Children with neutrophil-predominant severe asthma have pro-inflammatory neutrophils with enhanced survival and impaired clearance

Publication date: Available online 5 September 2018

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

Author(s): Jocelyn R. Grunwell, Susan T. Stephenson, Rabindra Tirouvanziam, Lou Ann S. Brown, Milton R. Brown, Anne M. Fitzpatrick

Background

Airway neutrophils are abundant in some children with severe asthma, but their functions are poorly understood.

Objective

We hypothesized that the inflammatory airway environment of children with neutrophil-predominant severe asthma promotes neutrophil survival and disrupts neutrophil-associated innate immune defenses.

Methods

Sixty seven children with severe asthma refractory to high-dose inhaled corticosteroid (ICS) treatment undergoing bronchoscopy with bronchoalveolar lavage (BAL) for clinical indications were stratified into neutrophil "high" versus "low" groups based on BAL differential counts. Neutrophil activation markers, functional assays and phenotyping studies were performed as well as airway macrophage functional assays. Results were compared to those from children with moderate asthma treated with ICS.

Results

Children with neutrophil-predominant severe asthma had increased markers of neutrophil activation/degranulation and a greater magnitude of airway pro-inflammatory cytokine and chemokine release. Primary neutrophils exposed to BAL of these children exhibited greater phagocytic capability and greater neutrophil extracellular trap formation, but a more impaired respiratory burst. Despite greater abundance of airway TGF-β1, the neutrophils were not more apoptotic. Instead, neutrophils had a highly pro-inflammatory phenotype associated with a number of surface markers that regulate neutrophil activation, recruitment/migration and granule release. Airway macrophages from children with neutrophil-predominant severe asthma were also more pro-inflammatory with impaired phagocytosis and increased apoptosis.

Conclusions

Children with neutrophil-predominant severe asthma have pro-inflammatory neutrophils with enhanced survival. Airway macrophages are also pro-inflammatory and dysfunctional and may contribute to global innate immune impairment. Therapies that target neutrophils and related inflammation may be warranted in this subset of children.

Bronchial Thermoplasty: A Decade of Experience: State of The Art

Publication date: Available online 5 September 2018

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

Author(s): Laren D. Tan, Ken Y. Yoneda, Samuel Louie, D.Kyle Hogarth, Mario Castro

Abstract:

Bronchial thermoplasty (BT) delivers targeted radiofrequency energy to bronchial airway walls and results in the partial ablation of the airway smooth muscle that is responsible for bronchoconstriction. It is approved for the treatment of severe persistent asthma. Multiple, large clinical trials including a recent "real-world" study demonstrate significant improvements in asthma-related quality of life, reduction in asthma exacerbations, emergency department visits and hospitalizations after BT that is sustained out to 5 years. In this article, we review the state of the art of BT treatment in severe persistent asthma and share a decade of BT research and clinical experience. We share our personal experience and introduce the three "I"s (identification, implementation and intense follow up) that we believe promote successful patient outcomes and help build a successful BT program.

Fatal asthma: an audit of 30 million patient-years of health plan membership from 2007 to 2015

Publication date: Available online 5 September 2018

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

Author(s): Eric Macy, Janis F. Yao, Wansu Chen

Abstract

Background

Without accurate data on deaths directly caused by asthma, prevention will be difficult.

Objective

Determine how often asthma could be confirmed as a proximal cause of death in a large well-defined population with active health plan membership and no acute barriers to medical care.

Methods

All deaths occurring in active Kaiser Permanente Southern California health plan members between 2007 and 2015 were identified. Asthma-coded deaths were manually audited for cause. Healthcare and asthma medication use in the 6 months prior to death were determined.

Results

There were 248 [0.80 per 100,000 patient-years] un-audited asthma-coded deaths. There were only 63 (26.5%) [0.20 per 100,000 patient-years] asthma-confirmed deaths. Individuals with asthma-confirmed deaths were younger, less likely to have ever smoked, and had fewer emergency visits in the 6 months prior to death compared to those with asthma excluded. Individuals with asthma-confirmed deaths used preventative inhalers at very low rates. We unexpectedly found that ever inclusion in the 2016 National Committee for Quality Assurance health effectiveness data and information set (HEDIS) for persistent asthma was associated with a higher risk of all cause early death. Individuals with asthma-confirmed deaths were also unlikely to be in the HEDIS asthma dataset in the year they died, thus not targeted for outreach.

Conclusions

Audit-confirmed fatal asthma is more likely to occur in younger, non-smoking, individuals, using very low rates of preventive inhalers. This will be a very difficult group to prospectively identify and manage effectively. Further research into the reasons for early death after HEDIS asthma dataset inclusion is warranted.

Profile of the skin microbiota in a healthy Chinese population

The Journal of Dermatology, EarlyView.

Photochemical oxidation of di- n -butyl phthalate in atmospheric hydrometeors by hydroxyl radicals from nitrous acid

Abstract

The photochemical oxidation of di-n-butyl phthalate (DBP) by ^•OH radicals from nitrous acid (HONO) in atmospheric hydrometeors was explored by two techniques, steady-state irradiation, and laser flash photolysis (LFP). The effects of atmospheric liquid parameters on DBP transformation were systematically evaluated, showing that DBP does not react with HONO directly and ^•OH-initiated reactions are crucial steps for consumption and transformation of DBP. Two reaction channels are operative: ^•OH addition and hydrogen atom abstraction. The overall rate constant for the reaction of DBP with ^•OH is 5.7 × 10⁹ M⁻¹ s⁻¹, and its specific rate constant for addition is 3.7 × 10⁹ M⁻¹ s⁻¹ determined by using laser flash photolysis technique. Comparing the individual reaction rate constant for aromatic ring addition with the total rate constant, the majority of the ^•OH radicals (about 65%) attack the aromatic ring. The major transformation products were identified by GC-MS, and the trends of their yields derived from both ring addition and H-abstraction with time are discussed. These results provide important insights into the photochemical transformation of DBP in atmospheric hydrometeors and contribute to atmospheric aerosol chemistry.

Levels and sources of organic compounds in fine ambient aerosols over National Capital Region of India

Abstract

The study presents the spatial and temporal variation of fine ambient aerosols (PM_2.5) over National Capital Region (NCR), India, during January to June 2016. The investigation includes three sampling sites, one in Delhi and two in the adjoining states of Delhi (Uttar Pradesh and Haryana), across NCR, India. The average PM_2.5 concentration was highest for Delhi (128.5 ± 51.5 μg m⁻³) and lowest for Mahendragarh, Haryana (74.5 ± 28.7 μg m⁻³), during the study period. Seasonal variation was similar for all the sites with highest concentration during winter and lowest in summer. PM_2.5 samples were analysed for organic compounds using gas chromatograph (GC). The concentration of three organic compound classes, n-alkanes (C11–C35), polycyclic aromatic hydrocarbons (PAHs), and phthalates, present in PM_2.5 samples has been reported. Diagnostic ratios for n-alkanes demonstrated that biogenic emissions were dominant over Mahendragarh while major contributions were observed from petrogenic emissions over Delhi and Modinagar, Uttar Pradesh. Molecular diagnostic ratios were calculated to distinguish between different sources of PAHs, which revealed that the fossil fuel combustion (diesel and gasoline emissions), traffic emissions, and biomass burning are the major source contributors. Health risk associated with human exposure of phthalates and PAHs was also assessed as daily intake (DI, ng kg⁻¹ day⁻¹) and lung cancer risk, respectively. Backward trajectory analysis explained the local, regional, and long-range transport routes of PM_2.5 for all sites. Principal component analysis (PCA) results summarized that the vehicular emissions, biomass burning, and plastic burning were the major sources of the PAHs and phthalates over the sampling sites.

Earthworms as plug flow reactors: a first-order kinetic study on the gut of the vermicomposting earthworm Eudrilus eugeniae

Abstract

Earthworms are commonly referred as environmental engineers and their guts are often compared with chemical reactors. However, modeling experiments to substantiate it are lacking. The aim of this study was to use established reactor models, particularly PFR, on the gut of the vermicomposting earthworm Eudrilus eugeniae to understand more on its digestion. To achieve the objective, a mathematical model based on first-order kinetics was framed and used to determine the pattern of digestion rates of nutrient indicators, namely total carbon (%), total nitrogen (%), C/N ratio, ¹³C (‰), and ¹⁵N (‰) at five intersections (pre-intestine, foregut, midgut A, midgut B, and hindgut) along the gut of E. eugeniae. The experimental results revealed that the concentrations of TC, TN, ¹³C, and ¹⁵N decreased during gut transit, whereas C/N ratio increased. The first-order model demonstrated that all the nutrients exhibit a linear pattern of digestion during gut transit, which supports the PFR model. On this basis, the present study concludes that the gut of E. eugeniae functions as PFR.

Diagnostics of Pleiotropy in Mendelian Randomization Studies: Global and Individual Tests for Direct Effects

Abstract

Diagnosing pleiotropy is critical for assessing the validity of Mendelian randomization (MR) analyses. The popular MR-Egger method evaluates whether there is evidence of bias-generating pleiotropy among a set of candidate genetic instrumental variables. In this article, we propose GLIDE, GLobal and Individual tests for Direct Effects, a statistical method to systematically evaluate pleiotropy among the set of genetic variants, e.g., single nucleotide polymorphisms (SNPs), used for MR. As a global test, simulation experiments suggest that GLIDE is nearly uniformly more powerful than the MR-Egger method. As a sensitivity analysis, GLIDE is capable of detecting outliers in individual variant-level pleiotropy, in order to obtain a refined set of genetic instrumental variables. We used GLIDE to analyze both body-mass index and height for risk of colorectal cancer in the Genetics and Epidemiology of Colorectal Cancer Consortium. Among the body mass index associated SNPs and the height associated SNPs, several individual variants showed evidence of pleiotropy. Removal of these potentially pleiotropic SNPs resulted in attenuation of respective estimates of the causal effects. In summary, the proposed GLIDE method is useful for sensitivity analyses and improves the validity of MR.

Promise and Pitfalls of the Sibling Comparison Design in Studies of Optimal Birth Spacing

Abstract

Numerous observational studies have shown that infants born after short interpregnancy intervals (the interval between birth and subsequent conception) are more likely to experience adverse perinatal outcomes than infants born following longer intervals. Yet, it remains controversial whether the link between short interpregnancy interval and adverse outcomes is causal, or confounded by factors such as low socio-economic position, inadequate access to healthcare, and unintended pregnancy. Sibling comparison studies, which use a woman as her own control by comparing exposure and outcome status of her different pregnancies (i.e., comparing sibling offspring), have gained popularity as a strategy to reduce confounding by these difficult-to-measure factors that are nevertheless relatively stable within women. A variant of the design, used by Regan et al. in this issue (Am J Epidemiol 2018;XX:XXX-XXX), is a maternally-matched design based on a single interpregnancy interval per woman. Using real and simulated data, we highlight underappreciated shortcomings of these designs that may limit the validity of study findings. In particular, we illustrate how the single-interval variant appears to derive estimates from comparisons between different mothers, not within mothers. Future studies of optimal birth spacing using sibling comparison designs should examine in detail the potential consequences of these methodological limitations.

Detecting individual and global horizontal pleiotropy in Mendelian randomization: a job for the humble heterogeneity statistic?

