Opinions on Authorship: A Survey of Plastic Surgery Residents and Fellows

Background Scientific publications are the cornerstone of scholarly activities. The importance of appropriately assigned authorship cannot be overstated. Hence, we felt it prudent to examine the perception of plastic surgery trainees regarding authorship. We hypothesized that plastic surgery trainees would not be in compliance with International Committee of Medical Journal Editors guidelines when determining what constitutes an authorship justifying contribution. Methods An online survey describing 4 distinct scenarios was distributed to plastic surgery trainees at 2 academic institutions using the Qualtrics research software (Provo, UT). Additional parameters queried included level of training and number of publications. Linear regression models were used to test correlation between responses and level of training and number of publications. Results Thirty-three of 48 trainees responded (response rate, 68.8%). All respondents had previously authored publications, with the majority (54.5%) having at least 10 publications. Although none of the scenarios presented justified authorship based on international guidelines, 33.3% of respondents believed that authorship was warranted in at least 3 of the 4 presented scenarios. Linear regression comparing for demographic variables to number of perceived authorship scenarios found a mild-moderate positive correlation with level of training (R = 0.34, P = 0.05) and number of publications (R = 0.32, P = 0.07). Conclusions Plastic surgery trainees do not seem to be familiar with guidelines regarding authorship justifying contributions. It is important to raise awareness regarding criteria that warrant authorship and to educate our residents and fellows in matters of appropriate scholarly conduct because nothing short of the credibility of our scientific endeavors is otherwise in question.

Nipple-Sparing Mastectomy and Immediate Breast Reconstruction With a Deep Inferior Epigastric Perforator Flap: A Study of Patient Satisfaction

Introduction The morphological result of nipple-areola complex (NAC) reconstruction may be disappointing for patients who undergo skin-sparing mastectomies and immediate breast reconstruction, followed by secondary reconstruction of the nipple-areola complex. The aim of this study was to analyze patient satisfaction after nipple-sparing mastectomy and immediate breast reconstruction with a deep inferior epigastric perforator flap. Materials and Methods Our retrospective study involved all patients who underwent an immediate breast reconstruction after unilateral mastectomy with conservation of the NAC. The following three kinds of surgical approach were used: mastectomy with periareolar incision, mastectomy with hemiperiareolar incision and lateral extension, and mastectomy with inverted-T mammoplasty incision. Our study was based on a survey using a standardized questionnaire and a Likert scale to report patient satisfaction on the basis of criteria defined by the investigators. Results We evaluated 17 patients. All reconstruction patients were satisfied or very satisfied with the overall aesthetic appearance, projection, and volume as well as the appearance of scarring on the reconstructed breast. None of our patients reported dissatisfaction in response to the criteria under evaluation. A periareolar incision was used most often to perform the mastectomy (10 patients). Partial NAC necrosis was observed in five patients, without negatively influencing their perception of the morphological outcome of their reconstruction. Conclusions Immediate breast reconstruction using a deep inferior epigastric perforator free flap after nipple-sparing mastectomies met with a high rate of general satisfaction among patients and resulted in a low rate of nipple-areola complex necrosis.

Book Review: New Concepts on Abdominoplasty and Further Applications

No abstract available

Complications and Patient-Reported Outcomes in Male-to-Female Vaginoplasty—Where We Are Today: A Systematic Review and Meta-Analysis

Introduction There is an increased need for evidence-based practices in male-to-female (MtF) transgender vaginoplasty. Although there are a multitude of surgical techniques, there is a paucity of data comparing these procedures. A systematic review of retrospective studies on the outcomes of MtF vaginoplasty was conducted to minimize surgical complications and improve patient outcomes for transgender patients. Methods Applying the Preferred Reporting Items for Systematic Review and Meta-Analysis, a comprehensive search of several databases from 1985 to November 7, 2017, was conducted. The databases included PubMed, Ovid MEDLINE Epub Ahead of Print, Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, and Web of Science. The resulting publications were screened, and those that met our specified inclusion/exclusion criteria were analyzed. The DerSimonian and Laird random-effects model was used to pool complications and patient-reported outcomes. Results A total of 471 articles were initially identified, of which 46 met our eligibility criteria. A total of 3716 cases were analyzed. Overall incidence of complications included the following: 2% (1%–6%) fistula, 14% (10%–18%) stenosis and strictures, and 1% (0%–6%) tissue necrosis, and 4% (2%–10%) prolapse (upper and lower limits of the 95% confidence interval). Patient-reported outcomes included a satisfaction rate of 93% (79%–100%) with overall results, 87% (75%–96%) with functional outcomes, and 90% (79%–98%) with esthetic outcomes. Ability to have orgasm was reported in 70% (54%–84%) of patients. The regret rate was 1% (0%–3%). The length of the vaginal cavity was 12.5 cm (6.3–4.4 cm). Conclusions Multiple surgical techniques have demonstrated safe and reliable means of MtF vaginoplasty with low overall complication rates and with a significant improvement in the patient's quality of life. Studies using different techniques in a similar population and standardized patient-reported outcomes are required to further analyze outcomes among the different procedures and to establish best-practice guidelines.

Course Review: Birmingham and Coventry Hand and Forearm Cadaveric Dissection Course

Hand surgery constitutes an important part of plastic surgery and orthopedic training curricula. Although the value of simulation-based training is being increasingly recognized, attendance at such courses may be limited owing to cost, availability, and non–learner-centered schedules. The Birmingham and Coventry hand and forearm cadaveric dissection course is a 1-day course with a loose agenda that offers an inexpensive and learner-centered approach toward surgical access, dissection, and soft tissue coverage in the upper limb. This course is held in Coventry, United Kingdom, at a cost of £165 ($220 US dollars). In this review, we provide an evaluation of the course.

Repeated Use of Gluteal Fold Flaps for Post–Oncologic Vulvoperineal Reconstruction

Background and Aim Because of the associated high recurrence rate, future reconstructive options should be reckoned with during surgical treatment of primary or recurrent (pre)malignant vulvoperineal lesions. One of the claimed advantages of the gluteal fold flap is the possibility of repeated use of the flap in case of recurrence. We present our experience with such reuse of gluteal fold flaps to illustrate this possibility. Methods A mean of 27 months after initial use, 10 subcutaneously pedicled or perforator-based V-Y advancement or propeller-rotation flaps were elevated from previously used gluteal fold flaps in 9 women presenting with recurrent vulvoperineal (pre)malignancy. Five of these women had undergone radiotherapy prior to flap reuse. Results Although short-term complications were observed in 3 women, all flaps survived and healed completely. Conclusions We showed the feasibility of successful reuse of subcutaneous pedicled or perforator-based gluteal fold flaps for repeated vulvoperineal reconstruction, both in nonirradiated and irradiated women. This concept of reuse of the gluteal fold flap is useful for recurring (pre)malignant vulvoperineal defects, and reconstructive surgeons and patients may benefit from this potential option.

Course Review: AOTrauma—Hand Fixation for Surgeons

Hand trauma forms an important part of plastic surgery and orthopedic training curricula. Although numerous practical hand trauma courses exist, there is always difficulty in achieving the right balance between educational content and practical workshops. AOTrauma—Hand Fixation for Surgeons is a 2.5-day course for plastic surgery and orthopedic trainees that aims to instill the principles of hand fracture fixation and soft tissue coverage through self-directed learning, lectures, small group discussion, and dry bone practical workshops. This course with international faculty and delegates is held in Leeds, United Kingdom, at a cost of 860 Swiss francs (880 US dollars). In this review, we provide an evaluation of the course.

Extracorporeal Perfusion in Vascularized Composite Allotransplantation: Current Concepts and Future Prospects

Severe injuries of the face and limbs remain a major challenge in today's reconstructive surgery. Vascularized composite allotransplantation (VCA) has emerged as a promising approach to restore these defects. Yet, there are major obstacles preventing VCA from broad clinical application. Two key restrictions are (1) the graft's limited possible ischemia time, keeping the potential donor radius extremely small, and (2) the graft's immunogenicity, making extensive lifelong monitoring and immunosuppressive treatment mandatory. Machine perfusion systems have demonstrated clinical success addressing these issues in solid organ transplantation by extending possible ischemia times and decreasing immunogenicity. Despite many recent promising preclinical trials, machine perfusion has not yet been utilized in clinical VCA. This review presents latest perfusion strategies in clinical solid organ transplantation and experimental VCA in light of the specific requirements by the vascularized composite allograft's unique tissue composition. It discusses optimal settings for temperature, oxygenation, and flow types, as well as perfusion solutions and the most promising additives. Moreover, it highlights the implications for the utility of VCA as therapeutic measure in plastic surgery, if machine perfusion can be successfully introduced in a clinical setting.

Outcomes Analysis of Chief Cosmetic Clinic Over 13 Years

Background Adequate resident training in aesthetic surgery has become increasingly important with rising demand. Chief resident aesthetic clinics allow hands on experience with an appropriate amount of autonomy. The purpose of this study was to compare resident cosmetic clinic outcomes to those reported in the literature. Furthermore, we sought to assess how effective these clinics can be in preparing residents in performing common aesthetic surgery procedures. Method A retrospective chart review of 326 patients and 714 aesthetic procedures in our chief cosmetic clinic over a 13-year period was performed, and complication and revision rates were recorded. In addition, an electronic survey was sent to 26 prior chief residents regarding their experience and impressions of the chief resident aesthetic clinic. Result A total of 713 procedures were performed on 326 patients. Patient ages ranged from 5 to 75 years old (mean, 40.8 years old) with a mean follow-up of 76.2 days. On average, there were 56 procedures performed per year. Of the 714 total procedures performed, there were 136 minor procedures and 578 major procedures. Of the 136 minor procedures, there were no complications and there was 1 revision of a cosmetic injection. Of the 578 major procedures, the overall complication rate was 6.1% and the revision rate was 12.8%. Complication and revision rates for each individual surgery were further analyzed and compared with the literature. The complication rates for these procedures fell within the reference ranges reported. In regards to the chief resident survey, there was a 77% response rate. All respondents reported that the chief resident clinic positively affected their residency education and future practice. Ninety percent of respondents felt "very comfortable" performing facelifts, body contouring, and aesthetic breast surgery. No respondents completed a subsequent cosmetic fellowship, and 60% stated that their positive experience in chief clinic contributed to their decision not to pursue a cosmetic fellowship. Conclusions Chief resident clinics can provide results with acceptable complication and revision rates that fall within the acceptable ranges in the literature. In addition, it provides a valuable experience that leaves residents with high comfort levels in performing key procedures in aesthetic surgery.

