"Magnetic Reconnection Code: Applications to Sawtooth Oscillations, Error-Field Induced Islands, and the Dynamo Effect" - Final Technical Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fitzpatrick, Richard

2007-09-24

Dr. Fitzpatrick has written an MHD code in order to investigate the interaction of tearing modes with flow and external magnetic perturbations, which has been successfully benchmarked against both linear and nonlinear theory and used to investigate error-field penetration in flowing plasmas. The same code was used to investigate the so-called Taylor problem. He employed the University of Chicago's FLASH code to further investigate the Taylor problem, discovering a new aspect of the problem. Dr. Fitzpatrick has written a 2-D Hall MHD code and used it to investigate the collisionless Taylor problem. Dr. Waelbroeck has performed an investigation of themore » scaling of the error-field penetration threshold in collisionless plasmas. Paul Watson and Dr. Fitzpatrick have written a fully-implicit extended-MHD code using the PETSC framework. Five publications have resulted from this grant work.« less

Skin lightening preparations and the hydroquinone controversy.

PubMed

Draelos, Zoe Diana

2007-01-01

Skin lightening preparations are widely used in dermatology by persons of all Fitzpatrick skin types. Fitzpatrick skin types I-III require local pigment lightening for the treatment of hormonally induced melasma and postinflammatory hyperpigmentation caused by acne and trauma. Fitzpatrick skin types IV and darker have an even greater need for skin lightening for social reasons, as well as pigmentary changes that occur around the eyes, in the intertriginous areas, following dermatitis, or with acne and trauma. The gold standard dermatologic agent for skin lightening was hydroquinone, until regulatory agencies in Japan, Europe, and most recently in the United States questioned the safety of this substance. This has encouraged research into alternative agents to inhibit skin pigmentation such as retinoids, mequinol, azelaic acid, arbutin, kojic acid, aleosin, licorice extract, ascorbic acid, soy proteins, and N-acetyl glucosamine. The efficacy and safety of each of these ingredients is examined as possible topical alternatives to hydroquinone.

Successful Treatment of Rhinophyma With Fractionated Carbon Dioxide (CO2) Laser in an African-American Man: Case Report and Review of Literature of Fractionated CO2 Laser Treatment of Rhinophyma.

PubMed

Kraeva, Ekaterina; Ho, Derek; Jagdeo, Jared

2016-11-01

Rhinophyma, a late complication of rosacea (phymatous subtype), is a chronic, progressive dermatological condition. The classic pre- sentation of rhinophyma is nodular, thickened skin over the distal nose, and is often accompanied by underlying erythema secondary to in ammation. Due to the unpleasant aesthetic and dis guring appearance, rhinophyma may be associated with a signi cant nega- tive psychosocial impact, resulting in decreased patient quality-of-life. Treatment of rhinophyma is challenging as topical and systemic pharmacotherapies have shown limited ef cacy. We present a case of a 39-year-old African-American male with long-standing, mild rhinophyma who was successfully treated with two sessions of fractionated carbon dioxide (CO2) laser. We also review the medical literature on fractionated CO2 laser treatment of rhinophyma. To the best of our knowledge, this is the rst report of successful treat- ment of rhinophyma using fractionated CO2 laser in an African-American man (Fitzpatrick VI). We believe that fractionated CO2 laser may be a safe and ef cacious treatment modality for rhinophyma in skin of color patients (Fitzpatrick IV-VI) and early intervention with fractionated CO2 laser to prevent rhinophyma worsening may yield better results than late intervention. J Drugs Dermatol. 2016;15(11):1465-1468..

Annual SO/LIC Symposium and Exhibition (22nd) Held in Washington, DC on February 8-9, 2011

DTIC Science & Technology

2011-02-09

COL Fitz Fitzpatrick, USA, U.S. Army John F. Kennedy Special Warfare Center and School KEYNOTE ADDRESS: Joint, Interagency, and Multi...Center  COL Fitz Fitzpatrick, USA, U.S. Army John F. Kennedy Special Warfare Center and School 11:45 AM - 1:15 PM Networking Lunch...Joulwan • Richard Kohn • John Lehman • John Keane • Alice Maroni • John Nagl • Robert Scales • James Talent • Paul Van Riper • Larry Welch

A retrospective chart review to assess the safety of nonablative fractional laser resurfacing in Fitzpatrick skin types IV to VI.

PubMed

Clark, Charlotte M; Silverberg, Jonathan I; Alexis, Andrew F

2013-04-01

Laser resurfacing in patients with Fitzpatrick skin phototypes (SPT) IV to VI is associated with a higher risk of pigmentary alteration. There is a paucity of studies evaluating optimum treatment parameters for fractional lasers in darkly pigmented skin types. This is a retrospective review of medical records for patients with SPT IV to VI who were treated with a 1,550 nm erbium-doped fractional nonablative laser (Fraxel Re:Store SR 1550; Solta Medical, Hayword, CA). Data were collected from patient charts and the clinic laser logbook from January 2008 to January 2012. The frequency of treatment-associated postinflammatory hyperpigmentation (PIH) and treatment settings used were evaluated. A total of 115 total laser sessions (45 patients) were included in our analysis. Five of the sessions (4%) were accompanied by PIH, 2 of which occurred in a single patient. Only 1 episode of PIH lasted longer than 1 month (2 months). Two of the 5 cases had only transient PIH (≤7 days), one of which was reported by the patient and not clinically evident on examination. The 1,550 nm erbium-doped fractional laser is well tolerated in SPT IV to VI. Fractional laser resurfacing, with the settings used and pretreatment and posttreatment hydroquinone 4% cream, was associated with a low risk of PIH in darker skin types.

The Use of Soil in Criminal Investigations

NASA Astrophysics Data System (ADS)

Dawson, Lorna; Fitzpatrick, Robert

2013-04-01

Forensic soil science, as a newly developed discipline of soil science, has matured to the extent that well-defined questions and successful crime scene investigations are being addressed in increasingly refined ways to assist law enforcement agencies. Soils, rocks, regolith, minerals and man-made mineral particles such as bricks (i.e. referred to "human-made" soil materials) are being used in specialised forensic investigations to associate/disassociate a sample taken from an item, such as shoes, clothing, shovel or vehicle, with a specific location. The majority of forensic cases involving soil materials are usually overwhelmingly complex, and the challenges of associating relevant information from one source with another, often requires the use and development of sophisticated field and laboratory methods. Through examples from case studies, this presentation will demonstrate how advanced field and laboratory approaches have been critical in developing coherent, predictive, soil models, from landscape to microscopic scales, to help contribute to soil-based criminal investigations in both Australia and Scotland. To demonstrate the critical importance of soil materials in forensic investigations, the following 2 case studies, which tackle difficult problems at a range of scales involving highly complex issues, will be presented: •The use of soil evidence to help solve a double murder case. This investigation used morphological, chemical, physical and mineralogical properties to identify similarities between soil-regolith found on a shovel taken from the suspect's vehicle and wetland soil-regolith subsequently located in the bottom of a quarry (Fitzpatrick and Raven, 2012). •The use of soil and related material to help search and to provide evidence in a murder case. This investigation used soil mineralogical and organic properties to identify similarities between sand found on a shovel and sand subsequently located at a beach. Results illustrate the benefit of using a complementary approach and consideration of the two way transfer of materials (Dawson and Hillier, 2010). References Fitzpatrick R.W. and Raven M.D. (2012) How Pedology and mineralogy helped solve a double murder case: Using forensics to inspire future generations of soil scientists. Soil Horizons. 53 (5) doi:10.2136/sh12-05-0016. Dawson, L.A. Hillier, S. (2010) Measurement of soil characteristics for forensic applications. Surface and Interface Analysis, 42, 363-377.

Decide, design, and dewater de waste: A blueprint from Fitzpatrick

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robert, D.E.

1994-04-01

Using a different process to clean concentrated waste tanks at the James A. FitzPatrick nuclear power plant in New York saved nearly half million dollars. The plan essentially allowed processing concentrator bottoms as waste sludge (solidification versus dewatering) that could still meet burial ground requirements. The process reduced the volume from 802.2 to 55 cubic feet. This resin throwaway system eliminated chemicals in the radwaste systems and was designed to ease pressure on the pradwaste processing system, reduce waste and improve plant chemistry. This article discusses general aspects of the process.

Review of Feminist Bioethics At the Center, On the Margins, edited by Jackie Leach Scully, Laurel E. Baldwin-Ragaven, Petya Fitzpatrick

PubMed Central

2010-01-01

The anthology, Feminist Bioethics, edited by Jackie Leach Scully, Laurel E. Baldwin-Ragaven, and Petya Fitzpatrick, examines how feminist bioethics theoretically and methodologically challenges mainstream bioethics, and whether these approaches are useful for exploring difference in other contexts. It offers critical conceptual analyses of "autonomy", "universality", and "trust", and covers topics such as testing for hereditary cancer, prenatal selection for sexual orientation, midwifery, public health, disability, Indigenous research reform in Australia, and China's one child policy.

