Summary
Background
Early detection by skin self‐examination (SSE) could improve outcomes for melanoma. Mobile teledermoscopy may aid this process.
Objectives
To establish the clinical accuracy of SSE ...plus mobile teledermoscopy vs. clinical skin examination (CSE) and to test whether providing people with detailed SSE instructions improves accuracy.
Methods
Men and women aged 50–64 years (n = 58) performed SSE plus mobile teledermoscopy in their homes between May and November 2013 and were given technical instructions plus detailed SSE instructions (intervention) or technical instructions only (control). Within 3 months, they underwent a CSE. Outcome measures included (i) body sites examined, lesions photographed, and missed; (ii) sensitivity of SSE plus mobile teledermoscopy vs. in‐person CSE using either patients or lesions as denominator; and (iii) concordance of telediagnosis with CSE.
Results
Overall 49 of 58 randomized participants completed the study, and submitted 309 lesions to the teledermatologist. Intervention‐group participants were more likely to submit lesions from their legs compared with controls (P = 0·03), with no other differences. Eleven participants (22%) did not photograph 14 pigmented lesions that the dermatologist considered worthwhile photographing or monitoring. The sensitivity of SSE plus mobile teledermoscopy was 82% using the patient as denominator and 42% using the lesion as denominator. There was substantial agreement between telediagnosis and CSE (κ = 0·90), accounting for differential diagnoses.
Conclusions
SSE plus mobile teledermoscopy is promising for surveillance of particular lesions even without detailed SSE instructions. However, in the format tested in this study, consumers may overlook lesions and send many nonpigmented lesions. This investigation demonstrates that high‐quality dermoscopic images can be taken by patients at home with high accuracy.
What's already known about this topic?
Cancer agencies recommend skin self‐examination (SSE).
Teledermoscopy (if done during clinic visits) has excellent concordance with face‐to‐face clinical examination, but the sensitivity and specificity of SSE plus mobile teledermoscopy done by people at home has not been studied.
What does this study add?
The sensitivity of SSE plus teledermoscopy ranges from 42% to 82%, and the specificity from 56·3% to 89·6% depending on the analytical method.
SSE could complement melanoma screening and/or surveillance efforts.
Background
In single-center studies, both preterm birth and low birth weight (LBW) are associated with worse outcomes in childhood nephrotic syndrome. Using the Nephrotic Syndrome Study Network ...(NEPTUNE) observational cohort, we tested the hypothesis that in patients with nephrotic syndrome, hypertension, proteinuria status, and disease progression would be more prevalent and more severe in subjects with LBW and prematurity singly or in combination (LBW/prematurity).
Methods
Three hundred fifty-nine adults and children with focal segmental glomerulosclerosis (FSGS) or minimal change disease (MCD) and available birth history were included. Estimated glomerular filtration rate (eGFR) decline and remission status were primary outcomes, and secondary outcomes were kidney histopathology, kidney gene expression, and urinary biomarkers. Logistic regression was used to identify associations with LBW/prematurity and these outcomes.
Results
We did not find an association between LBW/prematurity and remission of proteinuria. However, LBW/prematurity was associated with greater decline in eGFR. This decline in eGFR was partially explained by the association of LBW/prematurity with
APOL1
high-risk alleles, but the association remained after adjustment. There were no differences in kidney histopathology or gene expression in the LBW/prematurity group compared to normal birth weight/term birth.
Conclusion
LBW and premature babies who develop nephrotic syndrome have a more rapid decline in kidney function. We did not identify clinical or laboratory features that distinguished the groups. Additional studies in larger groups are needed to fully ascertain the effects of (LBW) and prematurity alone or in combination on kidney function in the setting of nephrotic syndrome.
Horizon 2020 EuPRAXIA design study Walker, P A; Alesini, P D; Aschikhin, A ...
Journal of physics. Conference series,
07/2017, Letnik:
874, Številka:
1
Journal Article
Recenzirano
Odprti dostop
The Horizon 2020 Project EuPRAXIA ("European Plasma Research Accelerator with eXcellence In Applications") is preparing a conceptual design report of a highly compact and cost-effective European ...facility with multi-GeV electron beams using plasma as the acceleration medium. The accelerator facility will be based on a laser and/or a beam driven plasma acceleration approach and will be used for photon science, high-energy physics (HEP) detector tests, and other applications such as compact X-ray sources for medical imaging or material processing. EuPRAXIA started in November 2015 and will deliver the design report in October 2019. EuPRAXIA aims to be included on the ESFRI roadmap in 2020.
We evaluated the effects of dietary NDF concentration from alfalfa hay and bulk density of steam- flaked corn (SFC) on growth performance, carcass characteristics, and liver abscesses in finishing ...beef steers.
Crossbred beef steers (n = 214; 60 pens; initial BW = 417 ± 11.9 kg) were blocked by BW and assigned randomly to treatments and fed an average of 112 d. The treatments were arranged as a 2 × 3 factorial with 10 pens per treatment and consisted of 3 NDF concentrations from alfalfa hay (3%, 4.5%, or 6%) and 309 g/L (24 lb/bu) or 412 g/L (32 lb/bu) SFC (69% or 33% starch availability, respectively). Growth performance and carcass data were analyzed with PROC MIXED of SAS with pen as the experimental unit. Quality grades and liver scores were analyzed as binomial proportions using PROC GLIMMIX. Contrast statements were used to separate linear and quadratic effects of increasing roughage NDF.
