Description and molecular characterization of Trachactinolaimus persicus sp. n. from Iran (Nematoda, Dorylaimida, Actinolaimidae), with new insights into the taxonomy and evolutionary relationships of the genus.

A new species of the free-living nematode genus Trachactinolaimus, collected in natural habitats of northern Iran, is described, including morphological and molecular (28S-rDNA) data. Trachactinolaimus persicus sp. n. is characterized by its 1.95-2.44 mm long body, lip region weakly offset by depression and 18-20 µm wide, odontostyle 25-27 µm long, neck 540-636 µm long, pharyngeal expansion occupying one-half of the total neck length, bipartite uterus 2.6-3.9 body diameters long, vulva (V = 49-53) pore-like, tail long and filiform in both sexes (174-223 µm, c = 10.0-13.4, c' = 5.9-7.0 in females, 165-196 µm, c = 10.7-13.8, c' = 4.6-5.8 in males), spicules 68-75 µm long, and 12-14 almost contiguous ventromedian supplements with hiatus. Molecular data supports the monophyly of the genus and the hypothesis that Dorylaimidae are the sister group of actinolaims. The taxonomy of Trachactinolaimus is updated, including diagnosis, list of species, key to their identification, and a compendium of their main morphometrics. Dominiactinolaimus is regarded as its junior synonym.

Morphological and molecular characterization of Metaxonchium magnum sp. n. from Iran (Nematoda, Dorylaimida, Belondiridae), with new insights into the phylogeny of the genus.

A new species of the genus Metaxonchium is described from a natural habitat in Iran. Metaxonchium magnum sp. n. is characterized by its 3.62-4.65 mm long body, lip region cap-like and offset by constriction and 13-16 µm wide, odontostyle fusiform and 14-17 µm long, neck 1016-1359 µm long, both parts of the pharynx separated by a short isthmus-like narrowing, pharyngeal expansion occupying 74.2 (73-77)% of total neck length in females and 70.4 (66-72)% in males, female genital system mono-opistho-ovarian, didelphic, anterior genital branch a large uterine sac with a small terminal mass occupying 7-14% of body length, posterior uterus long and tripartite with a Z-like differentiation, V = 50-52, caudal region short and rounded (24-41 µm, c = 99-161, c' = 0.5-0.7), spicules 90-105 µm long and 10-13 spaced ventromedian supplements with hiatus. Analysis of D2-D3 28S rDNA sequences of the new species suggests that Metaxonchium might not be a monophyletic taxon, a matter that should be confirmed after future research.

A new needle nematode, Longidorus zanjanensis sp. nov. (Nematoda: Longidoridae) from north-western Iran.

During a survey of soil nematodes in 2022, a new species of the genus Longidorus, described here as Longidorus zanjanensis sp. nov., was discovered in the rhizosphere of Astragalus sp. in Zanjan Province, Iran. The new needle nematode is described and illustrated based on morphological, morphometric, and molecular traits. Further, its females are characterized by having a long body ranging 5.6-7.7 mm long, lip region anteriorly flattened and almost continuous or slightly offset by a depression with body contour, ca 16.5-18.5 µm wide, amphidial fovea pouch-like without basal lobes, guiding ring at 35-41 µm distance from the anterior end, and an odontostyle and odontophore ranging 102-115 and 47-75 µm long, respectively. The pharyngeal bulb is 123-153 µm long, female reproductive system didelphic-amphidelphic containing sperm, vulva almost equatorial, located at 46.7-51.4% of body length, tail short, rounded to bluntly conoid, bearing two pairs of caudal pores and terminus widely rounded with distinct radial lines in hyaline region (39-50 µm long, c = 122.4-189.4, c' = 0.6-0.8). Males are common, making up to 60% of the adults, and are functional, with spicules 68.0-80.0 µm long, as well as having 8-14 ventromedian copulatory supplements. All four juvenile life developmental stages were present, with the tail of first-stage juvenile conoid shape, dorso-ventrally curved with rounded terminus. The polytomous codes delimiting the new species are: A4-B3-C3-D3-E1-F34-G12-H1-I2-J1-K6. Morphologically, the new species comes close to eight known species of the genus, namely L. apulus, L. armeniacae, L. crassus, L. kheirii, L. soosanae, L. proximus, L. pauli, and L. ferrisi. The morphological differences between the new species and the aforementioned species are discussed. Molecular phylogenetic analyses based on D2-D3 of large subunit (LSU) and internal transcribed spacer 1 (ITS1) rRNA sequences indicate that Longidorus zanjanensis sp. nov. is closely related to L. hyrcanus, L. soosanae, and L. elongatus.

Genome-wide association studies and polygenic risk scores for skin cancer: clinically useful yet?