Self-reported pigmentary phenotypes and race are significant but incomplete predictors of Fitzpatrick skin phototype in an ethnically diverse population.

PubMed

He, Steven Y; McCulloch, Charles E; Boscardin, W John; Chren, Mary-Margaret; Linos, Eleni; Arron, Sarah T

2014-10-01

Fitzpatrick skin phototype (FSPT) is the most common method used to assess sunburn risk and is an independent predictor of skin cancer risk. Because of a conventional assumption that FSPT is predictable based on pigmentary phenotypes, physicians frequently estimate FSPT based on patient appearance. We sought to determine the degree to which self-reported race and pigmentary phenotypes are predictive of FSPT in a large, ethnically diverse population. A cross-sectional survey collected responses from 3386 individuals regarding self-reported FSPT, pigmentary phenotypes, race, age, and sex. Univariate and multivariate logistic regression analyses were performed to determine variables that significantly predict FSPT. Race, sex, skin color, eye color, and hair color are significant but weak independent predictors of FSPT (P<.0001). A multivariate model constructed using all independent predictors of FSPT only accurately predicted FSPT to within 1 point on the Fitzpatrick scale with 92% accuracy (weighted kappa statistic 0.53). Our study enriched for responses from ethnic minorities and does not fully represent the demographics of the US population. Patient self-reported race and pigmentary phenotypes are inaccurate predictors of sun sensitivity as defined by FSPT. There are limitations to using patient-reported race and appearance in predicting individual sunburn risk. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Underwater cleaning techniqued used for removal of zebra mussels at the FitzPatrick Nuclear Power Plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hobbs, B.; Kahabka, J.

1995-06-01

This paper discusses the use of a mechanical brush cleaning technology recently used to remove biofouling from the Circulating Water (CW) System at New York Power Authority`s James A. FitzPatrick Nuclear Power Plant. The FitzPatrick plant had previously used chemical molluscicide to treat zebra mussels in the CW system. Full system treatment was performed in 1992 with limited forebay/screenwell treatment in 1993. The New York Power Authority (NYPA) decided to conduct a mechanical cleaning of the intake system in 1994. Specific project objectives included: (1) Achieve a level of surface cleaniness greater than 98%; (2) Remove 100% of debris, bothmore » existing sediment and debris generated as a result of cleaning; (3) Inspect all surfaces and components, identifying any problem areas; (4) Complete the task in a time frame within the 1994-95 refueling outage schedule window, and; (5) Determine if underwater mechanical cleaning is a cost-effective zebra mussel control method suitable for future application at FitzPatrick. A pre-cleaning inspection, including underwater video photography, was conducted of each area. Cleaning was accomplished using diver-controlled, multi-brush equipment included the electro-hydraulic powered Submersible Cleaning and Maintenance Platform (SCAMP), and several designs of hand-held machines. The brushes swept all zebra mussels off surfaces, restoring concrete and metal substrates to their original condition. Sensitive areas including pump housings, standpipes, sensor piping and chlorine injection tubing, were cleaned without degradation. Submersible vortex vacuum pumps were used to remove debris from the cavity. More than 46,000 ft{sup 2} of surface area was cleaned and over 460 cubic yards of dewatered debris were removed. As each area was completed, a post-clean inspection with photos and video was performed.« less

Building Sustainable Adult Literacy Provision: A Review of International Trends in Adult Literacy Policy and Programs

ERIC Educational Resources Information Center

McKenna, Rosa; Fitzpatrick, Lynne

2004-01-01

This document summarizes an extensive study of policies and practices in adult literacy and adult basic education in a number of countries undertaken by Rosa McKenna and Lynne Fitzpatrick. The original study contains considerably greater detail and analyses issues on a country-by-country basis. The countries studied--Canada, the Republic of…

LBQ2D, Extending the Line Broadened Quasilinear Model to TAE-EP Interaction

NASA Astrophysics Data System (ADS)

Ghantous, Katy; Gorelenkov, Nikolai; Berk, Herbert

2012-10-01

The line broadened quasilinear model was proposed and tested on the one dimensional electrostatic case of the bump on tailfootnotetextH.L Berk, B. Breizman and J. Fitzpatrick, Nucl. Fusion, 35:1661, 1995 to study the wave particle interaction. In conventional quasilinear theory, the sea of overlapping modes evolve with time as the particle distribution function self consistently undergo diffusion in phase space. The line broadened quasilinear model is an extension to the conventional theory in a way that allows treatment of isolated modes as well as overlapping modes by broadening the resonant line in phase space. This makes it possible to treat the evolution of modes self consistently from onset to saturation in either case. We describe here the model denoted by LBQ2D which is an extension of the proposed one dimensional line broadened quasilinear model to the case of TAEs interacting with energetic particles in two dimensional phase space, energy as well as canonical angular momentum. We study the saturation of isolated modes in various regimes and present the analytical derivation and numerical results. Finally, we present, using ITER parameters, the case where multiple modes overlap and describe the techniques used for the numerical treatment.

Survey on skin aging status and related influential factors in Southeast China.

PubMed

Wang, Yi-na; Fang, Hong; Zhu, Wei-fang

2009-01-01

To investigate cutaneous aging patterns of residents in Hangzhou, Zhejiang, China, and their contributing factors. Eight hundred and forty-eight Hangzhou residents received the survey between March 2004 and September 2004. Facial wrinkling first occurred at 21 years of age and skin elasticity began to lose at 22 years of age. In middle-aged and old people, facial wrinkling and looseness escalated with the increase of ultraviolet (UV)-exposure time, indicating the accelerating effect of a higher accumulative dose of UV radiation on skin aging. Only Fitzpatrick types II, III and IV were found in the skin phototypes of residents in Hangzhou area, and Fitzpatrick type II seemed to be much more subject to severe wrinkling, elasticity destruction and skin tumors than types III and IV. The oily skin was more protected against wrinkling and facial looseness than dry skin. However, as to concomitant cutaneous diseases, no difference was found among different skin types. Age, solar-exposure time, Fitzpatrick type and skin type are the associated forces in promoting skin aging, and emotional factor seems to be another independent risk factor. The age of 49 years and 2 h/d of solar-exposure time seem to be the turning points responsible for dramatic changes of cutaneous appearance in the process of skin aging in Southeast China.

Parental use of sun protection for their children-does skin color matter?

PubMed

Tan, Marcus G; Nag, Shudeshna; Weinstein, Miriam

2018-03-01

Excessive sun exposure during childhood is a risk factor for skin cancer. This study aimed to compare the frequency of ideal sun protection use between parents with lighter- and darker-skinned children and explore their attitudes and beliefs on sun safety and their choice of sun protection. Parents of children aged 6 months to 6 years completed self-administered questionnaires about sun protection practices for their children. Parents assessed their child's Fitzpatrick phototype and were divided into lighter- (Fitzpatrick phototype I-III) and darker-skinned (Fitzpatrick phototype IV-VI) groups. Sun safety guidelines from the Canadian Dermatology Association were used to qualify ideal sun protection. A total of 183 parents were included. Overall, 31 parents (17%) used ideal sun protection for their children. As their children grew older, parents were less likely to use ideal sun protection (odds ratio = 0.69, 95% confidence interval = 0.53-0.90). Parents in the lighter-skinned group were more likely to use ideal sun protection for their children (odds ratio = 7.4, 95% confidence interval = 2.7-20.1), believe that sun exposure was harmful (odds ratio = 17.2, 95% confidence interval = 4.0-74.9), and perceive value in sun protection (odds ratio = 11.4, 95% confidence interval = 3.3-39.0); the darker-skinned group believed that darker skin tones provided more sun protection (odds ratio = 12.4, 95% confidence interval = 6.1-25.4). Ideal parental sun protection efforts are overall low, particularly in parents of darker-skinned children. The identified attitudes toward and beliefs about sun safety may aid in delivery of future sun protection interventions, especially in multiracial populations. © 2018 Wiley Periodicals, Inc.

A pilot methodology study for the photographic assessment of post-inflammatory hyperpigmentation in patients treated with tretinoin.

PubMed

Rossi, A B; Leyden, J J; Pappert, A S; Ramaswamy, A; Nkengne, A; Ramaswamy, R; Nighland, M

2011-04-01

Post-inflammatory hyperpigmentation (PIH) is a common occurrence in patients with acne vulgaris, particularly in those with skin of colour. A previous study has demonstrated the benefit of tretinoin (retinoic acid) in the treatment of PIH; however, there is currently no standard protocol to evaluate change in PIH following treatment. Based on these findings, we performed a pilot, exploratory, blinded, intraindividual-controlled methodology study that consisted of a photographic assessment protocol with facial mapping.   The study was based on a secondary analysis of a phase 4, community-based trial of 544 acne patients who were treated with tretinoin gel microsphere 0.04% or 0.1%. Only patients with Fitzpatrick types III-V (skin of colour) were included in the study; subjects with Fitzpatrick skin type VI were excluded because the photographic assessment did not allow for proper evaluation. Despite the small number of subjects evaluated (n=25), the results revealed consistent assessment of improvement in PIH between two independent graders (weighted κ=0.84). Further study with a larger population is recommended to validate the accuracy of this method. © 2010 Johnson & Johnson Consumer Companies, Inc. Journal of the European Academy of Dermatology and Venereology © 2010 European Academy of Dermatology and Venereology.

