Αναζήτηση αυτού του ιστολογίου

Δευτέρα 20 Αυγούστου 2018

An integrated modelling framework and a modified method for evaluating non-carcinogenic health risks from nonylphenol-contaminated food consumption in Long An, Vietnam

Abstract

This study proposed an integrated modelling framework and a modified method for evaluating non-carcinogenic health risks from nonylphenol (NP)-contaminated food consumption. First, a fugacity-based multimedia model and a food web bioaccumulation model were adopted to predict the distribution of NP in the Can Giuoc river and the bioaccumulative concentrations in biota. Next, local people's exposure to NP was quantified using the accumulative concentrations and the data of fishery products intake from a questionnaire survey distributed among 203 local people. Then, human health risk was evaluated in terms of fishery products intake and intake frequency which were each derived from the same survey. The study revealed that human health risk would exist, although the obtained bioaccumulation factors for the consumed organisms were lower than the bioaccumulation criteria. Consuming 141 g or more per serving of riverine food products resulted in an average NP intake exceeding 0.005 mg/kg of body weight per day among 45–73% of the local adults, of whom pregnant women or young and potential mothers accounted for 10–21%. Seventy-nine percent was the highest rate of the population to be at risk under medium river flow rate when food-intake amount and intake frequency were taken into account. Ingesting 70 g per serving of more contaminated species, such as whiteleg shrimp and small fish, less frequently could lead to less risk exposure than ingesting 267 g per serving of less contaminated species, such as sand goby and climbing pearch, more frequently. By coupling food intake with intake frequency, the modified method enables the studying of human health risk from NP-contaminated food consumption to be conducted with more care, and so benefits risk communication at local level.



A cost compensation model for construction and demolition waste disposal in South China

Abstract

Construction and demolition waste (C&D waste) is a worldwide issue that concerns the sustainable development of the construction industry. In this paper, detailed formulas are listed for calculating the costs of four typical kinds of disposal routes of C&D waste. They are illegal dumping, controlled dumping (landfill), centralized recycling, and on-site recycling. Through the specific formulas, the costs of the new construction project in Guangzhou are also estimated. Then, a cost compensation model of construction waste disposal is constructed, which serves to calculate the amount of compensation that the government shall make to the contractor's disposal cost. The results of this study include the following: (1) steps taken to ensure the appropriate measures for C&D waste disposal sites and recycling centers; (2) the on-site recycling will become the future trend of C&D waste disposal due to its lowest cost; (3) the brick cement mortar and scattered concrete take a relatively larger proportion in the total C&D waste generated during the new construction project, and their disposal costs are higher; (4) we find that the cost of illegal dumping is the lowest among four varieties of waste treatment options if only the direct cost of waste treatment is taken account. However, the cost of on-site recycling becomes the lowest if the total cost is considered; (5) according to the case study, the full estimated cost of construction waste disposal is 9074.56 CNY and the total cost compensation is 15,084.21 CNY. The amount of compensation is greater than the disposal cost and contractors make a profit, thus stimulating them to recycle and reuse construction waste. Based on the empirical findings, we make several policy proposals. The research puts forward some operational advice as a reference for decision-makers of C&D waste management.



Antony Charles Harington Watson MB,ChB,FRCSEd. (Tony)

1936–2018

Analyzing the significant environmental factors on the spatial and temporal distribution of water quality utilizing multivariate statistical techniques: a case study in the Balihe Lake, China

Abstract

The assessment of surface water quality is significant to the management of aquatic ecosystem. In this research, in Balihe Lake which is an agricultural watershed lake, 11 environmental parameters (pH, water temperature, water depth, turbidity, DO, COD, TN, NH4+-N, NO3−-N, TP, Chl-a) are monitored at 45 sampling sites in four seasons (winter of 2016, spring, summer, and autumn of 2017). With these monitoring data, two kinds of multivariate statistical methods including cluster analysis (CA) and principal component analysis (PCA) are applied to evaluate the spatial and temporal characteristics of the surface water quality. The results reveal that the spatial clusters (less, moderately, and highly polluted sections) of 45 sampling sites classified by the CA method are exactly consistent with the geographical distribution of these sampling sites, which rely on water quality meliorating downstream. From the perspective of time scale, the correlations between environmental parameters generated by the PCA method reveal that the main factors affecting the surface water quality are different in the four seasons. For the whole study period, which is a longer time scale rather than season, the main factors are also different to that of any season. Large time scale may weaken the effect and potential risk of nutrients on water quality, and it is therefore reasonable to select seasonal scale for the study of water quality in an agricultural watershed by using PCA. The results of this research may demonstrate significance to the identification of the main pollution factors and water quality assessment in freshwater lake with multivariate statistical methods.



Effect of vitamin A and vitamin C on attenuation of ivermectin-induced toxicity in male Wistar rats

Abstract

An in vivo study was performed to assay the effects of ivermectin on adult male Wistar rats. Twenty-five male Wistar rats aged 6 to 8 weeks and weighing 150–250 g were divided into five groups of five animals each for the purpose of this study. The groups received ivermectin; a mixture of ivermectin and vitamin A; a mixture of ivermectin and vitamin C; and a mixture of ivermectin, vitamin A, and vitamin C, respectively. One group served as the control group and was treated with double-distilled water. The treatment was carried out once a week for 3 weeks. The results of the study revealed that the animals were less affected as detected by slight changes in the body weight, stress oxidative parameters, serum levels of liver enzymes, kidney function indexes, cell blood counts, and sperm analysis upon exposure to ivermectin. Nevertheless, the use of vitamins A and C might have a promising effect against oxidant-antioxidant imbalance. Although, the administration of free ivermectin has fewer reactions on mammals, use of the drug supplemented with antioxidants such as vitamins A and C moderates its effects.



A review on the direct effect of particulate atmospheric pollution on materials and its mitigation for sustainable cities and societies

Abstract

Particulate matter (PM) has gained significant attention due to the increasing concerns related to their effects on human health. Although several reviews have shed light on the effect of PM on human health, their critical adverse effect on material's structure and sustainability was almost neglected. The current study is an attempt to fill this gap related to PM impact on structural materials under the overall consideration of sustainability. More specifically, this review highlights the existing knowledge by providing an overview on PM classification, composition, and sources in different locations around the world. Then, it focuses on PM soiling of surfaces such as solar panels due to an increasing need to mitigate the impact of soiling on reducing photovoltaic (PV) power output and financial competitiveness in dusty regions. This topic is of critical importance for sustainable deployment of solar energy in arid and desert areas around the world to help in reducing their impact on overall climate change and life quality. In addition, this review summarizes climate change phenomena driven by the increase of PM concentration in air such as radiative forcing and acid rain deposition due to their impact on human health, visibility and biodiversity. To this end, this work highlights the role of process management, choice of fuel, the implementation of clean technologies and urban vegetation as some possible sustainable mitigation policies to control PM pollution in cities and urban regions. This research is designed to conduct a comprehensive narrative literature review which targets broad spectrum of readers and new researchers in the field. Moreover, it provides a critical analysis highlighting the need to fill main research gaps in this domain. The findings of this review paper show that PM pollution imposes severe adverse impacts on materials, structures and climate which directly affect the sustainability of urban cities. The advantages of this review include the value of the extensive works that elaborate on the negative impacts of PM atmospheric pollution towards high level of public awareness, management flexibility, stakeholder's involvements, and collaboration between academy, research, and industry to mitigate PM impact on materials and human welfare.



Potential sources and meteorological factors affecting PM 2.5 -bound polycyclic aromatic hydrocarbon levels in six main cities of northeastern Italy: an assessment of the related carcinogenic and mutagenic risks

Abstract

A yearlong sampling campaign (2012–2013) was conducted in six major cities of the Veneto region to investigate the spatial-temporal trends and the factors affecting the polycyclic aromatic hydrocarbon (PAHs) variations and identify the local sources. Sixty samples per city were collected for analyses in every alternate month (April, June, August, October, December, and February): 10 samples per sampling site in 10 consecutive days of the months selected. Samples were ultrasonically extracted with acetonitrile and processed through high-performance liquid chromatography. Total Σ-PAH concentrations ranged from 0.19 to 70.4 ng m−3 with a mean concentration of 11.5 ng m−3. The mean benzo[a]pyrene (BaP) concentration reached 2.0 ng m−3, which is two-times higher than the limit set by the European Union. BaP contributed for 17.4% to the total concentration of PAHs, which showed the same pattern across the region with maxima during cold months and minima in the warm period. In this study, PAHs showed an inverse relationship with temperature, solar radiation, wind speed, and ozone. According to this study, biomass burning for household heating and cooking, followed by gaseous PAHs absorption on particles due to low atmospheric temperature, were the main reasons for increasing PAHs concentration in winter. Health risk, evaluated as lifetime lung cancer risk (LCR), showed a potential carcinogenic risk from the airborne BaPTEQ six-fold higher in the cold season than in the warm one. Diagnostic ratios and conditional probability functions were used to locate the sources, and results confirmed that local emission, overall domestic heating, and road transport exhausts were responsible for higher concentration rates of PAHs as well as of PM2.5.



Treating MTBE-contaminated water using sewage sludge-derived activated carbon

Abstract

In this study, sewage sludge-derived activated carbon (SDAC) was synthesized, characterized, and tested for its potential as an adsorbent of methyl tert-butyl ether (MTBE). The SDAC was produced by activating the sludge with zinc chloride and subsequently subjected to various ranges of pyrolytic temperatures. It was then characterized using SEM/EDX, BET, and TGA. The SEM-EDX analyses showed that impurities like Fe, Al, Mg, Mn, Ca, and Na of the raw sludge were removed by the higher pyrolytic temperature and acid-washing procedures. TGA showed the thermal stability of the produced material. Results of the BET revealed a significant increase in surface area of the sludge from 1.5 m2/g to 385 m2/g after acid washing. The MTBE removal efficiency of 70% was achieved after 60 min with 2 g/L of SDAC at pH 6, and initial MTBE concentration of 1 ppm. The adsorption kinetics of SDAC fitted into pseudo-second-order reactions. This work demonstrated a beneficial use of a bio-waste material (sewage sludge) in water treatment technologies.



GBM Drug Bank—a new resource for glioblastoma drug discovery and informatics research

The availability of open access chemical databases associating compounds with their biological activities impacts fundamentally the early stages of modern drug discovery.1 The increasing interest in both drug repurposing2 and drug combination3 also necessitates the development of databases detailing compounds and mechanisms that have been explored previously.

