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Cytokine blocking therapies have revolutionized the management of psoriasis and atopic dermatitis but can lead to the development of paradoxic psoriasis (PP). Patients treated with biologics should be closely monitored for the development of PP and other paradoxical eruptions (including inflammatory joint disease, inflammatory bowel disease, eczematous eruptions, lupus like eruptions, sarcoidal eruptions, and others) and occasionally the development of cutaneous T-cell lymphoma. Further understanding the immunologic mechanism of these processes will ultimately drive our understanding of and ability to predict and manage PPs.

Context The decline of birds in farmland is of global concern. Aims The aim of this paper was to provide a local-scale case study of the bird fauna of temperate inland eastern Australia’s sheep–wheat belt. Methods Relationships between species occurrence and various habitat elements in the landscape were examined in a 342km2 area of agricultural countryside near Wagga Wagga in southern inland New South Wales, Australia. The pre-agricultural bird fauna of this area was also investigated by collating records from previous studies of nearby larger woodland remnants. Key results The study identified a bird fauna of 115 species compared to 160 species known from nearby woodland remnants. Significant relationships were found with the presence of farm dams, extent of local woodland cover and roadside woodland at the levels of individual species, guilds and total fauna. A small ephemeral wetland also contributed substantially to waterbird diversity. Conclusion Twenty commonly recorded species typical of the farmland matrix and 15 species considered at particular risk of local extinction were identified. At the guild level, frugivore/granivores, small insectivores and hollow-users were found to be associated with remaining woodland elements in the agricultural landscape. Implications Ecologically sustainable management of agricultural areas is essential to avoid further local extinctions. Hollow-using species are expected to be particularly affected by the anticipated widespread loss of trees in the landscape over the next century.

AbstractMurphy MJJ, Sivarajah B, Grégoire DC, Vermaire JC. 2022. Assessing the ecological responses of a shallow mesotrophic lake to multiple environmental stressors using paleolimnological techniques. Lake Reserv Manage. 38:67–79.White Lake, located in southeastern Ontario, Canada is a long, shallow, multibasin lake that supports recreational activities year-round and has 1538 private and commercial dwelling units. The construction of a dam at Waba Creek in 1845 resulted in the minimum water level at White Lake increasing by ∼1.5 m, and several water-level management strategies have been implemented since the mid 20th century. The lake has also been impacted by land-clearance activities and shoreline development along the eastern shores and is presently mesotrophic. More recently, White Lake was colonized by zebra mussels (Dreissena polymorpha) in 2015, and annual algal blooms have also been observed. In this paleolimnological study, diatom-based approaches and loss on ignition were used to track past changes in water quality and sediment characteristics, respectively, to inform the White Lake Property Owners Association’s ongoing lake monitoring program. The diatom-inferred total phosphorus (DI-TP) reconstruction suggests that White Lake has been mesotrophic (DI-TP range 11.5 − 17 µg/L) over the past ∼200 years. Notable changes in the diatom assemblages and declines in sedimentary organic content were recorded around the 1890s in the sediment core retrieved near Hardwood Island. The decrease in sedimentary organic content was likely a response to early land-clearance activities around the lake as erosion often leads to greater inorganic export from the catchment to the lake. The switch among benthic fragilarioid diatom taxa suggests that the light conditions at this shallow lake may have changed in response to higher allochthonous inputs. Continuous monitoring of White Lake is needed to ensure that the cumulative impacts from emerging environmental stressors (e.g., climate-mediated changes, invasion by dreissenids) are considered when making management decisions.

IMPORTANCE: Persistent erythema multiforme (PEM) is poorly understood and lacks effective therapies other than glucocorticoids. OBJECTIVE: To report outcomes following treatment of PEM with Janus kinase (JAK) inhibition and to elucidate cytokine drivers of erythema multiforme (EM). DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective case series of 4 patients with PEM treated with tofacitinib and/or upadacitinib in 2015 to 2021 at the dermatology clinics of 2 major tertiary referral centers. Four consecutive patients with PEM refractory to multiple treatment approaches were treated. In 1 patient, skin biopsy specimens were obtained for RNA sequencing and proteomic analysis before and during treatment. Molecular findings were validated through RNA in situ hybridization analysis of cytokine expression in biopsy specimens from a total of 12 patients with EM (3 treated with tofacitinib in this study and 9 historic samples). INTERVENTIONS: Treatment with tofacitinib, 5 to 10 mg, twice daily or upadacitinib, 15 mg, once daily. MAIN OUTCOMES AND MEASURES: Change in PEM activity was assessed in all 4 patients treated with a JAK inhibitor. Median (range) follow-up was 20.5 months (10.0-36.0 mo). RESULTS: The study population of 4 female patients had a mean (SD) age of 46.2 (13.7) years and a mean (SD) disease duration of 21.75 (11.30) years. Marked clinical improvement was noted in all 4 patients. In 1 patient with a robust improvement following treatment with tofacitinib, RNA sequencing identified interferon gamma (IFN-γ) and interleukin 15 (IL-15) as cytokines with activity both highly upregulated at baseline in lesional skin and subsequently suppressed following tofacitinib treatment. Measurement of IFNG- and IL15-positive cells in additional EM biopsy specimens of 12 patients showed significant upregulation of IFNG (8.72 cells per mm; 95% CI, 2.60-14.84) and IL15 (14.13 cells per mm; 95% CI, 0.14-28.11) compared with normal skin (P = .008 and P = .045, respectively). CONCLUSIONS AND RELEVANCE: The results of this case series study suggest that JAK inhibition may be effective in treating PEM and that IFN-γ and IL-15 may be important cytokine mediators of the disease.

