ABSTRACT
A promising pollution control technology is cold plasma driven chemical processing. The plasma is a pulsed electric gas discharge inside a near atmospheric-pressure-temperature reactor. The system is energized by a continuous stream of very short high-voltage pulses. The exhaust gas to be treated flows through the reactor. The methods applied involve the development of robust cold plasma systems, industrial applications and measuring technologies. Tests of the systems were performed at many industrial sites and involved control of airborne VOC (volatile organic compound) and odor. Electrical, chemical and odor measuring data were collected with state-of-the-art methods. To explain the test data an approximate solution of global reaction kinetics of pulsed plasma chemistry was developed. It involves the Lambert function and, for convenience, a simple approximation of it. The latter shows that the amount of removal, in good approximation, is a function of a single variable. This variable is electric plasma power divided by gas flow divided by input concentration. In the results sections we show that in some cases up to 99% of volatile pollution can be removed at an acceptable energy requirement. In the final sections we look into future efficiency enhancements by implementation of (sub)nanosecond pulsed plasma and solid state high-voltage technology and by integration with catalyst technology.
Subject(s)
Emergency Service, Hospital , Smartphone , Telemedicine , Humans , Ophthalmology/methods , Male , Female , Middle AgedABSTRACT
INTRODUCTION: The incidence of melanoma is rising in Spain. The prognostic stages of patients with melanoma are determined by various biological factors, such as tumor thickness, ulceration, or the presence of regional or distant metastases. The Spanish Academy of Dermatology and Venereology (AEDV) has encouraged the creation of a Spanish Melanoma Registry (REGESMEL) to evaluate other individual and health system-related factors that may impact the prognosis of patients with melanoma. The aim of this article is to introduce REGESMEL and provide basic descriptive data for its first year of operation. METHODS: REGESMEL is a prospective, multicentre cohort of consecutive patients with invasive cutaneous melanoma that collects demographic and staging data as well as individual and healthcare-related baseline data. It also records the medical and surgical treatment received by patients. RESULTS: A total of 450 cases of invasive cutaneous melanoma from 19 participant centres were included, with a predominance of thin melanomas≤1mm thick (54.7%), mainly located on the posterior trunk (35.2%). Selective sentinel lymph node biopsy was performed in 40.7% of cases. Most cases of melanoma were suspected by the patient (30.4%), or his/her dermatologist (29.6%). Patients received care mainly in public health centers (85.2%), with tele-dermatology resources being used in 21.6% of the cases. CONCLUSIONS: The distribution of the pathological and demographic variables of melanoma cases is consistent with data from former studies. REGESMEL has already recruited patients from 15 Spanish provinces and given its potential representativeness, it renders the Registry as an important tool to address a wide range of research questions.
Subject(s)
Dermatology , Melanoma , Registries , Skin Neoplasms , Humans , Melanoma/epidemiology , Melanoma/surgery , Melanoma/pathology , Spain/epidemiology , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Skin Neoplasms/epidemiology , Prospective Studies , Male , Dermatology/statistics & numerical data , Female , Middle Aged , Aged , Venereology , Academies and Institutes/statistics & numerical data , Adult , Sentinel Lymph Node Biopsy/statistics & numerical data , Aged, 80 and over , Neoplasm StagingABSTRACT
The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists.
