Search

Abstract is missing (Commentary)

Isolated Cutaneous Myeloid Sarcoma (icMS) and Aleukemic Leukemia Cutis (ALC) are cutaneous extramedullary manifestations of leukemia in which leukemic cells infiltrate the skin before they can be identified either in the peripheral blood or in the bone marrow. We report the case of a 67-year-old patient who presented with a rapidly developing cutaneous tumour and scaly, erythematous-squamous plaques. Isolated Cutaneous Myeloid Sarcoma was diagnosed which rapidly progressed to terminal-stage Acute Myeloid Leukemia (AML). To highlight the disease characteristics of the adult-onset icMS and ALC cases that preceded AML we additionally compiled the pertinent literature of case reports of these rare conditions. We identified n=15 previously published icMS/ALC cases with adequately detailed clinical data descriptions. We could confirm the medical experience that icMS/ALC patients have an overall worse prognosis. Moreover, we could identify FAB M5 AML subtype as a significant adverse prognosticator of these patients.

Abstract Objective Double‐blind, randomized, and placebo‐controlled trial SP0967 (NCT02477839/2013‐000717‐20) did not demonstrate superior efficacy of lacosamide versus placebo in patients aged ≥1 month to

Candida auris, an emerging multidrug-resistant fungal pathogen, poses significant challenges in healthcare settings due to its high misidentification rate and resilience to treatments. Despite advancements in diagnostic tools, a gap remains in rapid, cost-effective identification methods that can differentiate C. auris from other Candida species, particularly on non-standard culture media. We used Raman spectroscopy to characterize C. auris grown on modified Dixon’s agar (mDixon) and differentiated it from Candida albicans and Candida parapsilosis. Key Raman spectral markers at 1171 cm−1 and 1452 cm−1, linked to mannan and β-glucan composition, differentiated C. auris into two subgroups, A and B. Despite the spectral similarities of groups A and B with C. albicans and C. parapsilosis, respectively, all Candida species were distinguishable through principal component analysis (PCA). Additionally, this study is the first to demonstrate the distinct spectral signature of mDixon agar, achieved through spatially offset Raman spectroscopy (SORS), which enables accurate discrimination between the culture medium and fungal samples. The observed inter-individual variability within C. auris, coupled with the spectral overlap between C. auris subgroups and other Candida species, highlights a major challenge in differentiating closely related fungi due to their similar molecular composition. Enhancements in spectral resolution and further fluorescence minimization from the culture medium are needed to reliably detect the subtle biochemical differences within these species. Despite these challenges, the results underscore the potential of Raman spectroscopy as a real-time, non-destructive, and complementary tool for fungal pathogen identification.

The automatic identification of various design elements in a floor-plan image has gained increasing attention in recent research. Emergency-evacuation applications can benefit greatly from automated floor-plan solutions, as they allow for the development of horizontal solutions instead of vertical solutions targeting a specific audience. In addition to that, current evacuation plans rely on static signs without taking into account the dynamic characteristics of each emergency case. This work aims to extract information from a floor-plan image and transform it into a graph that is used for pathfinding in an emergency evacuation. First, the basic elements of the floor-plan image, i.e., walls, rooms and doors, are identified. This is achieved using Panoptic-DeepLab, which is a state-of-the-art deep neural network for the panoptic segmentation of images, and it is available from DeepLab2, an image segmentation library. The neural network was trained using CubiCasa5K, a large-scale floor-plan image dataset containing 5000 samples, annotated into over 80 floor-plan object categories. Then, using the prediction of each pixel, a graph that shows how rooms and doors are connected is created. An application that presents this information in a user-friendly manner and provides graph editing capabilities was developed. Finally, the exits are set, and the optimal path for evacuation is calculated from each node using Dijkstra’s algorithm.