Sponge or skeletal metal catalysts (such as Raney-type hydrogenation catalysts) are ubiquitous and extensively used in large-scale industrial hydrogenation processes, including petrochemical refining, materials manufacturing, and even food chemistry. Despite the many advantages of these nonprecious metal catalysts, they are underutilized in smaller-batch organic synthesis, including pharmaceutical manufacturing processes, because of safety concerns. Here we describe a heretofore little known deactivation procedure using aqueous sodium nitrate that renders the spent catalyst safe to handle even when dry. During development of a chemoselective nitrile reduction using a sponge cobalt catalyst, we demonstrated that this procedure is much safer than other commonly employed oxidative or acidic quenching methods. This procedure should significantly improve the safety aspects of using these catalysts in myriad settings, from lab-scale synthesis to manufacturing processes for active pharmaceutical ingredients.

Increasing the Ni content of LiNixMnyCo1–x–yO2(NMC) cathodes can increase the capacity, but additional stability is needed to improve safety and longevity characteristics. In order to achieve this improved stability, Mg and Zr were added during the coprecipitation to uniformly dope the final cathode material. These dopants reduced the capacity of the material to some extent, depending on the concentration and calcination temperature. However, these dopants can impart substantial stabilization. It was found that the degree of stabilization is strongly dependent on the calcination temperature of the material. In addition, we used synchrotron X-ray diffraction during thermal breakdown to better understand why the different dopants impact the thermal stability and confirm the stabilization effects of the dopants.

Sixty-three butterfly species representing five families have been recorded from the Pilliga Forest in northern inland New South Wales – the largest surviving remnant of native forest on the western slopes of the Great Dividing Range. This is one of the richest recorded butterfly faunas of any location on the New South Wales western slopes and adjacent plains, reflecting the location of the Pilliga Forest in a biogeographic overlap zone between northern and southern faunal assemblages with proximity to both the western plains and outliers of the mesic eastern highlands. No narrow-range endemic species or species of state or national conservation concern were recorded; however, half of the species recorded have patchy, discontinuous distributions within their broad range due to specific habitat requirements. Some minor western range extensions are recorded and two hilltopping sites are documented. This study highlights the significant biodiversity conservation value of the Pilliga Forest in the predominantly cleared western slopes bioregions.

Acral dermatoses, including hyperkeratotic palmoplantar eczema (HPE), palmoplantar psoriasis (PP), and mycosis fungoides palmaris et plantaris (MFPP), can be challenging to diagnose clinically and histopathologically. In this setting, cytokine biomarkers may be able to help provide diagnostic clarity. Therefore, we evaluated IL-17A, IFN-γ, and IL-13 expression in PP, HPE, and MFPP and compared their expression profiles with nonacral sites. We used biopsy specimens from the Yale Dermatopathology database, selecting cases of HPE (n = 12), PP (n = 8), MFPP (n = 8), normal acral skin (n = 9), nonacral eczema (n = 10), and nonacral psoriasis (n = 10) with classic clinical and histopathologic features. IL17AmRNA expression by RNA in situ hybridization differentiated PP (median score 63.1 [interquartile range 9.4–104.1]) from HPE (0.8 [0–6.0]; P = 0.003), MFPP (0.6 [0–2.6]; P = 0.003), and normal acral skin (0 [0–0]; P< 0.001). Unexpectedly, both PP and HPE showed co-expression of IFNGand IL13mRNA. In contrast, nonacral psoriasis and eczema showed divergent patterns of IFNGand IL13mRNA expression. Taken together, we show that IL17AmRNA expression may be a useful biomarker of PP, and we further show that acral dermatoses exhibit unique immunology than to nonacral sites, with implications for clinical management.

