with systemic administration, intravesical taxane administration has thus far proven to be well-tolerated, with little to no systemic absorption. To our knowledge, features of taxane-induced systemic effects have not been reported in this setting. Herein, we report a case of a patient with recurrent urothelial carcinoma treated with intravesical docetaxel, along with primary cutaneous anaplastic large cell lymphoma, who developed characteristic dermatotoxic histologic findings associated with intravenous taxane administration. As such histopathologic findings often represent close mimickers of neoplastic and infectious etiologies, knowledge of the potential for systemic manifestations of taxane therapy in patients treated topically may prevent potentially costly diagnostic pitfalls.

Colliding, Colonizing, or Combining?: Four Cases Illustrating the Unique Challenges of Melanoma arising in conjunction with Basal Cell Carcinoma

Biphasic lesions comprised of melanocytic and epithelial components are rare entities believed to arise either as a collision of two histologically distinct lesions in the same anatomic location or as a singular progenitor tumor differentiating along two differing lineages. Regardless of mechanism of origin, these tumors present unique challenges in pathologic interpretation and in determining appropriate measurements, which assigns subsequent prognosis to the patient.

We present 4 tumors of melanoma co-existing with basal cell carcinoma and discuss relevant literature regarding these biphasic entities. Patients consisted of 3 males and 1 female, ranging in age from 62–93, with lesions located on the shoulder, frontal scalp, forearm, and nose. Three of four lesions demonstrated melanoma cells limited to basal cell carcinoma tumor lobules, without evidence of direct dermal invasion by melanoma cells, raising question of whether or not these tumors should be classified as in situ or invasive melanoma.

These cases highlight the complexity that such lesions pose to dermatopathologists, in terms of their uncertain origin and variable microscopic appearance. In the absence of data regarding outcomes for these tumors (given their rarity), it is important to utilize a case-by-case approach with careful clinical correlation and appropriate use of ancillary techniques.

How to take better photomicrographs: a step-wise approach

Digital photomicrographs are often used to illustrate cutaneous diseases; however, there exists no formal protocol on how to best capture these images. We present a nine-step photomicrographing protocol for dermatopathologists, using standard overhead cameras or smartphones alongside image editing packages. A notable difference in image quality is observed when using our detailed photomicrographing protocol compared to routinely procured photomicrographs.

Correction to: Behaviour and risk assessment of fluopyram and its metabolite in cucumber ( Cucumis sativus ) fruit and in soil

Abstract

Unfortunately, the original publication of this paper contains a mistake. The correct name of the 3rd Author is Sunny H. Patel. The original article has been corrected.

Fluorinated waste and firefighting activities: biodegradation of hydrocarbons from petrochemical refinery soil co-contaminated with halogenated foams

Abstract

Perfluorinated compounds, including fluorotelomers, are important constituents of firefighting foams to extinguish fuel fires in the petrochemical industry, airports, and at fire-training sites. In this study, we monitored the biodegradation process in a co-contamination scenario with monoaromatic hydrocarbons commonly found in fuels (benzene, toluene) and fluorotelomers. The CO₂ production rates were evaluated by a factorial design taking into account the effect of seasonality at in situ natural attenuation processes. Headspace analysis by gas chromatography with a thermal conductivity detector (GC-TCD) was applied to detect CO₂ production, whereas monoaromatics were analyzed by gas chromatography coupled to mass spectrometry (GC–MS). According to our results, seasonality had a detectable effect during summer, yielding different CO₂ production rates. Higher temperatures increased CO₂ production rate, while higher concentrations of fluorotelomer inhibited the biodegradation process. On average, benzene and toluene were depleted 17.5 days earlier in control assays without fluorotelomers. Toluene removal efficiency was also notably higher than benzene. The noticeable decrease in degradation rates of monoaromatics was caused by perfluorinated compounds that are possibly linked to metabolic inhibition mechanisms. Fluorotelomer diminished catabolism in all of our batch cultures. In addition to this, an alternative production of by-products could be detected. Thus, we propose that transient components of the benzene and toluene degradation may be differentially formed, causing the benzene, toluene, and perfluorinated co-contaminations to go through switched metabolic stages under the presence of fluoride in a contamination scenario.

Enhancing denitrification with waste sludge carbon source: the substrate metabolism process and mechanisms

Abstract

Using waste sludge internal carbon source for nitrogen removal in wastewater has drawn much attention, due to its economic advantages and sludge reduction. In this study, the performance of enhanced denitrification with waste sludge thermal hydrolysate and fermentation liquid as carbon sources at different SCOD/N (soluble chemical oxygen demand/NO₃^--N) was investigated. The optimum SCOD/N was 8 for sludge thermal hydrolysate and 7 for fermentation liquid, with NO₃^--N removal efficiency of 92.3 and 98.9%, respectively, and no NO₂^--N accumulation. To further understand the fate of sludge carbon source during denitrification, the changes of SCOD, proteins, carbohydrates, and volatile fatty acids (VFAs) were analyzed, and three-dimensional fluorescence excitation-emission matrix (EEM) spectroscopy with fluorescence regional integration (FRI) analysis was introduced. The utilization of SCOD was consistent with NO₃^--N reduction, and the utilization efficiency of different organic matter was as follows: VFAs > proteins > carbohydrates. The soluble organic-like materials (region IV) were the most readily utilized organic matter according to three-dimensional fluorescence EEM spectroscopy. Regarding denitrification mechanisms, the denitrification rate (V_DN), denitrification potential (P_DN), heterotroph anoxic yield (Y_H), and the most readily biodegradable COD (S_S) were also investigated.