Subject(s)
Melanoma , Skin Neoplasms , Humans , Skin Neoplasms/pathology , Melanoma/diagnostic imaging , Melanoma/pathology , Delphi Technique , Microscopy, Confocal/methods , Consensus , Dermoscopy/methodsABSTRACT
One of the new waters, and environmentally friendly agriculture initiatives in Peru is to encourage the utilization of agricultural waste, because low agricultural output is a threat to food security there. The purpose of this research was to evaluate the effect of harvest residues on the basidiocarp production of the fungus Pleurotus Ostreatus, in Acobamba-Huancavelica. The trial had a completely randomized design, and the treatments included T1, barley stubbles; T2, wheat stubbles; T3, pea stubbles; T4, broad bean stubbles; and T5, quinoa stubbles. The research was quantitative in nature, taking the form of an experiment with an applied, explanatory level of design. The recorded data was tabulated and analyzed with analysis of variance, as well as Tukey's test (α:0.05), for which the statistical software Infostat was used. The results are presented in tables and graphs for a better interpretation. As main results, it was obtained that the time (colonization), diameter (stem, pileus), length (stem) and weight (basidiocarps), present statistical differences between treatments showing significant enhancement in all parameters. Despite a numerical difference, a Tukey average comparison test revealed that there was no statistically significant difference between the averages for the variable time for fungus colonisation, suggesting that the treatment T5 in which quinoa substrate showed the greatest average. Treatment T4 in which broad bean stubbles were used gave the most low-average. In conclusion, increment in all parámeters were noted in all treatment of Pleurotus basidiocarps ostreatus under Acobamba conditions.
Subject(s)
Agaricales , Pleurotus , Pleurotus/chemistry , Agriculture/methods , TriticumABSTRACT
OBJECTIVE: To examine the potential association between vitamin D (VitD) deficiency and latent tuberculosis infection (LTBI) and its effect on TB infection conversion (TBIC) incidence.MATERIAL AND METHODS: We carried out a cross-sectional and prospective cohort study of nine pulmonary TB cases that occurred in 2015-2016 in five nursing homes and one mental disability institution in Castellon, Spain. QuantiFERON®-TB Gold and the tuberculin skin test were used to detect LTBI and TBIC, respectively. Serum 25-hydroxyvitamin D was measured using chemiluminescence immunoassay. Poisson regression and inverse probability weighting were used for statistical analyses.RESULTS: The study included 448 residents, 341 staff members with 48 relatives of TB cases (participation rate 82%): of these, respectively 122 (27.2%), 37 (10.9%) and 7 (14.6%) were LTBI-positive; and respectively 22 (7.7%), 10 (3.8%) and 1 (3.7%) were TBIC-positive. LTBI was not associated with VitD status. Severe VitD deficiency (SVDD; defined as VitD level < 10 ng/ml), found in 45.1% of residents, as well as VitD levels of <30 ng/ml (aRR 10.41 95% CI 1.48-73.26), were associated with increased TBIC risk (adjusted relative risk [aRR] 12.1, 95% CI 1.51-97.10), suggesting SVDD as a threshold effect. CONCLUSION: Severe VitD deficiency is a TBIC risk factor.
Subject(s)
Latent Tuberculosis , Cross-Sectional Studies , Humans , Latent Tuberculosis/diagnosis , Latent Tuberculosis/epidemiology , Nursing Homes , Prospective Studies , Spain/epidemiology , Tuberculin Test , Vitamin DABSTRACT
Although the arrival of new chemotherapy drugs and combinations has brought progress in terms of cancer patient survival, they entail many adverse effects that can compromise treatment, and hence prognosis, of the disease. Cytostatic agents can cause dermatological toxicity, among other side effects. The most familiar adverse effect of chemotherapy is alopecia. Although not serious, this changes the outward appearance of cancer patients. Other adverse effects include hypersensitivity and photosensitivity reactions, hand-foot syndrome, epidermal necrolysis, recall reactions, scleroderma-like reactions, Raynaud's phenomenon, eccrine squamous syringometaplasia, neutrophilic eccrine hidradenitis, nail abnormalities, pigmentation changes and extravasation injuries. Onset of these adverse effects often causes dose reduction and/or delayed treatment, which can affect patient survival and quality of life. It is therefore important to prevent their occurrence and treat them promptly, which requires cooperation between medical oncologists and dermatologists. This article reviews chemotherapy-associated dermatological toxicity, along with its diagnosis and therapeutic management.
