Transport of Escherichia coli phage through saturated porous media considering managed aquifer recharge

Abstract

Virus is one of the most potentially harmful microorganisms in groundwater. In this paper, the effects of hydrodynamic and hydrogeochemical conditions on the transportation of the colloidal virus considering managed aquifer recharge were systematically investigated. Escherichia coli phage, vB_EcoM-ep3, has a broad host range and was able to lyse pathogenic Escherichia coli. Bacteriophage with low risk to infect human has been found extensively in the groundwater environment, so it is considered as a representative model of groundwater viruses. Laboratory studies were carried out to analyze the transport of the Escherichia coli phage under varying conditions of pH, ionic strength, cation valence, flow rate, porous media, and phosphate buffer concentration. The results indicated that decreasing the pH will increase the adsorption of Escherichia coli phage. Increasing the ionic strength, either Na⁺ or Ca²⁺, will form negative condition for the migration of Escherichia coli phage. A comparison of different cation valence tests indicated that changes in transport and deposition were more pronounced with divalent Ca²⁺ than monovalent Na⁺. As the flow rate increases, the release of Escherichia coli phage increases and the retention of Escherichia coli phage in the aquifer medium reduces. Changes in porous media had a significant effect on Escherichia coli phage migration. With increase of phosphate buffer concentration, the suspension stability and migration ability of Escherichia coli phage are both increased. Based on laboratory-scale column experiments, a one-dimensional transport model was established to quantitatively describe the virus transport in saturated porous medium.

The Normative Foundations of Defamatory Meaning

Abstract

This paper assesses normative arguments regarding four views about defamatory meaning. The moralised view holds that a statement about a person is defamatory if and only if we ought to think less of that person if the statement is true. The nonmoralised view holds that a statement is defamatory if and only if people in fact think less of the subject on hearing the statement. A third - the dual view - can be split into two versions. The first version holds that a statement is defamatory if and only if it satisfies either the moralised or non-moralised views. The second version holds that statements satisfying either view can be defamatory, but they ought to be considered fundamentally different forms of personal defamation, with different remedies, defences and conditions of liability attached. Both the moralised and non-moralised views are rejected because they fail to acknowledge instrumental and intrinsic reputational value respectively. The first version of the dual view is rejected because it compromises the expressive value of defamation, implausibly suggests that truth should be a general defence and fails to recognise that different objections apply to the moralised and nonmoralised views. The upshot is that we ought to accept the second version of the dual view.

Improved medical image fusion based on cascaded PCA and shift invariant wavelet transforms

Abstract

Purpose

In the medical field, radiologists need more informative and high-quality medical images to diagnose diseases. Image fusion plays a vital role in the field of biomedical image analysis. It aims to integrate the complementary information from multimodal images, producing a new composite image which is expected to be more informative for visual perception than any of the individual input images. The main objective of this paper is to improve the information, to preserve the edges and to enhance the quality of the fused image using cascaded principal component analysis (PCA) and shift invariant wavelet transforms.

Methods

A novel image fusion technique based on cascaded PCA and shift invariant wavelet transforms is proposed in this paper. PCA in spatial domain extracts relevant information from the large dataset based on eigenvalue decomposition, and the wavelet transform operating in the complex domain with shift invariant properties brings out more directional and phase details of the image. The significance of maximum fusion rule applied in dual-tree complex wavelet transform domain enhances the average information and morphological details.

Results

The input images of the human brain of two different modalities (MRI and CT) are collected from whole brain atlas data distributed by Harvard University. Both MRI and CT images are fused using cascaded PCA and shift invariant wavelet transform method. The proposed method is evaluated based on three main key factors, namely structure preservation, edge preservation, contrast preservation. The experimental results and comparison with other existing fusion methods show the superior performance of the proposed image fusion framework in terms of visual and quantitative evaluations.

Conclusion

In this paper, a complex wavelet-based image fusion has been discussed. The experimental results demonstrate that the proposed method enhances the directional features as well as fine edge details. Also, it reduces the redundant details, artifacts, distortions.

MR scanning, tattoo inks, and risk of thermal burn: An experimental study of iron oxide and organic pigments

Abstract

Background

Tattooed persons examined with magnetic resonance imaging (MRI) can develop burning sensation suggested in the literature to be thermal burn from the procedure. MRI-induced thermal effect and magnetic behavior of known tattoo pigments were examined ex vivo.

