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Background: The coronavirus disease 2019 (COVID‐19) pandemic and related restrictions globally impacted mental health, particularly for those with pre‐existing severe mental illness (SMI). This qualitative study examined how adults with SMI perceived the effects of the COVID‐19 pandemic and related restrictions in the Netherlands, focusing on their personal recovery, well‐being and daily life, including an exploration of factors influencing these effects. Methods: Semi‐structured interviews were conducted, audio‐recorded and transcribed verbatim. Reflexive thematic analysis was applied. Purposive sampling was used to ensure diversity of individuals with SMI (i.e., age, gender, diagnosis, cultural background and mental healthcare institution). Results: Twenty participants (median age: 45 years [SD: 12, 8]; 11 females) were interviewed between May and July 2023. Findings revealed a wide range of experiences: while some individuals reported a negative impact on their existing psychiatric symptoms, others described adaptability, resilience and even positive effects of COVID‐19 restrictions on their mental health and well‐being. Factors influencing the heterogeneic perceptions of the COVID‐19 pandemic and related restrictions include the availability of trusted social relationships and enduring interactions with health professionals. Conclusion: Personalised support, both socially and professionally, is crucial for addressing fears, building resilience, reducing isolation and encouraging positive coping strategies for individuals with SMI during external crises. In this project, a participatory research approach that integrated the lived experience perspective helped uncover the unique perceptions of people with SMI with regard to the pandemic and related restrictions. Patient or Public Contribution: The study used a participatory action research approach, with experts‐by‐experience involved in every stage of the project as part of the research team. This included engagement with the funding application process, recruitment strategies for interviews, developing the interview guide, piloting the interview, interpreting findings, and knowledge dissemination activities. [ABSTRACT FROM AUTHOR]

A seismic swarm affected the 53.3°–54.3° Latitude North section of the Mid‐Atlantic Ridge from 26 September to 10 December 2022. We rely on regional, teleseismic and array data to relocate 61 hypocenters and derive 77 moment tensors. The 2022 swarm released a cumulative moment equivalent to Mw 6.3. Seismicity was shallow (7 ± 3 km depth). Most earthquakes are located along the ridge axis with typical, NS oriented normal faulting mechanisms, but a few among the largest and latest earthquakes have unusual thrust mechanisms and locations as far as ∼25 km from the ridge. We attribute the swarm to a shallow magmatic intrusion, with a vertical dike first propagating ∼60 km along axis, accompanied by shallow normal faulting, and then thickening and triggering thrust earthquakes off the ridge, in response to compressive stress buildup. The unrest provides a rare example of an energetic, magmatic driven swarm episode at the mid‐ocean ridge. Plain Language Summary: The largest plate boundary systems on Earth are Mid‐ocean ridges (MOR), where the plates continuously drift apart and new lithosphere is constantly being formed. Although the process is well understood, we rarely detect spreading events at MOR, mainly because these regions are remote and local monitoring is rarely possible. In September–November 2022 a large, unusual seismic swarm occurred along a spreading center ridge segment of the North Mid‐Atlantic Ridge. Despite the remoteness of the region, we managed to model regional and teleseismic data to perform earthquake relocation, depth estimation and moment tensor inversion. In this way, we could reconstruct the geometry and the evolution of the seismicity. We found that in the early days of the swarm, seismicity migrated unilaterally over ∼60 km along the ridge axis, from North to South, triggering normal faulting earthquakes, which are typical at MOR. Later, large thrust mechanisms, anomalous in an extensional environment, appeared and quickly became predominant. We explain seismological observations by a magmatic intrusion, which first propagated southward, producing shallow normal faulting earthquakes above the vertical magma dike, and later thickened, increasing compressional stresses on its sides, and triggering large thrust earthquakes. Key Points: Analysis of a short, intense seismic swarm at the Mid‐Atlantic RidgeIdentification of unusual, thrust focal mechanisms in an extensional environmentSwarm triggered by dike intrusion at the mid‐ocean ridge [ABSTRACT FROM AUTHOR]

On 12 August 2021, a >220 s lasting complex earthquake with Mw > 8.2 hit the South Sandwich Trench. Due to its remote location and short interevent times, reported earthquake parameters varied significantly between different international agencies. We studied the complex rupture by combining different seismic source characterization techniques sensitive to different frequency ranges based on teleseismic broadband recordings from 0.001 to 2 Hz, including point and finite fault inversions and the back‐projection of high‐frequency signals. We also determined moment tensor solutions for 88 aftershocks. The rupture initiated simultaneously with a rupture equivalent to a Mw 7.6 thrust earthquake in the deep part of the seismogenic zone in the central subduction interface and a shallow megathrust rupture, which propagated unilaterally to the south with a very slow rupture velocity of 1.2 km/s and varying strike following the curvature of the trench. The slow rupture covered nearly two‐thirds of the entire subduction zone length, and with Mw 8.2 released the bulk of the total moment of the whole earthquake. Tsunami modeling indicates the inferred shallow rupture can explain the tsunami records. The southern segment of the shallow rupture overlaps with another activation of the deeper part of the megathrust equivalent to Mw 7.6. The aftershock distribution confirms the extent and curvature of the rupture. Some mechanisms are consistent with the mainshocks, but many indicate also activation of secondary faults. Rupture velocities and radiated frequencies varied strongly between different stages of the rupture, which might explain the variability of published source parameters. Plain Language Summary: The earthquake of 12 August 2021 along the deep‐sea trench of the South Sandwich Islands in the South Atlantic reached a magnitude of 8.2 and triggered a tsunami. The automatic earthquake parameter determination of different agencies showed very different results shortly after the earthquake and partially underestimated the tsunami potential of the earthquake. A possible reason was the complex rupture process and that the tsunami was generated by a long and shallow slow slip rupture sandwiched between more conventional fast slip subevents at its northern and southern ends. In addition, the fault surface, which extended over 450 km, was highly curved striking 150°–220°. We investigated the different components of the seismic wavefields in different frequency ranges and with different methods. The analysis shows how even complex earthquakes can be deciphered by combining analyzing methods. The comparison with aftershocks and the triggered tsunami waves confirms our model that explains the South Sandwich rupture by four subevents in the plate boundary along the curved deep‐sea trench. Here, the depth, rupture velocities, and slip on each segment of the rupture vary considerably. The method can also be applied to other megathrust earthquakes and help to further improve tsunami warnings in the future. Key Points: A combination of multiple approaches, inversion setups, and frequency ranges deciphered the complex earthquake of 2021 South SandwichThe rupture consisted of four subevents with the largest occurring as a shallow slow rupture parallel to the South Sandwich TrenchForward modeling proves that the large, shallow thrust subevent caused the recorded tsunami [ABSTRACT FROM AUTHOR]