Abstract Plant-based mulch has been proposed as a sustainable way of maintaining soil fertility. However, the role of mulch diversity, quality, and size in decomposition dynamics, and their effect on crop yield, has not been fully explored. We investigated how mulch quality, proxied by the constituent plant species diversity, and residue size drive mulch decomposition, nutrient release, crop nutrition, and yield. A rhizotron experiment was set up with barley as a model crop, with the addition of mulch of two particle sizes (1.5 and 30 cm) and four different plant residue mixes of differing biodiversity (17, 12, 6, and 1 species) in a fully factorial design. Soil nutrient dynamics were measured at advanced decomposition stages, together with residue quality, arbuscular mycorrhizal fungal (AMF) root colonisation, and crop yield. Residue mass loss was significantly affected by its chemical composition. Initial NDF content was more restricted factor in C and N mineralisation than C:N or lignin. Long residues retained significantly higher C and N content, than short residues. Crop yield was not affected by residue type or size. Residue size significantly affected barley growth rate, influencing seed protein content. Soil available K was significantly increased by residues with a higher initial C:N ratio. Short residues resulted in higher soil Zn. Residues of higher diversity resulted inhigher AMF root colonisationof the barley plants. Generally, long residue mulches maintain higher fertilisation capacity at advanced stage of decomposition than short ones, without a deleterious effect on crop yield. Further investigation should evaluate the effect of continuous application of long residue mulches on soil fertility and microbial symbiosis.

The spline reconstruction technique (SRT) is a fast algorithm based on a novel numerical implementation of an analytic representation of the inverse Radon transform. The purpose of this study was to compare the SRT, filtered back-projection (FBP), and the Tera-Tomo 3D algorithm for various iteration numbers, using small-animal dynamic PET data obtained from a Mediso nanoScan® PET/CT scanner. For this purpose, Patlak graphical kinetic analysis was employed to noninvasively quantify the myocardial metabolic rate of glucose (MRGlu) in seven male C57BL/6 mice (n=7). All analytic reconstructions were performed via software for tomographic image reconstruction. The analysis of all PET-reconstructed images was conducted with PMOD software (version 3.506, PMOD Technologies LLC, Fällanden, Switzerland) using the inferior vena cava as the image-derived input function. Statistical significance was determined by employing the one-way analysis of variance test. The results revealed that the differences between the values of MRGlu obtained via SRT versus FBP, and the variants of he Tera-Tomo 3D algorithm were not statistically significant (p > 0.05). Overall, the SRT appears to perform similarly to the other algorithms investigated, providing a valid alternative analytic method for preclinical dynamic PET studies.

In this retrospective, chart review study, we evaluated the feasibility of immunocryosurgery in facial, non-superficial basal cell carcinomas (BCC) that had relapsed after standard surgery. Inclusion criteria were (a) ‘biopsy confirmed relapse of facial BCC’, (b) known ‘calendar year of surgical excision(s)’, and (c) ‘relapse within 10 years after the last surgical excision’. Tumors treated from 1 January 2011 to 31 December 2020 with a standard 5-week immunocryosurgery cycle (daily imiquimod application for 5 weeks and a cryosurgery session at day 14) were included. Descriptive statistics, Kaplan–Meier method, and Cox proportional hazards model were calculated with significance at p < 0.05. From the n = 27 BCC evaluated, n = 20 (74.1 ± 8.4%) cleared after one immunocryosurgery cycle. Two of the remaining cases cleared completely after a repeat cycle, one patient favored surgery, and four BCC did not clear despite additional immunocryosurgery cycles (feasibility 81.5 ± 7.5%). Of the 22 tumors with clinical outcome ‘complete clearance with immunocryosurgery’, three BCC relapsed at 9, 28, and 50 months. Overall, the 5–year treatment efficacy rate was 60.2 ± 13.4% (mean follow-up 94.6 ± 15.1 months). In total, 20/27 BCC relapses after surgery (74.1%) were tumor-free at the end of personalized follow-up times (66.7 ± 12.4% tumor free patients at 5-year follow-up). Number of tumor relapses before immunocryosurgery was the single predictor of tumor progression after immunocryosurgery (p = 0.012). Conclusively, immunocryosurgery could be further evaluated as an alternative, definitive treatment of selected facial BCC relapsing after surgery.

Bleomycin, an antineoplastic antibiotic that inhibits DNA synthesis, is used to treat various malignant tumours such as Hodgkin's lymphoma, squamous cell carcinoma, and germ cell tumors. Flagellate erythema is a rare rash with a linear pattern that has been observed in association with bleomycin treatment. Herein, we present a 43-year-old patient with metastatic testicular cell neoplasms who developed a whiplash rash during treatment with a chemotherapy regimen that included bleomycin. A typical case of bleomycin-related flagellate dermatitis has been diagnosed and the main features of this characteristic adverse drug event are briefly discussed.