Abstract

Mendelian randomization (MR) is gaining in recognition and popularity as a method for strengthening causal inference in epidemiology by utilizing genetic variants as instrumental variables. Concurrently with the explosion in empirical MR studies there has been the steady production of new approaches for MR-analysis. The recently proposed Global and Individual tests of Direct Effects (GLIDE) approach fits into a family of methods that aim to detect horizontal pleiotropy - at the individual SNP level and at the global level - and to adjust the analysis by removing outlying SNPs. The purpose of this commentary is to explain how existing methods can (and indeed are) being used to detect pleiotropy at the individual and global level, although not explicitly using this terminology. By doing so, we will show that the true comparator for GLIDE is not MR-Egger regression (as the authors of the GLIDE approach claim), but rather the humble heterogeneity statistic.

A Population-based Matched Sibling Analysis Estimating the Association between First Interpregnancy Interval and Birth Outcomes

Abstract

The association between a single interpregnancy interval (IPI) on birth outcomes has not yet been explored using matched methods. We modelled the odds of preterm birth, small-for-gestational age and low birthweight in a second, liveborn infant in a cohort of 192,041 sibling pairs born in Western Australia between 1980 and 2010. The association between IPI and birth outcomes was estimated from the interaction between birth order and IPI (with 18–23 months as the reference category), using conditional logistic regression. Matched analysis showed the odds of preterm birth were higher for siblings born following an IPI <6 month (adjusted Interaction Odds Ratio [IOR]: 1.22; 95% CI: 1.06, 1.38) compared with 18–23 month IPI. There were no significant differences for IPI <6 months for other outcomes (small-for-gestational age or low birthweight). This is the first study to use matched analyses to investigate the association between a single IPI on birth outcomes. IPI <6 months were associated with increased odds of preterm birth in secondborn infants, although the association is likely smaller than previously estimated by unmatched studies.

The uncertain role of interpregnancy interval and why we need new approaches to an old problem

Estimating the Short-term Effects of the Earned Income Tax Credit on Child Health

Abstract

The earned income tax credit (EITC) is the largest U.S. poverty alleviation program, yet few studies examine its effects on the health of recipients' children. We employed quasi-experimental techniques to test the hypothesis that EITC refund receipt is associated with short-term improvements in child health. The data set included children surveyed in the Third National Health and Nutrition Examination Survey (N=7,444). We employed a difference-in-differences approach, exploiting the seasonal nature of EITC refund receipt. We compared children of EITC-eligible families interviewed immediately after refund receipt (February-April) with those interviewed during other months (May-January), differencing out seasonal variation among non-EITC-eligible families. We examined outcomes that were likely to be affected immediately after refund receipt, including general health, nutrition, metabolic and inflammatory biomarkers, and test scores. There were improvements in physician-reported overall health after refund receipt, but no changes in infection, serum metabolic or inflammatory markers, or test scores, and contradictory findings for food insufficiency. In summary, EITC refunds are not strongly associated with most short-term health outcomes among recipients' children, although numerous previous studies have demonstrated impacts on longer-term outcomes. This highlights the importance of examining the effects of public policies on beneficiaries and their children using varying study designs.

Effects of Multiple Forms of Information Bias on Estimated Prevalence of Suicide Attempts by Sexual Orientation: An Application of a Bayesian Misclassification Correction Method to Data from a Systematic Review

Abstract

Multiple epidemiologic studies demonstrate a disparity in suicide risk between sexual minority (lesbian, gay, bisexual) and heterosexual populations; however, both 'exposure' (sexual minority status) and outcome (suicide attempts) may be affected by information bias related to errors in self-reporting. We therefore applied a Bayesian misclassification correction method to account for possible information biases. A systematic literature search identified studies of lifetime suicide attempts in sexual minority and heterosexual adults, and frequentist meta-analysis was used to generate unadjusted estimates of relative risk. A Bayesian model accounting for prior information about sensitivity and specificity of exposure and outcome measures was used to adjust for misclassification biases. In unadjusted frequentist analysis, the relative risk of lifetime suicide attempt comparing sexual minority to heterosexual groups was 3.38 (95% confidence interval: 2.65, 4.32). In Bayesian re-analysis, the estimated prevalence was slightly reduced in heterosexual adults and increased in sexual minority adults, yielding a relative risk of 4.67 (95% credible interval: 3.94, 5.73). The disparity in lifetime suicide attempts between sexual minority and heterosexual adults is greater than previously estimated, when accounting for multiple forms of information bias. Additional research on the impact of information bias in studies of sexual minority health should be pursued.

Re: ``Transportability of Trial Results Using Inverse Odds of Sampling Weights''

Diet Quality Indices and Risk of Type 2 Diabetes: The Singapore Chinese Health Study

Abstract

We aimed to test whether predefined dietary patterns inversely relating to risk of type 2 diabetes (T2D) in Western populations were similarly associated with lower T2D risk in an Asian population. We included 45,411 middle aged and older participants of the Singapore Chinese Health Study free of diabetes, cancer or cardiovascular disease at baseline (1993–1998). Participants were followed up for T2D diagnosis through 2010. Dietary information was collected using a validated food frequency questionnaire. Dietary pattern scores were calculated for the alternate Mediterranean diet, alternative Healthy Eating Index-2010, Dietary Approaches to Stop Hypertension diet, an overall plant-based diet index, and a healthful plant-based diet index. During a median 11.2 years of follow-up, 5,207 incident cases of T2D occurred. After the adjustment for multiple potential confounders, the 5 dietary pattern scores were significantly associated with 16% (for alternate Mediterranean diet) to 29% (for Dietary Approaches to Stop Hypertension diet) lower risk of T2D when comparing the highest with the lowest score quintiles (all P for trend <0.001). These associations did not vary substantially by baseline age, sex, body mass index or hypertension status, but were limited to non-smokers (P for interaction <0.001 for alternate Mediterranean diet and 0.03 for alternative Healthy Eating Index-2010). Adherence to a high-quality diet, as reflected by several predefined diet quality indices derived in Western populations, was significantly associated with lower risk of T2D in an Asian population.

Associations of Long-Term Exposure to Ultrafine Particles and Nitrogen Dioxide with Increased Incidence of Congestive Heart Failure and Acute Myocardial Infarction

Abstract

Although long-term exposure to traffic-related air pollutants such as nitrogen dioxide (NO₂) has been linked to cardiovascular mortality, little is known about the association of ultrafine particles (UFPs) with incidence of major cardiovascular events. We conducted a population-based cohort study to assess the associations of chronic exposure to UFPs and NO₂ with incident congestive heart failure (CHF) and acute myocardial infarction. Our study population comprised all long-term Canadian residents aged 30-100 years who lived in Toronto, Canada, 1996-2012. We estimated annual concentrations of UFPs and NO₂ using land-use regression models and assigned these estimates to participants' postal-code addresses in each year during the follow-up period. We estimated hazard ratios (HRs) for UFPs and NO₂ using random-effects Cox proportional hazards models. We controlled for smoking and obesity using an indirect adjustment method. Our cohorts comprised ~1.1 million individuals at baseline. In single-pollutant models, each interquartile increase in UFPs exposure was associated with increased incidence for CHF (HR_iqr: 1.03; 95%CI: 1.02, 1.05) and acute myocardial infarction (HR_iqr: 1.05; 95%CI: 1.02, 1.07), respectively. Adjustment for fine particles and NO₂ did not materially change these estimated associations. Exposure to NO₂ was also independently associated with higher CHF incidence (HR_iqr: 1.04; 95%CI: 1.03, 1.06).

RE: “EXAMINING THE ASSOCIATION BETWEEN APPARENT TEMPERATURE AND MENTAL HEALTH-RELATED EMERGENCY ROOM VISITS IN CALIFORNIA”

MGMT promoter methylation status testing to guide therapy for glioblastoma: refining the approach based on emerging evidence and current challenges

Abstract

Glioblastoma (GBM) is the most common primary malignant brain tumor, with a universally poor prognosis. The emergence of molecular biomarkers has had a significant impact on histological typing and diagnosis, as well as predicting patient survival and response to treatment. The methylation status of the O⁶-methylguanine-DNA methyl-transferase (MGMT) gene promoter is one such molecular biomarker. Despite the strong evidence supporting the role of MGMT methylation status in prognostication, its routine implementation in clinical practice has been challenging. The methods and optimal cutoff definitions for MGMT status determination remain controversial. Variation in detection methods between laboratories presents a major challenge for consensus. Moreover, consideration of other clinical and genetic/epigenetic factors must also be incorporated into treatment decision making. In this review, we distill the available evidence to summarize our position on the optimal use of available assays, and propose strategies for resolving cases with equivocal methylation status and a framework for incorporating this important assay into research and clinical practice.

A systematic review of financial implications of air pollution on health in Asia

Abstract

Economic losses due to health-related implications of air pollution were huge and incurred significant burdens towards healthcare providers. The objective of this study is to systematically review published literature on the financial implications of air pollution on health in Asia. Four databases: PubMed, Scopus, NHS Economic Evaluation Database (NHS EED), and Web of Science (WoS) were used to identify all the relevant articles. It was limited to all articles that had been published in the respected databases from January 2007 until March 2017. Twenty-four articles were included in this review. Five of the 24 studies (20.8%) reported financial implications of air pollution-related disease through value of statistical life (VOSL) which ranged from USD180 million to USD2.2 billion, six (25%) studies used cost of illness (COI) to evaluate air pollution-related morbidity and found that the cost ranged from USD5.4 million to USD9.1 billion. Another six studies (25%) used a combination of VOSL and COI for both mortality and morbidity valuation and found that the financial implications ranging from USD253 million to USD2.9 billion. Thirteen (54.2%) studies reported healthcare cost associated with both hospital admission and outpatient visit, five (20.1%) on hospital admission only, and one (4.2%) on outpatient visit only. Economic impacts of air pollution can be huge with significant deterioration of health among the Asians.

Application of magnesium peroxide (MgO 2 ) nanoparticles for toluene remediation from groundwater: batch and column studies

Abstract

In the present study, magnesium peroxide (MgO₂) nanoparticles were synthesized by electro-deposition process and characterized by X-ray diffraction (XRD) and field emission scanning electron microscopy (FESEM). The batch experiments were conducted to evaluate the MgO₂ half-life (600 mg/L) in groundwater under various temperatures (4, 15, and 30 °C) and initial pH (3, 7, and 12). The effect of Fe²⁺ ions (enhanced oxidation) on the toluene remediation by MgO₂ was also investigated. Nanoparticles were injected to sand-packed continuous-flow columns, and toluene removal (50 ppm) was studied within 50 days at 15 °C. The results indicated that the half-life of MgO₂ at pH 3 and 12 were 5 and 15 days, respectively, in comparison to 10 days at the initial pH 7 and 15 °C. The nanoparticles showed 20 and 7.5 days half-life at 4 and 30 °C temperatures, respectively. Injection of Fe²⁺ ions indicated an impressive effect on toluene removal by MgO₂, and the contaminant was completely removed after 5 and 10 days, in the batch and column experiments, respectively. Confocal laser scanning microscope (CLSM) analysis indicated that the attached biofilm had a significant role in the decontamination of groundwater. Comparison of bioremediation and enhanced oxidation resulted in a considerable insight into the application of magnesium peroxide in groundwater remediation.

