Summary
Psoriasis is an inflammatory skin disease associated with increased cardiovascular comorbidity. Smoking is associated with an increased risk of cardiovascular disease, and prior studies have ...suggested that patients with psoriasis are more likely to be active smokers. Smoking may also be a risk factor in the development of psoriasis. We conducted a systematic review and meta‐analysis to assess the prevalence of smoking among patients with psoriasis, and we reviewed the contribution of smoking to the incidence of psoriasis. A total of 25 prevalence and three incidence studies were identified. The meta‐analysis of prevalence studies included a total of 146 934 patients with psoriasis and 529 111 patients without psoriasis. Random effects meta‐analysis found an association between psoriasis and current smoking pooled odds ratio (OR) 1·78, 95% confidence interval (CI) 1·52–2·06, as well as between psoriasis and former smoking (pooled OR 1·62, 95% CI 1·33–1·99). Meta‐regression analysis did not reveal any sources of study heterogeneity, but a funnel plot suggested possible publication bias. A subset of studies also examined the association between moderate‐to‐severe psoriasis and smoking, with a pooled OR of 1·72 (95% CI 1·33–2·22) for prevalent smoking. The three incidence studies found an association between smoking and incidence of psoriasis, with a possible dose‐effect of smoking intensity and duration on psoriasis incidence. These findings suggest that smoking is an independent risk factor for the development of psoriasis, and that patients with established psoriasis continue to smoke more than patients without psoriasis.
What's already known about this topic?
Psoriasis is associated with a number of cardiovascular risk factors, many of which are influenced by smoking.
What does this study add?
Patients with psoriasis are more likely to be current or former smokers.
Smoking is also associated with an increased risk of developing psoriasis.
These findings emphasize that patients with psoriasis should be screened for smoking, and that public health efforts to reduce smoking could also decrease the incidence of psoriasis.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Summary
Psoriasis may be associated with dyslipidaemia, a known risk factor for cardiovascular disease. This systematic review aims to synthesize evidence for the association between psoriasis and ...dyslipidaemia. Through a systematic search using MEDLINE, Embase and the Cochrane Central Register, from 1 January 1980 to 1 January 2012, we identified 25 observational studies that met the inclusion criteria. These 25 studies included over 2·4 million participants, among whom 265 512 were patients with psoriasis. Twenty studies (80%) reported that psoriasis was significantly associated with dyslipidaemia, with odds ratios (ORs) for dyslipidaemia ranging from 1·04 to 5·55 in 238 385 patients with psoriasis, from a population of 2 340 605 participants. Specifically, four studies defining dyslipidaemia as triglyceride levels ≥ 150 mg dL−1 reported significantly increased ORs of 1·20–4·98 for hypertriglyceridaemia in psoriasis. Three studies found that patients with psoriasis presented with significantly increased ORs (1·36–1·77) for high‐density lipoprotein cholesterol levels < 40 mg dL−1, and two studies found hyperlipoproteinaemia to be significantly elevated in patients with psoriasis (ORs 1·55 and 2·09). One cohort study found a significantly higher incidence of hyperlipidaemia among patients with psoriasis (hazard ratio 1·17; 95% confidence interval 1·11–1·23). Among studies that assessed the severity of psoriasis, in 2662 patients with mild psoriasis and 810 patients with severe psoriasis, higher odds of dyslipidaemia were seen in patients with severe psoriasis. Five of the 25 studies (20%) in our review did not show any significant relationship between psoriasis and dyslipidaemia. This systematic review found that psoriasis was significantly associated with greater odds and incidence of dyslipidaemia. Greater psoriasis severity appeared to be associated with higher prevalence of dyslipidaemia.
What’s already known about this topic?
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Dyslipidaemia is a well‐established risk for cardiovascular disease.
What does this study add?
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This is the first systematic review dedicated to elucidating the relationship between psoriasis and dyslipidaemia. It synthesizes evidence from the largest number of studies and participants on this subject.