Materials and Methods

Magnetic resonance imaging effects on 3 commonly used commercial ink stock products marketed for cosmetic tattooing was studied. A main study tested 22 formulations based on 11 pigment raw materials, for example, one line of 11 called pastes and another called dispersions. Samples were spread in petri dishes and tested with a 0.97 T neodymium solid magnet to observe visual magnetic behavior. Before MRI, the surface temperature of the ink was measured using an infrared probe. Samples were placed in a clinical 3T scanner. Two scans were performed, that is, one in the isocenter and one 30 cm away from the center. After scanning, the surface temperature was measured again. Chemical analysis of samples was performed by mass spectroscopy.

Results

Mean temperature increase measured in the isocenter ranged between 0.14 and 0.26°C (P < .01) and in the off-center position from −0.16 to 0.21°C (P < .01). Such low increase of temperature is clinically irrelevant. Chemical analysis showed high concentrations of iron, but also nickel and chrome were found as contaminants. High concentration of iron was not associated with any increase of temperature or any physical draw or move of ink.

Conclusion

The study could not confirm any clinically relevant temperature increase of tattoo pigments after MRI.

Transcriptome analysis of ultraviolet A-induced photoaging cells with deep sequencing

Abstract

Gene expression changes associate with many biological processes. However, the relative consequences of the genetic alterations induced by ultraviolet (UV)-A radiation on skin photoaging are still not clear. Here, we performed deep sequencing of the transcriptome and explored altered genes related to biological changes in repeated UV-A-irradiated human dermal fibroblasts (HDF) to better understand the skin photoaging mechanisms. The repeatedly UV-A-irradiated group (HDF were induced by 10 J/cm² UV-A twice daily for 7 days) and the control group (HDF without irradiation) were evaluated. Expression genes profile was measured and compared using high-throughput sequencing on an Illumina HiSeq 2500 platform and DEGseq. Functional annotation and metabolic pathway analysis of genes with altered expression were preformed via National Center for Biotechnology Information, Uniprot, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes databases. Genes related to skin photoaging were verified by quantitative reverse transcription polymerase chain reaction. Transcriptome comparison revealed that 607 genes exhibited significant changes (P < 0.05), of which 238 genes were upregulated and 369 downregulated in UV-A-irradiated HDF. Functional annotations showed that genes altered by UV-A irradiation took part in a variety of biological process, cellular component synthesis, molecular function and metabolic pathway. Photoaging-related genes encoding elastin, sprout, cathepsin K, cathepsin D, cathepsin B ribose-phosphate diphosphokinase and phosphoglucomutase were identified to be changed. We obtained the comprehensive transcriptome and altered genes in repeated UV-A-irritated HDF and identified that the modulated genes were related to a wide panel of pathways and functions. Our results provide new insights into photoaging molecular mechanisms and suggest some novel targets for interfering in skin photoaging.

Azathioprine monotherapy in autoimmune blistering diseases: A feasible option for mild to moderate cases

Abstract

Azathioprine (AZP) is used as a corticosteroid (CS)-sparing medication to treat autoimmune blistering diseases. In this study, we examined the efficacy of AZP and the feasibility of using AZP monotherapy (without CS) to treat pemphigus and pemphigoid. We performed a retrospective study of 10 Japanese patients (seven with pemphigus and three with pemphigoid) with mild to moderate disease activity who had been treated using AZP. The treatment efficacy was evaluated based on decreases in the disease activity scores and autoantibody titers. The results demonstrate that seven out of 10 cases (70%) were treated successfully using AZP monotherapy with no severe adverse effects. The disease activity scores of the successfully-treated patients decreased to zero after 1–37.5 months (average, 11.9) and the average disease activity scores in these cases decreased significantly at 2 months (38.2 ± 36.6%) compared with the scores of the three patients who required additional systemic CS therapy (77.5 ± 3.5%) (P < 0.05). Additionally, the autoantibody titers of five cases treated successfully using AZP decreased by half at 6 months. In conclusion, our findings suggest that AZP monotherapy is a viable treatment option for mild to moderate pemphigus and pemphigoid.

