Atopic dermatitis: disease characteristics and comorbidities in smoking and non-smoking patients from the TREATgermany registry.

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease with a multifactorial genesis including genetic predispositions and environmental risk and trigger factors. One of the latter possibly is smoking, indicated by an increased prevalence of AD in adults and children that are actively or passively exposed to cigarette smoke. OBJECTIVES: In this study, AD characteristics and its atopic comorbidities are compared in smoking and non-smoking AD patients. METHODS: TREATgermany is a non-interventional clinical registry which includes patients with moderate to severe AD in Germany. Baseline data of patients included in TREATgermany from inception in June 2016 to April 2020 in 39 sites across Germany was analysed comparing AD disease characteristics and comorbidities in smokers vs. non-smokers. RESULTS: Of 921 patients, 908 (male: 58.7%) with a mean age of 41.9 ± 14.4 reported their smoking status. The objective Scoring of Atopic Dermatitis (oSCORAD) did not differ between smokers (n = 352; 38.8%) and non-smokers, however, lesions' intensity of oozing/crusts and excoriations as well as patient global assessment scores (PGA) of AD severity were higher in smoking as opposed to non-smoking patients. Smokers reported a lower number of weeks with well-controlled AD and more severe pruritus than non-smokers. Total IgE levels were more elevated in smokers and they displayed a younger age at the initial diagnosis of bronchial asthma. After adjustment for potential confounders, the increased intensity of oozing/crusts, the reduced number of weeks with well-controlled AD and the greater pruritus remained different in smokers compared to non-smokers. In addition, smoking patients with adult-onset AD showed a 2.5 times higher chance of involvement of the feet. CONCLUSIONS: German registry data indicate that AD patients who smoke have a higher disease burden with a different distribution pattern of lesions in adult-onset AD.

Phase singularity reduction in speckle interferometry by tailoring the spatial coherence of light.

Reducing the number of phase singularities in speckle interferometry by physical means increases the quality of the phase deconvolution and enhances the separability of fringe systems, especially for highly dynamic fringe systems. The reduction is achieved by tailoring the spatial coherence of the light source at the entrance of the interferometer. The reduction mechanism is non-intuitive and rests on a change of size and of position of the speckle patterns as a result of the spatially shaped coherence. After demonstrating the amount of reduction that may be achieved, the reduction mechanism is explained theoretically and via simulations, and it is vindicated in an experiment using a Michelson-Mach-Zehnder interferometer hybrid.

Estimation of genetic parameters and breeding values for feed intake and energy balance using pedigree relationships or single-step genomic evaluation in Holstein Friesian cows.

At the beginning of lactation, high-performing dairy cows often experience a severe energy deficit, which in turn is associated with metabolic stress. Increasing feed intake (FI) or reducing the energy deficit during this period could improve the metabolic stability and thus the health of the animals. Genomic selection for the first time enables the inclusion of this hard-to-measure trait in breeding programs. The objective of the current study was the estimation of genetic parameters and genomic breeding values for FI and energy balance (EB). For this purpose, 1,374 Holstein Friesian (HF) dairy cows from 8 German research farms were phenotyped with standardized FI data protocols. After data editing, phenotypic data of HF comprised a total of 40,012 average weekly FI records with a mean of 21.8 ± 4.3 kg/d. For EB 33,376 average weekly records were available with a mean of 3.20 ± 29.4 MJ of NEL/d. With the Illumina Bovine SNP50 BeadChip (Illumina Inc., San Diego, CA) 1,128 of phenotyped cows were genotyped. Thirty-five female candidates of the HF population were genotyped but not phenotyped. Pedigree information contained sires and dams 4 generations back. The random regression animal model included the fixed effects of herd test week (alternatively, herd group test week), parity, and stage of lactation, modeled by the function according to Ali and Schaeffer (1987). For both the random permanent environmental effect across lactations and the random additive genetic effect, third-order Legendre polynomials were chosen. Additionally, a random permanent environmental cow effect within lactation was included. Analyses for heritabilities, genetic correlations between different lactation stages, and breeding values were estimated using, respectively, pedigree relationships and single-step genomic evaluation, carried out with the DMU software package (Madsen et al., 2013). This allowed for comparison of conventional reliabilities with genomic-assisted reliabilities based on real data, to evaluate the gain of genotyping. Heritability estimates ranged between 0.12 and 0.50 for FI, and 0.15 and 0.48 for EB, and increased toward the end of lactation. Genetic correlations were weak between early and late lactation, with a value of 0.05 for FI and negative with a value of -0.05 for EB. Reliabilities for genomic values of cows for FI and EB ranged between 0.33 and 0.61, and 0.27 and 0.47, respectively. For the genotyped cows without phenotypes, the inclusion of genomic relationship leads to an increase of the average reliability of the breeding value for FI by nearly 9% and for EB by 4%. The results show the possibility of combining pedigree, genotypes, and phenotypes for increasing FI or EB to reduce health and reproductive problems, especially at the beginning of lactation. Nevertheless, the reference population needs to be extended to reach higher breeding value reliabilities.