Polycyclic aromatic hydrocarbons in a bakery indoor air: trends, dynamics, and dispersion

Abstract

Indoor air pollution assessment in work environments remains challenging due to a combination of logistic reasons and availability of costly instrumentation for data acquisition and post-processing. Existing literature focuses on energy production environments, hospitals, and less so on food production spaces. Studies on indoor air quality in bakeries are scarce or even absent. Motivated by this, the present study investigates indoor air quality in a bakery located in Bari province in South Italy, using a combination of approaches including analytical chemistry analyses and computational fluid dynamics to reconstruct the air ventilation in response to air temperature gradients within the working environment. PM_2.5 indoor samplings were collected every 6 h from 7 to 19 April 2013 in the proximity of two bakery ovens powered by gas and wood, respectively. For each sampling day, 4 PM_2.5 samples were collected: from 3:00 to 9:00 h (first), from 9:00 to 13:30 h (second), from 14:00 to 21:00 h (third), and from 21:00 to 3:00 h (fourth). In total, 40 samples were collected. On each sample, several polycyclic aromatic hydrocarbons (PAHs) were determined such as benzo[a]anthracene (228), benzo[b]fluoranthene (252), benzo[k]fluoranthene (252), benzo[a]pyrene (252), benzo[g,h,i]perylene (276), indeno[1,2,3-cd]pyrene (276), and dibenzo[a,h]anthracene (278), the main compounds of 16 priority US Environmental Protection Agency (US-EPA) PAHs in particulate phase. The PAH mean concentrations showed higher values during the first (from 3:00 to 9:00 h) and fourth (from 21:00 to 3:00 h) sampling intervals than the other two with benzo[a]pyrene mean values exceeding the Italian law limit of 1 ng/m³. Taking into account benzo[a]pyrene mean concentration for the first interval and the first plus the second one, which are the hours with the largest working activity, we have estimated that the baker and co-workers are exposed to a cancer risk of 4.3 × 10⁻⁷ and 5.8 × 10⁻⁷, respectively (these values are lower than US-EPA recommended guideline of 10⁻⁶). Our study was complemented by numerical analyses using state-of-the-art computational fluid dynamics to reconstruct at high resolution air movement from the various working places, i.e., the bakery and the selling area which were connected via a door. The numerical simulations were possible given that surface temperature using infrared thermography as well as air temperature was continuously recorded throughout the sampling acquisition. The use of this approach allowed us to estimate the transport and diffusion of benzo[a]pyrene from one area to the other thus complementing the point sampling information. Computational fluid dynamic simulation results confirm the presence of benzo[a]pyrene in the laboratory as obtained from the measurements and suggests its presence in the sales' area of the bakery with concentrations similar those found in the laboratory.

Undifferentiated headache: broadening the approach to headache in children and adolescents, with supporting evidence from a nationwide school-based cross-sectional survey in Turkey

Headache is a leading disabler in adults worldwide. In children and adolescents, the same may be true but the evidence is much poorer. It is notable that published epidemiological studies of these age groups h...

Exposure of human melanocytes to UVB twice and subsequent incubation leads to cellular senescence and senescence-associated pigmentation through the prolonged p53 expression

Skin aging is induced both intrinsically and extrinsically, with intrinsic aging reflecting the genetic background and dependent upon the passage of time, whereas extrinsic aging is caused by environmental factors, such as ultraviolet radiation (UVR), smoking, alcohol abuse, and poor nutrition [1,2]. Among these environmental factors, UVR contributes to up to 80% of the acceleration of skin aging by inducing DNA damage (photoaging) or by activation of diverse oncogenes [3]. To prevent DNA damage by UVR, skin cells harbor well-coordinated systems, including those associated with cell cycle checkpoints, DNA repair, apoptosis, and premature senescence.

Efficacy and safety of topical SR-T100 gel in treating actinic keratosis in Taiwan: A Phase III randomized double-blind vehicle-controlled parallel trial

Actinic keratosis (AK) is the precursor lesion of cutaneous squamous cell carcinoma (SCC) and displays squamous cell dysplasia confined to the epidermis [1]. AK is exceedingly common in the skin of elderly Caucasians who have chronic exposure to sunlight [2–4]. The actual risk regarding progression from AK to invasive SCC for specific individual lesions is not known, but is estimated to be approximately 0.25–20% per year [5]. Remarkably, up to 60% of invasive SCC was derived from AK [6]. Therefore, the current treatment consensus recommends eradication of all AK when detected clinically [5,7,8].

IL-33 down-regulates CLDN1 expression through the ERK/STAT3 pathway in keratinocytes

A skin barrier defect is a well-known distinctive feature of atopic dermatitis (AD). Stratum corneum (SC) and tight junction (TJ) molecules play important roles in the barrier function of keratinocytes [1]. TJs are major barrier structures of the skin, tightly connecting neighboring cells and restricting the paracellular passage of substances [2]. TJs are composed of numerous proteins such as occludin (OCLN), junctional adhesion molecule A, zonula occludens (ZO)-1 and, −2, cingulin, symplekin, and claudin (CLDN) [2].