Ann Oncol 2018; (doi:10.1093/annonc/mdy181)
Δευτέρα 13 Αυγούστου 2018
Homologous overexpression of NpDps2 and NpDps5 increases the tolerance for oxidative stress in the multicellular cyanobacterium Nostoc punctiforme
Abstract
The filamentous cyanobacterium Nostoc punctiforme has several oxidative stress-managing systems, including Dps proteins. Dps proteins belong to the ferritin superfamily and are involved in abiotic stress management in prokaryotes. Previously, we found that one of the five Dps proteins in Nostoc punctiforme, NpDps2, was critical for H2O2 tolerance. Stress induced by high light intensities is aggravated in Nostoc punctiforme strains deficient of either NpDps2, or the bacterioferritin-like NpDps5. Here, we have investigated the capacity of NpDps2 and NpDps5 to enhance stress tolerance by homologous overexpression of these two proteins in Nostoc punctiforme. Both overexpression strains were found to tolerate twice as high concentrations of added H2O2 as the control strain, indicating that overexpression of either NpDps2 or NpDps5 will enhance the capacity for H2O2 tolerance. Under high light intensities the overexpression of the two NpDps did not enhance the tolerance against general light-induced stress. However, overexpression of the heterocyst-specific NpDps5 in all cells of the filament, led to a higher amount of chlorophyll-binding proteins per cell during diazotrophic growth. The OENpDps5 strain also showed an increased tolerance to ammonium-induced oxidative stress. Our results provide information of how Dps proteins may be utilized for engineering of cyanobacteria with enhanced stress tolerance.Lpp, the Braun lipoprotein, turns 50 – Major achievements and remaining issues
Abstract
The discovery of Escherichia coli Lpp as the first protein with three acyl groups covalently attached to its N-terminal cysteine residue defined a new class of bacterial proteins, the lipoproteins. Lipoproteins are extracytoplasmic, globular proteins that are anchored to a membrane by a lipid moiety. Being anchored to the outer membrane, Lpp, which is also known as the Braun lipoprotein, is small (5.8 kDa) and folds into a trimeric helical structure. It is also the numerically most abundant protein in E. coli. A unique feature of Lpp is that its C-terminal lysine residue is covalently attached to the peptidoglycan, providing the only covalent connection between the outer membrane and the cell wall. Here, we review the knowledge gained on Lpp since its discovery in 1969 until the recent finding that Lpp functions as a major size determinant in the bacterial cell envelope. We also discuss the role played by Lpp in virulence and highlight the major questions that remain to be solved.Knowledge Gaps and Barriers to Early Peanut Introduction Among Allergists, Pediatricians, and Family Physicians
Publication date: Available online 13 August 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Elissa M. Abrams, Alexander G. Singer, Lianne Soller, Edmond S. Chan
Patterns of Fish Reproduction at the Interface Between Air and Water
Synopsis
Although fishes by nature are aquatic, many species reproduce in such a way that their embryos are exposed to air either occasionally or constantly during incubation. We examine the ecological context and review specific examples of reproduction by fishes at the air-water interface, including fishes that do and do not breathe air. Four modes of reproduction at the air-water interface are described across 18 teleost Orders, from fresh water, estuaries and sea water. Mode 1, the most common type of reproduction by fishes at the air-water interface, includes 21 Families of mostly marine teleosts that spawn in water onto a substrate surface, on vegetation, or into hollow objects such as shells that will later be continuously or occasionally exposed to air. Although the eggs are emerged into air, many of these species do not emerge into air as adults, and only about half of them breathe air. Mode 2 involves six Families of freshwater fishes setting up and guarding a nest and guarding on the water surface, either with bubbles or in vegetation. Most of these species breathe air. In Mode 3, annual killifishes in at least two Families in seasonally dry habitats bury eggs in mud in temporary pools, then die before the next generation emerges. These species neither guard nests nor breathe air. Mudskippers (Gobiidae) breathe air and use Mode 4, excavating burrows in a soft substrate and then storing air in a subterranean chamber. In a variation of Mode 4, eggs are placed on bubbles within a nesting burrow by swamp eels (Synbranchidae). No fishes from basal taxa are known to place their embryos where they will be exposed to air, although most of these species breathe air as adults. The widespread but still rare, diverse forms of fish reproduction at the air-water interface across a broad taxonomic spectrum suggest repeated independent evolutionary events and strong selection pressure for adult fishes to protect their embryos from hypoxic waters, aquatic predators, pathogens, and UV radiation. Air-breathing by adult fishes appears to be de-coupled from air exposure of developing embryos or aerial emersion of adults during spawning.Absorption, translocation, and detoxification of Cd in two different castor bean ( Ricinus communis L.) cultivars
Abstract
Cadmium (Cd) is considered to be the most phytotoxic heavy metal pollutant. The selection of castor bean cultivars with Cd tolerance and the exploration of the physiological mechanisms involved in Cd tolerance are critical steps for improving phytoremediation performance. In this study, a hydroponic experiment was used to investigate variations in Cd transportation, chelation, and subcellular distribution in two different castor bean cultivars, namely JX-22 and ZB-9. Both cultivars had high tolerance index scores, indicating that both cultivars were tolerant to Cd. The findings of the present study indicate that Cd is significantly more mobile in JX-22 than in ZB-9 during xylem and phloem transportation, resulting in the accumulation of Cd in the shoots of JX-22 was 7.67 times that in ZB-9. Subcellular distribution assessment verified that more Cd was bound to the biologically detoxified metal fractions than the metal sensitive fractions in JX-22. The contents of the non-protein thiol pool and glutathione in the leaves were higher in JX-22 than ZB-9 when exposed to Cd. These results indicate that JX-22 has a greater ability to accumulate Cd, and well-coordinated physiological changes in JX-22 afford greater Cd tolerance in comparison to ZB-9 under Cd exposure, indicating that JX-22 is suitable for use in the remediation of Cd-contaminated soils.
Understanding as compression
Abstract
What is understanding? My goal in this paper is to lay out a new approach to this question and clarify how that approach deals with certain issues. The claim is that understanding is a matter of compressing information about the understood so that it can be mentally useful. On this account, understanding amounts to having a representational kernel and the ability to use it to generate the information one needs regarding the target phenomenon. I argue that this ambitious new account can accommodate much of the data that has motivated theories of understanding in philosophy of science, and can also be generally applicable in epistemology and daily life as well.
Κυριακή 12 Αυγούστου 2018
Hotspots and main drivers of fecal pollution in Neusiedler See, a large shallow lake in Central Europe
Abstract
To minimize the risk of negative consequences for public health from fecal pollution in lakes, the continuous surveillance of microbiological water quality parameters, alongside other environmental variables, is necessary at defined bathing sites. Such routine surveillance may prove insufficient to elucidate the main drivers of fecal pollution in a complex lake/watershed ecosystem, and it may be that more comprehensive monitoring activities are required. In this study, the aims were to identify the hotspots and main driving factors of fecal pollution in a large shallow Central European lake, the Neusiedler See, and to determine to what degree its current monitoring network can be considered representative spatially. A stochastic and geostatistical analysis of a huge data set of water quality data (~ 164,000 data points, representing a 22-year time-series) of standard fecal indicator bacteria (SFIB), water quality and meteorological variables sampled at 26 sampling sites was conducted. It revealed that the hotspots of fecal pollution are exclusively related to sites with elevated anthropogenic activity. Background pollution from wildlife or diffuse agricultural run-off at more remote sites was comparatively low. The analysis also showed that variability in the incidence of SFIB was driven mainly by meteorological phenomena, above all, temperature, number of sunny hours, and wind (direction and speed). Due to antagonistic effects and temporal undersampling, the influence of precipitation on SFIB variance could not be clearly determined. Geostatistical analysis did reveal that the current spatial sampling density is insufficient to cover SFIB variance over the whole lake, and that the sites are therefore in the most part representative of local phenomena. Suggestions for the future monitoring and managing of fecal pollution are offered. The applied statistical approach may also serve as a model for the study of other such areas, and in general indicate a method for dealing with similarly large and spatiotemporally heterogeneous datasets.
In defense of unfair compromises
Abstract
It seems natural to think that compromises ought to be fair. But it is false. In this paper, I argue that it is never a moral desideratum to reach fair compromises and that we are sometimes even morally obligated to try to establish unfair compromises. The most plausible conception of the fairness of compromises is David Gauthier's principle of minimax relative concession. According to that principle, a compromise is fair when all parties make equal concessions relative to how much they can gain from an agreement and relative to how much they would lose without an agreement. To find out whether reaching a fair compromise sometimes is a moral desideratum, I discuss several paradigmatic cases in friendships, economics and politics, and I try to show that even when the parties have moral reasons to refrain from trying to maximize utility in the negotiations, they do not have moral reasons to aim at a fair compromise. My second claim is that we are sometimes morally obligated to try to establish unfair compromises, in particular when we are dealing with parties that try to establish morally very bad political arrangements. In such cases, we should try to concede as little as possible to achieve an outcome that is morally acceptable. Fair compromises, in other words, are morally much more dubious than is usually appreciated.
Σάββατο 11 Αυγούστου 2018
The microbiota of traumatic, open fracture wounds is associated with mechanism of injury
Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.
Use of Antibiotic Impregnated Resorbable Beads Reduces Pressure Ulcer Recurrence: A Retrospective Analysis
Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.
Risk factors for hypertrophic burn scar pain, pruritus, and paresthesia development
Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.
Tetrathiomolybdate, a copper chelator inhibited imiquimod-induced skin inflammation in mice
Humans have witnessed huge exploration and extensive utilization of heavy metal in the past few centuries. As a result, tremendous amount of heavy metal has entered the environment, in soil, water, and air, and inevitably into human bodies. In terms of millions of years of human evolution, elevation of the levels of heavy metal in the body is a quite recent event [1]. Increased body levels of heavy metal can cause many harmful effects [2]. Despite some heavy metals are essential for human body, toxic levels can cause inflammation and oxidative stress [3–6].