Complications of botulinum toxin injection for masseter hypertrophy: Incidence rate from 2036 treatments and summary of causes and preventions

Summary

Background

Masseter hypertrophy is a common, prominent feature in many Asian patients, and correction procedures are often requested for esthetic reasons. Toxin masseter injections have a high efficacy and safety profile, but the risks of a variety of side effects or complications remain.

Objectives

The categorization of various complications was based on etiology, with a presentation of the author's own incidence rates for consideration and comparison.

Methods

Six hundred and eighty patients received a total of 2036 sessions of toxin injection for masseter hypertrophy from 2011 to 2016, and complications or complaints were recorded through follow-up on a by-treatment basis. Complications were grouped together based on etiology and discussed.

Results

Of 2036 sessions, temporary mastication force decrease was reported after 611 (30%), bruising after 51 (2.5%), headaches after 12 (0.58%), smile limitation after 3 (0.15%), paradoxical bulging after 10 (0.49%), sunken cheeks (subzygomatic volume loss) after 9 (0.44%), and sagging after 4 (0.20%).

Conclusions

Masseter injections remain very safe. To further decrease the incidence rate, injections should only be inside the recommended safety zone, a quadrilateral within the muscle that avoids most important local structures. Keeping injections inside the safe zone, and ideally in 3-4 different locations at least 1 cm from any border, is crucial for the prevention of complications.

Possible role of interleukin-17 and macrophage migration inhibitory factor in cutaneous warts

Summary

Background/Objectives

Cutaneous warts (CW), or verrucae, are benign proliferation of skin that result from infection with human papilloma viruses. Cellular immune reactivity plays a significant role in wart regression. The aim of this study was to elucidate the cellular immune status of patients with CW through measurements of their serum levels of interleukin-17 (IL-17) and macrophage migration inhibitory factor (MIF,) and, identify the possible role of IL-17 and MIF in CW. We assessed serum IL-17 and MIF levels in patients with different forms of CW and compare the results with controls.

Patient and methods

Serum levels of IL-17 and MIF were measured using commercially available ELISA assay kits in 60 patients with CW and 20 healthy controls.

Results

Serum levels of IL-17 and MIF were significantly lower in patients with CW when compared with the controls (P-value <.01, <.05, respectively). There was nonsignificant correlation between IL-17 and MIF.

Conclusion

Low IL-17 and MIF levels may have a contributory role in occurrence, maintenance, severity, and recurrence of different types of CW which depend mainly on the defect of cell-mediated immunity. This may shed new light on nontraditional strategies for the future medical treatments of CW through regulation of IL-17 and MIF.

A web-based survey to identify current practice in skeletal pin site management

Infections associated with percutaneous pins and wires are common complications which can have a significant impact on patient outcomes. A survey was undertaken to identify current practice and gain insight into variations of clinical practice. Invitations were sent by email to complete an electronic questionnaire using SurveyMonkey. The survey was left open for 100 days. The single largest group of respondents (37.4%, n = 120) cleansed pin sites daily, with significant differences identified between medical and nursing professions (P = 0.02), and country of practice (P < 0.001). Significant differences were also identified in the use of different cleansing solutions between medical and nursing professions (P < 0.001) and country (P < 0.001). The majority group preferences were saline 30% (n = 96) and alcoholic chlorhexidine 29.6% (n = 95). Pin site crusts were routinely removed by 57.9% (n = 186). Pin sites were left exposed by 50.3% (n = 160). Dry gauze was identified as the most common dressing used to dress pin sites, however, substantial variation was identified in the types of dressings used. Compression was not routinely applied to pin sites by 51.6% (n = 165). There remains considerable diversity of practice when caring for pin sites. Further research is required to identify the most effective methods in preventing pin site infection.

An uncommon localization of black heels in a free climbing instructor

Black heels, also known as talon noir or calcaneal petechiae, are asymptomatic superficial cutaneous haemorrhages of the feet, mostly seen as post-traumatic lesions in young athletic individuals who practice sports such as tennis, football, or gymnastics. Here, we present a case of black heels in a young male rock climber.