Comparison of adverse events of laser and light-assisted hair removal systems in skin types IV-VI.

PubMed

Breadon, Jonith Y; Barnes, Chad A

2007-01-01

Photoepilation, utilizing lasers and noncoherent light sources, is designed to irradiate as much of the follicular unit as possible, with melanin as the target chromophore. Wavelength absorption should generate energy sufficient to heat and destroy the hair follicle, while preserving the surrounding tissue. When performing photoepilation on African-American skin (Fitzpatrick skin types IV-VI) a greater risk of potential epidermal adverse events, such as dyspigmentation, blistering, crusting, edema, and subsequent scarring, is possible. To reduce epidermal melanin absorption of energy longer wavelengths are considered safer for use on Fitzpatrick skin types IV to VI. This article reviews and compares the reported incidences of adverse events in African-American skin, utilizing lasers and noncoherent light sources for assisted hair removal.

Inhalation Injury.

DTIC Science & Technology

1994-01-01

spontaneously or assisted ), ᝺% since the elimination half-life supplemental 100% oxygen should be (t1, 2 ) for COHb is dependent on oxygen...persistent apy point out the increased incidence of hypovolemic shock and renal failure. fires involving polyurethanes, which Chest physiotherapy to...FITZPATRICK AND W. G. CIOFFI, JR. icals, the role of deficient surfactant Also in an animal study, pentoxifylline function, prevention of tracheobron- has been

Trajectories of Marital Conflict across the Life Course: Predictors and Interactions with Marital Happiness Trajectories

ERIC Educational Resources Information Center

Kamp Dush, Claire M.; Taylor, Miles G.

2012-01-01

Using typologies outlined by Gottman and Fitzpatrick as well as institutional and companionate models of marriage, the authors conducted a latent class analysis of marital conflict trajectories using 20 years of data from the Marital Instability Over the Life Course study. Respondents were in one of three groups: high, medium (around the mean), or…

Platelet-Rich Plasma for the Treatment of Photodamage of the Skin of the Hands.

PubMed

Cabrera-Ramírez, J O; Puebla-Mora, A G; González-Ojeda, A; García-Martínez, D; Cortés-Lares, J A; Márquez-Valdés, A R; Contreras-Hernández, G I; Bracamontes-Blanco, J; Saucedo Ortiz, J A; Fuentes-Orozco, C

2017-10-01

Platelet-rich plasma (PRP) provides growth factors that stimulate fibroblast activation and induce the synthesis of collagen and other components of the extracellular matrix. The objective of this study was to evaluate the effect of PRP in the treatment of photodamage of the skin of the hands. Experimental study enrolling persons with photoaged skin on the dorsum of the hands (Glogau photoaging scale, type III, or Fitzpatrick wrinkle classification, type II) were included between August 2012 and January 2013. A histological comparison was made of skin biopsies taken before and after the application of PRP to the skin of the dorsum of the hands. The mean (SD) age of the 18 women enrolled was 47.9 (4.3) years. Histological analysis showed an increase in the number of fibroblasts (P<.001), number of vessels (P<.001), and collagen density (P=.27). These changes produced significant improvements in the Fitzpatrick wrinkle and elastosis scale (P<.001) and in the Glogau photoaging scale (P=.01). PRP induced a reduction in the manifestations of skin aging, including an improvement in wrinkles and elastosis. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Characterization of an optimized light source and comparison to pulsed dye laser for superficial and deep vessel clearance.

PubMed

Weiss, Robert A; Ross, E Victor; Tanghetti, Emil A; Vasily, David B; Childs, James J; Smirnov, Mikhail Z; Altshuler, Gregory B

2011-02-01

An arc lamp-based device providing optimized spectrum and pulse shape was characterized and compared with two pulsed dye laser (PDL) systems using a vascular phantom. Safety and effectiveness for facial telangiectasia are presented in clinical case studies. An optimized pulsed light source's (OPL) spectral and power output were characterized and compared with two 595 nm PDL devices. Purpuric threshold fluences were determined for the OPL and PDLs on Fitzpatrick type II normal skin. A vascular phantom comprising blood-filled quartz capillaries beneath porcine skin was treated by the devices at their respective purpuric threshold fluences for 3 ms pulse widths, while vessel temperatures were monitored with an infrared (IR) camera. Patients with Fitzpatrick skin types II-III received a split-face treatment with the OPL and a 595 nm PDL. The OPL provided a dual-band output spectrum from 500 to 670 nm and 850-1,200 nm, pulse widths from 3 to 100 ms, and fluences to 80 J/cm(2). The smooth output power measured during all pulse widths provides unambiguous vessel size selectivity. Percent energy in the near infra-red increased with decreasing output power from 45% to 60% and contributed 15-26% to heating of deep vessels, respectively. At purpuric threshold fluences the ratio of OPL to PDL vessel temperature rise was 1.7-2.8. OPL treatments of facial telangiectasia were well-tolerated by patients demonstrating significant improvements comparable to PDL with no downtime. Intense pulsed light (IPL) and PDL output pulse and spectral profiles are important for selective treatment of vessels in vascular lesions. The OPL's margin between purpuric threshold fluence and treatment fluence for deeper, larger vessels was greater than the corresponding margin with PDLs. The results warrant further comparison studies with IPLs and other PDLs. Copyright © 2011 Wiley-Liss, Inc.

From global to heavy-light: 5-point conformal blocks

NASA Astrophysics Data System (ADS)

Alkalaev, Konstantin; Belavin, Vladimir

2016-03-01

We consider Virasoro conformal blocks in the large central charge limit. There are different regimes depending on the behavior of the conformal dimensions. The most simple regime is reduced to the global sl(2,C) conformal blocks while the most complicated one is known as the classical conformal blocks. Recently, Fitzpatrick, Kaplan, and Walters showed that the two regimes are related through the intermediate stage of the so-called heavy-light semiclassical limit. We study this idea in the particular case of the 5-point conformal block. To find the 5-point global block we use the projector technique and the Casimir operator approach. Furthermore, we discuss the relation between the global and the heavy-light limits and construct the heavy-light block from the global block. In this way we reproduce our previous results for the 5-point perturbative classical block obtained by means of the monodromy method.

Focal high-concentration trichloroacetic acid peeling for treatment of atrophic facial chickenpox scar: an open-label study.

PubMed

Barikbin, Behrooz; Saadat, Nelda; Akbari, Zahra; Yousefi, Maryam; Toossi, Parviz

2012-10-01

Despite their prevalence, there is a paucity of information in the medical literature on the treatment of atrophic chickenpox scars. To evaluate the efficacy and safety of using the chemical reconstruction of skin scar technique for the treatment of atrophic facial chickenpox scars. One hundred patients (mean age 23 years; Fitzpatrick skin types II-IV) were treated with focal chemical peeling with 70% trichloroacetic acid (TCA) for a maximum of six sessions. Improvement rate, frequency of adverse events and patient satisfaction were assessed. Five hundred thirty-three peeling sessions in 100 consecutive patients were performed. Final assessment at 12-week follow-up visit after the last treatment revealed improvement in 95% of patients: mild improvement in 12 cases, moderate improvement in 42 cases, and marked improvement in 41 cases. The appearance of scars did not change in five patients. Seventy-nine patients expressed moderate to high satisfaction with the results. Post-treatment side effects were mild and transient, resolving gradually within the study period. Focal peeling with high-concentration TCA appears to be a safe and effective alternative in the treatment of atrophic facial chickenpox scars. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

The Correlation Between End-Tidal Carbon Dioxide Measured By Capnoxygen (trademark) Mask and Nasal Cannula

DTIC Science & Technology

2000-10-01

Chair: Maura S. McAuliffe, CRNA, Ph.D. Date...dedicate this research to my two children, Kelly and Danny, who endured the long hours and the separation that was necessary to complete this project...shredded. Questions If you have any questions about this research study, you should contact LT Leo J. Fitzpatrick at 301-650-0009, or Maura S. McAuliffe

The Correlation Between End-Tidal Carbon Dioxide Measured by Capnoxygen (Trade Mark) Mask and Nasal Cannula

DTIC Science & Technology

2000-10-01

Chair: Maura S. McAuliffe, CRNA, Ph.D. Date...monitored anesthesia care procedures or conscious sedation. viii DEDICATION I would like to dedicate this research to my two children, Kelly and Danny, who...research study, you should contact LT Leo J. Fitzpatrick at 301-650-0009, or Maura S. McAuliffe, Ph.D., CRNA at 301-295-6565, chair of my thesis committee

Genetics Home Reference: isolated Pierre Robin sequence

MedlinePlus

... PG, Fitzpatrick DR, Lyonnet S. Highly conserved non-coding elements on either side of SOX9 associated with Pierre ... Citation on PubMed or Free article on PubMed Central Jakobsen LP, Ullmann R, Christensen SB, Jensen KE, ...