Can Covey's 7 Habits Produce a Highly Effective Plastic Surgeon?

No abstract available

Design of Mini Latissimus Dorsi Flap Based on Thoracodorsal Vascular Patterns

Introduction Latissimus dorsi (LD) flap has been used for reconstructive purposes in oncoplastic breast surgery. Using large part of the muscle as a flap leads to a residual functional loss. Muscle sparing and mini LD flaps can be used with no functional sequelae. However, the design of such flap presents a challenge. Methods Twenty cadavers were dissected on both sides to identify the different vascular patterns of the thoracodorsal (TD) pedicle. The vessels were counted, and the following measurements were taken: diameter, length, distance from inferior angel of scapula, and vertebral level. Data were collected and entered into the personal computer. Statistical analysis was done using (SPSS/version 20) software. Results Five vascular patterns of TD pedicle were found. Type 1: a long vertically descending pedicle giving 3 to 4 transverse medial branches to LD in 40%. Type 2: a short pedicle terminating into 1 to 2 serratus anterior collaterals and 1 to 2 transverse lateral branches to LD in 10%. Type 3: a long vertically descending pedicle giving 2 to 3 small lateral branches to upper part of LD and terminating into medial and lateral branches in the lower part of LD in 10%. Type 4: a short pedicle that gives 4 to 5 terminal branches to LD, one of them is a long vertically descending branch to lower part of LD in 20%. Type 5: a short pedicle that terminates into a transverse medial and a long vertical branch to LD in 20%. Conclusion The classically described pattern of TD pedicle (type 5) was found in 20% of cases, whereas the most commonly found pattern was type 1. This means that the pattern of TD branching is unpredictable, and a preoperative ultrasound is essential to define the existing pattern and plan the best LD flap design for each patient. In types 1 and 5, the flap can be designed using the transverse medial branch or branches. In type 2, one of the lateral transverse branches can be used. In types 3, 4, and 5, the long descending vertical branch can be used. It has a sizeable diameter (1.80.23 mm), length (12.31.64 cm), and can be located 6.50.96 cm below the inferior angle of scapula.

Long-term Fate of Denervated Skeletal Muscle After Microvascular Flap Transfer

Background Muscle flap is a valuable option in soft tissue reconstruction. Denervated skeletal muscle is known to undergo degeneration. However, information regarding histological and genetic changes in muscle free flap without reinnervation over long-term follow-up remains unclear. Methods We collected flap muscles obtained during secondary exploration surgery after more than 15 years of previous muscle free flap without reinnervation. Compared with normal muscle and fat, histomorphometric and gene expression analysis of flap muscle were performed. Results During the study period, we collected 5 samples of previous muscle free flap. The mean ± SD postoperative duration after free flap was 18.6 ± 4.0 years. All flap muscles were replaced with adipose tissue based on gross and histological findings. In flap muscle, the expression of gene related to muscle-specific MYH2 gene was downregulated, whereas the expression of genes related to adipose, fibroadipogenic progenitor, and blood vessel was upregulated compared with that of normal muscle. Vascular density and pattern were also similar to those in normal fat. Conclusions We demonstrated that muscle free flap without reinnervation eventually converts into adipose tissue regardless of spontaneous reinnervation during muscle regeneration. The long-term findings of the present study will be valuable for muscle flap selection and prognosis.

Skin Graft Fixation Using Hydrofiber (Aquacel® Extra)

Background The traditional method of skin graft fixation is with tie-over bollus dressing. The use of splints in the extremities for skin graft fixation is a common practice. However, these splints are heavy and uncomfortable and contribute considerably to our overall medical waste. Hydrofiber (Aquacel® Extra) has a strong fluid absorption property and fixates well to the underlying wound once applied. In this study, we used hydrofiber for fixation, avoiding the use of splints after skin grafting. Methods A total of 56 patients reconstructed with split-thickness skin graft that was fixated only with hydrofiber between March 2015 and March 2016 were included in this retrospective study. Results There were 44 men and 12 women with a mean age of 61 ± 18 years. The defect size ranged from 1 × 1 cm for fingertips to 30 × 12 cm for lower limb defects. The average defect size was 61 ± 78 cm2. The mean skin graft take was 96% ± 6%. Because splints were not required, we saved around 48 kg of medical waste over the space of 1 year. Conclusions The use of hydrofiber for skin graft fixation was effective and technically very simple. Splints were not required with this method, decreasing the medical waste created and increasing patient comfort. We suggest that this is an excellent alternative for skin graft fixation while at the same time decreasing our carbon footprint as surgeons.

Classification and Treatment of the Adult Buried Penis

In contrast to the concealed penis found in children, the adult buried penis (BP) is associated with obesity or found in patients after massive weight loss. Bariatric patients present with enormous prepubic fat masses into which the penile shaft retracts. As a consequence, urinating problems occur with wetting of the adjacent tissue. Many BP patients are circumcised with recurrence and worsening of the symptoms. In postbariatric patients, the penis is not engulfed into the prepubic tissue. In contrast to highly obese patients, the BP is covered underneath the cutaneous apron. Although all conditions are called BP, it is conceivable that plastic-surgical treatment differs. Hence, a novel classification for the adult BP was needed to adjust the procedures accordingly. We propose 3 types of the adult BP. The first type is termed "pseudo-BP." The penis is covered underneath the lax skin without signs of retraction. Here, an apronectomy and prepubic lift with tissue fixation are sufficient. The second type is the "intermediate-type BP" with partial penile invagination. After prepubic apronectomy, anchoring sutures secure the penile shaft from retraction. The third type is the "classical BP" seen in obese patients. The penile shaft is completely retracted into the prepubic fat. Often a stenotic scar tissue is found after previous circumcisions. The plastic-surgical reconstruction comprises scar excision, reduction of the prepubic fat masses with extraction of the penile shaft, anchoring sutures, and reconstruction of the penile envelope. In short, the etiology of the adult BP, a novel classification, and a treatment algorithm according to each type are presented in this comprehensive overview.

Risk Factors of Vasopressor-Induced Symmetrical Peripheral Gangrene

Background Symmetrical peripheral gangrene (SPG) is an uncommon syndrome showing symmetrical gangrene in acral regions without evidence of large-vessel occlusion or vasculitis. Intravenous vasopressors are frequently used to manage hemodynamically unstable patients. There have been few reports about SPG after using inotropics. However, risk factors for SPG have not been extensively studied. Therefore, the objective of this study was to analyze several cases of SPG and identify risk factors for SPG. Methods From October 2013 to October 2016, 36 patients with SPG after using vasopressors were included in this study. SPG is an extremely rare disease entity. Therefore, this work was designed as a matched case-control study. For the control group, 42 patients (25 men and 17 women) with similar age, admission department, sex, and vasopressor usage in intensive care unit patients during the same period were selected. Retrospective chart review was performed to identify risk factors within the following categories: medical conditions, vasopressor-related factors, and Sequential Organ Failure Assessment scores. Results Differences between the 2 groups concerning medical condition-related variables did not exist. Statistically significant differences were found in intensive care unit duration (P = 0.0011) and survival. All vasopressor-related factors were adjusted according to weights of patients. Weight-compensated mean dose of dopamin significantly (P = 0.028) affected the occurrence of SPG. Weight-compensated peak dose of norpin, dopamin, and epinephrine also significantly contributed to SPG. Conclusions Symmetrical peripheral gangrene is a rare clinical syndrome related with a high mortality and up to 70% of patients who survive require amputation. Several studies have mentioned that there are several factors affecting the result of SPG. Few studies on SPG have been reported and most of them are case reports. In this study, we revealed the influence of vasopressors to the occurrence of SPG, and this was the first matched case-control study based on the analysis of multiple risk factors.

Transcatheter Arterial Embolization in the Treatment of Maxillofacial Fractures With Life-Threatening Hemorrhage

Introduction Transcatheter arterial embolization (TAE) has gained importance in the management of maxillofacial fractures with life-threating hemorrhage (MFH). However, clinical evidence supporting the use of TAE has not been clearly established in the literature. Therefore, we evaluated the effectiveness of TAE for MFH, based on data obtained from the Japan Trauma Data Bank. Methods Patients were identified from Japan Trauma Data Bank entries for the years 2004 to 2014. Inclusion criteria for MFH were defined using the Abbreviated Injury Scale code (Maxilla fracture, LeFort III; blood loss. > 20%). On the basis of the treatment strategy, patients were categorized into either the TAE group or the non-TAE group. A comparative analysis of the demographics, injury characteristics, and outcomes was performed. Results From among 198,744 documented cases of trauma, a total 118 patients were eligible for the study; 26 of these patients (22.0%) underwent TAE. The Glasgow Coma Scale score was significantly lower in the TAE group than in the non-TAE group (P = 0.019); the other variables did not significantly differ between the groups. Overall, the in-hospital mortality rate was 39.8%, and the median hospital length of stay was 21.0 days (0.0–53.5 days). The in-hospital mortality was significantly lower in the TAE group than in the non-TAE group (23.1% vs 44.6%; odds ratio [OR], 0.37; 95% confidence interval [CI], 0.14–1.02; p = 0.048). However, patients in the TAE group had a longer median hospital length of stay (39.5 [7.3–53.5] vs 14.0 [0.0–55.3] days, p = 0.072). In the logistic regression model, the use of TAE was extracted as the independent predictor for better outcomes after adjusting for potential confounders (OR, 0.32; 95% CI, 0.66–0.88; P = 0.032). Hypotension, a high Injury Severity Score, aged 60 years or older, and a low Glasgow Coma Scale score were also independently associated with mortality, with an OR of 5.48, 3.99, 3.30, and 2.89, respectively. Conclusions Cases of MFH are rare, but they are associated with a high mortality. Transcatheter arterial embolization use appears to lead to successful outcomes in such cases. Further studies are required to confirm the efficacy of TAE and evaluate its indications and complications.

