A smartphone application supporting patients with psoriasis improves adherence to topical treatment: a randomized controlled trial.

BACKGROUND: Adherence to topical psoriasis treatments is low, which leads to unsatisfactory treatment results. Smartphone applications (apps) for patient support exist but their potential to improve adherence has not been systematically evaluated. OBJECTIVES: To evaluate whether a study-specific app improves adherence and reduces psoriasis symptoms compared with standard treatment. METHODS: We conducted a randomized controlled trial (RCT, clinicaltrials.gov registration: NCT02858713). Patients received once-daily medication [calcipotriol/betamethasone dipropionate (Cal/BD) cutaneous foam] and were randomized to no app (n = 66) or app intervention (n = 68) groups. In total, 122 patients (91%) completed the 22-week follow-up. The primary outcome was adherence, which was defined as medication applied ≥ 80% of days during the treatment period and assessed by a chip integrated into the medication dispenser. Secondary outcomes were psoriasis severity measured by the Lattice System Physician's Global Assessment (LS-PGA) and quality of life, measured using the Dermatology Life Quality Index (DLQI) at all visits. RESULTS: Intention-to-treat analyses using regression was performed. More patients in the intervention group were adherent to Cal/BD cutaneous foam than those in the nonintervention group at week 4 (65% vs. 38%, P = 0·004). The intervention group showed a greater LS-PGA reduction than the nonintervention group at week 4 (mean 1·86 vs. 1·46, P = 0·047). A similar effect was seen at weeks 8 and 26, although it did not reach statistical significance. CONCLUSIONS: This RCT demonstrates that the app improved short-term adherence to Cal/BD cutaneous foam treatment and psoriasis severity.

Adult and offspring size in the ocean over 17 orders of magnitude follows two life history strategies.

Explaining variability in offspring vs. adult size among groups is a necessary step to determine the evolutionary and environmental constraints shaping variability in life history strategies. This is of particular interest for life in the ocean where a diversity of offspring development strategies is observed along with variability in physical and biological forcing factors in space and time. We compiled adult and offspring size for 407 pelagic marine species covering more than 17 orders of magnitude in body mass including Cephalopoda, Cnidaria, Crustaceans, Ctenophora, Elasmobranchii, Mammalia, Sagittoidea, and Teleost. We find marine life following one of two distinct strategies, with offspring size being either proportional to adult size (e.g., Crustaceans, Elasmobranchii, and Mammalia) or invariant with adult size (e.g., Cephalopoda, Cnidaria, Sagittoidea, Teleosts, and possibly Ctenophora). We discuss where these two strategies occur and how these patterns (along with the relative size of the offspring) may be shaped by physical and biological constraints in the organism's environment. This adaptive environment along with the evolutionary history of the different groups shape observed life history strategies and possible group-specific responses to changing environmental conditions (e.g., production and distribution).

Emerging asymmetric interactions between forage and predator fisheries impose management trade-offs.

A size and trait-based marine community model was used to investigate interactions, with potential implications for yields, when a fishery targeting forage fish species (whose main adult diet is zooplankton) co-occurs with a fishery targeting larger-sized predator species. Predicted effects on the size structure of the fish community, growth and recruitment of fishes, and yield from the fisheries were used to identify management trade-offs among the different fisheries. Results showed that moderate fishing on forage fishes imposed only small effects on predator fisheries, whereas predator fisheries could enhance yield from forage fisheries under some circumstances.

Analysing migrations of Atlantic cod Gadus morhua in the north-east Atlantic Ocean: then, now and the future.

The application of data storage tags bears the potential for a quantum leap in the research on fish migrations, because not only first-capture and recapture positions are known, but at least theoretically, the migration path during the period at large can be reconstructed. Position, however, cannot be measured directly but has to be estimated using the available data on light, temperature, pressure and salinity. The reconstructed locations based on advanced estimation techniques have been termed geolocations. Examples are discussed which illustrate the applicability of geolocations in individual path descriptions, separation of reproductively isolated populations, timing and areas of spawning, tidal transport and use of protected areas. The examples are based on archival tag data from the North Sea, the Baltic Sea, the Barents Sea and Faroese and Icelandic Waters. Besides presenting the state-of-the-art geolocations for cod Gadus morhua in the north-east Atlantic Ocean, the major aim of this review is to raise awareness of gaps in knowledge and to identify ideas for new research.

The importance of motility and chemotaxis for extra-animal survival of Salmonella enterica serovar Typhimurium and Dublin.