Minimum exposure limits and measured relationships between the vitamin D, erythema and international commission on non-ionizing radiation protection solar ultraviolet.

PubMed

Downs, Nathan; Parisi, Alfio; Butler, Harry; Turner, Joanna; Wainwright, Lisa

2015-01-01

The International Commission on Non-Ionizing Radiation Protection (ICNIRP) has established guidelines for exposure to ultraviolet radiation in outdoor occupational settings. Spectrally weighted ICNIRP ultraviolet exposures received by the skin or eye in an 8 h period are limited to 30 J m(-2). In this study, the time required to reach the ICNIRP exposure limit was measured daily in 10 min intervals upon a horizontal plane at a subtropical Australian latitude over a full year and compared with the effective Vitamin D dose received to one-quarter of the available skin surface area for all six Fitzpatrick skin types. The comparison of measured solar ultraviolet exposures for the full range of sky conditions in the 2009 measurement period, including a major September continental dust event, show a clear relationship between the weighted ICNIRP and the effective vitamin D dose. Our results show that the horizontal plane ICNIRP ultraviolet exposure may be used under these conditions to provide minimum guidelines for the healthy moderation of vitamin D, scalable to each of the six Fitzpatrick skin types. © 2014 The American Society of Photobiology.

Idempotent Methods for Continuous Time Nonlinear Stochastic Control

DTIC Science & Technology

2012-09-13

AND ADDRESS(ES) dba AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Stochastech Corporation dba Tempest Technologies 8939 S...Stochastic Control Problems Ben G. Fitzpatrick Tempest Technologies 8939 S. Sepulveda Boulevard, Suite 506 Los Angeles, CA 90045 Sponsored by

Are lasers superior to lights in the photoepilation of Fitzpatrick V and VI skin types? - A comparison between Nd:YAG laser and intense pulsed light.

PubMed

Bs, Bibilash; Chittoria, Ravi Kumar; Thappa, Devinder Mohan; Mohapatra, Devi Prasad; Mt, Friji; S, Dineshkumar; Pandey, Sandhya

2017-10-01

There are no large volume comparative studies available to compare the efficacy of lasers over lights for hair removal in Fitzpatrick V and VI skin types. This study is designed to compare the efficacy of Nd:YAG laser versus IPL in the darker skin types. Thirty-nine patients included in Group-1 were treated with Nd:YAG and 31 in Group-2 with IPL. Both groups received 5 sessions of treatment. The hair counts were assessed using digital photography and manual counting method before and after treatment and the results were analysed. Patient satisfaction scores and pain scores were recorded in each session and compared. Mean hair reduction in the IPL group was 25.70 and Nd:YAG group was 24.12 (95% CI). In the Nd:YAG group, 59% of subjects had burning sensation while the figure was 32.3% in IPL group. Burning was less in IPL group (p < 0.023). There were no statistically significant differences noticed regarding hyperpigmentation in both the groups (p < 0.115). Both Nd:YAG and IPL are equally effective for epilation of the darker skin types. Nd:YAG is associated with mild burning sensation in a significant number of patients. Patient satisfaction scores were comparable in both the groups.

A Rationale for Participant Evaluation

ERIC Educational Resources Information Center

Boody, Robert M.

2009-01-01

There are many different models or approaches to doing program evaluation. Fitzpatrick, Sanders, and Worthen classify them into five general approaches: (a) objectives oriented, (b) management oriented, (c) consumer oriented, (d) expertise oriented, and (e) participant oriented. Within each of these general categories, of course, reside many…

TEACHING ETHNIC GROUPS.

ERIC Educational Resources Information Center

BLAIR, GEORGE E.; AND OTHERS

THE MAJOR THEME OF FIVE PAPERS OF A PANEL IS THE NEED FOR TEACHERS TO UNDERSTAND THE DIVERSE CULTURES AND VALUE SYSTEMS OF THEIR PUPILS. SISTER FRANCIS MAUREEN POINTS UP THE SENSITIVITIES AND CLOSE RELATIONSHIPS OF PUERTO RICAN CHILDREN, AND REVEREND JOSEPH FITZPATRICK REMARKS ON THE INTENSE FAMILY FEELING, NONCOMPETITIVE ATTITUDES, AND LACK OF…

Nonablative Fractional Laser Resurfacing in Skin of Color: Evidence-based Review.

PubMed

Kaushik, Shivani B; Alexis, Andrew F

2017-06-01

Background: Nonablative laser resurfacing represents one of the major advances in procedural dermatology over the past decade. However, its use in darker skin types is limited by safety concerns and a relative lack of available data. Aim: To provide evidence-based recommendations for the use of fractional lasers in darker skin types. Evidence review: A broad literature search of PubMed/Medline database was conducted in April 2016 using the term fractional lasers. A free text search of keywords including fractional resurfacing, nonablative lasers, skin type, skin of color, ethnic skin, Fitzpatrick skin type, Asian skin, African Americans, Afro-Caribbean, and Hispanics was also executed. An in-depth review of all the relevant articles fitting the authors' inclusion/exclusion criteria was performed. Thereafter, each study was assigned levels of evidence per the Modified Criteria by Oxford Center of Evidence Based Medicine. A recommendation was made for a specific treatment based on the presence of at least one Level 1 study or more than three Level 2 or 3 studies that had concordant results. Findings: The available evidence strongly suggests that fractional lasers are a favorable treatment option for a variety of dermatological diseases in Fitzpatrick skin phototypes IV to VI. Level 1 evidence was found for the use of fractional lasers for treating acne, striae and skin rejuvenation. Level 2 evidence was found for their use in acne scars, melasma, and surgical/traumatic scars. Conclusion: Fractional resurfacing is a safe and efficacious treatment option for various dermatological disorders in darker skin types; however, there is a paucity of high-quality studies involving skin types V and VI.

Clinical Evaluation of a 4% Hydroquinone + 1% Retinol Treatment Regimen for Improving Melasma and Photodamage in Fitzpatrick Skin Types III-VI.

PubMed

Rendon, Marta I; Barkovic, Sylvia

2016-11-01

The bene ts of monotherapy with hydroquinone for melasma and retinoids for photodamaged skin is well established. Here we report results of a hydroquinone skincare regimen designed for melasma treatment combined with a cosmetic retinol cream on subjects presenting with both melasma and facial photodamage in a 24-week study. Improvement in melasma and photodamage ef cacy pa- rameters of melasma pigmentation intensity and melasma area and severity index (MASI), as well as overall photodamage and mottled hyperpigmentation were found by week 4, the rst post-baseline time point. By week 8 signi cant improvements were also found in melasma disease severity assessment, tactile roughness, ne wrinkles, crepiness, actinic lentigines, and laxity. By week 18 signi cant reduction in coarse wrinkles was evident. Bene ts persisted through the study end on the panel of 31 subjects, with over 3⁄4 of par- ticipants demonstrating improvements in 10 of the 11 graded attributes. For the remaining attribute, coarse wrinkling, approximately 50% of the panel showed improvement. The regimen produced an average of "marked improvement" in melasma severity (51-75% improvement). Results of tolerance evaluations documented overall treatment mildness for a majority of the study participants. Subject questionnaires concur with high ratings of the study regimen for tolerability, ef cacy perception, product aesthetics and overall treat- ment satisfaction in subjects of Fitzpatrick Skin Type III-VI classi cation with melasma and photodamage in mild-to-moderate severity. J Drugs Dermatol. 2016;15(11):1435-1441..

Non-ablative radiofrequency associated or not with low-level laser therapy on the treatment of facial wrinkles in adult women: A randomized single-blind clinical trial.

PubMed

Pereira, Thalita Rodrigues Christovam; Vassão, Patrícia Gabrielli; Venancio, Michele Garcia; Renno, Ana Cláudia Muniz; Aveiro, Mariana Chaves

2017-06-01

The objective of this study was to evaluate the effects of Non-ablative Radiofrequency (RF) associated or not with low-level laser therapy (LLLT) on aspect of facial wrinkles among adult women. Forty-six participants were randomized into three groups: Control Group (CG, n = 15), RF Group (RG, n = 16), and RF and LLLT Group (RLG, n = 15). Every participant was evaluated on baseline (T0), after eight weeks (T8) and eight weeks after the completion of treatment (follow-up). They were photographed in order to classify nasolabial folds and periorbital wrinkles (Modified Fitzpatrick Wrinkle Scale and Fitzpatrick Wrinkle Classification System, respectively) and improvement on appearance (Global Aesthetic Improvement Scale). Photograph analyses were performed by 3 blinded evaluators. Classification of nasolabial and periorbital wrinkles did not show any significant difference between groups. Aesthetic appearance indicated a significant improvement for nasolabial folds on the right side of face immediately after treatment (p = 0.018) and follow-up (p = 0.029) comparison. RG presented better results than CG on T8 (p = 0.041, ES = -0.49) and on follow-up (p = 0.041, ES = -0.49) and better than RLG on T8 (p = 0.041, ES = -0.49). RLG presented better results than CG on follow-up (p = 0.007, ES = -0.37). Nasolabial folds and periorbital wrinkles did not change throughout the study; however, some aesthetic improvement was observed. LLLT did not potentiate RF treatment.

