bluuebunny/crossref_metadata_2025 huggingface dataset:
Cumulative biomass curves describe past and present conditions of Large Marine Ecosystems
Authors: Pranovi Fabio , Libralato Simone , Zucchetta Matteo , Anelli Monti Marco , Link Jason S.
Published: September 2019

Implementing the Ecosystem Approach in marine ecosystems is moving from preliminary steps—dedicated to defining the optimal features for indicators and developing efficient indicator frameworks—towards an operational phase where multisector marine management decisions are executed using this information. Within this operational context, emergent ecosystem properties are becoming quite promising as they have been demonstrated to be globally widespread and repeatable, and to be quite effective in detecting significant state variations of complex systems. Biomass accumulation across TLs (CumB‐TL) combines two important emergent properties of an ecosystem (energy flow, in terms of transfer efficiency, and storage, expressed as biomass), both amenable to detecting rapid ecosystem change. However, for further application, it is crucial to understand which types of drivers an indicator is sensitive to and how robust it is in relation to modifications of the external conditions and/or the system state. Here we address some outstanding questions of these CumB‐TL curves related to their sensitivity to various drivers by carrying out a global scale assessment (using data from 62 LMEs) over six decades (1950–2010). We confirm the consistency of the S‐pattern across all the LMEs, independent from latitude, ecosystem, environmental conditions, and stress level. The dynamics of the curve shape showed a tendency to stretch (i.e. decrease of steepness), in the presence of external disturbance and conversely to increase in steepness and shift towards higher TL in the case of recovery from stressed conditions. Our results suggest the presence of three main types of ecosystem dynamics, those showing an almost continuous increase in ecological state over time, those showing a continuous decrease in ecological state over time, and finally those showing a mixed behaviour flipping between recovering and degrading phases. These robust patterns suggest that the CumB‐TL curve approach has some useful properties for use in further advancing the implementation of the Ecosystem Approach, allowing us to detect the state of a given marine ecosystem based on the dynamics of its curve shape, by using readily available time series data. The value of being able to identify conditions that might require management actions is quite high and, in many respects, represents the main objective in the context of an Ecosystem Approach, with large applications for detecting and responding to global changes in marine ecosystems.
Rehabilitating livelihoods of relocated people affected by the Nuozhadu dam on the upper Lancang‐Mekong River
Authors: Ma Yurui , Fan Hui , Li Yanbo , Zhang Meiling
Published: September 2019

The potential impacts of dam building on resettled communities have been highlighted worldwide. This paper examines the impacts of the newly built Nuozhadu dam on the livelihoods of local communities following the implementation of China's new resettlement policies. Based on household‐level data collected from the resettlement communities using semi‐structured interviews and in‐depth questionnaires, the pre‐ and post‐dam differences in per capita land holdings, annual incomes, expenditures, and social capital of those resettled were analysed at a household level using the sustainable livelihoods framework. The results showed that significantly increased annual incomes and improved infrastructure occurred widely in the resettlement communities, although dam building led to significant losses of farmland and moderate impacts on social capital for the resettlers. Overall, the new resettlement policies have contributed significantly to bettering livelihoods of resettled people affected by dam building. This finding highlights the potential for improving the livelihoods of dam‐induced resettlers in the ethnically diverse mountainous regions of southwest China.
Ellagic acid, extracted from Sanguisorba officinalis, induces G1 arrest by modulating PTEN activity in B16F10 melanoma cells
Authors: Tan Yi Hsun , Shudo Toshiyuki , Yoshida Tomoki , Sugiyama Yuma , Si Jia Ying , Tsukano Chihiro , Takemoto Yoshiji , Kakizuka Akira
Published: September 2019

In Chinese medicine, herbal medicine is commonly used to treat individuals suffering from many types of diseases. We thus expected that some herbal medicines would contain promising compounds for cancer chemotherapy. Indeed, we found that Sanguisorba officinalis extracts strongly inhibit the growth of B16F10 melanoma cells, and we identified ellagic acid (EA) as the responsible ingredient. B16F10 cells treated with EA exhibited strong G1 arrest accompanied by accumulation of p53, followed by inactivation of AKT. Addition of a PTEN inhibitor, but not a p53 inhibitor, abrogated the EA‐induced AKT inactivation and G1 arrest. The PTEN inhibitor also diminished EA‐induced p53 accumulation. Furthermore, EA apparently increased the protein phosphatase activity of PTEN, as demonstrated by the reduced phosphorylation level of FAK, a protein substrate of PTEN. Furthermore, an in vitro PTEN phosphatase assay on PIP3 showed the direct modulation of PTEN activity by EA. These results suggest that EA functions as an allosteric modulator of PTEN, enhancing its protein phosphatase activity while inhibiting its lipid phosphatase activity. It is notable that a combination of EA and cisplatin, a widely used chemotherapy agent, dramatically enhanced cell death in B16F10 cells, suggesting a promising strategy in chemotherapy.
Tumour immune microenvironment in primary and metastatic papillary renal cell carcinoma
Authors: Eich Marie‐Lisa , Chaux Alcides , Mendoza Rodriguez Maria Angélica , Guner Gunes , Taheri Diana , Rodriguez Pena Maria Del Carmen , Sharma Rajni , Allaf Mohamad E , Netto George J
Published: September 2019

Aims

Among renal cell carcinoma (RCC) the tumour immune microenvironment has been best characterised in clear cell RCC. In this study we investigated the expression of several immune markers, including PD‐L1, FoxP3 and CD8 in primary and metastatic papillary RCC.

