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Τετάρτη 23 Μαΐου 2018

Integral use of plants and their residues: the case of cocoyam ( Xanthosoma sagittifolium ) conversion through biorefineries at small scale

Abstract

During last decades, there has been a growing interest of decreasing the environmental impact generated by humans. This situation has been approached from different perspectives being the integral use of raw materials as one of the best alternatives. It was estimated that 3.7 × 109 tonnes of agricultural residues are produced annually worldwide. Then, the integral use of feedstocks has been studied through the biorefinery concept. A biorefinery can be a promissory option for processing feedstocks in rural zones aiming to boost the techno-economic and social growth. However, many plants produced at small scale in rural zones without high industrial use contribute with residues usually not studied as raw materials for other processes. Cocoyam (Xanthosoma sagittifolium) is a plant grown extensively in tropical regions. Nigeria, China, and Ghana are the main producers with 1.3, 1.18, and 0.9 million tonnes/year, respectively. In Colombia, there are no technified crops, but it is used where it is grown mainly as animal feed. This plant consists of leaves, stem, and a tuber but the use is generally limited to the leaves, discarding the other parts. These discarded parts have great potential (lignocellulose and starch). This work proposes different processing schemes using the parts of the plant to obtain value-added products, and their techno-economic and environmental assessment. The simulation was performed with Aspen Plus and the economic package was used for the economic assessment. For the environmental assessment, Waste Algorithm Reduction of the U.S. EPA was implemented. The obtained results showed that the integral use of plants under a biorefinery scheme allows obtaining better techno-economic and environmental performance and that small-scale biorefineries can be a promissory option for boosting rural zones.



Endophytic bacterium Buttiauxella sp. SaSR13 improves plant growth and cadmium accumulation of hyperaccumulator Sedum alfredii

Abstract

Inoculation with endophytic bacterium has been considered as a prospective application to improve the efficiency of phytoextraction. In this study, the effect of Buttiauxella sp. SaSR13 (SaSR13), a novel endophytic bacterium isolated from the root of hyperaccumulator Sedum alfredii, on plant growth and cadmium (Cd) accumulation in S. alfredii was investigated. Laser scanning confocal microscopic (LSCM) images showed that SaSR13 was mainly colonized in the root elongation and mature zones. The inoculation with SaSR13 to Cd-treated plants significantly enhanced plant growth (by 39 and 42% for shoot and root biomass, respectively), chlorophyll contents (by 38%), and Cd concentration in the shoot and root (by 32 and 22%, respectively). SaSR13 stimulated the development of roots (increased root length, surface area, and root tips number) due to an increase in the indole-3-acid (IAA) concentrations and a decrease in the concentrations of superoxide anion (O2.−) in plants grown under Cd stress. Furthermore, inoculation with SaSR13 enhanced the release of root exudates, especially malic acid and oxalic acid, which might have facilitated the uptake of Cd by S. alfredii. It is suggested that inoculation with endophytic bacterium SaSR13 is a promising bioaugmentation method to enhance the Cd phytoextraction efficiency by S. alfredii.



Investigating the driving forces of China’s carbon intensity based on a dynamic spatial model

Abstract

In extant literature on China's carbon intensity, economic growth is considered an important determinant. However, the corresponding policy implications are slightly weak in subsequent practice because economic growth is an outcome of many economic activities, such as technological progress and capital stock accumulation. Furthermore, spatial spillover effects are ignored when using regional datasets. As a result, this study uses the dynamic spatial model to analyze the driving forces of China's provincial carbon intensity over the period 2000–2014. Results indicate that both technological progress and capital stock accumulation are important measures to carbon intensity reduction. China's current industrialization, urbanization, and special energy structure exert a negative effect on the decline in carbon intensity. In addition, China's provincial carbon intensity also exhibits considerable spatiotemporal distribution characteristics. As such, the corresponding policy measures are presented.



Impacts of meteorological conditions on wintertime PM 2.5 pollution in Taiyuan, North China

Abstract

Taiyuan frequently experiences heavy PM2.5 pollution in winter under unfavorable meteorological conditions. To understand how the meteorological factors influence the pollution in Taiyuan, this study involved a systematic analysis for a continuous period from November 2016 to January 2017, using near-surface meteorological observations, radiosonde soundings, PM2.5 measurements, and three-dimension numerical simulation, in combination with backward trajectory calculations. The results show that PM2.5 concentration positively correlates with surface temperature and relative humidity and anti-correlates with near-surface wind speed and boundary layer height (BLH). The low BLH is often associated with a strong thermal inversion layer capping over. In addition to the high local emissions, it is found that under certain synoptic conditions, the southwesterly and southerly winds could bring pollutants from Linfen to Taiyuan, leading to a near-surface PM2.5 concentration higher than 200 μg m−3. Another pollution enhancing issue is due to the semi-closed basin of Taiyuan affecting the planetary boundary layer (PBL): the surrounding mountains favor the formation of a cold air pool in the basin, which inhibits vertical exchanges of heat, flux, and momentum between PBL and the free troposphere, resulting in stagnant conditions and poor air quality in Taiyuan. These findings can be utilized to improve the understanding of PM2.5 pollution in Taiyuan, to enhance the accuracy of forecasting pollution, and to provide scientific support for policy makers to mitigate the pollution.



Linear Keratotic Lesions in a Young Woman

A woman in her 20s presented with linear hyperkeratotic papules on her right arm in a Blaschkoid pattern. What is your diagnosis?

Topical Sirolimus to Treat Tuberous Sclerosis Complex

Tuberous sclerosis complex (TSC) causes the formation of hamartomatous tumors in multiple organs. Facial angiofibromas frequently arise during childhood and can be a source of patient distress owing to bleeding and effects on appearance. The standard treatment is surgical, delivered by multiple modalities, including lasers, shave excision, dermabrasion, electrosurgery, or cryosurgery. These approaches are effective but can create concerns about the potential for scarring, pain, anesthesia risk, postoperative recovery, and the need for repeated procedures delivered in the office or operating room. Consequently, there has been interest in the development of a topical therapy for home use that is painless and nonscarring. In this issue, Koenig and collaborators show that topical 0.1% or 1.0% sirolimus (rapamycin) applied once daily is safe and effective for treating facial angiofibromas. This is welcome news for many with TSC. Furthermore, these results are expected to fuel investigations into other uses for sirolimus in dermatology. The story of how topical sirolimus became a treatment option for TSC is based in scientific discoveries of its molecular target and that target's role in relevant diseases.

Prevalence of Crohn Disease Among Patients With Hidradenitis Suppurativa

This cross-sectional cohort analysis of electronic health records from a large US database evaluates overall and subgroup prevalence of Crohn disease among patients with hidradenitis suppurativa.

Mogamilizumab Prior to Allogeneic Hematopoietic Stem Cell Transplantation

This case series describes characteristics of 8 patients with mycosis fungoides or Sézary syndrome who received mogamulizumab before allogeneic hematopoietic stem cell transplantation and any resulting graft-vs-host disease–related complications.

Topical Rapamycin in Patients With Facial Angiofibromas

This randomized clinical trial examines the efficacy and safety of topical rapamycin therapy for treatment of patients with tuberous sclerosis complex–related facial angiofibromas.

Immunotherapy-Related Eruption Limited to Sites of Melanoma Metastases

This case report describes 2 patients with cutaneous eruptions secondary to immunotherapy for metastatic melanoma limited to sites of locoregional melanoma metastases.

Commentary: Skin cancer in the military

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6
Author(s): Oliver J. Wisco, Tamar Hajar, Donald J. Grande




Cover Sheet for Index

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6





Table of Contents

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6





Effect of alcohol-based hand rub on hand microbiome and hand skin health in hospitalized adult stem cell transplant patients: A pilot study

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6
Author(s): Pranab K. Mukherjee, Jyotsna Chandra, Mauricio Retuerto, Karen A. Arters, Mary C. Consolo, A'ja Patterson, Saralee Bajaksouzian, James W. Arbogast, Todd J. Cartner, Michael R. Jacobs, Mahmoud A. Ghannoum, Robert A. Salata




Information for Readers

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6





Self-healing juvenile cutaneous mucinosis: Clinical and histopathologic findings of 9 patients

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6
Author(s): Isabelle Luchsinger, Jérôme Coulombe, Franco Rongioletti, Marc Haspeslagh, Anne Dompmartin, Isabelle Melki, Rawane Dagher, Brigitte Bader-Meunier, Sylvie Fraitag, Christine Bodemer
BackgroundSelf-healing juvenile cutaneous mucinosis (SHJCM) is a rare disorder, and its pathogenesis and long-term prognosis are unknown.ObjectiveTo elucidate the clinical and histopathologic characteristics, pathogenesis, and outcome in patients with SHJCM.MethodsRetrospective study of 9 patients with SHCJM. To complement initial findings, data collection forms were sent to the referring physicians.ResultsAll patients had an acute onset of firm nodules. Of the 9 patients, 6 presented initially with waxy papules on the dorsum of the hands; 5 suffered from periorbital edema, and 6 had a febrile prodrome. Histopathologic assessment of the papules revealed dermal mucin deposition, whereas the nodules showed proliferative fasciitis-like features or nonspecific chronic lobular panniculitis. Laboratory studies elicited evidence of active viral infection in 2 patients (human herpes virus 6 and rotavirus). Seven cases had spontaneous resolution within 6 months, and 2 patients with incomplete resolution showed subsequent transition to fibroblastic rheumatism and an autoinflammatory rheumatologic disease, respectively.LimitationsThis was a retrospective study with incomplete data from referring physicians.ConclusionsAlthough spontaneous complete regression is expected, patients with SHJCM need long-term follow-up because of the possible development of dematorheumatolgic conditions. The pathogenetic role of microbial agents deserves further investigation.