Abstract: Background: The X‐ACT study aimed to examine the effect of omalizumab treatment on quality of life (QoL) in chronic spontaneous urticaria (CSU) patients with angioedema refractory to high doses of H1‐antihistamines. Methods: In X‐ACT, a phase III, double‐blind, placebo‐controlled study, CSU patients (18‐75 years) with ≥4 angioedema episodes during the 6 months before inclusion were randomized (1:1) to receive omalizumab 300 mg or placebo every 4 weeks for 28 weeks. Angioedema‐related QoL, skin‐related QoL impairment, and psychological well‐being were assessed. Results: Ninety‐one patients were randomized and 68 (omalizumab, n = 35; placebo, n = 33) completed the 28‐week treatment period. At baseline, the mean (SD) total Angioedema QoL (AE‐QoL; 56.2 [18.7] and 59.9 [19.2]) and Dermatology Life Quality Index (DLQI; 14.6 [5.7] and 16.6 [7.3]) score were high in the omalizumab and placebo group, respectively. At Week 4 (after the first treatment), the least squares mean difference in the AE‐QoL and DLQI score between groups was −17.6 (P < .001) and −7.2 (P < .001), respectively. Significant QoL improvements in the omalizumab vs placebo groups continued until Week 28, but returned to placebo levels at the follow‐up visit. The mean (SD) baseline 5‐item World Health Organization Well‐being Index was 10.0 (5.5, omalizumab) and 7.7 (5.3, placebo), which increased above the depression threshold (<13) from Week 4 and throughout with omalizumab but not placebo treatment. Compared to placebo, omalizumab was also associated with decreased fear of suffocation due to angioedema. Conclusions: Our findings support omalizumab treatment in patients with severe H1‐antihistamine‐refractory CSU with angioedema. [ABSTRACT FROM AUTHOR]

Patients with chronic spontaneous urticaria ( CSU) are widely held to often have other autoimmune disorders, including autoimmune thyroid disease. Here, we systematically evaluated the literature on the prevalence of thyroid autoimmunity in CSU and vice versa. There is a strong link between CSU and elevated levels of IgG antithyroid autoantibodies ( AAbs), with most of a large number of studies reporting rates of ≥10%. Levels of IgG against thyroid peroxidase ( TPO) are more often elevated in CSU than those of other IgG antithyroid AAbs (strong evidence). Levels of IgG antithyroid AAbs are more often elevated in adult patients with CSU than in children (strong evidence). Patients with CSU exhibit significantly higher levels of IgG antithyroid AAbs (strong evidence) and IgE-anti- TPO (weak evidence) than controls. Elevated IgG antithyroid AAbs in CSU are linked to the use of glucocorticoids (weak evidence) but not to disease duration or severity/activity, gender, age, or ASST response (inconsistent evidence). Thyroid dysfunction rates are increased in patients with CSU (strong evidence). Hypothyroidism and Hashimoto's thyroiditis are more common than hyperthyroidism and Graves' disease (strong evidence). Thyroid dysfunction is more common in adult patients with CSU than in children (strong evidence) and in female than in male patients with CSU (weak evidence). Urticaria including CSU is more prevalent in patients with thyroid autoimmunity than in controls (weak evidence). CSU can improve in response to treatment with levothyroxine or other thyroid drugs (strong evidence). Pathogenic mechanisms in CSU patients with thyroid autoimmunity may include IgE against autoantigens, immune complexes, and complement. [ABSTRACT FROM AUTHOR]

Background Chronic spontaneous urticaria ( CSU) severely impacts quality of life (QoL), especially in patients with wheals and angioedema. Omalizumab is approved as add-on therapy for CSU patients; however, its effect on patients who are double-positive for wheals and angioedema has not been systematically studied. Objective The primary objective was to evaluate the efficacy of omalizumab vs placebo at week 28 using the Chronic Urticaria Quality of Life ( CU-Q2oL) questionnaire. Number of angioedema-burdened days, time interval between successive angioedema episodes, disease activity, angioedema-specific and overall QoL impairment were secondary objectives. Methods X- ACT was a phase III, randomized, double-blind study conducted in 24 centres (Germany), which selectively included CSU patients with angioedema and wheals. Patients were randomized (1 : 1) to omalizumab 300 mg or placebo (every 4 weeks up to week 24) (ClinicalTrials.gov number: NCT01723072). Results Of the 91 patients randomized to omalizumab ( n = 44) or placebo ( n = 47) at baseline, 68 completed the 28-week treatment phase (omalizumab, 35; placebo, 33). Omalizumab was superior to placebo in improving CU-Q2oL scores at week 28 ( P < 0.001). There was a threefold improvement in angioedema-burdened days/week with omalizumab (0.3) vs placebo (1.1). The median time to first recurrence of angioedema was 57-63 days with omalizumab and <5 days with placebo. Omalizumab significantly improved angioedema-specific QoL ( P < 0.001). The adverse events reported are in line with the established safety profile of omalizumab. Conclusion Omalizumab was an effective treatment option for patients with moderate-to-severe CSU symptoms and angioedema unresponsive to high doses of antihistamine treatment. [ABSTRACT FROM AUTHOR]

Background GA² LEN, the Global Allergy and Asthma European Network, has recently launched a program for the development, interaction, and accreditation of centers of reference and excellence in special areas of allergy embedded in its overall quality management of allergy centers of excellence. The first area chosen is urticaria. Urticaria is a common and debilitating condition and can be a challenge for both patients and treating physicians, especially when chronic. Centers of reference and excellence in urticaria ( UCAREs) can help to improve the management of hard-to-treat conditions such as urticaria. Aims Here, we describe the aims, the requirements and deliverables, the application process, and the audit and accreditation protocol for GA² LEN UCAREs. Results The main aims of GA² LEN UCAREs are to provide excellence in urticaria management, to increase the knowledge of urticaria by research and education, and to promote the awareness of urticaria by advocacy activities. To become a certified GA² LEN UCARE, urticaria centers have to apply and fulfill 32 requirements, defined by specific deliverables that are assessed during an audit visit. Discussion and Conclusion The GA² LEN UCARE program will result in a strong network of urticaria specialists, promote urticaria research, and harmonize and improve urticaria management globally. [ABSTRACT FROM AUTHOR]

A new species, Diatraea mitteri Solis, that had been residing cryptically as Diatraea crambidoides (Grote), feeding on eastern gama grass (Tripsacum dactyloides (L.) L., is described. D. crambidoides occurs in the southern United States and Mexico and is an economic pest of corn (Zea mays L.). It has been reported to also feed on sorghum (Sorghum bicolor (L.) Moench), johnsongrass (Sorghum halepense (L.) Persoon), and sugar cane (Saccharum officinarum L.). We confirm that D. crambidoides also feeds on eastern gama grass. Morphological and molecular characters support the status of D. mitteri as a new species. Parsimony analysis resulted in two clades corresponding to D. crambidoides and D. mitteri. We confirm the distribution of D. mitteri from Kansas, Oklahoma, and Texas, but its distribution could be as broad as the remaining range of eastern gama grass in the eastern United States. All the life stages are described and illustrated. A novel host association, Alabagrus imitatus Cresson (Hymenoptera: Braconidae), as a parasitoid of D. mitteri is reported. [ABSTRACT FROM AUTHOR]

In today's dental school curricula, an increasing amount of time is dedicated to technological advances, and preventive dentistry topics may not be adequately addressed. Freshman ( D1) students participated in a new Introduction to Preventive Dentistry course, which consisted of didactic lectures, active learning breakout sessions and case-based studies. The goal of this study was to determine if D1 dental students completing the course had a better knowledge and comfort level with basic preventive dentistry concepts and caries risk assessment than the upcoming graduating senior dental students. Following the completion of the course, D1 students were administered a survey that assessed their comfort level describing preventive dentistry topics to patients. This was immediately followed by an unannounced examination over the same topics. Senior ( D4) students, who had not taken a formal course, reported statistically significant higher comfort levels than D1 students. However, the D4s scored significantly lower in all of the examination areas than the D1 students. Higher scores in D1s may have been due to recent exposure to the course material. However, the basic nature of the content-specific questions should be easily answered by novice practitioners educating their patients on oral disease prevention. As the current data shows lower content-specific scores of basic preventive dentistry knowledge amongst graduating D4 students, this may indicate a need for more guidance and education of students during the patient care. This study showed that implementation of a formalised course for D1 students can successfully ameliorate deficiencies in knowledge of preventive dentistry topics. [ABSTRACT FROM AUTHOR]