Modified 2-Stage Method for Auricular Reconstruction

Background Auricular reconstruction is one of the most challenging procedures in the field of plastic surgery. The aims of this study were to apply the modified 2-stage method to perform auricular reconstruction and to summarize the clinical experience in the past 10 years. Methods Auricular reconstruction was performed in 243 patients (total 254 ears) of congenital microtia using autologous costal cartilage. The whole procedure is divided into 2 stages. Stage I: the individualized framework fabricated with autologous costal cartilage is inserted into subcutaneous pocket in the mastoid region, and then the earlobe was transposed backward to connect with the lower part of the framework. The second-stage surgery mainly includes the following main contents: ear elevation, fixing the bracket behind the reconstructed ear framework, harvesting the retroauricular fascial flap to cover the bracket, and closing the defect with free skin grafts. Results A total of 243 patients (254 ears) of congenital microtia underwent ear reconstruction. The follow-up time ranged from 6 months to 4 years; 220 patients were satisfied with the results. Surgery-related complications such as infection, partial skin graft necrosis, flap necrosis, bad projection of the constructed auricle, and extrusion of cartilage occurred in 24 cases, and hypertrophic scars occurred in 16 patients. Conclusions This modified 2-stage method for auricle reconstruction can receive acceptable results and fewer complications; furthermore, it is relatively simple and easy to master. The 10-year experience validates that this modified method is an ideal method in auricular reconstruction.

Masculinizing Top Surgery: A Systematic Review of Techniques and Outcomes

Background Chest wall masculinization by means of mastectomy is an important gender affirming surgery for transmasculine and non-binary patients. Limited data exist comparing commonly used techniques in masculinizing top surgery, and most are single institution studies. Methods A systematic review was performed on primary literature dedicated specifically to the technical aspects and outcomes of mastectomy for masculinizing top surgery. For each study, patient demographics and surgical outcomes were compared. Results Eight studies met inclusion criteria. There were 2138 breasts with an average patient age of 28.6 years and the average breast weight was 353 g. The most commonly reported techniques are those without skin resection (8.0%), those with periareolar skin resection (34.1%), inferior pedicle mammoplasty (15.7%), and inframammary fold skin excision with free nipple grafting (FNG, 42.2%). In total, 6.0% of all breasts required acute reoperation for hematoma and 26.5% required secondary operations. Acute reoperation occurred significantly less often in the FNG cohort (4.8%) compared with both the inferior pedicle mammaplasty cohort (8.9%, P

Utilization of Microdissected Thin Perforator Flap Technique in the Treatment of Bulky and Deformed Skin Flaps

Background This study investigates the feasibility and clinical impact of the microdissected thin perforator skin flap strategy on bulky and deformed skin flaps during second-stage revision surgery. Methods Seventeen patients were selected and underwent the microdissected thin perforator skin flap technique to treat bulky and deformed skin flaps after free flap reconstruction between October 2013 and October 2015. Perforator vessels were isolated and protected under a microscope. Subdermal fat with a thickness of 4 mm to 7 mm was preserved, and excess adipose tissue was resected. Results No skin flap necrosis was observed after the operation in all 17 patients, and all wounds healed without complications. Patients were followed up for 3 to 24 months, with an average follow-up time of 10 months. The skin flaps maintain normal color and texture. Both appearance and function of the recipient sites were improved significantly. Conclusions The utilization of microdissected thin perforator flap technique to further thin bulky skin flaps at the second stage can be effective in a single operation. The blood supply of all free flaps was preserved, with no evidence of necrosis or healing complications. This technique offers an effective approach for secondary thinning of bulky free flaps.

Discussion: Predictors of Complications After Pectoralis Major Transposition for Sternum Dehiscence

No abstract available

Science in Places of Grandeur: Communication and Engagement in National Parks

Abstract

The United States has set aside over 400 national parks and other protected areas to be managed by the National Park Service (NPS). Collectively, these sites attract over 300 million visits per year which makes the NPS one of the largest informal education institutions in the country. Because the NPS supports and facilitates scientific studies in parks, the national park system provides abundant opportunity for biologists and other scientists to engage global audiences in learning, exploring, and even conducting science. Those opportunities are best pursued through collaborations among scientists and the professional communication staff (interpreters, educators, media specialists, etc.) of parks and their partner organizations. This article describes unique opportunities and rationale for such collaborations, presents several examples that highlight the range of activities and lessons drawn from them, and invites scientists to conduct studies in parks and bring their science into the public eye.

Phototransduction gene expression and evolution in cave and surface crayfishes

Abstract

In the absence of light in caves, animals have repeatedly evolved reduced eyes and visual systems. Whether the underlying genetic components remain intact in blind species remains unanswered across taxa. The freshwater crayfish have evolved to live in caves multiple times throughout their history; therefore, this system provides an opportunity to probe the genetic patterns and processes underlying repeated vision loss. Using transcriptomic data from the eyes of 14 species of cave and surface crayfishes, we identify the expression of 17 genes putatively related to visual phototransduction. We find a similarly complete repertoire of phototransduction gene families expressed in cave and surface species, but that the expression levels of those transcripts are consistently lower in cave species. We find statistical support for episodic positive selection, increased selection strength and decreased selection strength in caves, depending on the gene family. Analyses of gene expression evolution suggests convergent and possibly adaptive downregulation of these genes across eye-reduction events. Our results reveal of combination of evolutionary processes acting on the sequences and gene expression levels of vision-related genes underlying the loss of vision in caves.

Rumfitt on truth-grounds, negation, and vagueness

Abstract

In The Boundary Stones of Thought (2015), Rumfitt defends classical logic against challenges from intuitionistic mathematics and vagueness, using a semantics of pre-topologies on possibilities, and a topological semantics on predicates, respectively. These semantics are suggestive but the characterizations of negation face difficulties that may undermine their usefulness in Rumfitt's project.

Application of triolein-embedded cellulose acetate membrane (TECAM) passive sampler to study phase distribution of hexabromocyclododecanes (HBCDs) in sediment

Abstract

Hexabromocyclododecanes (HBCDs) are a class of widely used brominated flame retardants (BFRs) that exhibit strong hydrophobicity. The ubiquity and persistence of HBCDs in sediment have attracted significant attention because of public health concerns. The environmental fate and ecological risks of HBCDs closely depend on their phase distribution in sediments. However, little information is available regarding the freely dissolved concentrations (C_free ) of HBCDs in sediment porewater. In this study, we developed a method to measure C_free of HBCDs in sediment porewater using triolein-embedded cellulose acetate membranes (TECAM). The TECAM-to-water partitioning coefficient (log K_TECAM ) was 4.69, 4.77, and 4.63 for α-HBCD, β-HBCD, and γ-HBCD, respectively. In sediments, HBCDs sorbed to the sediment solid phase accounted for more than 99% of the total chemical mass. The dissolved organic carbon (DOC)-water partition coefficient (K_DOC ) values were derived from TECAM measurements, and the log K_DOC values ranged from 5.77 to 6.23 for the three HBCD diastereomers, suggesting a strong tendency for HBCDs to sorb to DOC. The high sorption of HBDCs for DOC implies a potential for DOC-facilitated transport which may enhance the environmental mobility of HBCDs.

Iron nanoparticles in situ encapsulated in lignin-derived hydrochar as an effective catalyst for phenol removal

Abstract

In this work, we have developed a low-cost and green strategy for nanoscale zero-valent iron (ZVI) in situ encapsulated in lignin-derived hydrochar (Fe@HC) by a facile one-pot synthesis route. The as-synthesized Fe@HC was characterized for physicochemical properties by X-ray diffraction (XRD), X-ray photoelectron spectra (XPS), scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), transmission electron microscope (TEM), thermal gravimetric analysis (TGA), and Fourier-transform infrared spectroscopy (FT-IR). Further catalytic experiment revealed that phenol could be completely degraded by Fe@HC-800 within 20 min with peroxymonosulfate (PMS) at mild temperatures. Fe@HC-800 catalyst also exhibited stable performance after three runs of regeneration. The XPS and XRD results proved the key role of Fe⁰ in the degradation of phenol. This approach is of great potential to the development of green materials biomass-derived carbon materials for wastewater treatment applications.

Targeting glioblastoma-derived pericytes improves chemotherapeutic outcome

Abstract

Glioblastoma is the most common malignant brain cancer in adults, with poor prognosis. The blood–brain barrier limits the arrival of several promising anti-glioblastoma drugs, and restricts the design of efficient therapies. Recently, by using state-of-the-art technologies, including thymidine kinase targeting system in combination with glioblastoma xenograft mouse models, it was revealed that targeting glioblastoma-derived pericytes improves chemotherapy efficiency. Strikingly, ibrutinib treatment enhances chemotherapeutic effectiveness, by targeting pericytes, improving blood–brain barrier permeability, and prolonging survival. This study identifies glioblastoma-derived pericyte as a novel target in the brain tumor microenvironment during carcinogenesis. Here, we summarize and evaluate recent advances in the understanding of pericyte's role in the glioblastoma microenvironment.

Cultivable bacteria from Pectinatella magnifica and the surrounding water in South Bohemia indicate potential new Gammaproteobacterial, Betaproteobacterial, and Firmicutes taxa

Abstract

Pectinatella magnifica is a freshwater bryozoan, which has become a subject of scientific interest because of its invasive expansion worldwide. To obtain a comprehensive overview of its influence on environments, information on associated bacteria is needed. In this study, cultivable bacteria associated with P. magnifica were investigated. In total, 253 isolates were selected for preliminary identification by MALDI-TOF mass spectrometry and clustered based on REP-PCR profiles. Among these, 169 strains were selected and identified using 16S rRNA gene comparative analyses. The sequences were grouped into 76 phylotypes and affiliated with 67 species. The majority of isolated bacteria belonged to Gammaproteobacteria, followed by Betaproteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria. Most strains within the Betaproteobacteria were isolated exclusively from bryozoan colonies. Aeromonas was the genus predominantly isolated from both P. magnifica and the water samples. Based on 16S rDNA similarity values, 15 putative new species belonging to the genera Aeromonas, Aquitalea, Clostridium, Herbaspirillum, Chromobacterium, Chryseobacterium, Morganella, Paludibacterium, Pectobacterium, Rahnella, Rhodoferax, and Serratia, and putative new genera belonging to families Clostridiaceae and Sporomusaceae were revealed. The majority of the detected bacteria were species widely distributed in the environments; nevertheless, a possible symbiotic association of two new putative species with P. magnifica cannot be excluded.