Graphical abstract

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Transparency in Algorithmic and Human Decision-Making: Is There a Double Standard?

Abstract

We are sceptical of concerns over the opacity of algorithmic decision tools. While transparency and explainability are certainly important desiderata in algorithmic governance, we worry that automated decision-making is being held to an unrealistically high standard, possibly owing to an unrealistically high estimate of the degree of transparency attainable from human decision-makers. In this paper, we review evidence demonstrating that much human decision-making is fraught with transparency problems, show in what respects AI fares little worse or better and argue that at least some regulatory proposals for explainable AI could end up setting the bar higher than is necessary or indeed helpful. The demands of practical reason require the justification of action to be pitched at the level of practical reason. Decision tools that support or supplant practical reasoning should not be expected to aim higher than this. We cast this desideratum in terms of Daniel Dennett's theory of the "intentional stance" and argue that since the justification of action for human purposes takes the form of intentional stance explanation, the justification of algorithmic decisions should take the same form. In practice, this means that the sorts of explanations for algorithmic decisions that are analogous to intentional stance explanations should be preferred over ones that aim at the architectural innards of a decision tool.

How much does community-based targeting of the ultra-poor in the health sector cost? Novel evidence from Burkina Faso

Targeting efforts aimed at increasing access to care for the poorest by reducing to a minimum or completely eliminating payments at point of use are increasingly being adopted across low and middle income coun...

Environmental exposure of anthropogenic micropollutants in the Prut River at the Romanian-Moldavian border: a snapshot in the lower Danube river basin

Abstract

The Prut River, the second longest tributary of the Danube river, was investigated for a wide range of anthropogenic organic pollutants to fill the data gap on environmental contamination in eastern European surface waters. In this study, the occurrence of a wide range of organic pollutants was measured along the transboundary Prut River, between Sculeni and Branza in 2010–2012. Using two different analytical methods, gas chromatography coupled to mass spectrometry and liquid chromatography coupled to high-resolution mass spectrometry, over 300 compounds were screened for and 88 compounds were determined in the Prut River. In general, the chemicals occurred at low levels. At the last sampling site upstream of the confluence with the Danube river at Branza, the highest average concentrations (≥ 100 ng L⁻¹) were determined for the artificial sweetener acesulfame, the pharmaceuticals metformin, 4-acetamidoantipyrene, and 4,4,5,8-tetramethylchroman-2-ol, the antioxidants 2,4-di-tert-butylphenol, 3-tert-butyl-4-hydroxyanisol, and 3,5-di-tert-butyl-4-hydroxy-toluene, the personal care products HHCB (galaxolide), 4-phenyl-benzophenone, and octyl dimethyl-p-aminobenzoic acid, the industrial chemical diphenylsulfone, and the sterol cholesterol. Low concentrations of agricultural pesticides occurred in the catchment. At Branza, the total accumulated load of all measured compounds was calculated to be almost 19 kg day⁻¹. In comparison to the Rhine River, the loads in the Prut, determined with same LC-HRMS method for the same set of analytes, were two orders of magnitude lower. Discharge of wastewater without proper treatment from the city of Iasi in the Jijia catchment (Romania) as well as from the city of Cahul (Moldova) revealed a distinct increase in concentrations and loads in the Prut at Frasinesti and Branza. Thus, an implementation of wastewater treatment capacities in the Prut River basin would considerably reduce the loads of micropollutants from urban point sources.

Depersonalization Disorder, Affective Processing and Predictive Coding

Abstract

A flood of new multidisciplinary work on the causes of depersonalization disorder (DPD) provides a new way to think about the feeling that experiences "belong" to the self. In this paper I argue that this feeling, baptized "mineness"(Billon 2013, 2018a, b) or "subjective presence" (Seth, Trends in Cognitive Sciences 17(11): 565–573, 2013) emerges from a multilevel interaction between emotional, affective and cognitive processing. The "self" to which experience is attributed is a predictive model made by the mind to explain the modulation of affect as the organism progresses through the world. When the world no longer produces predicted affect, the organism needs to explain or explain this unpredicted absence of feeling away. It is important to this account that cognition and perception are otherwise intact. Consequently the mind's representation of the world and its emotionally salient properties are unchanged, leading the mind to predict a characteristic affective response. When that prediction is not fulfilled the organisms feels as if she is no longer present in experience. This is reported at the as feeling of depersonalization.

Radiostrontium transport in plants and phytoremediation

Abstract

Radiostrontium is a common product of nuclear fission and was emitted into the environment in the course of nuclear weapon tests as well as from nuclear reactor accidents. The release of ⁹⁰Sr and ⁸⁹Sr into the environment can pose health threats due to their characteristics such as high specific activities and easy access in human body due to its chemical analogy to calcium. Radiostrontium enters the human food chain by the consumption of plants grown on sites comprising fission-derived radionuclides. For humans, Sr is not an essential element, but, due to solubility in water and homology with calcium, once interred in the body, it gets deposited in bones and in teeth. This concern has drawn the attention of researchers throughout the globe to develop sustainable treatment processes to remediate soil and water resources. Nowadays, phytoremediation has become a promising approach for the remediation of large extents of toxic heavy metals. Some of the plants have been reported to accumulate Sr inside their biomass but detailed mechanisms at genetic level are still to be uncovered. However, there is inadequate information offered to assess the possibility of this remediation approach. This review highlights phytoremediation approach for Sr and explains in detail the uptake mechanism inside plants.

Sensitization to, and allergic contact dermatitis caused by, colophonium in north‐eastern Italy in 1996 to 2016 with a focus on occupational exposures

Contact Dermatitis, EarlyView.

Silver Doped TiO2 Coated Cotton Fabric as an Effective Photocatalytic System for Dye Decolorization in UV and Visible Light

Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.

Aesthetic dermatology: What's new, what's true?

Dermatologic Therapy, EarlyView.

Application of Photoacoustic Methods and Confocal Microscopy for Monitoring of Therapeutic Response in Plaque Psoriasis

Psoriasis is prone to relapses and requires long-term therapy that may induce a range of adverse effects; therefore, an efficient and early detection of relapses is desirable. In this study, photoacoustic imaging and confocal laser scanning microscopic (CLSM) methods were investigated for their suitability in psoriasis follow-up examinations. Using a high-resolution photoacoustic system, the vascular structures of 11 psoriatic patients and 6 healthy volunteers were investigated. No differences were detected with respect to the average vessel diameter and vasculature per unit volume in the tissue of healthy volunteers and non-lesional and lesional skin areas of psoriatic patients. By means of CLSM, the diameters of the dermal papillae of 6 volunteers and 6 psoriatic patients were determined. The diameters of the dermal papillae of the healthy volunteers (0.074 ± 0.006 mm) revealed no significant difference when compared to non-lesional skin areas of psoriatic patients (0.079 ± 0.005 mm). The results obtained for the lesions in psoriatic patients showed a significant difference (Wilcoxon test, p = 0.028) between the diameters of the dermal papillae of the lesional skin areas (0.114 ± 0.012 mm) and the non-lesional skin areas (0.079 ± 0.005 mm). Thus, CLSM can be applied for monitoring psoriasis follow-up examinations.
Skin Pharmacol Physiol 2018;31:308–315

Heavy metal leaching and plant uptake in mudflat soils amended with sewage sludge

Abstract

The leaching and uptake of Cd, Cu, Pb, and Zn by maize (Zea mays L.) in mudflat saline-alkali soils amended by sewage sludge was examined using a greenhouse leaching column experiment. Application of sewage sludge caused decreased pH, increased DOC, and increased Cd, Cu, Pb, and Zn concentrations in leachates. The similar temporal dynamics of DOC and the metal concentrations in leachates suggested complexation of the metals with DOC. There was downward movement of metals as evidenced by the metal enrichment in the bottom layer (20–40-cm depth) of leaching columns (p < 0.05). The enrichment of metals was contributed by the acid-soluble/exchangeable fraction (EX), reducible fraction (RG), oxidizable fraction (OXI), and residual fraction (RES), indicating redistribution of leached metals from the top 20-cm layer. The sewage sludge application also enhanced plant uptake of metals. However, even under the greatest sludge application rate (150 g kg⁻¹), very small proportions, averagely 0.65% and 0.35%, of the applied metals were leached and taken up by maize, respectively, over the experimental period. Long-term field-scale research is warranted for further investigation of the effects of sewage sludge amendment on heavy metal fractionation and distribution in mudflat soil-plant-water system.

Treatment of penile actinomycosis

Dermatologic Therapy, EarlyView.

The clinical, biochemical, and ultrasonographic characteristics of patients with hidradenitis suppurativa in Northern Peninsular Malaysia: a multicenter study

International Journal of Dermatology, EarlyView.

Mammalian meat allergy

International Journal of Dermatology, EarlyView.

Lues maligna in an immunocompetent female

Swetalina Pradhan, Chandra S Sirka, Maitreyee Panda, Manas Baisakh

Indian Dermatology Online Journal 2018 9(5):344-346

“Hair building” fibers through the dermoscope

Feroze Kaliyadan, Kaberi Feroze

Indian Dermatology Online Journal 2018 9(5):362-363

A study of cutaneous adverse drug reactions in a tertiary care center in Punjab

Niharika Jha, Emy Alexander, Bimal Kanish, Dinesh K Badyal

Indian Dermatology Online Journal 2018 9(5):299-303

Context: Cutaneous adverse drug eruptions are the most common adverse reactions attributed to drugs in which any type of skin reaction can be mimicked, induced, or aggravated. Aims: To study the pattern of various types of cutaneous adverse drug reactions (CADRs), to find out the causative drug(s) involved and to determine the response to treatment and outcome in patients with CADRs. Patients and Methods: This prospective study was done in the department of dermatology. Patients with suspected drug rash, of either sex and all age groups were included in the study. Statistical Analysis: Frequencies and proportions were calculated using Chi-square test and t-test as the tests of significance. Data was analyzed using SPSS version 21. Results: A total of 258 patients were enrolled in the study. The most common CADR observed in the study was exanthematous drug eruption in 42.63% patients followed by drug induced urticaria in 21.32% patients. Antimicrobials were the most common offending drugs in 64.73% of patients, followed by non-steroidal anti-inflammatory drugs (NSAIDs) in 15.50% patients. In the study, 12 patients (4.65%) were found to have severe cutaneous adverse drug reactions (SCADRs). Stevens–Johnson syndrome (SJS) - Toxic epidermal necrolysis (TEN) was the most common SCADR (50%) and antituberculous drugs were the most common causative group of drugs causing SCADRs. Conclusion: The most common CADR observed in the study was exanthematous drug eruption and antimicrobials were the most common causative drugs.