Subepidermal moisture detection of heel pressure injury: The pressure ulcer detection study outcomes

We examined subepidermal moisture (SEM) and visual skin assessment of heel pressure injury (PrI) among 417 nursing home residents in 19 facilities over 16 weeks. Participants were older (mean age 77 years), 58% were female, over half were ethnic minorities (29% African American, 12% Asian American, 21% Hispanic), and at risk for PrI (mean Braden Scale Risk score = 15.6). Blinded concurrent visual assessments and SEM measurements were obtained at heels weekly. Visual skin damage was categorised as normal, erythema, stage 1 PrI, deep tissue injury (DTI) or stage 2 or greater PrI. PrI incidence was 76%. Off-loading occurred with pillows (76% of residents) rather than heel boots (21%) and often for those with DTI (91%). Subepidermal moisture was measured with a device where higher readings indicate greater moisture (range: 0-70 tissue dielectric constant), with normal skin values significantly different from values in the presence of skin damage. Subepidermal moisture was associated with concurrent damage and damage 1 week later in generalised multinomial logistic models adjusting for age, diabetes and function. Subepidermal moisture detected DTI and differentiated those that resolved, remained and deteriorated over 16 weeks. Subepidermal moisture may be an objective method for detecting PrI.

Effects of ambient conditions on the risk of pressure injuries in bedridden patients—multi-physics modelling of microclimate

Scientific evidence regarding microclimate and its effects on the risk of pressure ulcers (PU) remains sparse. It is known that elevated skin temperatures and moisture may affect metabolic demand as well as the mechanical behaviour of the tissue. In this study, we incorporated these microclimate factors into a novel, 3-dimensional multi-physics coupled model of the human buttocks, which simultaneously determines the biothermal and biomechanical behaviours of the buttocks in supine lying on different support surfaces. We compared 3 simulated thermally controlled mattresses with 2 reference foam mattresses. A tissue damage score was numerically calculated in a relevant volume of the model, and the cooling effect of each 1°C decrease of tissue temperature was deduced. Damage scores of tissues were substantially lower for the non-foam mattresses compared with the foams. The percentage tissue volume at risk within the volume of interest was found to grow exponentially as the average tissue temperature increased. The resultant average sacral skin temperature was concluded to be a good predictor for an increased risk of PU/injuries. Each 1°C increase contributes approximately 14 times as much to the risk with respect to an increase of 1 mmHg of pressure. These findings highlight the advantages of using thermally controlled support surfaces as well as the need to further assess the potential damage that may be caused by uncontrolled microclimate conditions on inadequate support surfaces in at-risk patients.

Identifying risk factors associated with infection in patients with chronic leg ulcers

Leg ulcers are hard to heal. Infection causes delayed healing, negatively impacting patients' quality of life, the healthcare system, and society. Early recognition of patients at high risk of infection is essential to prevent complications and reduce negative impacts. However, at present, factors associated with infection in this population are not yet clearly understood.

The study aimed to identify factors that were significantly associated with infection in chronic leg ulcers. A sample of 561 patients with chronic leg ulcers, who were previously recruited at outpatient clinics and community settings within Australia between 2008 and 2015, were selected for the current analysis. The prevalence of infection in the sample at study recruitment was 7.8%.

A multivariate logistic regression model was used to identify factors associated with infection. The study identified 7 factors that were significantly independently associated with infection, including depression, chronic pulmonary disease, anti-coagulant use, calf ankle circumference ratio < 1.3, ulcer area ≥ 10 cm², slough in the wound bed tissue, and ulcers with heavy exudate.

These findings could assist clinicians in the early recognition of patients at risk of infection and individualise treatment for these patients, thereby promoting wound healing.

Commentary on: Surgical Site Irrigation in Plastic Surgery: What is Essential?

"There Is Nothing New Except What Has Been Forgotten."―Marie Antoinette

ASJ’s Position on Publishing Papers That Discuss Off-Label Product Usage

As the Editor-in-Chief of Aesthetic Surgery Journal (ASJ), I would like to thank Dr Solomon for his Letter to the Editor entitled "Comments on 'Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations.'"¹ One of Dr Solomon's remarks calls for a response.