Dry matter intake responded quadratically from d 0 to 35 as roughage NDF increased from 3% to 6%, and DMI increased linearly as roughage NDF increased on d 70 to 105 and d 0 to final. Otherwise, no differences in growth performance were noted. Marbling score responded quadratically to roughage level and was greater for steers fed 3% than for those fed 4.5% or 6% roughage NDF. Steers fed 309 g/L SFC tended to have a larger LM area than those fed 412 g/L SFC. The total percentage of abscessed livers at slaughter decreased linearly as roughage NDF was increased from 3% to 6% of DM as did the presence of A+ abscesses. In addition, total liver abscesses were 13.9 percentage points less in steers fed 412 versus 309 g/L SFC.
Results suggest that increasing roughage NDF and bulk density of SFC are dietary strategies that can decrease the presence of liver abscesses at slaughter without negatively affecting growth performance.
Our goal was to evaluate the use of a novel direct-fed microbial as an alternative to antimicrobials to decrease liver abscesses in finishing beef cattle.
Beef steers (n = 240; initial BW = 263 ± ...18.0 kg) were used in a randomized complete block design comprising 3 BW blocks and 3 pen replications per treatment during the receiving period and 3 BW blocks and 14 to 15 pen replications per treatment during the finishing phase. Experimental treatments were assigned randomly to pen within BW block and consisted of (1) negative control, dietary supplement with no tylosin phosphate; (2) positive control, dietary supplement formulated to supply 90 mg of tylosin phosphate daily (Tylan-100; Elanco Animal Health); (3) positive control with tylosin phosphate removed the last 65 d of the feeding period; and (4) novel direct-fed microbial Bacillus licheniformis fed daily at 1 × 1011 cfu/steer.
From d 0 to 59, ADG, DMI, DMI as a percentage of BW, and G:F did not differ. During the finishing period, live- and carcass-adjusted final BW did not differ among treatments. Likewise, in the finishing period, there were no differences in ADG, DMI, DMI as a percentage of BW, or G:F. No differences in hot carcass weight, DP, marbling score, longissimus dorsi area, 12th-rib fat thickness, or calculated yield grade were detected among dietary treatments. Liver abscess incidence and severity were not affected by dietary treatments.
The use of a novel direct-fed microbial, B. licheniformis, in beef cattle fed in small research pens did not affect growth performance, carcass characteristics, or liver abscess prevalence or severity. Bacillus licheniformis is not a viable strategy to decrease liver abscesses in growing and finishing beef cattle.
Plasma photocathode wakefield acceleration combines energy gains of tens of GeV m
with generation of ultralow emittance electron bunches, and opens a path towards 5D-brightness orders of magnitude ...larger than state-of-the-art. This holds great promise for compact accelerator building blocks and advanced light sources. However, an intrinsic by-product of the enormous electric field gradients inherent to plasma accelerators is substantial correlated energy spread-an obstacle for key applications such as free-electron-lasers. Here we show that by releasing an additional tailored escort electron beam at a later phase of the acceleration, when the witness bunch is relativistically stable, the plasma wave can be locally overloaded without compromising the witness bunch normalized emittance. This reverses the effective accelerating gradient, and counter-rotates the accumulated negative longitudinal phase space chirp of the witness bunch. Thereby, the energy spread is reduced by an order of magnitude, thus enabling the production of ultrahigh 6D-brightness beams.
We describe a less than one-hour manual method for immunocytochemical analyses of B5 or formalin-fixed, paraffin-embedded tissue sections. The method employs capillary action to sequentially apply, ...incubate and remove liquid reagents from apposed pairs of up to 20 glass microscope slides and allows for simultaneous immunocytochemical analyses of as many as 10 different antigens. The method described here uses a) positively charged glass slides to rapidly immobilize tissue sections; b) rapid deparaffinization techniques; c) multipurpose reagents; d) ethanol-enriched buffer washes to improve capillary action and reduce nonspecific background; e) a single broad spectrum streptavidin-peroxidase or streptavidin-alkaline phosphatase detection system that identifies most primary monoclonal and polyclonal antibodies; and f) specific immunocytochemical signal amplification by cyclic chromogen enhancement.
Abstract
The Horizon 2020 project EuPRAXIA (European Plasma Research Accelerator with eXcellence In Applications) is producing a conceptual design report for a highly compact and cost-effective ...European facility with multi-GeV electron beams accelerated using plasmas. EuPRAXIA will be set up as a distributed Open Innovation platform with two construction sites, one with a focus on beam-driven plasma acceleration (PWFA) and another site with a focus on laser-driven plasma acceleration (LWFA). User areas at both sites will provide access to free-electron laser pilot experiments, positron generation and acceleration, compact radiation sources, and test beams for high-energy physics detector development. Support centres in four different countries will complement the pan-European implementation of this infrastructure.
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