Erstlinientherapie des mRCC: ein Update

Zusammenfassung

Hintergrund

Neue medikamentöse Perspektiven lassen auf Fortschritte in der Erstlinientherapie des metastasierten Nierenzellkarzinoms (mRCC) hoffen.

Fragestellung

Die aktuelle First-Line-Therapie beim mRCC, Erweiterung der Therapieoptionen durch Tivozanib und Cabozantinib und zukünftig erwartete Substanzen werden diskutiert.

Material und Methode

Aktuelle DGHO-Empfehlungen, Diskussion pivotaler Studien zur Erstlinientherapie des mRCC.

Ergebnisse

Derzeit sind 6 zielgerichtete Wirkstoffe in der Erstlinie des mRCC relevant: Bevacizumab plus Interferon-α (INF-α), Pazopanib, Sunitinib, Tivozanib, Cabozantinib und Temsirolimus. Die Substanzen werden risikostratifiziert eingesetzt. Ein neuer zugelassener Wirkstoff ist Tivozanib. In der zulassungsrelevanten Studie war der Tyrosinkinaseinhibitor (TKI) einer Therapie mit Sorafenib hinsichtlich des progressionsfreien Überlebens (PFS) überlegen (11,9 vs. 9,1 Monate; HR 0,797). Die Verträglichkeit von Tivozanib erwies sich als gut mit weniger Hand-Fuß-Syndromen und Diarrhö: Off-Target-Effekte im Vergleich zu anderen VEGFR-TKI könnten hier einen Therapievorteil bedeuten. Eine Zulassungserweiterung für Cabozantinib ergänzt die Optionen in der Erstlinientherapie für Patienten mit intermediärem und hohem Risiko. Die sich abzeichnende Einführung der Immunkombinationstherapie aus Nivolumab plus Ipilimumab könnte künftig eine wichtige Rolle spielen: Ergebnisse der CheckMate-214-Studie bestätigen die Verbesserung der Ansprechrate und die Verlängerung des Gesamtüberlebens gegenüber Sunitinib beim mRCC mit intermediärem oder hohem Risiko.

Schlussfolgerungen

Tivozanib ergänzt die Erstlinientherapie des mRCC um eine wirksame und gut verträgliche Substanz. Auch für Cabozantinib folgte eine Zulassungserweiterung für die Erstlinie. Mit Nivolumab plus Ipilimumab wird die erste Immunkombinationstherapie in der Erstlinie erwartet.



Endokrine Spätfolgen nach onkologischer Therapie im Kindesalter

Zusammenfassung

Hintergrund

Da die Überlebensraten nach einer Krebserkrankung im Kindesalter während der letzten Jahrzehnte kontinuierlich zunahmen, steigt die Anzahl der Langzeitüberlebenden stetig. Viele dieser Patienten haben ein erhöhtes Risiko, im Laufe ihres Lebens Spätfolgen zu entwickeln, die durch die Krebsbehandlung verursacht wurden. Deren Auftreten hängt von der erhaltenen Behandlung ab und kann verschiedene Organe betreffen. Endokrine Spätschäden gehören zu den häufigsten Spätfolgen.

Fragestellung

Im vorliegenden Übersichtsartikel werden die verschiedenen endokrinen Spätfolgen sowie das empfohlene Vorgehen zu ihrer Diagnose und Behandlung dargestellt.

Ergebnisse

Endokrine Spätfolgen betreffen bis zu 50 % der Langzeitüberlebenden nach einer Krebserkrankung im Kindesalter und treten insbesondere nach einer Bestrahlung auf. Sie beinhalten sowohl Funktionsstörungen als auch sekundäre Malignome, die, abhängig von der erhaltenen Therapie, in unterschiedlicher Häufigkeit auftreten. Insbesondere die Schilddrüse, die Gonaden und die Hypophyse sind von Spätfolgen betroffen, wobei auch das Risiko für seltenere endokrine Erkrankungen nach einer onkologischen Behandlung erhöht ist. Durch die unspezifische Symptomatik dieser Erkrankungen beruht die Diagnose auf laborchemischen Untersuchungen, die in manchen Fällen durch Stimulationstests oder weiterführende bildgebende Diagnostik ergänzt werden müssen.

Diskussion

Viele endokrine Spätkomplikationen einer onkologischen Therapie im Kindesalter können gut behandelt werden, wenn sie rechtzeitig erkannt werden. In nationalen und internationalen Leitlinien werden daher risikoadaptierte Vorsorgeuntersuchungen empfohlen, die in spezialisierten Nachsorgezentren lebenslang durchgeführt werden sollten.



Neurophysiological correlates of clinical improvement after greater occipital nerve (GON) block in chronic migraine: relevance for chronic migraine pathophysiology

Therapeutic management of Chronic Migraine (CM), often associated with Medication Overuse Headache (MOH), is chiefly empirical, as no biomarker predicting or correlating with clinical efficacy is available to ...

Anodal frontal tDCS for chronic cluster headache treatment: a proof-of-concept trial targeting the anterior cingulate cortex and searching for nociceptive correlates

Percutaneous occipital nerve stimulation (ONS) is effective in refractory chronic cluster headache (rCCH) patients. Responders to ONS differ from non-responders by greater glucose metabolism in subgenual anter...

Anatomy, Animation and Visual Effects: the Reciprocal Tools of Biology and Film-Making

Abstract
Locomotion studies, biomechanics, and particularly vertebrate paleontology have had a deep influence on the development of motion pictures, animation, and computer generated visual effects. Biologically straightforward concepts such as morphological correlates of diet, sexual dimorphism, and ontogenetic change are powerful tools for animators and visual effects artists. Despite this deep debt to the ever-increasing role of science and technology in film making, scientists often forget to mine the communication strategies of their science-savvy entertainment industry kin. Further, many of the tools of the film industry are making a direct impact on basic research or have the potential to do so. It is becoming increasingly clear as part of the overall outreach for science, technology, engineering, and mathematics ("STEM"), scientists must inform and engage with the public. Significantly, many of the concepts and stories we offer as useful to film makers are compelling stories to offer to our own students. And these can be as compelling to the public as the entertainment they often facilitate. Whereas STEM is critically important, adding "A" – art – as in the artistic strategies from the fields of animation and visual effects to produce "STEAM" helps to build a potentially unstoppable tool for science communication and the public good.

Immunotherapeutic maintenance treatment with toll-like receptor 9 agonist lefitolimod in patients with extensive-stage small-cell lung cancer: Results from the exploratory, controlled, randomized, international phase 2 IMPULSE study

Abstract
Background
The immune surveillance reactivator lefitolimod (MGN1703), a DNA-based TLR9 agonist, might foster innate and adaptive immune response and thus improve immune-mediated control of residual cancer disease. The IMPULSE phase 2 study evaluated the efficacy and safety of lefitolimod as maintenance treatment in extensive-stage small-cell lung cancer (ES-SCLC) after objective response to first-line chemotherapy, an indication with a high unmet medical need and stagnant treatment improvement in the last decades.
Patients and methods
103 patients with ES-SCLC and objective tumor response (as per RECIST 1.1) following 4 cycles of platinum-based first-line induction therapy were randomized to receive either lefitolimod maintenance therapy or local standard of care at a ratio of 3:2 until progression or unacceptable toxicity.
Results
From 103 patients enrolled, 62 were randomized to lefitolimod, 41 to the control arm. Patient demographics and response patterns to first-line therapy were balanced. Lefitolimod exhibited a favorable safety profile and pharmacodynamic assessment confirmed the mode-of-action showing a clear activation of monocytes and production of interferon-gamma-induced protein 10 (IP-10). While in the ITT population no relevant effect of lefitolimod on progression-free and overall survival (OS) could be observed, two pre-defined patient subgroups indicated promising results, favoring lefitolimod with respect to OS: in patients with a low frequency of activated CD86+ B cells (hazard ratio, HR 0.53, 95%CI 0.26-1.08; n = 38 of 88 analyzed) and in patients with reported chronic obstructive pulmonary disease (COPD) (HR 0.48, 95%CI 0.20-1.17, n = 25 of 103).
Conclusions
The IMPULSE study showed no relevant effect of lefitolimod on the main efficacy endpoint OS in the ITT, but (1) the expected pharmacodynamic response to lefitolimod, (2) positive OS efficacy signals in two pre-defined subgroups and (3) a favorable safety profile. These data support further exploration of lefitolimod in SCLC.

Normalcy, justification, and the easy-defeat problem

Abstract

Recent years have seen the rise of a new family of non-probabilistic accounts of epistemic justification. According to these views—we may call them Normalcy Views—a belief in P is justified only if, given the evidence, there exists no normal world in which S falsely beliefs that P. This paper aims to raise some trouble for this new approach to justification by arguing that Normalcy Views, while initially attractive, give rise to problematic accounts of epistemic defeat. As we will see, on Normalcy Views seemingly insignificant pieces of evidence turn out to have considerable defeating powers. This problem—I will call it the Easy-Defeat Problem—gives rise to a two-pronged challenge. First, it shows that the Normalcy View has counterintuitive implications and, second, it opens the door to an uncomfortable skeptical threat.



Dermoscopy improves diagnostic accuracy for clinically amelanotic nodules

Australasian Journal of Dermatology, EarlyView.


Facial angiofibromas treated by rapamycin 0.05% ointment and a combined laser therapy

Journal of Cosmetic Dermatology, EarlyView.


Pathomorphological criteria of use efficiency of resorbable and permanent implants in aesthetic medicine and cosmetic dermatology

Journal of Cosmetic Dermatology, EarlyView.


Structural changes of hair shaft after application of chemical hair straighteners: Clinical and histopathological study

Journal of Cosmetic Dermatology, EarlyView.