Children with chronic atopic dermatitis (AD)-related itch require a comprehensive treatment approach that addresses the underlying cause of pruritus, as well as symptoms and complications that extend beyond the physical domain. In small children and infants, the short-term complications of quality of life disturbance and sleep dysfunction are closely associated with the course of adolescent development. In addition, the physical damage that results from uncontrolled pruritus and scratching can lead to disease chronification. Therefore, the rapid relief of acute pruritic flares, followed by the long-term maintenance of symptom-free skin, should be prioritized in AD treatment, in an effort to avoid the emotional, social and physical chronic manifestations described above. Alleviation of AD symptoms with fourth-generation topical anti-inflammatory agents like methylprednisolone aceponate is an appropriate choice of therapy for children and infants, due to its optimized therapeutic index and versatility in formulation. Especially in AD, supplemental disease management education should be considered, to address the psycho-social needs of children (and their families) suffering from pruritus. [ABSTRACT FROM AUTHOR]

Chronic pruritus is a major symptom in numerous dermatological and systemic diseases. Similar to chronic pain, chronic pruritus can have a dramatic impact on the quality of life and can worsen the general condition of the patient considerably. The pathogenesis of itch is diverse and involves a complex network of cutaneous and neuronal cells. In recent years, more and more itch-specific mediators and receptors, such as interleukin-31, gastrin-releasing peptide receptor or histamine H4 receptor have been identified and the concept of itch-specific neurons has been further characterized. Understanding of the basic principles is important for development of target-specific treatment of patients with chronic pruritus. In this review, we summarize the current knowledge about the pathophysiological principles of itch and provide an overview about current and future treatment options. Key points • Chronic pruritus is a common problem affecting a large proportion of the population. • The pathophysiological mechanisms underlying chronic pruritus are still insufficiently understood. • In the skin, diverse and complex interactions of keratinocytes, mast cells and sensory nerves largely determine the occurrence and the control of pruritus. • Management of patients with chronic pruritus requires an individually tailored therapy based on the condition of the skin (inflamed or non-inflamed), possible underlying causes and existing co-medication. • Systemic treatment with antihistamines often requires up-dosing up to 4-fold of the recommended daily dose. • Alternative systemic treatments of chronic pruritus are anticonvulsant drugs, μ-opioid receptor antagonists, antidepressants and UV light therapy. • Novel treatment options for chronic pruritus are to be expected in the near future and include H4 receptor antagonists, κ-opioid receptor agonists and neurokinin 1-receptor antagonists. [ABSTRACT FROM AUTHOR]

High-grade gliomas in children are rare and the best treatment is undetermined. The German language group study HIT-GBM compares various induction protocols for subsequent patient cohorts. Currently, cisplatinum, etoposide, ifosfamide, and vincristine are given simultaneously with extended-field radiotherapy. Imaging is done 3 weeks after to define treatment response, followed by 6-weekly controls during consolidation with lomustine, vincristine, and prednisone. The authors report on 2 patients with incompletely resected glioblastoma multiforme in which response was lacking 3 weeks after radiochemotherapy but became evident 12 weeks later. This suggests that later time points are required to assess induction protocol response. [ABSTRACT FROM AUTHOR]

Linked Article: Ständer and Yosipovitch. Br J Dermatol 2019; 181:932–938. [ABSTRACT FROM AUTHOR]

Abstract In malignant brain tumours which may disseminate staging, usually by cranial and spinal MRI is necessary. If MRI is performed in the postoperative period pitfalls should be considered. Nonspecific subdural contrast enhancement on spinal staging MRI is rarely reported after resection of posterior fossa turnouts, which may be mistaken for dissemination of malignancy. We investigated the frequency of spinal subdural enhancement after posterior cranial fossa neurosurgery in children. We reviewed 53 postoperative spinal MRI studies performed for staging of paediatric malignant brain tumours, mainly infratentorial primitive neuroectodermal tumours 2-40 days after surgery. There was contrast enhancement in the spinal subdural space in seven cases. This was not seen in any of eight patients who had been operated upon for a supratentorial tumour. After resection of 45 posterior cranial fossa tumours the frequency of subdural enhancement was 15.5%. MRI showing subdural enhancement was obtained up to 25 days postoperatively. No patient with subdural enhancement had cerebrospinal fluid (CSF) examinations positive for tumour cells or developed dissemination of disease in the CSF. Because the characteristic appearances of subdural contrast enhancement, appropriate interpretation is possible; diagnosis of neoplastic meningitis should rarely be impeded. Because of the striking similarity to that in patients with a low CSF pressure syndrome and in view of the fact that only resection of tumours of the posterior cranial fossa, usually associated with obstructive hydrocephalus, was followed by this type of enhancement one might suggest that rapid changes in CSF pressure are implicated, rather the effects of blood introduced into the spinal canal at surgery. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a highly prevalent inflammatory skin disorder characterized by episodic exacerbations and remissions. Why the clinically healthy skin of AD patients becomes rapidly inflamed and very pruritic is poorly understood. Objective: To investigate cowhage‐ and histamine‐induced itch and skin expression levels of their target receptors in lesional and non‐lesional skin of AD, compared to the skin of patients with psoriasis, chronic spontaneous urticaria (CSU) and healthy subjects. Methods: Patients with AD, psoriasis and chronic spontaneous urticaria (CSU) as well as healthy control subjects (HC) (n = 20 each) were assessed for differences in itch parameters, neurogenic flare reaction and local blood flow responses to skin provocations with cowhage and histamine. Skin biopsies from 10 AD, 10 psoriasis,11 CSU and 12 HC were obtained to assess expression of protease‐activated receptors 2 and 4 (PAR‐2, PAR‐4), histamine H1 and H4 receptors (H1R, H4R), and mast cells. Results: Provocation of non‐lesional skin of AD patients with cowhage resulted in prolonged itch (p = 0.020), which was not observed in psoriasis and CSU. Significantly prolonged and more intense cowhage‐ and histamine‐induced itch (for duration, peak and overall intensity) was also observed in lesional AD skin. Diminished neurogenic flare reaction and blood flow after histamine provocation were shown in AD and psoriasis patients. Non‐lesional AD skin along with lesional AD and psoriasis skin showed an increased expression of PAR‐2 and PAR‐4, H1R and H4R. Mast cell number was higher in lesional AD and psoriasis skin (p = 0.006 and p = 0.006, respectively). Conclusion: The non‐lesional skin of AD patients markedly differs from healthy skin in cowhage‐induced itch responses and the expression of receptors for proteases and histamine. Proactive therapeutic interventions that downregulate these receptors may prevent episodic exacerbation in AD. [ABSTRACT FROM AUTHOR]