Giant shagreen patch in tuberous sclerosis complex

V Kuntoji, PV Bhagwat, C Kudligi

Indian Dermatology Online Journal 2018 9(5):353-355

Prevalence of metabolic syndrome in patients with lichen planus: A cross-sectional study from a tertiary care center

Hashim Hashba, Joy Bifi, Anoop Thyvalappil, Rajiv Sridharan, Ajayakumar Sreenivasan, Pretty Mathew

Indian Dermatology Online Journal 2018 9(5):304-308

Background: There have been reports of association between lichen planus (LP) and metabolic syndrome and its various parameters. Aims and Objectives: To determine the prevalence of metabolic syndrome in patients with LP and to determine the association between the morphologic types of LP and metabolic syndrome. Materials and Methods: In this cross-sectional study conducted over a period of 1 year, 70 clinically diagnosed patients with LP were included and evaluated for metabolic syndrome based on the modified National Cholesterol Education Program: Adult Treatment Panel III guidelines. Data were analyzed using Statistical Package for the Social Sciences version 17 software, and inferential statistical tools such as t-test for continuous data and Chi-square test for categorical data were used. Results: A 35.7% prevalence of metabolic syndrome was found in patients with LP. The average duration of LP was found to be higher in patients with metabolic syndrome. There was a higher prevalence of central obesity, increased fasting blood sugar, and low high-density lipoprotein-cholesterolin patients with LP. Conclusion: Metabolic syndrome was seen in 25 patients (35.7%) with LP. It is important to advise our patients to adopt healthy lifestyle choices to help prevent comorbidities and improve the general health of population. As this study was a cross-sectional study, the directionality of the association between LP and metabolic syndrome could not be assessed. Lack of controls and a small sample size are other limitations of our study.

Prevalence and association of dermatological manifestations with fanconi anemia: A retrospective study

Pallavi Shukla, Seema Korgaonkar, Lily Kerketta, Babu R Vundinti

Indian Dermatology Online Journal 2018 9(5):341-342

Impact of palmoplantar dermatoses on quality of life

Rochit Singhal, Nilofar G Diwan, Pragya A Nair

Indian Dermatology Online Journal 2018 9(5):309-313

Background: Palmoplantar dermatoses are commonly found in dermatological practice. Quality of life (QOL) is severely impaired if these areas are affected. Early and appropriate management of palmoplantar dermatoses help in improving patient's QOL. Aim: To assess the impact of palmoplantar dermatoses on QOL. Materials and Methods: Patients with palmoplantar dermatoses with or without other body part involvement were enrolled in the study. QOL was assessed by Dermatology Life Quality Index (DLQI) questionnaire for >16 years of age and by Children's Dermatology Life Quality Index (CDLQI) questionnaire for 5–16 years of age. Results: Two hundred and two patients participated, of which 108 (53.46%) were males and 94 (46.53%) were females. The commonest age group affected was 17–40 years (42.57%). Housewives 61 (30.2%) and laborers 53 (26.2%) were most common occupational group affected. The mean DLQI and CDLQI scores were 7.68 and 7.46, respectively. Fifty-seven (28.21%) patients had palmoplantar psoriasis (PPP), 35 (17.32%) had palmoplantar keratoderma (PPK), and 26 (12.87%) had hand eczema (HE) with mean DLQI scores 8.60, 8.53, 8.60, and CDLQI scores 8.40, 8.28, and 8.26, respectively. In both DLQI and CDLQI, questions on symptoms and feelings scored maximum. Gender, age, occupation, duration, progress, and type of dermatosis did not show statistically significant association with DLQI. However, chronic recalcitrant dermatoses such as PPP, PPK, and HE showed significant impairment in QOL in relation to occupation and duration of disease. Limitation: Severity of various palmoplantar dermatoses was not graded and therefore relation between severity of various dermatoses and QOL was not established. Conclusion: Majority of patients with palmoplantar dermatoses especially those having chronic course had significant impairment in their QOL.

A rare case of neurofibromatosis type i with coexistent wilson disease

Tulika Rai, Vijay Kumar, Najuma Subba

Indian Dermatology Online Journal 2018 9(5):348-350

Coexistence of fungal infections in psoriatic nails and their correlation with severity of nail psoriasis

Suteeraporn Chaowattanapanit, Penvadee Pattanaprichakul, Charussri Leeyaphan, Onjuta Chaiwanon, Panitta Sitthinamsuwan, Waritch Kobwanthanakun, Suchanan Hanamornroongruang, Sumanas Bunyaratavej

Indian Dermatology Online Journal 2018 9(5):314-317

Background: Nail involvement in psoriasis is often complicated by concomitant fungal infections. The aim of this study was to investigate the prevalence of fungal infections in nail psoriasis and correlate it with the severity of nail psoriasis. Materials and Methods: This retrospective study included patients with nail psoriasis aged ≥18 years with at least one fingernail and one toenail involvement who were treated at Siriraj Hospital from September 2012 to January 2014. Severity of nail psoriasis was assesed by Nail Psoriasis Area Severity Index (NAPSI) score. The nail clippings from the the least and most severely involved psoriatic fingernails and toenails were cultured to determine the presence of coexisting fungal infections and isolate the fungal species. Results: Sixty-two patients (33 males, 29 females) fulfilling the inclusion criteria were included in the study. The mean age at the time of presentation was 51.3 years mention SD. The most common nail change consistent with psoriasis was onycholysis, followed by subungual hyperkeratosis. The most commonly isolated fungi in the most severely affected fingernails were Candida spp. (41.9%) manifesting as paronychia in 5 patients (19.2%). The most commonly isolated fungi in the most severely affected toenails were nondermatophytes (NDMs) other than candida (32.3%). Dermatophytes were not detected from any of the psoriatic nails. The fungal species isolated from the most severely affected fingernails were significantly different than the isolated fungal species in the most severely affected toenails (P = 0.026). Fungal organisms were identified in 32.3% of the most severely affected fingernails and in 27.4% of the most severely affected toenails. The overall rate of isolation of fungus was significantly significantly higher in severely affected nails than in the least affected nails (P < 0.005). Conclusion: A high rate of concomitant fungal infections, especially yeasts and NDMs, was found in psoriatic nail patients. The rate of isolation of fungal species was higher in severely involved psoriatic nails than mildly involved ones. The spectrum of fungal species isolated from the the severely involved toenails and fingernails were also different from each other. These organisms may be true pathogens that cause onychomycosis or their presence may reflect colonization, contamination, or concurrent infection.

Cutaneous larva migrans in an infant

Farzana Ansari, Lalit K Gupta, Ashok K Khare, Manisha Balai, Asit Mittal, Sharad Mehta

Indian Dermatology Online Journal 2018 9(5):359-359

The prevalence of psychiatric comorbidity in patients with prurigo nodularis

Lovee Dhawan, Shubh M Singh, A Avasthi, M Sendhil Kumaran, Tarun Narang

Indian Dermatology Online Journal 2018 9(5):318-321

Background: Prurigo nodularis (PN) is a chronic, recalcitrant itchy dermatosis. It is supposed to be associated with psychological factors, but research in this area is scarce. Objectives: To study the prevalence and determinants of psychiatric morbidity, and the phenomenology of itch in PN. Materials and Methods: This study was carried out in the outpatient service of the Department of Dermatology. Purposive sampling was used to recruit 50 patients each with PN, chronic urticaria (CU), and vitiligo (V). A one-time cross-sectional assessment was carried out on the participants. Psychiatric morbidity was assessed using Mini-International Neuropsychiatric Interview and Patient Health Questionnaire-9. Results: The three groups were comparable on socio-demographic parameters. The prevalence of any psychiatric disorder (current or lifetime) was 48%, 42%, and 58% in the PN, CU, and V groups, respectively (P = 0.27). Limitations: The limitations of this study include the small sample size and the purposive, non-blind nature of assessments. Conclusion: Our study suggests that there is significant psychiatric morbidity in PN which is comparable to that seen in CU and V.

Systemic drug-induced chronic paronychia and periungual pyogenic granuloma

Uwe Wollina

Indian Dermatology Online Journal 2018 9(5):293-298

Paronychia is a painful inflammatory disorder of the nail fold. Periungual pyogenic granuloma – a benign vascular tumor of the capillaries – can develop as a complication of paronychia. We report both, paronychia and periungual pyogenic granuloma, as possible adverse events during systemic drug-therapy. The following groups of systemic drugs have been considered: taxanes, epidermal growth factor-receptor (EGFR) inhibitors, EGFR tyrosine kinase inhibitors, tyrosine kinase inhibitors, inhibitors of MEK/ERK, BRAF inhibitors, CD20 antagonists, vascular endothelial growth factor inhibitors, and retinoids. Recommendations for prevention and treatment are given. Since paronychia is a painful inflammatory disorder that has a negative impact on daily activities, early recognition and adequate treatment improve adhesion to treatment and quality of life.

Innovative use of felt-tip pen applicator for uniform spread of linkage fluid during dermatoscopy

Deepak Jakhar, Chander Grover

Indian Dermatology Online Journal 2018 9(5):322-323

Dermoscopic features of cutaneous collagenous vasculopathy: A report of rare disorder

Daksha Vasava, Hita Mehta

Indian Dermatology Online Journal 2018 9(5):342-344

Caruncular oncocytoma: Report of two cases with review of literature

Suvradeep Mitra, Khushboo Lath, Ramanuj Samanta, Uma N Saikia

Indian Dermatology Online Journal 2018 9(5):324-327

Caruncular lesions are uncommon and could be related to hair follicles, sebaceous glands, sweat glands, and accessory lacrimal gland harbored in caruncle. As the lesions of caruncle are diverse, the clinical diagnosis is difficult. Majority of the caruncular lesions are benign although rare malignant lesions have also been reported. Caruncular oncocytoma (CO) is a rare ocular neoplasm with an incidence of <3%, as per the Western literature. However, only two cases of ocular oncocytoma are reported in the Indian literature. Here, we report two more cases of CO from India with their histochemical and ultrastructural characteristics.

Tubular apocrine adenoma on vulva: An unusual location

Sarina Jain, Kausar Valiulla, Atul M Dongre, Balasaheb V Malkar

Indian Dermatology Online Journal 2018 9(5):346-348

Methotrexate cutaneous toxicity following a single dose of 10 mg in a case of chronic plaque psoriasis: A possible idiosyncratic reaction

Aastha Gupta, Kabir Sardana, Minakshi Bhardwaj, Ajeet Singh

Indian Dermatology Online Journal 2018 9(5):328-330

Low-dose methotrexate is a well-tolerated and inexpensive systemic immunosuppressive agent used commonly in dermatology. However, several adverse events such as pancytopenia, pneumonitis, mucositis, and cutaneous ulcerations may develop during acute toxicity with dose-dependent or idiosyncratic mechanisms. Risk factors for methotrexate toxicity include advanced age, hypoalbuminemia, renal dysfunction, and concomitant drugs increasing the level of methotrexate in the body. We present a case of methotrexate toxicity presenting with classical features along with mucocutaneous side-effects, such as ulceration of psoriatic plaques and acral erythema, following a single dose of methotrexate.

Unilateral facial telangiectasia macularis eruptiva perstansmimicking as rosacea

Preema Sinha, Anwita Sinha, Deep K Raman, Aradhana Sood

Indian Dermatology Online Journal 2018 9(5):351-353

The mTOR-inhibitor Sirolimus decreases the cyclosporine-induced expression of the oncogene ATF3 in human keratinocytes

Cutaneous Squamous cell carcinoma (cSCC) is after basal cell carcinoma the second most common non-melanoma skin cancer and accounts for 20% of all cutaneous malignancies [1]. Particularly effected are organ transplant recipients (OTRs) with a 65 to 250 higher risk than the general population due to their immunosuppression as major risk factor [2]. Moreover, cSCC in OTRs are often quite aggressive with high recurrence rates, metastasis and death [3]. The most widely used agents to prevent graft rejection in solid OTRs are calcineurin-inhibitors in combination with mycophenolate mofetil (MMF) and corticosteroids as the standard triple therapy especially after renal transplantation.

sOPTIMISING EXPOSURE OF THE CORONOID PROCESS DURING LENGTHENING TEMPORALIS MYOPLASTY FOR FACIAL REANIMATION

Dear Sir,

Sweaty feet in adolescents—Early use of botulinum type A toxin in juvenile plantar hyperhidrosis

Pediatric Dermatology, EarlyView.