Morphology and Navigational Landmarks of the Cranio-orbital Foramen in a Portuguese Population

Purpose: The cranio-orbital and accessory foramina are located in the lateral wall of the orbit and adjacent to the superior orbital fissure. In the literature, there is a lack of consistency concerning the location and morphology of these foramina in different populations. Therefore, considering its clinical importance during orbital surgeries, it was the authors' aim to determine the incidence, location, and number of cranio-orbital and accessory foramina in a Portuguese population and compare the findings with data from other studies. Methods: A total of 310 orbits from 155 dry skulls from the collection of the Museum of Anatomy of the Faculty of Medicine of Porto were studied. The characterization of both cranio-orbital and accessory cranio-orbital foramina was performed. Results: The cranio-orbital foramen was present in at least 1 orbit per skull in 58.17% with a median diameter of 0.60 ± 0.33 mm. No relation was found between the presence of this foramen and the gender of the individuals or a tendency for laterality. However, it was found that the presence of 1 or more accessory foramina was related to higher diameters of the cranio-orbital foramen. Conclusions: There might be a relationship between the localization, diameter, and communication of foramina with the cranial fossae. Foramina located on the greater wing of the sphenoid bone presented a larger diameter and communicated with the middle cranial fossa. High diameters of the main vessel in the cranio-orbital foramen may imply more developed branches and collateral irrigation of the orbital structures using 1 or more accessory foramina. Surgeons should be aware of the location of the cranio-orbital foramen to reduce potential sources of hemorrhage during orbital dissections. Accepted for publication June 17, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to José Paulo Andrade, M.D., Ph.D., Department of Biomedicine, Unit of Anatomy, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal. E-mail: jandrade@med.up.pt © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Third-Nerve Palsy Presenting 16 Years After Resection of Pituitary Adenoma

No abstract available

Distinguishing IgG4-Related Ophthalmic Disease From Graves Orbitopathy

Purpose: The authors aimed to determine key features of IgG4-related ophthalmic disease (IgG4-ROD) and Graves orbitopathy (GO) to aid in diagnosis. Methods: The authors retrospectively identified ophthalmology patients seen between June 2009 and November 2013 with clinical overlap of GO and IgG4-ROD. Patient findings were reviewed to characterize the 2 conditions. Results: Among 8 patients (7 male and 1 female), the mean age was 45.8 years. Time between diagnoses of GO and IgG4-ROD ranged from 1 month to 8 years. Imaging showed enlarged extraocular muscles in all patients. Enlarged infraorbital nerves were seen in 4 patients. Tissue biopsy showed CD20+ lymphocytes with a large proportion of IgG4 plasma cells in 7 of 8 orbital specimens. Six patients had a ratio of IgG4:IgG cells >40%. Discussion: No pathognomonic clinical findings for GO or IgG4-ROD have been reported, but some key features can help distinguish the conditions. GO is likely if findings include increased thyrotropin receptor antibodies, lid retraction/lid lag, and enlarged extraocular muscles with typical tendon-sparing morphology. Findings suggestive of IgG4-ROD include history of asthma and progressive orbital disease in patients with previous diagnosis of GO, disproportionately large lateral rectus muscle, and enlarged infraorbital nerves. Increased serum IgG4 level and biopsy showing >10 IgG4+ plasma cells/high-power field and IgG4:IgG ratio >40% will support the diagnosis of IgG4-ROD. Conclusions: GO and IgG4-ROD are complicated inflammatory processes affecting the orbit and present diagnostic challenges. The authors recommend biopsy for patients who do not follow the usual clinical course of GO or have clinical characteristics of IgG4-ROD. Accepted for publication June 27, 2018. Supported by Research to Prevent Blindness (New York, NY). The funding organization had no role in the design or conduct of this research. The authors have no financial or conflicts of interest to disclose. Presented at the Annual Meeting of the Association for Research in Vision and Ophthalmology on May 7–11, 2017 in Baltimore, MD, U.S.A. and at Women in Ophthalmology Symposium on August 10–13, 2017 in San Diego, CA, U.S.A. Address correspondence and reprint requests to James A. Garrity, M.D., Department of Ophthalmology, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail: garrity.james@mayo.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Orbital Apex Syndrome in Pseudomonas Sinusitis After Functional Endoscopic Sinus Surgery

Sinusitis complicated by orbital apex syndrome is rare. The majority of cases are due to mucormycosis in immunocompromised patients. The authors report a case of orbital apex syndrome secondary to Pseudomonas sinusitis. The patient was a 79-year-old Type 2 diabetic woman who underwent left-sided functional endoscopic sinus surgery. Three months postprocedure, she presented with a 3-week history of gradual vision loss and constant temporal headache on the ipsilateral side. Examination revealed light perception vision, a relative afferent pupillary defect, absent corneal reflex, and disc pallor. Imaging revealed opacification of the posterior ethmoidal air cells extending to involve the orbital apex. Urgent orbital and sinonasal decompression was performed. Intraoperative specimens grew Pseudomonas aeruginosa. The patient was treated with liposomal amphotericin B, posaconazole, and piperacillin/tazobactam. The patient recovered with no visual sequelae. Pseudomonas is an important mimicker to consider in sinusitis causing orbital apex syndrome, and it may occur following functional endoscopic sinus surgery. Accepted for publication June 22, 2018. The authors have no financial or conflicts of interest to disclose. Portions of this work were presented, in abstract form, at the Annual Scientific Congress of the Royal Australian and New Zealand College of Ophthalmologists on October 28–November 1, 2017 in Perth, Australia. Address correspondence and reprint requests to Vannessa Leung, B.Med., M.D., Royal North Shore Hospital, Reserve Rd St Leonards, NSW 2065, Australia. E-mail: vannessa.leung@gmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Prevalence of a Histologic Change of Ocular Adnexal Lymphoma in Patients With a History of Lymphoma

Purpose: The authors examined the prevalence of a histologic change of ocular adnexal lymphoma (OAL) grade in patients with a history of lymphoma in nonocular sites. Methods: In this retrospective study, the authors reviewed the clinical and pathological data of 209 patients with OAL treated by the senior author during 2000 to 2017. Results: Of 209 patients with OAL, 65 (31%) had a history of lymphoma. In 54 of the 65 patients (83%), the original lymphoma and OAL were of the same histologic type. In 8 of the 65 patients (12.3%), the OAL was more indolent than the original lymphoma: 6 patients with a history of diffuse large B-cell lymphoma, one of mantle cell lymphoma, and one of grade 3 follicular lymphoma had biopsy-proven extranodal marginal-zone lymphoma in the orbital area. Two additional patients (3%) with a history of chronic lymphocytic leukemia developed OAL: diffuse large B-cell lymphoma in one patient and extranodal marginal-zone lymphoma in the other. One patient (1.5%) with a history of a low-grade follicular lymphoma relapsed as a different low-grade histology of extranodal marginal-zone lymphoma. Lower-grade OAL than the original lymphoma was more common than higher-grade OAL than the original lymphoma (p = 0.048). Conclusions: In this cohort of 209 patients with OAL, the authors found that nearly one third had a history of lymphoma, 17% of whom had a different histologic type of lymphoma in the orbit, more commonly a more indolent type. This underscores the importance of biopsy of OAL even in patients with a known history of lymphoma to determine the histologic subtype of orbital lymphoma and to help guide appropriate treatment. Accepted for publication July 10, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Bita Esmaeli, M.D., Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1488, Houston, TX 77030. E-mail: besmaeli@mdanderson.org © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

The Relationship Between Eyebrow and Eyelid Position in Patients With Ptosis, Dermatochalasis and Controls

Purpose: The purpose of this study is to explore mechanical and co-innervational factors involved in both voluntary and involuntary brow elevation among people affected by ptosis and dermatochalasis. Methods: In this prospective cohort study of normal controls and eyelids with ptosis or dermatochalasis, marginal reflex distance (MRD1) and brow height were measured under the following conditions: neutral position, involuntary mechanical brow elevation, voluntary brow elevation, and maximal eyelid opening. The primary outcome measure was change in MRD1. Secondary outcome measures included brow height and coupling (mm brow height change per mm MRD1 change). Analysis of variance and t tests were performed for intra- and intercondition comparisons, respectively. Results: Mechanical (involuntary) brow elevation significantly raised MRD1 in control eyelids and eyelids with dermatochalasis, but not in eyelids with ptosis. Voluntary brow elevation produced significantly greater brow height than maximal eyelid opening in controls and eyelids with dermatochalasis, but not in eyelids with ptosis. Maximal eyelid opening increased MRD1 greater than voluntary brow elevation significantly in control eyelids, but not in eyelids with dermatochalasis or ptosis. Coupling of the brow and eyelid margin during maximal eyelid opening was significantly greater in eyelids with ptosis relative to controls. Conclusions: In eyelids with ptosis, mechanical brow elevation does not change eyelid position; however, voluntary brow elevation raises eyelid position to a similar position as maximal eyelid opening. These results argue against the contention that the brow is elevated to mechanically lift the eyelid in ptosis and instead suggest that the brow elevation is driven by efforts to raise the eyelid, possibly via co-innervation. Accepted for publication June 5, 2018. The authors have no financial or conflicts of interest to disclose. Presented at ASOPRS 2016 Spring Scientific Symposium on June 5, 2016, in Ojai, CA. The authors alone are responsible for the content and writing of the article. Address correspondence and reprint requests to Daniel B. Rootman, M.D., M.S., Division of Orbital and Oculoplastic Surgery, Doheny and Stein Eye Institutes, David Geffen School of Medicine at UCLA, 300 Stein Plaza, University of California, Los Angeles, Los Angeles, CA 90095. E-mail: rootman@jsei.ucla.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Preventing Postoperative Atypical Mycobacterial Infection

Purpose: To report a recent outbreak of atypical mycobacterial infection following upper eyelid surgery and the results of a prevention protocol that was successfully instituted to dramatically reduce the infection rate. Methods: This is a multicenter retrospective nonrandomized comparative interventional case series. A chart review of 7 patients who developed atypical mycobacterium infection after undergoing blepharoplasty was conducted. Preventative intervention included exchanging ice compresses for reusable gel packs and substituting tap water with bottled or distilled water for facial cleaning during postoperative care. The main outcome measure was disease incidence. Results: Of the 368 patients who underwent upper eyelid blepharoplasty and/or blepharoptosis repair from December 2014 to May 2015, 7 people developed cutaneous atypical mycobacterium infection with an incidence of 1.9%. Eighty-six percent of patients received clarithromycin as part of their treatment with average treatment length of 2.8 months. Debridement was performed in 71% of the patients. Biopsy was performed in all patients, and all had histopathology showing granulomatous inflammation. A prevention protocol was developed to reduce potential inoculation in the immediate postoperative period, which successfully reduced the infection rate from 1.9% to 0.06% (p = 0.019). Conclusions: Atypical mycobacterium infection, although rare, should be considered as a possible diagnosis in a blepharoplasty patient with delayed development of nodular lesions. Long-term clarithromycin therapy and debridement have shown good outcomes for these patients; however, the best treatment for any infection is prevention. This study provides the first evidence based approach within the ophthalmic literature for reducing the mycobacterium infection rate in blepharoplasty patients. Accepted for publication July 8, 2018. The authors have no financial or conflicts of interest to disclose. Presented, in part, at the ASOPRS 48th Annual Fall Scientific Symposium on November 9–10, 2017 in New Orleans, LA. Address correspondence and reprint requests to Alan E. Oester, Jr, M.D., Wilmington Eye, 1729 New Hanover Medical Park Dr, Wilmington, NC 28403. E-mail: coester@wilmingtoneye.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Soft Tissue Chondroma of the Eyelid