JAAD Case Reports Article List

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6





Rapid improvement of prurigo nodularis with cyclosporine treatment

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6
Author(s): Lauren E. Wiznia, Shields W. Callahan, David E. Cohen, Seth J. Orlow




Journal Based CME Instructions and Information

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6





Should medical students follow up on skin biopsy results? When education conflicts with patient privacy

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6
Author(s): Marissa L.H. Baranowski, Benjamin K. Stoff




Langerhans cell histiocytosis in children

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6
Author(s): Jolie Krooks, Milen Minkov, Angela G. Weatherall
Langerhans cell histiocytosis (LCH) is an inflammatory neoplasia of myeloid precursor cells driven by mutations in the mitogen-activated protein kinase pathway. When disease involves the skin, LCH most commonly presents as a seborrheic dermatitis or eczematous eruption on the scalp and trunk. Evaluation for involvement of other organ systems is essential, because 9 of 10 patients presenting with cutaneous disease also have multisystem involvement. Clinical manifestations range from isolated disease with spontaneous resolution to life-threatening multisystem disease. Prognosis depends on involvement of risk organs (liver, spleen, and bone marrow) at diagnosis, particularly on presence of organ dysfunction, and response to initial therapy. Systemic treatment incorporating steroids and cytostatic drugs for at least one year has improved prognosis of multisystem LCH and represents the current standard of care.



Editorial Board

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6





CME examination

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6





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

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6
Author(s): Julio Jasso-Olivares, José Manuel Diaz-Gonzalez, Mariya Miteva
BackgroundThe histologic findings of scalp involvement in dermatomyositis are not well characterized on account of a lack of large series.ObjectiveTo systematize the histologic features of scalp involvement in dermatomyositis on horizontal and vertical sections.MethodsA descriptive, prospective, cross-sectional study recruited 31 patients with pathologically and serologically confirmed dermatomyositis in Mexico City, Mexico, from June 2014 to June 2015. A total of 36 scalp biopsy specimens from 20 patients with scalp involvement in dermatomyositis were processed as 20 vertical and 16 horizontal sections.ResultsDilated capillaries and diffuse mucin deposition were detected in all biopsy specimens, followed by interface dermatitis. Partial or segmental thickening of the basement membrane, hyperkeratosis, atrophic epidermis, and acrosyringeal hypergranulosis with hyperkeratosis were other very common findings. Preserved follicular architecture, with intact or slightly atrophic sebaceous glands, was present in most horizontal sections. There was decreased follicular density, with a terminal-to-vellus ratio of 4:1 and telogen count of 10.3%. Eosinophils were present in 15% and 25% of horizontal and vertical sections, respectively.LimitationsNo special stains performed.ConclusionScalp involvement in dermatomyositis shows nonscarring pattern on horizontal sections that is consistent with chronic telogen effluvium. Telangiectasia and mucin are universal histologic features; eosinophils and acrosyringeal hypergranulosis with hyperkeratosis are new findings.



Answers to CME examination

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6





Treatment of vitiligo with the topical Janus kinase inhibitor ruxolitinib: A 32-week open-label extension study with optional narrow-band ultraviolet B

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6
Author(s): Deep Joshipura, Abdulaziz Alomran, Pedro Zancanaro, David Rosmarin




Langerhans cell histiocytosis in children

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6
Author(s): Jolie Krooks, Milen Minkov, Angela G. Weatherall
A definitive diagnosis of Langerhans cell histiocytosis (LCH) requires a combination of clinical presentation, histology, and immunohistochemistry. The inflammatory infiltrate contains various proportions of LCH cells, the disease hallmark, which are round and have characteristic "coffee-bean" cleaved nuclei and eosinophilic cytoplasm. Positive immunohistochemistry staining for CD1a and CD207 (langerin) are required for a definitive diagnosis. Isolated cutaneous disease should only be treated when symptomatic, because spontaneous resolution is common. Topical steroids are first-line treatment for localized disease of skin and bone. For multifocal single-system or multisystem disease, systemic treatment with steroids and vinblastine for 12 months is the standard first-line regimen. Current research is seeking more effective regimens because recurrence rates, which increase the risk of sequelae, are still high (30-50%) in patients with multisystem disease. An active area of research is the use of targeted therapy directed at the mitogen-activated protein kinase pathway. Adequate follow-up to monitor for disease progression, relapse, and sequelae is recommended in all patients.



Occurrence of vismodegib-induced cramps (muscular spasms) in the treatment of basal cell carcinoma: A prospective study in 30 patients

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6
Author(s): Edwina Girard, Arnaud Lacour, Henry Abi Rached, Nassima Ramdane, Carole Templier, Véronique Dziwniel, Eve Desmedt, Emilie Le Rhun, Laurent Mortier




CME examination

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6





Answers to CME examination

Publication date: June 2018
Source:Journal of the American Academy of Dermatology, Volume 78, Issue 6





Short-term effects of particle size fractions on lung function of late adolescents

Abstract

Although ambient air pollution has been linked to reduced lung function in healthy students, longitudinal studies that compare the response of asthmatic and healthy adolescents are lacking. To evaluate lung function responses to short-term ambient air particulate matter (PM10, PM2.5, and PM1) levels, we conducted a study on high school students aged 15–18 years. The aim of this study was to assess effects of acute exposure to ambient air particulate matter (PM) on lung function in healthy and asthmatic late adolescents. We examined associations of lung function indices and ambient PM levels in 23 asthmatic and 23 healthy students. Paired-samples T test was used to evaluate the association of exposure to airborne PM concentrations with lung function test results (FVC, FEV1, FEV1/FVC, and FEF25–75). We observed negative impact of exposure to an increased concentration of ambient air PM10, PM2.5, and PM1 on lung function parameters of asthmatic and healthy late adolescents. These findings are consistent with other similar short-term studies which have confirmed the adverse effect of PM air pollution. These associations were stronger in asthmatic subjects compared with those in healthy ones. There are significant adverse effects of ambient air PM on pulmonary function of adolescents, especially asthmatics.



Co-digestion of sewage sludge with crude or pretreated glycerol to increase biogas production

Abstract

Anaerobic co-digestion of sewage sludge and glycerol from the biodiesel industry was evaluated in three experimental stages. In the first step, the addition of higher proportions of crude glycerol (5–20% v/v) to the sludge was evaluated, and the results showed a marked decrease in pH and inhibition of methane production. In the second step, co-digestion of sludge with either a lower proportion (1% v/v) of crude glycerol or glycerol pretreated to remove salinity resulted in volatile acid accumulation and low methane production. The accumulation of volatile acids due to the rapid degradation of glycerol in the mixture was more detrimental to methanogenesis than the salinity of the crude glycerol. In the third step, much lower amounts of crude glycerol were added to the sludge (0.3, 0.5, 0.7% v/v), resulting in buffering of the reaction medium and higher methane production than in the control (pure sludge). The best condition for co-digestion was with the addition of 0.5% (v/v) crude glycerol to the sewage sludge, which equals 0.6 g glycerol/g volatile solids applied. Under this condition, the specific methane production (mL CH4/g volatile solids applied) was 1.7 times higher than in the control.



Aquatic plant debris changes sediment enzymatic activity and microbial community structure

Abstract

The retention of aquatic plant debris in freshwater systems favors a reduction in soluble reactive phosphorus (P) in overlying water through microbe-mediated mechanisms in sediment. For a more complete view of the changes in sediment microbial structure and functioning when receiving plant debris, the enzyme activities and microbial community structure in sediments incubated with or without plant debris were investigated. Significantly higher fluorescein diacetate (FDA) hydrolysis, alkaline phosphatase, polyphenol oxidase, cellulase, β-glucosidase, and dehydrogenase activities were observed with plant debris treatment. High-throughput pyrosequencing showed that the number of total operational taxonomic units (OTUs) of bacteria estimated by using the Chao1 analysis was 2064 (in the control) and 1821 (with the plant debris treatment). The Shannon index, functional organization, and Venn diagrams revealed that the enriched OTUs in plant debris-treated community were less diversified than those in the control sample. The prominent bacterial phyla Firmicutes and Bacteroidetes were more diverse after plant debris addition. At the class level, the relative abundance of Alphaproteobacteria increased by 114% when plant debris was added, whereas the relative abundances of Beta-, Delta-, and Gammaproteobacteria decreased by 42, 78, and 86%, respectively. Azospirillum and Dechloromonas, the dominant phylogenetic groups at the genus level, increased with plant debris addition. Our study showed the importance of the above microbial genera in plant debris-mediated P retention in sediment.