An Epigenome-Wide Association Study (EWAS) of Obesity-Related Traits

Abstract

We conducted an epigenome-wide association study on obesity-related traits. We used data from two prospective, population-based cohort studies: the Rotterdam Study (RS) (2006–2013) and the Atherosclerosis Risk in Communities (ARIC) Study (1990–1992). We used RS (n = 1,454) as the discovery panel and ARIC (n = 2,097) as replication panel. Linear mixed-effect models were used to assess the cross-sectional association between genome-wide DNA methylation in leukocytes with body mass index (BMI) and waist circumference (WC) adjusting for sex, age, smoking, leukocyte proportions, array number and position on array. The two latter were modelled as random effects. Fourteen CpGs were associated with BMI and 26 CpGs with WC in RS after Bonferroni-correction (P < 1.07 × 10⁻⁷), of which 12 and 13 CpGs replicated in ARIC Study, respectively. The most significant novel CpGs were located at MSI2 (cg21139312) and LARS2 (cg18030453) and were associated both with BMI and WC. CpGs at BRDT, PSMD1, IFI44L, MAP1A, and MAP3K5 were associated with BMI. CpGs at LGALS3BP, MAP2K3, DHCR24, CPSF4L, and TMEM49 were associated with WC. We report novel associations of methylation at MSI2 and LARS2 with obesity-related traits. These results provide further insight in mechanisms underlying obesity-related traits, which can enable identification of new biomarkers in obesity-related chronic diseases.

Residential Racial Isolation and Spatial Patterning of Type 2 Diabetes Mellitus in Durham, North Carolina

Abstract

Neighborhood characteristics such as racial segregation may be associated with type 2 diabetes mellitus, but studies have not examined these relationships using spatial models appropriate for geographically patterned health outcomes. We construct a local, spatial index of racial isolation (RI) for blacks, which measures the extent to which blacks are exposed to only one another, to estimate associations of diabetes with RI and examine how RI relates to spatial patterning in diabetes. We obtained 2007–2011 electronic health records from the Duke Medicine Enterprise Data Warehouse. Patient data were linked to RI based on census block of residence. We use aspatial and spatial Bayesian models to assess spatial variation in diabetes and relationships with RI. Compared to spatial models with patient age and sex, residual geographic heterogeneity in diabetes in spatial models that also included RI was 29% and 24% lower for non-Hispanic whites and blacks, respectively. A 0.20 unit increase in RI was associated with 1.24 (95% credible interval: 1.17, 1.31) and 1.07 (1.05, 1.10) increased risk of diabetes for whites and blacks, respectively. Improved understanding of neighborhood characteristics associated with diabetes can inform development of policy interventions.

Longitudinal Physical Activity Patterns Among Older Adults: A Latent Transition Analysis

Abstract

Most epidemiologic studies of physical activity measure either total energy expenditure or engagement in a single activity type, such as walking. These approaches may gloss over important nuances in activity patterns. We performed a latent transition analysis to identify patterns of activity types as well as neighborhood and individual determinants of changes in those activity patterns over two years in a cohort of 2,023 older adult residents of New York City, NY, surveyed between 2011 and 2013. We identified seven latent classes: 1) Mostly Inactive, 2) Walking, 3) Exercise, 4) Household Activities and Walking, 5) Household Activities and Exercise, 6) Gardening and Household Activities, and 7) Gardening, Household Activities, and Exercise. The majority of subjects retained the same activity patterns between waves (54% unchanged between waves 1 and 2, 66% unchanged between waves 2 and 3).Most latent class transitions were between classes distinguished only by one form of activity, and only neighborhood unemployment was consistently associated with changing between activity latent classes. Future latent transition analyses of physical activity would benefit from larger cohorts and longer follow-up periods to assess predictors of and long-term impacts of changes in activity patterns.

Polybrominated diphenyl ethers in cord blood and perinatal outcomes from Laizhou Wan Birth Cohort, China

Abstract

We explored whether polybrominated diphenyl ethers (PBDEs) exposed in cord blood could have any potential relationship with perinatal outcomes. Participants were pregnant females (n = 222) who were recruited from a prospective birth cohort (Laizhou Wan Birth Cohort, LWBC) between September 2010 and February 2012. We measured eight PBDE congeners (BDE-28, BDE-47, BDE-85, BDE-99, BDE-100, BDE-153, BDE-154, and BDE-183) in cord serum and examined their relationship with perinatal outcomes. The median levels of BDE-28, BDE-47, BDE-85, BDE-99, BDE-100, BDE-153, BDE-154, and BDE-183 were 2.92, 3.93, 2.29, 7.03, 3.03, 3.14, 1.46, and 2.55 ng/g lipids, respectively. For each log unit increase in BDE-47, BDE-100, and ∑₄PBDEs, gestational age increased by 0.70 weeks (95% confidence interval [CI] 0.25, 1.15), 0.48 weeks (95% CI 0.03, 0.94), and 0.73 weeks (95% CI 0.12, 1.34), respectively. We also found that BDE-47 was positively associated with head circumference (β = 0.42, 95% CI 0.00, 0.84). Given that our study area is one of the major brominated flame retardant production areas in China, and the cord PBDEs levels were relatively higher than those reported in most other Asian areas, more studies on the effects of in utero PBDE exposure on fetal growth and child development are warranted.

The formation of unsaturated zones within cemented paste backfill mixtures—effects on the release of copper, nickel, and zinc

Abstract

Flooding of cemented paste backfill (CPB) filled mine workings is, commonly, a slow process and could lead to the formation of unsaturated zones within the CPB fillings. This facilitates the oxidation of sulfide minerals and thereby increases the risk of trace metal leaching. Pyrrhotitic tailings from a gold mine (cyanidation tailing (CT)), containing elevated concentrations of nickel (Ni), copper (Cu), and zinc (Zn), were mixed with cement and/or fly ash (1–3 wt%) to form CT-CPB mixtures. Pyrrhotite oxidation progressed more extensively during unsaturated conditions, where acidity resulted in dissolution of the Ni, Cu, and Zn associated with amorphous Fe precipitates and/or cementitious phases. The establishment of acidic, unsaturated conditions in CT-CBP:s with low fractions (1 wt%) of binders increased the Cu release (to be higher than that from CT), owing to the dissolution of Cu-associated amorphous Fe precipitates. In CT-CPB:s with relatively high proportions of binder, acidity from pyrrhotite oxidation was buffered to a greater extent. At this stage, Zn leaching increased due the occurrence of fly ash-specific Zn species soluble in alkaline conditions. Irrespective of binder proportion and water saturation level, the Ni and Zn release were lower, compared to that in CT. Fractions of Ni, Zn, and Cu associated with acid-soluble phases or amorphous Fe precipitates, susceptible to remobilization under acidic conditions, increased in tandem with binder fractions. Pyrrhotite oxidation occurred irrespective of the water saturation level in the CPB mixtures. That, in turn, poses an environmental risk, whereas a substantial proportion of Ni, Cu, and Zn was associated with acid-soluble phases.

Effects of heavy metal species, concentrations, and speciation on pentachlorophenol sorption by river biofilms

Abstract

The sorption of trace organic pollutants at solid/liquid interfaces is one of the most important processes that influence their fate and behaviours in the aquatic environment. Sorption is affected by coexisting contaminants. The process and extent to which coexisting heavy metals affect the sorption of organochlorine pesticides (OCPs), especially acid radical anion heavy metals, are still unclear. Here, the effects of the species, concentrations, and speciation of the heavy metals Cu, Pb, and Cr, and the metalloid As on the sorption of pentachlorophenol (PCP), as a model OCP, by river biofilms were investigated through batch experiments. The results show that the presence of Cu, Pb, Cr, and As decreased the maximum sorption quantity of PCP onto the biofilms by 67.7, 9.2, 58.4, and 14.4%, respectively. The inhibitory effect of heavy metals on sorption decreased as the initial concentration ratios of heavy metals to PCP increased. In addition, the impact of heavy metals on PCP sorption was attributed to differences in heavy metal speciation. Cu and Pb commonly existed as divalent cations, but Cr and As existed as anionic acid radicals under the experimental conditions. The inhibitory effects of heavy metals on PCP sorption by biofilms were enhanced as the cation valence state increased, while the effects were weakened as the anionic acid radical valence state increased. Although all four heavy metals had inhibitory effects on PCP sorption by biofilms, there were distinct differences in the mechanisms causing these effects.

Determinants of CO 2 emissions in the MERCOSUR: the role of economic growth, and renewable and non-renewable energy

Abstract

The main objective of this study was to analyze the impact of energy consumption (divided into renewable and non-renewable sources) and income on CO₂ emissions within the environmental Kuznets curve (EKC) model for the Southern Common Market (MERCOSUR). To do so, the annual panel data collected during the 1990–2014 periods was used. The CO₂ variable, representing carbon dioxide emissions in metric tons per capita, was used as a proxy for the emission of pollutants. The annual data were obtained from the World Bank (World Development Indicators). The sample consisted of the five MERCOSUR member countries: Argentina, Brazil, Paraguay, Uruguay, and Venezuela, comprising a period of 25 consecutive years. The results showed that energy consumption from renewable sources had a negative impact on CO₂ emissions, while the energy consumption from non-renewable sources had a positive impact. The positive impact of economic development on CO₂ emissions was also seen. In addition, this study supports the validity of the EKC hypothesis for the MERCOSUR because GDP (real output) leads to environmental degradation while GDP² reduces the level of gas emissions.

Remediation of arsenic-contaminated paddy soil by iron-modified biochar

Abstract

Arsenic contamination in paddy soils has aroused global concern due to its threats to food security and human health. Biochar modified with different iron materials was prepared for arsenic (As) immobilization in contaminated soils. Soil incubation experiments were carried to investigate the effects of biochar modified with Fe-oxyhydroxy sulfate (Biochar-FeOS), FeCl₃ (Biochar-FeCl₃), and zero-valent iron (Biochar-Fe) on the pH, NaHCO₃-extractable As concentrations, and the As fractions in soils. The scanning electron microscope and X-ray diffraction analysis demonstrated that iron was successfully loaded onto the surface or embedded into the pores of the biochar. Addition of Biochar-FeOS, Biochar-FeCl₃, and Biochar-Fe had no significant effects on the soil pH but significantly decreased the contents of NaHCO₃-extractable As in soils by 13.95–30.35%, 10.97–28.39%, and 17.98–35.18%, respectively. Biochar-FeOS, Biochar-FeCl₃, and Biochar-Fe treatments decreased the concentrations of non-specifically sorbed and specifically sorbed As fractions in soils, and increased the amorphous and poorly crystalline, hydrated Fe, Al oxide-bound, and residual As fractions. Compared with the other iron-modified biochars, Biochar-FeOS showed the most effective immobilization and has the potential for the remediation of As-contaminated paddy soils.