Melanotic neuroectodermal tumor of infancy: A rare pediatric head and neck lesion

Pediatric Dermatology, EarlyView.

Long-term follow-up of a community sample of adolescents with frequent headaches

Several outcome studies have reported on the short- and long-term effects of migraine in selected clinical samples of children and adolescents. However, current knowledge of the course, incidence, and outcome ...

Congenital Syphilis—Still a Shadow on the Land

The US Surgeon General, Thomas Parran, chose an ominous phrase—Shadow on the Land—as the title of his best-selling book about syphilis, published in 1937. It was not without reason. At the time, according to Parran, nearly 700 000 Americans were being treated for syphilis, constituting only a fraction of the approximately 1.7 million that he estimated needed treatment. At least 500 000 new infections occurred in the United States each year, Parran stated, including 60 000 cases of congenital syphilis. Cardiovascular syphilis claimed 40 000 lives each year. The arsenic-containing compound salvarsan, supplemented with mercury or bismuth, was the most effective treatment. Syphilis, Parran wrote, was "the most urgent public health problem in this country today."^(p52)

Plankton community assessment in anthropogenic-impacted oligotrophic coastal regions

Abstract

Microbial planktonic communities are critical components of marine biogeochemical pathways. Despite this, there is still limited knowledge on the dynamics of this group in warm and oligotrophic waters. We used high-throughput sequencing to characterise the bacterial (16S rRNA) and eukaryotic (18S rRNA) microbial plankton communities in two regions under the influence of anthropogenic impacts (a port and sewage outflow) and a coastal region with no direct anthropogenic disturbances in the central Red Sea. Overall, bacterial and eukaryotic components responded in a similar way to the environmental conditions. Community composition and structure were more sensitive than alpha diversity measures to environmental impacts. With the exception of eukaryotes, for which the number of OTU differed significantly between sampling periods in all the regions, environmental changes associated with anthropogenic pressures seem to be better reflected by variations in the relative dominance of microbial groups. For example, elevated proportional abundances of nitrifying and sewage-/faecal-related bacteria at the impacted sites were observed compared with the coastal region. The recently developed microgAMBI also appeared to correlate well with the level of anthropogenic impact the regions experienced, showing the potential to be applied in oligotrophic waters.

Nitrate leaching from open-field and greenhouse vegetable systems in China: a meta-analysis

Abstract

The potential for nitrate leaching in Chinese vegetable systems is substantial because of high inputs of nitrogen (N) fertilizer and water. To quantify the nitrate leaching and identify the key controlling factors in Chinese vegetable systems, we conducted a meta-analysis that included 221 data sets from 18 field studies. The results revealed that nitrate leaching over the entire crop growing season in Chinese vegetable systems was very high and averaged 79.1 kg N ha⁻¹ and primarily resulted from extremely high N fertilizer inputs (in average 423 kg N ha⁻¹). Nitrate leaching was, on the average, 63.9% greater in the greenhouse systems (98.0 kg N ha⁻¹) than in open-field systems (59.8 kg N ha⁻¹). The leaching factor, defined as the proportion of the quantity of N applied to soils that was lost due to nitrate leaching, averaged 14.6% overall and was significantly lower in greenhouse systems (10.9%) than in open-field systems (18.4%). This difference appears to be due to lower of the total water inputs (irrigation + precipitation) in greenhouse systems. Nitrate leaching increased with water input, the number of growing days, and the N rate. The nitrate leaching response to increasing N rate was linear. The leaching factor significantly increased with water input but was not affected by the N rate or the number of growing days. Compared with application of synthetic fertilizer alone, the application of manure alone or manure plus synthetic fertilizer significantly reduced both the nitrate leaching and the leaching factor in open-field and greenhouse systems. These results suggest that nitrate leaching in Chinese vegetable systems can be reduced by optimizing rates of N and water supply to synchronize crop needs. Application of mixed synthetic N fertilizer and manure is more effective in reducing nitrate leaching, compared to synthetic N only.

Influence of earthworms on the nitrogen transfer of sewage sludge in the vermifilter process

Abstract

A 6-year laboratory study was conducted to explore the performance of the vermifilter (VF) on reducing sewage sludge. Sewage sludge was found to be reduced significantly in the VF and exhibited a better performance of sludge reduction as compared with the conventional biofilter (BF), which could be traced through the nitrogen-rich organic matter. The nitrogen stable isotope technology was applied to study the matter flow of sewage sludge in the VF process and the influence of earthworms Eisenia fetida on sewage sludge reduction. Results showed that (1) the protein material could be consumed more than the polysaccharide and lipid materials, respectively, in the VF; (2) the presence of earthworms could enhance the consumption capacity of the VF on the protein-rich material of the sewage sludge; (3) earthworms played a leading role on the nitrogen lifting of the sewage sludge, leading to the performance difference of the effluent sludge or biofilm sludge between the VF and BF; (4) in the VF, nitrogen-isotope accumulation in either biofilms or earthworms happened more significantly in the lower layer than in the upper one, while nitrogen transfer of sewage sludge happened more significantly in the upper layer than in the lower one; (5) earthworms improved the feeding environment of organisms (microorganisms in biofilms, moth fly larvae, Limacidaes, and Lymnaeidaes); (6) biofilms, Limacidaes, and moth fly larvae performed better than leeches, Lymnaeidaes, and moth fly adults at nitrogen transfer of sewage sludge.

Molecular variability and genetic structure of White spot syndrome virus strains from northwest Mexico based on the analysis of genomes

Abstract

White spot syndrome virus (WSSV) has a ∼300 kb double-stranded DNA genome. It originated in China, spread rapidly through shrimp farms in Asia, and subsequently to America. This study determined complete genome sequences for nine historic WSSV strains isolated from Pacific white shrimp (Litopenaeus vannamei) captured in farm ponds in northwest Mexico (Sinaloa and Nayarit). Genomic DNA was captured by an amplification method using overlapping long-range PCR and sequencing by Ion Torrent-PGM. Complete genome sequences were assembled (length range 255–290 kb) and comparative genome analysis with WSSV strains revealed substantial deletions (3 and 10 kb in two regions) in seven strains, with two strains differing from the rest. Phylogenetic analysis identified that the WSSV strains from the northern area of the state of Sinaloa clustered with strains from China (LC1, LC10, DVI) and Korea (ACF2, ACF4), while those from the southern region of the state of Nayarit (AC1 and JP) differed from both of those and from strains found in Taiwan and Thailand. Our data offer insights into the diversity of the WSSV genome in one country and their divergent origin, suggest that it entered Mexico via multiple routes and that specific genome regions can accommodate substantial deletions without compromising viability.

Tracing sediment sources in a mountainous forest catchment under road construction in northern Iran: comparison of Bayesian and frequentist approaches

Abstract

Development and land use change lead to accelerated soil erosion as a serious environmental problem in river catchments in Iran. Reliable information about the sources of sediment in catchments is therefore necessary to design effective control strategies. This study used a composite sediment source tracing procedure to determine the importance of forest road cuttings as a sediment source in a mountainous catchment located in northern Iran. A fallout radionuclide (¹³⁷Cs) and 12 geochemical tracers (Ca, Cu, Fe, K, Mg, Mn, Na, Ni, OC, Pb, Sr and TN) were used to determine the relative contributions of three sediment source types (hillslopes, road cuttings and channel banks) to both suspended and bed sediment samples. Two mixing models based on different mathematical concepts were used to apportion the sediment sources: the mixture sampling importance resampling Bayesian model which incorporates the mass-balance matrix and a distribution model using normal and summed probability of normal distributions. The results of both mixing models indicated that sub-soil erosion from road cuttings and channel banks dominated the sources of river bed and suspended sediment samples, respectively. These results therefore highlight that conservation that works in the study area to remedy the sediment problem should initially focus on stabilisation and rehabilitation of road cuttings and channel banks. This successful application of a composite (radionuclide and geochemical) tracing technique for discriminating source end members characterised by different erosion processes underscores the importance of sub-soil erosion in this case study.

Behandlung des nichtkleinzelligen Lungenkarzinoms

Zusammenfassung

Die stadienabhängige Behandlung des nichtkleinzelligen Lungenkarzinoms unterliegt Veränderungen. In den frühen Stadien ist die Resektion, gefolgt von einer adjuvanten Chemotherapie bei Lymphknotenbefall oder großem Tumor, der Standard. Das Stadium III ist eine Domäne der Chemoradiotherapie, in Zukunft gefolgt von einer Konsolidierungstherapie mit einem Checkpointinhibitor. Unter gewissen Umständen hat in diesem Stadium auch die Resektion einen Stellenwert. Die größten Veränderungen sind bei metastasierter Erkrankung zu erwarten. Neue Medikamente und Kombinationen gegen Tumoren mit Treibermutationen sowie die Kombinationen von Chemo- und Immuntherapie werden die Behandlung grundlegend verändern.

Preventive treatment with dizocilpine attenuates oedema in a carrageenan model of inflammation: the interaction of glutamatergic and nitrergic signaling

Abstract

Dizocilpine is a highly selective and potent non-competitive antagonist of the N-methyl-d-aspartate (NMDA) glutamate receptor. It is well known that dizocilpine has different neuroprotective effects in animal models of pain, epilepsy and oedema during trauma. The search for alternative antiinflammatory drugs is ongoing. We investigated the anti-oedematous effects of dizocilpine and the probable mechanism of action in a rat model that mimics local and persistent inflammation without tissue injury or damage. Male Wistar rats were injected with 100 μL of 0.5% carrageenan to the plantar surface of the hind paw. Anti-oedematous activity was assessed in the carrageenan-induced paw inflammatory oedema test with a plethysmometer. To assess possible mechanisms of dizocilpine action, we examined the effects of the selective inhibitor of neuronal [N-ω-propyl-l-arginine hydrochloride (L-NPA)] and inducible [S-methylisothiourea (SMT)] nitric oxide synthase (NOS). Dizocilpine after systemic (0.0005, 0.005 and 0.02 mg/kg, subcutaneous (s.c.)), but not after local peripheral administration, reduced the paw inflammatory oedema. The effect is not dose dependent, and the highest decrease by about 47% at the time of maximally developed oedema was achieved with 0.005 mg/kg. Intraperitoneally (i.p.) administered L-NPA (0.5, 1 and 2 mg/kg) or SMT (0.005, 0.01 and 0.015 mg/kg) before dizocilpine abolished or reduced the anti-oedematous effect of dizocilpine by about 70–85%. An acute single dose of dizocilpine administered before inducing oedema systemically reduced the development of inflammatory oedema. The mechanism of the anti-oedematous effect includes, at least partially, an increase in nitric oxide (NO) production.

Ranking skin‐sensitizing hair dye molecules according to their potency by the use of human cells

Contact Dermatitis, EarlyView.