Reply to Crispin Wright and Richard Zach



Omalizumab effectiveness by biomarker status in patients with asthma: Evidence from PROSPERO, a prospective real-world study

Publication date: Available online 22 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Thomas B. Casale, Allan T. Luskin, William Busse, Robert S. Zeiger, Benjamin Trzaskoma, Ming Yang, Noelle M. Griffin, Bradley E. Chipps




Long Term Follow up after Penicillin Allergy De-labeling in Ambulatory Patients

Publication date: Available online 22 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Idit Lachover, Shoshan Sharon, Yossi Rosman, Keren Meir-Shafrir, Ronit Confino-Cohen
BackgroundUnverified penicillin allergy label has negative health implications. Toaddress this, several de-labeling methods have been proposed.ObjectiveTo appraise the long term outcomes of the penicillin allergy evaluation in ambulatory patients, focusing on subsequent use of penicillins in individuals found not allergic. A secondary objective was to examine the consistency between the evaluation's recommendations and the allergy label.MethodsA retrospective medical records review and phone survey were carried out in ambulatory patients that were evaluated for suspected penicillin allergy in our allergy unit. Patients with an uneventful oral challenge test (OCT) were interviewed regarding subsequent penicillins use. Medical records were examined for antibiotic prescriptions and purchases. The records were also investigated for existing/erased penicillin allergy label and its consistency with the allergy evaluation.ResultsSix hundred and thirty nine patients with an uneventful OCT were available for the survey. During a 56 month follow-up, 70% (447 patients) have used penicillins at least once. One hundred and ninety two patients (30%) did not use penicillins. The main reason for not using penicillins was lack of a clinical indication. Three hundred thirty five patients (51.22%) carried a penicillin allergy label in their electronic medical file in spite of an uneventful OCT.ConclusionPenicillin allergy annulling via OCT has proven to be effective. Most of the patients who previously avoided penicillins have re-used penicillins safely.



Analysis of HLA-B allelic variation and interferon-gamma ELISpot responses in patients with severe cutaneous adverse reactions associated with drugs

Publication date: Available online 22 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Jettanong Klaewsongkram, Chonlaphat Sukasem, Pattarawat Thantiworasit, Nithikan Suthumchai, Pawinee Rerknimitr, Papapit Tuchinda, Leena Chularojanamontri, Yuttana Srinoulprasert, Ticha Rerkpattanapipat, Kumutnart Chanprapaph, Wareeporn Disphanurat, Panlop Chakkavittumrong, Napatra Tovanabutra, Chutika Srisuttiyakorn
BackgroundThe prevention and confirmation of drug-induced severe cutaneous adverse reactions (SCARs) are difficult.ObjectiveTo determine the benefit of HLA-B allele pre-screening and the measurement of drug-specific interferon-gamma (IFN-γ) releasing cells in the prevention and identification of the culprit drug in SCAR patients.MethodsA total of 160 SCAR patients were recruited from six university hospitals in Thailand over a 3-year period. HLA-B alleles were genotypically analyzed. The frequencies of drug-specific (IFN-γ) releasing cells in SCAR patients were also measured.ResultsThe drugs commonly responsible for SCARs were anticonvulsants, allopurinol, beta-lactams, anti-tuberculosis agents, and sulfonamides. If culprit drugs had been withheld in patients carrying known HLA-B alleles at risk, it would have prevented 21.2% of SCAR cases, mainly allopurinol- and carbamazepine-related SCARs. Culprit drug-specific IFN-γ releasing cells could be identified in 45.7% (53/116) of patients with SCARs caused by five major drug groups, particularly in patients diagnosed with drug reactions with eosinophilia and systemic symptoms-DRESS (50.0%), followed by Stevens-Johnson syndrome/toxic epidermal necrolysis (46.0%), and acute generalized exanthematous pustulosis (31.3%). According to our study, high frequencies of drug-specific IFN-γ releasing cells were significantly demonstrated in patients who suffered from DRESS phenotype, having anticonvulsants or the drugs belonging to the "probable" category based on the Naranjo algorithm scale, as the culprit drugs.ConclusionsHLA-B pre-screening would succeed in preventing only a minority of SCAR victims. Drug-specific IFN-γ releasing cells are detectable in almost half of patients. Better strategies are required for better SCAR prevention and culprit drug confirmation.



Delayed hypersensitivity skin reaction to hydroxychloroquine: successful short desensitization

Publication date: Available online 22 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Héloïse Barailler, Brigitte Milpied, Annick Chauvel, Pauline Claraz, Alain Taïeb, Julien Seneschal, Anne-Sophie Darrigade




Response to the Letter to the Editor by Goldberg and Terry



Re: “Growth Trajectories, Breast Size, and Breast-Tissue Composition in a British Pre-Birth Cohort of Young Women”



Hybrid Diffuse Reflectance Spectroscopy: Non-Erythemal in vivo Testing of Sun Protection Factor

Background/Aims: In order to define a label sun protection factor (SPF) of topically applied sunscreens, in vivo test methods like ISO 24444, FDA guideline, or the Australian standard are used worldwide. The basis of all these methods is provoking an erythemal skin reaction by UV irradiation to find the level of unprotected and protected minimal erythemal doses (MED). In vitro methods replacing the human skin by any kind of non-human material are still not available. Thus, offering the new hybrid diffuse reflectance spectroscopy (HDRS) technique that is able to stay on an in vivo level for SPF testing but meanwhile neglecting the UV-dose-related erythemal skin reaction is a perfect combination to take care of sun protection and any ethical concerns in SPF testing nowadays. Methods: HDRS is a combination of in vivo diffuse reflectance spectroscopy (DRS) measurements on the skin and in vitro transmission measurements of a sunscreen on a roughened polymethylmethacrylate plate. By this technique, the in vivo behavior of the investigated sunscreen on the skin is measured as well as the UVB absorption, which is still non-visible in the reflectance technique. In order to establish an alternative method for in vivo SPF testing, a huge number of sunscreens (80 samples) was measured by HDRS and compared to the worldwide accepted standard ISO 24444. The variety of sunscreens measured reflects a wide range of different types of formulations as well as a wide range of SPFs (5–120) to validate this new alternative SPF testing procedure. Results: The applied quantity of product as well as skin color dependencies of signal generation are shown to support any basic correlation of DRS signal generation and sun protection expectations. Far-reaching statistical data analyses show an excellent link of the new non-erythemally driven HDRS-SPF technique and ISO 24444 results. In the same way, HDRS-UVA-PF results can be correlated with UVA-PF values calculated from ISO 24443. Conclusion: Due to the elimination of any erythemal relevant UVB and UVA doses, absolutely no skin reaction occurs. Consequently there is no need to define a MED any more. For the first time an alternative way to SPF is shown without any ethical concerns of SPF testing in vivo and/or any restriction of SPF testing in vitro. Regardless of the type of formulation or the level of protection, an excellent correlation of SPFHDRS and SPF24444 for sunscreen labeling could be found. By this new alternative non-erythemal technique, not only SPF values can be measured, but also UVA-PF values can be calculated with an excellent correlation to ISO 24443 from the same set of data. For the first time a robust alternative test method of SPF- and UVA-PF values is described, taking into account the interaction of sunscreen formulation and skin.
Skin Pharmacol Physiol 2018;31:220–228

Costaria costata Extract Suppresses Development of Atopic Dermatitis in chloro-2,4-dinitrobenzene-treated NC/Nga Mice

We investigated the potential effects of Costaria costata (CC) on atopic dermatitis (AD) development in chloro-2,4-dinitrobenzene (DNCB)-treated NC/Nga mice. CC is a brown alga distributed across the seas of Korea, China, and Japan. A total of 40 mice were randomly assigned to 5 groups with 8 mice per group: untreated Balb/c mice, AD control (0.1% w/v DNCB-treated NC/Nga mice), positive control (i.e., DNCB-treated NC/Nga mice fed a dietary supplement of 66.6 mg/kg of body weight [b.w.] of CJLP133), DNCB-treated NC/Nga mice fed a dietary supplement of 100 mg/kg b.w. of CCE10 (CCE10 100), and DNCB-treated mice fed a dietary supplement of 300 mg/kg b.w. of CCE10 (CCE10 300) groups. The CCE10 100 and CCE10 300 treatment groups suppressed AD development including clinical and histopathological changes and a reduction in skin hydration induced by DNCB. In addition, Th2 cytokine production in primary splenocytes, serum IgE and histamine production, and mast cell infiltration into the skin were suppressed in the CCE10 300 mice compared to the CCE10 100 mice. Our finding demonstrated an inhibitory effect of CCE10 in AD development by means of improving the Th1/Th2 cytokine balance and anti-inflammatory effect in an in vivo model.
Skin Pharmacol Physiol 2018;31:212–219

