Summary
Background The development of antibiotic resistance by microorganisms is an increasing problem in medicine. In chronic wounds, bacterial colonization is associated with impaired healing. ...Cold atmospheric plasma is an innovative promising tool to deal with these problems.
Objectives The 5‐min argon plasma treatment has already demonstrated efficacy in reducing bacterial numbers in chronic infected wounds in vivo. In this study we investigated a 2‐min plasma treatment with the same device and the next‐generation device, to assess safety and reduction in bacterial load, regardless of the kind of bacteria and their resistance level in chronic wounds.
Methods Twenty‐four patients with chronic infected wounds were treated in a prospective randomized controlled phase II study with 2 min of cold atmospheric argon plasma every day: 14 with MicroPlaSter alpha device, 10 with MicroPlaSter beta device (next‐generation device) in addition to standard wound care. The patient acted as his/her own control. Bacterial species were detected by standard bacterial swabs and bacterial load by semiquantitative count on nitrocellulose filters. The plasma settings were the same as in the previous phase II study in which wounds were exposed for 5 min to argon plasma.
Results Analysis of 70 treatments in 14 patients with the MicroPlaSter alpha device revealed a significant (40%, P < 0·016) reduction in bacterial load in plasma‐treated wounds, regardless of the species of bacteria. Analysis of 137 treatments in 10 patients with the MicroPlaSter beta device showed a highly significant reduction (23·5%, P < 0·008) in bacterial load. No side‐effects occurred and the treatment was well tolerated.
Conclusions A 2‐min treatment with either of two cold atmospheric argon plasma devices is a safe, painless and effective technique to decrease the bacterial load in chronic wounds.
Summary
Background Bacterial colonization of chronic wounds slows healing. Cold atmospheric plasma has been shown in vitro to kill a wide range of pathogenic bacteria.
Objectives To examine the ...safety and efficiency of cold atmospheric argon plasma to decrease bacterial load as a new medical treatment for chronic wounds.
Patients and methods Thirty‐eight chronic infected wounds in 36 patients were treated in a prospective randomized controlled phase II study with 5 min daily cold atmospheric argon plasma in addition to standard wound care. The patient acted as his or her own control. Bacterial species were detected by standard bacterial swabs and semiquantitative changes by nitrocellulose filters. Plasma setting and safety had been determined in a preceding phase I study.
Results Analysis of 291 treatments in 38 wounds found a highly significant (34%, P < 10−6) reduction of bacterial load in treated wounds, regardless of the type of bacteria. No side‐effects occurred and the treatment was well tolerated.
Conclusions Cold atmospheric argon plasma treatment is potentially a safe and painless new technique to decrease bacterial load of chronic wounds and promote healing.
Convolutional neural networks (CNNs) efficiently differentiate skin lesions by image analysis. Studies comparing a market-approved CNN in a broad range of diagnoses to dermatologists working under ...less artificial conditions are lacking.
One hundred cases of pigmented/non-pigmented skin cancers and benign lesions were used for a two-level reader study in 96 dermatologists (level I: dermoscopy only; level II: clinical close-up images, dermoscopy, and textual information). Additionally, dermoscopic images were classified by a CNN approved for the European market as a medical device (Moleanalyzer Pro, FotoFinder Systems, Bad Birnbach, Germany). Primary endpoints were the sensitivity and specificity of the CNN’s dichotomous classification in comparison with the dermatologists’ management decisions. Secondary endpoints included the dermatologists’ diagnostic decisions, their performance according to their level of experience, and the CNN’s area under the curve (AUC) of receiver operating characteristics (ROC).
The CNN revealed a sensitivity, specificity, and ROC AUC with corresponding 95% confidence intervals (CI) of 95.0% (95% CI 83.5% to 98.6%), 76.7% (95% CI 64.6% to 85.6%), and 0.918 (95% CI 0.866–0.970), respectively. In level I, the dermatologists’ management decisions showed a mean sensitivity and specificity of 89.0% (95% CI 87.4% to 90.6%) and 80.7% (95% CI 78.8% to 82.6%). With level II information, the sensitivity significantly improved to 94.1% (95% CI 93.1% to 95.1%; P < 0.001), while the specificity remained unchanged at 80.4% (95% CI 78.4% to 82.4%; P = 0.97). When fixing the CNN’s specificity at the mean specificity of the dermatologists’ management decision in level II (80.4%), the CNN’s sensitivity was almost equal to that of human raters, at 95% (95% CI 83.5% to 98.6%) versus 94.1% (95% CI 93.1% to 95.1%); P = 0.1. In contrast, dermatologists were outperformed by the CNN in their level I management decisions and level I and II diagnostic decisions. More experienced dermatologists frequently surpassed the CNN’s performance.
Under less artificial conditions and in a broader spectrum of diagnoses, the CNN and most dermatologists performed on the same level. Dermatologists are trained to integrate information from a range of sources rendering comparative studies that are solely based on one single case image inadequate.