Lactation curves and model evaluation for feed intake and energy balance in dairy cows.

A good health status of high-performing dairy cows is essential for successful production. Feed intake affects the metabolic stability of dairy cows and can be used as a measurement for energy balance. By implementing feed intake and energy balance into the breeding goal, these traits provide great potential for an improvement in the health of dairy cows by breeders. In this study, fixed and random regression models were tested to establish appropriate models for a further analysis of this approach. A total of 1,374 Holstein-Friesian cows and 327 Simmental cows (SI) from 12 German research farms participating in a collaboration called optiKuh were phenotyped. Feed intake data recording was standardized across farms, and energy balance was calculated using phenotypic information on milk yield, milk ingredients, live weight, gestation stage, and feed intake. The phenotypic data set consisted of a total of 40,012 Holstein-Friesian and 16,996 SI with average weekly dry matter intakes of 21.8 ± 4.3 and 20.2 ± 3.6 kg/d, respectively. Observations of days in milk 1 to 350 were used to evaluate the best-fitting models and to estimate the repeatability and correlations between cow effects at different stages for feed intake and energy balance. Four parametric functions (Ali and Schaeffer and Legendre polynomials of second, third, and fourth degree) were compared to model the lactation curves. Based on the corrected Akaike information criterion and the Bayesian information criterion, the goodness of fit was evaluated to choose the best-fitting model for the finest description of lactation curves for the traits energy balance and feed intake. Legendre polynomial fourth degree was the best-fitting model for random regression models. In contrast, Ali and Schaeffer was the best choice for fixed regression models. Feed intake and energy balance acted as expected: the feed intake increased slowly at the beginning of lactation and the negative energy balance switched to a positive range around 40 to 80 d of lactation. The repeatabilities of both traits were quite similar and the repeatabilities for SI were the highest for both traits. Additionally, correlations between cow effects were closest between early days in milk. These results emphasize the possibility that the unique optiKuh data set can be used for further genetic analyses to enable genomic selection for feed intake or energy balance.

Circulating adiponectin concentrations during the transition from pregnancy to lactation in high-yielding dairy cows: testing the effects of farm, parity, and dietary energy level in large animal numbers.

Dairy cows experience a negative energy balance due to increasing energy demands and insufficient voluntary feed intake in the transition from late pregnancy to early lactation. For supplying sufficient energy toward the conceptus and the mammary gland, insulin sensitivity in peripheral tissues is reduced leading to adipose tissue mobilization. Adiponectin, an insulin-sensitizing adipokine, is presumably related to energy metabolism and could play an important role in these metabolic adaptations. We hypothesize (1) that primiparous cows would differ from pluriparous cows in their circulating adiponectin concentrations during the transition from late pregnancy to early lactation and (2) that feeding different energy levels would affect the adiponectin concentrations during early lactation in dairy cows. For the first hypothesis, we examined 201 primiparous and 456 pluriparous Holstein dairy cows on three experimental farms. Ante partum, primiparous cows had lower adiponectin and greater NEFA concentrations than pluriparous cows, but vice versa post partum. Hence, adiponectin might be involved in the energy partitioning in primiparous cows (conceptus and lactation vs other still growing body tissues) with changing priorities from pregnancy to lactation. For the second hypothesis, 110 primiparous and 558 pluriparous Holstein and Simmental dairy cows in six experimental farms received either roughage with 6.1 or 6.5 MJ NEl/kg dry matter (adjusted with different amounts of wheat straw) ad libitum, combined with either 150 or 250 g concentrates/kg energy corrected milk. Greater amounts of concentrate lead to greater milk yield, but did not affect the blood variables. The higher energy level in the roughage led to greater glucose and IGF-1 but lower adiponectin in pluriparous cows. Further studies are needed to elucidate the mechanisms behind the roughage effect and its metabolic consequences.

[Decreased professional performance and quality of life in patients with moderate-to-severe atopic eczema : Results from the German atopic eczema registry TREATgermany]. / Verminderte berufliche Leistungsfähigkeit und Lebensqualität bei Patienten mit moderater bis schwerer Neurodermitis : Ergebnisse aus dem Deutschen Neurodermitisregister TREATgermany.