Algoritmo de tratamiento con omalizumab en urticaria crónica espontánea
Publication date: Available online 11 August 2018
Source: Actas Dermo-Sifiliográficas
Author(s): J. Spertino, E. Rozas Muñoz, L. Curto Barredo, I. Figueras Nart, A. Gimenez Arnau, E. Serra Baldrich, M. Bonfill-Ortí, V. Expósito-Serrano, A. Guilabert, G. Melé Ninot, M. Villar Buil, J. Garcias Ladaria, X. García Navarro, M. Vilavella, I. Bielsa Marsol, G. Aparicio Ortiz, C. Baliu Piqué, A. Álvarez Abella, N. Lamas Domenech, J.M. Mascaró
Resumen
Antecedentes y objetivo
Los ensayos pivotales de omalizumab en urticaria crónica espontánea (UCE) tienen un periodo de tratamiento de entre 12 y 24 semanas. Sin embargo, muchos pacientes en práctica clínica requieren periodos de tratamiento más prolongados. Por ello el objetivo es presentar un algoritmo de manejo del fármaco.
Materiales y métodos
El documento de consenso que detallamos nace de la puesta en común, aceptación, revisión y confrontación de la literatura reciente del grupo de trabajo de UCE «Xarxa d'Urticària Catalana i Balear» (XUrCB).
Resultados
Se inicia el tratamiento a dosis autorizada y se ajusta la dosis en intervalos trimestrales en función del Urticaria Activity Score de los últimos 7 días (UAS7) y/o el Urticarial Control Test (UCT).
Conclusiones
El algoritmo propuesto pretende servir de guía respecto a cómo ajustar dosis, cómo y cuándo parar el fármaco y el modo de reintroducirlo en casos de recaída.
Abstract
Background and objective
Pivotal trials with omalizumab for treatment of chronic spontaneous urticaria (CSU) are generally run over 12 to 24 weeks. However, in clinical practice, many patients need longer treatment. In this article, we present an algorithm for treatment with omalizumab.
Material and methods
The consensus document we present is the result of a series of meetings by the CSU working group of "Xarxa d'Urticària Catalana i Balear" (XUrCB) at which data from the recent literature were presented, discussed, compared, and agreed upon.
Results
Treatment with omalizumab should be initiated at the authorized dose, and is adjusted at 3-monthly intervals according to the Urticaria Activity Score Over 7 days, the Urticaria Control Test, or both.
Conclusions
The algorithm proposed is designed to provide guidance on how to adjust omalizumab doses, how and when to discontinue the drug, and how to reintroduce it in cases of relapse.
Uptake and accumulation of polycyclic aromatic hydrocarbons in the mangroves Avicennia marina and Rhizophora mucronata
Abstract
This study investigated the uptake and accumulation of polycyclic aromatic hydrocarbons (PAHs) in two mangrove species, Avicennia marina and Rhizophora mucronata. We tested the hypothesis that A. marina would absorb and accumulate more PAHs than R. mucronata. One-year old seedlings of both species were subjected to Bunker Fuel Oil 180 for 3 weeks, and the concentration of PAHs was analyzed by gas chromatography-mass spectrometry (GC/MS). The concentration of PAHs was significantly higher in A. marina than in R. mucronata. The major portion of the PAH pool was in roots (96% in A. marina, 98% in R. mucronata) compared to leaves. The dominant PAHs in roots of both species possessed two to three rings and included phenanthrene, anthracene, fluorene, and acenaphthene. In shoots, PAHs in A. marina included phenanthrene, chrysene, anthracene, acenaphthene, benzo[k+b]fluoranthene, pyrene, benzo[a] anthracene, and benzo[a] pyrene, while those in R. mucronata included phenanthrene, naphthalene, fluoranthene, fluorene, and acenaphthene. Phenanthrene was the dominant PAH in roots and shoots of both species. The greater susceptibility of A. marina appears to be due to its greater root length and specific root length, which permit more exposure to oil than R. mucronata. Other contributory factors include root anatomical characteristics such as larger air spaces, lower suberization of root epidermal cells, lower concentrations of polyphenols, tannins, lignin, and a less efficient antioxidative system. This study provides novel information on differences in the uptake and accumulation of PAHs in two contrasting mangrove species.
A new esophageal elongation technique for long-gap esophageal atresia: in vitro comparison of myotomy techniques
Abstract
Background
Complications such as stricture, leakage, recurrent tracheoesophageal fistula and mucosal pouch are commonly seen in myotomy techniques used for long-gap esophageal atresia (LGEA) treatments. Therefore, we think that there is a clear need for other techniques which would enable us to create more robust and longer esophagus in such cases. In this study, we reviewed multiple V-myotomy (VM) technique and the differences of the said technique with Livaditis circular myotomy (LM) and Kimura spiral myotomy (KM) techniques using literature as an aid.
Methods
21 esophagus samples from 21 male lambs aged 12 months were used in vitro for the study. All esophageal samples were matched to have a length of 120 mm. Samples were divided into 3 groups of 7 and VM, LM and KM techniques were used in each group, respectively. Post-op esophagus lengths, elongation amount with each incision and perforation pressures were measured.
Results
Post-op esophageal lengths were measured as 227, 210 and 200 mm for VM, LM and KM, respectively. Elongation amount per incision was measured as 5.1, 4 and 3.34 mm, again in previous order of VM, LM, and KM. Finally, perforation pressure following VM, LM, and KM was measured as 460, 400, and 410 mmHg.
Conclusion
VM was found to significantly increase total esophagus length and elongation per incision over LM and KM. In addition, VM was also shown to have a higher perforation pressure. Although in vivo live animal studies are required, we can say that VM can be used to create longer and robust esophagus.
Do you know when a wound has healed? Insights from a large‐scale multinational consumer survey
Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.
Prurigo pigmentosa au cours de la grossesse
Publication date: Available online 11 August 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): I. Devred, A. Sfecci, N. Cardot-Leccia, J.-P. Lacour, T. Passeron
Résumé
Introduction
Le prurigo pigmentosa est une dermatose inflammatoire rare marquée par son caractère prurigineux et son aspect réticulé typique du tronc, laissant un réseau pigmenté cicatriciel. Elle est très rarement rapportée en dehors de l'Asie et est encore méconnue en France.
Observation
Une femme de 21 ans, originaire du Maghreb, présentait une éruption très prurigineuse, faite de macules et de papules coalescentes formant un réseau réticulé inflammatoire sur le tronc. Cette éruption survenait lors du premier trimestre d'une grossesse marquée par des vomissements gravidiques majeurs ayant conduit à la perte de 13 kg, avec présence d'une cétonémie et d'une cétonurie. Devant l'aspect clinique caractéristique, l'absence de diagnostic différentiel et un aspect histologique compatible, le diagnostic de prurigo pigmentosa était retenu. L'évolution était marquée par des phases de diminution de l'inflammation et du prurit en alternance avec des poussées inflammatoires rythmées par des ré-ascensions de la cétonémie. Les symptômes étaient seulement résolus au deuxième trimestre de la grossesse, après disparition des vomissements, laissant un réseau hyperpigmenté brun séquellaire.
Discussion
Bien que rare, le prurigo pigmentosa a un aspect clinique très évocateur qui doit facilement en faire évoquer le diagnostic. D'étiologie encore indéterminée, il a été rapporté dans des cas de jeûne intense, d'anorexie, de diabète de type 1 mais aussi dans deux autres cas de grossesse avec vomissements intenses. Notre observation souligne l'importance de rechercher et de prendre en charge efficacement une cétonémie sous-jacente pour obtenir une rémission des poussées inflammatoires de prurigo pigmentosa.
Summary
Introduction
Prurigo pigmentosa is a rare inflammatory dermatosis characterized by pruritic and reticulate papules on the trunk leaving hyperpigmentation. This dermatosis has been rarely described outside Asia. The pathophysiology remains obscure.
Case report
We report the case of a 21-year-old North-African woman presenting with a highly pruritic eruption with numerous erythematous macules and papules coalescing in a reticular pattern on the trunk. The eruption occurred during the first trimester of pregnancy, which was marked by severe vomiting resulting in weight loss of 13 kg with ketonemia and ketonuria. Taking into account the characteristic pattern of the eruption, the absence of differential diagnosis, and the histological examination, we concluded on a diagnosis of prurigo pigmentosa. Progression of the disease exhibited phases of decreased inflammation and of pruritus alternating with episodes of inflammatory flares triggered by relapses of ketonemia. The symptoms finally resolved during the 2nd trimester of pregnancy after vomiting ceased. Secondary reticulated hyperpigmentation was observed.
Conclusion
Although rare, the highly evocative clinical presentation of the eruption should help clinicians in diagnosing prurigo pigmentosa. While pathophysiology remains undetermined, prurigo pigmentosa was reported in cases of intense fasting, anorexia, type-1 diabetes, and in two other cases of pregnancy with severe vomiting. Our case underlines the need to screen for and treat underlying ketonemia to achieve control of the inflammatory flares of prurigo pigmentosa.
On snubbing proximal intentions
Abstract
In the simplest case, a proximal intention is an intention one has now to do something now. Recently, some philosophers have argued that proximal intentions do much less work than they are sometimes regarded as doing. This article rebuts these arguments, explains why the concept of proximal intentions is important for some scientific work on intentional action, and sketches an empirical approach to identifying proximal intentions. Ordinary usage of "intend" and the place of intention in folk psychology and scientific psychology are discussed.
L’hydrochlorothiazide augmenterait le risque de mélanome
Publication date: Available online 10 August 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): J.-L. Schmutz
Exchange Rate and Risk of Noise-Induced Hearing Loss in Construction Workers
Akaike information criterionconstruction3-dB5-dBexchange ratehearing lossnoisenoise-inducedimpacttask-based
Synergetic effect of hydrochar on the transport of anatase titanium dioxide nanoparticles in the presence of phosphate in saturated quartz sand
Abstract
The rapid development of nanomaterials has led to the unavoidable leakage and release of nanoparticles (NPs) into soil and the underlying groundwater. It is possible for chars and phosphate introduced into soil to improve crop soil properties by improving contact with NPs. In this study, the influences of hydrochar and/or phosphate on the anatase nTiO2 transport behaviors were investigated under different conditions. The breakthrough curves (BTCs) and retention profiles were obtained by the saturated sand column experiments. The additional analysis of zeta potentials, sedimentation kinetics, Raman mapping, and the two-site kinetic attachment model (TSKAM) was conducted to explore the possible underlying mechanisms. The simultaneous presence of phosphate and hydrochar acted in a synergetic fashion to enhance the transport of nTiO2 in a sand medium compared to the facilitated effect of single phosphate or hydrochar. The higher levels of hydrochar induce the more nTiO2 in the high IC solution passing through the saturated sand columns in the co-presence of phosphate. It was attributed to the competitive adsorption of hydrochar with nTiO2 to the sand site and the phosphate adsorption on nTiO2 occurred simultaneously through the sand columns. The fitting results of BTCs using TSKAM showed that the value of k2 for nTiO2 (the irreversible attachment coefficient at site 2) was smaller than that of k1d/k1 (the first-order reversible detachment and attachment coefficient at site 1, respectively), suggesting irreversible retention of anatase nTiO2 at site 1. The value of k1d/k1 could be better used to explain the retention of nTiO2 with combined phosphate and hydrochar. This study provides insight into the implications of phosphate and/or hydrochar for nTiO2 transport in crop soil environments.