Dandruff is a common scalp disorder with multiple microbial and host-related factors contributing to its aetiology, including alterations in scalp sebum. Despite existing evidence that the yeast Malassezia restricta plays a key role in the onset of dandruff, the interplay of these factors is poorly understood. Recently, squalene monohydroperoxide and malondialdehyde were established as biomarkers of dandruff-afflicted scalp, highlighting the role of sebum lipoperoxidation in the triggering and maintenance of dandruff, although its mechanism of action is unknown. The current study provides evidence that M. restricta mediates sebum peroxidation, leading to production of squalene monohydroperoxide and malondialdehyde. Furthermore, in vitro data show that these lipoperoxidation products act on epidermal cells and alter the skin barrier. These results support the role of Malassezia restricta-induced lipoperoxides as triggers of dandruff, which suggests that blocking their production could be a novel anti-dandruff treatment approach.

Candida auris, an emerging multidrug-resistant fungal pathogen, poses significant challenges in healthcare settings due to its high misidentification rate and resilience to treatments. Despite advancements in diagnostic tools, a gap remains in rapid, cost-effective identification methods that can differentiate C. auris from other Candida species, particularly on non-standard culture media. We used Raman spectroscopy to characterize C. auris grown on modified Dixon's agar (mDixon) and differentiated it from Candida albicans and Candida parapsilosis. Key Raman spectral markers at 1171 cm−1 and 1452 cm−1, linked to mannan and β-glucan composition, differentiated C. auris into two subgroups, A and B. Despite the spectral similarities of groups A and B with C. albicans and C. parapsilosis, respectively, all Candida species were distinguishable through principal component analysis (PCA). Additionally, this study is the first to demonstrate the distinct spectral signature of mDixon agar, achieved through spatially offset Raman spectroscopy (SORS), which enables accurate discrimination between the culture medium and fungal samples. The observed inter-individual variability within C. auris, coupled with the spectral overlap between C. auris subgroups and other Candida species, highlights a major challenge in differentiating closely related fungi due to their similar molecular composition. Enhancements in spectral resolution and further fluorescence minimization from the culture medium are needed to reliably detect the subtle biochemical differences within these species. Despite these challenges, the results underscore the potential of Raman spectroscopy as a real-time, non-destructive, and complementary tool for fungal pathogen identification. [ABSTRACT FROM AUTHOR]

Background/Objectives: Patients with Non-Alcoholic Fatty Liver Disease (NAFLD) are reported to have an increased risk of developing severe infections, leading to hospitalizations with sepsis. However, data regarding the impact of comorbid NAFLD on in-hospital outcomes of patients with sepsis is scarce. Methods: This nationwide retrospective observational study using discharge data from the National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), and Agency for Healthcare Research and Quality included 21,057,911 adult patients who were admitted to hospitals in the United States between 2000 and 2019 with a primary discharge diagnosis of sepsis. These patients were categorized according to the presence or absence of comorbid NAFLD. The twenty-year trend of nationwide NAFLD prevalence among sepsis inpatients was elucidated. Multivariable logistic regression analysis was used to analyze NAFLD's impact on sepsis outcomes. Results: In the twenty-year study period, the prevalence of NALFD among sepsis inpatients trended up from 1.2% in 2000 to 4.2% in 2019. Similar trends were observed in regional analysis. While overall sepsis mortality decreased, comorbid NAFLD in sepsis patients was consistently associated with a higher adjusted in-hospital all-cause mortality rate (adjusted odds ratio (OR), 1.19; 95% confidence interval (CI), 1.07–1.32), higher odds of developing septic shock, and higher likelihood of development of multi–organ dysfunction. Conclusions: Comorbid NAFLD in the stage of NASH or cirrhosis is associated with higher in-hospital all-cause mortality and worse clinical outcomes in sepsis inpatients. Addressing this rising epidemic will be of paramount importance to improve sepsis in-hospital outcomes. [ABSTRACT FROM AUTHOR]