BACKGROUND: Clinical registries may provide high-quality evidence on the use and effectiveness of therapeutic interventions under real-life conditions. Adults with moderate-to-severe atopic eczema (atopic dermatitis [AD]) are enrolled into TREATgermany and prospectively followed over at least 2 years. This paper analyses the association between dermatological quality of life and work limitations. MATERIALS AND METHODS: Treatment modalities and a broad set of physician- and patient-reported outcome measures are documented using validated instruments to assess clinical disease severity (EASI [Eczema Area and Severity Index], objective SCORAD [objective-SCORing Atopic Dermatitis]), quality of life (DLQI [Dermatology Life Quality Index]), symptoms (POEM [Patient-oriented Eczema Measure]), global disease severity, as well as patient satisfaction and work limitations including presenteeism (WLQ [Work Limitation Questionnaire]). From 06/2016 until 12/2017, 241 individuals (mean age 43 ± 15 years, 38.6% female) were enrolled at 19 recruitment centers; 69% of the patients were employed. RESULTS: Employed persons had DLQI and WLQ scores of 10.6 ± 6.9 points and 17.7 ± 18.1%, respectively. Mean presenteeism was substantial accounting for 9.2%. With coefficients of 0.39 and 0.33 WLQ and presenteeism scores significantly correlate with DLQI (p < 0.000). Bootstrapped regression models showed that the limitations in coping with work requirements increase by 1.7% as DLQI increases by one point. Lower quality of life due to AD is most strongly associated with limitations in the area of physical and performance requirements in general. Presenteeism increases by 0.5% as DLQI increases by one point. CONCLUSION: Moderate-to-severe AD has substantial adverse economic impact with mean productivity loss of patients of almost 10%. Future analyses from TREATgermany will address the impact of innovative treatment modalities on quality of life and work productivity of patients with moderate-to-severe AD.

Concentric ring metal grating for generating radially polarized light.

A subwavelength concentric ring metal grating for visible light (λ=632.8 nm) is designed and fabricated by electron-beam lithography to transform circularly polarized light into radially polarized light. Experimental results are compared to theoretical predictions and the advantages and disadvantages of the element with alternative methods are discussed.

Effect of early postnatal breastfeeding support: a cluster-randomized community based trial.

AIM: To assess the impact of a supportive intervention on the duration of breastfeeding. DESIGN AND SETTING: A community based cluster-randomized trial in Western Denmark. SUBJECTS: Fifty-two health visitors and 781 mothers in the intervention group, and 57 health visitors and 816 mothers in the comparison group. INTERVENTION: Health visitors in the intervention group received an 18-h course. The intervention addressed maternal psychosocial factors and consisted of 1-3 home visits during the first 5 weeks post-partum. Health visitors in the comparison group offered their usual practice. MAIN OUTCOME MEASURE: Duration of exclusive breastfeeding during 6 months of follow-up. RESULTS: Mothers in the intervention group had a 14% lower cessation rate (HR = 0.86 CI: 0.75-0.99). Similar results were seen for primipara, and multipara with previously short breastfeeding experience. Mothers in the intervention group received their first home visit earlier, had more visits and practical breastfeeding training within the first 5 weeks. Babies in the intervention group were breastfed more frequently, fewer used pacifiers, and their mothers reported more confidence in not knowing the exact amount of milk their babies had received when being breastfed. CONCLUSION: Home visits in the first 5 weeks following birth may prolong the duration of exclusive breastfeeding. Postnatal support should focus on both psychosocial and practical aspects of breastfeeding. Mothers with no or little previous breastfeeding experience require special attention.

[Long-term antihypertensive therapy with urapidil. A 3-year open, multicenter trial of tolerance, safety and effectiveness]. / Antihypertensive Langzeittherapie mit Urapidil. Offene, multizentrische Prüfung über drei Jahre zu Verträglichkeit, Sicherheit und Wirksamkeit.

Within the framework of an open, multicenter study of 16 physicians treated 206 hypertensive patients with a daily dose of 2 x 30 mg to 2 x 90 mg of urapidil over a period of 3 years. Data are available on 182 patients for the entire study period. 24 patients discontinued the study due to adverse effects (n = 2), an inadequate effect (n = 2), or for reasons unrelated to therapy (n = 20); 58 (28.2%) patients had complaints. The most frequently reported symptoms were nausea, dizziness, drowsiness and fatigue. No relevant changes in laboratory values were observed. Average body weight remained constant and there were no signs of sodium or water retention. In the first year systolic blood pressure was reduced by 25 mm Hg from 174 +/- 13 mm Hg to 149 +/- 10 mm Hg (mean value +/- SD), and diastolic pressure by 17 mm Hg from 103 +/- 6 mm Hg to 86 +/- 6 mm Hg. At the same average dose this drop in BP persisted in the second year (150 +/- 12/86 +/- 7 mm Hg) and the third year (146 +/- 10/85 +/- 7 mm Hg), indicating that there was no decrease in urapidil effect. The pulse rate fell from 77 +/- 8 beats/minute to 74 +/- 6 beats/minute and remained virtually constant over the next 2 years.