•A market-approved convolutional neural network (CNN) trained on dermoscopic images was tested against 96 dermatologists.•Test data included a broad range of skin lesions and was compiled from external sources not involved in CNN training.•Dermatologists indicated their management decisions after reviewing clinical, dermoscopic, and textual case information.•In this setting dermatologists performed on par with the CNN's classifications based on dermoscopic images alone.
Defect-free GaP growth on exact (0
0
1) Si substrates is an important prerequisite for integrating III/V-based optics with Si-based electronics. In the present paper, dynamic electron diffraction in ...transmission electron microscopy using specific excitation conditions are exploited to unambiguously identify anti-phase domains (APDs) and anti-phase boundaries (APBs) in GaP. These defects are amongst the most critical and detrimental defects when heteroepitaxially growing III/Vs on Si. The geometry of the APDs is correlated to the Si-wafer morphology prior to the GaP growth as well as to the GaP nucleation and growth conditions. It is also demonstrated that APDs intersecting the GaP surface can be seen in the scanning probe surface images of these layers as deep trenches, if a suitable annealing procedure is applied. The GaP growth temperature needs to be high enough to allow for the kinking of the APBs away from the {1
1
0} planes. Furthermore, the Si surface area covered by monolayer high islands should be as small as possible to initiate self-annihilation of the APBs. Combining optimized GaP growth with optimized Si surface pretreatment, one can realize APD-free GaP on Si after only 40
nm film growth.
Summary
Background
Over the last few years, several articles on dermoscopy of non‐neoplastic dermatoses have been published, yet there is poor consistency in the terminology among different studies.
...Objectives
We aimed to standardize the dermoscopic terminology and identify basic parameters to evaluate in non‐neoplastic dermatoses through an expert consensus.
Methods
The modified Delphi method was followed, with two phases: (i) identification of a list of possible items based on a systematic literature review and (ii) selection of parameters by a panel of experts through a three‐step iterative procedure (blinded e‐mail interaction in rounds 1 and 3 and a face‐to‐face meeting in round 2). Initial panellists were recruited via e‐mail from all over the world based on their expertise on dermoscopy of non‐neoplastic dermatoses.
Results
Twenty‐four international experts took part in all rounds of the consensus and 13 further international participants were also involved in round 2. Five standardized basic parameters were identified: (i) vessels (including morphology and distribution); (ii) scales (including colour and distribution); (iii) follicular findings; (iv) ‘other structures’ (including colour and morphology); and (v) ‘specific clues’. For each of them, possible variables were selected, with a total of 31 different subitems reaching agreement at the end of the consensus (all of the 29 proposed initially plus two more added in the course of the consensus procedure).
Conclusions
This expert consensus provides a set of standardized basic dermoscopic parameters to follow when evaluating inflammatory, infiltrative and infectious dermatoses. This tool, if adopted by clinicians and researchers in this field, is likely to enhance the reproducibility and comparability of existing and future research findings and uniformly expand the universal knowledge on dermoscopy in general dermatology.
What's already known about this topic?
Over the last few years, several papers have been published attempting to describe the dermoscopic features of non‐neoplastic dermatoses, yet there is poor consistency in the terminology among different studies.
What does this study add?
The present expert consensus provides a set of standardized basic dermoscopic parameters to follow when evaluating inflammatory, infiltrative and infectious dermatoses.
This consensus should enhance the reproducibility and comparability of existing and future research findings and uniformly expand the universal knowledge on dermoscopy in general dermatology.
Linked Editorial: Bahadoran. Br J Dermatol 2020; 182:260–261.
Plain language summary available online
This paper summarizes results of the epitaxial growth of Ga(AsBi) by metal organic vapor phase epitaxy (MOVPE) using all-liquid group V precursors. Ga(AsBi)/GaAs multi quantum well (MQW) samples are ...grown on GaAs (001) substrates at temperatures as low as 375°C and 400°C using triethylgallium (TEGa), tertiarybutylarsine (TBAs) and trimethylbismuth (TMBi) as precursors. High resolution x-ray diffraction (HR-XRD), transmission electron microscopy (TEM) as well as atomic force microscopy (AFM) measurements show that MQW structures with good crystalline quality are realized. Under specific growth conditions, the Bi droplet formation can be avoided completely. The incorporated Bi-content is limited depending on the growth temperature used. Surplus Bi segregates at the surface and incorporates into the subsequent GaAs barrier when the Bi supply is stopped. The MQW samples show room temperature photoluminescence (PL) already after growth. A redshift and a decreasing PL signal intensity with increasing Bi fraction is observed.
► The growth of Ga(AsBi)/GaAs MQWs by MOVPE is investigated. ► Structural analyses show that MQWs with good crystalline quality are realized. ► Under specific growth conditions no Bi-droplets occur. ► Room temperature photoluminescence is observed already after growth.
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