Micro gas turbines (mGT) have not yet succeeded in conquering the small-scale combined heat and power (CHP) market. One reason is that their electrical efficiency is not high enough to maintain a cost-effective operation. A two-shaft intercooled mGT has the potential to meet the current market demand. This technology maintains a high electrical efficiency even at part-load and coupled with its fuel-flexible combustion chamber, it is an ideal candidate for CHP concepts in a renewable future. In this paper, performance analysis on two-spool mGT is carried out with various fuel blends. Attention is given to the low-pressure and high-pressure compressors and the variation of surge margin by adding hydrogen and syngas. Two control strategies for the mGT are adopted. In the first scenario, the two shafts have equal rotational speeds while in the second, the speeds are controlled independently. As the engine is operated at equal speeds, the maximum performance with 100 vol. % of syngas is observed at 85% of the nominal load while 100 vol. % of hydrogen shows maximum efficiency at a load of 63.7%. At electric power lower than 60% and for high amounts of syngas in natural gas, the low-pressure compressor (LPC) operates closely to surge line. In the second scenario, the efficiency increases as the load decreases and the LPC runs in an efficient and safe operating region. Additionally, the amount of nitrogen in syngas affects the part-load performance of the two-spool mGT. [ABSTRACT FROM AUTHOR]

Malassezia furfur yeast strains isolated from diseased human skin preferentially biosynthesize indole alkaloids which can be detected in the human skin and are highly potent activators of the aryl hydrocarbon receptor (AhR) and AhR-dependent gene expression. Chemical analysis of an EtOAc extract of a M. furfur strain obtained from diseased human skin and grown on l-tryptophan agar revealed several known AhR active tryptophan metabolites along with a previously unidentified compound, pityriazepin. While its structure resembled that of the known alkaloid pityriacitrin, the comprised pyridine ring had been transformed into an azepinone. The indoloazepinone scaffold of pityriazepin is extremely rare in nature and has only been reported once previously. Pityriazepin, like the other isolated compounds, was found to be a potent activator of the AhR-dependent reporter gene assay in recombinant cell lines derived from four different species, although significant species differences in relative potency were observed. The ability of pityriazepin to competitively bind to the AhR and directly stimulate AhR DNA binding classified it as a new naturally-occurring potent AhR agonist. M. furfur produces an expanded collection of extremely potent naturally occurring AhR agonists, which produce their biological effects in a species-specific manner.

The spline reconstruction technique (SRT) is a fast algorithm based on a novel numerical implementation of an analytic representation of the inverse Radon transform. The purpose of this study was to compare the SRT, filtered back-projection (FBP), and the Tera-Tomo 3D algorithm for various iteration numbers, using small-animal dynamic PET data obtained from a Mediso nanoScan® PET/CT scanner. For this purpose, Patlak graphical kinetic analysis was employed to noninvasively quantify the myocardial metabolic rate of glucose ( M R G l u ) in seven male C57BL/6 mice ( n = 7 ). All analytic reconstructions were performed via software for tomographic image reconstruction. The analysis of all PET-reconstructed images was conducted with PMOD software (version 3.506, PMOD Technologies LLC, Fällanden, Switzerland) using the inferior vena cava as the image-derived input function. Statistical significance was determined by employing the one-way analysis of variance test. The results revealed that the differences between the values of M R G l u obtained via SRT versus FBP, and the variants of he Tera-Tomo 3D algorithm were not statistically significant (p > 0.05). Overall, the SRT appears to perform similarly to the other algorithms investigated, providing a valid alternative analytic method for preclinical dynamic PET studies. [ABSTRACT FROM AUTHOR]