Laser and Light Treatments for Hair Reduction in Fitzpatrick Skin Types IV-VI: A Comprehensive Review of the Literature.

PubMed

Fayne, Rachel A; Perper, Marina; Eber, Ariel E; Aldahan, Adam S; Nouri, Keyvan

2018-04-01

Unwanted facial and body hair presents as a common finding in many patients, such as females with hirsutism. With advances in laser and light technology, a clinically significant reduction in hair can be achieved in patients with light skin. However, in patients with darker skin, Fitzpatrick skin types (FST) IV-VI, the higher melanin content of the skin interferes with the proposed mechanism of laser-induced selective photothermolysis, which is to target the melanin in the hair follicle to cause permanent destruction of hair bulge stem cells. Many prospective and retrospective studies have been conducted with laser and light hair-removal devices, but most exclude patients with darkly pigmented skin, considering them a high-risk group for unwanted side effects, including pigmentation changes, blisters, and crust formation. We reviewed the published literature to obtain studies that focused on hair reduction for darker skin types. The existing literature for this patient population identifies longer wavelengths as a key element of the treatment protocol and indicates neodymium-doped yttrium aluminum garnet (Nd:YAG), diode, alexandrite, and ruby lasers as well as certain intense pulsed light sources for safe hair reduction with minimal side effects in patients with FST IV-VI, so long as energy settings and wavelengths are appropriate. Based on the findings in this review, safe and effective hair reduction for patients with FST IV-VI is achievable under proper treatment protocols and energy settings.

Resurfacing of Facial Acne Scars With a New Variable-Pulsed Er:YAG Laser in Fitzpatrick Skin Types IV and V

PubMed Central

Chathra, Namitha; Mysore, Venkataram

2018-01-01

Introduction: The Er:YAG laser, considered to be less effective than CO2 laser in its traditional form, in its new modulated version has variable pulse technology that is claimed to be superior to the earlier versions of the laser. Aim: The aim of the study was to check efficacy and safety of the new variable square pulse (VSP) Er:YAG laser in the management of acne scar in patients with Fitzpatrick skin types IV and V. Materials and Methods: This retrospective study consisted of 80 patients (Fitzpatrick skin types IV and V) with atrophic and hypertrophic facial acne scars. Records of the patients who had undergone four treatment sessions with VSP technology equipped with Er:YAG laser were extracted. Each patient had undergone a minimum of four sessions. Fractional mode at medium laser pulse (SP) and long pulse (LP) was employed for the depressed center of the scars to stimulate neocollagenogenesis. Short laser pulse (MSP) in nonfractionated mode was used for ablating the raised scar border and hypertrophic scars. Goodman and Baron global scarring grading system was used for qualitative and quantitative assessments. Patient’s satisfaction to the treatment and observer’s assessment of improvement (based on photographs) was graded as poor (<25% improvement), fair (25–50% improvement), good (51–75% improvement), and excellent (>75% improvement). Results: At the end of the four sessions, the number of patients in grade IV postacne scarring reduced from 16 to 2 and that in grade III from 47 to 29. The mean score significantly dropped from 36.94 to 27.5. Subjective assessment revealed that 78 of 80 patients had noticed more than 25% improvement, with 50 of them showing more than 50% improvement at the end of four sessions. Eight patients perceived an excellent response and 42 reported a good response. This is notably higher than the observer’s grading, which showed an excellent response in only 2 patients and a good response in 35. Adverse effects were limited to prolonged erythema (two patients), prolonged crusting (one patient), and postinflammatory hyperpigmentation (one patient). Conclusion: Ninety-seven percent of the subjects in our study perceived at least a fair improvement. We also saw a significant change in the objective score with a fall of the mean quantitative score from 36.94 to 27.15. This underscores the new variable-pulsed Er:YAG laser’s effectiveness in the treatment of acne scars. It also has the added advantage of lesser adverse events and faster healing. PMID:29731588

Resurfacing of Facial Acne Scars With a New Variable-Pulsed Er:YAG Laser in Fitzpatrick Skin Types IV and V.

PubMed

Chathra, Namitha; Mysore, Venkataram

2018-01-01

The Er:YAG laser, considered to be less effective than CO 2 laser in its traditional form, in its new modulated version has variable pulse technology that is claimed to be superior to the earlier versions of the laser. The aim of the study was to check efficacy and safety of the new variable square pulse (VSP) Er:YAG laser in the management of acne scar in patients with Fitzpatrick skin types IV and V. This retrospective study consisted of 80 patients (Fitzpatrick skin types IV and V) with atrophic and hypertrophic facial acne scars. Records of the patients who had undergone four treatment sessions with VSP technology equipped with Er:YAG laser were extracted. Each patient had undergone a minimum of four sessions. Fractional mode at medium laser pulse (SP) and long pulse (LP) was employed for the depressed center of the scars to stimulate neocollagenogenesis. Short laser pulse (MSP) in nonfractionated mode was used for ablating the raised scar border and hypertrophic scars. Goodman and Baron global scarring grading system was used for qualitative and quantitative assessments. Patient's satisfaction to the treatment and observer's assessment of improvement (based on photographs) was graded as poor (<25% improvement), fair (25-50% improvement), good (51-75% improvement), and excellent (>75% improvement). At the end of the four sessions, the number of patients in grade IV postacne scarring reduced from 16 to 2 and that in grade III from 47 to 29. The mean score significantly dropped from 36.94 to 27.5. Subjective assessment revealed that 78 of 80 patients had noticed more than 25% improvement, with 50 of them showing more than 50% improvement at the end of four sessions. Eight patients perceived an excellent response and 42 reported a good response. This is notably higher than the observer's grading, which showed an excellent response in only 2 patients and a good response in 35. Adverse effects were limited to prolonged erythema (two patients), prolonged crusting (one patient), and postinflammatory hyperpigmentation (one patient). Ninety-seven percent of the subjects in our study perceived at least a fair improvement. We also saw a significant change in the objective score with a fall of the mean quantitative score from 36.94 to 27.15. This underscores the new variable-pulsed Er:YAG laser's effectiveness in the treatment of acne scars. It also has the added advantage of lesser adverse events and faster healing.

Cross-Validation of Levenson's Psychopathy Scale in a Sample of Federal Female Inmates

ERIC Educational Resources Information Center

Brinkley, Chad A.; Diamond, Pamela M.; Magaletta, Philip R.; Heigel, Caron P.

2008-01-01

Levenson, Kiehl, and Fitzpatrick's Self-Report Psychopathy Scale (LSRPS) is evaluated to determine the factor structure and concurrent validity of the instrument among 430 federal female inmates. Confirmatory factor analysis fails to validate the expected 2-factor structure. Subsequent exploratory factor analysis reveals a 3-factor structure…

Chemical Blistering: Cellular and Macromolecular Components

DTIC Science & Technology

1984-11-15

accumulation of fluid appears to Sbe secondary to fundamental damage to cellular structures (1). As noted by Warthin and Weller (2) and by Sinclair (3...Medicine. fT. P. Fitzpatrick, A. Z. Eisen, K. Wolff, I. M. Freedberg and K. F. Austen, Eds.) McGraw-Hill, New York, pp. 287-294). 2.’ Warthin , A. S., and

77 FR 56202 - Notification of an External Peer Review Meeting for the Draft Framework for Human Health Risk...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-12

... the Science Advisor announces that Versar, Inc., a contractor to the EPA, will convene an independent...: Julie Fitzpatrick, Office of the Science Advisor, Mail Code 8105-R, U.S. Environmental Protection Agency... recommendations presented in the National Research Council's report Science and Decisions: Advancing Risk...

Non-invasive high-intensity focused ultrasound for UV-induced hyperpigmentation in Fitzpatrick skin types III and IV: a prospective, randomized, controlled, evaluator-blinded trial.

PubMed

Vachiramon, Vasanop; Jurairattanaporn, Natthachat; Harnchoowong, Sarawin; Chayavichitsilp, Pamela

2018-02-01

Skin hyperpigmentation is a frequently encountered problem, particularly in darker skin types. Unfortunately, standard treatments for this condition have shown disappointing results. High-intensity focused ultrasound (HIFU) is commonly indicated for skin laxity, but recently was used to treat UV-induced hyperpigmentation in animal models. This study is aimed to evaluate the efficacy and safety of high-intensity focused ultrasound for UVB-induced hyperpigmentation in human subjects. A randomized, evaluator-blinded pilot study was conducted on 20 subjects. Each subject was induced three hyperpigmentary spots by local broadband UVB. After 2 weeks, each spot was randomly allocated to control, low-energy, and high-energy HIFU. Subjects were instructed to follow up weekly for a duration of 1 month. Lightness index measurements, mean improvement scores, subjects' satisfaction, pain scores, and side effects were evaluated. All 20 subjects completed the study. Fourteen subjects had Fitzpatrick (FPT) skin type III and six subjects had FPT skin type IV. Twelve subjects showed greater improvement at control sites while eight subjects showed greater improvement at HIFU-treated sites. In FPT skin type III, HIFU appeared to be inferior to control in both lightness index and mean improvement scores, but in FPT skin type IV, HIFU had greater lightness index improvement and higher improvement scores than control. Side effects were more frequent in high-energy-treated areas. Focused ultrasound may be offered in some patients with hyperpigmentary conditions. More research is needed to determine proper energy settings for optimal outcome.