A 54-year-old woman presented with a 2-year history of a slow-growing subcutaneous nodule of the medial right lower eyelid adjacent to the inferior canaliculus. The patient reported right-sided epiphora suggesting lacrimal outflow obstruction. The surgically excised nodule was consistent with a chondroma. A rare tumor, soft tissue chondroma, is most often seen in the extremities, but has also been observed in the head and neck region. To their knowledge, this is the first reported case of a soft tissue chondroma of the eyelid. Accepted for publication June 27, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to R. Patrick Yeatts, M.D., Department of Ophthalmology, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157. E-mail: pyeatts@wakehealth.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Workflow for Pediatric Midface and Orbital Reconstruction With a Patient-Specific Autogenous Bone Graft

Extensive midface and orbital reconstruction is challenging, especially in a pediatric population. A 13-year-old patient was diagnosed with fibrous dysplasia of the midface, which required complete resection of the zygomatic bone and orbital floor. The authors present a complete midface and orbital reconstruction, using a patient-specific autologous bone graft, in a growing pediatric patient. Postoperative analysis showed a symmetric orbital floor and good clinical outcome. After 12 months of follow up, no bone resorption was observed. Patient-specific autologous bone grafts have a clear role in the treatment algorithm of patients with large skull bone defects, with emphasis on the pediatric patient. The advantages can be even greater in a pediatric population, because they can benefit more from the minimal invasive approach. Furthermore, this technique allows single-stage complex reconstructive surgeries with a decreased operating time. Accepted for publication July 8, 2018. The authors have no financial or personal relationship with organizations that could inappropriately influence or bias this work. The authors have no conflict of interest to declare from the following organizations: National Institutes of Health (NIH), Welcome Trust, Howard Hughes Medical Institute (HHMI), Research Council UK, and other(s). Address correspondence and reprint requests to Yasmin Opdenakker, M.D., Department of Maxillo-Facial Surgery, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. E-mail: yasmin.opdenakker@gmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Predominant Contribution of Superior Rectus–Levator Complex Enlargement to Optic Neuropathy and Inferior Visual Field Defects in Thyroid Eye Disease

Purpose: To compare extraocular muscle volumes in thyroid eye disease patients with and without compressive optic neuropathy. Methods: A retrospective review of 44 orbital CT scans (28 orbits without compressive disease and 16 orbits with compressive optic neuropathy) was conducted. The extraocular muscle volumes, summated soft tissue volumes, and optic nerve volumes were calculated at a section in the posterior 1/3 of the orbit. The visual fields of the orbits with compressive optic neuropathy were analyzed. Results: The mean combined extraocular muscle/summated soft tissue volume ratio and the mean superior rectus–levator complex/summated soft tissue volume ratio were greater in those with compressive optic neuropathy than in those without compressive optic neuropathy (p = 0.02, 0.008, respectively). The ratio of the mean inferior, medial, or lateral rectus/summated soft tissue volume did not differ significantly between patients with or without compressive optic neuropathy (p values of 0.315, 0.615, and 0.254, respectively). Visual field analysis of the compressive optic neuropathy group demonstrated that 58% of the orbits with visual field defects had inferior field defects. Conclusions: When measured at a section near the orbital apex, the mean combined muscle/summated soft tissue volume ratio and the mean superior rectus–levator complex/summated soft tissue volume ratio are greater in those with compressive disease than those without. This suggests that the specific enlargement of the superior rectus–levator complex makes a significant contribution to thyroid eye disease-compressive optic neuropathy and may explain the inferior visual field deficits classically found in this group of patients. Accepted for publication July 27, 2018. The authors have no financial or conflicts of interest to disclose. Presented at the 48th Annual ASOPRS Fall Scientific Symposium on November 9–10, 2017, in New Orleans, LA, U.S.A. Address correspondence and reprint requests to Michael Kazim, MD, Edward S. Harkness Eye Institute, Columbia University Medical Center, 635 West 165th Street, New York, NY 10032. E-mail: mk48@columbia.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Cutaneous adverse drug reaction after apomorphine infusion, possibly caused by a systemic type IV hypersensitivity reaction to sodium metabisulfite: Report of 2 cases

Contact Dermatitis, EarlyView.


Aluminium sensitization in a French paediatric patch test population

Contact Dermatitis, EarlyView.


Κυριακή 19 Αυγούστου 2018

‘Physics is a kind of metaphysics’: Émile Meyerson and Einstein’s late rationalistic realism

Abstract

Gerald Holton has famously described Einstein's career as a philosophical "pilgrimage". Starting on "the historic ground" of Machian positivism and phenomenalism, following the completion of general relativity in late 1915, Einstein's philosophy endured (a) a speculative turn: physical theorizing appears as ultimately a "pure mathematical construction" guided by faith in the simplicity of nature and (b) a realistic turn: science is "nothing more than a refinement "of the everyday belief in the existence of mind-independent physical reality. Nevertheless, Einstein's mathematical constructivism that supports his unified field theory program appears to be, at first sight, hardly compatible with the common sense realism with which he countered quantum theory. Thus, literature on Einstein's philosophy of science has often struggled in finding the thread between ostensibly conflicting philosophical pronouncements. This paper supports the claim that Einstein's dialog with Émile Meyerson from the mid 1920s till the early 1930s might be a neglected source to solve this riddle. According to Einstein, Meyerson shared (a) his belief in the independent existence of an external world and (b) his conviction that the latter can be grasped only by speculative means. Einstein could present his search for a unified field theory as a metaphysical-realistic program opposed to the positivistic-operationalist spirit of quantum mechanics.



Molecular Subtypes of Bladder Cancer

Abstract

Purpose of Review

Recent whole genome characterizations of primary human bladder cancers revealed that they can be grouped into "intrinsic" basal and luminal molecular subtypes. Here, we provide an overview of the subtypes and discuss their biological and clinical properties.

Recent Findings

Basal cancers are characterized by advanced stage and metastatic disease at presentation. They tend to be enriched with squamous and small cell/neuroendocrine features and inactivating mutations and deletions of TP53 and RB1. Basal cancers can be divided into "epithelial" and "mesenchymal" (also known as "claudin low") subsets, and a portion of the latter form a "neuroendocrine/neuronal" subset that is associated with particularly poor survival. Luminal cancers are often enriched with papillary histopathological features and activating mutations in FGFR3, and they can also be divided into additional subsets based on differential stromal cell infiltration, relative genomic instability, and high- versus low-level expression of carcinoma in situ (CIS) gene expression signatures. Importantly, the bladder cancer molecular subtypes display differential sensitivities to neoadjuvant chemotherapy and immune checkpoint blockade, and preliminary data also suggest that they respond differently to radiation with or without hypoxia modulation. Ongoing studies are investigating the relevance of the molecular subtypes to the bladder cancer histopathological variants and to upper tract urothelial cancer.

Summary

The bladder cancer molecular subtypes were associated with different prognoses and responses to conventional and targeted therapies in retrospective studies. If validated in prospective studies, molecular subtyping will be integrated into bladder cancer clinical management.



Triple-Negative Breast Cancers: Systematic Review of the Literature on Molecular and Clinical Features with a Focus on Treatment with Innovative Drugs

Abstract

Purpose of Review

Triple-negative breast cancer (TNBC) accounts for 15–20% of diagnosed breast tumours, with higher incidence in young and African-American women, and it is frequently associated with BRCA germline mutations. Chemotherapy is the only well-established therapeutic option in both early- and advanced-stages of the disease. TNBC tumours relapse earlier after standard anthracycline- and/or taxane-based chemotherapy treatments, generally within 1–3 years after the diagnosis, and often develop visceral metastases, representing the subtype with a worse prognosis among all breast cancers. In the present review, we will provide an updated overview of the available results of recent clinical trials for this disease and we will describe the implications of the known molecular pathways representing novel targets for development of future therapies for TNBC patients.

Recent Findings

Over the past decade, the advent of gene expression micro-array technology has led to the identification of different actionable targets including various genomic alterations, androgen receptor, PARP, PI3K, VEGF and other proteins of the angiogenic pathway. Thus, novel targeted drugs have been tested in clinical trials reporting promising results in specific TNBC molecular subgroups.

Summary

Although cytotoxic chemotherapy remains the mainstay of treatment for TNBC patients, the identification of novel 'drugable' targets and pathways for developing personalized treatments represents a promising investigational approach in the management of the TNBC subtype.



Analyzing the environmental Kuznets curve for the EU countries: the role of ecological footprint

Abstract

A great majority of the environmental Kuznets curve (EKC) literature use CO2 emissions to proxy for environmental degradation. However, this is an important shortage in application of the EKC concept because environmental degradation cannot be captured by CO2 emissions only. By using a broader proxy, ecological footprint, this study aims to investigate the presence of environmental Kuznets curve hypothesis for the EU countries. The annual data from 1980 to 2013 is examined with second generation panel data methodologies which take into account the cross-sectional dependence among countries. The results show that there is U-shaped relationship between the real income and ecological footprint. In addition, non-renewable energy increases the environmental degradation while renewable energy and trade openness decrease the environmental degradation in the EU countries. Policy implications are further discussed.



Asthma, sinonasal disease, and the risk of active tuberculosis

Publication date: Available online 18 August 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Anthony C. Yii, Avril Z. Soh, Cynthia B.E Chee, Yee T. Wang, Jian-Min Yuan, Woon-Puay Koh

Abstract
Background

Although asthma is associated with impaired lung immunity, it is unclear whether asthma affects risk of active tuberculosis (TB). Since the upper and lower airways are immunologically related, sinonasal disease may also modify susceptibility to TB disease.

Objectives

To evaluate whether asthma and sinonasal disease prospectively modulate the risk of active TB in the Singapore Chinese Health Study.

Methods

In this population-based prospective cohort, we recruited 63,257 Chinese adults aged 45-74 years from 1993-1998 in Singapore, and conducted follow-up I interviews among 52,325 surviving participants from 1999-2004. Data on self-reported history of physician-diagnosed sinonasal disease was collected at baseline, and data on asthma and chronic bronchitis were collected at follow-up I interviews. Active TB cases were identified by linkage with the national TB notification registry through December 2014. Multivariable Cox proportional hazards regression models were used to estimate risk of active TB.