A survey of the herpetofauna of Yarrigan National Park (NP), in the southern Pilliga forest in northern inland New South Wales, was done over the period 2011 to 2013. The total identified herpetofauna community comprised 11 frog species (three families) and 35 reptiles (10 families) and includes a mix of eastern (Bassian), western (Eyrean) and northern (Torresian) species. This study demonstrates the significant species diversity, biogeographical interest and conservation value of the Pilliga forest's herpetofauna. Noteworthy findings from this study included a number of declining woodland reptile species (Nobbi Diporiphora nobbi, Australian Coral Snake Brachyurophis australisand Inland Carpet Python Morelia spilota metcalfei), locally rare species (Excitable Delma Delma tinctaand Southern Rainbow Skink Carlia tetradactyla) and edge of range species (Litter Skink Lygisaurus foliorum). The study provides a useful benchmark of the composition and status of the herpetofauna community of Yarrigan NP in the first decade following a land management shift from timber production to conservation.

Major depressive disorder is frequently accompanied by sleep disturbances such as insomnia or hypersomnia and polysomnographic sleep findings of increased rapid-eye-movement sleep and decreased slow wave sleep. For many patients, insomnia persists even after mood symptoms have been adequately treated. These patients have poorer outcomes than patients without sleep problems. These outcomes suggest that overlapping neural mechanisms regulate sleep and mood. Treatment of these patients can incorporate sedating antidepressants, nonbenzodiazepine γ-aminobutyric acid agonists, and cognitive behavioral therapy. Sleep restriction has been found to improve mood in depressed patients; however, the benefits typically disappear after recovery sleep.

Myofibroma is a rare, benign myofibroblastic tumor that commonly presents at birth or in early infancy, usually as a painless, slow-growing, solitary, nodular mass. We present a case of a 40-year-old woman with a painful, solitary, myofibroma on the right elbow. The unique features of this case include age and gender of the patient, site, pain on presentation, tumor morphology, and putative intravascular nature of the tumor.

OBJECTIVE: There is increasing prevalence of hypercholesterolemia among patients with osteoarthritis (OA) and rheumatoid arthritis (RA). We examined the effectiveness of statins on total cholesterol (TC), cardiovascular (CV) morbidity, and mortality in patients with OA or RA. METHODS: A population-based cohort study was done using a record-linkage database in Tayside, Scotland. In total, 2024 OA or RA patients who had at least 2 separate TC measurements between 1993 and 2007 were studied. They were categorized into statin-exposed and statin-unexposed groups according to statin use status during followup. The main outcomes were TC concentration change from baseline, CV events, and all-cause mortality during the followup. Multivariate Cox regression models with a time-dependent variable for statins were employed to assess the risk of outcomes. RESULTS: Statin-associated TC concentrations in OA decreased by 15% in patients without CV disease (primary prevention, n = 1269) and 7% in patients with CV disease (secondary prevention, n = 247) from baseline of 5.30 mmol/l and 4.54 mmol/l, respectively. Correspondingly, in RA TC was reduced by 16% (n = 430) and 15% (n = 78) with baselines of 5.54 mmol/l and 4.95 mmol/l. In primary prevention, statins were associated with reduced CV events and all-cause mortality in RA patients [adjusted HR 0.45 (95% CI 0.20–0.98) and 0.43 (95% CI 0.20–0.92), respectively] and all-cause mortality in OA patients [adjusted HR 0.43 (95% CI 0.25–0.72)]. Statins were not associated with reduced risk of CV events or all-cause mortality in the secondary prevention of RA or OA patients [adjusted HR 0.68 (95% CI 0.30–1.54) and 0.52 (95% CI 0.20–1.34) for OA patients, and HR 0.58 (95% CI 0.07–4.79) and 0.79 (95% CI 0.18–3.53) for RA patients]. CONCLUSION: Statins reduced TC concentrations between 7% and 16% in patients with OA or RA. Statins were associated with reduced CV events and mortality in RA and mortality in OA in primary prevention.

The article discusses a study on the distribution and habitat requirements of the endangered and threatened plant species associated with the sand deposits of Illinois. Forty of the approximately 70 species that grow in these deposits were studied and determined their habitat fidelity and natural community types. Some of the data used are based on a report prepared for the Illinois Endangered Species Protection Board. It was found that moisture levels within sand communities can be highly variable and can influence vegetation composition and structure.