Dietary soyasaponin attenuates 2,4‐dinitrofluorobenzene‐induced contact hypersensitivity via gut microbiota in mice

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

Immunohistochemistry of p16 in nevi of pregnancy and nevoid melanomas

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.

Influence of Relative Humidity on Electrodermal Levels and Responses

Background/Aim: Electrodermal activity (EDA) is a widely used measure in psychophysiological research, and its use in wearable devices has grown in recent times. It is recommended to have proper conditions for EDA measurement, and skin hydration is one factor that has a significant influence. It is, however, not known to what extent the ambient humidity influences the recording. This study explored the influence of relative humidity (RH) on EDA levels, and also the responses using a new technique for simultaneous recording of all measures of EDA: skin conductance (SC), skin susceptance (SS), and skin potential (SP) at the same skin site. Methods: A total of 10 healthy subjects were exposed to environments of low and high RH while EDA measures were recorded, including cognitive, visual and breathing stimuli for evoking electrodermal responses of different origin. EDA levels and responses were compared between the two humidity levels for all stimuli and all EDA measures. Results: It was found that EDA levels, in particular for SC and SS, were significantly increased during high humidity exposure, but that the change in EDA responses (SC, SS, and SP) was not statistically significant (p #x3e; 0.05, paired t test). Conclusion: This suggests that ambient humidity influences the recording of EDA levels and is important to consider when these parameters are used, but is not important in the recording or analysis of EDA responses.
Skin Pharmacol Physiol 2018;31:298–307

Successful treatment with diclofenac sodium 1% gel of a case of suspected Darier disease

Clinical and Experimental Dermatology, EarlyView.

Determinants of pollution and the role of the military sector: evidence from a maximum likelihood approach with two structural breaks in the USA

Abstract

We investigate the role of military expenditure on emission in USA during the period 1960–2015. To achieve the objectives of this study, two measures of military expenditure are utilised, while several timeseries models are constructed with the gross domestic product (GDP) per capita, population, energy consumption per capita, non-renewable energy consumption per capita, renewable energy consumption per capita, urbanisation, trade openness and financial development serving as additional determinants of air pollution. We also use ecological indicator as an alternative measure of pollution. Moreover, different timeseries methods are utilised including a likelihood-based approach with two structural breaks. The output of this research concluded that all the variables are cointegrated. It is found that military expenditure has mixed impact on CO₂ emissions. Real GDP per capita, energy consumption per capita, non-renewable energy consumption per capita, population and urbanisation increase CO₂ emissions per capita in the long-run, while renewable energy consumption, financial development and trade openness reduce it. There is also evidence for the mixed role of military expenditure, when ecological footprint is utilised as the environmental degradation index. From the output of this research, few policy recommendations are offered for the examined country.

Adsorption of cadmium, nickel and lead ions: equilibrium, kinetic and selectivity studies on modified clinoptilolites from the USA and RSA

Abstract

The performance of modified clinoptilolites (zeolites) from two different sources (South Africa and the USA) for the adsorption of Ni²⁺, Cd²⁺ and Pb²⁺ from synthetic industrial effluent contaminated with metal concentration levels at 50, 150 and 500 ppm was evaluated. The selectivity of the clinoptilolite for the adsorption of Ni²⁺, Cd²⁺ and Pb²⁺ was investigated with mixed feed solutions containing all three ions in equal concentrations and single-component concentrations containing only one of the ions. The homoionic forms of the clinoptilolite were made of Na⁺, K⁺ and Ca²⁺. Batch experiments were then conducted to measure the uptake of metals by the zeolites. The zeolites were characterised using SEM, XRD and BET. The South African clinoptilolite showed a higher surface area and pore volume (17.52m²/g and 0.047cm³/g respectively) than the USA zeolite (12.26m²/g and 0.028cm³/g respectively) for the Na⁺ homoionic form. According to the equilibrium studies, the selectivity sequence was found to be Pb²⁺ > Cd²⁺ > Ni²⁺, with good fits being obtained using Langmuir and Freundlich adsorption isotherms for low metal concentrations. Examples of equilibrium adsorption capacities for RSA and USA clinoptilolite modified with Na⁺ for Pb were 26.94 mg/g and 27.06 mg/g when RSA-Na⁺ and USA-Na⁺ were used respectively. The adsorption was found to depend on the homoionic form of the zeolite and to a lesser extent the source of the zeolite. The selectivity of a particular zeolite for a particular heavy metal can be altered by the homoionic form of the zeolite. Overall, the adsorption capacity of the USA clinoptilolite was higher than the adsorption capacity of the SA clinoptilolite, revealing the potential of clinoptilolite in metal-polluted industrial effluent treatment.

Expression of hormone receptors, adipophilin, and GCDFP‐15 in mucinous carcinoma of the skin

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.

The Sjögren's syndrome‐associated autoantigen Ro52/TRIM21 modulates follicular B cell homeostasis and immunoglobulin production

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

Melanoma and mastocytosis: is really only a coincidence?

Clinical and Experimental Dermatology, EarlyView.

Use of vismodegib for the treatment of multiple basal cell carcinomas in a patient with xeroderma pigmentosum

Pediatric Dermatology, EarlyView.

Yellowish‐orange plaques and slack skin in a Chinese boy

Australasian Journal of Dermatology, EarlyView.

Allergic contact dermatitis caused by propolis‐enriched honey: A case of severe penile oedema

Australasian Journal of Dermatology, EarlyView.

Multimodal therapy: Holistic approach

TM Srinivasan

International Journal of Yoga 2018 11(3):175-176

Yoga as an integrative approach for prevention and treatment of oral cancer

Akshay Anand, Atul Kumar Goyal, Jaimanti Bakshi, Kaushal Sharma, Dharam Vir, Anita Didi

International Journal of Yoga 2018 11(3):177-185

Despite tremendous advancements in medicine, the number of oral cancer cases continues to increase, and the need for integrating alternate medicine or adopting an integrative approach has become a compelling cost-effective requirement for the management and treatment of diseases. Conventional treatment of oral cancer involves surgery followed by radiotherapy with or without chemotherapy which causes several complications including poor quality of life and high chances of recurrence of cancer. Oral cancer is often linked with obesity which is major risk factors in other cancers. Apart from obesity, oral cancer is thought to have an inverse relation with neurodegenerative disorders presumably because cell death decreases in the former case and increases in the latter. Ancient mind–body techniques such as yoga have not been adequately tested as a tool to synergize the cellular equilibrium pertaining to the treatment of oral cancer. Nerve growth factor (NGF), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) are among the early experimental cellular biomarkers that may be used to probe the modulation of oral cancer, obesity, and neurodegenerative disorders. Yoga has been reported to influence these molecules in healthy individuals but whether their expression can be altered in patients of oral cancer by yoga intervention is the subject of this research being discussed in this review article. Therefore, the present article not only reviews the current status of research studies in oral cancer, obesity, and neurodegenerative disorders but also how these are linked to each other and why the investigations of the putative NGF pathway, involving TNF-α and IL-6, could provide useful clues to understand the molecular effects brought about by yoga intervention in such patients.

Effect of yoga-nidra on adolescents well-being: A mixed method study

Bhalendu S Vaishnav, Smruti B Vaishnav, Vibha S Vaishnav, Jagdish R Varma

International Journal of Yoga 2018 11(3):245-248

Context: Adolescent well-being is a priority area for health-care interventions in the 21st century. Yoga-nidra is an ancient Indian method of enabling individuals to attain a positive state of deep physical, mental, and emotional relaxation. The practice produces a state of simultaneous relaxation and detachment resulting in inner awareness and release of stress on all planes of one's being. Aim: This mixed method study was carried out in adolescent students aged 13–15 years with an aim to assess effects of Yoga-nidra on various dimensions of well-being. Materials and Methods: Thirty-six students received Yoga-nidra sessions 30 min daily for 3 days in a week for 1 month. Primary outcome measures were happiness, perceived stress, overall quality of life, and psychological general well-being. These and other experiential dimensions of well-being comprising of enthusiasm, alertness, quietude, clarity of thought, control over anger, self-confidence, and self-awareness were evaluated before and after intervention. Qualitative observations were recorded from participants, their teachers, and parents. Results of quantitative and qualitative methods were analyzed and compared. Results: Yoga-nidra intervention resulted in significant improvement in all primary outcome measures. Participants reported significant improvement in the feelings of happiness, enthusiasm, quietude, being more inspired and alert, active, having clarity of thought, control over anger, and self-confidence at the end of the study period. Mixed method design of the study provided cross-validation and convergence of results obtained from quantitative and qualitative assessment tools. Conclusion: Yoga-nidra is beneficial in improving multiple dimensions of adolescent well-being.

Implication of asana, pranayama and meditation on telomere stability

Mrithunjay Rathore, Jessy Abraham

International Journal of Yoga 2018 11(3):186-193

Telomeres, the repetitive sequences that protect the ends of chromosomes, help to maintain genomic integrity and are of key importance to human health. Telomeres progressively shorten throughout life and a number of studies have shown shorter telomere length to be associated with lifestyle disorders. Previous studies also indicate that yoga and lifestyle-based intervention have significant role on oxidative DNA damage and cellular aging. However, very few publications investigate telomere stability and its implication from the point of view of asana, pranayama, and meditation. In this context, a review was conducted to systematically assess the available data on the effectiveness of asana, pranayama, and meditation in maintaining telomere and telomerase. Literature search was performed using the following electronic databases: Cochrane Library, NCBI, PubMed, Google Scholar, EMBASE, and Web of Science. We explored the possible mechanisms of how asana, pranayama, and meditation might be affecting telomere length and telomerase. Moreover, results showed that asana and pranayama increase the oxygen flow to the cells and meditation reduces the stress level by modulating the hypothalamic–pituitary–adrenal axis. Summing up the result, it can be concluded that practice of asana, pranayama, and meditation can help to maintain genomic integrity and are of key importance to human health and lifestyle disorders.

Effect of yoga-based ocular exercises in lowering of intraocular pressure in glaucoma patients: An affirmative proposition

Sankalp , Tanuj Dada, Raj Kumar Yadav, Muneeb Ahmad Faiq

International Journal of Yoga 2018 11(3):239-241

Glaucoma is the most common cause of irreversible blindness worldwide, with >65 million sufferers. It is incurable and the only therapeutic approach accepted till now is the lowering of intraocular pressure (IOP) medically and/or surgically. These known interventions might have many side effects and complications. Yoga-based interventions are now well accepted as alternative therapy in many chronic diseases. The effects of yoga in glaucoma, however, have not been studied adequately. Accommodation (the process of adjustment of optical power to maintain clear vision) of eyes leads to instant lowering of IOP. Therefore, we hypothesize that one of the yoga-based interventions, Tratak kriya, which includes ocular exercises might lead to lowering of IOP in glaucoma patients. The proposed Tratak kriya leads to contraction and relaxation of ciliary muscles which might increase outflow of aqueous humor. In addition, this yoga-based intervention might decrease stress and improve quality of life in glaucoma patients.