Results

During a mean follow-up of 17 years from recruitment, there were 1249 cases of active TB, and among them, 678 cases were diagnosed in the 12-year period from follow-up I interviews. We observed reduced risk of active TB in those with a history of asthma at follow-up I [hazard ratio (HR) 0.55, 95% confidence interval (CI) 0.32-0.93] or sinonasal disease at baseline (HR 0.59, 95% CI 0.36-0.95). Conversely, history of chronic bronchitis was not associated with risk of TB (HR 0.95, 95% CI 0.68-1.31).

Conclusions

A history of asthma or sinonasal disease may modulate immunological response to reduce incidence of active TB in the adult population.



The ‘Enseki’ Sandbath’: A novel, safe and effective far‐infrared bathing procedure for health

Photodermatology, Photoimmunology &Photomedicine, Volume 0, Issue ja, -Not available-.


Local production of prolactin in lesions may play a pathogenic role in psoriatic patients and imiquimod‐induced psoriasis‐like mouse model

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


Role of IL‐17A receptor blocking in melanocytes survival: A strategic intervention against vitiligo

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


Autoantibody to transcriptional intermediary factor‐1β as myositis‐specific antibody: clinical correlation with CADM or DM with mild myopathy

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Impact of Hidradenitis Suppurativa on Work Loss, Indirect Costs and Income

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Skin resident memory T cell population is not effectively constructed in systemic sclerosis

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Long‐term 52‐week trends in apremilast safety outcomes for treatment of psoriasis in clinical practice: a multicentre, retrospective case series

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Blastema formation and periosteal ossification in the regenerating adult mouse digit

Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.


Comparative analysis of immune cell subsets in peripheral blood from patients with periodontal disease and healthy controls

Clinical &Experimental Immunology, Volume 0, Issue ja, -Not available-.


Σάββατο 18 Αυγούστου 2018

Immunotherapy in Prostate Cancer: Teaching an Old Dog New Tricks

Abstract

Immunotherapy is rapidly transforming cancer care across a range of tumor types. Although Sipuleucel-T represented the first successful vaccine for the treatment of established cancer, other immunotherapeutic approaches for prostate cancer such as checkpoint inhibitors have been relatively disappointing to date. However, significant promise is on the horizon as there is a wide array trials evaluating immunotherapy in prostate cancer patients. These include both immune checkpoint inhibitors and antigen-specific approaches including vaccines, antibody-drug conjugates, and antitumor antibodies. Furthermore, a better understanding of the key mechanisms that promote the immunosuppressive microenvironment of prostate cancer is emerging. These insights may eventually make it possible to determine which patients will benefit from immunotherapy. This review will discuss the successes and failures of immunotherapy in prostate cancer. We will also present key lessons learned from completed trials and highlight important ongoing studies.



Long-term Effects of Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Patients with Acute Lymphoblastic Leukemia

Abstract

Purpose of Review

Allogeneic hematopoetic stem cell transplantation (HSCT) is a curative option for children and adolescents with high-risk leukemia. Although acute complications were reduced during the last decade, considerable late effects are still limiting the overall success rate. This article emphasizes the specific pediatric aspects of long-term aftercare following myeloablative HSCT and provides an organ-based overview that covers main clinical patterns, incidence, and risk factors enhanced by current references and screening guidelines.

Recent Findings

In the last years, several attempts were made to separate pediatric outcome data from findings in adults. It turned out that not only the indication for but also the time and the procedures of HSCT substantially differ. Nearly any organ might be affected after the complex transplantation process and includes endocrinopathies, musculoskeletal disorders, cardiopulmonary complications, and secondary malignancies.

Summary

Patients after HSCT in childhood have a high risk for developing a wide range of late sequelae and may benefit from regular screening and early intervention. The occurrence and patterns of late effects depend on the intensity and severity of conditioning and are strongly associated with patient's age at transplant and beginning of complications.



Adoptive Cell Therapy in Treating Pediatric Solid Tumors

Abstract

Purpose of Review

This review will discuss the challenges facing adoptive cell techniques in the treatment of solid tumors and examine the therapies that are in development for specifically pediatric solid tumors.

Recent Findings

Targeting solid tumors with adoptive cell therapy has been limited by the inhibitory tumor microenvironment and heterogeneous expression of targetable antigens. Many creative strategies to overcome these limitations are being developed but still need to be tested clinically. Early phase clinical trials in neuroblastoma with GD2 CAR T cells are promising but results need to be validated on a larger scale. Most research in other pediatric solid tumors is still in early stages.

Summary

Adoptive cell therapy represents a useful tool to improve the outcomes of many pediatric solid tumors but significant study is still required. Several clinical trials are ongoing to test therapies that have shown promise in the lab.



Immune Checkpoint Inhibitor Toxicity

Abstract

Purpose of review

Immune checkpoint inhibitors have revolutionised the treatment of multiple malignancies and have a growing list of indications. As our familiarity with these agents grows, so does our understanding of their unique spectrum of toxicities. Here, we will review the literature regarding the toxicities of checkpoint inhibitors and address challenges encountered in day-to-day clinical practice.

Recent findings

Inhibitors of the PD-1/PD-L1 axis are considerably less toxic than the anti-CTLA-4 antibody ipilimumab. The combination of ipilimumab and anti-PD-1 agents is being trialled in multiple malignancies and is associated with increased toxicity. There is accumulating evidence suggesting a potential correlation between a subset of toxicities and clinical benefit in several tumour types, although conflicting data exists. Retrospective series have shown that anti-PD-1 can be safely administered to patients with prior high-grade toxicity from ipilimumab or combination immunotherapy.

Summary

The management of checkpoint inhibitor toxicity is complex and requires collaboration with our subspecialty colleagues. Identifying predictive biomarkers of both efficacy and toxicity would likely help guide treatment decisions, and should be a research priority in the years ahead.



Endoscopic Treatment of Early-Stage Esophageal Cancer

Abstract

Purpose of Review

Esophageal cancer is a leading cause of global cancer-related mortality. Here, we discuss the major endoscopic treatment modalities for management of early esophageal cancer (EEC).

Recent Findings

Advances in endoscopic imaging and therapy have shifted the paradigm of managing early esophageal cancers. Though esophagectomy remains the preferred management for advanced cancers, guidelines now recommend endoscopic resection followed by ablative therapy for early (Tis and T1a) cancers. Available data suggests endoscopic treatment is comparable to surgery with regard to overall and cancer-specific survival with lower procedural morbidity and mortality.

Summary

Endoscopic modalities are emerging as frontline treatment options for patients with early esophageal cancers. Accurate clinical staging with assessment of disease extent, tumor grade, and risk of nodal metastases is crucial when determining eligibility for endoscopic management of EEC. High-quality routine surveillance endoscopy is critical in patients who have undergone resection and/or ablation.



The content of dioxins and furans in soils, bottom sediments of water bodies, and tissues of small mammals near the landfill site with municipal solid wastes (Moscow, Russia)

Abstract

For the first time, the levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) were characterized in the tissues of wild small mammals living in contaminated sites near a municipal solid waste landfill (Moscow, Russia). The Ural field mice Sylvaemus uralensis, the bank voles Clethrionomys glareolus, and the common shrews Sorex araneus were trapped at 1- and 5-km distances from the landfield "Salariyevo." High-resolution chromatography-mass spectrometry was used to measure the levels of 17 PCDD/Fs congeners in the animal organisms and natural objects (soils, bottom sediments). The values of the total toxic equivalencies (WHO-TEQ05) for animals were many times higher than those for soils and bottom sediments. The octo-substituted congeners dominated in the samples from the habitat, whereas the highly toxic 2,3,7,8-substituted ones — in the mammalian tissues. The levels of WHO-TEQ05 were comparable in the soil samples collected at 1- and 5-km distances from the dump body. The levels of WHO-TEQ05 in tissues of mammals caught 1 km from the dump were much higher than those of the distant territory inhabitants. The maximum WHO-TEQ05 levels were found in the shrews, and this has been considered in terms of nutrition characteristics. The data obtained will be used to assess the risks of chronic exposure to low doses of PCDD/Fs contaminating the environment near landfills.



Polyallylamine hydrochloride coating enhances the fluorescence emission of Human Serum Albumin encapsulated gold nanoclusters

Publication date: Available online 18 August 2018

Source: Journal of Photochemistry and Photobiology B: Biology

Author(s): Ben Allan Russell, Barbara Jachimska, Yu Chen

Abstract

Protein encapsulated gold nanoclusters have received much attention due to the possibility of using them as a non-toxic fluorescent probe or marker for biomedical applications, however one major disadvantage currently is their low brightness and quantum yield in comparison to currently used fluorescent markers. A method of increasing the fluorescence emission of Human Serum Albumin (HSA) encapsulated gold nanoclusters (AuNCs) via a Polyallylamide hydrochloride (PAH) coating is described. PAH molecules with a molecular weight of ~17,500 Da were found to enhance the fluorescence emission of HSA-AuNCs by 3-fold when the protein/polymer concentration ratio is 2:1 in solution. Interestingly, the fluorescence lifetime of the AuNCs was found to decrease while the native tryptophan (TRP) fluorescence lifetime also decreased during the fluorescence emission intensity enhancement caused by the PAH binding. Coinciding with the decrease in fluorescence lifetime, the zeta potential of the system was observed to be zero during maximum fluorescence intensity enhancement, causing the formation of large aggregates. These results suggest that PAH binds to the HSA-AuNCs acting as a linker; causing aggregation and rigidification, which results in a decrease in separation between native TRP of HSA and AuNCs; improving Förster Resonance Energy Transfer (FRET) and increasing the fluorescence emission intensity. These findings are critical to the development of brighter protein encapsulated AuNCs.

Graphical Abstract

Unlabelled Image



Detection of tris(2,3-dibromopropyl) phosphate and other organophosphorous compounds in Arctic rivers

Abstract

The flame-retardant tris(2,3-dibromopropyl) phosphate (TDBrPP) was in the 1970s banned for uses in textiles that may be in contact with the skin, owing to strong suspicions that the substance was a human carcinogen. The substance is looked for but rarely detected in samples from the built and natural environments, but there are indications that TDBrPP is still in use. Here, we report the measurement of a polymer-water partition coefficient (Kpw) for two types of silicone rubber (SR), allowing quantitative estimation of freely dissolved concentrations of TDBrPP by passive sampling in water. We found levels of 100 to 200 pg/L in two Arctic rivers that were sampled during a 2014–2015 survey of contamination using passive samplers in Norwegian and Russian rivers draining into the Barents Sea. We also report the widespread presence of other organophosphorus flame retardants in this survey of eight rivers that drain into the Barents Sea.