Methods and results

Three tissue microarrays were constructed from 78 cases with primary papillary RCC and paired metastatic tumour (24 cases) from 78 patients treated between 1982 and 2014. Immunohistochemistry analysis was performed using commercially available antibodies for PD‐L1 (clone E1L3N), FoxP3, CD8 and Ki‐67. Markers expression level in tumour and/or associated immune cells was analysed by tissue type (non‐tumour versus primary tumour versus metastatic tumour) and correlated to clinicopathological features and outcome.

Conclusion

We found PD‐L1 expression in up to one‐quarter of primary and metastatic papillary RCC. On univariate analysis, CD8/FoxP3 ratio >1 was associated with favourable outcome, whereas papillary RCCs with high numbers of dual CD8/Ki‐67‐positive lymphocytes showed an increased likelihood for tumour progression and overall and cancer‐related mortality. The association of CD8/FoxP3 ratio >1 and high count of CD8/Ki‐67 with outcome remained significant on multivariate analysis when adjusting for stage, grade and patient's age.
The decline and rise of the Kransberg Cape Vulture colony over 35 years has implications for composite population indices and survey frequency
Authors: Benson Patrick C. , McClure Christopher J. W.
Published: September 2019

Long‐term monitoring is key for detecting population declines. Composite indices allow researchers to combine trends from disparate monitoring programmes into a single estimate of population change. Inferences from composite indices, however, are limited to the time periods and areas studied. We show that the number of breeding pairs in a colony of Cape VulturesGyps coprotheresin South Africa declined between the years 1983 and 2003 but increased in both the number of breeding pairs and fledglings per pair from 2004 to 2017. We performed a retrospective power analysis determining the minimum annual frequency with which the colony could have been monitored without sacrificing inference into population trends. This power analysis revealed the post‐2003 population increase would not have been apparent if we skipped more than 2 years between surveys. We incorporated our estimates into a previously published composite index for Cape Vultures that considered only data collected pre‐2000 and demonstrate that the inference is unchanged if the trend from the decline period or the entire study is incorporated, yet if only the trend during the period of population increase is used, there is no longer a statistically significant decline across the species’ range. Our results demonstrate the utility of long‐term monitoring because if our study had concluded before 2003, there would be little evidence of the current population increase at Kransberg.
Niche dynamics of sympatric non‐breeding shearwaters under varying prey availability
Authors: Carvalho Paloma C. , Davoren Gail K.
Published: September 2019

Variation in prey availability can cause changes in species interactions among marine predators. Foraging theory predicts that niche breadth will expand when resources become limited, possibly leading to higher niche overlap among sympatric species; however, a species’ niche can become constrained by interactions with other similar species, resulting in an inability to shift niche breadth or position. In coastal Newfoundland, Capelin Mallotus villosus is the main forage fish species and its availability (i.e. biomass) during the summer has varied considerably following a population collapse in the 1990s. During the summer, non‐breeding Great and Sooty Shearwaters Ardenna gravis and A. grisea migrate and aggregate at annually persistent Capelin spawning sites. We used stable isotope ratios (δ13C, δ15N) of blood components (plasma, red blood cells) to investigate variation in isotopic niche breadth (95% prediction ellipse areas) and overlap of the two shearwater species during 2014, 2015 and 2016. Capelin availability varied among years, illustrated by lower peak biomass in 2015 (0.126 g/m²) and 2016 (0.027 g/m²) relative to 2014 (0.254 g/m²). The isotopic niche breadth (plasma) of both shearwater species expanded similarly from 2014 (0.65–0.66‰²) to 2015 (2.22–2.57‰²) and 2016 (1.15–1.42‰²), suggesting the incorporation of alternative prey types into their diet during years of lower prey availability. Isotopic niche overlap between Great and Sooty Shearwaters remained high across years (44–63%), however, providing little evidence for dietary niche partitioning during years of lower prey availability. Findings suggest that both shearwater species are flexible foragers and can modify their diet during the non‐breeding season to accommodate fluctuations in prey availability.
Experimental investigation of different morphology textured ceramic tools by in‐situ formed for the dry cutting
Authors: Feng Yihua , Yuan Peidong , Wang Li , Zhang Jiyun , Zhang Jiahui , Zhou Xuan
Published: September 2019

Surface texture is considered an important measure to improve the cutting performance of a tool. In this study, we have prepared three types of textured and conventional tools on the rake face by an in‐situ formed method. During the experiment, the best parameters of three types of textured tools were selected for dry cutting AISI 1045 steel at different cutting speeds. Cutting forces, cutting temperatures, workpiece surface roughness, and tool wear were measured during the cutting process. The results showed that textured tools have significantly reduced cutting force, cutting temperature, and tool wear, and the roughness of the workpiece was improved compared with the conventional tool. The micro‐pit texture tool has less stress contact region than the micro‐groove width texture tool, but the micro‐groove width texture tool exhibiting the best cutting performance. This investigation clearly showed that the textured tool prepared by the in‐situ formed method has improved cutting performance.
Enhanced vacuum glazing bonding strength by anodic bonding‐assisted sealing method
Authors: Li Hong , Chen Peng , Zhang Ping , Xiong Dehua , Cao Xin , Shi Lifen , Fang Yueping , Peng Shou
Published: September 2019