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We found a significant association between psoriasis and dyslipidaemia. The prevalence and incidence of dyslipidaemia are greater in patients with psoriasis, and this association is stronger with increased psoriasis severity.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Summary
Recent studies suggest that cigarette smoking may trigger the development of psoriasis through oxidative, inflammatory and genetic mechanisms. Smoking initiates formation of free radicals ...that stimulate cell signalling pathways active in psoriasis including mitogen‐activated protein kinase (MAPK), nuclear factor‐κB (NF‐κB) and Janus kinase/signal transducers and activators of transcription (JAK‐STAT). Smoking damages the skin by increasing formation of reactive oxygen species and decreasing the gene expression of antioxidants. Nicotine also stimulates innate immune cells integral to the pathogenesis of psoriasis including dendritic cells, macrophages and keratinocytes. These cells release cytokines that activate T lymphocytes and perpetuate a cycle of chronic inflammation. Smoking also enhances expression of genes known to confer an increased risk of psoriasis, including HLA‐Cw6, HLA‐DQA1*0201 and CYP1A1. Improved understanding of the possible link between smoking and psoriasis pathogenesis may provide further insight into mechanisms underlying smoking, psoriasis and risk of subsequent cardiovascular disease.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The expanded compositional freedom afforded by high-entropy alloys (HEAs) represents a unique opportunity for the design of alloys for advanced nuclear applications, in particular for applications ...where current engineering alloys fall short. This review assesses the work done to date in the field of HEAs for nuclear applications, provides critical insight into the conclusions drawn, and highlights possibilities and challenges for future study. It is found that our understanding of the irradiation responses of HEAs remains in its infancy, and much work is needed in order for our knowledge of any single HEA system to match our understanding of conventional alloys such as austenitic steels. A number of studies have suggested that HEAs possess `special' irradiation damage resistance, although some of the proposed mechanisms, such as those based on sluggish diffusion and lattice distortion, remain somewhat unconvincing (certainly in terms of being universally applicable to all HEAs). Nevertheless, there may be some mechanisms and effects that are uniquely different in HEAs when compared to more conventional alloys, such as the effect that their poor thermal conductivities have on the displacement cascade. Furthermore, the opportunity to tune the compositions of HEAs over a large range to optimise particular irradiation responses could be very powerful, even if the design process remains challenging.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Objective:
To describe a distinctive seizure semiology that closely associates with voltage‐gated potassium channel (VGKC)‐complex/Lgi1 antibodies and commonly precedes the onset of limbic ...encephalitis (LE).
Methods:
Twenty‐nine patients were identified by the authors (n = 15) or referring clinicians (n = 14). The temporal progression of clinical features and serum sodium, brain magnetic resonance imaging (MRI), positron emission tomography/single photon emission computed tomography, and VGKC‐complex antibodies was studied.
Results:
Videos and still images showed a distinctive adult‐onset, frequent, brief dystonic seizure semiology that predominantly affected the arm and ipsilateral face. We have termed these faciobrachial dystonic seizures (FBDS). All patients tested during their illness had antibodies to VGKC complexes; the specific antigenic target was Lgi1 in 89%. Whereas 3 patients never developed LE, 20 of the remaining 26 (77%) experienced FBDS prior to the development of the amnesia and confusion that characterize LE. During the prodrome of FBDS alone, patients had normal sodium and brain MRIs, but electroencephalography demonstrated ictal epileptiform activity in 7 patients (24%). Following development of LE, the patients often developed other seizure semiologies, including typical mesial temporal lobe seizures. At this stage, investigations commonly showed hyponatremia and MRI hippocampal high T2 signal; functional brain imaging showed evidence of basal ganglia involvement in 5/8. Antiepileptic drugs (AEDs) were generally ineffective and in 41% were associated with cutaneous reactions that were often severe. By contrast, immunotherapies produced a clear, and often dramatic, reduction in FBDS frequency.
Interpretation:
Recognition of FBDS should prompt testing for VGKC‐complex/Lgi1 antibodies. AEDs often produce adverse effects; treatment with immunotherapies may prevent the development of LE with its potential for cerebral atrophy and cognitive impairment. ANN NEUROL 2010;
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Psoriasis is an inflammatory skin disease affecting 2-4% of the world population. The objective of this study was to perform a systematic review and meta-analysis synthesizing the epidemiological ...associations between psoriasis and obesity.