Graphical abstract
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The Gracilis Free Flap Is a Viable Option for Large Extremity Wounds
Background Traditionally, the gracilis free flap is used for coverage of small- to medium-sized wounds (100 cm2). Methods We retrospectively reviewed records of 34 patients who underwent extremity soft-tissue reconstruction using gracilis free flaps for wounds larger than 100 cm2 from 1998 to 2016. The primary outcome was overall flap success rate. Secondary outcomes were rates of major and minor complications. Mean defect size was 145 cm2 (range, 104–240 cm2). Seven flaps covered defects greater than 175 cm2. Indications were tumor extirpation (n = 18) and traumatic/posttraumatic wounds (n = 16). The most common time period for flap coverage was immediately (3 days or less) after the defect was created (n = 14). Most flaps were solely muscle (n = 28) and were used for lower extremity or foot coverage (n = 29). Results The overall success rate was 94%. Major and minor complications occurred in 5 and 13 cases, respectively. The most common major complication was unplanned reoperation (n = 5), and the most common minor complications were partial skin graft loss (n = 3), partial flap necrosis (n = 3), and planned recipient-site reoperation (n = 5). Conclusions Reconstruction of large extremity wounds using the gracilis free flap showed a 94% success rate with few major complications.Ptosis Sensitivity Threshold for the Lay Observer
Purpose This study aims to understand the degree to which ptosis is recognizable to a layperson. Methods Fifteen color drawings of a gender-neutral human face were created. Six faces exhibited right-sided ptosis (decreased margin reflex distance 1 and lengthened tarsal platform show) of 0.5 mm, 1 mm, 1.5 mm, 2 mm, 2.5 mm, and 3 mm, respectively. Six more faces exhibited left-sided ptosis of the same amounts. The 12 ptotic faces and 3 symmetrical faces were randomly placed on three 11-inch by 14-inch sheets of paper with 5 faces on each page. Lay observers were provided 6 seconds per face to indicate whether it appeared to be asymmetrical. Statistical tests examined the observers' ability to detect asymmetry better than chance. Sex differences in correctly recognizing asymmetry in ptosis at each 0.5 mm increment were analyzed. Results One hundred thirty-one lay observers were enrolled in the study. Fifty-seven were women and 74 were men. Lay people were able to correctly recognize ptosis better than chance when the asymmetry was 1.5 mm or greater. Moreover, females were more accurate in recognizing ptosis at 1.5 mm, 2.0 mm, and 2.5 mm of asymmetry. Conclusions Lay observers tend to recognize between 1.0 mm and 1.5 mm of ptosis on one side as being abnormal. This may have implications in the selection of candidates for ptosis surgery and the analysis of subsequent surgical outcomes.The ReSurge Global Training Program: A Model for Surgical Training and Capacity Building in Global Reconstructive Surgery
Background A paradigm shift is underway in the world of humanitarian global surgery to address the large unmet need for reconstructive surgical services in low- and middle-income countries (LMICs). Here, we discuss the ReSurge Global Training Program (RGTP), a model for surgical training and capacity building in reconstructive surgery in the developing world. The program includes an online reconstructive surgery curriculum, visiting educator trips, expert reconstructive surgeon involvement, trainee competency tracking system, and identification of local outreach partners to provide safe reconstructive surgery to the neediest of patients in the developing world. Methods A retrospective review of the components of the RGTP from July 2014 through June 2017 was performed. Trainee milestones scores were analyzed to observe trends toward competency in specific plastic surgery skill sets. Results There were a total of 38 visiting educator trips during the study period. The trips took place in 10 LMICs. A total of 149 trainees were evaluated in the context of the visiting educator trips with 377 distinct submodule evaluations. Four trainees had more than 10 submodule evaluations over 2 or more visiting educator trips. There was notable improvement in milestones ratings over time among the trainees in this program. Conclusions The RGTP is a model of reconstructive surgical training and capacity building in LMICs. Trainees develop important skill sets in reconstructive surgery as a result of their involvement in the program. This comprehensive training approach addresses the disparity in access to care in the developing world by providing short- and long-term solutions to unmet reconstructive needs.Salvage of Threatened Cardiovascular Implantable Electronic Devices: Case Series and Review of Literature
Background The treatment of infected or exposed cardiac pacing and defibrillator devices is controversial. The conservative and widely accepted management calls for removal of the device and leads with immediate or delayed replacement of new components in a new site. Lead extraction carries a 2% major complication risk. In this article, we describe our experience with device salvage techniques and review the current literature. Methods This is a retrospective case series of consecutive patients with infected, exposed, or at-risk implanted cardiac devices that were treated with aggressive surgical debridement, local pocket irrigation, and revision. A comprehensive review of the literature regarding device infection management was performed. Results Ten patients with threatened devices were identified. Surgical revision with the aim to salvage the device was successful in 8 (80%) of 10 cases. Seventeen retrospective publications were reviewed. All indicate success with attempted salvage surgery, but heterogeneity of data limits formal meta-analysis and prevents management recommendations. Conclusions Cardiac pacing and defibrillator devices with low-grade infection or threatened exposure may be salvaged without explantation. Despite the lack of clear management guidelines or data, plastic surgeons may be asked to assist in the management of threatened cardiac devices. Further prospective trials are required to evaluate the safety, efficacy, and cost-effectiveness of attempted implant salvage.The Tuck-in Mastopexy
Background Breast ptosis is an inevitable consequence of gravity and time. Every breast tends to become ptotic in different shapes and degrees. Many surgical techniques were described to solve this problematic issue. The aim of this article is to describe a mastopexy technique used for grades 1 to 2 ptosis, "tuck-in" mastopexy technique. Methods Keyhole pattern was used for skin markings. All the planned skin excision areas were de-epithelialized. Breast mound was elevated as a 1-piece flap with extensive subglandular dissection. Elevated breast flap was reshaped and repositioned. Skin incisions were sutured in 2 layers. Results Seventeen patients were operated on with this technique; average follow-up time was 10.1 months. No major complications were seen. The results were pleasing for both the patients and the surgeon. Conclusions The "tuck-in" mastopexy technique uses breast mound as 1-piece flap, which has great vascularity from medial, superior, and lateral pedicles. Large areas of de-epithelialization facilitate reshaping and repositioning. It permits simultaneous or secondary breast augmentation with silicone gel implants. This easy-to-do technique has low complication rates and a short learning period.A Technique for the Prevention of Recurrent Eyebrow Ptosis After Brow Lift Surgery
Background Preventing the recurrence of eyebrow ptosis after brow lift surgery is challenging. We developed a novel technique to maintain elevation of the eyebrow after brow lift surgery. Methods A consecutive sample of patients who underwent brow lift surgery between June 2014 and June 2016 was divided into 2 groups. Group A underwent resection of excess skin during brow lift surgery; group B underwent the new eyebrow lift technique, which involved resecting skin and the lateral part of the orbital orbicularis oculi muscle, elevating the lower margin of the orbital orbicularis oculi muscle, and suturing it to the orbital periosteum. Eyebrow height and patient satisfaction were measured preoperatively and after surgery. Results This study included 273 patients. Mean follow-up time was 24.8 months (range, 6–52 months). Brow height was similar in groups A and B immediately postoperatively (group A: 28.37 ± 3.02 mm vs group B: 29.21 ± 2.97 mm) and at 6 months after operation (group A: 26.65 ± 2.53 mm vs group B: 27.45 ± 2.77 mm). At 12 months (group A: 22.73 ± 2.31 mm vs group B: 25.61 ± 2.62 mm) and 24 months (group A: 20.76 ± 2.22 mm vs group B: 24.74 ± 3.10 mm) after operation, the amount of brow elevation was significantly greater in group B. Two patients in group B experienced supraorbital neuralgia after surgery, which resolved by the 6-month follow-up. At 12 and 24 months after operation, patients in group B were significantly more satisfied with their surgery than patients in group A. Conclusion Our novel technique is simple and effective for preventing recurrent eyebrow ptosis after brow lift surgery.Surgical Refinement Following Free Gracilis Transfer for Smile Reanimation
Importance Gracilis free muscle transfer is widely regarded as the gold standard functional smile reanimation in long-standing facial palsy. Although most patients achieve meaningful oral commissure movement, a subset has suboptimal aesthetic outcomes due to midfacial bulk or oral commissure malposition. Safe refinements that do not compromise excursion would be a welcome addition to the surgical armamentarium for this population. Objectives The goal of this study was to describe surgical approaches to the 3 most common postoperative sequelae that detract from the final result after gracilis facial reanimation and to examine how these surgical refinements affect aesthetic outcome, smile excursion, and quality of life. Design This was a retrospective case series. Setting Tertiary care center (Massachusetts Eye and Ear Infirmary Facial Nerve Center). Participants Of 260 gracilis transfers performed since 2003, meaningful excursion (>3 mm) but poor aesthetic outcome requiring additional surgery was noted in 21 patients and was related either to excess muscle bulk (9), resting inferior malposition of the oral commissure (9), or resting superior/lateral malposition of the oral commissure (3). Intervention Specific surgical interventions to address each of these negative sequelae were developed and refined, to preserve muscle functionality but eliminate the unsightly feature. Main Outcome Aesthetic status, determined by midfacial symmetry; quantitative smile excursion; and quality of life (using the FaCE instrument) were measured before and after revision. Results Patients who underwent gracilis refinement directed at either muscle debulking, or gracilis tightening or loosening experienced significantly improved aesthetics/midfacial symmetry and improved quality of life with no significant decrease in smile excursion. Conclusions Improved aesthetics and quality of life can be achieved through targeted revision of the gracilis free tissue transfer, without significant loss of smile excursion.Financial Implications of Atypical Mycobacterial Infections After Cosmetic Tourism: Is It Worth the Risk?