Nonablative Fractional Laser Resurfacing in Skin of Color: Evidence-based Review

PubMed Central

Alexis, Andrew F.

2017-01-01

Background: Nonablative laser resurfacing represents one of the major advances in procedural dermatology over the past decade. However, its use in darker skin types is limited by safety concerns and a relative lack of available data. Aim: To provide evidence-based recommendations for the use of fractional lasers in darker skin types. Evidence review: A broad literature search of PubMed/Medline database was conducted in April 2016 using the term fractional lasers. A free text search of keywords including fractional resurfacing, nonablative lasers, skin type, skin of color, ethnic skin, Fitzpatrick skin type, Asian skin, African Americans, Afro-Caribbean, and Hispanics was also executed. An in-depth review of all the relevant articles fitting the authors’ inclusion/exclusion criteria was performed. Thereafter, each study was assigned levels of evidence per the Modified Criteria by Oxford Center of Evidence Based Medicine. A recommendation was made for a specific treatment based on the presence of at least one Level 1 study or more than three Level 2 or 3 studies that had concordant results. Findings: The available evidence strongly suggests that fractional lasers are a favorable treatment option for a variety of dermatological diseases in Fitzpatrick skin phototypes IV to VI. Level 1 evidence was found for the use of fractional lasers for treating acne, striae and skin rejuvenation. Level 2 evidence was found for their use in acne scars, melasma, and surgical/traumatic scars. Conclusion: Fractional resurfacing is a safe and efficacious treatment option for various dermatological disorders in darker skin types; however, there is a paucity of high-quality studies involving skin types V and VI. PMID:28979657

Multicenter clinical trial of a home-use nonablative fractional laser device for wrinkle reduction.

PubMed

Leyden, James; Stephens, Thomas J; Herndon, James H

2012-11-01

Until now, nonablative fractional treatments could only be delivered in an office setting by trained professionals. The goal of this work was to perform clinical testing of a nonablative fractional laser device designed for home-use. This multicenter trial consisted of two clinical studies with slightly varying treatment protocols in which subjects performed at-home treatments of periorbital wrinkles using a handheld nonablative fractional laser. Both studies included an active treatment phase (daily treatments) and a maintenance phase (twice-weekly treatments). In all, 36 subjects were followed up for as long as 5 months after completion of the maintenance phase and 90 subjects were followed up until the completion of the maintenance phase. Evaluations included in-person investigator assessment, independent blinded review of high-resolution images using the Fitzpatrick Wrinkle Scale, and subject self-assessment. All 124 subjects who completed the study were able to use the device following written instructions for use. Treatments were well tolerated with good protocol compliance. Independent blinded evaluations by a panel of physicians showed Fitzpatrick Wrinkle Scale score improvement by one or more grades in 90% of subjects at the completion of the active phase and in 79% of subjects at the completion of the maintenance phase. The most prevalent side effect was transient posttreatment erythema. Lack of a control group and single-blinded study groups were limitations. Safety testing with self-applications by users demonstrated the utility of the device for home use. Independent blinded review of clinical images confirmed the device's proficiency for improving periorbital wrinkles. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

The Impact of ICT Training through Wikis on In-Service EFL Teachers: Changes in Beliefs, Attitudes, and Competencies

ERIC Educational Resources Information Center

Fandiño Parra, Yamith José

2012-01-01

The development of information and communication technology (ICT) invites teachers to abandon traditional roles and act more as mentors, exploring the new media themselves as learners and thus acting as role models for their students (Fitzpatrick & Davies, 2003). For turning students into producers of online content and creating a…

Adult Pacific Lamprey Migration Behavior and Escapement in the Bonneville Reservoir and Lower Columbia River Monitored Using the Juvenile Salmonid Acoustic Telemetry System (JSATS), 2011

DTIC Science & Technology

2012-01-01

sea lions (Zalophus californicus, Eumetopias jubatus) or white sturgeon (Acipenser transmontanus) in the tailrace, moved to spawning tributaries...and management of three parasitic lampreys of North America. Fisheries 35:580-594. Close, D. A., M. Fitzpatrick, and H. Li. 2002. The ecological

76 FR 187 - Programmatic Environmental Assessment and Final Finding of No Significant Impact for Exemptions...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-03

... proposed action may include issuing exemptions to nuclear power plant licensees for up to 40 nuclear power.... Fitzpatrick Nuclear Power Plant Joseph M. Farley Nuclear Plant, Units 1 and 2 Millstone Power Station, Unit... Palisades Nuclear Plant Palo Verde Nuclear Generating Station, Units 1, 2, and 3 Perry Nuclear Power Plant...

Rejuvenation of the male scalp using 1,927 nm non-ablative fractional thulium fiber laser.

PubMed

Boen, Monica; Wilson, Monique J Vanaman; Goldman, Mitchel P; Wu, Douglas C

2017-07-01

The male scalp undergoes extensive photodamage due to a high prevalence of androgenic alopecia and exposure to ultraviolet radiation. This photodamage presents as solar lentigines, fine rhytides, and keratosis, and can prematurely age a patient. In this study, we demonstrate the safety and efficacy of the fractionated 1,927 nm thulium fiber laser using high density and high energy settings to achieve rejuvenation of the male scalp after a single treatment session. Four male patients with Fitzpatrick skin types II-III and extensive photodamage on the scalp underwent one treatment with the fractional non-ablative 1,927 nm thulium fiber laser. The patients had a 60-90% improvement in dyspigmentation, lentigines, and keratosis. No adverse events were observed and the patients tolerated the procedure well. This case series is the first report in the literature demonstrating the successful rejuvenation of the scalp using the 1,927 nm thulium fiber laser. Lasers Surg. Med. 49:475-479, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Photograph-based diagnosis of burns in patients with dark-skin types: the importance of case and assessor characteristics.

PubMed

Boissin, C; Laflamme, L; Wallis, L; Fleming, J; Hasselberg, M

2015-09-01

This study assessed whether photographs of burns on patients with dark-skin types could be used for accurate diagnosing and if the accuracy was affected by physicians' clinical background or case characteristics. 21 South-African cases (Fitzpatrick grades 4-6) of varying complexity were photographed using a camera phone and uploaded on a web-survey. Respondents were asked to assess wound depth (3 categories) and size (in percentage). A sample of 24 burn surgeons and emergency physicians was recruited in South-Africa, USA and Sweden. Measurements of accuracy (using percentage agreement with bedside diagnosis), inter- (n=24), and intra-rater (n=6) reliability (using percentage agreement and kappa) were computed for all cases aggregated and by case characteristic. Overall diagnostic accuracy was 67.5% and 66.0% for burn size and depth, respectively. It was comparable between burn surgeons and emergency physicians and between countries of practice. However, the standard deviations were smaller, showing higher similarities in diagnoses for burn surgeons and South-African clinicians compared to emergency physicians and clinicians from other countries. Case characteristics (child/adult, simple/complex wound, partial/full thickness) affected the results for burn size but not for depth. Inter- and intra-rater reliability for burn depth was 55% and 77%. Size and depth of burns on patients with dark-skin types could be assessed at least as well using photographs as at bedside with 67.5% and 66.0% average accuracy rates. Case characteristics significantly affected the accuracy for burn size, but medical specialty and country of practice seldom did in a statistically significant manner. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Objective color measurements: clinimetric performance of three devices on normal skin and scar tissue.

PubMed

van der Wal, Martijn; Bloemen, Monica; Verhaegen, Pauline; Tuinebreijer, Wim; de Vet, Henrica; van Zuijlen, Paul; Middelkoop, Esther

2013-01-01

Color measurements are an essential part of scar evaluation. Thus, vascularization (erythema) and pigmentation (melanin) are common outcome parameters in scar research. The aim of this study was to investigate the clinimetric properties and clinical feasibility of the Mexameter, Colorimeter, and the DSM II ColorMeter for objective measurements on skin and scars. Fifty scars with a mean age of 6 years (2 months to 53 years) were included. Reliability was tested using the single-measure interobserver intraclass correlation coefficient. Validity was determined by measuring the Pearson correlation with the Fitzpatrick skin type classification (for skin) and the Patient and Observer Scar Assessment Scale (for scar tissue). All three instruments provided reliable readings (intraclass correlation coefficient ≥ 0.83; confidence interval: 0.71-0.90) on normal skin and scar tissue. Parameters with the highest correlations with the Fitzpatrick classification were melanin (Mexameter), 0.72; ITA (Colorimeter), -0.74; and melanin (DSM II), 0.70. On scars, the highest correlations with the Patient and Observer Scar Assessment Scale vascularization scores were the following: erythema (Mexameter), 0.59; LAB2 (Colorimeter), 0.69; and erythema (DSM II), 0.66. For hyperpigmentation, the highest correlations were melanin (Mexameter), 0.75; ITA (Colorimeter), -0.80; and melanin (DSM II), 0.83. This study shows that all three instruments can provide reliable color data on skin and scars with a single measurement. The authors also demonstrated that they can assist in objective skin type classification. For scar assessment, the most valid parameters in each instrument were identified.