Oxygen consumption during viniyoga practice in adults

Gurjeet S Birdee, Sujata Ghosh Ayala, Regina Tyree, Maciej Buchowski

International Journal of Yoga 2018 11(3):194-200

Context: The purpose of this study was to measure the oxygen consumption (V̇O2) during Viniyoga yoga movements (asanas) and to compare V̇O2walking among adults. Methods: Yoga practitioners (n = 10) were recruited to measure V̇O2while at rest (30 min), practicing yoga (16 movements with different variations), and treadmill walking at 2 mph (10 min) and 3 mph (10 min). V̇O2was measured using a whole-room indirect calorimetry. Each yoga movement was categorized by body orientation as standing, lying, and sitting. The differences in V̇O2between yoga and walking were examined using Pearson's correlations. Differences in V̇O2between poses (standing, sitting, and lying) were examined using linear regression models. V̇O2. Results: Mean yoga-V̇O2for the entire yoga session was 3.7 (standard deviation [SD] 0.43, range: 4.4–8.9) ml/kg/min. Yoga-V̇O2varied by body orientation: standing = 7.5 (SD = 1.5) ml/kg/min, lying = 5.3 (SD = 1.0) ml/kg/min, and sitting = 5.4 (SD = 1.1) ml/kg/min. After adjusting for body mass, frequency of yoga practice, and resting energy expenditure, female gender was negatively associated with mean yoga V̇O2for standing (B = −112.19, P < 0.05), lying (B = −141.87, P < 0.05), and sitting (B = −129.96, P < 0.05). Mean V̇O2for walking 2 mph was comparable with sitting (r = 0.836, P < 0.05) and lying (r = 0.735, P < 0.05) whereas walking at 3 mph was comparable with standing (r = 0.718, P < 0.05) and sitting (r = 0.760, P < 0.05). Conclusion: We conclude that V̇O2during yoga practice is comparable to V̇O2during slow treadmill walking and may vary based on gender and body orientation.

Effect of a structured yoga program on fatigue, depression, cardiorespiratory fitness, and quality of life in a postmenopausal breast cancer survivor

Ashwini A Dangi, Sheetal K Aurangabadkar, Medha V Deo

International Journal of Yoga 2018 11(3):255-257

A 52-year-old postmenopausal female diagnosed with duct carcinoma of the left breast underwent modified radical mastectomy 2 years ago. She had completed six cycles of chemotherapy postsurgery and complained of significant fatigue and depression. Her fatigue score on Piper Fatigue Scale was 4.1 and depression score on Beck's Depression Inventory was 22. She had a poor 6-min walking distance and a reduced quality of life. She was given a structured yoga program for 40 min five times a week for 4 weeks. Results showed a marked reduction in fatigue and depression scores and improvement in cardiorespiratory fitness. Her quality of life also showed improvement after the structured yoga therapy. This case report highlights the benefits of yoga for reducing fatigue, depression, and improving the cardiorespiratory fitness and overall quality of life in a breast cancer survivor.

Musculoskeletal modeling and analysis of trikonasana

Arun Kumar, Rohith C Kapse, Navneet Paul, Anil M Vanjare, SN Omkar

International Journal of Yoga 2018 11(3):201-207

Context: Yoga has origins speculated to date back to pre-Vedic Indian period and is practiced as a common exercise, both in India as well as all around the world. Although the yoga practices are ages old, there is not much research literature available. Moreover, with the advancement in technology, the modern analysis tools are not used up to their full potential. Aims: This research focuses on developing a framework for analyzing trikonasana, using the optical motion capture system, and validating the noninvasive method for analyzing muscle activity in prominent muscles while performing trikonasana. Subjects and Methods: We have adopted the noninvasive analysis method using optical motion capture system OptiTrack™ for recording the human motion and musculoskeletal modeling software LifeMod™ to analyze the muscle activity while performing trikonasana. Surface electromyography (sEMG) studies were performed using Trigno™ (Delsys Inc.) wireless sEMG sensors to validate the LifeMod simulation results pertaining muscle activation. Results: It was observed that the characteristics of the sEMG match to that of the estimated muscle tension from the architecture used in this study. The muscle groups such as external right obliques muscles, rectus abdominis of the front leg, and gluteus maximus and gluteus medius of the rear leg were observed to undergo major activation during an isometric contraction while performing trikonasana. The magnitudes of the muscle tension during the left bend depict a close resemblance to the muscle tension magnitudes during the right bend. Conclusions: The optical motion capture system and musculoskeletal modeling software can be used to analyze muscle activity in any yoga exercise noninvasively. Since the yoga exercises majorly require the practitioner to maintain a certain posture for a considerable duration, our approach can be used to find the important muscles involved and their corresponding muscle tension when they undergo isometric contraction.

Development and validation of integrated yoga module for obesity in adolescents

Sunanada Surendra Rathi, Nagarathna Raghuaram, Padmini Tekur, Ruchira Rupesh Joshi, Nagendra Hongasandra Ramarao

International Journal of Yoga 2018 11(3):231-238

Background: Obesity is a growing global epidemic and cause of noncommunicable diseases. Yoga is one of the effective ways to reduce stress which is one of the causes of obesity. Nowadays, children in adolescent age are more prone to get obese due to lack of physical activity making them more sedentary. Aim: To identify the design and validation of Integrated Approach of Yoga Therapy Module (IAYTM) for obesity in adolescents. Materials and Methods: First phase – IAYTM for obesity was designed based on the literature review of classical texts and recently published research articles. Second phase – Designed IAYTM was validated by 16 subject matter (yoga) experts. Content-validity ratio (CVR) was analyzed using Lawshe's formula. Results: Yoga practices were designed for Integrated Yoga Module for Obesity in Adolescents. Yoga practices with CVR ≥0.5 and which were validated by 16 yoga experts and approved in faculty group discussion were included in final Integrated Yoga Therapy Module. Conclusion: The yoga practices were designed and validated for IAYTM for obesity in adolescents.

A randomized trial comparing effect of yoga and exercises on quality of life in among nursing population with chronic low back pain

Nitin J Patil, R Nagaratna, Padmini Tekur, PV Manohar, Hemant Bhargav, Dhanashri Patil

International Journal of Yoga 2018 11(3):208-214

Background: Chronic low back pain (CLBP) adversely affects quality of life (QOL) in nursing professionals. Integrated yoga has a positive impact on CLBP. Studies assessing the effects of yoga on CLBP in nursing population are lacking. Aim: This study was conducted to evaluate the effects of integrated yoga and physical exercises on QOL in nurses with CLBP. Methods: A total of 88 women nurses from a tertiary care hospital of South India were randomized into yoga group (n = 44; age – 31.45 ± 3.47 years) and physical exercise group (n = 44; age – 32.75 ± 3.71 years). Yoga group was intervened with integrated yoga therapy module practices, 1 h/day and 5 days a week for 6 weeks. Physical exercise group practiced a set of physical exercises for the same duration. All participants were assessed at baseline and after 6 weeks with the World Health Organization Quality of Life-brief (WHOQOL-BREF) questionnaire. Results: Data were analyzed by Paired-samples t-test and Independent-samples t-test for within- and between-group comparisons, respectively, using the Statistical Package for the Social Sciences (SPSS). Within-group analysis for QOL revealed a significant improvement in physical, psychological, and social domains (except environmental domain) in both groups. Between-group analysis showed a higher percentage of improvement in yoga as compared to exercise group except environmental domain. Conclusions: Integrated yoga was showed improvements in physical, psychological, and social health domains of QOL better than physical exercises among nursing professionals with CLBP. There is a need to incorporate yoga as lifestyle intervention for nursing professionals.

Add-on yoga therapy for social cognition in schizophrenia: A pilot study

Ramajayam Govindaraj, Shalini Naik, NK Manjunath, Urvakhsh Meherwan Mehta, BN Gangadhar, Shivarama Varambally

International Journal of Yoga 2018 11(3):242-244

Background: Yoga as a mind–body therapy is useful in lifestyle-related disorders including neuropsychiatric disorders. In schizophrenia patients, yoga has been shown to significantly improve negative symptoms, functioning, and plasma oxytocin level. Aim: The aim of the study was to study the effect of add-on yoga therapy on social cognition in schizophrenia patients. Materials and Methods: In a single pre-post, study design, 15 schizophrenia patients stabilized on antipsychotic medication for 6 weeks were assessed for social cognition (theory of mind, facial emotion recognition, and social perception [SP]) and clinical symptoms (negative and positive symptoms and social disability) before and after twenty sessions of add-on yoga therapy. Results: There was a significant improvement in the social cognition composite score after 20 sessions of yoga (t[13] = −5.37, P≤ 0.001). Clinical symptoms also reduced significantly after twenty sessions of yoga. Conclusion: Results are promising to integrate yoga in clinical practice, if proven in well-controlled clinical trials.

The impact of yoga Nidra and seated meditation on the mental health of college professors

Camila Ferreira-Vorkapic, Claudio Joaquim Borba-Pinheiro, Murilo Marchioro, Daniel Santana

International Journal of Yoga 2018 11(3):215-223

Background: World statistics for the prevalence of anxiety and mood disorders shows that a great number of individuals will experience some type of anxiety or mood disorder at some point in their lifetime. Mind–body interventions such as Hatha Yoga and seated meditation have been used as a form of self-help therapy and it is especially useful for challenging occupations such as teachers and professors. Aims: In this investigation, we aimed at observing the impact of Yoga Nidra and seated meditation on the anxiety and depression levels of college professors. Materials and Methods: Sixty college professors, men and women, aged between 30 and 55 years were randomly allocated in one of the three experimental groups: Yoga Nidra, seated meditation, and control group. Professors were evaluated two times throughout the 3-month study period. Psychological variables included anxiety, stress, and depression. Results: Data analysis showed that the relaxation group presented better intragroup results in the anxiety levels. Meditation group presented better intragroup results only in the anxiety variable (physical component). Intergroup analysis showed that, except for the depression levels, both intervention groups presented better results than the control group in all other variables. Conclusions: Prepost results indicate that both interventions represent an effective therapeutic approach in reducing anxiety and stress levels. However, there was a tendency toward a greater effectiveness of the Yoga Nidra intervention regarding anxiety, which might represent an effective tool in reducing both cognitive and physiological symptoms of anxiety.

Home-Based yoga program for the patients suffering from malignant lymphoma during chemotherapy: A feasibility study

Gurpreet Kaur, Gaurav Prakash, Pankaj Malhotra, Sandhya Ghai, Sukhpal Kaur, Mahender Singh, Kulbeer Kaur

International Journal of Yoga 2018 11(3):249-254

Background: Yoga is proven beneficial in improving quality of life among breast cancer survivors receiving chemotherapy, but its effectiveness in lymphoma patients needs to be explored. As chemotherapy-induced neutropenia is very common among lymphoma patients, they are much prone to infections from the environment. Furthermore, trained yoga instructors are not available in every setting, so there is a need to develop home-based yoga program modules for lymphoma patients receiving chemotherapy. Aim: The aim of the study was to explore the feasibility and safety of yogic exercises among lymphoma patients during chemotherapy. Subjects and Methods: An interventional, single-arm prepost design study was conducted at a tertiary health-care center. Patients suffering from malignant lymphoma (18–65 years) with Eastern Cooperative Oncology Group performance status from 0 to 2, planned to receive chemotherapy were administered a home-based yoga program over a period of 2 months from the start of chemotherapy. The primary outcome variables were retention rate, acceptance rate, safety, and adherence. Health-related quality of life (HRQOL), fatigue level, overall sleep quality, depression, anxiety level, and pain were also assessed. Statistical Analysis: Descriptive statistics was used to see the feasibility and adherence. The paired t-test was used to compare various pre and postintervention outcome measures. Results: Fourteen patients (median age: 36 years, range13–65 years) of malignant lymphoma were enrolled in the study. Male-to-female ratio was 9:5. Non-Hodgkin's lymphoma patients constituted 64%. The recruitment rate was 93%. Favorable retention (100%), acceptability (97%), adherence (78.6%), and no serious adverse events following yoga practice were reported. Improvement was also found in HRQOL, fatigue, sleep, depression, and anxiety. However, it needs further validation in a randomized study. Conclusion: Home-based yoga program is safe and feasible among the patients suffering from malignant lymphoma receiving chemotherapy.