Chronic pruritus (CP) is frequent in general medicine and the most common complaint in general dermatology. The prevalence of CP is expected to rise in the future due to the ageing population. The clinical presentation, underlying aetiology and treatment strategy of CP are heterogeneous. Also, individual treatment aims and physical, psychic and economic burdens of patients might vary. Chronic prurigo (CPG) is the most severe disease in the chronic pruritus spectrum, being associated with long‐standing scratch‐induced skin lesions and a therapy refractory itch‐scratch‐cycle. It is thus important to raise disease awareness for CP and CPG in the general public and among decision‐makers in the health system. Further, there is a need to support a rational clinical framework to optimize both diagnostics and therapeutics. Currently, there is still a shortcoming regarding approved therapies and understanding CP/CPG as severe medical conditions. Therefore, the EADV Task Force Pruritus decided to publish this white paper based on several consensus meetings. The group consented on the following goals: (a) ensure that CP is recognized as a serious condition, (b) increase public awareness and understanding of CP and CPG as chronic and burdensome diseases that can greatly affect a person's quality of life, (c) clarify that in most cases CP and CPG are non‐communicable and not caused by a psychiatric disease, (d) improve the support and treatment given to patients with CP to help them manage their disease and (e) publicize existing therapies including current guidelines. We aim to point to necessary improvements in access and quality of care directed to decision‐makers in health policy, among payers and administrations as well as in practical care. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the cases of a 73-year-old woman and a 61-year-old woman with notalgia paraesthetica (NP) who both undergo treatment of the disease with an 8% capsaicin patch.

The article focuses on the discovery of anti-immunoglubulin E (anti-IgE) therapy with omalizumab as a successful medical alternative for cholinergic urticaria treatment. Cholinergic urticaria is described as an acute pruritus and pin-sized wheals covered by erytherma. Some of the symptoms of cholinergic urticaria includes body temperature increase, physical exercise and emotional stress. Clinical trials cite that the anti-IgE therapy (omalizumab) improves efficacy towards patient recovery.

Presents a letter to the editor about Still's disease.

Background: Omalizumab, an anti‐IgE monoclonal antibody, is an effective treatment in chronic spontaneous urticaria (CSU). Predictors of fast and good response for omalizumab treatment have not yet been identified and characterized. Objective: To evaluate whether soluble FcεRI (sFcεRI), a marker of IgE‐mediated mast cell activation, predicts the time of response to omalizumab in CSU. Methods: Sera of 67 CSU patients were obtained before omalizumab treatment and analysed for sFcεRI levels by ELISA (2 ng/mL was used as cut‐off for elevated sFcɛRI). Treatment response during the first 4 weeks was assessed with the urticaria activity score (UAS7), urticaria control test (UCT) and the rolling UAS7 (rUAS7). Results: Elevated pre‐treatment sFcɛRI levels were detected in more than 70% of patients with completely controlled disease (UCT = 16) and well‐controlled disease (UCT = 12–15) and were significantly associated with disease control (χ2 = 4.94, p < 0.05). More than half of the patients (14/25) with low levels had poor disease control (UCT < 12). Of the patients who achieved complete and marked UAS7 response, respectively, 75% and 63% had elevated baseline sFcɛRI levels. Post‐treatment UAS7 scores were lower in patients with elevated sFcɛRI levels reaching statistical significance at Week 3 (p < 0.05). Patients with elevated baseline sFcɛRI levels achieved rUAS7 ≤ 6 and = 0 earlier than those with lower levels (Days 9 vs. 13 and Days 12 vs. 14, respectively). Conclusion: Elevated sFcεRI serum levels predict early and good response to treatment with omalizumab, which may help to better design treatment options for CSU patients. [ABSTRACT FROM AUTHOR]

The investigation of stresses, faults, structure and seismic hazards requires a good understanding and mapping of earthquake rupture and slip. Constraining the finite source of earthquakes from seismic and geodetic waveforms is challenging because the directional effects of the rupture itself are small and dynamic numerical solutions often include a large number of free parameters. The computational effort is large and therefore difficult to use in an exploratory forward modelling or inversion approach. Here, we use a simplified self-similar fracture model with only a few parameters, where the propagation of the fracture front is decoupled from the calculation of the slip. The approximative method is flexible and computationally efficient. We discuss the strengths and limitations of the model with real-case examples of well-studied earthquakes. These include the M w 8.3 2015 Illapel, Chile, megathrust earthquake at the plate interface of a subduction zone and examples of continental intraplate strike-slip earthquakes like the M w 7.1 2016 Kumamoto, Japan, multisegment variable slip event or the M w 7.5 2018 Palu, Indonesia, supershear earthquake. Despite the simplicity of the model, a large number of observational features ranging from different rupture-front isochrones and slip distributions to directional waveform effects or high slip patches are easy to model. The temporal evolution of slip rate and rise time are derived from the incremental growth of the rupture and the stress drop without imposing other constraints. The new model is fast and implemented in the open-source Python seismology toolbox Pyrocko , ready to study the physics of rupture and to be used in finite source inversions. [ABSTRACT FROM AUTHOR]

The life history and host range of the South American leaf-tier Tentamen atrivirgulatum Metz, 2019 (Lepidoptera: Gelechiidae) was evaluated to determine its suitability for classical biological control of invasive Brazilian peppertree, Schinus terebinthifolia, in the USA. Larvae were collected during a survey in the native range of Brazil feeding on Brazilian peppertree. A quarantine colony was established and no-choice tests were conducted to determine the host range of this species. The results of these tests indicated that the larvae fed and completed development on seven of the eleven non-target species tested. Percent survival on these non-targets ranged from 20% to 100%. Larval survival was 50% when fed the target weed Brazilian peppertree. When larvae were fed leaves of these non-targets, pupal weights were significantly lower only for those fed Pistacia chinensis. Development time to the pupal and adult stages did not differ with larval diet. These no-choice results indicate T. atrivirgulatum larvae have a broad host range and thus this species will not be developed as a biological control agent for Brazilian peppertree in the USA. [ABSTRACT FROM AUTHOR]

The article focuses on the differential effects of skin nerves on allergic skin inflammation. A study was conducted to asses the four major features of allergic skin inflammation- rubor, calor, tumor and pruritus, in the absence of functional sensory nerves as well as in normal skin. It was found that sensory skin nerves contribute differentially to allergic and histamine-induced skin inflammation.