A novel sealing method of vacuum glazing is introduced in this study. Anodic bonding technology was used to enhance the bonding strength of the sealant of vacuum glazing. Two sheets of plane glass were sealed by V2O5‐P2O5‐TeO2 glass powder with low glass transition temperature (339.3℃) using anodic bonding‐assisted low‐temperature sintering. Through analyzing the results of Shear Strength test, the diagram of microstructures of the sealing bond taken by a micro Super‐depth Microscopy, Scanning Electron Microscope (SEM), and Energy Dispersive Spectrometer (EDS), the best bonding treatment schedule was determined for achieving the strongest bond. The experiment results show that anodic bonding has a dramatic influence on bonding performance. When the sealing temperature and bonding time are kept constant, the shear strength of the sample increases by increasing the bonding voltage. With the bonding temperature of 470℃ and the voltage of 600 V, the air tightness of the sealed sample is 3.9 × 10−9 Pa·m3/s. The improved bonding strength can enhance life‐time of vacuum glazing.
Effect of temperature and PH value on the stability of bioactive compounds and antioxidative activity of juice from colour‐fleshed potatoes
Authors: Rytel Elżbieta , Tajner‐Czopek Agnieszka , Kita Agnieszka , Sokół‐Łętowska Anna , Kucharska Alicja Z. , Wojciechowski Wiesław
Published: September 2019

The colour‐fleshed potatoes represent a good raw material for the extraction of juices with a high content of biologically active compounds and a high antioxidant activity. The blue‐fleshed potatoes turned out to be a rich source of total polyphenols, as they had approximately 3.5 times higher content of identified anthocyanidins. Regardless of anthocyanin composition, all juices made of colour‐fleshed potatoes were highly stable. Both, high temperature, exposure time to these temperatures, and medium pH had no significant effect on changes in total polyphenols content of potato juices. The juices examined, especially these made of blue‐fleshed potatoes, demonstrated a higher ABTS+ stability during their heating than during pH changes. In addition, a higher antioxidant activity of juices was determined at neutral and alkaline than at acidic pH value of the medium.
A mixed resilient‐efficient approach toward blood supply chain network design
Authors: Haeri Abdorrahman , Hosseini‐Motlagh Seyyed‐Mahdi , Ghatreh Samani Mohammad Reza , Rezaei Marziehsadat
Published: September 2019

Unlike its inherent beneficial attributes, the blood supply chain is very complex due to its uncertain nature and irregular donation besides a high vulnerability to disruptions. In this regard, this study provides a multi‐objective integrated resilient‐efficient model to design a blood supply chain network under uncertainty. To evaluate the efficiency, an augmented form of the data envelopment analysis model is incorporated into the extended model. On the other hand, to improve supply chain resilience, different resiliency measures as optimization tools are introduced and inserted into the considered network. As blood donors have a main role in the blood supply chain, this paper undertakes motivational social aspects to stimulate blood donation for reducing possible shortages. Furthermore, to handle the multi‐objective problem, an interactive fuzzy approach is utilized. Finally, to indicate the applicability of the extended model and its solution approaches, a case study is provided considering realistic data. The results revealed that simultaneously considering all three measures of efficiency, resilience, and cost can assist in improvement of blood supply chain network design and a trade‐off among these three measures can be set by decision maker's preferences.
A biased‐randomized iterated local search for the distributed assembly permutation flow‐shop problem
Authors: Ferone Daniele , Hatami Sara , González‐Neira Eliana M. , Juan Angel A. , Festa Paola
Published: September 2019

Modern production systems require multiple manufacturing centers—usually distributed among different locations—where the outcomes of each center need to be assembled to generate the final product. This paper discusses the distributed assembly permutation flow‐shop scheduling problem, which consists of two stages: the first stage is composed of several production factories, each of them with a flow‐shop configuration; in the second stage, the outcomes of each flow‐shop are assembled into a final product. The goal here is to minimize the makespan of the entire manufacturing process. With this objective in mind, we present an efficient and parameter‐less algorithm that makes use of a biased‐randomized iterated local search metaheuristic. The efficiency of the proposed method is evaluated through the analysis of an extensive set of computational experiments. The results show that our algorithm offers excellent performance when compared with other state‐of‐the‐art approaches, obtaining several new best solutions.
Effect of HfC nanowires grown on carbon fibers on the microstructure and thermophysical properties of C/C composites
Authors: Fu Yanqin , Zhang Yulei , Li Tao , Zhang Jian
Published: September 2019

One‐dimensional (1D) hafnium carbide nanowires (HfCnws) were grown in situ on carbon fibers (CFs) via a Ni‐assisted pyrolysis method of organometallic polymer precursor. Scanning electron microscopy (SEM), transmission electron microscope (TEM), polarized‐light optical microscopy (PLM), and Raman were used to analyze the effect of HfCnws on the microstructure of pyrolytic carbon (PyC). The specific heat capacity (HC), thermal diffusivity (TD), thermal conductivity (TC), and coefficient of thermal expansion (CTE) of HfCnws‐C/C composites were also investigated. Results show that HfCnws wrapped by carbon nanosheet were successfully synthesized. The diameter of HfCnws is about 30 nm and the thickness of carbon nanosheet is about 10 nm, which could induce the formation of isotropic (ISO) PyC. After introducing HfCnws, the TD and CTE of HfCnws‐C/C composites were increased. Ni2HfCnws‐C/C composites show a higher TC and TD, and the CTE increased with the increasing content of HfCnws.
Lateral cracks during sliding indentation on various optical materials
Authors: Suratwala Tayyab , Steele Rusty , Shen Nan , Ray Nathan , Wong Lana , Miller Phil E. , Feit Michael
Published: September 2019