Morphology-tunable tellurium nanomaterials produced by the tellurite-reducing bacterium Lysinibacillus sp. ZYM-1

Abstract

Although tellurite is highly toxic to organisms, elemental tellurium nanomaterials (TeNMs) have many uses. The microbe-mediated reduction of tellurite to Te(0) has been shown to be a green and cost-effective approach for turning waste into wealth. However, it is difficult to tune the morphology of biogenic nanomaterials. In this study, a series of experiments was conducted to investigate the factors influencing tellurite reduction by the tellurite-reducing bacterium Lysinibacillus sp. ZYM-1, including pH, tellurite concentration, temperature, and heavy metal ions. The optimal removal efficiency of tellurite was respectively achieved at pH 8, 0.5 mM tellurite, and 40 °C. All of the tested metal ions retarded the reduction of tellurite, especially Cd²⁺ and Co²⁺, which completely inhibited its reduction. Further characterization of the biogenic TeNMs indicated that their morphology could be tuned by the tellurite concentration, pH, temperature, and organic solvents used. Regular Te nanosheets were produced using 5 mM tellurite. The TeNMs were primarily synthesized in the cell membrane. Hexagonal Te nanoplates, nanorods, nanoflowers, and nanobranches were synthesized when combining membrane fractions with tellurite and NADH. The diverse morphologies are assumed to be induced by the synergy between the reduction kinetics and the protein structure. Therefore, this study confirmed that the bacterium can tune the morphology of TeNMs, broadening the potential application of biogenic TeNMs.

Controlling risks of P water pollution by sorption on soils, pyritic material, granitic material, and different by-products: effects of pH and incubation time

Abstract

Batch experiments were used to test P sorbent potential of soil samples, pyritic and granitic materials, mussel shell, mussel shell ash, sawdust, and slate waste fines for different pH and incubation times. Maximum P sorption varied in a wide range of pH: < 4 for pyritic material, 4–6 for forest soil, > 5 for slate fines, > 6 for shell ash, and pH 6–8 for mussel shell. P sorption was rapid (< 24 h) for forest soil, shell ash, pyritic material, and fine shell. On the opposite side, it was clearly slower for vineyard soil, granitic material, slate fines, pine sawdust, and coarse shell, with increased P sorption even 1 month later. For any incubation time, P sorption was > 90% in shell ash, whereas forest soil, pyritic material, and fine shell showed sorption rates approaching 100% within 24 h of incubation. These results could be useful to manage and/or recycle the sorbents tested when focusing on P immobilization or removal, in circumstances where pH changes and where contact time may vary from hours to days, thus aiding to diminish P pollution and subsequent eutrophication risks, promoting conservation and sustainability.

Comparative study on treatment of kitchen wastewater using a mixed microalgal culture and an aerobic bacterial culture: kinetic evaluation and FAME analysis

Abstract

Microalgae-based treatment systems have been successfully used for the polishing of domestic wastewater. Research is underway in studying the suitability of using these systems as main treatment units. This study focuses on comparing the performances of a mixed microalgal culture and an aerobic bacterial culture, based on the kinetic evaluation, in removing organic carbon from a kitchen wastewater. The two systems were operated at six different solid retention times (SRTs)—2, 4, 6, 8, 10, and 12 days in continuous mode. The influent and effluent samples were analyzed for chemical oxygen demand (COD), total organic carbon (TOC), total nitrogen (TN), phosphates, and surfactants. Steady-state kinetics (k, K_s, Y, and k_d) for organic carbon removal were obtained by fitting experimental data in linearized Michaelis-Menten and Monod equations. The mixed microalgal system showed similar or better performance in COD and TN removal (88 and 85%, respectively) when compared with the COD and TN removal by the aerobic bacterial system (89 and 48%). A maximum lipid yield of 40% (w/w of dry biomass) was observed in the microalgal system. Saturated fatty acids accounted for 50% of the total observed FAME species. The study indicates that the mixed microalgal culture is capable of treating kitchen wastewater and has the potential to replace aerobic bacteria in biological treatment systems in certain cases.

Immobilization of soil cadmium using combined amendments of illite/smectite clay with bone chars

Abstract

The widespread use of cadmium (Cd)-containing organic fertilizers is a source of heavy metal inputs to agricultural soils in suburban areas. Therefore, the research and development of new materials and technologies for the remediation of Cd-contaminated soil is of great significance and has the potential to guarantee the safety of agricultural products and the protection of human health. We performed pot experiments to determine the potential of combined amendments of illite/smectite (I/S) clay with bone chars for the remediation of Cd-contaminated agricultural soils in a suburban area of Beijing, China. The results showed that both diethylene triamine pentaacetic acid (DTPA)-extractable Cd in soil and the Cd in Brassica chinensis were significantly decreased by the application of 1, 2, or 5% combined amendments with various I/S and bone char (BC) ratios. The higher proportions of BC used in the combined amendments resulted in a better immobilization of soil Cd. The application of the 5% amendment that combined I/S with either pig or cattle BC resulted in the best immobilization. All of the combined amendments, regardless of the composition and ratio of the components, had no negative effects on the growth of B. chinensis. Therefore, it was concluded that combined amendments of I/S and BC have a good potential for remediating Cd-contaminated soils.

Preparation and Cr(VI) removal performance of corncob activated carbon

Abstract

Corncob activated carbon (CCAC) was prepared by a H₃PO₄ activation method. The optimum conditions for the preparation of CCAC were determined by orthogonal experiments. The effects of pH, reaction time, CCAC dosage, and hexavalent chromium (Cr(VI)) concentrations on Cr(VI) removal by CCAC were studied. Corn straw activated carbon (CSAC) was also prepared using the optimum preparation conditions determined for CCAC. The properties of samples were characterized by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Brunauer–Emmett–Teller (BET) analysis, scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS). The results showed that the optimum preparation conditions for CCAC were as follows: a mass of corncob of 10 g; a mass ratio of corncob to H₃PO₄ of 1:2; a 5% H₃BO₃ content of 10 mL; an impregnation time of 45 min; a carbonization temperature of 500 °C. The optimum conditions for the removal of Cr(VI) were as follows: pH < 9; temperature, 308 K; rotation speed, 150 r min⁻¹; reaction time, 60 min; CCAC dosage, 1 g L⁻¹. The Cr(VI) removal rate was above 98%, and the maximum adsorption capacity of CCAC was 9.985 mg g⁻¹. The concentration of residual Cr(VI) in water was less than 0.05 mg L⁻¹. FTIR showed that the surfaces of the samples had more oxygen-containing functional groups, which promoted the adsorption. XRD showed that CCAC and CSAC had similar peaks and that these peaks promoted the adsorption of Cr(VI). BET indicated that the number of pores in the samples followed the order CCAC > CSAC > CAC. SEM showed that the CCAC surface had a more porous structure, which enhanced adsorption. EDS showed that the C contents of CCAC and CSAC were much higher than that of CAC. Cr(VI) adsorption on CCAC followed quasi-second-order kinetics and was in accordance with a Langmuir adsorption isotherm, with monolayer adsorption. The adsorption reaction was endothermic, where higher temperatures increased the degree of spontaneous reaction.

M2 macrophages promote wound-induced hair neogenesis

In humans, full-thickness skin excision usually leaves hairless scars, but the definitive evidence for de novo hair regeneration has been shown in skin scars of genetically normal adult mice [1]. This phenomenon was termed wound induced hair neogenesis (WIHN). The fact that hair follicles can be regenerated in vivo in scarred skin without the use of ES cells or iPS cells has high impact on tissue engineering.

Green synthesis of palm oil mill effluent-based graphenic adsorbent for the treatment of dye-contaminated wastewater

Abstract

Textile wastewater contains methylene blue (MB), a major coloring agent in textile industry. Activated carbon (AC) is the most widely used adsorbent in removing dyes from industrial wastewater. However, high production cost of AC is the major obstacle for its wide application in dye wastewater treatment. In this study, a sustainable approach in synthesizing graphenic adsorbent from palm oil mill effluent (POME), a potential carbonaceous source, has been explored. This new development in adsorption technique is considered as green synthesis as it does not require any binder during the synthesis process, and at the same time, it helps to solve the bottleneck of palm oil industry as POME is the main cause contributed to Malaysia's water pollution problem. The synthesized GSC was characterized through XRD, FESEM, and EDX. The adsorption performance of the synthesized GSC was evaluated by adsorption of MB. The effect of initial concentration of synthetic MB solution (1–20 mg/L) and weight of GSC (5–20 g) were investigated. A remarkable change in color of synthetic MB solution from blue to crystal clear was observed at the end of adsorption study. High efficiency of the synthesized GSC for dye-contaminated wastewater treatment is concluded.

3D/2D model-to-image registration by imitation learning for cardiac procedures

Abstract

Purpose

In cardiac interventions, such as cardiac resynchronization therapy (CRT), image guidance can be enhanced by involving preoperative models. Multimodality 3D/2D registration for image guidance, however, remains a significant research challenge for fundamentally different image data, i.e., MR to X-ray. Registration methods must account for differences in intensity, contrast levels, resolution, dimensionality, field of view. Furthermore, same anatomical structures may not be visible in both modalities. Current approaches have focused on developing modality-specific solutions for individual clinical use cases, by introducing constraints, or identifying cross-modality information manually. Machine learning approaches have the potential to create more general registration platforms. However, training image to image methods would require large multimodal datasets and ground truth for each target application.

Methods

This paper proposes a model-to-image registration approach instead, because it is common in image-guided interventions to create anatomical models for diagnosis, planning or guidance prior to procedures. An imitation learning-based method, trained on 702 datasets, is used to register preoperative models to intraoperative X-ray images.

Results

Accuracy is demonstrated on cardiac models and artificial X-rays generated from CTs. The registration error was \(2.92\pm 2.22\,\hbox { mm}\) on 1000 test cases, superior to that of manual ( \(6.48\pm 5.6\,\hbox { mm}\) ) and gradient-based ( \(6.79\pm 4.75\,\hbox { mm}\) ) registration. High robustness is shown in 19 clinical CRT cases.

Conclusion

Besides the proposed methods feasibility in a clinical environment, evaluation has shown good accuracy and high robustness indicating that it could be applied in image-guided interventions.