Subject(s)
Antineoplastic Agents/adverse effects , Drug Eruptions/etiology , Alopecia/chemically induced , Antineoplastic Agents/classification , Disease Management , Drug Eruptions/therapy , Drug Hypersensitivity/etiology , Humans , Nail Diseases/chemically induced , Neoplasms/complications , Neoplasms/drug therapy , Photosensitivity Disorders/chemically induced , Pigmentation Disorders/chemically induced , Referral and Consultation , Severity of Illness Index , SpainABSTRACT
Unspent Transaction Outputs (UTXOs) are the internal mechanism used in many cryptocurrencies to represent coins. Such representation has some clear benefits, but also entails some complexities that, if not properly handled, may leave the system in an inefficient state. Specifically, inefficiencies arise when wallets (the software responsible for transferring coins between parties) do not manage UTXOs properly when performing payments. In this paper, we study three cryptocurrencies: Bitcoin, Bitcoin Cash and Litecoin, by analysing the state of their UTXO sets, that is, the status of their sets of spendable coins. These three cryptocurrencies are the top-3 UTXO-based cryptocurrencies by market capitalization. Our analysis shows that the usage of each cryptocurrency presents some differences, and led to different results. Furthermore, it also points out that the management of the transactions has not always been performed efficiently and therefore, the current state of the UTXO sets is far from ideal.
ABSTRACT
Progress in the understanding of many tumors has enabled the development of new therapies, such as those targeted at specific molecules involved in cell growth (targeted therapies) or intended to modulate the immune system (immunotherapy). However, along with the clinical benefit provided by these new treatments, new adverse effects have also appeared. Dermatological toxicities such as papulopustular eruptions, xerosis, and pruritus are common with EGFR inhibitors. Other adverse effects have also been described with PDGFR, BCR-ABL, and MAPK tyrosine kinase inhibitors, antiangiogenic drugs, and inhibitors at immune checkpoints such as CTLA-4 and PD-1/PD-L1. Onset of these adverse effects often causes dose reductions and/or delays in administering the prescribed therapy, which can affect patient survival and quality of life. It is, therefore, important to prevent the occurrence of these adverse effects, or to treat unavoidable ones as soon as possible. This requires cooperation between medical oncologists and dermatologists. This article reviews the various dermatological toxicities associated with targeted therapies and immunotherapies, along with their diagnosis and therapeutic management.
Subject(s)
Antineoplastic Agents/adverse effects , Immunotherapy/adverse effects , Molecular Targeted Therapy/adverse effects , Neoplasms/drug therapy , Quality of Life , Skin Diseases/prevention & control , Consensus , Dermatology , Disease Management , Humans , Neoplasms/pathology , Skin Diseases/chemically induced , Societies, Medical , VenereologyABSTRACT
New drugs against advanced melanoma have emerged during last decade. Target therapy and immunotherapy have changed the management of patients with metastatic disease. Along with its generalized use, drug toxicities have appeared and the skin is the target organ of a significant part of them. This revision summarizes the most common side effects and consensus management to improve the compliance of therapies and patients' quality of life. Among the BRAF inhibitors, main cutaneous side effects are photosensitivity, plantar hyperkeratosis, and the appearance of verrucal keratosis or squamous cell carcinoma. Special attention must be paid to the development of new primary melanomas or changes on nevi during BRAF inhibitor therapy. The most common cutaneous side effects of immunotherapy are rash, pruritus, and vitiligo. It remains controversial the possible role of these toxicities as markers of response to therapy.