Introduction With increasing use of digital scanning with restorative procedures in the dental office, it becomes necessary that educational institutions adopt instructional methodology for introducing this technology together with conventional impression techniques. Objective To compare the time differences between instructing dental students on digital scanning ( DS) ( LAVA C.O.S. digital impression system) and a conventional impression technique ( CI) (polyvinyl siloxane), and to compare students' attitudes and beliefs towards both techniques. Materials and methods Volunteer sophomore dental students ( n = 25) with no prior experience in clinical impressions were recruited and IRB consent obtained. Participants responded to a pre-and post-exposure questionnaire. Participants were instructed on the use of both DS and CI for a single tooth full coverage crown restoration using a consecutive sequence of video lecture, investigator-led demonstration and independent impression exercise. The time necessary for each step (minutes) was recorded. Statistical significance was calculated using dependent t-tests (time measurements) and 2-sample Mann-Whitney (questionnaire responses). Results The time spent teaching students was greater for DS than CI for video lecture (15.95 and 10.07 min, P = 0.0000), demonstration time (9.06 and 4.70 min, P = 0.0000) and impression time (18.17 and 8.59 min, P = 0.0000). Prior to the instruction and practice, students considered themselves more familiar with CI (3.96) than DS (1.96) ( P = 0.0000). After the instruction and practice, participants reported CI technique proved significantly easier than expected (pre-instruction: 3.52 and post-instruction: 4.08, P = 0.002). However, overall participants' perception of ease of use for DS was not influenced by this instruction and practice experience (pre-instruction: 3.84 and post-instruction: 3.56, P = 0.106). Despite the results, 96% of participants expressed an expectation that DS will become their predominant impression technique during their careers. Conclusions Dental students with no clinical experience have high expectations for digital scanning, and despite their initial difficulty, expect it to become their primary impression technique during their professional futures. The instructional time necessary for introducing DS into the curriculum is significantly greater than CI in both classroom (lecture) and clinical simulation settings (investigator-led demonstration). [ABSTRACT FROM AUTHOR]

Background: Pruritus is prevalent in psoriasis but still many features of pruritus, its response to therapy and its burden in psoriasis remain to be better characterized. Objective: To investigate characteristics and burden of pruritus in an international cohort of patients with psoriasis. Methods: This cross‐sectional study included a total of 634 patients and 246 controls from Germany, Poland and Russia. Physicians examined and interviewed participants, recording clinical characteristics, such as severity, therapy and localization of psoriatic lesions. Participants filled out self‐reported questionnaires including questions on pruritus severity and impact, characteristics, and response to therapy, and quality of life (QoL). Localization patterns of pruritus and skin lesions were visualized using body heat maps. Results: Most patients (82%) experienced pruritus throughout their disease, and 75% had current pruritus. The majority of patients (64%) perceived pure pruritus, and those who reported additional painful and/or burning sensations (36%) reported overall stronger pruritus. The scalp was the most frequently reported localization of pruritus, even in the absence of skin lesions. Body surface area (BSA) of pruritus was not linked to pruritus intensity, but to BSA of psoriatic lesions (rho = 0.278; P < 0.001). One third of patients (31%) reported impaired sex‐life, and 4% had suicidal ideations due to pruritus. In up to one third of patients, psoriasis therapies had little or no effect on pruritus. The only therapeutic option offered to some of these patients were antihistamines, which appeared to be effective in most cases. Conclusion: Pruritus is highly prevalent in psoriasis and is linked to a significant burden. Current psoriasis therapies are frequently insufficient to control pruritus. Managing psoriasis should include the assessment and control of itch. Efficient antipruritic therapies should be developed and be made available for patients with psoriasis. [ABSTRACT FROM AUTHOR]

In its native range the invasive weed,Rhodomyrtus tomentosais host to a suite of herbivores. One,Strepsicratessp. (Lepidoptera: Tortricidae), was collected in China in 2014, introduced under quarantine in Florida, USA, and tested against related species to determine its host range and suitability for biological control. In no-choice tests, neonates fed and completed development to the pupal stage on several species of Myrtaceae, including the target weedR. tomentosa, the exoticsMelaleuca quinquenervia, andEucalyptus camaldulensis, and three native species,Eugenia axillaris,Mosiera longipesandMorella cerifera(Myricaceae). Due to the broad host range exhibited in quarantine testing, this species will not be pursued as a biological control agent ofR. tomentosa. [ABSTRACT FROM AUTHOR]

Background: Sleep, which is crucial for restoring of physiological functions and health, is reportedly impaired in psoriasis. The role of different potential sleep confounding factors, including detailed pruritus characteristics, and the complex interplay between psychological variables (anxiety and depression), pruritus and sleep disturbance in psoriasis remain insufficiently investigated. Objectives: To investigate sleep characteristics and to identify clinical, demographic and psychological factors associated with sleep disturbance in psoriasis. Methods: This cross‐sectional study included 334 psoriasis patients (response rate 86%) and 126 control subjects (response rate 82%). Measures included sleep quality [Pittsburgh Sleep Quality Index (PSQI)], psoriasis severity, pruritus characteristics, including average pruritus intensity [visual analogue scale (VAS)], severity of comorbidities, anxiety and depression (Hospital Anxiety and Depression Scale – HADS) and quality of life (Dermatology Life Quality Index – DLQI, and Short Form 12 – SF12). Results: Fifty‐nine per cent of patients and 34% of control subjects (P < 0.001) suffered from sleep disturbance (PSQI > 5). Patients slept 1 h less than control subjects (median 6 vs. 7 h, P < 0.001). Patients without pruritus had less impaired sleep (global PSQI) than patients with strong (P < 0.001) and very strong pruritus (P < 0.001). Anxiety (HADS‐A) and depression (HADS‐D) levels were the strongest predictors of sleep impairment, followed by pruritus exacerbation at night, age, female sex, pruritus exacerbation in the morning, average pruritus intensity (VAS), diagnosed depression and gastroesophageal reflux disease, altogether explaining 32%–37% of the variance in global sleep quality. Both anxiety (HADS‐A) and depression (HADS‐D) were significant mediators explaining the association between pruritus intensity (VAS) and sleep impairment in 42% and 37% respectively. Conclusions: Sleep disturbance in patients with psoriasis is highly prevalent. Patients with psoriasis should be assessed for sleep impairment, pruritus, anxiety and depression. Reduction in pruritus should be considered as an important therapeutic goal, along with therapies aimed at reducing anxiety and depression. [ABSTRACT FROM AUTHOR]

There can be a disconnect between the level of content covered in undergraduate coursework and the expectations of professional-level faculty of their incoming students. Some basic science faculty members may assume that students have a good knowledge base in the material and neglect to appropriately review, whilst others may spend too much class time reviewing basic material. It was hypothesised that the replacement of introductory didactic physiology lectures with interactive online modules could improve student preparedness prior to lectures. These modules would also allow faculty members to analyse incoming student abilities and save valuable face-to-face class time for alternative teaching strategies. Results indicated that the performance levels of incoming U.S. students were poor (57% average on a pre-test), and students often under-predicted their abilities (by 13% on average). Faculty expectations varied greatly between the different content areas and did not appear to correlate with the actual student performance. Three review modules were created which produced a statistically significant increase in post-test scores (46% increase, P < 0.0001, n = 114-115). The positive results of this study suggest a need to incorporate online review units in the basic science dental school courses and revise introductory material tailored to students' strengths and needs. [ABSTRACT FROM AUTHOR]

Background Chronic urticaria is a common disorder characterized by recurrent wheals, angioedema, or both. Several differential diagnoses need to be considered in patients presenting with wheals and/or angioedema. These include rare diseases such as autoinflammatory syndromes and urticarial vasculitis in patients with recurrent wheals and bradykinin-mediated angioedema in patients with recurrent swellings. Aim and Result In order to not miss these conditions, we have developed a symptom-based diagnostic algorithm for the management of patients with wheals and/or angioedema. Discussion and Conclusion By asking the right questions and performing a limited diagnostic workup as suggested here, this algorithm may help to establish the right diagnosis and treat patients early and more effectively. [ABSTRACT FROM AUTHOR]