Diclofenac Sodium 3% in Hyaluronic Acid 2.5% Gel Significantly Diminishes the Actinic Keratosis Area and Severity Index

Background/Aims: Actinic keratosis area and severity index (AKASI) is a new assessment tool to quantify the severity of actinic damage on the head. Thus far, it has not been evaluated in monitoring the efficacy of field-directed topical treatments in actinic keratosis (AK) in routine clinical practice. Thus, the aim of this study was to determine treatment outcomes by using AKASI 3 months after the initiation of topical application of diclofenac sodium 3% in hyaluronic acid 2.5% gel (DFS) in patients with AKs on the head. Methods: We performed a retrospective analysis of patients with AKs who had AKASI scores prior to and after treatment with DFS. Results: Of the 24 patients included, 20 (83.3%) showed an improvement in AKASI, 2 (8.3%) a stable AKASI, and 2 (8.3%) a worsening of AKASI after a median (interquartile range) follow-up period of 91.5 days (89.8–104.3). The median AKASI reduction was 31.4% (16.7–59.1). The Wilcoxon test showed significant differences (p = 0.0008) between baseline and posttreatment AKASI values. Conclusions: AKASI is an easy-to-use quantitative tool for assessing the treatment outcome of field-directed therapies. Field-directed therapies of AK should no longer be monitored by assessments based on lesion counts alone.
Skin Pharmacol Physiol 2018;31:206–211

Antimicrobial resistance and the presence of extended-spectrum beta-lactamase genes in Escherichia coli isolated from the environment of horse riding centers

Abstract

The aim of the study was to determine the antimicrobial resistance profile and the occurrence of extended-spectrum beta-lactamase genes and to analyze the genetic diversity of Escherichia coli strains isolated from the environment of horse riding centers. The study was conducted using E. coli strains isolated from the air, manure, and horse nostril swabs in three horse riding centers differing in the system of horse keeping—stable (OJK Pegaz and KJK Szary) and free-range (SKH Nielepice). Resistance to antibiotics was determined using the disk-diffusion method, and the PCR technique was employed to detect the extended-spectrum β-lactamase (ESBL) genes, while the genetic diversity of strains was assessed by rep-PCR. A total of 200 strains were collected during the 2-year study, with the majority isolated from KJK Szary, while the smallest number was obtained from SKH Nielepice. The strains were mostly resistant to ampicillin, aztreonam, and ticarcillin. The tested strains were most frequently resistant to one or two antibiotics, with a maximum of ten antimicrobials at the same time. Two multidrug-resistant (MDR) strains were detected in OJK Pegaz while in KJK Szary there were two MDR and one extensively drug-resistant (XDR) strain. The ESBL mechanism was most frequently observed in OJK Pegaz (20.31% of strains) followed by KJK Szary (15.53% of strains) and SKH Nielepice (15.15% of strains). Among the ESBL-determining genes, only blaTEM and blaCTXM-9 were detected—blaTEM was mostly found in KJK Szary (53.40% of strains), while the second detected gene—blaCTXM-9—was most frequent in SKH Nielepice (6.06% of strains). The rep-PCR genotyping showed high variation among the analyzed strains, whereas its degree differed between the studied facilities, indicating that the type of horse keeping (stable vs. free-range) affects the genetic diversity of the E. coli strains. Having regard to the fact that the tested strains of E. coli were derived from non-hospitalized horses that were not treated pharmacologically, we can assume that the observed antimicrobial resistance may be of both—natural origin, i.e., not the result of the selection pressure, and acquired, the source of which could be people present in the horse riding facilities, the remaining horses which were not included in the study, and air, as well as water, fodder, and litter of the animals. Therefore, it can be concluded that the studied horses are the source of resistant E. coli and it is reasonable to continue monitoring the changes in antimicrobial resistance in those bacteria.



Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†



Précis of The Boundary Stones of Thought



Evaluation of membrane‐bound and soluble forms of human leucocyte antigen‐G in systemic sclerosis

Clinical &Experimental Immunology, EarlyView.


Introduction of a laser safety checklist in the ENT operating theatre—our experience across twenty cases

Clinical Otolaryngology, EarlyView.


Undergraduate ear, nose and throat training: How do we inspire the next generation?

Clinical Otolaryngology, EarlyView.


Τρίτη 22 Μαΐου 2018

Micro-scale pollution mechanism of dust diffusion in a blasting driving face based on CFD-DEM coupled model

Abstract

In order to investigate the diffuse pollution mechanisms of high-concentration dusts in the blasting driving face, the airflow-dust coupled model was constructed based on CFD-DEM coupled model; the diffusion rules of the dusts with different diameters at microscopic scale were analyzed in combination with the field measured results. The simulation results demonstrate that single-exhaust ventilation exhibited more favorable dust suppression performance than single-forced ventilation. Under single-exhaust ventilation condition, the motion trajectories of the dusts with the diameter smaller than 20 μm were close to the airflow streamline and these dusts were mainly distributed near the footway walls; by contrast, under single-forced ventilation condition, the motion trajectories of the dust particles with a diameter range of 20~40 μm were close to the airflow streamlines, and a large number of dusts with the diameter smaller than 20 μm accumulated in the regions 5 m and 17~25 m away from the head-on section. Moreover, under the single-exhaust ventilation, the relationship between dust diameter D and negative-pressured-induced dust emission ratio P can be expressed as P = − 25.03ln(D) + 110.39, and the dust emission ratio was up to 74.36% for 7-μm dusts, and the path-dependent settling behaviors of the dusts mainly occurred around the head-on section; under single-forced ventilation condition, the z value of the dusts with the diameter over 20 μm decreased and the dusts with a diameter smaller than 7 μm are particularly harmful to human health, but their settling ratios were below 22.36%.

Graphical abstract

The airflow-dust CFD-DEM coupling model was established. The numerical simulation results were verified. The migration laws of airflow field were obtained in a blasting driving face. The diffusion laws of dusts were obtained after blasting.


Innovative sludge pretreatment technology for impurity separation using micromesh

Abstract

In order to reduce the impacts on sludge treatment facilities caused by impurities such as fibers, hairs, plastic debris, and coarse sand, an innovative primary sludge pretreatment technology, sludge impurity separator (SIS), was proposed in this study. Non-woven micromesh with pore size of 0.40 mm was used to remove the impurities from primary sludge. Results of lab-scale tests showed that impurity concentration, aeration intensity, and channel gap were the key operation parameters, of which the optimized values were below 25 g/L, 0.8 m3/(m2 min), and 2.5 cm, respectively. In the full-scale SIS with treatment capacity of 300 m3/day, over 88% of impurities could be removed from influent and the cleaning cycle of micromesh was more than 16 days. Economic analysis revealed that the average energy consumption was 1.06 kWh/m3 treated sludge and operation cost was 0.6 yuan/m3 treated sludge.



Removal of cobalt and lead ions from wastewater samples using an insoluble nanosponge biopolymer composite: adsorption isotherm, kinetic, thermodynamic, and regeneration studies

Abstract

In this study, an insoluble nanosponge biopolymer composite was synthesized, using a combined process of amidation reaction, cross-linking polymerization, and sol-gel method to obtain a phosphorylated multiwalled carbon nanotube-cyclodextrin/silver-doped titania (pMWCNT-βCD/TiO2-Ag). This work mainly emphasized on the removal of lead (Pb2+) and cobalt (Co2+) metal ions from synthetic and real wastewater samples using the synthesized pMWCNT-βCD/TiO2-Ag as a biosorbent. The new material was characterized by Fourier transform infrared (FTIR) spectroscopy, zeta potential, Brunauer-Emmett-Teller (BET) method, and scanning electron microscopy (SEM). Adsorption studies for the model pollutants were performed in batch mode. The effect of the solution pH, adsorbent dosage and the presence of competiting ions were investigated. The isotherm, kinetic, thermodynamic, and regeneration studies were also undertaken. The ability of the new material to effectively remove Pb2+ and Co2+ from synthetic wastewater and mine effluent samples was tested. The maximum removal capacities achieved for the removal of Pb2+ and Co2+ from mine effluent sample were 35.86 and 7.812 mg/g, respectively.



Plastic surgeons’ opinions and practices regarding compatibility of MRI and breast tissue expanders

As more women undergo breast reconstruction with tissue expanders, the situation where a patient with ferromagnetic port-containing breast tissue expanders (FPCBTE) develops a need for magnetic resonance imaging (MRI) has also become more frequent. Such indications include the new symptoms suggestive of neurologic or osseous metastases, trauma, and perforator mapping if the patient transitions to autologous reconstruction.

Deep inferior epigastric perforator (DIEP) flap: Impact of drain free donor abdominal site on long term patient outcomes and duration of inpatient stay

The deep inferior epigastric perforator (DIEP) flap is widely regarded as the Gold Standard in autologous breast reconstruction. Although drain-free abdominoplasty is performed in many centres, there is a paucity of evidence comparing outcomes when applied to DIEP breast reconstruction.