Subject(s)
Drug Eruptions/etiology , Drugs, Investigational/adverse effects , Immunotherapy/adverse effects , Melanoma/therapy , Molecular Targeted Therapy/adverse effects , Skin Neoplasms/therapy , Therapies, Investigational/adverse effects , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized/adverse effects , Drug Eruptions/pathology , Humans , Melanoma/pathology , Molecular Targeted Therapy/methods , Nivolumab/administration & dosage , Nivolumab/adverse effects , Protein Kinase Inhibitors/therapeutic use , Proto-Oncogene Proteins B-raf/genetics , Proto-Oncogene Proteins B-raf/immunology , Skin Neoplasms/pathologyABSTRACT
The most destructive wildfire experienced in Spain since 2004 occurred close to Valencia in summer 2012. A total of 48.500ha were affected by two wildfires, which were mostly active during 29-30 June. The fresh smoke plume was detected at the Burjassot measurement station simultaneously to a severe dust episode. We propose an empirical method to evaluate the dust and smoke mixing and its impact on the microphysical and optical properties. For this, we combine direct-sun measurements with a Cimel CE-318 sun-photometer with an inversion methodology, and the Mie theory to derive the column-integrated size distribution, single scattering albedo (SSA) and asymmetry parameter (g). The mixing of dust and smoke greatly increased the aerosol load and modified the background aerosol properties. Mineral dust increased the aerosol optical depth (AOD) up to 1, while the smoke plume caused an extreme AOD peak of 8. The size distribution of the mixture was bimodal, with a fine and coarse modes dominated by the smoke particles and mineral dust, respectively. The SSA and g for the dust-smoke mixture show a marked sensitivity on the smoke mixing-ratio, mainly at longer wavelengths. Mineral dust and smoke share a similar SSA at 440nm (~0.90), but with opposite spectral dependency. A small dust contribution to the total AOD substantially affects the SSA of the mixture, and also SSA at 1020nm increases from 0.87 to 0.95. This leads to a different spectral behaviour of SSA that changes from positive (smoke plume) to negative (dust), depending on the dust and smoke mixing-ratio.
Subject(s)
Areca/adverse effects , Mouth Diseases/etiology , Mouth Mucosa/pathology , Precancerous Conditions/etiology , Substance-Related Disorders/etiology , Aged , Bangladesh/ethnology , Diagnosis, Differential , Female , Fibrosis , Glucocorticoids/therapeutic use , Humans , Mastication , Mouth Diseases/diagnosis , Mouth Diseases/drug therapy , Mouth Diseases/pathology , Precancerous Conditions/diagnosis , Precancerous Conditions/drug therapy , Precancerous Conditions/pathology , Range of Motion, Articular , Spain , Substance-Related Disorders/diagnosis , Substance-Related Disorders/drug therapy , Substance-Related Disorders/pathology , Trismus/etiologyABSTRACT
OBJECTIVES: To study the diagnostic and prognostic contribution of laryngeal electromyography in unilateral vocal-fold immobility in adults. MATERIAL AND METHODS: A retrospective study included patients with unilateral vocal-fold immobility undergoing laryngeal electromyography between 2007 and 2015. Neurogenic, normal or myogenic findings were compared to the clinical aspect. Prognosis for recovery was assessed from motor unit potentials on laryngeal electromyography, and compared to subsequent progress on laryngoscopy. RESULTS: Sixty-three patients (mean age, 59 years) were initially included; 2 were subsequently excluded from analysis. Mean time from onset of immobility to laryngeal electromyography was 7 months. 85% of the 61 patients showed neurogenic findings, indicating neural lesion; 13% showed normal electromyography, indicating cricoarytenoid joint ankylosis; and 1 patient showed a myogenic pattern. Neurogenic cases were usually secondary to cervical surgery. Thirty-eight patients were followed up. In total, 75% of patients showing reinnervation potentials recovered. The positive predictive value of laryngeal electromyography was 69.2%. CONCLUSION: Laryngeal electromyography is effective in specifying the origin of unilateral vocal-fold immobility in adults. It also has a prognostic role, lack of reinnervation potentials being a possible indication for early medialization surgery.