Background Cosmetic tourism has become increasingly popular despite many associated risks. The economic impact of atypical mycobacterial infections in cosmetic tourism is poorly defined in the literature. We sought to investigate the costs and clinical course of patients with these infections. Methods A retrospective review of all patients managed by the Plastic Surgery Division at Columbia University Medical Center from 2013 to 2014 with atypical mycobacterial surgical site infections after cosmetic surgery outside the United States was performed. Data including patient demographics, procedure costs, clinical course, impact on daily life, and costs associated with complications were collected using hospital billing information, patient questionnaires, telephone interviews, and clinical charts. Cost analysis was done to identify the personal and societal costs of these complications. Results Data from 10 patients were collected and analyzed. Management of mycobacterial infections cost an average of $98,835.09 in medical charges. The indirect cost of these infections was $24,401 with a mean return to work time of 6.7 months. Total patient savings from cosmetic tourism was $3419. The total cost of a mycobacterial infection was greater than $123,236.47. Although the incidence of mycobacterial infection abroad is unknown, the potential cost of an infection alone outweighs the financial benefits of cosmetic tourism if the risk exceeds 2.77%. Conclusions Atypical mycobacterial infections as a result of cosmetic tourism come at considerable cost to patients and the health care system. When our results are taken into consideration with other risks of cosmetic tourism, the financial risks likely far outweigh the benefits.A Single Surgeon's Experience With Transgender Female-to-Male Chest Surgery
Background Chest wall recontouring is a common surgical treatment of gender dysphoria in transmen and nonbinary individuals assigned female at birth. This study reviews more than 20 years of cases to identify risk factors for postoperative complications and likelihood of preservation of nipple sensation. Methods One hundred thirty-seven cases of female-to-male chest wall recontouring by a single surgeon from 1994 to 2016 were reviewed, 99 of which were included for final analysis. Double-incision free nipple graft and double incision with nipple transposition on a pedicle were the most common techniques used. Complication rates between these 2 techniques were compared, and multivariate analysis was used to identify possible predictors of major complications, and minor complications. Results No significant risk factors for major complications were identified. With regard to minor complications, advanced patient age (odds ratio [OR], 1.67; P = 0.03) and early surgical experience (OR, 5.08; P = 0.001) were found to be associated with increased risk. Preoperative hormonal treatment was found to trend toward a protective effect (OR, 0.13; P = 0.07). Conclusions Any of the reviewed techniques are safe in practice; however, there is a learning curve associated with their use, and longer follow-up will allow for the identification of late complications. The double incision with nipple transposition on a pedicle technique can be considered for patients for whom depigmentation of the nipple-areola complex is a significant concern, especially if they are willing to tolerate a potentially suboptimal chest contour.Direct-to-Implant as a Frontline Option for Immediate Breast Reconstruction: A Comparative Study With 2-Stage Reconstruction
Background Immediate single-stage direct-to-implant breast reconstruction requires caution owing to the possibility of skin necrosis and implant failure. Nevertheless, this method has been performed widely for breast reconstruction. This study aimed to analyze the safety of single-stage implant reconstruction by comparing it with 2-stage reconstruction (TSR). Methods Immediate single-stage reconstructions (SSRs) and TSRs with a tissue expander, performed from January 2011 to December 2016, were retrospectively reviewed. Acellular dermal matrix was used in both groups to maintain similar pocket conditions. Risk factors were not considered in patient selection. Results We enrolled 290 patients including 8 who received bilateral breast reconstruction. A total of 298 breasts were operated, including 233 SSR cases (78%) and 65 TSR cases (22%). The surgical success (ie, the implant was maintained without explantation) rate was higher in SSR (97%) than in TSR (90.2%) (P = 0.03). Two-stage reconstruction had a significantly higher rate of hematoma (12.3% vs 3.4%, P = 0.005), seroma (41.5% vs 20.6%, P = 0.001), and implant failure (9.8% vs 3.0%, P = 0.03). However, the rate of skin necrosis was lower in TSR (7.7% vs 10.3%) with a trend toward significance (P = 0.053). The implant salvage rate was higher in SSR (61.1%) than in TSR (12.5%) even after revision operation (P = 0.013). Conclusions Single-stage reconstruction yielded a lower complication rate than TSR. Moreover, the high salvage rate of SSR causes less concern about implant failure despite the possibility of revision operation. Therefore, SSR may be considered a frontline method for breast reconstruction without any patient selection interference.Resorbable Implants for Orbital Fractures: A Systematic Review
Background Orbital fractures are one of the most common sequelae of facial trauma. Objective The objective of this study was to summarize published data for resorbable implants in orbital reconstruction, including polymer composition, degradation characteristics, osteoconductivity, and complications such as enophthalmos, diplopia, and peri-implant inflammation. A literature search of the National Library of Medicine was performed via PubMed using the keyword resorbable orbital implant. A total of 27 studies were reviewed. Strength of data was assessed according to the Oxford Centre criteria. Results Most commercially available implants provide adequate tensile strength for up to 6 months (with the exception of polydioxanone, which loses strength within 1 month, and poly(D,L-lactide) within 3 months). This is sufficient for the isolated orbital floor or medial wall (tensile strength, ~300 MPa) but insufficient for reconstruction of load-bearing areas (eg, the inferior orbital rim with tensile strength of ~1.2 GPa). Thicker products (>1 mm) have increased risk for delayed inflammation than thinner products. Postoperative complications including delayed inflammation (0%–9%), eyelid malposition (0%–5%), enophthalmos (5%–16%), diplopia (0%–16%), infection (0%–2%), and infraorbital nerve hypesthesia (2%–18%) are variably distributed across implants with several notable exceptions: poly(L-lactide) has an increased risk of delayed inflammation, and polydioxanone has a risk of delayed enophthalmos and hematoma. Conclusions Resorbable implants are suitable for isolated medial wall or floor fractures with intact bony buttresses and function as a barrier rather than a load-bearing support.Axillary Lymphadenectomy and Wound Complications in Implant-Based Breast Reconstruction
Background The most common method of breast reconstruction in the United States today is implant-based reconstruction. However, reported complication rates are high, from 30% to 50%. Thus, it is important for reconstructive surgeons to identify factors associated with or contributing to wound complications after breast reconstruction. This study sought to identify associations between axillary lymph node dissection and postoperative wound complications in implant-based breast reconstruction. Methods A retrospective chart review was performed of subjects undergoing breast oncologic and reconstructive surgery by a single breast surgeon and reconstructive surgeon, respectively, from 2013 to 2016. Medical records were reviewed of 273 subjects with 338 reconstructed breasts. Data were recorded on the extent of axillary node dissection and subsequent wound complications including seroma requiring percutaneous drainage, seroma requiring open drainage, wound dehiscence requiring local wound care, wound dehiscence requiring operative revision, implant exposure, and implant loss. Results Analysis of the data demonstrated an increase in complication rates with extent of axillary lymph node dissection; however, these rates did not reach statistical significance. Statistically significant associations, however, were identified between wound complication rates and other known risk factors including increasing age and body mass index, as well as smoking status. Conclusions Although an association between increasing complication rates and the extent of lymph node dissection has previously been reported, this study failed to demonstrate a statistically significant association with logistic regression analysis.Chest Wall–Based Flap for Repairing Partial Mastectomy Defects: A Multipurpose Flap
Objective The objective of this study is to introduce a single and reproducible tissue-rearrangement oncoplastic technique that is applicable for all quadrants partial-mastectomy defects in small- to medium-sized breasts, using grounds drawn from cosmetic surgery. Methods Eleven small- to medium-sized breast cancer patients with tumor involvement of more than a quarter of the breast were operated on using the chest wall–based flap technique. The procedure is described in detail, and the results are analyzed in terms of both cosmetic and oncological results. Results The flap successfully reached all breast quadrants as necessary, as well as the areola-nipple complex. The resection borders were found to be free of tumor in all cases, and there were no perioperative complications. Patients rated nearly all the cosmetic parameters as "somewhat satisfied" or "very satisfied," and there was no evidence of fat necrosis in the postoperative mammography examinations. Conclusions Applying principles taken from the cosmetic plastic surgery lies at the base of any high standard reconstructive surgery in general and oncoplastic breast surgery in particular. The chest wall–based flap is suitable for the reconstruction of a wide range of breast lumpectomy defects and is feasible for small- to medium-sized breasts, which are usually not easily amenable to tissue rearrangement techniques. The learning curve is short, with replicable results.Ceftriaxone-Resistant Aeromonas hydrophila Infection Following Leech Therapy: A New Resistant Strain
We report a case of ceftriaxone-resistant Aeromonas hydrophila infection in a 32-year-old man after medicinal leech therapy. The patient underwent a free gracilis muscle flap for dorsal foot soft tissue reconstruction. Because of persistent congestion after venous revision, medicinal leech therapy was initiated to aid in flap salvage. Intravenous ceftriaxone was administered prior to application of leeches for prophylaxis against A. hydrophila. Leech therapy was discontinued after 1 week, and ceftriaxone was discontinued 24 hours thereafter. An infection developed despite being on appropriate antibiotics. Culture sensitivities indicated that A. hydrophila was resistant to ceftriaxone.Modified Treatment Algorithm for Pseudogynecomastia After Massive Weight Loss
Background Pseudogynecomastia is the increased aggregation of fatty tissue in the area of the male breast with resultant female appearance. Two forms can appear: pseudogynecomastia after massive weight loss (pseudogynecomastia obese [PO]) and pseudogynecomastia, which is caused only by adipose tissue (pseudogynecomastia fat). For PO, only the Gusenoff classification with corresponding operative treatment options exists. However, this classification is limited by the fact that it underestimates the extensive variability of residual fat tissue and skin excess, both crucial factors for operative planning. For this reason, we propose a modification of the treatment algorithm for the Gusenoff classification based on our results to achieve more masculine results. Materials and Methods A total of 43 male patients with PO were included in this retrospective study (grade 1a, n = 1; grade 1b, n = 1; grade 2, n = 17; grade 3, n = 24). Forty-two mastectomies with a free nipple-areola complex (NAC) transposition (grades 2 and 3) and 1 with a subcutaneous mastectomy (grade 1a) with periareolar lifting were performed. A retrospective chart review was performed to obtain data regarding age, body mass index, body mass index loss, weight loss, reason for weight loss, comorbidities, nicotine, and additional procedures, postoperative sensitive on the NAC transplants and complications. Results None of the free-nipple grafts were lost. Forty (95%) of 42 patients with mastectomy had a resensitivity on the NAC. Conclusions For pseudogynecomastia, the treatment algorithm of the Gusenoff classification should be modified and adapted according to our recommendations to achieve more optimal masculine results.Curcumin and Biodegradable Membrane Promote Nerve Regeneration and Functional Recovery After Sciatic Nerve Transection in Adult Rats