Managing aesthetic referrals in NHS Scotland: Outcomes from 1,122 patients in the East of Scotland

The Adult Exceptional Aesthetic Referral Protocol (AEARP) encompasses a series of aesthetic procedures which, as they do not treat an underlying disease process, are not routinely available within the National Health Service. Provision of these services can only be provided on an exceptional basis.In this prospective study, we evaluated the referral process and outcomes of 1,122 patients referred under the AEARP over a 3.5-year period. Referrals were screened by a vetting panel comprising of a plastic surgeon, clinical nurse specialist, and clinical psychologist.

Long-term Results of Bacterial Septic Arthritis of the Wrist

Septic arthritis of the wrist is a serious condition, yet little is known about its long-term outcome. A retrospective analysis of 22 patients treated for bacterial septic arthritis of the wrist was conducted with subsequent follow-up of 18 patients with a median period of 44 months to assess functional results via DASH-Score and clinical examination.Arthrotomy was used to treat all patients; in 19 patients, multiple operations were needed to cure the infection. Follow-up revealed a mean DASH-score of 34 (SD 22) and a significant correlation with needed surgical radicality and number of needed operations.

Response to letter commenting on Upgrading the BREAST-Q questionnaire

We read with interest the reply from Klassen and colleagues1 to our publication2 and we fully agree about the lack of methodological validity related to our suggestion of a BREAST-Q expansion. In fact, our aim was meant to focus the attention on the need for an update of the already existing autologous BREAST-Q, according to the evolution in breast reconstruction and flap choice. This was the reason why we wanted to highlight and in parallel put the accent on this topic.

Adding Scales to BREAST-Q Must Follow the Same Rigor as Original Scales

Dear Editor,

Sentinel lymph node biopsy in melanoma: which hot nodes should be harvested and is blue dye really necessary?,,✯✯✯

The '10% rule' has become widely accepted by surgeons performing sentinel lymph node biopsy (SLNB) for melanoma. The purpose of this study was to compare the '10% rule' with alternative node harvesting criteria. In particular, we were interested to see whether the use of blue dye had any impact on the sensitivity of the test and whether it is necessary to remove all hot nodes.

A Survey Analysis on the Management of Moderately Dysplastic Nevi Among Academic Dermatologists Across the United States



The Potential of Narrow Band UVB to Induce Sustained Durable Complete Remission off-Therapy in Stage I Mycosis Fungoides

Narrow Band UVB (NB UVB) produces high rates of complete response (CR) for patients with stage I mycosis fungoides (MF). Data on long-term remission off therapy are lacking. NB UVB induced >5 years disease and therapy free survival in ∼ 60% of CR patients. NB UVB can be considered a disease modifying and potentially curative therapy for patients with stage I MF..

Financial burden of emergency department visits for atopic dermatitis in the United States

Patients with atopic dermatitis have multiple risk factors for utilizing the emergency department.; The prevalence and cost of emergency department visits for atopic dermatitis was high and increased between 2006 and 2012.; Interventions are needed to decrease ED visits for AD.

Atopic dermatitis is associated with osteoporosis and osteopenia in older adults



Acid and alkaline solubilization (pH shift) process: a better approach for the utilization of fish processing waste and by-products

Abstract

Several technologies and methods have been developed over the years to address the environmental pollution and nutritional losses associated with the dumping of fish processing waste and low-cost fish and by-products. Despite the continuous efforts put in this field, none of the developed technologies was successful in addressing the issues due to various technical problems. To solve the problems associated with the fish processing waste and low-value fish and by-products, a process called pH shift/acid and alkaline solubilization process was developed. In this process, proteins are first solubilized using acid and alkali followed by precipitating them at their isoelectric pH to recover functional and stable protein isolates from underutilized fish species and by-products. Many studies were conducted using pH shift process to recover proteins from fish and fish by-products and found to be most successful in recovering proteins with increased yields than conventional surimi (three cycle washing) process and with good functional properties. In this paper, problems associated with conventional processing, advantages and principle of pH shift processing, effect of pH shift process on the quality and storage stability of recovered isolates, applications protein isolates, etc. are discussed in detail for better understanding.



Response to letter commenting on Upgrading the BREAST-Q questionnaire

Publication date: Available online 22 May 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Chiara Stocco, Andrea Figus, Sergio Razzano




Sentinel lymph node biopsy in melanoma: which hot nodes should be harvested and is blue dye really necessary?,,✯✯✯

Publication date: Available online 22 May 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): JM Ranson, NM Pantelides, D Gharpuray Pandit, JKG Laitung
OBJECTIVESThe '10% rule' has become widely accepted by surgeons performing sentinel lymph node biopsy (SLNB) for melanoma. The purpose of this study was to compare the '10% rule' with alternative node harvesting criteria. In particular, we were interested to see whether the use of blue dye had any impact on the sensitivity of the test and whether it is necessary to remove all hot nodes.METHODSWe reviewed 537 SLNBs performed for primary melanoma from 2009-2015. SLNB was offered to all patients with 1- 4mm Breslow thickness melanoma and sentinel nodes were harvested according to the '10% rule'.RESULTS116 patients (22%) had at least one positive sentinel node and there were 45 positive nodal basins from which more than one sentinel node had been harvested. Excluding blue dye and sampling only hot nodes would have enabled a 5% reduction in nodes harvested, without any compromise in the sensitivity of the test. However, applying harvesting criteria whereby not all hot nodes are taken was associated with a loss of sensitivity, with positive sentinel nodes being missed and patients understaged.CONCLUSIONSOur data does not support the continued use of blue dye in SLNB for melanoma, as it does not improve the sensitivity of the test. This series adds to growing evidence to suggest that the '10% rule' with the inclusion of blue nodes should be reconsidered and that radiocolloid tracer alone is sufficient for sentinel node localisation.



Plastic surgeons’ opinions and practices regarding compatibility of MRI and breast tissue expanders

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Publication date: Available online 22 May 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Brielle Weinstein, Peter W. Henderson, Jessica J. Means, Andrew L. Weinstein, Martin R. Prince, Christine H. Rohde




Long-term Results of Bacterial Septic Arthritis of the Wrist

Publication date: Available online 22 May 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Mehran Dadras, Christian Böhm, Christoph Wallner, Johannes Maximilian Wagner, Björn Behr, Marcus Lehnhardt, Adrien Daigeler
Septic arthritis of the wrist is a serious condition, yet little is known about its long-term outcome. A retrospective analysis of 22 patients treated for bacterial septic arthritis of the wrist was conducted with subsequent follow-up of 18 patients with a median period of 44 months to assess functional results via DASH-Score and clinical examination.Arthrotomy was used to treat all patients; in 19 patients, multiple operations were needed to cure the infection. Follow-up revealed a mean DASH-score of 34 (SD 22) and a significant correlation with needed surgical radicality and number of needed operations. The range of motion of the wrist and grip strength of the affected side was 49% (SD 20%) and 70% (SD 28%) of the contralateral side, respectively. In conclusion, septic arthritis of the wrist leads to long-term functional restrictions with a strong correlation with the stage of the disease. Hence, early diagnosis and treatment are paramount.



Deep inferior epigastric perforator (DIEP) flap: Impact of drain free donor abdominal site on long term patient outcomes and duration of inpatient stay

Publication date: Available online 22 May 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Mr Amitabh Thacoor, Mr Muholan Kanapathy, Miss Jana Torres-Grau, Mr Jagdeep Chana
BackgroundThe deep inferior epigastric perforator (DIEP) flap is widely regarded as the Gold Standard in autologous breast reconstruction. Although drain-free abdominoplasty is performed in many centres, there is a paucity of evidence comparing outcomes when applied to DIEP breast reconstruction.MethodA retrospective review of patients who underwent DIEP breast reconstruction without abdominal drain insertion at Royal Free Hospital between Jan 2012-Nov 2016 was undertaken. Results were compared to previously published data from our centre on patients undergoing DIEP breast reconstruction with abdominal drains between Jan 2011-Jul 2012.ResultsThirty-five patients underwent abdominal drain-free reconstruction(GroupA). Of 74 patients who previously underwent reconstruction with abdominal drains, 33 patients underwent drain removal by postoperative day (POD)3 regardless of output (GroupB) and 41 underwent drain removal after POD3 following instructions on drainage volume/24h (GroupC). There was no significant difference in the length of stay between patients in Group A and B (3.6 vs 3.9 days; p=0.204). Length of stay in Group C was significantly higher than Group A and B (p=0.001, p=0.001). There were no statistically significant differences in total (11.43% vs 12.12% vs 17.07%, p=0.780) or specific complications: Seroma: 2.86% vs 0% vs 4.88% (p= 0.774); Wound dehiscence: 8.57% vs 9.09% vs 4.88% (p=0.728); Haematoma: 0% vs 3.00% vs 7.32% (p=0.316) between Groups A, B and C respectively.ConclusionOur data suggests that drain-free abdominal closure in DIEP reconstruction can be safely achieved without increased postoperative complications. These conclusions support existing evidence on the use of a drain-free approach in cosmetic abdominoplasty.