Background and Purpose: Aspirin reduces the risk of myocardial infarction and stroke by inhibiting thromboxane production in platelets. This inhibition can be competitively antagonized by some non-steroidal anti-inflammatory drugs (NSAIDs).Experimental Approach: By measuring thromboxane B(2) production in healthy volunteers, we investigated whether ibuprofen (800 mg three times daily for 7 days) or diclofenac (50 mg three times daily for 7 days) taken concurrently with aspirin 80 mg (once daily for 7 days) influenced the inhibitory effect of aspirin. The effects were compared with aspirin 30 mg (once daily for 7 days), which is the lowest dose of aspirin with a proven thromboprophylactic effect.Key Results: The median percentage inhibition of thromboxane B(2) levels by 30 mg or 80 mg aspirin was 90.3% (range 83.1-96.0%) and 98.0% (range 96.8-99.2%) respectively. The inhibition by concurrent administration of slow release diclofenac and 80 mg aspirin was 98.1% (range 97.2-98.9%), indicating no interference between aspirin and diclofenac. The inhibition decreased significantly by concurrent administration of immediate release ibuprofen and 80 mg aspirin (86.6%; range 77.6-95.1%) to a level less than 30 mg aspirin.Conclusions and Implications: As alternatives are easily available, NSAIDs such as diclofenac should be preferred to ibuprofen for combined use with aspirin. [ABSTRACT FROM AUTHOR]

Aims To compare the effects of nabumetone and meloxicam, two cyclo-oxygenase-2 (COX-2) preferential nonsteroidal anti-inflammatory drugs (NSAIDs), on platelet COX-1 activity and platelet function. Methods Twelve healthy volunteers (3 male, 9 female, median age 22 years) participated in an open, randomized, cross-over trial of nabumetone 1000 mg twice daily vs meloxicam 7.5 mg twice daily during 1 week with 2 weeks wash-out. After a second 2 week wash-out period, one dose of indomethacin 50 mg was given as a positive control to check for NSAID induced inhibition of platelet function. COX-1 inhibition was measured as percentage inhibition of serum TXB2 generation in clotting whole blood, and as closure time with use of the platelet function analyser PFA-100. Data are reported as median with range. Paired variables were analysed using Wilcoxons signed rank test. Results TXB2 levels decreased significantly after all three medications, but percentage inhibition after nabumetone and indomethacin (88% and 97%, respectively) was significantly higher than after meloxicam (63%) (P <0.05). Closure times increased significantly after administration of all three medications (P <0.05). Increases in closure time after administration did not differ between nabumetone and meloxicam (24% and 14%, respectively), but were significantly larger after indomethacin administration (63%) (P <0.01). Conclusions In the maximum registered dosage, nabumetone inhibits thromboxane production much more than meloxicam, signifying less COX-2 selectivity of the former. However, both nabumetone and meloxicam cause only minor impairment in platelet function in comparison with indomethacin and the difference between them is not significant. [ABSTRACT FROM AUTHOR]

Background: Rabeprazole has a faster onset of antisecretory action than omeprazole, and it is of interest to determine whether this translates into faster symptom relief in patients with gastro-oesophageal reflux disease. Aims: To assess the relief from heartburn after 3 days of treatment with standard-dose rabeprazole or high-dose omeprazole (primary end-point). Secondary end-points included the decrease in score for other symptoms of gastro-oesophageal reflux disease, healing rates and quantification of antacid use. Methods: Patients with endoscopically confirmed erosive oesophagitis were randomized to receive 4 weeks of double-blind treatment with rabeprazole (20 mg) or omeprazole (40 mg). Patients who were not healed after 4 weeks received a further 4 weeks of treatment. Results: Two hundred and seventy-four patients were screened, 251 patients were randomized and 230 patients completed the trial. The numbers of patients with relief from heartburn on day 4 were similar in the two groups (84% for rabeprazole; 95% confidence interval, 76–90%; 83% for omeprazole; 95% confidence interval, 75–89%). There were no significant differences between the treatments in the relief from other gastro-oesophageal reflux disease symptoms or in healing rates. The number of reports of severe heartburn during the first 3 days was higher in the omeprazole group (daytime heartburn: 4.7% for rabeprazole vs. 10.3% for omeprazole, P =0.005; night-time heartburn: 4.7% for rabeprazole vs. 9.8% for omeprazole, P =0.01; statistical comparisons defined post hoc ). Conclusions: Standard-dose rabeprazole was as effective as high-dose omeprazole in relieving symptoms by day 4 of treatment and in healing oesophageal lesions, but had a faster onset of action in patients with severe heartburn. This suggests that the improved pharmacological properties of rabeprazole translate into a clinically relevant advantage. [ABSTRACT FROM AUTHOR]

Background: Chronic nodular prurigo (CNPG) is a condition characterized by chronic itch, a prolonged scratching behaviour and the presence of pruriginous nodules. A comprehensive understanding of this condition, especially regarding its clinical characteristics and impact on quality of life is still lacking. Objectives: Aim of this pan‐European multicentre cross‐sectional study was to establish the clinical profile of CNPG, including its associated burden. Methods: Fifteen centres from 12 European countries recruited CNPG patients presenting at the centre or using the centres' own databases. Patients were asked to complete a questionnaire in paper or electronic format. Demography, current co‐morbidities, underlying disease, itch intensity, additional sensory symptoms, quality of life, highest burden and emotional experience of itch were assessed. Results: A total of 509 patients (210 male, median age: 64 years [52; 72]) were enrolled. Of these, 406 reported itch and CNPG lesions in the previous 7 days and qualified to complete the whole questionnaire. We recorded moderate to severe worst itch intensity scores in the previous 24 h. Scores were higher in patients with lower educational levels and those coming from Eastern or Southern Europe. Most patients experience itch often or always (71%) and report that their everyday life is negatively affected (53%). Itch intensity was considered to be the most burdensome aspect of the disease by 49% of the patients, followed by the visibility of skin lesions (21%) and bleeding of lesions (21%). The majority of patients was unaware of an underlying condition contributing to CNPG (64%), while psychiatric diseases were the conditions most often mentioned in association with CNPG (19%). Conclusions: This multicentre cross‐sectional study shows that itch is the dominant symptom in CNPG and reveals that the profile of the disease is similar throughout Europe. [ABSTRACT FROM AUTHOR]

Purpose: Imaging glioma biology holds great promise to unravel the complex nature of these tumors. Besides well-established imaging techniques such O-(2-[18F]fluoroethyl)-l-tyrosine (FET)-PET and dynamic susceptibility contrast (DSC) perfusion imaging, amide proton transfer–weighted (APTw) imaging has emerged as a promising novel MR technique. In this study, we aimed to better understand the relation between these imaging biomarkers and how well they capture cellularity and vascularity in newly diagnosed gliomas. Methods: Preoperative MRI and FET-PET data of 46 patients (31 glioblastoma and 15 lower-grade glioma) were segmented into contrast-enhancing and FLAIR-hyperintense areas. Using established cutoffs, we calculated hot-spot volumes (HSV) and their spatial overlap. We further investigated APTw and CBV values in FET-HSV. In a subset of 10 glioblastoma patients, we compared cellularity and vascularization in 34 stereotactically targeted biopsies with imaging. Results: In glioblastomas, the largest HSV was found for APTw, followed by PET and CBV (p < 0.05). In lower-grade gliomas, APTw–HSV was clearly lower than in glioblastomas. The spatial overlap of HSV was highest between APTw and FET in both tumor entities and regions. APTw correlated significantly with cellularity, similar to FET, while the association with vascularity was more pronounced in CBV and FET. Conclusions: We found a relevant spatial overlap in glioblastomas between hotspots of APTw and FET both in contrast-enhancing and FLAIR-hyperintense tumor. As suggested by earlier studies, APTw was lower in lower-grade gliomas compared with glioblastomas. APTw meaningfully contributes to biological imaging of gliomas. [ABSTRACT FROM AUTHOR]

