Phytoplankton optical fingerprint libraries for development of phytoplankton ocean color satellite products.

Phytoplankton respond to physical and hydrographic forcing on time and space scales up to and including those relevant to climate change. Quantifying changes in phytoplankton communities over these scales is essential for predicting ocean food resources, occurrences of harmful algal blooms, and carbon and other elemental cycles, among other predictions. However, one of the best tools for quantifying phytoplankton communities across relevant time and space scales, ocean color sensors, is constrained by its own spectral capabilities and availability of adequately vetted and relevant optical models. To address this later shortcoming, greater than fifty strains of phytoplankton, from a range of taxonomic lineages, geographic locations, and time in culture, alone and in mixtures, were grown to exponential and/or stationary phase for determination of hyperspectral UV-VIS absorption coefficients, multi-angle and multi-spectral backscatter coefficients, volume scattering functions, particle size distributions, pigment content, and fluorescence. The aim of this publication is to share these measurements to expedite their utilization in the development of new optical models for the next generation of ocean color satellites.

Microneedling Prior to Levulan PDT for the Treatment of Actinic Keratoses: A Split-Face, Blinded Trial.

INTRODUCTION: Photodynamic Therapy (PDT) with topical Levulan is an approved and efficacious method for treating actinic keratoses. This therapy depends on the ability of the Levulan (delta amino levulinic acid) to penetrate the stratum corneum and enter the cells of the epidermis. Microneedling is an increasing popular cosmetic therapy in which an array of tiny needles is used to make holes in the epidermis and presumably induce a wound healing cascade that leads to cosmetic improvement of the skin. We were interested to know if prior microneedling would enhance the penetration of topical Levulan and thus enhance the PDT treatment, and if a cosmetic improvement beyond the PDT alone would be seen when it is used in conjunction with microneedling.
METHODS: 20 patients each with at least 4 non hyperkeratotic AKs on each side of their face were enrolled. All patients were randomized to receive multiple passes with a microneedling device to ½ of their face, left or right, followed by application of Levulan to the entire face. The Levulan was allowed to incubate 1 hour followed by exposure to blue light (Blu U) for 1000 seconds.
RESULTS: 19 patients completed the study with 4-month follow up. The mean percentage reduction in AKs was 89.3% on the microneedling side versus 69.5% on the PDT alone side, a significant difference. A physician's global cosmetic assessment was performed based on Canfield Visia photographs: 15 of the 19 patients had a noticeable improved cosmetic appearance on one side of the face versus the other, and in 13 of these patients the improved side was the microneedled side.
DISCUSSION: Prior microneedling significantly enhances the effect of Levulan PDT. It also seems to provide a cosmetic benefit above and beyond the PDT alone. It was safe and well tolerated in this study.

J Drugs Dermatol. 2016;15(9):1072-1074.

Criminal Forensic Psychiatry: A Primer for Psychiatrists.

Many mentally ill people are currently held in correctional settings, and general psychiatrists should be familiar with criminal forensic psychiatry in order to understand the legal aspects of the evaluation and treatment of these individuals, especially with regard to competency to stand trial and insanity. This educational activity briefly explains these evaluations and reviews relevant landmark legal cases.

Multi-method approach to quantify uncertainties in the measurements of light absorption by particles.

Through technological and research advances, numerous methods and protocols have emerged to estimate spectral absorption of light by particles, ap, in an aquatic medium. However, the level of agreement among measurements remains elusive. We employed a multi-method approach to estimate the measurement precision of measuring optical density of particles on a filter pad using two common spectrophotometric methods, and the determination precision, or uncertainty, of the computational techniques for estimating ap for six ocean color wavelengths (412, 443, 490, 510, 555, 670 nm). The optical densities measured with the two methods exhibited a significant, positive correlation. Optical density measurement precision ranged from 0.061%-63% and exhibited a significant, positive correlation. Multi-method uncertainty ranged from 7.48%-119%. Values of ap at 555 nm and 670 nm exhibited the highest values of uncertainty. Poor performance of modeled ap compared to determined ap suggest uncertainties are propagated into bio-optical algorithms.

Iloperidone-induced retrograde ejaculation.

This case series describes the development of retrograde ejaculation with the antipsychotic iloperidone. Iloperidone is a relatively new antipsychotic and has a strong α-1 receptor antagonism, which may explain this rare adverse effect.

Clindamycin phosphate 1.2% and tretinoin 0.025% gel for rosacea: summary of a placebo-controlled, double-blind trial.

Rosacea is a common, chronic, and poorly understood dermatological condition characterized by an inflammatory component composed of papules and pustules and a vascular component composed of flushing and erythema. Current treatment options include topical, systemic, and light-based methods, each of which focuses on either the inflammatory or the vascular component. Retinoids are not routinely indicated as treatment because of the common conception that they would be too inflammatory for the sensitive rosacea patient. However, photodamage may play a role in rosacea and tretinoin is well-known to repair photodamage. Thirty rosacea subjects were enrolled to assess their response to the use of clindamycin phosphate 1.2% and tretinoin 0.025% gel (ZIANA; Medicis Pharmaceutical Corporation, Scottsdale, AZ) for a period of 12 weeks. The results showed a dramatic decrease in pustules and papules without any significant inflammation or overall intolerance. No improvement in facial redness was achieved. Based on our results, more investigation of topical retinoids for rosacea treatment is prudent.