AIMS: This study investigated the importance of flagella and motility of Salmonella enterica serovar Typhimurium and Dublin in models of extra-animal survival. METHODS AND RESULTS: The study was performed using transposon mutants in flagella genes fliC and fljB and in chemotaxis genes cheA, cheB and cheR. Flagella and chemotaxis were found to be of minor importance for attachment to plant leaves, survival in liquid manure and interaction with the nematode C. elegans, while differences were observed between the fliC mutant and the wild-type strain of S. Dublin in interactions with amoebae. CONCLUSIONS: The study shows that flagella and chemotaxis play a minor role in extra-animal survival of these two serovars of Salmonella under the conditions tested. SIGNIFICANCE AND IMPACT OF THE STUDY: Extra-animal survival is important in the full infection cycle for zoonotic salmonellae. Such serovars are motile. Even though the current study was only based on the characterization of two serovars, it strongly suggests that motility and chemotaxis are of minor importance during the spread of Salmonella from one animal to the next through the external environment.

Damped trophic cascades driven by fishing in model marine ecosystems.

The largest perturbation on upper trophic levels of many marine ecosystems stems from fishing. The reaction of the ecosystem goes beyond the trophic levels directly targeted by the fishery. This reaction has been described either as a change in slope of the overall size spectrum or as a trophic cascade triggered by the removal of top predators. Here we use a novel size- and trait-based model to explore how marine ecosystems might react to perturbations from different types of fishing pressure. The model explicitly resolves the whole life history of fish, from larvae to adults. The results show that fishing does not change the overall slope of the size spectrum, but depletes the largest individuals and induces trophic cascades. A trophic cascade can propagate both up and down in trophic levels driven by a combination of changes in predation mortality and food limitation. The cascade is damped as it comes further away from the perturbed trophic level. Fishing on several trophic levels leads to a disappearance of the signature of the trophic cascade. Differences in fishing patterns among ecosystems might influence whether a trophic cascade is observed.

Polarized ³He as a probe for short-range spin-dependent interactions.

We have studied the relaxation of a spin-polarized gas in a magnetic field, in the presence of short-range spin-dependent interactions. As a main result we have established a link between the specific properties of the interaction and the dependence of the spin-relaxation rate on the magnitude of the holding magnetic field. This allows us to formulate a new, extremely sensitive method to study (pseudo) magnetic properties at the submillimeter scale, which are difficult to access by other means. The method has been used as a probe for nucleon-nucleon axionlike P, T violating interactions which yields a two-order-of-magnitude improved constraint on the coupling strength (g(s)g(p)) as a function of the force range (λ): g(s)g(p)λ² < 3×10⁻²7 m².

Trophic and individual efficiencies of size-structured communities.

Individual and trophic efficiencies of size-structured communities are derived from mechanistically based principles at the individual level. The derivations are relevant for communities with a size-based trophic structure, i.e. where trophic level is strongly correlated with individual size as in many aquatic systems. The derivations are used to link Lindeman's trophic theory and trophic theory based on average individuals with explicit individual-level size spectrum theory. The trophic efficiency based on the transfer of mass between trophic levels through predator-prey interactions is demonstrated to be valid only when somatic growth can be ignored. Taking somatic growth into account yields an average individual growth efficiency that is smaller than the trophic efficiency.

Some Atlantic cod Gadus morhua in the Baltic Sea visit hypoxic water briefly but often.

Individual behaviour of Atlantic cod Gadus morhua in the presence of hypoxic water was measured in situ in the vertically stratified Bornholm Basin of the Baltic Sea. Considering all recaptured individuals, the use of hypoxic habitat was comparable to data derived by traditional survey data, but some G. morhua had migrated towards the centre of the c.100 m deep basin and spent about a third of their time at oxygen saturation <50%, possibly to forage on zoobenthos. Maximal residence time per visit in such hypoxic water was limited to a few hours, allowing for the digestion of consumed prey items in waters with sufficient dissolved oxygen.

Disentangling time-focusing from beam divergence: A novel approach for high-flux thermal neutron spectroscopy at continuous and long-pulse sources.

We present the concept of a novel time-focusing technique for neutron spectrometers, which allows us to disentangle time-focusing from beam divergence. The core of this approach is a double rotating-crystal monochromator that can be used to extract a larger wavelength band from a white beam, thus providing a higher flux at the sample compared to standard time-of-flight instruments, yet preserving energy resolution and beam collimation. The performances of a spectrometer based on this approach are quantitatively discussed in terms of possible incident wavelengths, flux at the sample, and (Q, E)-resolution. Analytical estimates suggest flux gains of about one order of magnitude at comparable resolutions in comparison to conventional time-of-flight spectrometers. Moreover, the double monochromator configuration natively shifts the sample away from the source line-of-sight, thus significantly improving the signal-to-noise ratio. The latter, in combination with a system that does not increase the beam divergence, brings the further advantage of a cleaner access to the low-Q region, which is recognized to be of fundamental interest for magnetism and for disordered materials, from glasses to biological systems.