Changes in reaction time after yoga bellows-type breathing in healthy female volunteers

Shirley Telles, Sushma Pal, Ram Kumar Gupta, Acharya Balkrishna

International Journal of Yoga 2018 11(3):224-230

Background: Previously, yoga bellows-type breathing (bhastrika pranayama) reduced reaction time (RT) or reduced anticipatory responses in male participants or a mixed group of male and female participants. Aims: The present study as a control trial aimed to assess the effects of yoga bellows-type breathing on RT in females exclusively. Methods: The sample consisted of 25 healthy females, aged between 19 and 32 years (group mean ± standard deviation, 22.8 ± 3.5 years). All of them had prior minimum experience of yoga including yoga bellows-type breathing of 12 months. The RT was assessed in each participant before and after three randomized sessions differed in the intervention given held on three separate days. The sessions were (i) YOGA bellows-type breathing or bhastrika pranayama(BHK), (ii) Breath awareness (BAW), and (iii) Sitting quietly (CTL) as a control session. The duration of the intervention was 18 min, and the participants were assessed for RT before and after the intervention. Results: Repeated measures ANOVA, post hoc tests with Bonferroni adjusted showed that the time taken to obtain a correct response reduced significantly after 18 min of BAW (P < 0.05) and CTL (P < 0.05). However, no changes were seen in the RT after BHK. Conclusions: The results suggest that different interventions may optimize performance in tasks requiring attention in females compared to males.

Model, methods, and perspectives in yoga

Ananda Balayogi Bhavanani

International Journal of Yoga 2018 11(3):258-260

Airborne foliar transfer of particular metals in Lactuca sativa L.: translocation, phytotoxicity, and bioaccessibility

Abstract

The uptake, translocation, and human bioaccessibility of metals originating from atmospheric fine particulate matters (PM) after foliar exposure is not well understood. Lettuce (Lactuca sativa L.) plants were exposed to micronic PbO, CuO, and CdO particulate matters (PMs) by the foliar pathway and mature plants (6 weeks old) were analyzed in terms of: (1) metal accumulation and localization on plant leaf surface, and metal translocation factor (TF) and global enrichment factor (GEF) in the plants; (2) shoot growth, plant dry weight (DW), net photosynthesis (Pn), stomatal conductance (Gs), and fatty acid ratio; (3) metal bioaccessibility in the plants and soil; and (4) the hazard quotient (HQ) associated with consumption of contaminated plants. Substantial levels of metals were observed in the directly exposed edible leaves and newly formed leaves of lettuce, highlighting both the possible metal transfers throughout the plant and the potential for human exposure after plant ingestion. No significant changes were observed in plant biomass after exposure to PbO, CuO, and CdO-PMs. The Gs and fatty acid ratio were increased in leaves after metal exposure. A dilution effect after foliar uptake was suggested which could alleviate metal phytotoxicity to some degree. However, plant shoot growth and Pn were inhibited when the plants are exposed to PbO, and necrosis enriched with Cd was observed on the leaf surface. Gastric bioaccessibility of plant leaves is ranked: Cd > Cu > Pb. Our results highlight a serious health risk of PbO, CuO, and CdO-PMs associated with consumption of vegetables exposed to these metals, even in newly formed leaves in the case of PbO and CdO exposure. Finally, the study highlights the fate and toxicity of metal rich-PMs, especially in the highly populated urban areas which are increasingly cultivated to promote local food.

Zn(II), Pb(II), and Cd(II) adsorption from aqueous solution by magnetic silica gel: preparation, characterization, and adsorption

Abstract

A novel magnetic silica gel adsorbent (Fe₃O₄-Si-COOH) was successfully prepared by introducing carboxyl group in situ to improve the performance for Pb(II), Zn(II), and Cd(II) adsorption. Infrared spectroscopy (IR), scanning electron microscope (SEM), transmission electron microscope (TEM), thermo-gravimetric analyzer (TGA), the Brunauer-Emmett-Teller (BET) surface area, X-ray diffraction (XRD), and vibrating sample magnetometer (VSM) characterizations suggested that Fe₃O₄-Si-COOH has been successfully prepared. The adsorption performance was evaluated by batch experiments with different initial concentrations, ionic strength, contact time, and pH. The adsorption kinetics data followed pseudo-second-order model and exhibited a three-stage intraparticle diffusion mode. Isothermal adsorption equilibrium data were best fitted by the Freundlich model and the adsorption capacity were 155, 110, and 93 mg/g (initial concentration 210 mg/L) for Pb(II), Zn(II), and Cd(II), respectively. The result of X-ray photoelectron spectroscopy (XPS) survey spectrum suggested that the main adsorption mechanism is that the H⁺ of carboxyl groups exchanged with heavy metal ions in the adsorption processes. In addition, the adsorbed Fe₃O₄-Si-COOH could be regenerated and the adsorption capacity of reused Fe₃O₄-Si-COOH could maintain 80.3% after five cycles. Hence, the Fe₃O₄-Si-COOH could be a kind of potential material for removing Pb(II), Zn(II), and Cd(II) from wastewater.

Graphical abstract

Cadmium accumulation and subcellular distribution in populations of Hylotelephium spectabile (Boreau) H. Ohba

Abstract

A pot experiment was conducted among six populations of Hylotelephium spectabile (Boreau) H. Ohba: four from Jiangsu province, one from Shandong province, and one from Shanxi province, China, to investigate the variation of Cd accumulation and subcellular distribution of this species (a newly reported Cd high accumulator). Under five different real Cd-contaminated soils (Cd: 0.93–97.97 mg/kg), results showed considerable differences in Cd concentration in (a) leaf (1.09–50.7 mg/kg), (b) stem (0.61–13.0 mg/kg), and (c) root (1.55–24.5 mg/kg) among the populations. Analysis of subcellular Cd distribution indicated that Cd accumulated in the leaves of H. spectabile was mainly in the cellular debris (44.1 to 53.5%), followed by heat-stable protein (HSP, 20.9 to 29.0%), Cd-rich granules (MRG, 9.9 to 19.5%), heat-denatured protein (6.0 to 8.5%), and organelle fractions (3.1 to 7.4%). The populations of H. spectabile with more Cd partitioned to cellular debris and biological detoxified metal (HSP + MRG) fractions have greater capacity to accumulate Cd, indicating the probable intrinsic mechanism to accumulate Cd. Therefore, H. spectabile has the considerable potential of phytoremediation for Cd-contaminated soils, but screening suitable populations according to soil Cd concentrations is necessary before used for phytoremediation of Cd-contaminated soils.

Plant uptake and translocation of perfluoroalkyl acids in a wheat–soil system

Abstract

Application of per- and polyfluoroalkyl substances (PFASs) is shifting to short-chain analogs (C ≤ 6) that raises concerns for their potential ecotoxicological risks. In the present study, pot experiments were carried out to study the effects of perfluoroalkyl acids (PFAAs), including perfluoroalkyl carboxylic acids (PFCAs) and perfluoroalkyl sulfonic acids (PFSAs), with different carbon chain lengths (C4, C6, and C8) on the growth of wheat seedlings and their plant uptake and transfer at two spiking levels (200 and 2000 μg/kg soil). Exposure to C4 PFAAs slightly inhibited chlorophyll activity, whereas exposure to C8 PFAAs showed enhancement. The bioaccumulation factors (BAFs) for C4 PFAAs in wheat were over 10, while BAFs for C8 PFAAs were all below 1. Rhizospheric and root to shoot transfer factors for PFAAs were both negatively correlated with their log K_ow (p < 0.05). PFCAs exhibited both higher rhizospheric mobility and accumulation potentials than PFSAs of the same chain lengths. Hence, perfluoroalkyl chain governs the mobility of PFAAs in a soil–plant system besides interactions of their head groups, and the substitution with shorter chain PFASs raises concerns for their higher plant accumulation potential that brings higher ecotoxicological and human exposure risks via food chains.

The concentration of heavy metals in noodle samples from Iran’s market: probabilistic health risk assessment

Abstract

In the current study, the concentration of heavy metals including lead (Pb), chromium (Cr), cadmium (Cd), and aluminum (Al) in commonly instant noodles consumed in Iran (either imported from other countries or produced in Iran) was investigated by acid digestion method followed by an inductively coupled plasma optical emission spectrometry system (ICP-OES). Also, the associated non-carcinogenic risk due to ingestion of heavy metals for adults and children was estimated by calculating percentile 95% target hazard quotient (THQ) in the Monte Carlo simulation (MCS) method. The average concentrations of Pb, Cr, Cd, and Al in Iranian instant noodle samples were measured as 1.21 ± 0.81, 0.08 ± 0.10, 0.03 ± 0.06, and 9.15 ± 4.82 (mg/kg) and in imported instant noodle samples were 1.00 ± 0.61, 0.07 ± 0.07, 0.04 ± 0.03, and 15.90 ± 0.93 (mg/kg), respectively. A significant difference (p value < 0.05) in the mean concentration of Pb, Cr, Cd, and Al of Iranian instant noodle and imported instant noodle samples was observed. Also, the concentration of Pb, Cr, Cd, and Al in all brands of instant noodle (0.025 mg/kg, 0.050 mg/kg, 0.003 mg/kg, and 0.237 mg/kg, respectively) surpassed the WHO-permitted limits for Pb, Cr, Cd, and Al. Percentile 95% of THQ of Pb, Cr, Cd, and Al for the adult consumers was calculated as 0.012, 0.000007, 0.010, and 1.789; while in the case of children, percentile 95% of THQ of Pb, Cr, Cd, and Al was defined as 0.044, 0.00023, 0.035, and 6.167, respectively. Health risk assessment indicated that both adults and children are at considerable non-carcinogenic health risk for Al (THQ > 1). Therefore, approaching the required strategies in order to reduce the concentration of heavy metals particularly Al in the instant noodle is recommended.

Efficacy of breast reconstruction with fat grafting: A systematic review and meta-analysis

Breast reconstruction with fat grafting is a new alternative to prosthetic implants and flaps for women with breast cancer. In this study, we investigate the efficacy of fat grafting for breast reconstruction in a meta-analysis.

Cartilage sparing surgery for melanoma of the external ear

The excision of melanoma of the external ear poses a challenge to surgeons, who must achieve adequate oncological control while minimising impact on form and function. Cartilage preserving surgery is an attractive option as it leaves behind a scaffold for immediate reconstruction with a variety of techniques including full thickness skin grafts (FTSGs) and local flaps. This manuscript will review the literature comparing cartilage sparing surgery with composite excision of skin and cartilage for the treatment of auricular melanoma.