A series of static and sliding indentation (ie, scratching) was performed and characterized on a wide range of optical workpiece materials [single crystals of Al2O3(sapphire), SiC, Y3Al5O12(YAG), CaF2, and LiB3O5(LBO); a SiO2–Al2O3–P2O5–Li2O glass ceramic (Zerodur); and glasses of SiO2:TiO2(ULE), SiO2(fused silica), and P2O5–Al2O3–K2O–BaO (Phosphate)] at various applied loads using various indenters (Vickers, 10 µm conical, and 200 µm conical). Despite having different load dependencies, the lateral crack depth formed during sliding indentation quantitatively scales with that formed during static indentation, explaining why static indentation has been historically effective in describing various grinding parameters. Depending on the indenter geometry, the amount of residual trench damage (plastic deformation and local fracturing) during sliding indentation was often enhanced by more than an order of magnitude compared with static indentation. A simple ploughing scratch model, which considers both tangential and normal stresses (where the tangential stress is amplified by relatively small tangential contact area), explains this enhancement and other observed trends. Accounting for the high correlation between residual trench depth and volumetric fracturing, the model is extended to estimate the amount of fracture damage as a function of the material properties of the workpiece, indenter geometry, and applied load. Such a model has utility in the design of optimized grinding processes, particularly the abrasive geometry. Finally, at higher loads (>1 N), lateral cracks were often observed to preferentially propagate in the forward scratching direction, as opposed to perpendicular to the scratch as typically observed. High‐speed imaging of the scratch process confirms that these cracks propagate ahead of the sliding indenter during the scratching event. Finite element stress analysis suggests the ploughing frictional forces increase the mode I tensile stresses at the leading edge of the sliding indenter explaining the direction of crack propagation of such cracks.
Mechanochemical synthesis and annealing of tungsten di‐ and tetra‐boride
Authors: Long Ying , Wu Zong , Zheng Xin , Lin Hua‐Tay , Zhang Fenglin
Published: September 2019

Tungsten diboride and tetra‐boride were synthesized by a combination of mechanochemical method and the subsequent heat treatment. To clarify the formation process of tungsten diboride (WB2) and tetra‐boride (WB4) using W‐B mixture system with variable B concentration, the effects of ball‐to‐powder ratio, W to B molar ratio on mechanochemical process were studied, and the relationship between phase composition and annealing temperature was built. The results show that, the synthesis of WB2 with W:B = 1:5 can be improved by increasing ball‐to‐powder ratio from 4:1 to 6:1, but no WB4 phase can be directly synthesized by mechanochemical method. WB2 (AlB2‐WB2, P6/mmm) phase can be only synthesized with W to B molar ratio of 1:4 and 1:5. Further increase in B content to W:B = 1:6 or less, W was present as the main phase with high crystallinity (>71%). WB4 phase was formed as an annealing temperature as low as 1000°C, which was not stable and may decompose to WB2 (WB2‐WB2, P6/mmm) phase with the increase in temperature. The decomposition temperature of WB4 can be improved by increasing the B content. Compared with the W‐B mixtures (W:B = 1:12) being milled for 1 hour, the powders milled for 40 hours present 20% higher of WB4 weight fraction after being annealed at 1400°C for 2 hours.
Oxygen‐vacancy‐controlled magnetic properties with magnetic pole inversion in BiFeO3‐based multiferroics
Authors: Liu Run , Wang Zihan , Peng Silu , Bi Jian , Wu Jiangtao , Ye Zuo‐Guang
Published: September 2019

Oxygen vacancies which are generally present in ferrite oxide may significantly affect their magnetic properties. A comprehensive understanding of the relationship between oxygen vacancies and magnetism is of great importance. In this work, we report an oxygen vacancy concentration dependence of magnetism in a single‐phase multiferroic BiFeO3 (BFO)‐based system. The BiFeO3‐DyFeO3 (BDFO) solid solution is synthesized with controlled oxygen vacancies and is characterized by X‐ray powder diffraction (XRD), X‐ray photoelectron spectroscopy (XPS), and AC impedance spectroscopy. The magnetic properties, especially magnetic pole inversion, are found to be highly dependent on oxygen vacancy concentration. The oxygen vacancies generate a Weiss molecular field on the Dy3+ ions in the magnetic field range of 570‐1000 Oe depending on the oxygen vacancy concentration, and result in a residual net magnetization by breaking the balance between the two nearly antiparallel spin lattices of Fe3+ ions. This work demonstrates an effective way to control oxygen vacancies and thereby the magnetic properties and sheds light on the relationship between oxygen vacancies and magnetism in BFO‐based multiferroics.
Competitive effects of free volume, rigidity, and self‐adaptivity on indentation response of silicoaluminoborate glasses
Authors: Liu Pengfei , Januchta Kacper , Jensen Lars R. , Bauchy Mathieu , Smedskjaer Morten M.
Published: September 2019