Managing aesthetic referrals in NHS Scotland: Outcomes from 1,122 patients in the East of Scotland

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Publication date: Available online 22 May 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Abdulla Ibrahim, Mahmoud K. Nassar, Daniel J. Jordan, Manish Sinha, Fiona J. Hogg
The Adult Exceptional Aesthetic Referral Protocol (AEARP) encompasses a series of aesthetic procedures which, as they do not treat an underlying disease process, are not routinely available within the National Health Service. Provision of these services can only be provided on an exceptional basis.In this prospective study, we evaluated the referral process and outcomes of 1,122 patients referred under the AEARP over a 3.5-year period. Referrals were screened by a vetting panel comprising of a plastic surgeon, clinical nurse specialist, and clinical psychologist. Following initial vetting, supported patients underwent psychological assessment. Patients supported by psychology were assessed in clinic, and if deemed clinically suitable, were offered surgery.Overall, 20% (225/1,122) of referrals were supported for surgery. Following primary vetting, 57% (640/1,122) of referrals were supported, 40% (197/492) of referrals to clinical psychology were supported, and 65% (225/345) of the remaining cases referred for consultation were supported for surgery. Unsupported referrals included those not fulfilling the referral guidelines or those with contraindications.The AEARP is simple and effective to implement, and has been instrumental in streamlining the referral-to-outcome process in a centralised, transparent, and fair manner. It reduces a potential high number of clinic appointments where patients do not meet the aesthetic criteria and/or fail to attend – thereby helping to streamline other surgical pathways by improving clinic efficiency. Moreover, it aids referring clinicians and patient education around aesthetic issues including a holistic approach. Wide adoption of such standards may reduce waiting times, facilitate cost savings, and ultimately enhance patient outcomes.



Adding Scales to BREAST-Q Must Follow the Same Rigor as Original Scales

Publication date: Available online 22 May 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Anne F. Klassen, Manraj N. Kaur, Andrea L. Pusic




Probabilistic risk-based pollution prevention model for a foundry: a case study of casting

Abstract

Hazardous air pollutants from industrial activities have long been associated with serious health effects. Traditional health risk assessment uses point estimates of inhalation concentrations based on standard Gaussian diffusion models with steady-state emission rate assumptions. This traditional approach was criticized because it does not account for variability and thus leading to a potential overestimate of the health risk from the batch processes. To overcome this deficiency, a probabilistic risk assessment model is proposed. The foundry industry with processes typically associated with several hazardous air pollutants is identified and iron casting is chosen as a case study to compare risk estimates. Existing data, representing historical proprietary information of the case study, were used to deliver representative risk values and help identify potential replacements or interventions in the manufacturing process. A probability distribution function of emitted concentrations was simulated to model the batch process emissions from mold and core resin binders, a major source of pollution. The same method was applied to exposure factors to feed into the risk model resulting in a probabilistic risk evaluation. Several alternative resin binders in commercial use were examined to offer a risk-based substitute to the resin binder in use. The risk results provided an opportunity to consider newer and environmentally friendlier options. A comparison of the results from this approach and those from the point estimate analysis reveals a gross over estimation of risks. The point estimate risk values were about eight time larger than the mean value and about twice the 95th percentile values of the probabilistic risk approach. The wide range of variability among resin binders associated risk results, close to two orders of magnitude in some cases, presented opportunities to select from a variety of binders with lesser emissions and lower risk. Optimal selection will depend on several pollutants emitted from this process to help address cumulative impacts of multiple pollutants. Investigations are underway for a multi-pollutant strategy including trade-offs, and other quality controls vital to the decision-making.



The double face of the same disease

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.


Cocaine‐induced pyoderma gangrenosum‐like lesions

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.


Angiokeratoma corporis diffusum with normal enzyme activity: three new Italian cases

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.


Multiple acquired pigmented lesions in a patient affected by melanoma

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.


Formulation of oil-in-water emulsions for pesticide applications: impact of surfactant type and concentration on physical stability

Abstract

Oil-in-water (O/W) emulsions can be utilized as effective pesticide delivery systems in the agricultural industry. In this study, the effects of hydrophile-lipophile balance (HLB), concentration, and location of surfactants on the formation and physical stability of O/W emulsions suitable for pesticide applications was investigated using dynamic light scattering and vertical laser profiling. A non-polar pesticide (lambda-cyhalothrin) was used as a model. The pesticide emulsion with the highest stability was obtained using a commercial non-ionic surfactant (polyoxyethylene castor oil ether, EL-20) with a required HLB value of 10.5. Emulsion stability increased as the surfactant concentration was increased from 2 to 6%, which was attributed to the formation of smaller oil droplets during emulsification. Emulsions prepared with the surfactant initially in the oil phase were more stable than those prepared with it initially in the aqueous phase. The optimum formulation of the pesticide emulsion was determined as follows: 5% lambda-cyhalothrin (active ingredient) and 6% EL-20 (surfactant) dissolved in 5% S-200 (aromatic hydrocarbon, as oil phase), then deionized water up to 100%, which met the quality indicators set by the FAO standards. The present study is expected to provide useful information to improve the stability of pesticide emulsions for commercial applications.



New Formulation, New Drug? The Importance of Assessing the Safety of New Supportive Care Formulations in Oncology



PARPi related toxicities: do we need more appropriate instruments to evaluate it?



Advances in the systemic treatment of melanoma brain metastases

Abstract
Of the solid tumor types that metastasize to the brain, melanoma has the highest propensity to form brain metastases. In addition, much remains unknown regarding the pathophysiology involved in melanoma cell extravasation through the blood-brain barrier, which enables interactions with the microenvironment, and melanoma cell transcriptomic responses to brain-specific cues. However, recent developments in targeted therapy and immunotherapy have generated considerable optimism regarding the treatment of metastatic melanoma. Although robust efficacy data exist on systemic therapy treatment of extracranial melanoma, data in the setting of melanoma brain metastases (MBM) are limited, primarily because patients with MBM are typically excluded from clinical trials. However, several clinical trials focusing on patients with MBM are now complete, and more are underway. Clinical evaluation of serine/threonine-protein kinase B-Raf (BRAF) inhibition in combination with MEK inhibition for MBM produced intracranial response rates of close to 60%, suggesting that inhibition of the mitogen-activated protein kinase pathway has the potential to further improve MBM outcomes. For immunotherapy, there is now increasing evidence that checkpoint inhibitors may also be effective in MBM with a high rate of durable intracranial responses observed with combination therapy. Furthermore, radiotherapy—particularly MBM treatment with mainstay stereotactic radiosurgery—appears to be safe and effective when combined with systemic therapy. Finally, evolving magnetic resonance imaging capabilities have inspired new approaches to the measurement of tumor burden and treatment responses. This review evaluates current published evidence describing MBM as a multifaceted disease and presents an overview of currently available and investigational treatments for patients with MBM.

Artificial intelligence for melanoma diagnosis: How can we deliver on the promise?



The hard road to patient-centered care: 3 or 6 months of adjuvant chemotherapy for patients with stage III colon cancer?



Six cycles of R-CHOP-21 are not inferior to eight cycles for treatment of diffuse large B-cell lymphoma - A Nordic Lymphoma Group population-based study



The reducing clade IIb polyketide synthase PKS14 acts as a virulence determinant of the entomopathogenic fungus Beauveria bassiana

Abstract
pks14, a reducing clade IIb polyketide synthase gene, is preserved throughout the evolution of entomopathogenic fungi. We examined the functions of pks14 in Beauveria bassiana using targeted gene disruption. pks14 disruption was verified by Southern blot and PCR analyses. The radial growth, cell dry weight and conidial germination of Δpks14 were comparable to that of the wild type. Our sequence and gene expression analyses of the pks14 biosynthetic cluster demonstrated: (i) cotranscription and constitutive expression of nearly all genes of the aforementioned cluster including C2H2 zinc finger transcription regulator gene, but not pks14 and cytochrome P450 gene; (ii) expression of pks14 gene in insect-containing culture condition only; whereby (iii) a KAR9-like gene in direct proximity with pks14 is the only gene showing co-regulation. The Δpks14-infected Spodoptera exigua larvae survived significantly longer than those infected by the wild type, indicating a marked reduction in virulence of Δpks14 against the insect. LT50 of Δpks14 was increased by 1.55 days. Hyphal body formation was decreased in the hemolymph of insects infected by Δpks14 as compared to those inoculated by the wild type. Our results suggest that PKS14-catalyzed polyketide enhances virulence and pathogenicity of B. bassiana on insects.

A simple approach to estimate daily loads of total, refractory, and labile organic carbon from their seasonal loads in a watershed

Abstract

Loads of naturally occurring total organic carbons (TOC), refractory organic carbon (ROC), and labile organic carbon (LOC) in streams control the availability of nutrients and the solubility and toxicity of contaminants and affect biological activities through absorption of light and complex metals with production of carcinogenic compounds. Although computer models have become increasingly popular in understanding and management of TOC, ROC, and LOC loads in streams, the usefulness of these models hinges on the availability of daily data for model calibration and validation. Unfortunately, these daily data are usually insufficient and/or unavailable for most watersheds due to a variety of reasons, such as budget and time constraints. A simple approach was developed here to calculate daily loads of TOC, ROC, and LOC in streams based on their seasonal loads. We concluded that the predictions from our approach adequately match field measurements based on statistical comparisons between model calculations and field measurements. Our approach demonstrates that an increase in stream discharge results in increased stream TOC, ROC, and LOC concentrations and loads, although high peak discharge did not necessarily result in high peaks of TOC, ROC, and LOC concentrations and loads. The approach developed herein is a useful tool to convert seasonal loads of TOC, ROC, and LOC into daily loads in the absence of measured daily load data.



