The prevalence of atopic eczema has been found to have increased greatly in some parts of the world. Building on a systematic review of global disease trends in asthma, our objective was to study ...trends in incidence and prevalence of atopic eczema. Disease trends are important for health service planning and for generating hypotheses regarding the aetiology of chronic disorders. We conducted a systematic search for high quality reports of cohort, repeated cross-sectional and routine healthcare database-based studies in seven electronic databases. Studies were required to report on at least two measures of the incidence and/or prevalence of atopic eczema between 1990 and 2010 and needed to use comparable methods at all assessment points. We retrieved 2,464 citations, from which we included 69 reports. Assessing global trends was complicated by the use of a range of outcome measures across studies and possible changes in diagnostic criteria over time. Notwithstanding these difficulties, there was evidence suggesting that the prevalence of atopic eczema was increasing in Africa, eastern Asia, western Europe and parts of northern Europe (i.e. the UK). No clear trends were identified in other regions. There was inadequate study coverage worldwide, particularly for repeated measures of atopic eczema incidence. Further epidemiological work is needed to investigate trends in what is now one of the most common long-term disorders globally. A range of relevant measures of incidence and prevalence, careful use of definitions and description of diagnostic criteria, improved study design, more comprehensive reporting and appropriate interpretation of these data are all essential to ensure that this important field of epidemiological enquiry progresses in a scientifically robust manner.
Atopic dermatitis (AD) is the most common dermatological disease of childhood. Many children with AD have asthma and AD shares regions of genetic linkage with psoriasis, another chronic inflammatory ...skin disease. We present here a genome-wide association study (GWAS) of childhood-onset AD in 1563 European cases with known asthma status and 4054 European controls. Using Illumina genotyping followed by imputation, we generated 268 034 consensus genotypes and in excess of 2 million single nucleotide polymorphisms (SNPs) for analysis. Association signals were assessed for replication in a second panel of 2286 European cases and 3160 European controls. Four loci achieved genome-wide significance for AD and replicated consistently across all cohorts. These included the epidermal differentiation complex (EDC) on chromosome 1, the genomic region proximal to LRRC32 on chromosome 11, the RAD50/IL13 locus on chromosome 5 and the major histocompatibility complex (MHC) on chromosome 6; reflecting action of classical HLA alleles. We observed variation in the contribution towards co-morbid asthma for these regions of association. We further explored the genetic relationship between AD, asthma and psoriasis by examining previously identified susceptibility SNPs for these diseases. We found considerable overlap between AD and psoriasis together with variable coincidence between allergic rhinitis (AR) and asthma. Our results indicate that the pathogenesis of AD incorporates immune and epidermal barrier defects with combinations of specific and overlapping effects at individual loci.
•We explore virtual reality (VR) techniques on smartphones to provide safety instructions.•We propose a Mobile VR tool that instructs about how to don an aircraft life preserver.•We evaluate the ...effectiveness of the tool, also in comparison with a traditional safety card.•Knowledge transfer to the real-world is significantly better in those who used Mobile VR.•Moreover, users perceived the tool as significantly more engaging, simple and effective.
Aviation safety knowledge is a key factor in determining how passengers will respond in an emergency, but the effectiveness of the tools (preflight safety briefing, safety briefing card) used by airlines to educate passengers about safety has been shown to be lacking. This paper explores how one of these tools could be made interactive in order to increase its effectiveness. In particular, we use Virtual Reality (VR) techniques, adapting them to the constraints imposed by on-board aircraft use, such as usage on non-immersive, small displays. As a practical application, the paper examines aviation life preserver donning, which the literature has shown to be particularly difficult for passengers. To evaluate the proposed mobile VR tool, we contrasted it with the traditional safety briefing card in a between-groups study with 68 participants, age 20–24, focusing on different aspects of effectiveness. The results of the study show that the participants who used the mobile VR tool were able to transfer the presented safety knowledge to the real world, and don an aviation life preserver significantly faster and with fewer errors than participants who used the traditional briefing card. Moreover, these objective results were consistent with subjective ratings by participants; the mobile VR tool was perceived as significantly more engaging, simpler, and more effective than the traditional briefing card. Finally, participants who used the mobile VR tool attained a higher level of self-efficacy. The generalizability of these results would benefit with additional work aimed at an older age cohort that would ostensibly be less familiar with interactive VR technology.
A bifurcative step transition from low-density, high-temperature, attached divertor conditions to high-density, low-temperature, detached divertor conditions is experimentally observed in DIII-D ...tokamak plasmas as density is increased. The step transition is only observed in the high confinement mode and only when the B×∇B drift is directed towards the divertor. This work reports for the first time a theoretical explanation and numerical simulations that qualitatively reproduce this bifurcation and its dependence on the toroidal field direction. According to the model, the bifurcation is primarily driven by the interdependence of the E×B-drift fluxes, divertor electric potential structure, and divertor conditions. In the attached conditions, strong potential gradients in the low field side (LFS) divertor drive E×B-drift flux towards the high field side divertor, reinforcing low density, high temperature conditions in the LFS divertor leg. At the onset of detachment, reduction in the potential gradients in the LFS divertor leg reduce the E×B-drift flux as well, such that the divertor plasma evolves nonlinearly to high density, strongly detached conditions. Experimental estimates of the E×B-drift fluxes, based on divertor Thomson scattering measurements, and their dependence on the divertor conditions are qualitatively consistent with the numerical predictions. The implications for divertor power exhaust and detachment control in the next step fusion devices are discussed.