Spectra of particulate backscattering in natural waters.

Hyperspectral profiles of downwelling irradiance and upwelling radiance in natural waters (oligotrophic and mesotrophic) are combined with inverse radiative transfer to obtain high resolution spectra of the absorption coefficient (a) and the backscattering coefficient (b(b)) of the water and its constituents. The absorption coefficient at the mesotrophic station clearly shows spectral absorption features attributable to several phytoplankton pigments (Chlorophyll a, b, c, and Carotenoids). The backscattering shows only weak spectral features and can be well represented by a power-law variation with wavelength (lambda): b(b) approximately lambda(-n), where n is a constant between 0.4 and 1.0. However, the weak spectral features in b(b)b suggest that it is depressed in spectral regions of strong particle absorption. The applicability of the present inverse radiative transfer algorithm, which omits the influence of Raman scattering, is limited to lambda < 490 nm in oligotrophic waters and lambda < 575 nm in mesotrophic waters.

Post-electroconvulsive therapy agitation with etomidate.

Agitation immediately after electroconvulsive therapy (ECT) is a common clinical problem. This can vary in severity from mild to severe and may necessitate the administration of sedating medications and at times physical restraint. There are many factors involved in the etiology of post-ECT agitation. One factor, the choice of anesthetic agent, is described in this case. Here, etomidate was associated with significant post-ECT agitation after several uneventful treatments with methohexital. The patient had no further episodes of post-ECT agitation after being switched back to methohexital.

Lithium: clinical considerations in internal medicine.

Bipolar Disorders affect up to 5% of the population. While the pharmacological options for the treatment of bipolar disorder have expanded over the past several years, lithium remains an inexpensive and efficacious treatment for bipolar disorder. Lithium has been demonstrated to be an effective treatment for acute mania, bipolar depression, the prophylactic treatment of bipolar disorder, and as an augmentation agent in the treatment of unipolar major depression. Lithium also is the only mood stabilizer that has been demonstrated to lower the suicide rate in patients with bipolar disorder. Use in special populations, side effects and toxicity, and drug interactions are discussed. Important laboratory monitoring guidelines are included in this review. Lithium remains an important intervention for the treatment of mood disorders.

Use of optical scattering to discriminate particle types in coastal waters.

The particulate scattering characteristics of coastal waters were examined at nine locations around the United States, including near-shore sites in the Gulf of Mexico and the Atlantic and Pacific oceans. The scattering measurements were used in conjunction with inversion models to estimate particle size distributions and bulk refractive indices of the suspended particles. The relationships between various scattering properties and chlorophyll concentration were also investigated and compared with previous relationships described for case I waters. Although the general patterns of scattering and particle characteristics in coastal waters were fairly consistent, fine-scale variability within the water column was substantial. Combining optical measurements with inversion techniques provided a more informative view of the environment and a better understanding of the nature of particle populations in the coastal ocean.

The struggle to maintain neutrality in the treatment of patient with pedophilia.

This article explores the ethical concept of neutrality through use of a psychiatric clinical vignette. In this case a psychiatry resident is faced with the treatment of a patient who was found by the FBI to be in possession of child pornography. Although not accused of any other crimes, the patient was a fugitive from the law and requesting treatment for pedophilia. Faced with the pressures of limited resources and anxiety about the patient's dangerousness to others, the resident and his supervisor tried to strike a balance between the ethical principles of neutrality and beneficence. Through this vignette, the importance of neutrality, as well as how it can be compromised by other pressures such as expediency and anxiety, is explored.

The impact of reproductive events on the course of bipolar disorder in women.

BACKGROUND: Little is known about the impact of female reproductive hormones on the course of bipolar disorder. This study was designed to assess the influence of reproductive events and hormonal therapies on the course of bipolar disorder in women. METHOD: Fifty women with DSM-IV bipolar disorder completed a structured clinical interview to assess the impact of reproductive events on the course of their illness. RESULTS: The onset of bipolar disorder occurred before menarche in 32% (N = 16) of women; 18% (N = 9) experienced the onset within 1 year of menarche. Most women did not receive an accurate diagnosis of nor treatment for bipolar disorder until after they had children, and therefore the majority were not treated with mood stabilizers during or immediately after pregnancies. Of women with children, 20 (67%) of 30 experienced a postpartum mood episode. Of the women who had postpartum episodes after delivery of a first child, all had episodes after subsequent pregnancies. Having a postpartum mood episode after a first pregnancy significantly increased the risk of a postpartum episode after subsequent deliveries (p = .02). Postpartum episodes were almost exclusively depressive. Increased depressive symptoms during pregnancy were significantly associated with postpartum mood episodes (p = .01). Women who were not using hormone replacement therapy (HRT) were significantly more likely than those who were using HRT to report worsening of symptoms during perimenopause/menopause (p = .02). CONCLUSION: These data suggest that hormonal fluctuations are associated with increased risk of affective dysregulation and mood episodes in women with bipolar disorder.