Lithium aluminoborate glasses have recently been found to feature high resistance to crack initiation during indentation, but suffer from relatively low hardness and chemical durability. To further understand the mechanical properties of this glass family and their correlation with the network structure, we here study the effect of adding SiO2 to a 25Li2O–20Al2O3–55B2O3 glass on the structure and mechanical properties. Addition of silica increases the average network rigidity, but meanwhile its open tetrahedral structure decreases the atomic packing density. Consequently, we only observe a minor increase in hardness and glass transition temperature, and a decrease in Poisson's ratio. The addition of SiO2, and thus removal of Al2O3 and/or B2O3, also makes the network less structurally adaptive to applied stress, since Al and B easily increase their coordination number under pressure, while this is not the case for Si under modest pressures. As such, although the silica‐containing networks have more free volume, they cannot densify more during indentation, which in turn leads to an overall decrease in crack resistance upon SiO2 addition. Our work shows that, although pure silica glass has very high glass transition temperature and relatively high hardness, its addition in oxide glasses does not necessarily lead to significant increase in these properties due to the complex structural interactions in mixed network former glasses and the competitive effects of free volume and network rigidity.
Three‐component non‐invasive risk score for undiagnosed diabetes in Chinese people: Development, validation and longitudinal evaluation
Authors: Woo Yu Cho , Gao Bin , Lee Chi Ho , Fong Carol Ho‐yi , Lui David Tak‐wai , Ming Jie , Wang Li , Yeung Kristy Man‐yi , Cheung Bernard Man‐yung , Lam Tai Hing , Janus Edward , Ji Qiuhe , Lam Karen Siu‐ling
Published: September 2019

Aims/Introduction

To develop a new non‐invasive risk score for undiagnosed diabetes in Chinese people, and to evaluate the incident diabetes risk in those with high‐risk scores, but no diabetes on initial testing.

Materials and Methods

A total of 2,609 participants with no known diabetes (aged 25–74 years) who underwent oral glucose tolerance tests in Hong Kong (HK) were investigated for independent risk factors of diabetes to develop a categorization point scoring system, the Non‐invasive Diabetes Score (NDS). This NDS was validated in a cross‐sectional study of 2,746 participants in Shaanxi, China. HK participants tested to not have diabetes at baseline were assessed for subsequent incident diabetes rates.

Results

In the HK cohort, hypertension, age and body mass index were the key independent risk factors selected to develop the NDS, with ≥28 out of 50 NDS points considered as high risk. The area under the receiver operating characteristic curve for undiagnosed diabetes was 0.818 and 0.720 for the HK and Shaanxi cohort, respectively. The negative predictive value was 97.4% (HK) and 95.8% (Shaanxi); the number needed to screen to identify one case of diabetes was five (HK) and 11 (Shaanxi), respectively. Among those that tested non‐diabetes at baseline, individuals with NDS ≥28 had a threefold risk of incident diabetes during the subsequent 20.9 years, compared with those with NDS <28 (P < 0.001), with a steeper rise in incident diabetes observed in those with NDS at higher tertiles.

Conclusions

This new three‐component risk score is a user‐friendly tool for diabetes screening, and might inform the subsequent testing interval for high‐risk non‐diabetes individuals.
Palladium causes bizarre skin hyperpigmentation in long‐term dihydrocodeinone ‘Braun’ abusers
Authors: Arenbergerova M. , Arenberger P. , Gkalpakiotis S. , Sticova E. , Hulkova H. , Trhlikova O. , Sikora J.
Published: September 2019

Background

‘Braun’ is an illegal injectable dihydrocodeinone‐enriched drug mixture of semi‐synthetic opioids. It is prepared by palladium‐catalysed hydrogenation from codeine‐containing tablets.

Objective

We aimed to characterize the dermatologic consequences of long‐term abuse of ‘Braun’.

Methods

Skin biopsies of two long‐term ‘Braun’ abusers were evaluated histopathologically, immunohistochemically and ultrastructurally. Palladium skin content was assessed by X‐ray fluorescence (XRF) spectrometry.

Results

Both patients showed generalized diffuse dark blue–grey hyperpigmentation of the skin. In both, an abnormal population of cells containing intracytoplasmic brownish granular material was identified in the papillary dermis by light microscopy. Electron microscopy revealed a dense and minimally structured material that predominantly accumulated in macrophages, fibroblasts and vascular endothelial cells. XRF analysis confirmed elevated levels of palladium in the patient's skin in comparison to healthy controls.

Conclusion

Long‐term abuse of palladium‐contaminated dihydrocodeinone (‘Braun’) results in excessive accumulation of granular material in various dermal cell types and causes generalized diffuse skin hyperpigmentation.
Lymphomatoid papulosis: an update and review
Authors: Martinez‐Cabriales S.A. , Walsh S. , Sade S. , Shear N.H.
Published: September 2019

Lymphomatoid papulosis (LyP) is a benign chronic often relapsing skin condition that belongs to theCD30‐positive cutaneous lymphoproliferative disorders. LyP typically presents as crops of lesions with a tendency to self‐resolve, and morphology can range from solitary to agminated or diffuse papules and plaques to nodules or tumours. The clinical–histological spectrum can range from borderline cases to overlap with primary cutaneous anaplastic cell lymphoma (pcALCL). Histology and immunophenotype commonly show overlap with otherCD30‐positive disorders and sometimes may be identical to pcALCL, making its diagnosis more difficult. Patients with LyP have an increased risk of developing a second neoplasm such as mycosis fungoides, pcALCLand/or Hodgkin lymphoma. Clinical correlation allows its proper classification and diagnosis, which is fundamental for treatment and prognosis. This review focuses on the clinical appearance, histopathological features, diagnosis, differential diagnosis and management of LyP.
Retrospective analysis of alpha‐human papillomavirus (HPV) types in tissue samples from anogenital dysplasias – introduction of the RICH (Risk of HPV‐related Carcinoma in HIV+/− patients) score
Authors: Hildebrand J.A. , Fischbeck A.J. , Hundsdoerfer B. , Clanner‐Engelshofen B.M. , Marsela E. , Wollenberg A. , Flaig M. , French L.E. , Reinholz M.
Published: September 2019

Background

Chronic viral infections caused by highly contagious human papillomaviruses (HPVs) from the alpha genus are a substantial risk factor for tumour diseases.