Topical glycopyrronium tosylate (DRM04) for the treatment of primary axillary hyperhidrosis: Pooled results from the ATMOS-1 and ATMOS-2 phase 3 randomized controlled trials

Introduction: The impact of hyperhidrosis on quality of life is comparable to, or greater than, psoriasis or eczema. Glycopyrronium tosylate (GT; formerly DRM04) is a cholinergic receptor antagonist developed for topical application for the treatment of primary axillary hyperhidrosis. ATMOS-1 (NCT02530281) and ATMOS-2 (NCT02530294) were designed to assess the efficacy and safety of GT in patients with primary axillary hyperhidrosis.

Multicenter clinical study proving antiseptic, bactericide and fungicide efficacy in a talc containing 17% sulfur in the treatment of patients with interdigital mycosis of the feet

Introduction: Set as an infection caused by fungi that use the keratin of skin, nails and hair as nutrients, the superficial mycosis develop under favorable conditions, such as heat and humidity, and stand out among the dermatologic diseases most prevalent in Brazil. One of the most common superficial mycoses is interdigital mycosis, characterized by flaking, cracks and itching between the toes, and the use of products with drying and antiseptic action is recommended to contribute to the decrease in the incidence of the disease.

Pseudocellulitis and gemcitabine, a recently described entity: Case report and literature review

Case report: A 55-year-old woman presents with a dermatosis disseminated to the abdomen and left pelvic extremity, constituted by two erythematous and edematous plaques, with a diameter of 30 × 15 cm in the abdomen and 20 × 15 cm in the thigh, well circumscribed with "peau d'orange" appearance. The evolution was of sudden development 2 days before presenting to consultation, with mild pain and pruritus, without any previous treatment. Patient refered 2 previous similar episodes, presenting after administration of chemotherapy, with 2 cycles of clindamycin and remission of symptoms after 7 days.

Chronic spontaneous urticaria treated with omalizumab (Xolair): A proposal of standardized tapering protocol before withdrawal to achieve the minimal effective dosage

Background: Chronic spontaneous urticaria (CSU) may represent a therapeutic challenge, although the recombinant humanized monoclonal antibody omalizumab has demonstrated a high effectiveness in the treatment of antihistamines-resistant CSU. There are no clear recommendations regarding the optimal duration of the treatment or the way to taper down the drug. The objective of our study was to describe our experience with a standardized tapering protocol of omalizumab before withdrawal.

Quality Improvement Project: Improving intake forms to make them more readable for patients in an urban clinic setting

In the landscape of increasing demands on physician and staff time, intake forms are frequently utilized to gather information before the start of the clinical encounter. These forms typically contain information on reason for visit, allergies, current medications, pertinent health history, abbreviated review of systems and important social history. We assessed a sample of the intake forms at our clinic and found that 63% of the time the forms were not filled out at all. A resident poll showed that 75% of residents felt the forms were not useful.

Transdermal effectiveness of a lipid-based antimicrobial emulsion

A proprietary lipid-based emulsion (ML:8) with established antimicrobial efficacy was investigated. To model a clinical situation in which bacteria have penetrated the integumentary barrier, a reference strain of Staphylococcus aureus (NCTC 8255-4) was inoculated into the subdermal compartment of isolated sheets of pig skin mounted between two chamber-halves to permit separate access to surface and to subdermal compartments. The objective was to evaluate transdermal efficacy of a range of concentrations of ML:8 through porcine skin in vitro.

Tie-over bolsters versus quilting sutures for the closure of full-thickness skin grafts

Background: Full-thickness skin grafting is a well established and preferred technique in the reconstruction of various tissue defects and wounds. However, lack of uniformity in the procedure of closing and securing the grafts has led to a wide-range of different techniques.

The use of intralesional triamcinolone as treatment of primary cutaneous B-cell lymphomas

Primary cutaneous B-cell lymphomas (PCBCLs) are benign malignancies which rarely disseminate, with 5-year disease-specific survival ranging from 94% to 100%. They are commonly treated with excision, radiation, or chemotherapy, alone or in combination. Intralesional corticosteroid injection is an alternative that is cost-effective with minimal side-effects, although it is less-frequently utilized as a primary mode of treatment. The present study was undertaken to evaluate the experience of an academic medical center in using intralesional corticosteroid injection as first-line therapy for PCBCL.

The rodent, the Hedgehog, and the man with nosocomephobia

A 71-year-old Caucasian gentleman presented in 2004 with a basal cell carcinoma (BCC) on his right cheek. A wide excision was arranged but was rescheduled and subsequently cancelled by the patient. He was noted to have a severe hospital phobia (nosocomephobia) related to childhood experiences concerning medical care of his parents. He declined all efforts to provide treatment and accepted the consequences. He represented 12 years later with a large tumor involving his right cheek, nose and sight threating eyelid involvement.

The Onychomycosis/Onychodystrophy Dermoscopy study (OMODO)—A comparative prospective study of onychoscopy features

Background: Onychomycosis (OM) and traumatic onychodystrophy (OD) are common causes of toenail dystrophy. Their treatment and prognosis differ, so early diagnosis is essential and questionable without mycology. Onychoscopy may prove useful in this setting. Although, few studies have addressed this issue and none directly compared OM and OD onychoscopic findings. We aimed to identify and describe onychoscopic patterns associated with OM and OD, proposing an onychoscopy-based algorithm to guide their differential.

Application of paclobutrazol: a strategy for inducing lodging resistance of wheat through mediation of plant height, stem physical strength, and lignin biosynthesis

Abstract

Lodging is a major constraint contributing to poor grain yield and quality of wheat (Triticum aestivum L.) worldwide. The use of plant growth regulators is becoming a foremost agro-chemical approach for minimizing the risk of lodging in cereal crops. The present study was conducted to examine the effects of the paclobutrazol application on culm physical strength, lignin content, and lodging resistance of wheat. Wheat seeds were soaked in paclobutrazol at the concentrations of 0 (CK, as control), 200 (PB1), 300 (PB2), and 400 (PB3) mg L−1. Our results showed that paclobutrazol resulted in a dose-dependent decrease of plant height, internode length, and center of gravity height. Paclobutrazol treatments evidently increased the culm diameter, culm filling degree, and wall thickness of basal internodes, resulting in greater stalk-breaking strength and lodging resistance index (CLRI), where their maximum values were obtained with PB1 treatment. In addition, the activities of lignin-related enzymes were improved by paclobutrazol, particularly at low concentration, which increased the lignin accumulation of the basal internodes of wheat, subsequently improving the capability of stalk lodging resistance. Moreover, the correlation analysis revealed significant correlations between stem diameter, culm filling degree, and lignin with stalk bending strength and CLRI. The paclobutrazol concentration ≥ 300 mg L−1 (PB2 and PB3 treatments) showed inhibitive effects on various culm morphological traits. These results suggest that not only the plant height, but also the lignin contents and physical strength of internodes are closely related with the lodging resistance of wheat, and reduction in plant height along with improved culm morphological characteristics and higher lignin accumulation in basal internodes could effectively relieve the risk of lodging.



Effects of combined exposure to perfluoroalkyl acids and heavy metals on bioaccumulation and subcellular distribution in earthworms ( Eisenia fetida ) from co-contaminated soil

Abstract

The effects of combined exposure to perfluoroalkyl acids (PFAAs) and heavy metals (HMs) including cadmium (Cd), copper (Cu), zinc (Zn), nickel (Ni), and lead (Pb) on earthworms (Eisenia fetida) were investigated. The results have demonstrated that the concentrations of labile acid exchangeable Cd, Zn, Ni, Pb, and Cu in soil were enhanced in addition of PFAAs. With PFAAs, the uptake of Cd, Zn, Ni, Pb, and Cu in earthworms was increased compared to those without PFAAs with the order of Cd > Zn > Pb > Ni > Cu. In the presence of HMs, the average biota-to-soil accumulation factors (BSAFs) of PFAAs in earthworms were decreased by 0.498–0.729 times for perfluorooctane sulfonate (PFOS) and 0.606–0.978 times for perfluorooctanoic acid (PFOA), indicating decrease rates of PFOS were higher than those of PFOA. And different levels of HMs led to insignificant different responses on the inhibiting effects of PFAAs uptake in earthworms. The increase of Cd in fraction C (associated with cytosol) and decrease of PFAAs in fraction C and fraction P (associated with tissue fragments, cell membranes, and intact cells) especially for fraction C were revealed when they were combined, suggesting cytosolic PFAAs and Cd were susceptibly mutual effected. This study indicated that PFAAs and metals mutually affected their bioaccumulation and subcellular distribution in earthworms, which will help to understand the fate and risks of PFAAs and metals in co-contaminated soil.



A new approach for excess sludge reduction by manganese dioxide oxidation: performance, kinetics, and mechanism studies

Abstract

A considerable amount of excess sludge, a kind of hazardous waste, is produced from the conventional wastewater treatment systems such as activated sludge process, and efficient sludge reduction processes are needed. A new chemical method for sludge reduction was proposed by using manganese dioxide as oxidant in this study. A favorable condition for sludge reduction is determined as manganese dioxide dosage of 0.165 g g−1 wet sludge, sulfuric acid concentration of 3 mol L−1, and reduction temperature of 90 °C for 90 min, where the sludge reduction efficiency can reach 73.30%. Reaction kinetic study revealed that the sludge reduction rate was controlled by the surface chemical reaction and the reaction followed a shrinking core kinetic model with apparent activation energy of 37.76 kJ mol−1. Furthermore, reaction process analysis indicated that the sludge hydrolysis included two steps, i.e., floc destruction and microbial cell disruption. Considering the high efficiency and short treatment time, manganese dioxide oxidation is suggested to be a feasible method for disintegration of excess activated sludge.