BACKGROUND: Genome-wide association studies (GWAS) have identified thousands of susceptibility variants, although most have been associated with small individual risk estimates that offer little predictive value. However, combining multiple variants into polygenic risk scores (PRS) may be more informative. Multiple studies have developed PRS composed of GWAS-identified variants for cutaneous cancers. This review highlights data from these studies. OBJECTIVES: To review published GWAS and PRS studies for melanoma, cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC), and discuss their potential clinical utility. METHODS: We searched PubMed and the National Human Genome Research Institute-European Bioinformatics Institute GWAS catalogue to identify relevant studies. RESULTS: Results from 21 GWAS (11 melanoma, 3 cSCC, 7 BCC) and 11 PRS studies are summarized. Six loci in pigmentation genes overlap between these three cancers (ASIP/RALY, IRF4, MC1R, OCA2, SLC45A2 and TYR). Additional loci overlap for cSCC/BCC and BCC/melanoma, but no other loci are shared between cSCC and melanoma. PRS for melanoma show roughly two-to-threefold increases in risk and modest improvements in risk prediction (2-7% increases). PRS are associated with twofold and threefold increases in risk of cSCC and BCC, respectively, with small improvements (2% increase) in predictive ability. CONCLUSIONS: Existing data indicate that PRS may offer small, but potentially meaningful, improvements to risk prediction. Additional research is needed to clarify the potential utility of PRS in cutaneous carcinomas. Clinical translation will require well-powered validation studies incorporating known risk factors to evaluate PRS as tools for screening. What's already known about this topic? Over 50 susceptibility loci for melanoma, basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) have been identified in genome-wide association studies (GWAS). Polygenic risk scores (PRS) using variants identified from GWAS have also been developed for melanoma, BCC and cSCC, and investigated with respect to clinical risk prediction. What does this study add? This review provides an overview of GWAS findings and the potential clinical utility of PRS for melanoma, BCC and cSCC.

Morphological and molecular characterization of Lenonchium zanjanense sp. n. (Dorylaimida, Nordiidae) from Iran, with new insights into the phylogeny of the genus and a revision of its taxonomy.

The new species Lenonchium zanjanense sp. n. is described from a natural habitat of Zanjan province, Iran, including line, light microscopy and scanning electron microscopy illustrations and a molecular (18S, 28S) study. It is characterized by its 3.50-4.51 mm long body, rounded lip region, continuous and 13.5-15.5 µm broad, odontostyle 21-24 µm long, neck 362-490 µm long, double guiding ring, pharyngeal expansion 190-285 µm long, female genital system didelphic-amphidelphic, uterus simple and 185-320 µm long or 3.4-5.9 times the corresponding body diameter, vulva nearly equatorial (V = 45-53), tail conical-elongated to filiform (90-165 µm, c = 23-43, c' = 2.4-5.3) with three or four mucro-like projections at the tip, spicules 58-64 µm long and 16-21 contiguous ventromedian supplements ending at the level of the anterior end of the spicules. The taxonomy of the genus is updated, with an emended diagnosis, list of species, key to their identification and a compendium of their main morphometrics. Lenonchium asterocaudatum is regarded as identical and a junior synonym of L. denticaudatum. New insights into the phylogeny of the group are also provided, and the classification of Lenonchium within Nordiidae is seriously questioned.

Photosensitizing antihypertensive drug use and risk of cutaneous squamous cell carcinoma.

BACKGROUND: Many antihypertensive drugs (ADs) are photosensitizing, heightening reactivity of the skin to sunlight. Photosensitizing ADs have been associated with lip cancer, but whether they impact the risk of cutaneous squamous cell carcinoma (cSCC) is unknown. OBJECTIVES: To examine the association between AD use and cSCC risk among a cohort of non-Hispanic white individuals with hypertension enrolled in a comprehensive integrated healthcare delivery system in northern California (n = 28 357). METHODS: Electronic pharmacy data were used to determine exposure to ADs, which were classified as photosensitizing, nonphotosensitizing or unknown, based on published literature. We identified patients who developed a cSCC during follow-up (n = 3010). We used Cox modelling to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Covariates included age, sex, smoking, comorbidities, history of cSCC and actinic keratosis, survey year, healthcare utilization, length of health plan membership and history of photosensitizing AD use. RESULTS: Compared with nonuse of ADs, risk of cSCC was increased with ever having used photosensitizing ADs (aHR = 1·17, 95% CI 1·07-1·28) and ever having used ADs of unknown photosensitizing potential (aHR = 1·11, 95% CI 1·02-1·20), whereas no association was seen with ever having used nonphotosensitizing ADs (aHR = 0·99; 95% CI 0·91-1·07). Additionally, there was a modest increased risk with an increased number of prescriptions for photosensitizing ADs (aHR = 1·12, 95% CI 1·02-1·24; aHR = 1·19, 95% CI 1·06-1·34; aHR = 1·41, 95% CI 1·20-1·67 for one to seven, eight to 15 and ≥ 16 fills, respectively). CONCLUSIONS: These findings provide moderate support for an increased cSCC risk among individuals treated with photosensitizing ADs.