High-throughput NIR spectroscopic (NIRS) detection of microplastics in soil

Abstract

The increasing pollution of terrestrial and aquatic ecosystems with plastic debris leads to the accumulation of microscopic plastic particles of still unknown amount. To monitor the degree of contamination, analytical methods are urgently needed, which help to quantify microplastics (MP). Currently, time-costly purified materials enriched on filters are investigated both by micro-infrared spectroscopy and/or micro-Raman. Although yielding precise results, these techniques are time consuming, and are restricted to the analysis of a small part of the sample in the order of few micrograms. To overcome these problems, we tested a macroscopic dimensioned near-infrared (NIR) process-spectroscopic method in combination with chemometrics. For calibration, artificial MP/ soil mixtures containing defined ratios of polyethylene, polyethylene terephthalate, polypropylene, and polystyrene with diameters < 125 μm were prepared and measured by a process FT-NIR spectrometer equipped with a fiber-optic reflection probe. The resulting spectra were processed by chemometric models including support vector machine regression (SVR), and partial least squares discriminant analysis (PLS-DA). Validation of models by MP mixtures, MP-free soils, and real-world samples, e.g., fermenter residue, suggests a reliable detection and a possible classification of MP at levels above 0.5 to 1.0 mass% depending on the polymer. The benefit of the combined NIRS chemometric approach lies in the rapid assessment whether soil contains MP, without any chemical pretreatment. The method can be used with larger sample volumes and even allows for an online prediction and thus meets the demand of a high-throughput method.

Editorial board

Publication date: May 2018
Source:Annales de Dermatologie et de Vénéréologie, Volume 145, Issue 5

Publication date: May 2018 Source:Annales de Dermatologie et de Vénéréologie, Volume 145, Issue 5 ...

Publication date: May 2018
Source:Annales de Dermatologie et de Vénéréologie, Volume 145, Issue 5

Characterization of extracellular polysaccharide/protein contents during the adsorption of Cd(II) by Synechocystis sp. PCC6803

Abstract

Cyanobacteria have been proven to be cheaper and more effective for the removal of metallic elements in aqueous solutions. In this study, the living cyanobacteria Synechocystis sp. PCC6803 was used to adsorb Cd(II) and its extracellular polymeric substances (EPS) were investigated in the adsorption process. The initial stage of adsorption of Cd(II) was a rapid process, and then increase slowly accompanied with the increases of biomass. The final adsorption percentage could achieve 86% when the Cd(II) concentration was 0.5 mg/L. It proved that Synechocystis sp. PCC6803 has a good adsorption capacity for heavy metal ions. EPS was extracted to investigate the secretion of which was dynamic and the maximum extracellular polysaccharides and proteins were 134.2 and 100.9 mg/g, respectively. Furthermore, the real-time PCR (RT-PCR) results of genes (slr0977 and exoD) involved in EPS synthesis and secretion indicated that the EPS production was firstly increased and then decreased slightly. Transmission electron microscope (TEM) observation revealed that heavy metal ions were absorbed into EPS layer. Fourier transform infrared spectrum (FT-IR) analysis showed that EPS was rich in functional groups which could combine with heavy metal ions, such as –OH and –NH groups. All the results obtained show that the secretion of EPS by cyanobacteria was one of the ways to resist heavy metal stress. And it shows a trend of rising first and then decreasing, the change regulation of which was consistent with adsorptive behavior.

Testing of Disposable Protective Garments Against Isocyanate Permeation From Spray Polyurethane Foam Insulation

Abstract

Background

Diisocyanates (isocyanates), including methylene diphenyl diisocyanate (MDI), are the primary reactive components of spray polyurethane foam (SPF) insulation. They are potent immune sensitizers and a leading cause of occupational asthma. Skin exposure to isocyanates may lead to both irritant and allergic contact dermatitis and possibly contribute to systemic sensitization. More than sufficient evidence exists to justify the use of protective garments to minimize skin contact with aerosolized and raw isocyanate containing materials during SPF applications. Studies evaluating the permeation of protective garments following exposure to SPF insulation do not currently exist.

Objectives

To conduct permeation testing under controlled conditions to assess the effectiveness of common protective gloves and coveralls during SPF applications using realistic SPF product formulations.

Methods

Five common disposable garment materials [disposable latex gloves (0.07 mm thickness), nitrile gloves (0.07 mm), vinyl gloves (0.07 mm), polypropylene coveralls (0.13 mm) and Tyvek coveralls (0.13 mm)] were selected for testing. These materials were cut into small pieces and assembled into a permeation test cell system and coated with a two-part slow-rise spray polyurethane foam insulation. Glass fiber filters (GFF) pretreated with 1-(9-anthracenylmethyl)piperazine) (MAP) were used underneath the garment to collect permeating isocyanates. GFF filters were collected at predetermined test intervals between 0.75 and 20.00 min and subsequently analyzed using liquid chromatography-tandem mass spectrometry. For each garment material, we assessed (i) the cumulative concentration of total isocyanate, including phenyl isocyanate and three MDI isomers, that effectively permeated the material over the test time; (ii) estimated breakthrough detection time, average permeation rate, and standardized breakthrough time; from which (iii) recommendations were developed for the use of similar protective garments following contamination by two-component spray polyurethane foam systems and the limitations of such protective garments were identified.

Results

Each type of protective garment material demonstrated an average permeation rate well below the ASTM method F-739 standardized breakthrough rate threshold of 100.0 ng/cm² min⁻¹. Disposable latex gloves displayed the greatest total isocyanate permeation rate (4.11 ng/cm² min⁻¹), followed by the vinyl and nitrile gloves, respectively. The Tyvek coverall demonstrated a greater average rate of isocyanate permeation than the polypropylene coveralls. Typical isocyanate loading was in the range of 900 to 15,000 ng MDI/cm².

Conclusion

Permeation test data collected during this study indicated that each type of protective garment evaluated, provided a considerable level of protection (i.e. 10–110-fold reduction from the level of direct exposure) against the isocyanate component of the SPF insulation mixture. Nitrile gloves and polypropylene coveralls demonstrated the lowest rate of permeation and the lowest cumulative permeation of total isocyanate for each garment type.

Impact of secondary generated minerals on toxic element immobilization for air pollution control fly ash of a municipal solid waste incinerator

Abstract

Impacts of secondary generated minerals on mineralogical and physical immobilization of toxic elements were investigated for chelate-treated air pollution control (APC) fly ash of a municipal solid waste incinerator. Scanning electron microscope (SEM) observation showed that ettringite was generated after the moistening treatment with/without chelate. Although ettringite can incorporate toxic elements into its structure, elemental analysis by energy dispersive X-ray could not find concentrated points of toxic elements in ettringite structure. This implies that mineralogical immobilization of toxic element by the encapsulation to ettringite structure seems to be limited. Physical immobilization was also investigated by SEM observation of the same APC fly ash particles before and after the moistening treatment. The transfer of soluble elements was inhibited only when insoluble minerals such as gypsum were generated and covered the surface of fly ash particles. Neoformed insoluble minerals prevented soluble elements from leaching and transfer. However, such physical immobilization seems to be limited because insoluble mineral formation with surface coverage was monitored only one time of more than 20 observations. Although uncertainty owing to limited samples with limited observations should be considered, this study concludes that mineralogical and physical immobilization of toxic elements by secondary minerals is limited although secondary minerals are always generated on the surface of APC fly ash particles during chelate treatment.

Chronic low back pain: a mini-review on pharmacological management and pathophysiological insights from clinical and pre-clinical data

Abstract

Globally, low back pain (LBP) is one of the most common health problems affecting humans. The lifetime prevalence of non-specific LBP is approximately 84%, with the chronic prevalence at about 23%. Chronic LBP in humans is defined as LBP that persists for more than 12 weeks without a significant pain improvement. Although there are numerous evidence-based guidelines on the management of acute LBP, this is not the case for chronic LBP, which is regarded as particularly difficult to treat. Research aimed at discovering new drug treatments for alleviation of chronic mechanical LBP is lacking due to the paucity of knowledge on the pathobiology of this condition, despite its high morbidity in the affected adult population. For a debilitating condition such as chronic LBP, it is necessary to assess the sustained effects of pharmacotherapy of various agents spanning months to years. Although many rodent models of mechanical LBP have been developed to mimic the human condition, some of the major shortcomings of many of these models are (1) the presence of a concurrent neuropathic component that develops secondary to posterior intervertebral disc puncture, (2) severe model phenotype, and/or (3) use of behavioural endpoints that have yet to be validated for pain. Hence, there is a great, unmet need for research aimed at discovering new biological targets in rodent models of chronic mechanical LBP for use in drug discovery programs as a means to potentially produce new highly effective and well-tolerated analgesic agents to improve relief of chronic LBP. On a cautionary note, it must be borne in mind that because humans and rats display orthograde and pronograde postures, respectively, the different mechanical forces on their spines add to the difficulty in translation of promising rodent data to humans.

The potential accumulation of polycyclic aromatic hydrocarbons in phytoplankton and bivalves in Can Gio coastal wetland, Vietnam

Abstract

Polycyclic aromatic hydrocarbons (PAHs) are one of the most important classes of anthropogenic persistent organic contaminants in the marine environment. This review discusses a whole range of findings that address various aspects of the bioaccumulation of PAHs in two common marine biota (phytoplankton and bivalves) globally and especially for Can Gio coastal wetland, Vietnam. The published information and collected data on the bioconcentration and accumulation mechanisms of PAHs as well as implications for Can Gio coastal wetland are compiled for phytoplankton and bivalves. PAHs are still released to Can Gio coastal environments from various sources and then transported to coastal environments through various physical processes; they may enter marine food chains and be highly accumulated in phytoplankton and bivalves. Thus, PAHs' bioaccumulation should be considered as one important criterion to assess the water's quality, directly linked to human health due to seafood consumption. Ecologically, Can Gio coastal wetland plays an important role to the South Vietnam key economic zone. However, it is also an area of potential PAHs inputs. With the abundant phytoplankton and bivalves in Can Gio coastal wetland, the PAHs bioaccumulation in these biota is inevitably detected. Thus, further study on the bioavailability of these contaminants is urgently needed in order to mitigate their negative effects and protect the ecosystems.