Bell’s mania (mania with delirium) is an acute neurobehavioral syndrome of unknown etiology that is characterized by the rapid onset of grandiosity, psychomotor excitement, emotional lability, psychosis, and sleep disruption consistent with mania, coupled with alterations in sensorium, and disorientation characteristic of delirium. Catatonia is a common feature of the syndrome.

Landfalling atmospheric rivers (ARs) over the western US are responsible for ∼30%–50% of the annual precipitation, and their accurate forecasts are essential for aiding water management decisions and reducing flood risks. Sparse coverage of conventional observations over the Pacific Ocean, which can cause inadequate upstream initial conditions for numerical weather prediction models, may limit the improvement of forecast skill for these events. A targeted field program called AR Reconnaissance (Recon) was initiated in 2016 to better understand and reduce forecast errors of landfalling ARs at 1–5 days lead times. During the winter seasons of 2016, 2018, and 2019, 15 Intensive Observation Periods (IOPs) sampled the upstream conditions for landfalling ARs. This study evaluates the impact on forecast accuracy of assimilating these dropsonde data. Data denial experiments with (WithDROP) and without (NoDROP) dropsonde data were conducted using the Weather Research and Forecasting model with the Gridpoint Statistical Interpolation four‐dimensional ensemble variational system. Comparisons between the 15 paired NoDROP and WithDROP experiments demonstrate that AR Recon dropsondes reduced the root‐mean‐square error in integrated vapor transport (IVT) and inland precipitation for more than 70% of the IOPs, averaged over all forecast lead times from 1 to 6 days. Dropsondes have improved the spatial pattern of forecasts of IVT and precipitation in all 15 IOPs. Significant improvements in skill are found beyond the short range (1–2 days). IOP sequences (i.e., back‐to‐back IOPs every other day) show the most improvement of inland precipitation forecast skill. Atmospheric rivers (ARs) are long and narrow corridors of water vapor transport in the atmosphere from the tropics to higher latitudes. Up to half of the annual precipitation in the western US states is related to landfalling ARs. Therefore, accurate forecasts of these events are important to reduce socio‐economic damage from the associated high‐impact weather and to better manage water resources over the western US. However, the forecast accuracy can be limited by sparse observations upstream over the Pacific Ocean. To fill observation gaps and improve forecast skills, a weather reconnaissance mission called Atmospheric River Reconnaissance was initiated in 2016 to release dropsondes from aircraft in key upstream sensitive regions. This study assesses the value of these observations in improving the initial conditions and the forecast skill of a regional model operated at the Center for Western Weather and Water Extremes for near real‐time weather forecasts. We found that the use of these additional observations collected during 2016, 2018, and 2019 has a positive impact on reducing the forecast error of water vapor transport within the Northeastern Pacific domain and the inland precipitation skill over the western US. These observations have more impact in poorly forecasted cases. Dropsondes have reduced the forecast error of water vapor transport over the Northeast Pacific with continuous improvement out to day 3Dropsondes overall improved the precipitation forecast over the US West Coast in 11 out of 15 Intensive Observation Periods (IOPs)IOP sequences (i.e., back‐to‐back IOPs every other day) have the most positive impact on improving the precipitation forecast skill Dropsondes have reduced the forecast error of water vapor transport over the Northeast Pacific with continuous improvement out to day 3 Dropsondes overall improved the precipitation forecast over the US West Coast in 11 out of 15 Intensive Observation Periods (IOPs) IOP sequences (i.e., back‐to‐back IOPs every other day) have the most positive impact on improving the precipitation forecast skill

Biochemical analysis of cerebrospinal fluid may provide answers to important clinical questions. This review summarizes these questions and outlines the value and limitations of cerebrospinal fluid analysis.

The vapor‐phase optical rotation (or circular birefringence) of (S)‐1,2‐epoxybutane, (S)‐epichlorohydrin, and (S)‐epifluorohydrin has been measured at the nonresonant excitation wavelengths of 355 nm and 633 nm by means of Cavity Ring‐Down Polarimetry (CRDP). Complementary solution‐phase studies were performed in a wide variety of dilute solvent media to highlight the pronounced influence of solute–solvent interactions. Density functional theory calculations of optical activity have been enlisted to unravel the structural and electronic provenance of experimental observations. Three stable, low‐lying conformers have been identified and characterized for each of the targeted chiral species, with thermal (relative population weighted) averaging of their antagonistic chiroptical properties allowing specific rotation values to be predicted under both isolated and solvated conditions. For (S)‐epichlorohydrin and (S)‐epifluorohydrin, a self‐consistent isodensity polarizable continuum model (SCI‐PCM) has been exploited to gain further insight into the underlying nature of solvation effects. Chirality, 2008. © 2007 Wiley‐Liss, Inc.