Subject(s)
Electromyography , Vocal Cord Paralysis/diagnosis , Vocal Cord Paralysis/physiopathology , Adolescent , Adult , Aged , Aged, 80 and over , Arytenoid Cartilage/physiopathology , Cricoid Cartilage/physiopathology , Evoked Potentials/physiology , Female , Humans , Laryngeal Muscles/innervation , Laryngeal Muscles/physiopathology , Male , Middle Aged , Predictive Value of Tests , Prognosis , Retrospective Studies , Sensitivity and Specificity , Young AdultABSTRACT
Localized cutaneous argyria is a rare condition secondary to skin deposition of silver following exposure to substances containing this metal. The clinical appearance and dermoscopy findings require deep melanocytic lesions and particularly melanoma metastasis to be ruled out. Silver deposits are usually confirmed by scanning electron microscopy and/or energy-dispersive X-ray spectroscopy. Herein we describe the in vivo reflectance confocal microscopy (RCM) features observed in one case of localized cutaneous argyria. These features include the presence of a hyperrefractile network in the papillary dermis and a periadnexal dotted bright pattern. In vivo RCM might be a useful tool for an early diagnosis of this uncommon entity.
Subject(s)
Argyria/diagnostic imaging , Silver/metabolism , Aged, 80 and over , Dermoscopy/methods , Humans , Male , Microscopy, Confocal/methods , Skin/metabolismABSTRACT
INTRODUCTION: Despite the increasing interest in vitamin D functions, new cases of deficiency have been reported in sunny regions where optimal levels are expected. The aim of this study was to analyze 25-hydroxivitamin D levels in children younger than 2 years admitted for acute mild diseases in a tertiary hospital in Valencia and its relationship with factors that can be associated with its deficiency. METHODS: This one year prospective and observational study was conducted on 169 children admitted for acute mild diseases. 25-hydroxivitamin D levels were analyzed. A standardized physical examination and structured interviews to the parents were performed. Children were classified into two groups, according to 25-hydroxivitamin D levels (cut-off 30 ng/mL). RESULTS: A total of 169 children were included, with a median age of 9 months, being more prevalent Caucasians (75.7%) and youger than one year old (79.3%). Almost one quarter (24.3%) of the children had 25-hydroxivitamin D levels <30 ng/mL, more frequently in winter/spring, and in children with higher skin phototypes (P<.01). Levels >30 ng/mL were associated with vitamin D prophylaxis during the first year, in children of a Caucasian mother, and those who did not wear a hijab. No statistical differences were found in diet characteristics (P=.65). Prophylaxis was given to 47% of the breastfed children younger than one year. CONCLUSIONS: In Valencia, Spain, 25-hydroxivitamin D levels lower than 30 ng/mL were found in a quarter of the children younger than two years. Our results emphasize the importance of vitamin D prophylaxis during the first year of life, even in sunny Mediterranean regions.
Subject(s)
Sunlight , Vitamin D Deficiency/epidemiology , Vitamin D/blood , Climate , Cross-Sectional Studies , Humans , Infant , Prospective Studies , Spain/epidemiologyABSTRACT
Postsurgical oral self-administration of analgesics in rodents is an interesting technique of providing analgesia, avoiding the negative effects of manipulation. Several strategies, using gelatin or nutella, have already been described. However, rodents require some habituation period to reach a good intake because of their neophobic behavior. The current study aimed to explore whether buprenorphine when mixed with an extruded diet offers a potential treatment option in the pain management of mice using a triple approach: by measuring the spontaneous intake in healthy animals; by using the hot-plate test; and finally by assessing the drug's ability to provide postoperative analgesia in a surgical intervention of moderate severity (intra-utero electroporation). Mice consumed during 20 hours, similar amounts of extruded diet alone, mixed with glucosaline, and mixed with buprenorphine (0.03 mg per pellet) or meloxicam (0.25 mg per pellet) both of which were diluted in glucosaline, showing that no neophobia was associated with these administrations. Relative increase from baseline latency (% maximal possible effect) in the hot-plate test at 20 h of administration was significantly higher for oral buprenorphine in diet 0.03 mg/pellet, and diet 0.15 mg/pellet, compared with placebo and no differences were found between those oral administrations and subcutaneous buprenorphine 0.1 mg/kg measured 3 h later. The treatment was also effective in attenuating the reductions in food consumption and body weight that occur after surgery. These data suggest that providing buprenorphine with the diet is a feasible and effective way of self-administration of analgesia in mice and does not cause neophobia and may easily contribute to the refinement of surgical procedures.