Background Curcumin has immunomodulatory anti-inflammatory, antioxidant, and neuroprotective properties. The goal of this study was to determine the effects of curcumin and biodegradable membrane on nerve healing in rat sciatic nerve transected injuries. Methods Rats were divided into groups: (1) control group (Ctrl), (2) curcumin group (Cur), (3) membrane group (Mem), and (4) membrane and curcumin group (Mem + Cur). Functional recovery was evaluated at 2, 4, 6, and 8 weeks after surgery. At the end of the eighth week after surgery, histological assessments were done. Results At the end of 8th week after surgery, functional assessments (sciatic nerve index, withdrawal reflex latency, and electromyography) in the Mem + Cur group improved compared with other groups (POutcome of the Modified Meek Technique in the Management of Major Pediatric Burns
Introduction The modified Meek micrografting technique has been used in the treatment of severely burned patients and a number of articles have examined the use of the modified Meek technique in adults and in mixed-age groups. However, there is a paucity of research pertaining to the outcome in the pediatric age group. The aim of this study is to present our favorable outcome in pediatric major burns using the modified Meek technique. Methods A retrospective review of burn cases in Hospital Universiti Sains Malaysia from 2010 to 2015 was conducted. Cases of major burns among pediatric patients grafted using the Meek technique were examined. Results Twelve patients were grafted using the Meek technique. Ten (91.7%) patients were male, whereas 2 (8.3%) were female. The average age of patients was 6 years (range, 2–11 years). The average total body surface area was 35.4% (range, 15%–75%). Most burn mechanisms were due to flame injury (66.7%) as compared with scalds injury (16.7%) and chemical injury (16.7%). There was no mortality. All patients were completely grafted with a good donor site scar. The average graft take rate was 82.3%, although 8 cases had positive tissue cultures from the Meek-grafted areas. The average follow-up duration was 3.6 years (range, 1.1–6.7 years). Only 1 case developed contracture over minor joint. Conclusions The Meek technique is useful when there is a paucity of donor site in the pediatric group. The graft take is good, contracture formation is low, and this technique is cost-effective.Primary Closure of Wide Fasciotomy and Surgical Wounds Using Rubber Band–Assisted External Tissue Expansion: A Simple, Safe, and Cost-effective Technique
Background Although decompressive fasciotomy is a limb-saving procedure in the setting of acute compartment syndrome, it leaves a large wound defect with tissue edema and skin retraction that can preclude primary closure. Numerous techniques have been described to address the challenge of closing fasciotomy wounds. This study reports our experience with fasciotomy closure using rubber bands (RBs) for external tissue expansion. Methods Patients were informed about RB closure and split-thickness skin graft options. Only patients who opted for RB closure and had wounds that could not be approximated using the pinch test underwent the procedure. Starting from the apex and progressively advancing, the RBs were applied to the skin edges at 3 to 4 mm intervals using staples. The RBs were advanced by twisting back-and-forth to create a criss-cross pattern. One week after application, fasciotomy wounds were closed primarily or underwent further RB application, based on clinical assessment of adequacy of skin advancement, compartment tension, and perfusion. Review of a prospectively maintained database was performed, including demographics, comorbidities, etiology, wound and operative details, hospital stay, and complications. Results Seventeen consecutive patients with 25 wounds (22 fasciotomy and 3 other surgical wounds) were treated using the RB technique. Average wound length and width measured 15.7 cm (range, 5–32 cm) and 5.2 cm (range, 1–12 cm), respectively. Locations of wounds included forearm (n = 12, 48.0%), leg (n = 7, 28.0%), hand (n = 4, 16.0%), elbow (n = 1, 4.0%), and hip (n = 1, 4.0%). Eighteen of 25 wounds (72.0%) were closed primarily after 1 RB application. Additional RB application was required for 5 wounds to achieve primary closure. Between stages, patients were discharged home if they did not have other conditions requiring in-hospital stay. No complications were observed, and no revision surgeries were required. Patient satisfaction was 100%, and all indicated that they would choose the RB technique over skin grafting. Conclusions The modified RB technique is a simple, safe, and cost-effective alternative for treating fasciotomy and other surgical defects resulting in high patient satisfaction and good cosmetic outcome, without the need for split-thickness skin graft or flap coverage.Παρασκευή 10 Αυγούστου 2018
Correction to: Multiple diversity concepts and their ethical-epistemic implications
The original version of this article unfortunately contained a mistake. The fourth author's name is Bianca Crewe, not Bianca Crew. The original article has been corrected.
Mercury contamination in the sludge of drinking water treatment plants dumping into a reservoir in Rio de Janeiro, Brazil
Abstract
Although sludge piles from drinking water treatment plants can contain harmful substances, in many countries, their disposal methods are still unregulated. Besides aluminum, which is a major constituent in these residues, many other contaminants—like trace metals—can be present and may result from the quality of the raw materials used for water treatment. The application of these chemicals for the treatment of drinking water can generate toxic sludge and contaminate the produced water. In the present work, mercury contamination in the sludge piles of two drinking water treatment plants located along the margins of the Juturnaíba Reservoir, Southeast Brazil, was evaluated to verify whether contaminants are incorporated during water treatment. In the summer 2012, five cores were collected from the piles, and were analyzed for Eh, granulometry, total carbon, total nitrogen, and total mercury. The results indicated an anoxic environment, reflecting composition of the suspended matter. Carbon and nitrogen presented elevated concentrations, but also seemed to reproduce the characteristics of the suspended matter in the raw water. The concentrations of mercury were extremely variable but presented unexpectedly high values in some of the layers, reaching 18,484 ng g−1. On the other hand, concentrations ten times lower than those observed in the natural system (8 ng g−1) could be observed. It was concluded that the only possible source for the contamination of the sludge was the chemicals used for water treatment.
Incorporating diffusion- and perfusion-weighted MRI into a radiomics model improves diagnostic performance for pseudoprogression in glioblastoma patients
Abstract
Background
Pseudoprogression is a diagnostic challenge in early post-treatment glioblastoma. We therefore developed and validated a radiomics model using multiparametric MRI to differentiate pseudoprogression from early tumor progression in patients with glioblastoma. Methods
The model was developed from the enlarging contrast-enhancing portions of 61 glioblastomas within 3 months after standard treatment with 6472 radiomic features being obtained from contrast-enhanced T1-weighted imaging, fluid-attenuated inversion recovery imaging, and apparent diffusion coefficient (ADC), and cerebral blood volume (CBV) maps. Imaging features were selected using a least absolute shrinkage and selection operator (LASSO) logistic regression model with 10-fold cross-validation. Diagnostic performance for pseudoprogression was compared with that for single parameters (mean and minimum ADC and mean and maximum CBV) and single imaging radiomics models using the area under the receiver-operating-characteristics curve (AUC). The model was validated with an external cohort (n = 34) imaged on a different scanner and an internal prospective registry data (n = 23). Results
Twelve significant radiomic features (3 from conventional, 2 from diffusion and 7 from perfusion MRI) were selected for model construction. The multiparametric radiomics model (AUC 0.90) showed significantly better performance than any single ADC or CBV parameter (AUC 0.57-0.79, P<.05), and better than single radiomics model using conventional MRI (AUC 0.76, P =.012), ADC (AUC 0.78, P =.014), or CBV (AUC 0.80, P=.43). The multiparametric radiomics showed higher performance in the external validation (AUC 0.85) and internal validation (AUC 0.96) than any single approach, thus demonstrating robustness. Conclusions
Incorporating diffusion- and perfusion-weighted MRI into a radiomics model improved diagnostic performance for identifying pseudoprogression and showed robustness in a multicenter setting.Trust in Police and Fear of Crime Among Young People from a Gender Perspective: The Case of Mexico
Violence and Gender, Ahead of Print.
Hypersensitivity Reactions to Antiepileptic Drugs in Children: Epidemiologic, Pathogenetic, Clinical, and Diagnostic Aspects
Publication date: Available online 10 August 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Semanur Kuyucu, Jean-Christoph Caubet
Epilepsy affects approximately 10 million children globally. Antiepileptic drugs (AEDs) are among the most frequent causes of drug hypersensitivity reactions (DHRs), especially severe ones. However, systematic studies about AED hypersensitivity among children are very rare. In this review, we aimed to gather all relevant and important data about different aspects of DHRs to AEDs in children by conducting a PubMed search including English-language studies published between January 1990 and June 2017. In these studies, aromatic AEDs were mostly incriminated in DHRs, but still being dominantly prescribed in both developed and developing countries. Although newer AEDs were increasingly prescribed owing to their presumed low toxicity profile, surveillance of DHRs is strongly recommended because case reports about severe reactions were recently reported. The pathogenesis seemed to be multifactorial including metabolic, genetic, and immunologic factors. Recent pharmacogenomic studies demonstrated strong genetic associations between some human leucocyte antigens and/or polymorphisms of AED metabolic enzymes and AED-induced DHRs among both adults and children. Young children, concurrent medications, a high starting dose and rapid dose escalation, and some genetic markers are important risk factors for AED-induced hypersensitivity. There were a very limited number of studies in the pediatric population evaluating the efficacy of different available diagnostic tools, such as intradermal, patch, and drug provocation tests. Data including mostly adult patients showed that patch tests had relatively high diagnostic value to identify the culprit with a positivity rate that ranged between 19.7% and 100% in delayed reactions to AEDs. Clinical cross-reactivity rates of 15% to 70% have been reported mainly between aromatic AEDs. In selected cases, where there is no other option, desensitization can be considered, although experience in children remained limited.
Combination therapy with montelukast and loratadine alleviates pharyngo-laryngeal symptoms related to seasonal allergic rhinitis
Publication date: Available online 10 August 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Yoshimasa Imoto, Tetsuji Takabayashi, Masafumi Sakashita, Takahiro Tokunaga, Taiyo Morikawa, Takahiro Ninomiya, Masayuki Okamoto, Norihiko Narita, Shigeharu Fujieda
One-Piece Nasal Osteotomy for the Correction of a Centrally Deviated Nose
Abstract
Background
A severely crooked nose due to trauma or other causes is difficult to correct. Although various nasal osteotomy techniques have been suggested, satisfactory outcomes have not always been achieved especially in centrally deviated noses. Definite correction of the midline and shape of the bony framework is necessary. We aimed to investigate a novel one-piece nasal bone osteotomy approach consisting of transverse osteotomy continued with bilateral lateral osteotomies for the correction of a centrally deviated nose.