Background and objective: Pruritus is a major symptom of many inflammatory diseases and impacts greatly the quality of life in patients. We aimed to specify the characteristics of experimentally induced pruritus in normal skin and in experimentally induced inflammatory dermatitis in healthy volunteers. Methods: Skin inflammation was induced by the repeated application of sodium lauryl sulphate (SLS 2%) on the volar forearms of 30 healthy volunteers. Inflammatory dermatitis intensity was assessed using the eczema score adapted from Frosch and Kligman. Non‐histaminergic pruritus was induced by cowhage spicules rubbed on the volar forearms and recorded for 30 min on a 10‐cm visual analogue scale (VAS) in both non‐inflamed and inflamed skin. Results: Induction of inflammatory dermatitis by SLS resulted in a mild inflammatory dermatitis with an inflammation score of 2.3 ± 0.1 within 7 days of treatment. Cowhage‐induced pruritus was of markedly higher intensity (P < 0.001), and all but two individuals had higher maximum pruritus intensity in inflamed skin as compared to non‐inflamed skin, whereas the kinetics of the pruritus response were similar. The quality of cowhage‐induced pruritus was significantly different with more 'burning' and 'painful sensations' in inflamed skin (P < 0.01). Maximum pruritus intensity in inflamed skin strongly correlated with maximum pruritus intensity in non‐inflamed skin (r = 0.51, P = 0.004). Skin hydration, skin barrier integrity and dermatitis severity did not correlate with pruritus intensity. Conclusion: Taken together, pruritus in inflamed skin is perceived as more intense, painful and burning. This may explain, in part, why pruritus is a major driver of quality‐of‐life impairment in patients with chronic inflammatory skin conditions such as atopic dermatitis. [ABSTRACT FROM AUTHOR]

Skin wound infections are a significant health problem, and antibiotic resistance is on the rise. Mast cells (MCs) have been shown to contribute to host-defense responses in certain bacterial infections, but their role in skin wound superinfection is unknown. We subjected 2 MC-deficient mouse strains to Pseudomonas aeruginosa skin wound infection and found significantly delayed wound closure in infected skin wounds. This delay was associated with impaired bacterial clearance in the absence of MCs. Engraftment of MCs restored both bacterial clearance and wound closure. Bacterial killing was dependent on IL-6 released from MCs, and engraftment with IL-6-deficient MCs failed to control wound infection. Treatment with recombinant IL-6 enhanced bacterial killing and resulted in the control of wound infection and normal wound healing in vivo. Taken together, our results demonstrate a defense mechanism for boosting host innate immune responses, namely effects of MC-derived IL-6 on antimicrobial functions of keratinocytes. [ABSTRACT FROM AUTHOR]

BACKGROUND In the majority of patients with chronic spontaneous urticaria, most currently available therapies do not result in complete symptom control. Ligelizumab is a next-generation high-affinity humanized monoclonal anti-IgE antibody. Data are limited regarding the dose-response relationship of ligelizumab and the efficacy and safety of ligelizumab as compared with omalizumab and placebo in patients who have moderate-to-severe chronic spontaneous urticaria that is inadequately controlled with Hr antihistamines at approved or increased doses, alone or in combination with H2-antihistamines or leukotriene-receptor antagonists. METHODS In a phase 2b dose-finding trial, we randomly assigned patients to receive ligelizumab at a dose of 24 mg, 72 mg, or 240 mg, omalizumab at a dose of 300 mg, or placebo, administered subcutaneously every 4 weeks for a period of 20 weeks, or a single 120-mg dose of ligelizumab. Disease symptoms of hives, itch, and angioedema were monitored by means of weekly activity scores. The main objective was to determine a dose-response relationship for the complete control of hives (indicated by a weekly hives-severity score of 0, on a scale from 0 to 21, with higher scores indicating greater severity); the primary end point of this response was assessed at week 12. Complete symptom control was indicated by a weekly urticaria activity score of 0 (on a scale from 0 to 42, with higher scores indicating greater severity). Safety was analyzed throughout the trial. RESULTS A total of 382 patients underwent randomization. At week 12, a total of 30%, 51%, and 42% of the patients treated with 24 mg, 72 mg, and 240 mg, respectively, of ligelizumab had complete control of hives, as compared with 26% of the patients in the omalizumab group and no patients in the placebo group. A dose--response relationship was established. At week 12, a total of 30%, 44%, and 40% of the patients treated with 24 mg, 72 mg, and 240 mg, respectively, of ligelizumab had complete control of symptoms, as compared with 26% of the patients in the omalizumab group and no patients in the placebo group. In this small and short trial, no safety concerns regarding ligelizumab or omalizumab emerged. CONCLUSIONS A higher percentage of patients had complete control of symptoms of chronic spontaneous urticaria with ligelizumab therapy of 72 mg or 240 mg than with omalizumab or placebo. (Funded by Novartis Pharma; ClinicalTrials.gov number, NCT02477332.) [ABSTRACT FROM AUTHOR]

Background: In skin diseases and experimental models of pruritus, pure itch is accompanied by additional sensations that are poorly characterized. Objectives: This study compared the sensory qualities evoked by different models of experimentally induced pruritus including skin prick testing (SPT) with histamine or capsaicin and application of cowhage spicules. SPT as a method of capsaicin application was validated for this purpose. Methods: Two pilot experiments were performed in eight healthy volunteers. First, a concentration of 8% capsaicin was identified as evoking a reproducible itch using SPT. Further, a list of the seven most frequently reported sensations was chosen after SPT with 10 mg/mL histamine, 8% capsaicin and application of 40–45 cowhage spicules. Finally, 31 subjects were challenged with the same itch‐inducers. Wheal and flare were measured at 10, 20, 40, 60 and 90 min, itch intensity every minute for 30 min, and the overall evaluation of sensory descriptors were recorded on a 100‐mm visual analogue scale once itching had subsided. Results: Skin prick testing with histamine and capsaicin resulted in flare reactions, which were 23% smaller for capsaicin (P < 0.001). Histamine, capsaicin and cowhage‐induced pruritus, the duration of which was shorter for cowhage than for histamine (13.5 ± 1.4 vs. 8.8 ± 1.2 min, P = 0.005). Different mediators induced sensations of different intensities. Capsaicin produced less itch and physical urge to scratch than histamine (P = 0.001) and cowhage (P < 0.001). However, both capsaicin and cowhage induced more burning than histamine (P = 0.002 and P = 0.04, respectively). Provocation with cowhage caused more intense sensations of pricking than histamine (P = 0.033). Conclusion: This study shows that provocation with histamine, capsaicin and cowhage results in itch responses that are different in their duration, the profile of accompanying sensations, and the flare that comes with the itch. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 43-year-old woman who was presented with non-allergic refractory eosinophilic asthma. Topics discussed include treatment of asthma with reslizumab, diagnosis of chronic spontaneous and cold urticaria and monitoring of patient through urticaria control test (UCT).