Elucidation of contamination sources for poly- and perfluoroalkyl substances (PFASs) on Svalbard (Norwegian Arctic)

Abstract

A combination of local (i.e. firefighting training facilities) and remote sources (i.e. long-range transport) is assumed to be responsible for the occurrence of per- and polyfluoroalkyl substances (PFASs) in Svalbard (Norwegian Arctic). However, no systematic elucidation of local PFASs sources has been conducted yet. Therefore, a survey was performed aiming at identifying local PFAS pollution sources on the island of Spitsbergen (Svalbard, Norway). Soil, freshwater (lake, draining rivers), seawater, meltwater run-off, surface snow and coastal sediment samples were collected from Longyearbyen (Norwegian mining town), Ny-Ålesund (research facility) and the Lake Linnévatnet area (background site) during several campaigns (2014–2016) and analysed for 14 individual target PFASs. For background site (Linnévatnet area, sampling during April to June 2015), ΣPFAS levels ranged from 0.4 to 4 ng/L in surface lake water (n = 20). PFAS in meltwater from the contributing glaciers showed similar concentrations (~ 4 ng/L, n = 2). The short-chain perfluorobutanoate (PFBA) was predominant in lake water (60–80% of the ΣPFASs), meltwater (20–30%) and run-off water (40%). Long-range transport is assumed to be the major PFAS source. In Longyearbyen, five water samples (i.e. 2 seawater, 3 run-off) were collected near the local firefighting training site (FFTS) in November 2014 and June 2015, respectively. The highest PFAS levels were found in FFTS meltwater run-off (118 ng/L). Perfluorooctane sulfonic acid (PFOS) was the most abundant compound in the FFTS meltwater run-off (53–58% PFASs). At the research station Ny-Ålesund, seawater (n = 6), soil (n = 9) and freshwater (n = 10) were collected in June 2016. Low ΣPFAS concentrations were determined for seawater (5–6 ng/L), whereas high ΣPFAS concentrations were found in run-off water (113–119 ng/L) and soil (211–800 ng/g dry weight (dw)) collected close to the local FFTS. In addition, high ΣPFAS levels (127 ng/L) were also found in freshwater from lake Solvatnet close to former sewage treatment facility. Overall, at both FFTS-affected sites (soil, water), PFOS was the most abundant compound (60–69% of ΣPFASs). FFTS and landfill locations were identified as major PFAS sources for Svalbard settlements.

Effect of foliar-applied iron complexed with lysine on growth and cadmium (Cd) uptake in rice under Cd stress

Abstract

Contamination of soils with cadmium (Cd) is a serious problem worldwide. Rice (Oryza sativa L.) is reported to accumulate relatively higher Cd contents in consumable parts and is considered a main source of Cd toxicity to humans from rice-derived products. The aim of this pot trial was to investigate the effect of foliar-applied iron (Fe) complexed with lysine on growth, photosynthesis, Cd concentration in plants, oxidative stress, and activities of antioxidants of rice in soil contaminated with Cd. Rice seedlings (30-day-old) were transferred to the soil, and after 2 weeks, different concentrations of Fe-lysine (0, 1.5, 3.0, 4.5, 6.0, and 7.5 mg L⁻¹) were applied as a foliar spray once in a week for 4 weeks and plant samples were taken after 10 weeks of growth in the soil under ambient conditions. Foliar supply of Fe-lysine complex significantly enhanced the plant height, dry weights of plants, concentration of chlorophyll, and gas exchange attributes in Cd-stressed rice. Fe-lysine decreased the Cd concentrations in plants while increasing the Fe concentrations in rice seedlings being maximum with Fe-lysine of 6.0 mg L⁻¹. Electrolyte leakage decreased while activities of key antioxidant enzymes increased with Fe-lysine compared to the control. According to the present results, Fe-lysine complex can effectively be used to reduce Cd concentrations in rice and probably in other crop species.

Effect of Pseudomonas fluorescens and pyoverdine on the phytoextraction of cesium by red clover in soil pots and hydroponics

Abstract

With the aim of improving the phytoextraction rate of cesium (Cs), the effect of Pseudomonas fluorescens ATCC 17400 and its siderophore pyoverdine (PVD) on the uptake of Cs by red clover was studied in soil pots. This work also provides a mechanistic understanding of the Cs-bacteria (or PVD)-illite-plant interactions by using a simplified experimental design, i.e., hydroponics with either Cs in solution or Cs-spiked illite in suspension. For soil spiked with 11.2 mmol kg⁻¹ (1480 mg kg⁻¹) of Cs, 0.43% of total Cs was taken up by red clover in 12 days (119 μmol g⁻¹ (16 mg g⁻¹) of Cs dry matter in roots and 40 μmol g⁻¹ (5 mg g⁻¹) in shoots). In hydroponics with Cs in solution (0.1 mmol L⁻¹ or 13 mg L⁻¹), 75% of Cs was taken up vs. only 0.86% with Cs-spiked illite suspension. P. fluorescens and PVD did not increase Cs concentrations in aboveground parts and roots of red clover and even decreased them. The damaging effect of PVD on red clover growth was demonstrated with the biomass yielding 66% of the control in soil pots (and 100% mortality after 12 days of exposition) and only 56% in hydroponics (78% with illite in suspension). Nonetheless, PVD and, to a lesser extent, P. fluorescens increased the translocation factor up to a factor of 2.8. This study clearly showed a direct damaging effect of PVD and to a lower extent the retention of Cs by biofilm covering both the roots and illite, both resulting in the lower phytoextraction efficiency.

Lead exposure is associated with risk of impaired coagulation in preschool children from an e-waste recycling area

Abstract

Environmental lead exposure leads to various deleterious effects on multiple organs and systems, including the hematopoietic system. To explore the effects of lead exposure on platelet indices in preschool children from an informal, lead-contaminated electronic waste (e-waste) recycling area, we collected venous blood samples from 466 preschool children (331 from an e-waste area (Guiyu) and 135 from a non-e-waste area (Haojiang)). Child blood lead levels (BLLs) were determined by graphite furnace atomic absorption spectrophotometry, while platelet indices were quantified using a Sysmex XT-1800i hematology analyzer. Higher blood lead levels are observed in e-waste lead-exposed preschool children. Significant relationships between high blood lead levels (exceeding current health limits) and elevated platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV), and platelet large cell ratio (P-LCR) were also uncovered. Furthermore, the median PLT and PCT levels of children from the exposed group both exceeded the respective recommended maximum reference range value, whereas the reference group did not. Location of child residence in Guiyu and BLLs were both risk factors related to platelet indices. These results suggest that high blood lead exposure from e-waste recycling may increase the risk of an amplified coagulation process through the activation of platelets in preschool children.

The Janus head of Bachelard’s phenomenotechnique: from purification to proliferation and back

Abstract

The work of Gaston Bachelard is known for two crucial concepts, that of the epistemological rupture and that of phenomenotechnique. A crucial question is, however, how these two concepts relate to one another. Are they in fact essentially connected or must they be seen as two separate elements of Bachelard's thinking? This paper aims to analyse the relation between these two Bachelardian moments and the significance of the concept of phenomenotechnique for today. This will be done by examining certain historical uses of the concepts of Bachelard have been used from the 1960s on. From this historical perspective, one gets the impression that these two concepts are relatively independent from each other. The Althusserian school has exclusively focused on the concept of 'epistemological break', while scholars from Science & Technology Studies (STS), such as Bruno Latour, seem to have only taken up the concept of phenomenotechnique. It in fact leads to two different models of how to think about science, namely the model of purification and the model of proliferation. The former starts from the idea that sciences are rational to the extent that they are purified and free from (epistemological) obstacles. Scientific objectivity, within this later model, is not achieved by eradicating all intermediaries, obstacles and distortions, but rather exactly by introducing as many relevant technical mediators as possible. Finally, such a strong distinction will be criticized and the argument will be made that both in Bachelard's and Latour's thought both concepts are combined. This leads to a janus-headed view on science, where both the element of purification (the epistemological break) and the element of proliferation (phenomenotechnique) are combined.

Paulo Freire and Philosophy for Children: A Critical Dialogue

Abstract

This paper is an attempt to connect the Brazilian Paulo Freire's well known educational thinking with the "philosophy for children" movement. It considers the relationship between the creator of philosophy for children (P4C), Matthew Lipman and Freire through different attempts to establish a relationship between these two educators. The paper shows that the relationship between them is not as close as many supporters of P4C have claimed, especially in Latin America. It also considers the context of Educational Policies in our time and why Freire's understanding of the politics of education makes it impossible to be Freirean and at the same time be neutral or favorable to the actual status quo. Finally, after presenting Lipman's understanding of the relationship between philosophy, education and democracy and their connection to capitalism, it proposes ways to begin the political path of philosophizing with children inspired by Paulo Freire's educational thinking. As a result, a more politically committed path to doing philosophy with children is offered.

Durable Complete Responses in Some Recurrent High Grade Glioma Patients Treated with Toca 511 & Toca FC

Abstract

Background

Vocimagene amiretrorepvec (Toca 511) is an investigational gamma-retroviral replicating vector encoding cytosine deaminase that, when used in combination with extended-release 5-fluorocytosine (Toca FC), results preclinically in local production of 5-fluorouracil, depletion of immune-suppressive myeloid cells, and subsequent induction of anti-tumor immunity. Recurrent high grade glioma (rHGG) patients have a high unmet need for effective therapies that produce durable responses lasting more than 6 months. In this setting, relapse is nearly universal and most responses are transient.

Methods

In this Toca 511 ascending-dose phase I trial (NCT01470794), HGG patients who recurred after standard of care underwent surgical resection, received Toca 511 injected into resection cavity wall followed by orally administered cycles of Toca FC.

Results

Among 56 patients, durable complete responses were observed. A subgroup was identified based on Toca 511 dose and entry requirements for the follow-up phase III study. In this subgroup, which included both IDH1-mutant and -wildtype tumors, the durable response rate is 21.7%. Median duration of follow-up for responders is 35.7+ months. As of August 25, 2017, all responders remain in response and are alive, 33.9+ to 52.2+ months after Toca 511 administration, suggesting a positive association of durable response with overall survival.

Conclusions

Multi-year durable responses have been observed in rHGG patients treated with Toca 511 & Toca FC in a phase I trial and the treatment will be further evaluated in a randomized phase III trial. Among IDH1 mutant patients treated at first recurrence, there may be an enrichment of complete responders.