Prognostic factors and survival in acral lentiginous melanoma.

BACKGROUND: Acral lentiginous melanoma (ALM) is a rare melanoma subtype that disproportionately afflicts people of colour. ALMs have a worse prognosis than other melanoma subtypes; this has been attributed to aggressive biological behaviour, more advanced stage at presentation and possible disparities in access to health care. OBJECTIVES: To examine, using comprehensive patient data and long-term follow-up information in a well-characterized cohort, how patient, tumour and clinical management variables impact overall and melanoma-specific survival. METHODS: We characterized a consecutive cohort of 123 ALMs diagnosed from 1987 to 2013 and analysed predictors of overall and melanoma-specific survival for their association with survival. RESULTS: Univariate hazard ratios and 95% confidence intervals using Cox regression models showed that increased Breslow depth, presence of ulceration, receipt of radiation, chemo- and vaccine therapy were associated with worse melanoma-specific survival. Notably, nonwhite race/ethnicity was not associated with worse overall or melanoma-specific survival. Multivariate modelling adjusting for patient, tumour and management variables revealed Breslow depth > 2 mm and disease extent as significantly associated with poor melanoma-specific survival. CONCLUSIONS: Melanoma-specific mortality among patients with ALM is associated with increased tumour thickness and more advanced stage at presentation, but not with race/ethnicity. Advanced tumour features at presentation and access to care may account for less favourable survival outcomes reported among nonwhite patients.

Research gaps in the management and prevention of cutaneous squamous cell carcinoma in organ transplant recipients.

Although tremendous progress has been made in recent years in skin cancer care for organ transplant recipients, significant gaps remain in data-driven clinical guidelines, particularly for the treatment and prevention of cutaneous squamous cell carcinoma (cSCC), the most common malignancy among this population. In this review, we aim to summarize current knowledge around the management of cSCC and highlight the most significant gaps in knowledge that continue to pose challenges in the delivery of skin cancer care for organ transplant recipients. We suggest future directions for research that will bridge existing gaps and establish evidence-driven guidelines for primary prevention, screening and treatment of cSCC in this high-risk patient population.

Risk prediction tools for keratinocyte carcinoma after solid organ transplantation: a review of the literature.

Long-term iatrogenic immunosuppression increases the risk of cutaneous malignancies in organ transplant recipients (OTRs), particularly the keratinocyte cancers basal cell carcinoma and cutaneous squamous cell carcinoma (cSCC). cSCC is the most common malignancy in OTRs, with the risk increased to over 65-fold in transplanted patients relative to the general population. There have been very few risk prediction tools developed for accurate determination of the risk of developing keratinocyte cancers in the OTR population. This review summarizes the prediction tools developed to date, and outlines future directions for developing more accurate prediction models that are clinically useful for the transplant physician and dermatologist.

Voriconazole Exposure and Risk of Cutaneous Squamous Cell Carcinoma, Aspergillus Colonization, Invasive Aspergillosis and Death in Lung Transplant Recipients.

Voriconazole is a triazole antifungal used to prevent and treat invasive fungal infections after lung transplantation, but it has been associated with an increased risk of developing cutaneous squamous cell carcinoma (SCC). Despite widespread use, there are no clear guidelines for optimal prophylactic regimens that balance the competing risks and benefits. We conducted a retrospective cohort study of all lung transplant recipients at the University of California, San Francisco, who were transplanted between October 1991 and December 2012 (n = 455) to investigate whether voriconazole exposure affected development of SCC, Aspergillus colonization, invasive aspergillosis and all-cause mortality. Voriconazole exposure was associated with a 73% increased risk of developing SCC (hazard ratio [HR] 1.73; 95% confidence interval [CI]: 1.04-2.88; p = 0.03), with each additional 30-day exposure at the standard dose increasing the risk by 3.0% (HR 1.03; 95% CI: 1.02-1.04; p < 0.001). Voriconazole exposure reduced risk of Aspergillus colonization by 50% (HR 0.50; 95% CI: 0.34-0.72; p < 0.001), but we were underpowered to detect risk reduction for invasive aspergillosis. Voriconazole exposure significantly reduced all-cause mortality among subjects who developed Aspergillus colonization (HR 0.34; 95% CI: 0.13-0.91; p = 0.03) but had no significant impact on those without colonization. Physicians should consider patient-specific factors that modify the potential risks and benefits of voriconazole for the care of lung transplant recipients.