Awareness of and phobias about topical corticosteroids in parents of infants with eczema in Hangzhou, China

Pediatric Dermatology, EarlyView.


Why Separation Logic Works

Abstract

One might poetically muse that computers have the essence both of logic and machines. Through the case of the history of Separation Logic, we explore how this assertion is more than idle poetry. Separation Logic works because it merges the software engineer's conceptual model of a program's manipulation of computer memory with the logical model that interprets what sentences in the logic are true, and because it has a proof theory which aids in the crucial problem of scaling the reasoning task. Scalability is a central problem, and some would even say the central problem, in appli- cations of logic in computer science. Separation Logic is an interesting case because of its widespread success in verification tools. For these two senses of model—the engineering/conceptual and the logical—to merge in a genuine sense, each must maintain their norms of use from their home disciplines. When this occurs, both the logic and engineering benefit greatly. Seeking this intersection of two different senses of model provides a strategy for how computer scientists and logicians may be successful. Furthermore, the history of Separation Logic for analysing programs provides a novel case for philosophers of science of how software engineers and computer scientists develop models and the components of such models. We provide three contributions: an exploration of the extent of models merging that is necessary for success in computer science; an introduction to the technical details of Separation Logic, which can be used for reasoning about other exhaustible resources; and an introduction to (a subset of) the problems, process, and results of computer scientists for those outside the field.



Weak speech reports

Abstract

Indirect speech reports can be true even if they attribute to the speaker the saying of something weaker than what she in fact expressed, yet not all weakenings of what the speaker expressed yield true reports. For example, if Anna utters 'Bob and Carla passed the exam', we can accurately report her as having said that Carla passed the exam, but we can not accurately report her as having said that either it rains or it does not, or that either Carla passed the exam or pandas are cute. This paper offers an analysis of speech reports that distinguishes weakenings of what the speaker expressed that yield true reports from weakenings that do not. According to this analysis, speech reports are not only sensitive to the informational content of what the speaker expressed, but also to the possibilities a speaker raises in making an utterance. As I argue, this analysis has significant advantages over its most promising competitors, including views based on work by Barwise and Perry (J Philos 78(11): 668–691, 1981), views appealing to recent work on the notion of content parthood by Fine (J Philos Log 45(2):199–226, 2016) and Yablo (Aboutness. Princeton University Press, Princeton, 2014), and Richard's (Mind Lang 13(4): 605–616, 1998) proposal appealing to structured propositions.



Ascorbic acid inhibits cadmium-induced disruption of the blood-testis barrier by regulating oxidative stress-mediated p38 MAPK pathways

Abstract

Ascorbic acid (AA), one of the best-known reactive oxygen species (ROS) scavengers, exhibits numerous functions such as antioxidant, anti-cancer, and anti-inflammatory effects. Increasing evidence demonstrates that oxidative stress plays an important role in testicular toxicity. In the present study, we investigated the protective effect of AA against cadmium (Cd)-induced blood-testis barrier (BTB) disruption. Sprague-Dawley (SD) rats were divided into four groups: the Cd-treated group received a single dose (s.c.) of 2 mg/kg BW cadmium chloride; the AA antagonism group received an injection of AA at a dose of 400 mg/kg BW (200 mg 24 h prior to Cd treatment and 200 mg 24 h following Cd treatment); and the control groups received an equal volume of saline or an equal dose of AA. As expected, ROS expression was upregulated in the Cd-treated rats, accompanied by an increase in malondialdehyde (MDA). Interestingly, AA suppressed Cd-induced oxidative stress by decreasing the levels of ROS and MDA and increasing the activity of superoxide dismutase (SOD) and catalase (CAT). In addition, AA also reduced BTB disruption by inhibiting TGF-β3 activation and p38 MAPK phosphorylation. Significant decreases in occludin and claudin-11 expression were observed in the Cd-treated rats, whereas AA administration attenuated this effect. Moreover, testicular histopathology and transmission electron microscopy further demonstrated the protective effects of AA against Cd-induced BTB damage. In conclusion, the results of the present study suggest that AA protects BTB destruction via the inhibition of oxidative stress and the TGF-β3/p38 MAPK signalling pathway in the testis of Cd-exposed rats.



Analysis of mercury adsorption at the gibbsite-water interface using the CD-MUSIC model

Abstract

Mercury (Hg), one of the most toxic substances in nature, has long been released during the anthropogenic activity. A correct description of the adsorptive behavior of mercury is important to gain a better insight into its fate and transport in natural mineral surfaces, which will be a prerequisite for the development of surface complexation model for the adsorption processes. In the present study, simulation experiments on macroscopic Hg(II) sorption by gibbsite (α-Al(OH)3), a representative aluminum (hydr)oxide mineral, were performed using the charge distribution and multi-site complexation (CD-MUSIC) approach with 1-pK triple plane model (TPM). For this purpose, several data sets which had already been reported in the literature were employed to analyze the effect of pH, ionic strength, and co-exisiting ions (NO3 and Cl) on the Hg(II) adsorption onto gibbsite. Sequential optimization approach was used to determine the acidity and asymmetric binding constants for electrolyte ions and the affinity constants of the surface species through the model simulation using FITEQLC (a modified code of FITEQL 4.0). The model successfully incorporated the presence of inorganic ligands at the dominant edge (100) face of gibbsite with consistent surface species, which was evidenced by molecular scale analysis. The model was verified with an independent set of Hg(II) adsorption data incorporating carbonate binding species in an open gibbsite-water system.



Energy consumption habits and human health nexus in Sub-Saharan Africa

Abstract

This study explores the impact of fossil fuels consumption, solid fuels consumption for cooking purposes, economic growth, and carbon emissions on human health, with a key emphasis on the occurrence of tuberculosis and the high mortality rate in Sub-Saharan Africa. For its practical insights, the study develops a system Generalized Method of Moment (GMM) for a panel of 34 middle- and lower-middle-income countries from 1995 to 2015. The study adopts a flexible methodology to tackle endogeneity in the variables. The robust results report that the use of solid fuels (charcoal, peat, wood, wood pellets, crop residues) for cooking purposes and the consumption of fossil fuels (oil, coal, gas) are significantly increasing the occurrence of tuberculosis. In addition, the results highlight that the consumption of both solid fuels and fossil fuels has adverse affects on life expectancy by increasing the mortality rate in Sub-Saharan African countries. Results report that renewable energy sources like sun, wind, and water (all with potential to prevent households from direct exposure to particulate matters and harmful gases) as well as a rise in economic growth serve as helping factors to control the occurrence of tuberculosis and to decrease the mortality rate. Moreover, the use of renewable energy sources is serving to lessen emissions of carbon dioxide, nitrogen dioxides, and particulate matters, which can ultimately decrease the mortality rate and extend the life expectancy in Sub-Saharan Africa.



Drosophila melanogaster has the enzymatic machinery to make the melanic component of neuromelanin

Pigment Cell &Melanoma Research, EarlyView.


Immuntherapie des Melanoms

Zusammenfassung

Hintergrund

Die Prognose für Patienten mit fernmetastasiertem Melanom war bis zur Zulassung des Anti-CTLA-4-Antikörpers Ipilimumab 2011 mit einem medianen Gesamtüberleben von 6 bis 10 Monaten infaust. Die Zulassung der Immuncheckpointinhibitoren, die für Patienten mit metastasiertem Melanom ein Langzeitüberleben erwirken können, stellt einen Durchbruch dar.

Ziel, Material und Methoden

Die aktuellen zugelassenen Systemtherapien des Melanoms unter Berücksichtigung der Studiendaten, die auf der Jahrestagung 2017 der American Society of Clinical Oncology (ASCO) sowie der European Society for Medical Oncology (ESMO) vorgestellt wurden, werden in dieser Übersichtsarbeit zusammengefasst.