This study investigates the potential of laser ablation inductively coupled plasma mass spectrometry (LA‐ICP‐MS) U‐Pb dating for carbonate nodules in the Late Triassic Ischigualasto Formation of ...northwestern Argentina. We establish a fully characterized paragenetic sequence to guide the analysis of three pedogenic carbonates and compare the U‐Pb ages with published geochronology from volcanic ashes within the sedimentary succession. Our findings demonstrate the importance of interpreting U‐Pb data within a well‐defined paragenetic framework for accurate age interpretation of pedogenic carbonates. We observe variations in U‐Pb isotopic signatures across different generations of carbonate precipitates and identify syn‐pedogenic and early burial calcite cements as most suitable for precise dating. Respectively, these two calcite cements are interpreted as microcodium and crack‐lining calcite cements formed early in the paragenetic sequence during pedogenesis to early burial of the paleosols as they transitioned from the unsaturated vadose to saturated phreatic zone below the water table. The U‐Pb ages obtained from the carbonate nodules agree with the radioisotopic ages of volcanic ashes, supporting the validity of our dating strategy. These results contribute to advancing U‐Pb carbonate geochronology and highlight its increased potential for dating sedimentary records in the terrestrial realm. Future research should focus on replicating similar work on different carbonate nodules within the Ischigualasto Fm and expanding the application of LA‐ICP‐MS U‐Pb dating to other carbonate‐bearing formations, especially in successions with limited absolute ages or where volcanic ashes are sparse or absent.
Plain Language Summary
Carbonate minerals that formed in fossil soils can provide valuable insights into past physical, biological, and chemical processes on Earth's surface. Despite their significance in reconstructing ancient climates and environments, determining the age of these fossil soils via uranium‐to‐lead dating has proven challenging. This difficulty arises from factors associated with soil carbonate minerals, including low uranium content, high lead content, complex formation chemistry, multiple formation episodes (generations), and potential for post‐formation chemical alteration. To address these issues, we first identified the order in which carbonate minerals formed within three samples from the Late Triassic Ischigualasto Formation of Argentina. Then, we dated each generation within each sample and compared the results to identify and understand the most optimal sample locations for dating. Analysis of our data shows that carbonate minerals formed due to biological processes near the surface as well as during the burial and submersion of the fossil soils below the water table are the most suitable for dating and approximate the timing of soil formation. Importantly, the ages from these soil carbonate samples align with ages from volcanic ashes found within the Ischigualasto Formation, thus validating our results and the potential to apply our strategy in other locations.
Key Points
A well‐defined paragenetic framework is necessary to interpret laser ablation inductively coupled plasma mass spectrometry U‐Pb data for accurate age interpretation of pedogenic carbonates
U‐Pb isotopic signatures vary across generations of carbonate precipitates, with syn‐pedogenic and early burial cements being the most suitable for precise dating
Syn‐pedogenic and early burial cements approximate the timing of pedogenesis and transition from the unsaturated vadose to the saturated phreatic zone, respectively
In renal transplant patients with de novo donor‐specific antibodies (dnDSA) we studied the value of microcirculation inflammation (MI; defined by the addition of glomerulitis (g) and peritubular ...capillaritis (ptc) scores) to assess long‐term graft survival in a retrospective cohort study. Out of all transplant patients with standard immunological risk (n = 638), 79 (12.4%) developed dnDSA and 58/79 (73%) had an indication biopsy at or after dnDSA development. Based on the MI score on that indication biopsy patients were categorized, MI0 (n = 26), MI1 + 2 (n = 21) and MI ≥ 3 (n = 11). The MI groups did not differ significantly pretransplantation, whereas posttransplantation higher MI scores developed more anti‐HLA class I + II DSA (p = 0.011), showed more TCMR (p < 0.001) and showed a trend to C4d‐positive staining (p = 0.059). Four‐year graft survival estimates from time of indication biopsy were MI0 96.1%, MI1 + 2 76.1% and MI ≥ 3 17.1%; resulting in a 24‐fold increased risk of graft failure in the MI ≥ 3 compared to the MI0 group (p = 0.003; 95% CI 3.0–196.0). When adjusted for C4d, MI ≥ 3 still had a 21‐fold increased risk of graft failure (p = 0.005; 95% CI 2.5–180.0), while C4d positivity on indication biopsy lost significance. In renal transplant patients with de novo DSA, microcirculation inflammation, defined by g + ptc, associates with graft survival.
The authors demonstrate that in renal transplant patients with de novo donor‐specific antibodies, the value of the microcirculation injury score (as defined by the combination of glomerulitis and peritubular capillaritis), measured in the first biopsy taken after donor‐specific antibody occurrence, is associated with long‐term renal graft survival.
Genetic association studies have identified 21 loci associated with atopic dermatitis risk predominantly in populations of European ancestry. To identify further susceptibility loci for this common, ...complex skin disease, we performed a meta-analysis of >15 million genetic variants in 21,399 cases and 95,464 controls from populations of European, African, Japanese and Latino ancestry, followed by replication in 32,059 cases and 228,628 controls from 18 studies. We identified ten new risk loci, bringing the total number of known atopic dermatitis risk loci to 31 (with new secondary signals at four of these loci). Notably, the new loci include candidate genes with roles in the regulation of innate host defenses and T cell function, underscoring the important contribution of (auto)immune mechanisms to atopic dermatitis pathogenesis.
PDF