Effect of Bacillus cereus peptide conjugated with nanoporous silica on inactivation of Listeria monocytogenes in apple juice, as an ecofriendly preservative

Abstract

Bacteriocins are ribosomally synthesized antimicrobial proteins/peptides. They are of great interest in the food processing industries as potential natural preservative agent to control food-borne pathogens. Bacillus spp. are one among the potential probiotics receiving more attention since they produce a broad spectrum of antimicrobial bioactive peptides. In this study, a small-scale medium composition and bioprocessing parameters were statistically optimized to increase the yield of bacteriocin namely cerein from Bacillus cereus NS02 showing antagonism against a wide range of food-borne pathogens. The cerein was partially purified, characterized, and evaluated for their optimal reaction condition. It was subjected to surface adsorption onto food-grade silica to evaluate its maximal adsorption, reached at 4 h, 40 °C, pH 6–7, and at the initial concentration of 200 AU mL−1. The effectiveness of silica-adsorbed and silica-free cerein was checked in Listeria monocytogenes inoculated fresh apple juice and demonstrated biopreservative activity. In juice treated with silica-cerein, the colony forming unit (CFU) was found to be less in count on the 15th day of storage at 4 °C whereas, free-cerein was found to contain 3.8 log CFU mL−1. While, on the same day of storage, the control juice contained the strength of 14.6 log CFU mL−1. Based on the above, this study concludes that the identified heat stable low molecular weight peptide cerein from B. cereus NS02 could serve as a potential biopreservative with effective antilisterial activity in the food system. However, a more detailed study is required to determine if their quality change especially the effect of cerein in organoleptic and nutritional properties of food beyond their addition is necessary, before it is to be exploited as an ecofriendly biopreservative.



Proposed Response Assessment and Endpoints for Meningioma Clinical Trials: Report from the Response Assessment in Neuro-Oncology (RANO) Working Group

Abstract
No standard criteria exist for assessing response and progression in clinical trials involving patients with meningioma and there is no consensus on the optimal endpoints for trials currently underway. As a result, there is substantial variation in the design and response criteria of meningioma trials, making comparison between trials difficult. In addition, future trials should be designed with accepted standardized endpoints. The Response Assessment in Neuro-Oncology Meningioma Working Group is an international effort to develop standardized radiologic criteria for treatment response for meningioma clinical trials. In this proposal, we present the recommendations for response criteria and endpoints for clinical trials involving patients with meningiomas.

Leptin is a physiological regulator of skeletal muscle angiogenesis and is locally produced by PDGFRα and PDGFRβ expressing perivascular cells

Abstract

Skeletal muscle capillarity is characteristically reduced in mature leptin receptor-deficient (Leprdb) mice, which has been attributed to the capillary loss that occurs secondary to metabolic dysfunction. Despite wide recognition of leptin as a pro-angiogenic molecule, the contribution of this adipokine has largely been overlooked in peripheral tissues. Moreover, prior documentation of leptin production within skeletal muscle indicates a potential paracrine role in maintaining local tissue homeostasis. Thus, we hypothesized that leptin is a physiological local paracrine regulator of skeletal muscle angiogenesis and that its production may be modulated by nutrient availability. Leprdb mice exhibited impaired angiogenesis during normal developmental maturation of skeletal myocytes, corresponding with an inability to increase vascular endothelial growth factor-A (VEGFA) mRNA and protein levels between 4 and 13 weeks. In cultured murine and human skeletal myocytes, recombinant leptin increased VEGFA mRNA levels. Leptin mRNA was detectable in skeletal muscle, increasing with prolonged high-fat feeding in mice, and with adiposity in human subjects. Platelet-derived growth factor receptor (PDGFR)α− and PDGFRβ− expressing perivascular cell populations were identified as leptin producing within skeletal muscle of mice and humans. Furthermore, in response to 2 weeks of high-fat feeding, PDGFRβ+ but not PDGFRα+ cells increased leptin production. We conclude that leptin is a physiological regulator of the capillary network in skeletal muscle and stimulates VEGFA production by skeletal myocytes. PDGFRβ expressing perivascular cells exhibit the capacity to act as local "nutrient-sensors" that couple nutrient status to leptin production in skeletal muscle.



Trend of the environmental supervision on submarine pipeline installation



Crude oil removal from aqueous solution using raw and carbonized Xanthoceras sorbifolia shells

Abstract

Fruit shell residue from Xanthoceras sorbifolia was investigated as a potential biosorbent to remove crude oil from aqueous solution. The shell powder and its carbonized material were compared while assessing various factors that influenced oil removal capacity. The structure and sorption mechanism were characterized using scanning electron microscopy and Fourier-transform infrared spectroscopy. The oil removal capacity of the raw material (75.1 mg g−1) was better than the carbonized material (49.5 mg g−1). The oil removal capacity increased with greater saponin content, indicating that hydrophobic and lipophilic surface characteristics of the saponins improved adsorption by the raw X. sorbifolia shell. An orthogonal experimental design was used to optimize the adsorption. Using 4 g L−1 of raw X. sorbifolia shell (particle size of < 0.15 mm), the highest crude oil removal efficiency was obtained using an initial oil concentration of 400 mg L−1, adsorption temperature of 30 °C, adsorption time of 10 min at a shaking speed of 150 rpm. The adsorption of crude oil onto X. sorbifolia shell was best described using a pseudo-second-order kinetic model. Raw X. sorbifolia shell material was more efficient than the carbonized material at crude oil removal from aqueous solution. This was attributable to the functional groups of saponins in raw X. sorbifolia shell. This study highlights that some agricultural and forest residues could be a promising source of low-cost biosorbents for oil contaminants from water—without requiring additional processing such as carbonization.



Arundo donax L. stem-derived biochar increases As and Sb toxicities from nonferrous metal mine tailings

Abstract

Toxic metal(loid)s released from tailing residues of mining operations have become a global issue with regard to environmental impacts. Biochar derived from the agriculture waste is considered as a cost-effective and stable material, which could be applied for remediation of sites contaminated with toxic metal(loid)s. In the present study, tailings were amended for 90 days with increasing concentrations of Arundo donax L. stem-derived biochar (ASBC; at 0, 1, 3, and 5%). The 7-day wheat seed germination toxicity test was then used to assess the bioavailability of toxicants in aqueous leachates of the biochar-amended tailing samples. Concentrations of As, Cd, Cu, Pb, and Sb in leachates and the Community Bureau of Reference chemical fractions were determined using ICP-OES. The results indicated that tailing leachates were phytotoxic, an effect that was partially decreased due to increasing concentrations of ASBC, with maximum effects (∼47% of tailing phytotoxicity) occurring at 3% ASBC. Results of further fractionation analyses indicated that increasing concentrations of ASBC amendment decreased the mobile fractions of Cd, Cu, and Pb in tailing samples, but increased the mobilities of As and Sb. A novel approach using the relative toxicity index (= sum of toxicities of individual potentially toxic elements) indicated that the toxicity of the tailings decreased when As was not present, since As decreased the biochar-reduced toxicity. Our results suggest that the ability of using biochar to decrease toxicity in tailings (by sequestration of cationic metals such as Cd, Cu, and Pb) is limited by its inability to immobilize oxyanionic metalloids such as As and Sb.



Éruption lichénoïde cutanéo-muqueuse sous anti-PD-1

Publication date: Available online 17 August 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): M. Amini-Adle, B. Balme, M. Locatelli-Sanchez, P.-J. Souquet, S. Dalle



Étude rétrospective d’une série de pemphigus paranéoplasiques

Publication date: Available online 17 August 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): M. Fournet, P. Roblot, P. Levillain, G. Guillet, L. Machet, L. Misery

Résumé
Contexte

Le pemphigus paranéoplasique (PPN) est une maladie très rare et de mauvais pronostic associant un pemphigus, particulier par certains critères cliniques, immunologiques et histologiques, à une néoplasie.

Méthodes

Nous avons rétrospectivement analysé les dossiers de patients présentant un PPN dans la région Poitou-Charentes entre 2000 et 2015.

Résultats

Sept patients présentaient neuf néoplasies diagnostiquées de 4 mois avant à 25 mois après l'apparition des lésions cutanées (6/7) ou muqueuses (6/7) de pemphigus. Les lésions étaient cliniquement polymorphes. L'examen histologique révélait une acantholyse épidermique (7/7), des nécroses kératinocytaires (4/7) et une dermite lichénoïde d'interface (5/7). On mettait en évidence des dépôts d'IgG et de C3 intercellulaires ou le long de la jonction dermo-épidermique en immunofluorescence directe (IFD) (7/7), des anticorps anti-substance intercellulaire en immunofluorescence indirecte (IFI) sur vessie de rat (4/6), un immunotransfert reconnaissant les cibles antigéniques du PPN (2/4). La durée du suivi allait de 1 à 132 mois, la survie à 1 an était de 85,7 %.

Discussion

Les présentations cliniques et histopathologiques observées chez nos patients sont polymorphes, avec un chevauchement entre les manifestations cliniques et histologiques de PPN et de pemphigus classique. Le pronostic est meilleur dans notre série que dans la littérature. Les néoplasies associées sont diverses. Il semble exister des associations fortuites de pemphigus à des néoplasies, de meilleur pronostic que les véritables PPN. Un nouveau consensus pour les critères diagnostiques du PPN est nécessaire, qui aiderait les praticiens à diagnostiquer le PPN de manière plus homogène pour réaliser des études pronostiques ou des essais thérapeutiques.

Summary
Context

Paraneoplastic pemphigus (PNP) is a rare condition associated with poor prognosis. It associates polymorphic mucocutaneous manifestations with neoplasia. Diagnosis is difficult because of the various clinical and histological features involved and the lack of specificity of immunological examinations.

Methods

We retrospectively analyzed the records of patients presenting with PNP in the Poitou-Charentes region between 2000 and 2015.

Results

Seven patients were included. They presented 9 neoplasias (1 lymphoma, 1 melanoma, and 7 carcinomas) diagnosed from 4 months before to 25 months after the occurrence of cutaneous (6/7) and/or mucosal (6/7) polymorphic lesions. Histological examination revealed epidermal acantholysis (7/7), keratinocytic necrosis (4/7), and interface lichenoid dermatitis (5/7). Intercellular deposits of IgG and C3 or along the dermo-epidermal junction were detected with direct immunofluorescence (IF) (7/7). Four of 6 patients tested had positive indirect IF on rat bladder epithelium. Follow-up ranged from 1–132 months with a one-year survival of 85.7%.

Discussion

The clinical and histopathological presentations observed in our patients were polymorphic, with overlap between the clinical and histological features of PNP and classical pemphigus. Prognosis and survival appear better in our series than in the literature. It is possible that in some cases, the association of pemphigus with neoplasia was fortuitous, which might account for the better prognosis. A new consensus on the diagnostic criteria for PNP is needed to help practitioners to consensually diagnose it for prognostic or therapeutic trials.