Life-history constraints on the success of the many small eggs reproductive strategy.

The reproductive strategy of most fishes is to produce a large number of tiny eggs, leading to a huge difference between egg size and asymptotic body size. The viability of this strategy is examined by calculating the life-time reproductive success R(0) as a function of the asymptotic body size. A simple criterion for the optimality of producing small eggs is found, depending on the rate of predation relative to the specific rate of consumption. Secondly it is shown that the success of the reproductive strategy is increasing with asymptotic body size. Finally the existence of both upper and lower limits on the allowed asymptotic sizes is demonstrated. A metabolic upper limit to asymptotic body size for all higher animals is derived.

Asymptotic size determines species abundance in the marine size spectrum.

The majority of higher organisms in the marine environment display indeterminate growth; that is, they continue to grow throughout their life, limited by an asymptotic size. We derive the abundance of species as a function of their asymptotic size. The derivation is based on size-spectrum theory, where population structure is derived from physiology and simple arguments regarding the predator-prey interaction. Using a hypothesis of constant satiation, which states that the average degree of satiation is independent of the size of an organism, the number of individuals with a given size is found to be proportional to the weight raised to the power -2.05, independent of the predator/prey size ratio. This is the first time the spectrum exponent has been derived solely on the basis of processes at the individual level. The theory furthermore predicts that the parameters in the von Bertalanffy growth function are related as K ∝ L⁻¹∞

Characteristic Sizes of Life in the Oceans, from Bacteria to Whales.

The size of an individual organism is a key trait to characterize its physiology and feeding ecology. Size-based scaling laws may have a limited size range of validity or undergo a transition from one scaling exponent to another at some characteristic size. We collate and review data on size-based scaling laws for resource acquisition, mobility, sensory range, and progeny size for all pelagic marine life, from bacteria to whales. Further, we review and develop simple theoretical arguments for observed scaling laws and the characteristic sizes of a change or breakdown of power laws. We divide life in the ocean into seven major realms based on trophic strategy, physiology, and life history strategy. Such a categorization represents a move away from a taxonomically oriented description toward a trait-based description of life in the oceans. Finally, we discuss life forms that transgress the simple size-based rules and identify unanswered questions.

Behavioral performance and seizure activity of lithium-intoxicated Sprague-Dawley rats treated with theophylline.

Male Sprague-Dawley rats were divided into four groups that were treated with various combinations of lithium, saline, and theophylline, i.e., saline/saline, saline/theophylline, lithium/theophylline, and lithium/saline. Neurobehavioral testing of cerebellar and neuromuscular functioning, and determination of the effect of the drug combinations on the animals' seizure threshold concluded that while theophylline increases lithium clearance, it does not exacerbate lithium neurotoxicity.

Cocaine exposure during the brain growth spurt: studies of neonatal survival, somatic growth, and brain development.

Neonatal Sprague-Dawley rat pups were assigned to one of five groups. Three cocaine-treated groups were injected SC with either 40, 60, or 80 mg/kg/day of cocaine from postnatal day (PND) 4 through 9. Control groups were either injected with equivalent volumes of sterile dH2O (vehicle control) or received no injections (normal control) from PND 4 through 9. This early postnatal period, corresponding to the third trimester of pregnancy in humans, is characterized as a period of rapid development within the central nervous system (CNS), generally termed the brain growth spurt. The survival rate, somatic growth, and brain development in response to the various dosages of postnatal cocaine administration were assessed. There was a dose-dependent relationship between cocaine administration and survival rate. Furthermore, significantly reduced somatic growth, assessed in terms of body weight, was found in animals given 80 mg/kg cocaine daily, as compared with controls. With respect to brain weight, no significant differences were obtained among the various doses of cocaine-treated and control animals and there was no evidence of regional vulnerability (forebrain, cerebellum, or brainstem) to the cocaine insult. Additionally, neither an effect of gender, nor the interactions of gender with various doses of cocaine treatment was found on somatic growth and brain development. Taken together, the present results suggest that the brain exhibits a greater resistance to the cocaine insults than does somatic growth. Several possible explanations regarding the somatic growth retardation are discussed.

Cocaine-induced somatic growth deficit during the brain growth spurt is prevented by artificial-rearing.

