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The Sea Traffic Management (STM) Validation Project is a European-based initiative with ambitions to improve maritime safety and efficiency through information sharing in real time. The purpose of this paper is to evaluate the “STM services,” which can be categorized as low-level automated functions designed to improve information exchange between ship and shore. Full-scale simulated scenarios were developed and tested on 16 professional vessel traffic service (VTS) operators comparing VTS operations as they are today with the added STM functionality. Data collection involved observations which assessed the frequency and type of interactions between ships and VTS, followed by questionnaires to provide an overall assessment of the user experience. The results indicate that the frequency and method of communication patterns between VTS operators and ships will be affected by the integration of the STM services. Additional access to navigational information could change the role of VTS operators in traffic situations compared with traditional operations. This paper discusses the findings from a socio-technical systems perspective while also addressing the individual STM services and their potential impact on VTS operations. This research provides valuable information for European VTS centers that could be affected by the implementation of e-Navigation and, specifically, the STM services.

51 psoriasis vulgaris patients and 93 controls were tested for HLA-A,B,C and DR antigenic frequencies. Significant increases of B17, Cw6 and DR7 were documented in the patient group, as well as a decreased frequency of DR1. The significance of these findings is discussed. DR7 occurred more often together with Cw6 in psoriasis patients than in controls, which might suggest that there are at least two interacting HLA linked genes which increase the disease susceptibility and possibly one DR1 linked gene associated with resistance to the disease.

Using recently processed Ca K filtergrams, recorded with a 1 A filter at the Big Bear Solar Observatory (BBSO), we quantitatively assess the component of solar irradiance variability attributable to bright magnetic features on the Sun's disk. The Ca K filtergrams, flattened by removing instrumental effects and center-to-limb variations, provide information about bright sources of irradiance variability associated with magnetic activity in both active regions and dispersed active region remnants broadly distributed in the supergranule network (termed collectively faculae). Procedures are developed to construct both total and UV spectral solar irradiance variations explicitly from the processed Ca K filtergrams, independently of direct irradiance observations. The disk-integrated bolometric and UV facular brightness signals determined from the filtergrams between late 1991 and mid-1995 are compared with concurrent solar irradiance measurements made by high-precision solar radiometers on the Upper Atmosphere Research Satellite (UARS). The comparisons suggest that active-region and active-network changes can account for the measured variations. This good agreement during a period covering most of the decline in solar activity from the cycle 22 maximum to the impending solar minimum directly implicates magnetic features as the sources of the 11 yr irradiance cycle, apparently obviating the need for an additional component other than spots or faculae.

High-speed jets of solar quiet regions have been observed at Big Bear Solar Observatory in Hα−1.0 U, and compared with high-resolution magnetograms. Over the whole Sun, the birthrate of the Hα−1.0 U jets is about 19±3 events s−1, which is much lower than the birthrate of spicules. The average lifetime of these jets is 2±1 min. Hα−1.0 U jets are very different from spicules, in the sense of birthrate, lifetime, and shape. Jets tend to recur in the same sites, always located in boundaries of supergranules. Under the best observing conditions, we found that 80% of the major jet sites are associated with converging magnetic dipoles – mainly the sites where intranetwork elements are canceling with opposite polarity network elements. In order to establish a possible relationship between the disk Hα jets and limb macrospicules, we have also obtained time sequences of Hα center-line images at the limb. These images are enhanced by median filtering so that jet structures over the limb are easily studied. We found that these limb Hα jets (above the spicule forest) repeatedly occur in the same sites, which is the property shared by the disk Hα−1.0 U jets. However, their mean lifetime is 10 min, substantially longer than that of disk jets. Comparison with simultaneous SOHO/EIT Heii 304 U images shows that every Heii 304 U jet over the limb coincides with an Hα jet, although Heii 304 U jets extend much farther out. Some Hα jets do not have associated He jets, probably due to the difference in image resolutions. Hα spectra of selected jets are analyzed, and we found that jets are not simply blue-shifted; instead, the line profiles are broadened with significantly larger broadening on the blue side. Two-component fitting finds that the velocity of the blue-shifted component (an optically-thin component) is around 20 to 40 km s−1.

A two-compound ointment containing calcipotriol plus betamethasone dipropionate is an effective treatment for psoriasis vulgaris. The same active ingredients have now been combined in a gel formulation. Our objective was to compare the efficacy and safety of once daily treatment of the two-compound gel with the single components in the same gel vehicle and the gel vehicle alone, in patients with psoriasis vulgaris on the trunk and/or limbs. 364 patients received once daily treatment for up to 8 weeks with either the two-compound gel, the single components in the gel vehicle or the gel vehicle alone. The percentage of patients whose disease was clear or very mild and who had at least a two-step improvement in the Investigator's Global Assessment of disease severity at week 8, was significantly higher with calcipotriol plus betamethasone dipropionate (27.2%) than with betamethasone dipropionate (16.9%, p = 0.027), calcipotriol (11.4%, p = 0.006) or gel vehicle (0.0%, p < 0.001). This exploratory study showed that the two-compound gel was safe and more efficacious than its individual ingredients in the treatment of psoriasis vulgaris.