A Bayesian assessment of occupational health surveillance in workers exposed to silica in the energy and construction industry

Abstract

Medical records generated during occupational health surveillance processes have large amounts of unexploited information that can help to reduce silica-related health risks and many occupational diseases. The methodology applied in this study consists in analyzing through machine learning techniques a database with 70,000 medical examinations from workers in the energy and construction industry in Spain. First, a general unsupervised Bayesian model is built and node force analysis is used to identify the factors with the greatest impact on the worker's health surveillance process. Second, a predictive Bayesian model is created and mutual information is employed to assess the more relevant factors affecting the medical capability of workers exposed to silica dust. The lung auscultation and the breathing exploration are the two factors that influence the most the medical capability of silica-exposed employees. Probabilistic inference shows a remarkable gender effect, where women present more resilience towards occupational diseases than men showing a higher proportion of normal results in certain key factors, such as body mass index (♀49.73%, ♂25.17%) or spirometry (♀53.73%, ♂48.91%). Finally, environmental conditions demonstrate to have a major influence on spatial variability of occupational diseases. The design of health prevention programs based on geographical variations can be crucial to the attainment of an ongoing and sustained healthier workforce with a reduction in the number of chronic workplace illnesses.



Zoon's plasma cell balanitis: clinical and dermoscopic features in pediatric patients

International Journal of Dermatology, EarlyView.


Recommendations for the use of telemedicine in severely under‐resourced settings: results from a pilot study in Niamey, Niger

International Journal of Dermatology, EarlyView.


Gastrointestinal prophylaxis in patients with autoimmune blistering disease treated with corticosteroids: an expert survey

International Journal of Dermatology, EarlyView.


(Invited thematic article) Prevalence and pathogenesis of osteopenia and osteoporosis in epidermolysis bullosa: An Evidence Based Review

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


Appropriate use of dressings containing nanocrystalline silver to support antimicrobial stewardship in wounds

International Wound Journal, EarlyView.


An evidence‐based review of split‐thickness skin graft donor site dressings

International Wound Journal, EarlyView.


Efficacy and safety of daylight photodynamic therapy after tailored pretreatment with ablative fractional laser or microdermabrasion: a randomized, side‐by‐side, single‐blind trial in patients with actinic keratosis and large area field cancerization

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Mosaic mutations in FGFR3 and FGFR2 are associated with naevoid acanthosis nigricans or RAVEN (round and velvety epidermal naevus)

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Tumor spontaneous regression in an elderly patient with Squamous Cell Carcinoma of the cranial vertex pre‐treated with cetuximab monotherapy

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Therapeutic efficacy of early photobiomodulation therapy on the zones of stasis in burns: An experimental rat model study

Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.


Adipose‐derived stem cells and the stromal vascular fraction in polyglycolic‐acid (PGA)‐collagen nerve conduits promote rat facial nerve regeneration

Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.


Patients’ prediction of their wound healing time

Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.


Validation of three‐dimensional wound measurements using a novel 3D‐WAM camera

Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.


Differences between Patient‐ and Proxy‐reported HRQoL Using the Wound‐Qol

Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.


A synthetic microRNA‐92a inhibitor (MRG‐110) accelerates angiogenesis and wound healing in diabetic and non‐diabetic wounds

Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.


Xeroderma pigmentosum group D: Report of a novel combination of ERCC2 variations and its phenotype

The Journal of Dermatology, EarlyView.


Development of Kasabach–Merritt phenomenon following vaccination: More than a coincidence?

The Journal of Dermatology, EarlyView.


Subungual exostosis with postoperative recurrence followed by spontaneous regression

The Journal of Dermatology, EarlyView.


Reciprocal relationship between herpes zoster and cardiovascular diseases: A nationwide population‐based case–control study in Korea

The Journal of Dermatology, EarlyView.


Παρασκευή 17 Αυγούστου 2018

Analysis of a photobioreactor scaling up for tertiary wastewater treatment: denitrification, phosphorus removal, and microalgae production

Abstract

The present work studies the removal of nutrients (nitrate and phosphate) from a synthetic wastewater simulating a secondary treatment effluent using the microalgae Chlorella vulgaris in autotrophic photobioreactors, together with an analysis of the critical points affecting the scaling-up process from laboratory to pilot scale. Laboratory experiments were done in open agitated 1-L photobioreactors under batch operation mode, while pilot-scale experiments were done using a 150-L closed tubular photobioreactor under continuous operation mode. In both scales, nitrate was the limiting substrate and the effect of its concentration on microalgae performance was studied. From laboratory experiments, an average microalgae productivity of 85 mgVSS L−1 day−1 and approximate maximum N-NO3− and P-PO43− removal rates of 8 mg N gVSS−1 day−1, and 2.6 mg P gVSS−1 day−1 were found. Regarding pilot scale, the average microalgae productivity slightly decreased (76 mgVSS L−1 day−1) while the approximate maximum N-NO3− and P-PO43− removal rates slightly were increased (11.7 mg N gVSS−1 day−1 and 3.04 mg P gVSS−1 day−1) with respect to the laboratory-scale results. The pilot-scale operation worked under lower levels of turbulence and higher dissolved oxygen concentration and light intensity than laboratory experiments; those parameters were difficult to control and they can be identified as the critical points in the differences found on both nutrient removal and microalgae production.



Integrating natural and engineered remediation strategies for water quality management within a low-impact development (LID) approach

Abstract

The objective of this paper is to demonstrate an interdisciplinary strategy combining both engineering- and biology-based approaches for stormwater and wastewater treatment. The work involves a novel and environmentally friendly surface material that can withstand urban load over its design service life, allows preliminary treatment through filtration, and diverts water to the subsurface to conduct secondary treatment below the surface through phytoremediation via the extensive rooting systems of trees. The present study highlights an interdisciplinary low-impact development (LID) approach developed for a polluted industrial wastewater site, for a cleaner and greener environment. The LID system involves (i) rhizofiltration and phytoremediation methods for removing heavy metals and organic pollutants using a hybrid poplar and aspen species; (ii) porous infrastructure produced using industrial waste, referred to as geopolymer pavers; and (iii) use of Silva cells as a tree-friendly and load support system. The design of the pavers over the Silva cells is innovative as it can deal with rainwater runoff and urban transportation loads simultaneously. The proposed system has the ability to extract heavy metals that are common in urban runoff or domestic and industrial effluents thus preserving the ecosystem naturally. The test site is only 15 m2, but designed for a water-retention capacity of 2 m3 (roughly 1:100 year design volume draining a 10 × 10 m parking lot), and remediation levels for Cu and Zn are expected to reach 180 mg/kg dry weight and 1200 mg/kg dry weight, respectively.



Short-term copper exposure as a selection pressure for antibiotic resistance and metal resistance in an agricultural soil

Abstract

Owing to the similar mechanisms of antibiotic and metal resistance, there is a growing concern that metal contamination may select for antibiotic resistance genes (ARGs) in the environment. Here, we constructed short-term laboratory microcosms to investigate the dynamics of a wide range of ARGs and two copper (Cu) resistance genes in an agricultural soil amended with a gradient of Cu concentrations (0~1000 mg kg−1). Mobile genetic elements (MGEs) were also quantified as a proxy for the horizontal gene transfer potential of ARGs. We detected 126 unique ARGs across all the soil samples using the high-capacity quantitative PCR array, and multidrug and β-lactam resistance were the most abundant ARG categories. The copper amendments significantly enhanced the absolute and relative abundances of ARGs and MGEs, which gradually increased along the gradient of increasing Cu concentrations. The two Cu resistance genes (copA and pcoR) were highly enriched in low-level Cu treatment (50 and 100 mg kg−1), and their abundances decreased with the increasing Cu concentrations. The level of metal and antibiotic resistance gradually declined over time in all Cu-amended treatments but was still considerably higher in contaminated soils than untreated soils after 56 days' incubation. Significant associations among ARGs and MGEs were revealed by the network analysis, suggesting the mobility potential of antibiotic resistance in Cu-amended soils. No significant positive correlations were found between ARGs and copper resistance genes, suggesting that these genes are not located in the same bacterial hosts. Taken together, our results provide empirical evidence that short-term copper stress can cause evolution of high-level antibiotic and metal resistance and significantly change the diversity, abundance, and horizontal transfer potential of soil ARGs.



Foliar application of Zn can reduce Cd concentrations in rice ( Oryza sativa L.) under field conditions

Abstract

Cadmium (Cd) pollution in rice and its transfer to food chain are cause of global concern. Application of zinc (Zn) can reduce Cd uptake by plants, as both these metals are generally antagonistic in soil–plant systems. In a field experiment on Cd-contaminated acid soil, we investigated the effectiveness of foliar application of Zn in minimizing Cd accumulation and its effect on the content of mineral nutrient elements in rice. The treatment was done at an early grain filling stag using 0.3 and 0.5% w/v ZnSO4·7H2O solution. The spray did not affect the grain yield of rice but decreased the Cd concentration in the root, straw, husk, and brown rice to some extent and increased the Zn concentration. Foliar application of 0.5% ZnSO4 resulted in maximum Zn concentration and minimum Cd concentration in brown rice. However, the concentrations of P, K, Ca, Mg, Cu, and Mn in brown rice were not affected. The correlation between Cd and Zn concentrations in brown rice, husk, and root was significantly negative, and that between Cd and Mn concentrations in brown rice was significantly positive. The inhibition of Cd uptake resulted in a decrease in its concentration in brown rice after the treatments. Thus, the foliar application of a suitable concentration of Zn at the early grain filling stage could effectively minimize the Cd concentration while enhancing the Zn concentration in brown rice on Cd-contaminated acid soil.



Evaluation of the odor impact of some environmental gaseous pollutants: calibration of the methodology and preliminary results

Abstract

During the last decades, it has been observed a growing interest on odor impact because of the frequenter social acceptability problems about energy plants handling and processing stored organic materials (e.g., biogas plants, landfills, farms, distilleries, etc.). In this context, the UNI EN 13725:2004 indicates the "dynamic olfactometry method" as validated, recognized, and adequate measurement procedure for estimating the odor concentration. This protocol is carried out by a panel of specifically trained and selected human receptors, but alternative analytical methodologies are currently under discussion. This work aims to describe the initial steps of a wider research toward the definition of a new analytical protocol for monitoring odor concentration. The alternative methodology is here presented through the implementation of a case study: stored organic materials exploited on an energy plant in Central Italy. The paper describes the preliminary activities related to the survey of the case study (i), the definition of alternative methods and devices for conducting emissions sampling (ii), and the adopted experimental approach (iii). Finally, preliminary results are also presented (iv). The resulting protocol, once validated, could be employed by local authorities to measure both the odor impacts and the effectiveness of specifically designed mitigation strategies.