Treatment of burn scars in Fitzpatrick phototype III patients with a combination of pulsed dye laser and non-ablative fractional resurfacing 1550 nm erbium:glass/1927 nm thulium laser devices.

PubMed

Tao, Joy; Champlain, Amanda; Weddington, Charles; Moy, Lauren; Tung, Rebecca

2018-01-01

Burn scars cause cosmetic disfigurement and psychosocial distress. We present two Fitzpatrick phototype (FP) III patients with burn scars successfully treated with combination pulsed dye laser (PDL) and non-ablative fractional lasers (NAFL). A 30-year-old, FP III woman with a history of a second-degree burn injury to the bilateral arms and legs affecting 30% body surface area (BSA) presented for cosmetic treatment. The patient received three treatments with 595 nm PDL (7 mm, 8 J, 6 ms), six with the 1550 nm erbium:glass laser (30 mJ, 14% density, 4-8 passes) and five with the 1927 nm thulium laser (10 mJ, 30% density, 4-8 passes). Treated burn scars improved significantly in thickness, texture and colour. A 33-year-old, FP III man with a history of a second-degree burn injury of the left neck and arm affecting 7% BSA presented for cosmetic treatment. The patient received two treatments with 595 nm PDL (5 mm, 7.5 J, 6 ms), four with the 1550 nm erbium:glass laser (30 mJ, 14% density, 4-8 passes) and two with the 1927 nm thulium laser (10 mJ, 30% density, 4-8 passes). The burn scars became thinner, smoother and more normal in pigmentation and appearance. Our patients' burn scars were treated with a combination of PDL and NAFL (two wavelengths). The PDL targets scar hypervascularity, the 1550 nm erbium:glass stimulates collagen remodelling and the 1927 nm thulium targets epidermal processes, particularly hyperpigmentation. This combination addresses scar thickness, texture and colour with a low side effect profile and is particularly advantageous in patients at higher risk of post-procedure hyperpigmentation. Our cases suggest the combination of 595nm PDL plus NAFL 1550 nm erbium:glass/1927 nm thulium device is effective and well-tolerated for burn scar treatment in skin of colour.

Recognizing Warning Signs of K-12 Christian School Distress That Lead to School Closure

ERIC Educational Resources Information Center

Fellers, Ron

2013-01-01

The objective of this research was to identify statistically significant warning signs of K12 Christian school distress that can lead to school closure in the areas of leadership, homogeneity of vision and culture, finances, and competition, as described by Fitzpatrick (2002) and Nichols (2006). Twenty-four strong, declining, and closed K-12…

Stable Optical Phase Modulation With Micromirrors

DTIC Science & Technology

2012-01-27

Stable optical phase modulation with micromirrors Caleb Knoernschild, Taehyun Kim, Peter Maunz, Stephen G. Crain, and Jungsang Kim∗ Fitzpatrick...position stability of the micromirror is dominated by the thermal mechanical noise of the structure. With this level of stability, we utilize the... micromirror to realize an optical phase modulator by simply reflecting light off the mirror and modulating its position. The resonant frequency of the

A complex stand on the white river national wildlife refuge: implications for bottomland hardwood old growth

Treesearch

Brian Roy Lockhart; Jamie E. Kellum

2006-01-01

With the possible re-discovery of the ivory-billed woodpecker (Campephilus principalis), interest has increased in the habitat requirements for the species and the current state of these habitats (Fitzpatrick et al. 2005). Tanner (1942) indicated that the ivory-billed woodpecker needs large, decadent trees for foraging. Trees in such decline provide...

ORAM-SENTINEL{trademark} demonstration at Fitzpatrick. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, L.K.; Anderson, V.M.; Mohammadi, K.

1998-06-01

New York Power Authority, in cooperation with EPRI, installed the ORAM-SENTINEL{trademark} software at James A. Fitzpatrick (JAF) Nuclear Power Plant. This software incorporates models of safety systems and support systems that are used for defense-in-depth in the plant during outage and on-line periods. A secondary goal was to include some pre-analyzed risk results to validate the methodology for quantitative assessment of the plant risks during proposed on-line maintenance. During the past year, New York Power Authority personnel have become familiar with the formal computerized Safety Assessment process associated with on-line and outage maintenance. The report describes techniques and lessons learnedmore » during development of the ORAM-SENTINEL model at JAF. It overviews the systems important to the Safety Function Assessment Process and provides details on development of the Plant Transient Assessment process using the station emergency operating procedures. The assessment results are displayed by color (green, yellow, orange, red) to show decreasing safety conditions. The report describes use of the JAF Probabilistic Safety Assessment within the ORAM-SENTINEL code to calculate an instantaneous core damage frequency and the criteria by which this frequency is translated to a color indicator.« less

Servant Leadership, Emotional Intelligence: Essential for Baccalaureate Nursing Students.

PubMed

Anderson, Della

2016-08-01

Baker University Bachelor of Science in Nursing students study servant leadership and emotional intelligence in a Leadership and Management in Professional Nursing course. The acquisition of these skills increases collaboration with clients and colleagues. Servant leadership improves care through encouragement and facilitation rather than power (Waterman, 2011). Emotional intelligence allows individuals to deal effectively with emotions and is associated with better health (Por, Barriball, Fitzpatrick, & Roberts, 2011). Knowledge of servant leadership, combined with emotional intelligence, creates a relationship with self; encourages relationships with others, clients, and providers; allows teamwork participation; and impacts the entire community.

Home-based wrinkle reduction using a novel handheld multisource phase-controlled radiofrequency device.

PubMed

Shemer, Avner; Levy, Hanna; Sadick, Neil S; Harth, Yoram; Dorizas, Andrew S

2014-11-01

In the last decade, energy-based aesthetic treatments, using light, radiofrequency (RF), and ultrasound, have gained scientific acceptance as safe and efficacious for non-invasive treatment for aesthetic skin disorders. The phase-controlled multisource radiofrequency technology (3DEEP™), which is based on the simultaneous use of multiple RF generators, was proven to allow significant pigment-independent dermal heating without pain or the need of epidermal cooling. This study was performed in order to evaluate the efficacy and safety of a new handheld device delivering multisource radiofrequency to the skin for wrinkle reduction and skin tightening in the home setting. A total of 69 participants (age 54.3 years ± 8.09; age range 37-72 years) were enrolled in the study after meeting all inclusion/exclusion criteria (100%) and providing informed consent. Participants were provided with the tested device together with a user manual and treatment diary, to perform independent treatments at home for 4 weeks. The tested device, (Newa™, EndyMed Medical, Cesarea, Israel) emits 12 W of 1Mhz, RF energy through six electrodes arranged in a linear fashion. Independent control of RF polarity through each one of the 6 electrodes allows significant reduction of energy flow through the epidermis with increased dermal penetration. Participants were instructed to perform at least 5 treatments a week, for one month. Four follow-up visits were scheduled (once a week) during the period of independent treatments at home, following 4 weeks of home treatments, 1 month follow-up visit (1 month after treatment end) and at 3 months follow-up (3 months following treatment end). Analysis of pre-and post treatment images was conducted by three uninvolved physicians experienced with the Fitzpatrick Wrinkle and Elastosis Scale. Fitzpatrick Wrinkle and Elastosis score of each time point (4 weeks following home use treatments; 1 month follow-up, 3 months follow-up) was compared to baseline. Participants were asked a series of questions designed to explore usability concerns and level of satisfaction regarding the device use and subjective efficacy. Altogether, 62 subjects completed the study course and follow-up visits. No unexpected adverse effects were detected or reported throughout the independent treatment. All study participants did not experience any difficulties while operating the tested device for independent wrinkle reduction treatments. Photographic analysis of pre- and post-one month of independent home use treatments, and one and three months follow-up after end of treatment course, was conducted by three uninvolved board certified dermatologists. Analysis of results revealed improvement (downgrade of at least 1 score according to the Fitzpatrick scale) in 91.93%, 96.77%, and 98.39% of study subjects (according to the first, second, and third reviewer, respectively). Results were found to be statistically significant. The majority of study participants were very satisfied from the results of the independent treatment using the tested device for wrinkle reduction.

Detection of Oil in Water Column: Sensor Design

DTIC Science & Technology

2013-02-01

rivers , and initiating dispersant application or oil recovery operations. Challenges in detecting oil within the water column include poor...facility and along transects in the Delaware River . However, all readings were at background, even when there was visible oil on the water surface...levels for extremely high CDOM rich rivers . Detection of Oil in Water Column: Sensor Design 14 UNCLAS//Public | CG-926 RDC | Fitzpatrick, et al

Periodontal disease may be associated with oral and gastrointestinal cancer.