Subject(s)
Infusion Pumps, Implantable/adverse effects , Insulin Infusion Systems/adverse effects , Mycobacterium Infections, Nontuberculous/etiology , Mycobacterium fortuitum , Adult , Diabetes Mellitus, Type 1/drug therapy , Female , Humans , Hypoglycemic Agents/administration & dosage , Insulins/administration & dosageABSTRACT
BACKGROUND: Nonsurgical treatment (radiotherapy, imiquimod) is increasingly employed for the management of lentigo maligna (LM). While the diagnosis of LM remains difficult, the detection of treatment failure is even more challenging. OBJECTIVES: To describe the sensitivity and specificity for the diagnosis of LM of individual features and methods using dermoscopy and in vivo reflectance confocal microscopy (RCM) to aid in the detection of treatment failure of LM following nonsurgical treatment. METHODS: A retrospective study of dermoscopy and RCM images (blinded to the correlation with pathology) in patients with biopsy-confirmed LM who were undergoing nonsurgical treatment in two referral institutions - one in Sydney, Australia, and the other in Barcelona, Spain. Ninety-eight patients were treated nonsurgically for LM during the period 2006-2012. Thirty-one patients had abnormal dermoscopy or RCM evaluation, and had a biopsy that identified LM recurrence in 15 patients and nonmelanoma diagnoses in 16 patients (one Bowen disease, 15 solar changes). RESULTS: The diagnosis of treatment failure was difficult with dermoscopy, with a sensitivity of 80% and specificity of 56%, even with the interpretation of an expert. The best criterion was asymmetric hyperpigmented follicular openings, but this was present in only 47% of treatment failure LM. Isolated, very fine brown dots ('dust' appearance) correlated highly with the diagnosis of treatment failure LM (73% sensitivity and 88% specificity) and with pagetoid cells seen with RCM. The LM score, comprising six criteria, had a specificity of 94% and sensitivity of 100%. CONCLUSIONS: These methods and descriptors should help to manage the diagnosis of treatment failure.
Subject(s)
Head and Neck Neoplasms/pathology , Hutchinson's Melanotic Freckle/pathology , Skin Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Dermoscopy/methods , Female , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapy , Humans , Hutchinson's Melanotic Freckle/drug therapy , Hutchinson's Melanotic Freckle/radiotherapy , Male , Microscopy, Confocal/methods , Middle Aged , Retrospective Studies , Sensitivity and Specificity , Skin Neoplasms/drug therapy , Skin Neoplasms/radiotherapy , Treatment FailureABSTRACT
BACKGROUND: Malignant transformation of oral lichen planus (OLP) to oral squamous cell carcinoma (OSCC) is controversial. C-MYC is a proto-oncogene involved in various solid tumours, including OSCC. OBJECTIVES: To determine MYC status using fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) in OLP lesions from 10 patients with progression to OSCC (group I) and to compare this with OLP lesions from patients without progression to OSCC (group II). METHODS: We constructed two tissue microarrays with 11 OSCC samples (group IA), 17 OLP samples from the same patients (group IB) and 13 OLP specimens from 12 control patients (group II). FISH evaluation of the MYC gains was determined in 100 nonoverlapping nuclei per sample. IHC evaluation was determined by calculating the percentage C-MYC expression in the epithelial cells. RESULTS: OSCC samples showed MYC copy number gains and C-MYC overexpression in 91% and 73% of cases, respectively. MYC gains were detected in 47% of samples from group IB and were absent from all samples from group II. C-MYC was overexpressed in 87% of cases from group IB and in only 44% of control specimens (group II). The differences in MYC status between groups IB and II were statistically significant. CONCLUSIONS: OLP lesions in patients with progression to OSCC show MYC gains and C-MYC overexpression. In patients with severe OLP, determining MYC status may predict a subgroup of subjects with a higher risk of progression to OSCC.