Background: Chronic prurigo (CPG) is a distinct disease characterized by chronic pruritus, history and/or signs of prolonged scratching and multiple pruriginous lesions. It may present with various clinical manifestations, including papules, nodules, plaques or umbilicated lesions. Some patients with chronic pruritus show pruriginous linear and scaring scratch lesions (LSSL) and it is unclear whether these lesions belong to the spectrum of CPG. Objective: To achieve a consensus on the classification of pruriginous LSSL and establish criteria to differentiate them from similar appearing conditions of different nature. Methods: Members of the Task Force Pruritus (TFP) of the European Academy of Dermatology and Venereology participated in the consensus conference, discussing representative clinical cases. Using the Delphi method, consensus was reached when ≥75% of members agreed on a statement. Results: Twenty‐one members of the TFP with voting rights participated in the meeting. It was consented that LSSL occurs due to chronic pruritus and prolonged scratching, and share common pathophysiological mechanisms with CPG. LSSL were thus considered as belonging to the spectrum of CPG and the term 'linear prurigo' was chosen to describe this manifestation. Conclusion: Considering linear prurigo as belonging to the spectrum of CPG has important clinical implications, since both the diagnostic and therapeutic approach of these patients should be performed as recommended for CPG. Importantly, linear prurigo should be differentiated from self‐inflicted skin lesions as factitious disorders or skin picking syndromes. In the latter, artificial manipulation rather than pruritus itself leads to the development of cutaneous lesions, which can show clinical similarities to linear prurigo. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: This research aimed to evaluate the students’ usage and perceptions of using smartphones in their general dental education and learning tooth preparation with the individually designed virtual 3D instructional models in the pre‐clinical removable partial denture course. Materials and Methods: Second‐year dental students were asked to voluntarily participate in a survey to investigate their demographic information, general usages of smartphones, perception of smartphones usage in dental education (construct 1) and perception of individually designed virtual 3D instructional models (construct 2). Students’ responses of general usages of the smartphones were compared with their demographic and educational backgrounds using nonparametric Kruskal‐Wallis test (for age) and Fisher's exact test (for sex, race and educational background). The sums of scores of the construct 1 and construct 2 were tested for associations with student's demographic and educational backgrounds using the Pearson product‐moment correlation (for age), t test (for sex and educational background) or one‐way ANOVA F test (for race) (α = .05). Results: A 75% response rate (N = 90) was achieved in this study, and all 90 participants owned smartphones. Students’ responses to general usages of the smartphones were not significantly influenced by their demographic background. For the construct 1, more than 73% of participants responded either agree or strongly agree to the usage of smartphones in general dental education and pre‐clinical setting; however, only 49% of participants responded the same way in the clinical setting. For the construct 2, 48 of 90 participants viewed the 3D models, and more than 73% of these 48 participants responded either agree or strongly agree to the usage of the 3D models in the pre‐clinical course. Student's demographic background did not have significant influence on the sums of scores of the construct 1 and construct 2. Conclusions: Within the limitations of this study, high usages and ownerships of smartphones were found amongst the students surveyed. The individually designed virtual 3D instructional models as supplemental teaching materials in the pre‐clinical course were perceived positively by the students. [ABSTRACT FROM AUTHOR]

Abstract: Background: The term prurigo has been used for many decades in dermatology without clear definition, and currently used terminology of prurigo is inconsistent and confusing. Especially, itch‐related prurigo remains unexplored regarding the epidemiology, clinical profile, natural course, underlying causes, available treatments and economic burden, although burdensome and difficult to treat. Objective: To address these issues, the multicentre European Prurigo Project (EPP) was designed to increase knowledge on chronic prurigo (CPG). In the first step, European experts of the EADV Task Force Pruritus (TFP) aimed to achieve a consensus on the definition, classification and terminology of CPG. Additionally, procedures of the cross‐sectional EPP were discussed and agreed upon. Methods: Discussions and surveys between members of the TFP served as basis for a consensus conference. Using the Delphi method, consensus was defined as an agreement ≥75% among the present members. Results: Twenty‐four members of the TFP participated in the consensus conference. Experts consented that CPG should be used as an umbrella term for the range of clinical manifestations (e.g. papular, nodular, plaque or umbilicated types). CPG is considered a distinct disease defined by the presence of chronic pruritus for ≥6 weeks, history and/or signs of repeated scratching and multiple localized/generalized pruriginous skin lesions (whitish or pink papules, nodules and/or plaques). CPG occurs due to a neuronal sensitization to itch and the development of an itch‐scratch cycle. Conclusion: This new definition and terminology of CPG should be implemented in dermatology to harmonize communication in the clinical routine, clinical trials and scientific literature. Acute/subacute forms of prurigo are separated entities, which need to be differentiated from CPG and will be discussed in a next step. In the near future, the cross‐sectional EPP will provide relevant clinical data on various aspects of CPG leading to new directions in the scientific investigation of CGP. [ABSTRACT FROM AUTHOR]

Summary: Background: Chronic spontaneous urticaria (CSU) is an inflammatory skin disorder characterized by recurrent weals, angio‐oedema or both. Recent studies have shown that the number of endothelial cells is increased in the skin of patients with CSU, but the underlying mechanisms and clinical implications of this are unclear. Aim: To evaluate whether mast cell (MC) or endothelial cell (EC) numbers correlate with CSU and whether they are relevant for disease duration, disease activity or the presence of clinical features. Methods: We determined the numbers of CD31+ ECs and MCs in nonlesional skin of 30 patients with CSU using quantitative histomorphometry, and assessed their correlation with each other and with clinical features such as disease duration, disease activity and occurrence of angio‐oedema. Results: The numbers of MCs and ECs were high in the nonlesional skin of patients with CSU, but did not correlate with each other. Neither MC number nor EC number correlated with disease duration or disease activity. Interestingly, patients with high numbers of cutaneous CD31+ ECs had higher rates of recurrent angio‐oedema and vice versa. Conclusions: Based on these findings, we speculate that vascular remodelling and MC hyperplasia in patients with CSU occurs independently and via different mechanisms. Targeting of the mechanisms that drive neoangiogenesis in CSU may result in novel therapeutic strategies for the management of patients with angio‐oedema. [ABSTRACT FROM AUTHOR]

The urticaria activity score ( UAS) is the gold standard for assessing disease activity in patients with chronic spontaneous urticaria ( CSU). Two different versions, the UAS7 and UAS7 TD, are currently used in clinical trials and routine care. To compare both versions and to obtain data on their interpretability, 130 CSU patients applied both versions and globally rated their disease activity as none, mild, moderate, or severe. UAS7 and UAS7 TD values correlated strongly ( r = .90, P < .001). Interquartile ranges for UAS7 and UAS7 TD values for mild, moderate, and severe CSU were 11-20 and 10-24, 16-30 and 16-32, and 27-37 and 28-40. UAS7 values were slightly, but significantly lower as compared to UAS7 TD values (mean difference: 1.6 ± 4.6, P < .001). This difference was driven by lower wheal subscores (2.1 ± 3.5, P < .001) and was most pronounced in patients with severe CSU (2.5 ± 5.6, P < .01). The UAS7/ UAS7 TD ratio was 0.96 ± 0.21 and did not differ significantly between mild, moderate, and severe CSU. Since the results of both UAS versions are comparable, we recommend the use of the UAS7, which is less burdensome in administration and scoring. [ABSTRACT FROM AUTHOR]