Ergebnisse und Diskussion

Verglichen mit Ipilimumab konnten die beiden zugelassenen Anti-PD-1-Antikörper Pembrolizumab und Nivolumab eine höhere Wirksamkeit bei niedrigerer Toxizität erzielen. Die 2016 zugelassene Immunkombinationstherapie mit Nivolumab und Ipilimumab erzielte eine Ansprechrate von 58 % und eine Dreijahresüberlebensrate von 58 %. Schwere Grad-3/4-Nebenwirkungen traten bei 55 % der Patienten auf. Die frühzeitige Diagnose immunvermittelter Nebenwirkungen unter Immuncheckpointinhibitor-Therapie und ihre adäquate Behandlung ggf. unter Einsatz von systemischen Glukokortikosteroiden und weiteren Immunsuppressiva ist unabdingbare Voraussetzung für den Therapieerfolg. Die Immunkombinationstherapie mit Nivolumab und Ipilimumab erzielte bei Patienten mit metastasiertem Melanom und Hirnmetastasen intrakranielle Ansprechraten von 42–55 %, wobei die Toxizität im Vergleich zu Patienten ohne Hirnmetastasen nicht erhöht war. Aufgrund des erfolgreichen Einsatzes von Immuncheckpointinhibitoren für die Therapie des metastasierten Melanoms werden aktuell mehrere Studien durchgeführt, die insbesondere Anti-PD-1-Antikörper im adjuvanten Setting evaluieren. In aktuellen und zukünftigen Studien werden zunehmend innovative Immunkombinationstherapien, z. B. Anti-PD-1-Antikörper in Kombination mit IDO-Inhibitoren (IDO Indoleamine-pyrrole 2,3-dioxygenase) untersucht. Bisher vorliegende Daten sprechen für eine hohe Wirksamkeit und eine niedrige Toxizität.



Δευτέρα 21 Μαΐου 2018

Basic red 2 and methyl violet adsorption by date pits: adsorbent characterization, optimization by RSM and CCD, equilibrium and kinetic studies

Abstract

The potential of raw date pits as a natural, widely available and low-cost agricultural waste has been studied in order to adsorb cationic dyes from an aqueous solution. Date pits were characterized by FTIR, SEM, BET, and XRD analysis. To optimize removal of two industrial dyes, basic red 2 (BR2) and methyl violet (MV), from aqueous solution using date pits, response surface methodology (RSM) is employed. Tests were carried out as per central composite design (CCD) with four input parameters namely contact time, temperature, initial concentration of adsorbate, and pH. Second-order polynomial model better fits experimental data for BR2 and MV and optimum values were then determined. In the optimum conditions, kinetic study was conducted and the pseudo-second-order model was found the best fitted model compared to pseudo-first-order model. Moreover, it was shown that intraparticle diffusion was not the sole controlling step and could be associated with other transfer resistance. On other hand, equilibrium isotherms were obtained for BR2 and MV and their maximum adsorption capacities were 92 and 136 mg g−1 respectively. Two-parameter isotherm models like Langmuir, Temkin, Freundlich, Dubinin–Radushkevich, and Halsay were investigated to fit equilibrium data. Three error functions of residual root mean square error, chi-square statistic, and average relative error were used to comfort us in the selected models, which were actually Dubinin–Radushkevich and Langmuir for BR2 and Frendlich, Temkin, and Halsay for MV.



Rethinking the prescription of biotin for dermatologic conditions

Dermatologic Therapy, EarlyView.


Reuse of organobentonites with a carbon dioxide responsive solvent

Abstract

Synthesized organobentonite (SOB), montmorillonite (MMT), and commercial organobentonite (COB) were used as adsorbents for paraffin oil, a model pollutant in land-based oil spills and oil pipeline rupture. The characterization of clays was carried out with scanning electron microscopy (SEM), thermogravimetric analysis (TG), Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). After adsorption, oil was separated from adsorbents with a carbon dioxide responsive solvent N,N-dimethylcyclohexylamine (DMCHA), and DMCHA was subsequently separated from paraffin oil upon CO2 bubbling instead of distillation with high energy cost. The adsorption capacity of oil to SOB, MMT, and COB was 0.686, 1.124, and 1.239 g/g, respectively. It was found that the adsorption capacity and rinsed amount of the adsorbents depended on the d-spacing, which is related to surfactant content. Electrical conductivity and pH measurements suggested that the separation process occurred via two steps. Firstly, during the initial 35 min, carbonate ions coexisted with bicarbonate ions. Then, only bicarbonate ions existed after the introduction of CO2 gas for 120 min. Thus, organobentonites were feasible for hydrocarbon adsorption and could be simply reused by an amine-based responsive solvent. This work provided a cost-effective and sustainable method of recycling of organobentonites and the responsive solvent, which can be used to deal with leaked oil and oil spills.



Onychomadesis: A rare skin sign occurring after chickenpox

Andrea Sechi, Marco Adriano Chessa, Miriam Leuzzi, Iria Neri

Indian Journal of Dermatology 2018 63(3):272-273



The effect of Candida albicans on the expression levels of toll-like receptor 2 and interleukin-8 in HaCaT cells under High- and Low-glucose conditions

Di Wang, Yong Jiang, Zhuoran Li, Lu Xue, Xiaoting Li, Yuanjun Liu, Chunli Li, Huiping Wang

Indian Journal of Dermatology 2018 63(3):201-207

Background: The diabetics are prone to skin infections, especially with Candida albicans. It is important to elucidate the different antifungal abilities of patients with hyperglycemia and healthy controls for the treatment of this condition. The toll-like receptor 2 (TLR2) and interleukin (IL)-8 secreted by keratinocytes counteract C. albicans. Aim: This study aims to explore the differential expression of toll-like receptor 2 (TLR2) and interleukin (IL)-8 secretion by keratinocytes between controls and diabetic patients when challenged with C. albicans. Materials and Methods: HaCaT cells were cultured in high-glucose (HG) Dulbecco's modified Eagle's medium (DMEM) and low-glucose (LG) DMEM. Then, they were exposed to C. albicans hyphae for 24 h. The expression levels of TLR2 and IL-8 were determined at different periods in both the HG and LG groups. Real-time polymerase chain reaction analysis, western blotting, and enzyme-linked immunosorbent assays were performed in this study. The morphological changes of HaCaT cells under two different glucose concentrations were also observed. Results: We found that the expression levels of both TLR2 and IL-8 increased and then decreased in the two groups. Notably, the IL-8 levels in the LG group were higher than those in the HG group at each time point (P<0.05), and the TLR2 levels in the LG group were higher than those in the HG group at the beginning of the experiment and after 24 h of treatment with C. albicans (P<0.05). In each group, the levels of IL-8 and TLR2 at the secretion peak were significantly different from those in the initial and the last period of observation (P<0.05). The cellular morphology of HaCaT cells treated with different concentrations of glucose was also similar. However, with prolonged coculture time, cell death increased. Conclusion: These observations showed that TLR2 and IL-8 act on the keratinocytes interacting with C. albicans, and HG status might affect the function of HaCaT cells by reducing the secretion of IL-8 and TLR2.

Reed's syndrome

Filipa Tavares Almeida, Rui P Santos, Sofia D Carvalho, Maria C Brito

Indian Journal of Dermatology 2018 63(3):261-263

Multiple cutaneous and uterine leiomyomatosis (MCUL), also known as Reed's syndrome, is a rare genodermatosis, with an autosomal dominant pattern of inheritance. It results from a germline heterozygous mutation of fumarate hydratase gene, that is classified as a tumor suppressor gene. Hereditary leiomyomatosis and renal cell cancer is characterized by the association of MCUL with renal cell carcinoma. We report a case of a 57-year-old woman, with multiple cutaneous leiomyomas as the presenting sign of Reed's syndrome.

The role of forkhead box class O3A and SIRT1 gene variants in early-onset psoriasis

Suzan Demir Pektas, Gursoy Dogan, Tuba Gokdogan Edgunlu, Sevim Karakas-Celik, Esra Ermis, Nilgun Solak Tekin

Indian Journal of Dermatology 2018 63(3):208-214

Background: Psoriasis is a chronic inflammatory skin disorder, which is characterized by a heightened immunological response. Although the immunogenetics of this chronic inflammatory disorder is poorly understood, its expression is known to be dependent on proinflammatory cytokines. It is known that two distinct subtypes of chronic plaque psoriasis: Early-onset psoriasis (EOP) before the age of 40 years and late-onset psoriasis after the age of 40 years. Forkhead box class O3A (FOXO3A) is a transcription factor, which plays an important role in cell-cycle regulation, apoptosis, oxidative stress, and DNA repair. The silent information regulator (SIRT) is thought to have a role in skin disorders, including psoriasis, that are characterized by hyperproliferation and inflammation. Aim: The aim of this study was to investigate FOXO3A and SIRT1 gene polymorphisms in EOP. Methods: The study group consisted of 142 EOP patients and 123 unrelated healthy controls. FOXO3A polymorphisms were determined using the polymerase chain reaction (PCR)-restriction fragment length polymorphism method. SIRT1 gene polymorphisms were determined by PCR-confronting two-pair primers methods. Results: The FOXO3A rs4946936 and SIRT1 rs7069102 gene polymorphisms were positively correlated with EOP and disease severity. The GG genotype frequency of SIRT1 rs7069102 gene polymorphisms was increased in severe EOP. The CC frequency of FOXO3A rs4946936 was increased in EOP with nail disorders. Conclusion: The rs7069102 gene polymorphism of SIRT1 and rs4946936 polymorphism of FOXO3A are associated with early onset psoriasis; this may be responsible for increased keratinocyte proliferation in the pathogenesis of psoriasis and disease severity.