Methods
This retrospective chart review included 66 consecutive patients who underwent corrective rhinoplasty with nasal bone osteotomy for a deviated nose. Group 1 was treated with one-piece osteotomy, and group 2 was treated with conventional lateral and/or medial osteotomy. Available preoperative and postoperative three-dimensional facial bone computed tomography images were used to quantify nasal landmarks through three-dimensional reconstruction. Patient satisfaction was evaluated using a rhinoplasty outcome evaluation questionnaire.
Results
Measurements of nasal landmark angles toward the longitudinal facial midline plane showed a statistically narrowed postoperative angle in group 1 (subnasale landmark: preoperative angle 1.66 ± 0.29° [group 1] vs. 0.76 ± 1.09° [group 2]; postoperative angle 0.96 ± 0.77° [group 1] vs. 0.31 ± 0.29° [group 2]). The questionnaire scores revealed higher satisfaction (3.11 ± 2.38 vs. 1.157 ± 1.147) and a higher proportion of 4-point scores in group 1.
Conclusions
This is the first study to introduce the one-piece nasal osteotomy technique for centrally deviated noses. The technique consists of transverse osteotomy with bilateral osteotomies in one stage, thus the name "one-piece." Considering anatomic variances in Asian rhinoplasty, a deviated nose should be effectively corrected to obtain satisfactory outcomes. We demonstrated the efficacy and satisfactory outcomes of this new technique.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
The Application of the Acellular Dermal Matrix in the Correction of the Tear Trough Deformity
Abstract
Objective
The acellular dermal matrix (ADM) used in correcting the tear trough deformity has been reported, but there were only a few cases. The long-term effectiveness of ADM was not clear. We aim to discuss the technique and the effect of using ADM to correct the tear trough deformity through more cases.
Methods
A retrospective study was conducted from January 2012 to January 2017. Twenty-six patients who showed obvious tear trough deformity with moderate or severe orbital fat bulging and excess of lower eyelid skin were treated with ADM to improve the appearance of the midface. Follow-up was performed for 2–12 months in 26 cases. The level of postoperative satisfaction was assessed by interview during the follow-up and rated as very satisfied, satisfied, acceptable, or unacceptable.
Result
Twenty patients were very satisfied for having achieved complete correction. Three patients were satisfied for having achieved obvious improvement. Three patients felt the results were just acceptable and were refilled because of the insufficiency of the filler. No one was unacceptable. There were no complications such as rapid resorption, rejection, or inflammation.
Conclusion
The method of using ADM for the correction of tear trough deformity has the advantages of low absorption rate, good appearance, and high security. It provides a new choice for the treatment of tear trough deformity.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Mycosis fungoides presenting with pigmented purpuric rash
A 55-year-old woman presented with a pruritic rash existing for three months which was unresponsive to topical steroids. Dermatologic examination revealed generalized purpuric patches with unclear borders primarily localized on buttocks, abdomen, wrists and upper legs. Biopsy taken with diagnoses of pigmented purpuric dermatosis, pityriasis Rosea and mycosis fungoides, showed superficial and middermal lymphoid infiltrate with epidermotrophism and atypical large cerebriform cells as well as basaloid vacuolization, spongiosis and extravasated erythrocytes in the superficial dermis.
Prospective pilot evaluation of the efficacy and safety of adjuvant topical ingenol mebutate gel for localized patch/plaque-stage mycosis fungoides
Introduction: Whether ingenol mebutate (IM) is effective as adjuvant topical treatment for mycosis fungoides (MF) remains undetermined.
Paraneoplastic angiomatosis: A new entity
Paraneoplastic syndromes result from tumor secretion of hormones, peptides, or cytokines or from immunologic cross reactions between malignant and normal cells. Numerous organ systems may be affected by paraneoplastic conditions, including the skin. We report 2 cases of benign cutaneous vascular proliferations occurring in the setting of malignancy and propose the term paraneoplastic angiomatosis. Case 1: A 62-year-old man with multiple comorbidities presented with a large, irregular, blanching erythematous abdominal plaque.
Pilot evaluation of safety, efficacy, and tolerability of a new topical formulation for facial hyperpigmentation, combining ascorbyl tetraisopalmitate and crosslinked resilient hyaluronic acid
This study evaluated therapy of facial hyperpigmentation with a novel topical formulation combining two synergistic melanogenesis inhibitors: ascorbyl tetraisopalmitate (ATIP), the esterified form of vitamin C (concentration equivalent to 8% L-ascorbic acid), and crosslinked resilient hyaluronic acid (RHA). Vitamin C inhibits multiple oxidative steps during melanogenesis, diminishing tyrosinase activity. Clinical challenges with L-ascorbic acid include low skin penetrance, instability due to oxidation, and potential irritation.
No disclosure of support by ISDIN SA on poster
"Antiaging facial serum containing melatonin, bakuchiol, and ascorbyl tetraisopalmitate up-regulates antioxidant gene expression in medaka embryos"
Predictors of response to tildrakizumab for moderate-to-severe chronic plaque psoriasis
Introduction: Efficacy of tildrakizumab (TIL), a high-affinity, humanized, IgG1/κ monoclonal antibody against IL-23p19, has been evaluated for chronic plaque psoriasis (Pso) in 2 phase 3 randomized controlled trials. The objective of this analysis was to determine predictors of response to TIL treatment in the 2 trials.
Pembrolizumab-induced bullous pemphigoid
Background: Bullous pemphigoid (BP) is an autoimmune blistering disorder characterized by autoantibody deposition at the epithelial basement membrane zone. It classically presents in elderly adults and can be idiopathic or drug-induced. The 2 major bullous pemphigoid antigens do not differ between the drug-induced and idiopathic variants of the disease, nor do the direct and indirect immunofluorescence (DIF and IIF) findings. Pembrolizumab is an anti–programmed cell death 1 (PD-1) antibody which inhibits the negative immune regulation caused by PD-1 receptor signaling resulting in reversal of T-cell suppression and induction of antitumor responses.
Omalizumab for chronic spontaneous urticaria in real-life practice
Background: Omalizumab has been shown to be highly effective in phase III clinical trials in treatment of chronic spontaneous urticaria (CSU).
National trends in staphylococcal scalded skin syndrome
Background: Staphylococcal scalded skin syndrome (SSSS) is a potentially fatal superficial blistering disorder caused by infection with exfoliative toxin producing strains of Staphylococcus aureus.
Comparison of Er:YAG laser, short pulse-duration pulsed dye laser, and long pulse-duration pulsed dye laser in treating sebaceous hyperplasia
Background: Patients of sebaceous hyperplasia (SH) usually seek treatment due to cosmetic concern. A few nonsurgical ablative devices are effective in treating SH, including carbon dioxide laser and erbium-doped yttrium aluminium garnetlaser (Er:YAG) laser. But these options bear the considerable risk of postoperative discoloration and scar formation. Pulsed dye laser (PDL) has been reported effective in treating SH. However, only short pulse-duration PDL (SPDL) has been used in previous studies.
Pseudomelanocytic nests leading to a misdiagnosis of lentigo maligna
Introduction: Dermoscopy of facial pigmented lesions is sometimes challenging and clinical-histologic correlation is essential.
Primary cutaneous mucinous carcinoma: Incidence and survival
Background: Primary cutaneous mucinous carcinoma (PCMC) is a rare eccrine carcinoma with a propensity to affect the head, especially the eyelid. It has the potential to be locally destructive with high rates of recurrence but low metastatic potential. Owing to its rarity, demographic and cancer-related data for PCMC are limited.
Poly-L-lactic injectable acid in the treatment of facial and extra facial flaccid areas: A case series
Poly-L-lactic acid (PLLA) is a synthetic, biocompatible and biodegradable polymer used as a sterile injectable solution to stimulate collagen production, leading to cutaneous filling, but do not act as a true volumizer. It has been used in facial and extrafacial areas to correct flaccidity, loss of volume, improve contour and skin elasticity. We report four female patients treated with PLLA, one vial per session. The final dilution was 10 cc for facial and 20 cc for extra facial injections. Case 1: 56 yo, treatment of medial region of the arms in 3 sessions.
Phase II study of KX2-391 ointment 1%, a novel field treatment for actinic keratosis, based on Src/tubulin polymerization inhibition
Background: KX2-391, a dual Src tyrosine kinase and tubulin polymerization inhibitor, inhibits the growth of human keratinocytes with IC50 of 32 nM and induces apoptosis in dividing cells. A phase I study demonstrated that KX2-391 ointment 1% reduced actinic keratosis (AK) lesion counts and was well tolerated following 3 or 5 days of treatment on the forearm. Aim: To determine the activity, safety and pharmacokinetics of KX2-391 ointment 1% (5 or 3 days) in adults with AK on the face or scalp.
Patient-reported global severity of atopic dermatitis is valid in adults
Atopic dermatitis (AD) is associated with a heterogeneous presentation and clinical course. There are many different patient-reported outcome measures available that measure different aspects of the disease. However, there are few simple, intuitive and validated severity assessments that are feasible for clinical practice and epidemiologic research. We sought to validate patient-reported global AD severity in adults. We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n = 265).
Oral Polypodium leucotomos extract and its impact on visible light–induced pigmentation
Background: Visible light has multiple effects on the skin including erythema, DNA damage secondary to free radical production, and pigmentation. Few sunscreens protect against visible light, which can exacerbate photodermatoses. Polypodium leucotomos extract (PLE) has antioxidant, photoprotective, chemoprotective, antiinflammatory, and immunomodulatory properties that may offer protection against visible light induced effects.
Objective assessment of dry skin roughness in a pediatric population
Introduction and objectives: Dry skin is a common condition during childhood. Clinical scoring of dry skin includes tactile evaluation of the skin surface to assess roughness. It also includes visual examination of the appearance of the skin and for severe cases the presence of dander. To our knowledge, no instrumental evaluation of roughness has ever been performed to objectively score skin dryness in a pediatric population, nor to document the clinical efficacy of skin care products specifically developed to address dry skin condition.
Neurofibromatosis type 1 and birth size: A retrospective registry-based total population study in Finland
Neurofibromatosis type 1 (NF1) is the most common dominantly inherited cancer predisposition syndrome with prevalence of ∼1:2,000. It is caused by mutations in NF1 gene on chromosome 17. The protein product of NF1 gene is neurofibromin, which acts as a tumor suppressor protein inhibiting Ras signaling pathway. The hallmark signs of the disorder are found on the skin, but NF1 is a multisystem disorder with increased risk for e.g., cancer, pregnancy complications, osteoporosis and learning difficulties.