A high-resolution videomagnetograph that records the images of opposite circular polarization simultaneously has been constructed for the Swedish vacuum solar telescope at La Palma. Magnetograms are obtained by off-line integration of bursts consisting of typically 50 frames of 20 ms exposures, with bad frames rejected, and the frame-to-frame image motion of the remaining frames compensated for by cross-correlation techniques. The short exposures combined with frame selection and elimination of image motion optimizes the resolution and thereby also the S/N, allowing good magnetograms to be obtained with an effective exposure time of less than 1 s at an image scale of 0.1″ pixel−1. The advantages and limitations of the system are discussed and compared with other techniques of making filter magnetograms are discussed.

Udgivelsesdato: 2008-null Many patients with moderate-to-severe plaque psoriasis do not respond adequately to methotrexate monotherapy. This pilot study, with a small patient population, was performed to evaluate the effectiveness and safety of etanercept and methotrexate combination in patients with plaque psoriasis and inadequate response to methotrexate. Outpatients with plaque psoriasis (Psoriasis Area and Severity Index > or = 8 and/or body surface area > 10%), despite methotrexate treatment (> or = 3 months; > or = 7.5 mg/week) were randomized to either etanercept with metho nottrexate tapered and discontinued (n = 28) or etanercept with continuous methotrexate (n = 31). Significantly more patients had a Physicians' Global Assessment of "clear"/"almost clear" in the combination group compared with etanercept/methotrexate taper (66.7 vs. 37.0%, respectively; p = 0.025). Adverse events were similar for both groups, with no cases of tuberculosis, malignancies or opportunistic infections reported. Addition of etanercept to methotrexate achieved significant improvement in psoriasis after 24 weeks.

Background/Aims We investigated the impact of diabetes mellitus type 2, overweight, alcohol over-consumption, and chronic hepatitis B or C as risk factors, for liver fibrosis in psoriasis patients treated with methotrexate. Methods One hundred and sixty-nine liver biopsies from 71 patients who underwent liver biopsies as part of the monitoring of methotrexate treatment for psoriasis were reviewed. Fibrosis, steatosis and inflammation were staged according to the NAFLD activity score. Results Twenty-six patients had one or more of the risk factors and 25 (96%) of these (median cumulative dose methotrexate 1500mg) developed liver fibrosis. Of those without risk factor, 26 (58%) ( p =0.012) developed fibrosis (median cumulative dose methotrexate 2100mg). Ten (38%) of the patients with risk factor(s) had severe fibrosis (stage 3–4) (mean cumulative dose methotrexate 1600mg), while four (9%) ( p =0.0012) of those without risk factors had severe fibrosis (median cumulative dose methotrexate 1900mg). Conclusions Patients with methotrexate treated psoriasis and risk factors for liver disease, especially diabetes type 2 or overweight, are at higher risk of developing severe liver fibrosis compared to those without such risk factors, even when lower cumulative methotrexate doses are given.

We have processed a 10-year set of BBSO Ca II K-line filtergrams covering most of solar cycle 22. The excess K-line emission is integrated to form linear and square-root activity indices that are fitted to UV data from UARS and SME. Good fits are found both for the Mg II core-wing ratio (linear) and total Lα irradiance (square root) and the indices are thus good proxies for UV data. The SME Lα irradiance is systematically lower by 20% than predicted from our corresponding K-line indices. The 10.7 cm radio data confirms that SME underestimated the flux. The network is partly responsible for the solar cycle variation of the indices and is relatively more important in Lα than in Mg II and Ca II K. This is due to the saturation of Lα equivalent width. We also report on substantial improvements to the equipment and reduction software. The system is now based on a digital CCD camera which promises more accurate measurements in the upcoming solar cycle 23.

We have compared three years of daily CaII K-line images from the Big Bear Solar Observatory (BBSO) with HI Lymanα irradiance data from the Upper Atmosphere Research Satellite (UARS). The daily full-disk CaII K-line images are reduced to a new index of integrated excess emission, which reproduces both the 27 day rotational modulation and the solar cycle decrease in Lyα irradiance. Our analysis shows that while plages reproduce the 27-day variation quite well, the total K-line emission excess above the quiet background is needed to reproduce the secular solar cycle trend in the Lyα irradiance. The resulting K-line index exhibits a high degree of correlation (0.9) with the time series of measured Lyα flux.

The age of microscopic lesions in psoriatic subjects was assessed from the stacking characteristics in the horny layer and related to type and density (cells/tissue volume) of mononuclear cells in the epidermis and the dermis determined by immunoperoxidase methods using monoclonal antibodies. Pan T cells (Lyt-2+, Lyt-3+, Leu-4+, OKT3+), T helper cells (Leu-3a+, OKT4+), T suppressor/cytotoxic cells (Leu-2a+, OKT8+), Ia+ cells and monocytes (OKM2+, BRL alpha mono+) were determined in epidermis and dermis. The psoriatic lesion was divided into regions underneath a parakeratotic and an orthohyperkeratotic/hypergranular portion of the horny layer and contrasted with perilesional and uninvolved psoriatic skin as well as with healthy skin. In the various regions and skin layers, the cell density was highest in parakeratosis and decreased toward normality with decreasing histologic abnormality. The relation between epidermal and dermal cell densities of the T-cell subsets was modified in the involved psoriatic skin with a selective preponderance of T suppressor/cytotoxic cells in the epidermis. The accumulation was present in the youngest lesion found (3 days) and cell densities were unchanged in older lesions. The findings suggests that the altered relationship in the subsets of T cells has an important role during the induction and progress of the psoriatic process in the skin.

