Characterization of High and Low IFNG-Expressing Subgroups in Atopic Dermatitis.

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases, with an increasing number of targeted therapies available. While biologics to treat AD exclusively target the key cytokines of type 2 immunity, Janus kinase inhibitors target a broad variety of cytokines, including IFN-γ. To better stratify patients for optimal treatment outcomes, the identification and characterization of subgroups, especially with regard to their IFNG expression, is of great relevance, as the role of IFNG in AD has not yet been fully clarified. This study aims to define AD subgroups based on their lesional IFNG expression and to characterize them based on their gene expression, T cell secretome and clinical attributes. RNA from the lesional and non-lesional biopsies of 48 AD patients was analyzed by RNA sequencing. Based on IFNG gene expression and the release of IFN-γ by lesional T cells, this cohort was categorized into three IFNG groups (high, medium, and low) using unsupervised clustering. The low IFNG group showed features of extrinsic AD with a higher prevalence of atopic comorbidities and impaired epidermal lipid synthesis. In contrast, patients in the high IFNG group had a higher average age and an activation of additional pro-inflammatory pathways. On the cellular level, higher amounts of M1 macrophages and natural killer cell signaling were detected in the high IFNG group compared to the low IFNG group by a deconvolution algorithm. However, both groups shared a common dupilumab response gene signature, indicating that type 2 immunity is the dominant immune shift in both subgroups. In summary, high and low IFNG subgroups correspond to intrinsic and extrinsic AD classifications and might be considered in the future for evaluating therapeutic efficacy or non-responders.

Comparison of the Efficacy of Combined Silver Nitrate Coagulation and Shave Excision With Surgical Excision and Linear Closure in the Treatment of Pyogenic Granuloma.

BACKGROUND: Pyogenic granuloma (PG) is a common benign vascular neoplasia. Optimal treatment should have an aesthetically pleasant scar and a low recurrence rate. No treatment method that is fully effective in solving these has been demonstrated. Silver nitrate cauterization is another method for the management of PG lesions. OBJECTIVE: The effects of silver nitrate on the treatment of PG have not been sufficiently investigated and should be investigated with objective data and a controlled study. METHODS: The prospective clinical trial was designed to compare silver nitrate cauterization with surgical excision treatment. Procedure times and procedure costs, comfort and satisfaction scales, recurrences, the Patient and Observer Scar Assessment Score, and the Vancouver Scar Scale were compared to evaluate treatments. RESULTS: Silver nitrate treatment had lower procedure times, costs, and better satisfaction and comfort scale scores. The scar assessment scores were better for the silver nitrate treatment. The patients in both groups were successfully treated and no recurrence was seen. CONCLUSION: Silver nitrate cauterization is low-cost, fast, safe, reliable, and effective with good aesthetic results for the treatment of PG lesions. This study shows that silver nitrate cauterization is a good alternative to surgical excision in the management of PG.

Self-determined motivation and academic buoyancy as predictors of achievement in normative settings.

BACKGROUND: Academic buoyancy (Martin & Marsh, 2006, Oxford Review of Education, 35, 353; 2008, Journal of School Psychology, 46, 53) is students' competence to respond effectively to academic daily setbacks and is considered an optimal characteristic of students' functioning related to achievement. From the self-determination theory perspective (Ryan & Deci, 2017, American Psychologist, 55, 68), satisfaction of the need for autonomy, competence, and relatedness and autonomous forms of motivation relate to students' optimal functioning in schooling. AIMS: We investigated (1) whether students' end-of-course (T2) academic buoyancy in the normative environment of English preparatory programmes (EPP) is predicted by their beginning-of-course (T1) need satisfaction or frustration and autonomous or controlled motivation (i.e., high or low self-determined motivation), and (2) whether students' T2 academic buoyancy mediates the relation between students' T1 self-determined motivation and final (T3) academic achievement. SAMPLE: In T1 and T2, 267 students (Mage  = 19.11, SD = 1.28) attending three EPPs in Ankara, Turkey, participated in the study. METHOD: A prospective design was used, data were collected through self-reports, and SEM was conducted to test the hypotheses. RESULTS: Students' T1 need frustration negatively predicted T1 autonomous motivation and positively predicted T1 controlled motivation, which (respectively) positively and negatively predicted T2 academic buoyancy. T1 need satisfaction related positively to T2 academic buoyancy. Finally, T2 academic buoyancy mediated the relation between students' need satisfaction and final achievement while controlled motivation was also negatively related to final achievement. CONCLUSION: Students' high need satisfaction and low need frustration as well as high autonomous and low controlled motivation could support students' buoyancy and achievement in the normative settings of EPP.