T-helper cell phenotype expression in cutaneous lesions of angioimmunoblastic T-cell lymphoma
Background: Angioimmunoblastic T-cell lymphoma (AITL) is a common type of peripheral T-cell lymphoma. AITL can be missed until lymphadenopathy develops in patients initially presenting with skin lesions, as skin biopsy may lack conclusive findings. The expression of follicular helper T-cell (THF) markers in the skin can be an important diagnostic clue. We present a case of AITL with skin lesions positive for CD10 and dim PD-1 T cells, with the purpose of highlighting the potential for diagnosing cutaneous AITL via skin biopsy.
A facewash containing specific plant-derived monoterpenes reduced Propionibacterium acnes burden and improved acne symptoms
The pathogenesis of acne is multifactorial, including increased sebum production, ductal epidermal proliferation, bacterial colonization and inflammation. While the sequence of events involved in acne pathogenesis have not yet been established, there is a strong corelationship between the presence of acne and growth of the microorganism Propionibacterium acnes (P. acnes) leading to suggestions that P. acnes is associated with acne. Recent studies have also shown an increased level of Staphylococcus epidermidis (S.
The Avoidance and Management of Complications, and Revision Surgery of the Lower Face and Neck
Complications are an inherent occurrence in surgery. In rhytidectomy, many complications are avoidable with thorough preoperative assessment and optimal intraoperative and postoperative care. Nevertheless, complications do occur. In certain situations, avoidance of risks is the best way to decrease the occurrence. Once complications do occur, there is a large body of literature to aid in the correction.
Difficult Necks and Unresolved Problems in Neck Rejuvenation
Neck rejuvenation attempts to correct the unattractive features that result from the process of facial aging. The aesthetic goals of surgery include creating a well-defined jaw contour, optimal cervicomental angle, smooth-appearing skin, and a healthy redistribution of soft tissue volume. Unique patient characteristics create inherent challenges that may limit the degree to which improvement can be made. Psychological expectations and motivations influence patient satisfaction and must be understood through careful evaluation and counseling. This article describes common difficult situations encountered during neck rejuvenation and discusses unresolved problems. Several clinical examples along with specific surgical solutions are included.
Reduction Neck Lift
A description of the deep structures of the neck that are responsible for submandibular fullness and a systematic surgical approach to reduce them are presented. The structures susceptible to surgical management include the subplatysmal fat, inter-sternocleidomastoid origin fat, anterior belly of the digastric muscle, hyoid bone, submandibular gland and the tail of the parotid gland. A thorough analysis of the key anatomic landmarks of the young and attractive neck is detailed in resting and dynamic positions. A clinical classification of parotid reduction in the face lift/neck lift patient is also presented.
Surgical and Nonsurgical Perioral/Lip Rejuvenation
Lip rejuvenation options have evolved from surgical augmentation with plastic to far more natural options to include fat, tissues, resurfacing, and surgical manipulation of lip borders and contour. An overview of different options contrasts the risks, benefits, costs, and results between available surgical options. The ideal treatment varies from patient to patient, but optimally incorporates numerous simultaneous procedures.
Management of the Submandibular Gland in Neck Lifts
Neck contour deformities are common among patients who present for facial rejuvenation. A thorough physical examination and photographic analysis, including an upward view of the flexed neck, enable the surgeon to determine which structures should be treated. Common causes of neck concerns include hypertrophy of the subplatysmal fat, the anterior belly of the digastric muscle, and/or the submandibular salivary glands. Partial removal of the submandibular salivary glands requires advanced knowledge of subplatysmal anatomy and surgical expertise but can be performed safely and reliably to yield favorable results of neck rejuvenation.
Gender Reassignment
Facial stigmata associated with one's assigned gender can be very distressing for the gender dysphoric patient. The lower face and neck contain several structures that play a significant role in their ability to "pass" as their desired gender. Clinical recognition and modification of these structures will allow the patient to have facial and neck features that are consistent with their desired gender. This article reviews the techniques of mandibular angle contouring, genioplasty, chondrolaryngoplasty, facelift, and neck lift as they pertain to the feminization and masculinization of the face and neck of the patient with gender dysphoria.
Editorial Board
Publication date: September 2018
Source: Journal of Photochemistry and Photobiology B: Biology, Volume 186
Author(s):
The Use of Ultrasound-Guided Injections for Tendinopathies
Abstract
Purpose of Review
The purpose of the study was to review the efficacy and safety of common ultrasound-guided injections for tendinopathy conditions. Corticosteroid injections have historically been the most common injection used for tendinopathy; however, there are an increasing number of injections including platelet-rich plasma, hyaluronan, polidocanol, botulinum toxin, and high volume saline injections.
Recent Findings
There is growing evidence that while corticosteroid injections for tendinopathies usually have short-term efficacy, they may result in medium-term harm, particularly for tennis elbow (lateral epicondylitis). Corticosteroid injections appear to have more clinical utility for tenosynovitis conditions. There is insufficient evidence regarding other injection options to make a broad recommendation in favour, although individual trials for certain tendons illustrate benefits for some of the non-corticosteroid options.
Summary
When considering the use of ultrasound-guided corticosteroid injections for tendinopathies, the risk of possible medium-term harm must be weighed up against any short-term efficacy. Other injection-based therapies may be appropriate in certain clinical situations; however, the evidence and clinical circumstances must be considered for the particular tendon and patient. Load-based rehabilitation remains the cornerstone of tendinopathy management.
Intracortical facilitation within the migraine motor cortex depends on the stimulation intensity. A paired-pulse TMS study
Connectivity within the primary motor cortex can be measured using the paired-pulse transcranial magnetic stimulation (TMS) paradigm. This evaluates the effect of a first conditioning stimulus on the motor evo...
Relationship Between Platelet Count and Insulin Resistance in Korean Adolescents: A Nationwide Population-Based Study
Metabolic Syndrome and Related Disorders, Ahead of Print.
CMTM4 regulates angiogenesis by promoting cell surface recycling of VE-cadherin to endothelial adherens junctions
Abstract
Vascular endothelial (VE) cadherin is a key component of endothelial adherens junctions (AJs) and plays an important role in maintaining vascular integrity. Endocytosis of VE-cadherin regulates junctional strength and a decrease of surface VE-cadherin reduces vascular stability. However, disruption of AJs is also a requirement for vascular sprouting. Identifying novel regulators of endothelial endocytosis could enhance our understanding of angiogenesis. Here, we evaluated the angiogenic potential of (CKLF-like MARVEL transmembrane domain 4) CMTM4 and assessed in which molecular pathway CMTM4 is involved during angiogenesis. Using a 3D vascular assay composed of GFP-labeled HUVECs and dsRED-labeled pericytes, we demonstrated in vitro that siRNA-mediated CMTM4 silencing impairs vascular sprouting. In vivo, CMTM4 silencing by morpholino injection in zebrafish larvae inhibits intersomitic vessel growth. Intracellular staining revealed that CMTM4 colocalizes with Rab4+ and Rab7+ vesicles, both markers of the endocytic trafficking pathway. CMTM4 colocalizes with both membrane-bound and internalized VE-cadherin. Adenovirus-mediated CMTM4 overexpression enhances the endothelial endocytic pathway, in particular the rapid recycling pathway, shown by an increase in early endosomal antigen-1 positive (EEA1+), Rab4+, Rab11+ , and Rab7+ vesicles. CMTM4 overexpression enhances membrane-bound VE-cadherin internalization, whereas CMTM4 knockdown decreases internalization of VE-cadherin. CMTM4 overexpression promotes endothelial barrier function, shown by an increase in recovery of transendothelial electrical resistance (TEER) after thrombin stimulation. We have identified in this study a novel regulatory function for CMTM4 in angiogenesis. CMTM4 plays an important role in the turnover of membrane-bound VE-cadherin at AJs, mediating endothelial barrier function and controlling vascular sprouting.
Novel combined method of biosorption and chemical precipitation for recovery of Pb 2+ from wastewater
Abstract
A novel combined biosorption-precipitation process has been designed and applied to recycle Pb2+ from low concentration lead containing wastewater. Pb2+ was firstly removed selectively from wastewater by pyromellitic dianhydride (PMDA) modified sugarcane bagasse (SB) fixed-bed column, and then, it was desorbed into the concentrated eluate and recycled by adding chemical precipitant. Adsorption performance of the column and optimum desorption and precipitation condition for Pb2+ were investigated in detail. Results showed that the as-prepared column could efficiently remove Pb2+ from aqueous solution and optimum condition for Pb2+ precipitation in eluate was at pH 3.0 and molar ratio of precipitant to Pb2+ of 5:1 by using Na3PO4 as precipitant. Recovery experiment illustrated that Pb2+ was selectively removed from wastewater containing ions of Pb2+, Zn2+, Cd2+, Ca2+, K+, and Na+ through competitive substitution adsorption on the modified SB, and mass ratio of the five metal ions in eluate was 96.8:0.7:0.7:0.7:0.5:0.5. Pb2+ in this concentrated and purified eluate solution was recycled efficiently by adding Na3PO4. The combined method had great potential in application of heavy metal recovery from wastewater.
Photo-catalytic deactivation of hazardous sulfate reducing bacteria using palladium nanoparticles decorated silicon carbide: A comparative study with pure silicon carbide nanoparticles
Publication date: Available online 10 August 2018
Source: Journal of Photochemistry and Photobiology B: Biology
Author(s): Umair Baig, M.A. Gondal, M.A. Dastageer, A.B. Khalil, S.M. Zubair
Abstract
Sulfate reducing bacteria (SRB) wreaks havoc in the oil industry by being an agent for oil souring and building corrosion in pipelines and thereby degrade the quality of crude oil. Palladium nanoparticles decorated silicon carbide nanomaterial (Pd-SiC) was synthesized by a facile single step synthesis process and this nanomaterial as a photo-catalyst, as compared to pure silicon carbide (SiC) nanoparticles showed a significant enhancement in the photo-catalytic efficiency in the process of the photo-catalytic deactivation of hazardous SRB. The morphological characterization studies such as Field emission scanning electron microscopy, Transmission electron microscopy, X-ray diffraction, and Fourier transform infrared spectroscopy unambiguously revealed that SiC surface was successfully decorated with palladium (Pd) nanoparticles. Also the Pd nanoparticles decorated on the SiC surface was further substantiated by EDX and elemental mapping analysis, which clearly revealed the presence of Pd along with Si and O. The band gap energy estimated using Diffuse reflectance spectra (DRS) showed the reduction of band gap energy from 2.82 eV to 2.72 eV. The observed enhancement in the efficiency of photo-catalytic deactivation of SRB with Pd-SiC can be attributed to the significant reduction in the recombination of photo-generated charge carriers, characteristically resulting from the metal (Pd) semiconductor (SiC) junction established by this synthesis process.