We searched for observational studies from MEDLINE, EMBASE and Cochrane Central Register from 1 January 1980 to 1 January 2012. We applied the Meta-Analysis of Observational Studies in Epidemiology guidelines in the conduct of this study.
We identified 16 observational studies with a total of 2.1 million study participants (201 831 psoriasis patients) fulfilling the inclusion criteria.
Using random-effects meta-analysis, the pooled odds ratio (OR) for obesity among patients with psoriasis was 1.66 (95% confidence interval (CI) 1.46-1.89) compared with those without psoriasis. From the studies that reported psoriasis severity, the pooled OR for obesity among patients with mild psoriasis was 1.46 (95% CI 1.17-1.82) and the pooled OR for patients with severe psoriasis was 2.23 (95% CI 1.63-3.05). One incidence study found that psoriasis patients have a hazard ratio of 1.18 (95% CI 1.14-1.23) for new-onset obesity.
Overall, compared with the general population, psoriasis patients have higher prevalence and incidence of obesity. Patients with severe psoriasis have greater odds of obesity than those with mild psoriasis.
•Detailed review of technical advances for high temperature nanoindentation.•Methods for avoiding and correcting thermal drift displacements are described.•Vacuum and in situ nanoindentation ...techniques at high temperature are discussed.•Several emerging high temperature nanoindentation techniques are illustrated.
Nanoindentation measurement capabilities at elevated temperatures have developed considerably over the last two decades. Commercially available systems can now perform stable indentation testing at temperatures up to ∼800°C with thermal drift levels similar to those present at room temperature. The thermal management and measurement techniques necessary to achieve this are discussed here, with particular emphasis on systems featuring independent heating of both the indenter and the sample. To enable measurements at temperatures where oxidation of the indenter and/or sample are a concern, vacuum nanoindentation techniques have also been developed. A natural extension of testing in vacuo is elevated temperature nanoindentation in situ in the scanning electron microscope, and the additional requirements for and benefits of this are discussed. Finally, several new emerging testing techniques are introduced: thermal cycling/fatigue, interfacial thermal resistance measurement and small scale transient plasticity measurements.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
High-entropy alloys (HEAs), based on equiatomic or near-equiatomic mixture of usually four or more elements, have attracted considerable attention as there are indications that along with surprising ...microstructural simplicity of some alloys, they may also offer intriguing combinations of mechanical and other properties. Amongst these properties, there is growing interest in the irradiation response of HEAs and their potential to withstand the neutron bombardment environment of future civil nuclear power plants. One of the first proposed HEAs is face-centred cubic CrMnFeCoNi, also known as the Cantor alloy, and the irradiation response of the Cantor alloy and its sub-systems are the focus of this review. Using irradiation analogues (electrons, heavy ions and He) to neutron bombardment and considering simulations, advanced microstructural analysis and property measurement, the Cantor alloy and its derivatives are shown to exhibit encouraging irradiation resistance that, in many instances, is superior to more traditional dilute alloys of the same elements. The beneficial aspects are high phase stability and resistance to radiation-induced segregation, smaller size but higher number density of dislocation loops, significantly lower extent of swelling and improved resistance to He bubble growth. The future research directions for irradiation resistant HEAs are also suggested.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The current magnetic confinement nuclear fusion power reactor concepts going beyond ITER are based on assumptions about the availability of materials with extreme mechanical, heat, and neutron load ...capacity. In Europe, the development of such structural and armour materials together with the necessary production, machining, and fabrication technologies is pursued within the EFDA long-term fusion materials programme. This paper reviews the progress of work within the programme in the area of tungsten and tungsten alloys. Results, conclusions, and future projections are summarized for each of the programme’s main subtopics, which are: (1) fabrication, (2) structural W materials, (3) W armour materials, and (4) materials science and modelling. It gives a detailed overview of the latest results on materials research, fabrication processes, joining options, high heat flux testing, plasticity studies, modelling, and validation experiments.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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