Primary investigation of the antialgal activity of shrimp shell on Microcystis aeruginosa

Abstract

This study aimed to explore the application potential of an eco-friendly waste—shrimp shell in Microcystis aeruginosa (M. aeruginosa) control—for the first time. Four treatments with different doses (0.75, 1.5, 3.0, and 6.0 g/L) were built to investigate the effects of shrimp shell on the growth, cell viability, physiological changes, and microcystins (MCs) release of M. aeruginosa cells. The water quality after shrimp shell treatment was also detected. Results showed that the growth of M. aeruginosa was effectively inhibited by shrimp shell, and the inhibition rates were dose-dependent within 7 days. Though shrimp shells at high doses could inhibit the cell growth greatly, the MC release was accelerated as they led to the cells lysis. While with the low shrimp shell dose (0.75 g/L), both satisfied inhibition effect and low MC release could be achieved simultaneously. For the water quality, we found that the turbidity and TN was not affected obviously with low dosage of shrimp shell, but it resulted in the increasing of COD_Mn and TP contents. In summary, the shrimp shell can be used as an effective algicide to control algal blooms but its adverse effect on COD_Mn and TP of water should be further solved.

Photodynamic therapy corrects abnormal cancer-associated gene expression observed in actinic keratosis lesions and induces a remodeling effect in photodamaged skin

Actinic keratoses (AK) are lesions formed from proliferations of transformed neoplastic keratinocytes in the epidermis, resulting from cumulative ultraviolet radiation (UVR) from sun exposure [1,2]. Lesions are found on sites of sun-exposed skin such as the face, balding scalp, chest, forearms and back of the hand. AKs may present on a patient as visible lesions, of which 5-10% have the potential to transform into squamous cell carcinoma (SCC) [3,4]. In Organ Transplant Recipients (OTR) as a consequence of long-term immunosuppressive therapy, the risk of developing cutaneous SCC is much higher, with an almost 250-fold increase compared with immunocompetent individuals [5,6].

Chronic Obesity and Incident Hypertension in Latina Women Are Associated with Accelerated Telomere Length Loss over a 1-Year Period

Metabolic Syndrome and Related Disorders, Ahead of Print.

Can Posting Be a Catalyst for Dating Violence? Social Media Behaviors and Physical Interactions

Violence and Gender, Ahead of Print.

Robust path planning for flexible needle insertion using Markov decision processes

Abstract

Purpose

Flexible needle has the potential to accurately navigate to a treatment region in the least invasive manner. We propose a new planning method using Markov decision processes (MDPs) for flexible needle navigation that can perform robust path planning and steering under the circumstance of complex tissue–needle interactions.

Methods

This method enhances the robustness of flexible needle steering from three different perspectives. First, the method considers the problem caused by soft tissue deformation. The method then resolves the common needle penetration failure caused by patterns of targets, while the last solution addresses the uncertainty issues in flexible needle motion due to complex and unpredictable tissue–needle interaction.

Results

Computer simulation and phantom experimental results show that the proposed method can perform robust planning and generate a secure control policy for flexible needle steering. Compared with a traditional method using MDPs, the proposed method achieves higher accuracy and probability of success in avoiding obstacles under complicated and uncertain tissue–needle interactions. Future work will involve experiment with biological tissue in vivo.

Conclusion

The proposed robust path planning method can securely steer flexible needle within soft phantom tissues and achieve high adaptability in computer simulation.

The phosphorus fractions and adsorption-desorption characteristics in the Wuliangsuhai Lake, China

Abstract

The phosphorus (P) fractions and adsorption-desorption characteristics in the Wuliangsuhai Lake were investigated through molybdenum blue/ascorbic acid method and indoor simulation experiments, respectively. The results showed that the highest total phosphorus concentration in overlying water (W-TP) was found in S1 which was in the hypereutrophic type. The mean concentration of particulate organic phosphorus (POP) was the most abundant P fraction (31.35% of the W-TP). The results of TP contents in sediments (S-TP) indicated that the most sampling sites were in the mild level of pollution. The contents of calcium-bound P (HCl-P) and residual P (Res-P) fractions together comprised 83.03–98.10% of the S-TP. Pseudo-second-order models fitted well with the adsorption-desorption kinetic of P fractions. The Langmuir and Freundlich models well described the adsorption isotherm of P fractions. The results of adsorption-desorption of P fractions indicated that the adsorption capacity was strong, the chemical adsorption was dominant, and the sediments was a source of P. Accordingly, we concluded that the Wuliangsuhai Lake was in the moderate pollution level, and the sediments as a source could desorb P in natural aquatic environment.

Evans on transparency: a rationalist account

Abstract

Gareth Evans famously observed that he can answer the question 'Do you think there is going to be a third world war?' by attending to "precisely the same outward phenomena as I would attend to if I were answering the question 'Will there be a third world war?'" (The varieties of reference, Oxford University Press, Oxford, p 225, 1982). I argue that this observation follows from two independently plausible ideas in philosophy of mind. The first is about rationality and consciousness: it is that to be rational is in part to be required to believe that you are in a conscious state if you are in one, at least if various background conditions are met. The second is about consciousness and attention: it is that consciousness in a belief state consists in its subject engaging, to a sufficient extent, in a certain sort of world-directed attention. I also argue that this suggestion is superior to others that have been made in the literature regarding Evan's observation. 

Sequential surgical signatures in micro-suturing task

Abstract

Purpose

Surgical processes are generally only studied by identifying differences in populations such as participants or level of expertise. But the similarity between this population is also important in understanding the process. We therefore proposed to study these two aspects.

Methods

In this article, we show how similarities in process workflow within a population can be identified as sequential surgical signatures. To this purpose, we have proposed a pattern mining approach to identify these signatures.

Validation

We validated our method with a data set composed of seventeen micro-surgical suturing tasks performed by four participants with two levels of expertise.

Results

We identified sequential surgical signatures specific to each participant, shared between participants with and without the same level of expertise. These signatures are also able to perfectly define the level of expertise of the participant who performed a new micro-surgical suturing task. However, it is more complicated to determine who the participant is, and the method correctly determines this information in only 64% of cases.

Conclusion

We show for the first time the concept of sequential surgical signature. This new concept has the potential to further help to understand surgical procedures and provide useful knowledge to define future CAS systems.

Propolis modulates NOS2/arginase-1 pathway in tropomyosin-induced experimental autoimmune uveitis

Abstract

In this study, we evaluated the preventive and curative effects of ethanolic extract of Propolis (EEP) during α-Tropomyosin-induced uveitis in an experimental model using Wistar rats, through the regulation of inducible nitric oxide synthase (NOS2) and arginase-1. In this context, rats received daily injection of EEP (100 mg/kg) for 5 days prior to immunization or for 9 days commencing 5 days post immunization with α-Tropomyosin extract, then were sacrificed at day 14. Histological examination, NOS2, arginase-1, and nuclear factor-κB (NF-κB) expression were evaluated in the retinas. Plasmatic production of nitric oxide (NO), urea, IL-4, and TNF-α was assessed. We have found that treatment with EEP substantially reduced the retinal histological damages induced by α-Tropomyosin. In the same context, a significant decrease of NO and TNF-α levels was noticed. Interestingly, EEP down-modulated NOS2 and NF-κB expression in retina. Also, an increase in urea and IL-4 levels was concomitant to an up-modulation of arginase-1 expression. Hence, it appears that EEP attenuated retinal damages through the induction of Th2 response and the inhibition of NF-κB/NOS2 pathway.

Allergic contact cheilitis in an adolescent to Ricinus communis seed oil (castor oil) in a lip balm

Contact Dermatitis, EarlyView.

Asthma Over the Age of 65: All's Well That Ends Well

Publication date: May–June 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 3
Author(s): Alan P. Baptist, Paula J. Busse
Asthma in older adults (often classified as those 65 years or older) is relatively common, underdiagnosed, and suboptimally treated. It is an important health problem, as the population of the United States continues to age. Unfortunately, asthma morbidity and mortality rates are highest in this age group. Alterations in the innate and adaptive immune responses occur with aging, and contribute to pathophysiologic differences and subsequent treatment challenges. The symptoms of asthma may differ from those in younger populations, and often include fatigue. There are unique factors that can complicate asthma management among older adults, including comorbidities, menopause, caregiver roles, and depression. Pharmacologic therapies are often not as effective as in younger populations, and may have greater side effects. Spirometry, peak flow measurements, and asthma education are typically underused, and may contribute to delays in diagnosis as well as worse outcomes. There are specific strategies that health care providers can take to improve the care of older adults with asthma.

Rethinking Access to Care

Publication date: May–June 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 3
Author(s): Peter J. Gergen

Safety of multi-dose immunotherapy vials after routine use

Publication date: Available online 9 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Priya Nath, John Freiler, Robert Anthony Gomez

Behavioral Interventions for Asthma: What Kind of Exercise and Diets Should We Be Prescribing?

Publication date: May–June 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 3
Author(s): Simon L. Bacon, Peter G. Gibson

The Use of Telemedicine for Penicillin Allergy Skin Testing

Publication date: Available online 8 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Mary L. Staicu, Anne Marie Holly, Kelly M. Conn, Allison Ramsey
BackgroundPenicillin skin testing (PST) is increasingly utilized as a tool to evaluate penicillin allergy in patients with a reported history. The limited availability of allergists, however, may be an impeding factor.ObjectiveWe sought to assess the clinical utility of telemedicine to facilitate PST.MethodsPenicillin allergic inpatients receiving systemic antibiotics were prospectively identified between April and August 2017. Qualifying patients underwent PST performed by a trained Allergy/Immunology physician assistant (PA). Upon completion of PST, a telemedicine consultation, through the use of real-time interactive video conferencing (Microsoft Lync 2013, Redmond, WA), was performed remotely by an allergist. Patients were surveyed regarding their satisfaction with the telemedicine experience.ResultsFifty patients consented to PST through a telemedicine consultation. The average total time to complete a consultation was 128 minutes (SD ± 33). Of this, average PA travel time was 46 minutes (36%) with the remaining time spent on clinical services (82 minutes, 64%). The average physician telemedicine time per patient was 5 minutes (SD ± 2). Patients rated their experience as an average of 4.5 on a scale of 1 (highly unsatisfied) to 5 (highly satisfied). Of the 46 PST-negative patients, 33 were transitioned to a β-lactam antibiotic which reduced the use of vancomycin, metronidazole, aztreonam, aminoglycosides, and clindamycin (p<0.05). More than $30,000 was saved throughout the study period.ConclusionTelemedicine is an effective and novel approach to facilitate PST in the inpatient setting and carries a high degree of patient satisfaction. This method has the potential to optimize and improve access to Allergy/Immunology resources.

CME Exam: Taming Asthma in School-Aged Children: A Comprehensive Review

Publication date: May–June 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 3