Objectives

The goal of this study was to compare the HPV infection pattern with histology in a patient group of immunocompromised HIV+ and non‐immunocompromised patients with anal intraepithelial neoplasia.

Materials and Methods

Tissue samples (n = 210) from the anogenital area of 121 patients underwent retrospective histological and molecular examination for HPV DNA prevalence by chip analysis. The study was part of a cancer screening from the Dermatology Department of the LMU Munich, Germany. All data were collected and processed anonymously.

Results

HPV 6 or 11 are more abundant in tissue samples from histologically diagnosed condylomata acuminata (47.7%) compared to grade 1, 2, and 3 intraepithelial neoplasias (IN 1‐3). Detection of high‐risk (hr) alpha‐HPV DNA was significantly higher in tissue samples from IN 3 (67.5%) compared to IN 1 and 2 (12.9%), and compared to condylomata acuminata (29.5%). No HPV types were detected in histologically unremarkable tissue samples. There was a significant association between the prevalence of HPV 16 and the classifications IN 1 to IN 3 (χ2 (2) = 13.62, P = 0.001). We identified a significant correlation between the prevalence of high‐risk and low‐risk (lr) HPV types and HIV, especially mixed infections of different HPV types correlated with high‐grade IN. Based on the present data, we suggest the risk of carcinoma in HIV+/− patients (RICH) score and test it in the 121 patients.

Conclusions

hr alpha‐HPVs, mainly HPV 16, are associated with increased oncogenic potential of premalignant lesions (IN 1‐3), especially in HIV+ patients. Based on the combination of HIV/HPV‐testing and histological analysis, we identified correlations that could potentially forecast the risk of malignant transformation and summarized them in the form of RICH score.
The role of mechanical stress in the formation of plantar melanoma: a retrospective analysis of 72 chinese patients with plantar melanomas and a meta‐analysis
Authors: Gong H.Z. , Zhang S. , Zheng H.Y. , Qu T. , Li J.
Published: September 2019

Background

Weightbearing areas of sole were reported to be significantly more vulnerable to melanoma than non‐weightbearing areas. Few studies have investigated the role that mechanical stress plays in increasing the incidence of plantar melanoma (PM).

Objective

This study aims to investigate the potential role of mechanical stress in the formation of PM and evaluate the association of mechanical stress with certain pathological features of melanoma by using meta‐analysis.

Methods

We analysed the distribution pattern of 72 PM lesions in Chinese patients and compared their incidence and demographic and clinicopathological features based on sites with different stress exposure.

Results

The most common region with a PM was the heel, followed by the forefoot, plantar aspect of the toes, lateral midfoot (LM) and arch. Both the heel and forefoot were significantly associated with a higher incidence of melanoma than the arch. A high density of lesions was observed in the posterior half of the heel and the lateral forefoot. Despite subtle differences in the contour maps of the density of lesions based on sex and age, different groups showed the same primary distribution tendency. The comparison between weightbearing and non‐weightbearing areas revealed no significant difference in sex, age, lateralization, clinical pigmentation, Breslow depth or ulceration. However, the meta‐analysis revealed that melanoma on weightbearing areas manifested as invasive melanoma at the time of diagnosis more frequently than cases on non‐weightbearing areas (OR = 0.300 [95% CI, 0.092–0.977]; P = 0.046).

Conclusion

Weightbearing areas indicating mechanical stress are correlated with a higher number of plantar melanoma compared with non‐weightbearing areas and also show a tendency to be involved by invasive melanomas at the time of diagnosis more frequently than non‐weightbearing areas.
Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma
Authors: Wang Y.‐J. , Lin E.‐T. , Chen Y.‐T. , Chiu P.‐C. , Lin B.‐S. , Chiang H.‐M. , Huang Y.‐H. , Wang K.‐Y. , Lin H.‐Y. , Chang T.‐M. , Chang C.‐C.
Published: September 2019

Background

Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identified to be effective for improving photoaging conditions.

Objective

We aimed to compare the efficacy and tolerance of the picosecond alexandrite laser with those of DLA and TCC in female Asian patients with melasma.

Methods

Twenty‐nine patients were randomly assigned to group A1 (3 laser sessions at 4‐week intervals), A2 (5 laser sessions at 4‐week intervals) or B (TCC daily for at least 8 weeks and then tapered until the final evaluation). The Melasma Area, Severity Index (MASI) score and VISIA were assessed at baseline, week 12 and week 20. By week 20, the follow‐up periods for groups A1 and A2 were 3 months and 1 month, respectively.

Results

Nine, 11 and 6 participants in groups A1, A2 and B completed the study, respectively. MASI scores were significantly improved in all 3 groups at weeks 12 and 20. In groups A1, A2 and B, the improvement rates at week 20 were 53%, 38% and 50%, respectively. VISIA® analysis additionally revealed a significant improvement in spots, porphyria, pores and brown spots after 3 laser sessions (P < 0.05). Group A2 showed greater improvements than group A1 in terms of spots, wrinkles and pores; however, only red areas were significantly different (P < 0.001). All side‐effects in the 3 groups were transient and gradually subsided after 1–3 months.