The Micromort Concept and its Applicability to Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Risk Assessment

I read with interest the article by Sieber and Adams about the micromort concept and its applicability to anaplastic large cell lymphoma (ALCL) risk assessment.¹ While I concur with the conclusions of the article, I wish to point out some issues with the source data in Table 1 for risks associated with common activities. I recently attempted to locate the original reference for the micromort concept and this proved challenging. The only reference from Ronald Howard listed in PubMed is from 1989.² A 1979 article by Richard Wilson in Technology Review³ is the first appearance of the table of lifestyle risks that I could locate. The author's methodology in drafting the table appears to have simply taken averages such as the number of deaths from alcoholic cirrhosis and national average drinking, and deriving risk of a single drink from that. More sophisticated analysis shows a J-shaped curve for alcohol, especially wine, with lower risk at moderate consumption.⁴ The risk we run is missing more nuanced aspects of risk for ALCL by not factoring in the positive aspects of breast implant use. For example, there is some evidence that breast cancer survival is improved with reconstruction⁵; breast implants may have their own J-shaped curve. So while micromort analysis offers a reassuring perspective on the ALCL situation, we need to be cautious about citing outdated and poorly documented data on comparative risk.

Response to “Comments on ‘Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations’”

We thank Dr Solomon¹ for his interest in our article.² We agree that penile augmentation using injectable materials, including hyaluronic acid (HA), does have some disadvantages. HA fillers do slowly reabsorb over time and so are not a permanent solution. However, our in-progress research suggests that the nonpermanency of the procedure is potentially part of the appeal for at least some patients. These men consider a nonpermanent procedure on such an important part of their body, which they closely associate with their sense of masculinity, to be less daunting.

Comments on “Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations”

I am writing to express my concern regarding this article.¹ The authors support the use of hyaluronic acid as an injectable material for penis enlargement. As a plastic surgeon who has been performing procedures for penis enlargement for more than 20 years, I have concerns about this endorsement. Hyaluronic acid dissipates in all cases over time. Its absorption is irregular creating nodules in every case (Figure 1). About half of the patients that I treat have unsatisfactory results from injection of a variety of materials, including hyaluronic acid, polymethylmethacrylate, fat (Figure 2), liquid silicone (Figure 3), and silicone devices (Figure 4). Each of these has unique challenges for surgical removal and each of these patients is very unhappy when they present to me. While there are options for increasing the length and girth of the penis, they are surgically demanding (Figure 5). Unlike hyaluronic acid, or any of the other fillers mentioned, the results are permanent. This is not to say that complications of surgery cannot occur. Complications do occur and as surgeons, we should be prepared to manage them to restore our patients to full function. I think it is incumbent for our members to be aware that the US Food and Drug Administration has not approved any filler for penile injection therapy. These are dermal fillers and there is no significant dermal layer in the penis. Due to the anatomy of the penis, these materials are placed in the superficial fascial layer of the penis. Placement of these materials disrupts the blood supply to the skin of the penis. When removing these materials, the blood supply to the overlying skin is compromised, which can cause skin loss as a subsequent challenge for reconstruction. I would discourage our members from adopting this method of penis enlargement.

Response to “The Micromort Concept and its Applicability to Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Risk Assessment”

Thank you for your insightful comments¹ on our article entitled "What's Your Micromort? A Patient-Oriented Analysis of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Risk Assessment."² Activities such as drinking wine present risk in a J-shaped curve, in part because wine consumption may occur along a spectrum from none to excess. Whereas moderate wine consumption, even alongside heavy alcohol consumption, demonstrates multiple health benefits.³ Although the activities demonstrated by Wilson occur along a spectrum as well, many may present as all or none events, such as riding a bicycle 10 miles, riding 300 miles in a car, or traveling 1000 miles in a jet.⁴ Despite his data being older, these events would not present in a J-shaped curve as riding less in a car will not impose health benefits, but will instead only decrease risk. Likewise, having breast implants is an all or nothing event. Therefore, one cannot have "less" of a breast augmentation in hopes of pursuing health benefits. For this reason, we believe using the micromort terminology is well founded and is a valuable tool for patient education on BIA-ALCL.

Effect of plants in constructed wetlands for organic carbonand nutrient removal: a review of experimental factors contributing to higher impact and suggestions for future guidelines

Abstract

Constructed wetland is a proven technology for water pollution removal, but process mechanisms and their respective contribution are not fully understood. The present review details the effect of plants on removal efficiency of constructed wetlands by focusing on literature that includes experiments with unplanted controls for organic carbon and nutrient (N and P) removal. The contribution of plant direct uptake is also assessed. Although it was found that several studies, mostly at laboratory or pilot scales, showed no statistical differences between planted and unplanted controls, some factors were found that help maximize the effect of plants. This study intends to contribute to a better understanding of the significance of the effect of plants in a constructed wetland, as well as to suggest a set of experimental guidelines in this field.