Sebotropic eruption associated with use of oral kava kava supplement.

Supplement use is prevalent, and its use is increasing among older adults. Dermatologists need to be aware of the adverse cutaneous effects that can result from herbal supplement use. A 55-year-old man presented with an eruption in a sebotropic distribution after consuming kava kava for 3 weeks, which resolved after discontinuation of the supplement. This case highlights the need for clinicians to consider kava kava in the differential of sebotropic eruptions. The biology, mechanism of action, and potential systemic and cutaneous effects of kava kava are reviewed.

Initiation of TNF inhibitor therapy and change in physiologic measures in psoriasis.

BACKGROUND: Psoriasis may predispose to cardiovascular disease and diabetes. However, the role of tumor necrosis factor (TNF) inhibitor in mediating this risk is controversial. OBJECTIVE: To assess this relationship, we estimated change in metabolic physiologic measures before and after initiation of TNF inhibitor therapy compared with methotrexate (MTX) therapy among psoriasis patients. METHODS: We conducted a retrospective cohort study, 2007-2012, using computerized clinical data for 1274 new users of TNF inhibitor and 979 new users of MTX therapy to compare change in blood pressure, lipids, triglycerides, fasting plasma glucose and body mass index (BMI) before and after start of TNF inhibitors or MTX. The study was restricted to new users. We computed within-person change in each measure, so that each patient served as their own control. In addition, we compared TNF inhibitor patients to MTX patients, by computing the adjusted difference in their group means. In secondary analyses, we examined phototherapy as a comparator. RESULTS: Among starters of TNF inhibitor and MTX therapy, within-person change in physiologic measures at 6 months did not differ significantly. We observed no important or significant changes in any of the physiologic measures with initiation of TNF inhibitor compared with MTX. The same results were found in subgroup analyses focused on men, and on those with hypertension, diabetes mellitus, or obesity. The same results were observed with phototherapy, except that diastolic blood pressure declined by 0.6 mmHg within person during the 6 months after starting phototherapy (P < 0.05). CONCLUSIONS: The study provides no evidence for improvement of physiologic measures associated with the metabolic syndrome resulting from TNF inhibitor use for psoriasis.

An Assessment of the Fire Safety Standards in Iranian Homes and Equipment As They Relate to Fire Accidents.

Fire accidents and burns are one of the leading causes of death and disability worldwide. This study was conducted with the aim of studying the etiology of fire accidents as well as investigating the fire safety standards of both homes and equipment in Iran. Samples included patients with flame burns who consented to answer the questions. Questions covered five areas: patient demographics, epidemiological characteristics of burns, the fire safety status of the home, the fire safety status of the equipment, and the mechanism of the accident. In this study, the mean extent of the burns was 18.07 ± 14.29% of body surface area and was significantly related to the age grouping of the patients. The highest total body surface area (TBSA) was observed in patients between 19 to 39 years. The most common cause of flame injuries was gas explosions (36.81%). The interviews revealed that most of the houses were not equipped with smoke detectors or fire extinguishers. The extent of burns was significantly higher in patients living in unequipped homes (P = 0.047). Cooking equipment was often involved in the accidents (38.1%). Considering the low home fire safety and the role of equipment misuse and damaged equipment use in the occurrence of accidents, it seems that installing fire alarms and firefighting equipment, proper training on how to work with and maintain the equipment, using cooking and heating equipment correctly along with discontinuing use if damaged would all be effective and are highly suggestive to reduce fire injuries.

Les incendies et les brûlures sont une cause majeure de décès et de handicap dans le monde. Les buts de cette étude était d'identifier les causes d'incendie en Iran et d'évaluer la sécurité des maison et des équipements en Iran. Nous avons interrogé des victimes d'incendie acceptant de répondre à nos questions, qui relevaient de 5 sujets: démographie des patients, caractéristiques des brûlures, sécurité- incendie de leur domicile ainsi que des équipements et mécanisme de l'incendie. La surface brûlée était de 18,07 +/- 14,29%, significativement corrélée à l'âge de la victime, la surface maximale étant observée dans le groupe 19-39 ans. Une explosion de gaz était la cause la plus fréquente de déclenchement de l'incendie (36,81%) et les équipements de cuisson étaient impliqués dans 38% des cas. La plupart des habitations ne se pas équipées de détecteurs de fumées (DAAF) ni d'extincteurs, les brûlures étant plus étendues en l'absence de tels matériels (p= 0,047). Il est donc nécessaire de promouvoir l'installation de DAAF et d'extincteurs, de développer l'éducation à l'utilisation et à l'entretien des appareils de chauffage comme de cuisson, de décourager l'utilisation de ces appareils quand ils sont endommagés afin de réduire le risque d'incendie de domicile.