The brain growth spurt is a dynamic period of central nervous system development that has been shown to be particularly vulnerable to a variety of insults. This study was designed to assess the effects of various doses of cocaine during this potentially vulnerable period on survival rate, somatic growth, and brain development, utilizing an artificial-rearing paradigm. Three cocaine-treated groups received SC administration of either 40, 60, or 80 mg/kg/day of cocaine HCl from postnatal days 4 through 9. There were significant differences in survival rates among 60 and 80 mg/kg/day cocaine-treated animals as compared with gastrostomy controls. No statistically significant differences were found with regard to body and brain weights between the various cocaine-treated groups and the gastrostomy control group. Additionally, there was no evidence of cocaine's effect on forebrain, cerebellum, or brainstem weights when compared with individually corresponding controls. Taken together with our previous results, these data suggest that cocaine administration during the brain growth spurt period produces a dose-related increase in lethality, and the use of artificial-rearing method seems to lower the lethal threshold of cocaine among these neonates. However, no statistically significant effects of cocaine exposure on brain weight measures were obtained. The most important finding was that the cocaine-induced somatic growth retardation observed previously under normal-rearing conditions was eliminated by using a nutritionally controlled artificial-rearing paradigm, suggesting that cocaine-induced restriction of somatic growth may be a function of interference with normal feeding behavior, and therefore, a secondary effect of cocaine exposure during development.

Illicit anabolic steroid use in athletes. A case series analysis.

Because of recent anabolic steroid abuse scandals at all levels of athletic competition ranging from high school sports to the 1988 Olympics in Seoul, Korea, the investigators closely examined the anabolic steroid use histories of 20 competitive and noncompetitive weight lifters. Steroid efficacy studies only examine the anabolic effects of individual drugs. However, these 20 steroid users consistently practiced polypharmacy. During steroid use cycles lasting between 7 and 14 weeks, athletes commonly used two or three oral agents and two long-acting injectable products. Dosages of oral preparations tended to be similar to those used in efficacy studies, whereas dosages of the long-acting injectable agents were approximately three to eight times greater than those used in controlled studies. Subjects reported significant increases in body weight and strength. In addition, mental status changes were reported that included symptoms of depression, hostility, aggression, and paranoia. Based on the pattern of anabolic steroid use currently being practiced in the United States, it is apparent that past efficacy and toxicology studies are of limited value in delineating the benefits and hazards of these drugs.

Influence of density and temperature on the microscopic structure and the segmental relaxation of polybutadiene.

We investigate the influence of temperature and density on the local structure and the dynamics of polybutadiene by controlling both hydrostatic pressure and temperature in polarized neutron diffraction experiments on deuterated polybutadiene and in inelastic incoherent scattering experiments on protonated polybutadiene. We observe that the static structure factor S(Q) does not change along macroscopic isochores. This behavior is contrary to the relaxations observed on the nanosecond and picosecond time scales and viewed by the dynamic incoherent scattering law S(Q,omega), which differ strongly along the same thermodynamic path. We conclude that the static behavior, i.e., S(Q), is dominated by macroscopic density changes, similar to the vibrational excitations in the meV range. However, the relaxation dynamics is more sensitive to thermal energy changes. This is confirmed by the finding that lines of identical relaxation behavior (in time, shape, and Q dependence), isochrones on the 10(-9) sec time scale, clearly cross the constant density lines in the (P,T) plane. Concerning S(Q), we can reasonably relate the variation of the main-peak position to the average neighbor chain distance and deduce crude microscopic thermal expansion and compressibility coefficients. In the low-Q regime, the observed pressure and temperature variation of S(Q) exceeds the compressibility contribution and suggests the existence of additional scattering, which might originate from structural correlations arising at higher temperature and low pressure.

Dynamical models for sand ripples beneath surface waves.

We introduce order parameter models for describing the dynamics of sand ripple patterns under oscillatory flow. A crucial ingredient of these models is the mass transport between adjacent ripples, which we obtain from detailed numerical simulations for a range of ripple sizes. Using this mass transport function, our models predict the existence of a stable band of wave numbers limited by secondary instabilities. Small ripples coarsen in our models and this process leads to a sharply selected final wave number, in agreement with experimental observations.

Corridors of barchan dunes: Stability and size selection.

Barchans are crescentic dunes propagating on a solid ground. They form dune fields in the shape of elongated corridors in which the size and spacing between dunes are rather well selected. We show that even very realistic models for solitary dunes do not reproduce these corridors. Instead, two instabilities take place. First, barchans receive a sand flux at their back proportional to their width while the sand escapes only from their horns. Large dunes proportionally capture more sand than they lose, while the situation is reversed for small ones: therefore, solitary dunes cannot remain in a steady state. Second, the propagation speed of dunes decreases with the size of the dune: this leads, through the collision process, to a coarsening of barchan fields. We show that these phenomena are not specific to the model, but result from general and robust mechanisms. The length scales needed for these instabilities to develop are derived and discussed. They turn out to be much smaller than the dune field length. As a conclusion, there should exist further, yet unknown, mechanisms regulating and selecting the size of dunes.