Graphical Abstract
Digital Technologies, Ethical Questions, and the Need of an Informational Framework
Abstract
Technologies have always been bearers of profound changes in science, society, and any other aspect of life. The latest technological revolution—the digital revolution—is no exception in this respect. This paper presents the revolution brought about by digital technologies through the lenses of a specific approach: the philosophy of information. It is argued that the adoption of an informational approach helps avoiding utopian or dystopian approaches to (digital) technology, both expressions of technological determinism. Such an approach provides a conceptual framework able to address the ethical challenges that digital technologies pose, without getting stuck in the dichotomous thinking of technological determinism, and to bring together ethics, ontology, and epistemology into a coherent account.
Organic contaminants in the effluent of Chinese wastewater treatment plants
Abstract
The effluents of wastewater treatment plants (WWTPs) are the important sources for pollutants. These pollutants may entry into surface water, groundwater, and soil by recharging and irrigation then pose risk to human beings. Using reports from the past 20 years (n = 58), we conducted this review of organic contaminants (OCs) in the effluent of Chinese WWTPs. All the studies were during 2005 to 2017 and more than two papers were conducted in every year. Nineteen provinces (20 cities) were covered and most of the studies were located in the eastern part of China, especially the most developed and highest density of population areas. Two hundred eighty-four OCs were contained. E antibiotics, endocrine-disrupting chemicals (EDCs), and pharmaceuticals were the most commonly studied groups of OCs, and ofloxacin, norfloxacin, and sulfamethoxazole were the three most commonly reported OCs. The highest concentration appeared for bisphenol A (BPA). The relative standard deviations (RSDs) of concentrations of the most commonly studied compounds were high. In the future, more studies should pay attention on national analysis and more pollutants.
Effect of amendments on contaminated soil of multiple heavy metals and accumulation of heavy metals in plants
Abstract
The contamination of soil with heavy metals is a severe problem due to adverse impact of heavy metals on environmental safety and human health. It is essential to remediate soil contaminated with heavy metals. This study has evaluated the effects of pine biochar, kaolin, and triple super phosphate (TSP) on multiple heavy metals (Ni, Zn, Cu, and Cd) in contaminated soil and accumulation of heavy metals in plants. The amendments can reduce availability of heavy metals in soil by increasing pH, adsorption, complexation, or co-precipitation. Different amendments have variable effects on accumulation of heavy metals in plants and in soil due to its diverse mechanism of stability. The results showed that application of triple super phosphate (TSP) has significant reduced soil Cd exchangeable (EXC) fraction from 58.59 to 21.30%. Bound to carbonates (CAR) fraction decreased from 9.84 to 5.11%, and bound to Fe-Mn oxides (OX) fraction increased from 29.61 to 69.86%. The triple super phosphate (TSP) has the ability to stabilize Cu and especially Cd. However, triple super phosphate (TSP) has enhanced ecological risk of Zn and Ni. Application of pine biochar has significantly enhanced soil pH. The kaolin has significantly reduced EXC fraction of Cd and increased OX fraction of Cu. The amendments and heavy metals have not caused significant effect on SPAD value of Buxus microphylla Siebold & Zucc (B. microphylla). The triple super phosphate (TSP) has significant decreased biomass of B. microphylla and bamboo-williow (Salix sp.) by 24.91 and 57.43%, respectively. Pine biochar and kaolin have increased the accumulation of Zn and Cd in plants. It is concluded that triple super phosphate (TSP) was effective in remediation of Cd and kaolin was effective in remediation of Cd and Cu. Pine biochar was effective in remediation of Cd, Cu, and Zn.
Comparison of esophageal submucosal glands in experimental models for esophagus tissue engineering applications
Abstract
Objective
Esophagus tissue engineering holds promises to overcome the limitations of the presently employed esophageal replacement procedures. This study investigated 5 animal models for esophageal submucosal glands (ESMG) to identify models appropriate for regenerative medicine applications. Furthermore, this study aimed to measure geometric parameters of ESMG that could be utilized for fabrication of ESMG-specific scaffolds for esophagus tissue engineering applications.
Methods
Ovine, avian, bovine, murine, and porcine esophagus were investigated using Hematoxylin–Eosin (HE), Periodic Acid Schiff (PAS), and Alcian Blue (AB), with AB applied in 3 pH levels (0.2, 1.0, and 2.5) to detect sulphated mucous. Celleye® (version F) was employed to gain parametric data on ESMGs (size, perimeter, distance to lumen, and acini concentration) necessary for scaffold fabrication.
Results
Murine, bovine, and ovine esophagus were devoid of ESMG. Avian esophagus demonstrated sulphated acid mucous producing ESMGs with a holocrine secretion pattern, whereas sulphated acid and neutral mucous producing ESMGs with a merocrine secretion pattern were observed in porcine esophagus. Distance of ESMGs to lumen ranged from 127–340 μm (avian) to 916–983 μm (porcine). ESMGs comprised 35% (avian) to 45% (porcine) area of the submucosa. ESMG had an area of 125000 μm2 (avian) to 580000 μm2 (porcine).
Conclusion
Avian and porcine esophagus possesses ESMGs. However, porcine esophagus correlates with data available on human ESMGs. Geometric and parametric data obtained from ESMG are valuable for the fabrication of ESMG-specific scaffolds for esophagus tissue engineering using the hybrid construct approach.
Communications principles for inviting inquiry and exploration through science and data visualization
Abstract
Science, in the popular imagination, is about finding answers to questions. Scientists make discoveries, develop theories, and deliver those discoveries and theories to audiences with an interest in the truth as backed up by science. Well-designed data visualization (dataviz), by contrast, can generate and address not only new questions but new kinds of questions. It has the particular quality of allowing its viewers, users and makers the ability to generate new inquiries, and to put them in a better place to answer them. Dataviz offers aesthetic and interactive platforms for discussion and inquiry that can help scientists to both do their work and better communicate their work to broader audiences.Here I will illustrate and examine case studies from multiple points along the rich and varied possibility space that opens up when science and dataviz work together. I will also introduce three communication principles that I have learned from my involvement with hundreds of dataviz projects over the years. Well-designed dataviz can help scientists and those involved with science find ways to navigate the multiple competing interests and priorities inherent in both communication to non-scientists and exploratory data-rich interfaces.http://sicb.org/meetings/2018/abstracts/correctsymposia.phpSexually dimorphic eye-loss driven by ecological selection in an ostracod crustacean: support for the reproductive role hypothesis
Abstract
Euphilomedes carcharodonta ostracods exhibit sex-specific eye-loss, with females lacking image-forming compound eyes compared to males and related species. The standard assumption is that sexual dimorphism is driven by sexual selection. However, previous work in E. carcharodonta suggests that male eyes are used to evade predators in the male-specific ecological niche, and that male-eyes lack the resolution to search for females. In this study, we examine whether sexual selection or ecological selection drives the retention of male eyes. Ecological niche differentiation was hypothesized by Darwin (1871) to be an alternative selective force for sexual dimorphism either through food competition or through dimorphic sex-role behavior, the reproductive role hypothesis. As of yet, there is little experimental evidence supporting this hypothesis. Here, we experimentally blindfold male E. carcharodonta to mimic the female phenotype and examine the effects on sex-specific niches and behavior. Blindfolding does not appear to grossly change male behavior, nor do females behave differently when exposed to blindfolded males. This leads us to conclude that the development of complex eyes in male E. arises from ecological selection rather than sexual selection.Correction to: Estimating the Reproducibility of Experimental Philosophy
Appendix 1 was incomplete in the initial online publication. The original article has been corrected.
Bildgebende radiologische Diagnostik und Verlaufsbeurteilung beim HCC
Zusammenfassung
Hintergrund
Die bildgebende radiologische Diagnostik ist heute aus den Untersuchungen beim hepatozellulären Karzinom (HCC) nicht mehr wegzudenken. Die Multidetektor-Computertomographie (CT) und Magnetresonanztomographie (MRT) spielen hierbei eine entscheidende Rolle. Die Kontrastmittelsonographie (CE-US, „contrast enhanced ultrasound") stellt zudem für die Charakterisierung des HCC bei einer in der B‑Bild-Sonographie zufällig entdeckten Leberläsion bei Hochrisikopatienten eine Alternative dar.
Methode
Es wurden eine Recherche und Analyse aktueller Literatur durchgeführt.
Ergebnisse
Die CT ist als schnell und universell verfügbare Bildgebungsmodalität eine wichtige Methode zur Diagnostik des HCC. Sie profitiert von den technischen Weiterentwicklungen der letzten Jahrzehnte, die sich neben reduzierter Strahlendosis v. a. in schnellerer Akquisition niederschlagen. Mit der MRT können noch weitere Diagnosekriterien für die Evaluation und Differenzialdiagnose von fokalen Leberläsionen in der zirrhotischen Leber herangezogen werden. Sie ist heute ausreichend robust, um bei den allermeisten Patienten adäquate Bilder zu generieren. Die CE-US ist in der aktuellen nationalen S3-Leitlinie zur Diagnostik und Therapie des HCC als alternatives bildgebendes Verfahren zur CT und MRT für die Charakterisierung des HCC empfohlen, wenn ein unklarer Leberrundherd unabhängig von seiner Größe in einer Hochrisikogruppe in der B‑Bild-Sonographie detektiert wird. Die Vorteile liegen in den geringen Kosten, der raschen Verfügbarkeit, der fehlenden Strahlenbelastung und der fehlenden Nephrotoxizität. Im klinischen Alltag hat sich die Responsebeurteilung mit den mRECIST-Kriterien beim HCC weitestgehend durchgesetzt.
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A Case of Diprosopus Tetraophthalmos: Ocular Findings and Surgical Treatment of Exposure KeratopathyDiprosopus is a rare variation of conjoined twinning. In this report, ophthalmic findings in an infant with diprosopus tetraophthalmos are p...