Background: Optical coherence tomography (OCT) is a non-invasive imaging technique based on the interferometry of backscattered light. However, strong light scattering hinders its applicability in clinical dermatology. The strength of scattering is exemplified by the attenuation coefficient which is the rate of OCT signal decay in depth. Attenuation can be reduced by topical application of hyperosmotic liquids with a high refractive index, namely optical clearing agents (OCAs). In this study, we assessed the impact of different OCAs to enhance skin optical permeability in OCT images. In vivo tests were carried out to determine the OCT attenuation coefficient (μOCT) and epidermal thickness in the treated and untreated epidermis. Methods: Four OCAs were studied: Propylenglycol, propylenglycol combined with oleic acid in equal proportions (1:1 v/v), Vaseline, and liquid Vaseline. Percentage change of μOCT and epidermal thickness were estimated by OCT imaging of a healthy forearm skin, prior to the application of each OCA and after the application, at two time points, t1 = 5 min, and t2 = 90 min. μOCT was quantitatively obtained by fitting the OCT signal to a single scattering model. Results: The application of OCAs induced significant changes in both μOCT (decreased) and epidermal thickness (increased). The synergistic effect of the combined propylenglycol with oleic acid reduced the μOCT by 43% while propylenglycol induced the highest increase (33%) in epidermal thickness, both at t2. Conclusions: Topical administration of propylenglycol combined with oleic acid can reduce light attenuation in OCT imaging within the clinically relevant timeframe of 90 min.

Yeasts of the genus, Malassezia, formerly known as Pityrosporum, are lipophilic yeasts, which are a part of the normal skin flora (microbiome). Malassezia colonize the human skin after birth and must therefore, as commensals, be normally tolerated by the human immune system. The Malassezia yeasts also have a pathogenic potential where they can, under appropriate conditions, invade the stratum corneum and interact with the host immune system, both directly but also through chemical mediators. The species distribution on the skin and the pathogenetic potential of the yeast varies between different Malassezia related diseases such as head and neck dermatitis, seborrheic dermatitis, pityriasis versicolor, and Malassezia folliculitis. The diagnostic methods used to confirm the presence of Malassezia yeasts include direct microcopy, culture based methods (often a combination of morphological features of the isolate combined with biochemical test), molecular based methods such as Polymerase Chain Reaction techniques, and Matrix Assisted Laser Desorption/Ionization—Time Of Flight mass spectrometry and the chemical imprint method Raman spectroscopy. Skin diseases caused by Malassezia are usually treated with antifungal therapy and if there are associated inflammatory skin mechanisms this is often supplemented by anti-inflammatory therapy. The aim of this paper is to provide an overview of Malassezia related skin disease, diagnostic methods and treatment options.

Skin cancer is currently the most common type of cancer with millions of cases diagnosed worldwide yearly. The current gold standard for clinical diagnosis of skin cancer is an invasive and relatively time-consuming procedure, consisting of visual examination followed by biopsy collection and histopathological analysis. Raman spectroscopy has been shown to efficiently aid the non-invasive diagnosis of skin cancer when probing the surface of the skin. In this study, we employ a recent development of Raman spectroscopy (Spatially Offset Raman Spectroscopy, SORS) which is able to look deeper in tissue and create a deep layer biochemical profile of the skin in areas where cancer lesions subtly evolve. After optimizing the measurement parameters on skin tissue phantoms, we then adopted SORS on human skin tissue from different anatomical areas to investigate the contribution of the different skin layers to the recorded Raman signal. Our results show that using a diffuse beam with zero offset to probe a sampling volume where the lesion is typically included (surface to epidermis-dermis junction), provides the optimum signal-to-noise ratio (SNR) and may be employed in future skin cancer screening applications.

Immunocryosurgery is a minimally invasive combinational therapeutic procedure that has been designed, developed, and evaluated in the Dermatology Department of the University of Ioannina from 2004. In a fixed time protocol, this approach combines immune stimulatory therapy with imiquimod and cryosurgery, i.e., cryosurgery is applied during continuous imiquimod treatment. Laboratory findings in tissue and blood level credit the efficacy to the synergy of imiquimod and cryosurgery. The synergy has been established through clinical trials and the excellent feasibility and efficacy demonstrated in clinical practice. Immunocryosurgery has extensive proof of excellent efficacy, comparable to surgery, in the treatment of basal cell carcinoma. It has also been evaluated in cases of Bowen’s disease, keratoacanthoma, Merkel cell carcinoma, lentigo maligna, and cutaneous squamous cell carcinoma with or without the addition of adjuvants. The aims of this review are to detail the immunocryosurgery protocol with the addition of daily practice clinical tips, compile data on the mechanism of action of immunocryosurgery, and delineate indications and possible future applications. Most of the available data originate from the treatment of BCC, of all histological types and localizations, and the principles reported mainly reflect on evidence related to the treatment of this common skin cancer.