Corneocyte layer formation rate using dansyl chloride as corneocyte marker was followed in noninvolved skin during a period of 2 weeks after that the skin had been subjected to cellophane stripping. The rate increased after stripping in 7 of 9 tested but it was not paralleled by any apparent parakeratosis. In 1 of 9 patients a Koebner reaction occurred. The corneocyte formation rate in the Koebner reaction was 6.1 times that of the noninvolved skin and with a degree of parakeratosis of 41%. In involved skin, a positive correlation, coefficient 0.81, was shown between corneocyte layer formation rate (range 3.9-15.2 layers/day) and degree of parakeratosis (range 24-100%). In the skin 5 to 14 days after stripping the rate of formation of the corneocyte layer varied from 1.6 to 8.2. In the noninvolved and involved skin the mean rate was 2.2 and 9.7, respectively. In the stripped skin epidermal glucose-6-phosphate dehydrogenase and pyruvate kinase activities generally were the same as those of the noninvolved skin. In the Koebner reacting epidermis the 2 enzymes were increased 2.2 and 1.1 times the noninvolved levels but were statistically not significantly increased from control values.

SUMMARY Microscopic lesions in active psoriasis were identified after careful examination with a magnifying glass in areas free of macroscopic lesions and of hair follicles. Biopsies were excised without anesthesia, immediately frozen and cryostat-sectioned. Care was taken to preserve the horny layer which was stained to reveal corneocyte membranes and nuclei when present. The interlocking sheets of corneocyte layers made it feasible to outline and trace intercellular spaces parallel to the surface and count the number of corneocyte layers between pairs of these. It was assumed that the location of such a space in the horny layer indicates the period of time from its formation. This information was used to assess the rate of corneocyte layer formation at specified intervals of time. The result shows that adjacent areas of the horny layer could be compared and relative rates of corneocyte layer formation computed. In the parakeratotic part of the early lesions of psoriasis studied the rate of corneocyte layer formation was 15 times higher than that in the non-involved skin. The peak rate, coincident with parakeratosisj was preceded by a number of thickened corneocyte layers. These also showed an increased rate of formation, up to 6.6 times that in non-involved skin. There was no acanthosis in the lesions studied. A subepidermal cellular infiltrate was observed. Periods of rapid corneocyte formation with parakeratosis were often short (not more than one day). These were interrupted by periods with a lower rate. The relationship between corneocyte morphology and stratum corneum kinetics is a distinct feature in the early psoriatic lesion.

In a double-blind study comprising 17 patients with symmetrical psoriasis lesions of the scalp, the combination of grenz ray treatment and topical steroid showed a faster clearing than with the topical steroid alone. The results also indicate a longer remission time with the combination therapy compared to grenz rays alone. Therefore both the faster clearing and the longer remission time with the combination therapy, as compared to our previous study of grenz ray treatment of scalp psoriasis, are probably due to the additional effect of steroid therapy, on grenz rays.

Fifty patients with plaque psoriasis were treated with dithranol and UVB 5 days per week. Twenty-six of these patients also received 13 treatments (once daily in the 1st week, every other day in the 2nd week, twice in the 3rd week and once in the 4th week) with topical clobetasol propionate. The median time for clearance was 2.5 weeks for those on the clobetasol propionate-dithranol-UVB combination compared with 4 weeks when only dithranol-UVB was used. Scaling and induration of the lesions disappeared during the first 2 weeks of treatment with clobetasol propionate-dithranol-UVB which was a significant improvement compared with dithranol-UVB alone. The time of remission in patients completely cleared was the same in the two groups. Relapses occurred slightly more often in the clobetasol propionate treated than in the control group (during treatment 5 of 26 versus 2 of 24; after 6 months 7 of 18 versus 4 of 15) but the differences were not statistically significant. The study shows that addition of topical clobetasol propionate according to our schedule to the traditional dithranol-UVB regimen of psoriasis results in a more rapid clearance of lesions without undesirable side effects.

Large vessels of the nose have been treated with razor blade shave technique in 5 patients. A good cosmetic result has been achieved.

A simple method for the removal of linear tattoos is described, where tissue destruction is limited to tattooed skin and the resulting necrosis does not extend more than 1 mm into non-tattooed skin. The epidermis overlying tattooed skin can easily be scraped after heat separation. Table salt is rubbed into and left on the area where epidermis has been removed. The achieved necrosis appears only in the heat-treated skin and heals with an acceptable scar.

This simple method is both a diagnostic and therapeutic procedure which combines the advantages of other methods that have been proposed in the literature. The cosmetic results have been very good in the presented cases.