Conclusion

Picosecond alexandrite laser treatment using DLA showed comparable efficacy with TCC for the treatment of melasma. Improvements in texture, spots, wrinkles and pores were observed in the laser groups. Patients with melasma lesions that exhibit telangiectasia may benefit from additional laser treatment sessions.
Accuracy of a smartphone application for triage of skin lesions based on machine learning algorithms
Authors: Udrea A. , Mitra G.D. , Costea D. , Noels E.C. , Wakkee M. , Siegel D.M. , de Carvalho T.M. , Nijsten T.E.C.
Published: September 2019

Background

Machine learning algorithms achieve expert‐level accuracy in skin lesion classification based on clinical images. However, it is not yet shown whether these algorithms could have high accuracy when embedded in a smartphone app, where image quality is lower and there is high variability in image taking scenarios by users. In the past, these applications were criticized due to lack of accuracy.

Objective

In this study, we evaluate the accuracy of the newest version of a smartphone application (SA) for risk assessment of skin lesions.

Methods

This SA uses a machine learning algorithm to compute a risk rating. The algorithm is trained on 131 873 images taken by 31 449 users in multiple countries between January 2016 and August 2018 and rated for risk by dermatologists. To evaluate the sensitivity of the algorithm, we use 285 histopathologically validated skin cancer cases (including 138 malignant melanomas), from two previously published clinical studies (195 cases) and from the SA user database (90 cases). We calculate the specificity on a separate set from the SA user database containing 6000 clinically validated benign cases.

Results

The algorithm scored a 95.1% (95% CI, 91.9–97.3%) sensitivity in detecting (pre)malignant conditions (93% for malignant melanoma and 97% for keratinocyte carcinomas and precursors). This level of sensitivity was achieved with a 78.3% (95% CI, 77.2–79.3%) specificity.

Conclusions

This SA provides a high sensitivity to detect skin cancer; however, there is still room for improvement in terms of specificity. Future studies are needed to assess the impact of this SA on the health systems and its users.
Non‐melanoma skin cancer as a clinical marker for internal malignancies: a nationwide population‐based cohort study
Authors: Yun S.J. , Bae J.M. , Kim H. , Park B.C. , Kim J.S. , Seo S.H. , Ahn H.H. , Lee D.Y. , Kim Y.C. , Park H.J. , Chung K.Y.
Published: September 2019

Introduction

Non‐melanoma skin cancers (NMSCs) are the most common cancers in the world, but the risk of internal malignancy in patients with NMSC has not been well investigated.

Objectives

We aimed to assess the risk of internal malignancy in patients with NMSC compared with controls without NMSC in Korean population.

Methods

This nationwide cohort study, compared 27 259 NMSC patients with 54 518 matched controls without NMSC, 40 years or older using the data from Korea Health Insurance Review and Assessment Service from 2007 to 2016. The first 2 years were washout period, and we followed the patients for 8 years to observe the development of any internal malignancies after a diagnosis of NMSC. The Cox proportional hazard model was used to determine the hazard ratios (HRs) for developing internal malignancies.

Results

The overall risk of internal malignancies at all sites was 2727.7 and 1392.4 per 100 000 person‐years for the patients with NMSC and controls, respectively. The risk was significantly higher in the patients with NMSC (HR 1.866, 95% confidence interval [CI] 1.768–1.970). Bone cancer showed the highest risk (HR 12.745, 95% CI 6.288–25.834), followed by nasal cavity and larynx (HR 10.279, 95% CI 6.178–7.103), oral cavity and pharynx (HR 10.211, 95% CI 7.375–14.137), anus and anal canal (HR 8.147, 95% CI 3.893–17.051) and cervical (HR 5.900, 95% CI 3.694–9.423) cancers with risks greater than fivefold higher in NMSC patients compared with the controls. The risks of cancers of the thorax, oesophagus, breast, lung, stomach, thyroid gland and non‐Hodgkin's lymphoma were also statistically higher in the patients with NMSC. In contrast, the risks of cancers of the colon and rectum were found to be significantly decreased in the patients with NMSC (HR 0.765, 95% CI 0.657–0.890).

Conclusion

Patients with NMSC require careful screening and follow‐up for internal malignancy.
Benefit and risk profile of tofacitinib for the treatment of alopecia areata: a systemic review and meta‐analysis
Authors: Guo L. , Feng S. , Sun B. , Jiang X. , Liu Y.
Published: September 2019

Background

Recent insights showed the possibility of using JAK inhibitors for the treatment of alopecia areata (AA). Most of the previous articles evaluated the overall efficacy of existing JAK inhibitors rather than evaluating one of them alone. Currently, the benefit and risk profile of tofacitinib for the treatment of AA is still not clear.

Objective

To estimate the safety and efficacy of tofacitinib in patients with AA based on summarizing the clinical outcomes.

Methods

The systematic review and meta‐analysis was performed according to PRISMA guidelines. ROBINS‐I (Risk of Bias in Non‐randomized Studies‐of Interventions) was used for quality assessment.

Results

We enrolled 14 studies including six clinical trials and eight observational studies with 275 patients. The result of meta‐analysis showed that tofacitinib has reasonable effectiveness in patients with AA. The pooled good/complete hair regrowth rate of tofacitinib treating patient with AA was 54.0% (95% CI: 46.3%–61.5%), and the pooled rate of partial response in patients with AA taking tofacitinib was 26.1% (20.7–32.2%). Approximately a quarter of patients had experience of relapse, most of which was reported due to discontinuation of tofacitinib. In terms of toxicity, reported adverse effects included only mild symptoms. Upper respiratory infection, headache and acne were the most common adverse events.