Biochemical analysis of pleural fluid may provide answers to important clinical questions. This review summarizes these questions and outlines the value and limitations of pleural fluid analysis.

Accurate evaluation of patients with suspected or known cutaneous lymphoma requires the integration of many sources and types of information, including clinical evaluation, microscopic analysis of tissue, immunophenotyping, gene rearrangement studies, clinical staging, and longitudinal observation. Diagnoses should be based on knowledge of specific lymphoma types as described in modern classification systems. Management of patients with cutaneous lymphoma requires collaboration among dermatologists, dermatopathologists, hematopathologists, and medical, surgical and radiation oncologists. (J Am Acad Dermatol 2002;46:325-57.) Learning objective:At the conclusion of this learning activity, participants should better understand how to evaluate and manage patients for suspected or established lymphoma of the skin. Components include the clinical history and physical examination, optimal biopsy and tissue handling, interpretation of pathology and adjunctive test results, clinicopathologic correlation, and therapy. Participants should also understand the basis for establishing a specific diagnosis of cutaneous lymphoma based on current classification and staging.

Proximal tubules (PT) in 7–10-day old chick mesonephros were examined histochemically to evaluate their structural and functional properties related to the absorption capacity of the epithelium and its possible alterations leading to cystically dilated tubules (CDT). Alkaline phosphatase activity at the apical cell membrane was demonstrated in varying intensities in large PT. A similar heterogeneity was also detected in the expression of proteoglycans (Lewisxantigen) localized in the apical part of the epithelial cell membrane but not in the basolateral membrane parts (β-catenin, Na+,K+-ATPase). In analogy, the ability to accumulate trypan blue was found in the same cell population. We hypothesize that epithelial cells in proximal tubules of nephrons with a defective apical cell membrane cause reduced fluid absorption and subsequent overfilling and dilation of the tubules.

Over the last five years, insurance products have been expanded to assist companies better manage environmental liabilities. The most progressive of these products is a finite‐structured program whereby the convergence of insurance and financial markets expand the meaning of “alternative risk transfer.” Finite programs blend financial markets and banking concepts with risk transfer concepts to more effectively and efficiently allow the insured to manage the financial implications of its environmental liabilities. This article presents the advantages of using finite‐structured environmental insurance policies and discusses how potential insureds can protect against several types of remediation project risks, including cleanup costs, inflation uncertainty, and variability in investment returns. © 2001 John Wiley & Sons, Inc.

Over the last five years, insurance products have been expanded to assist companies better manage environmental liabilities. The most progressive of these products is a finite-structured program whereby the convergence of insurance and financial markets expand the meaning of “alternative risk transfer.” Finite programs blend financial markets and banking concepts with risk transfer concepts to more effectively and efficiently allow the insured to manage the financial implications of its environmental liabilities. This article presents the advantages of using finite-structured environmental insurance policies and discusses how potential insureds can protect against several types of remediation project risks, including cleanup costs, inflation uncertainty, and variability in investment returns. © 2001 John Wiley & Sons, Inc.

In specific settings, biochemical and haematological analysis of ascitic fluid may provide answers to important clinical questions. This review seeks to outline the value and limitations of ascitic fluid analysis and the main clinical scenarios in which it may be useful.

The detonation reaction rate in μs⁻¹ is derived from Size Effect data using the relation – DUs(∂Us/∂y)⁻¹, where y =1/Ro, where U^s is the detonation velocity for a ratestick of radius R^o and D is the infinite-radius detonation velocity. These rates are generally not constant with radius and have pressure exponents ranging from &lt;−5 to > 5. JWL++, a simple Reactive Flow code, is run with one rate constant on many samples to compare its rates. JWL++'s pressure exponents vary from about 0.5 to 2.5, and failure occurs outside this range. There are three classes of explosives: (1) those for which the pressure exponent is between 1 and 2 and the rate is nearly constant (e.g. porous urea nitrate); (2) higher pressure explosives with a concave-down shape and large positive pressure exponents (dense TNT); and (3) explosives with negative pressure exponents and concave-up shapes (porous PETN). JWL++ fits only the first class well and has the most trouble with class 3. The pressure exponent in JWL++ is shown to be set by the shape of the Size Effect curve – a condition that arises in order to keep a constant reaction rate for all radii. Some explosives have too much bend to be modeled with one rate constant, e.g. Comp. B near failure. A study with creamed TNT shows that the rate constant need not be changed to account for containment. These results may well be pertinent to a larger consideration of the behavior of Reactive Flow models.