Conclusion

Tofacitinib seems to be a promising drug for the treatment of AA with only mild adverse effects. More thorough larger sized randomized clinical trials are required to further assess the safety and clinical efficacy of tofacitinib for the treatment of AA.
Treatment of rosacea and demodicosis with benzyl benzoate: effects of different doses on Demodex density and clinical symptoms
Authors: Forton F.M.N. , De Maertelaer V.
Published: September 2019

Background

Patients with rosacea or demodicosis have high facial skin Demodex densities (Dds). Topical ivermectin, benzyl benzoate (BB) and crotamiton have been shown to decrease Dds in vivo, but there are few data on the clinical and acaricidal effects of BB among patients with rosacea.

Objective

To evaluate the impact of topical BB (+crotamiton) treatment on Dds and clinical symptoms of rosacea and demodicosis, and compare three BB treatment regimens.

Methods

In this retrospective observational study, 394 patients (117 with rosacea, 277 with demodicosis) were included. Three BB (+crotamiton) treatment regimens were compared: 12% once daily, 12% twice daily and 20% once daily. Dds were measured using two consecutive standardized skin surface biopsies [superficial (SSSB1) and deep (SSSB2)] before treatment and at the first follow‐up. Symptoms were evaluated using investigator global assessment. Treatment was considered effective if the Dd had normalized (SSSB1 ≤ 5 D/cm2 AND SSSB2 ≤ 10 D/cm²) or symptoms had cleared and curative if the Dd had normalized and symptoms had cleared.

Results

At an average of 2.7 months after treatment start, the total Dd (SSSB1 + 2) had decreased by 72.4 ± 2.6% from the initial value across the whole cohort. Dds had normalized in 139 patients (35%), and symptoms had cleared in 122 (31%). Treatment was effective in 183 (46%) patients and curative in 78 (20%). Compliance was good: 77% of patients correctly followed treatment instructions. Results were similar in patients with rosacea and those with demodicosis. The 12% once‐daily regimen was less effective than the other doses and had poorer compliance than the 12% twice‐daily regimen.

Conclusion

Topical treatment with BB (+crotamiton) may be an effective treatment for rosacea and demodicosis, indirectly supporting a key role of the mite in the pathophysiology of rosacea. The two higher dose regimens were more effective than the lower dose.
Factors associated with improvement of quality of life among parents of children with atopic dermatitis: 1‐year prospective cohort study
Authors: Maksimovic N. , Zaric M. , Reljic V. , Nikolic M. , Gazibara T.
Published: September 2019

Background

Previous studies exploring the impact of atopic dermatitis (AD) in children focused on factors associated with parental quality of life at one point in time.

Objective

To examine factors associated with change of quality of life among parents of children affected with AD.

Methods

The study cohort comprised 98 parent–children pairs treated for AD at the Clinic of Dermatovenereology; however, 18 parents (18.4%) were lost to follow‐up after 1 year. Children were assessed with SCORing Atopic Dermatitis Index (SCORAD) and Children Dermatology Life Quality Index (CDLQI) or the Infants’ Dermatitis Quality of Life Index (IDQOL), depending on their age. Parents filled in socio‐demographic questionnaire and Dermatitis Family Impact Questionnaire (DFI). After 1 year, both children and parents were reassessed using the same AD‐related battery of questionnaires.

Results

After follow‐up, a significant improvement in the average total DFI score was observed, especially for domains of fatigue/exhaustion, emotional distress and impact of helping in child treatment. Lower baseline SCORAD, greater improvement of SCORAD over follow‐up, better CDLQI/IDQOL at baseline, greater improvement in CDLQI/IDQOL over follow‐up, not having asthma and having older child with AD were associated with better parental quality of life after 1 year of follow‐up. Parental higher education level, shorter AD duration, better baseline SCORAD and greater improvement in CDLQI/IDQOL over follow‐up were associated with greater improvement in parental life quality over 1 year of follow‐up.

Conclusion

Contributors to parental quality of life after 1 year included clinical features of AD and child's comorbidity (asthma), but also the perception of child's quality of life and its improvement.
Epidemiology of hidradenitis suppurativa in Germany – an observational cohort study based on a multisource approach
Authors: Kirsten N. , Petersen J. , Hagenström K. , Augustin M.
Published: September 2019

Background

Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory skin disease. In Germany, there are no population‐based data on the epidemiology of HS.

Objectives

The objective of this study was to examine the occurrence of HS in inpatient as well as in outpatient settings.

Methods

We used three data sources for analysing the prevalence, incidence and case‐related occurrence of HS in different settings: data of two German statutory health insurance (SHI) companies and hospital discharge data provided by the Federal Statistical Office. The studied period was from 2010 to 2015.

Results

In a representative sample of about 2.3 million insurees (out of 5.9 million total persons) of the SHI DAK‐Gesundheit, 791 were diagnosed with HS in 2010. This coding prevalence of 0.03% is in accordance with the data of another SHI (Barmer) on about 9 million total insurees. In 2015, at least 34.7% of incident persons with HS had one potential misdiagnosis in 2014.

Conclusion

This population‐based study analyses the prevalence and incidence of HS in Germany. The coding prevalence of 0.03% observed in two independent SHI data sets is lower than expected. The findings of considerable potential misdiagnosis add to the underdiagnosis of HS in general and underline the need for future strategies to early detection and valid diagnosis of HS.