PubMed

Nugent, Zoann

2010-12-01

The association between periodontal disease and cancer:a review of the literature. Fitzpatrick SG, Katz J.J Dent 2010;38(2):83-95. Epub 2009 Nov 4. Zoann Nugent, Ph. D. To assess the published research to date on the relationship between periodontal disease and cancer. Information not available. Comprehensive literature review. Level 3: Other evidence. Grade C: Consensus, disease-oriented evidence, expert opinion.

A Randomized, Investigator-Blinded Comparison of Two Topical Regimens in Fitzpatrick Skin Types III-VI With Moderate to Severe Facial Hyperpigmentation.

PubMed

Vanaman Wilson, Monique J; Jones, Isabela T; Bolton, Joanna; Larsen, Lisa; Wu, Douglas C; Goldman, Mitchel P

2017-11-01

Purpose: Though hydroquinone (HQ) remains the gold standard for treatment of hyperpigmentation, concerns about its safety have prompted the development of HQ-free topical skin lightening systems. To compare the efficacy and tolerability of a new HQ-free system and a popular HQ-based system for the improvement of facial hyperpigmentation and photoaging in darker skin types. This investigator-blinded trial randomized 30 subjects of Fitzpatrick skin types III to VI with moderate to severe hyperpigmentation to a new 7-product HQ-free system or a 7-product HQ-based system for 12 weeks. At 4, 8, and 12 week follow-up visits, a blinded investigator assessed efficacy and tolerability using standardized scales. Subjects also performed a self-assessment at each visit. Both the HQ-free and HQ-based systems produced significant improvements in Overall Hyperpigmentation that were sustained through week 12 (P=0.008, 0.0003). The HQ-based system demonstrated better improvement in overall hyperpigmentation at weeks 4, 8, 12 (P=0.01, 0.001, 0.003, respectively). Mottled Pigmentation Area Severity Index (MoPASI) scores improved with both systems (P=0.02, 0.01), with no statistically significant differences between the two treatment groups. Subject-rated hyperpigmentation was not different between groups. Subjects reported significantly more discomfort with the HQ-free system at week 8 (P=0.02); otherwise, measures of irritation were the same between groups. All irritation was described as mild to moderate. At week 12, 100% of subjects in the HQ-free group and 92.3% of subjects in the HQ-based group were satisfied with their outcome. Both a new HQ-free skincare system and a widely-available HQ-based system improved hyperpigmentation in Fitzpatrick skin types III to VI. Though the HQ-based system produced greater improvement in hyperpigmentation when compared to the HQ-free system, there was no difference in MoPASI scores between the treatment groups. Subjects were satisfied with both treatments and reported only mild to moderate irritation using either system.

J Drugs Dermatol. 2017;16(11):1127-1132.

Video-based heart rate monitoring across a range of skin pigmentations during an acute hypoxic challenge.

PubMed

Addison, Paul S; Jacquel, Dominique; Foo, David M H; Borg, Ulf R

2017-11-09

The robust monitoring of heart rate from the video-photoplethysmogram (video-PPG) during challenging conditions requires new analysis techniques. The work reported here extends current research in this area by applying a motion tolerant algorithm to extract high quality video-PPGs from a cohort of subjects undergoing marked heart rate changes during a hypoxic challenge, and exhibiting a full range of skin pigmentation types. High uptimes in reported video-based heart rate (HR vid ) were targeted, while retaining high accuracy in the results. Ten healthy volunteers were studied during a double desaturation hypoxic challenge. Video-PPGs were generated from the acquired video image stream and processed to generate heart rate. HR vid was compared to the pulse rate posted by a reference pulse oximeter device (HR p ). Agreement between video-based heart rate and that provided by the pulse oximeter was as follows: Bias = - 0.21 bpm, RMSD = 2.15 bpm, least squares fit gradient = 1.00 (Pearson R = 0.99, p < 0.0001), with a 98.78% reporting uptime. The difference between the HR vid and HR p exceeded 5 and 10 bpm, for 3.59 and 0.35% of the reporting time respectively, and at no point did these differences exceed 25 bpm. Excellent agreement was found between the HR vid and HR p in a study covering the whole range of skin pigmentation types (Fitzpatrick scales I-VI), using standard room lighting and with moderate subject motion. Although promising, further work should include a larger cohort with multiple subjects per Fitzpatrick class combined with a more rigorous motion and lighting protocol.

Patterns of bird-window collisions inform mitigation on a university campus

PubMed Central

Winton, R. Scott; Wu, Charlene J.; Zambello, Erika; Wittig, Thomas W.; Cagle, Nicolette L.

2016-01-01

Bird-window collisions cause an estimated one billion bird deaths annually in the United States. Building characteristics and surrounding habitat affect collision frequency. Given the importance of collisions as an anthropogenic threat to birds, mitigation is essential. Patterned glass and UV-reflective films have been proven to prevent collisions. At Duke University’s West campus in Durham, North Carolina, we set out to identify the buildings and building characteristics associated with the highest frequencies of collisions in order to propose a mitigation strategy. We surveyed six buildings, stratified by size, and measured architectural characteristics and surrounding area variables. During 21 consecutive days in spring and fall 2014, and spring 2015, we conducted carcass surveys to document collisions. In addition, we also collected ad hoc collision data year-round and recorded the data using the app iNaturalist. Consistent with previous studies, we found a positive relationship between glass area and collisions. Fitzpatrick, the building with the most window area, caused the most collisions. Schwartz and the Perk, the two small buildings with small window areas, had the lowest collision frequencies. Penn, the only building with bird deterrent pattern, caused just two collisions, despite being almost completely made out of glass. Unlike many research projects, our data collection led to mitigation action. A resolution supported by the student government, including news stories in the local media, resulted in the application of a bird deterrent film to the building with the most collisions: Fitzpatrick. We present our collision data and mitigation result to inspire other researchers and organizations to prevent bird-window collisions. PMID:26855877

Melasma and assessment of the quality of life in Brazilian women.

PubMed

Ikino, Juliana Kida; Nunes, Daniel Holthausen; Silva, Vanessa Priscilla Martins da; Fröde, Tania Silvia; Sens, Mariana Mazzochi

2015-01-01

Melasma is a chronic, acquired hyperpigmentation disease on sun-exposed areas of the skin, which affects patients' quality of life. To assess the impact on the quality of life of women living in Florianópolis, Brazil, through questionnaire (MelasQol), and investigate the clinical aspects and risk factors for melasma, correlating them with the MelasQol scores. This study was performed on 51 melasma patients cared for at the University Hospital of the Universidade Federal de Santa Catarina. The variables included were: age, gender, age of onset of melasma, Fitzpatrick phototype (I-VI), duration and family history of melasma, onset of melasma during pregnancy, use of hormonal contraceptive, thyroid disorder and distribution of melasma. The MelasQoL questionnaire, validated for Brazilian Portuguese (MelasQoL-BP), was applied. The mean age was 38.43±6.75 years. All patients were women. The most common Fitzpatrick skin phototypes were III (49.02%) and IV (33.33%). Melasma had a mean age of onset of 29.18±7.05 years and a mean duration of 9.25±6.18 years. The majority of patients did not have familial history of melasma (50.98%). Melasma onset was associated with pregnancy (45.10%). The MelasQoL-BP analysis revealed significant emotional impact on patients, such as feeling bothered (94.11%), frustrated and embarrassed (64.71%), and depressed (52.94%) about their skin appearance, as well as unattractive (78.43%). No social impact was observed (P>0.05). Melasma has a strong emotional impact on quality of life, resulting especially from feelings about skin appearance.

Relationship between Depressive Symptoms and Cardiovascular Disease Risk Factors in African American Individuals

DTIC Science & Technology

2011-01-01

cholesterol , triglycerides , high - density cholesterol (HDL), and calculated low- density lipoprotein (LDL)), and blood glucose level. 2.3. Assessments 2.3.1...separately; BP: blood pressure; HDL: high - density lipoprotein ; LDL: low- density lipoprotein . at or above threshold with those who do not among a group of...261, 2001. [11] G. R. Warnick, R. H. Knopp, V. Fitzpatrick, and L. Branson, “Estimating low- density lipoprotein

Detection of Oil in Water Column, Final Report: Detection Prototype Tests

DTIC Science & Technology

2014-07-01

first phase of the project involved initial development and testing of three technologies to address the detection problem . This second phase...important oceanic phenomena such as density stratification and naturally occurring particulate matter, which will affect the performance of sensors in the ...2 UNCLAS//Public | CG-926 RDC | M. Fitzpatrick, et al.| Public July 2014 spills of submerged oil is far more complex due to the problems

Uncertainties in the interstellar extinction curve and the Cepheid distance to M101

NASA Astrophysics Data System (ADS)

Nataf, David M.

2015-05-01

I revisit the Cepheid-distance determination to the nearby spiral galaxy M101 (Pinwheel Galaxy) of Shappee & Stanek, in light of several recent investigations questioning the shape of the interstellar extinction curve at λ ≈ 8000 Å (i.e. the I band). I find that the relatively steep extinction ratio AI/E(V - I) = 1.1450 from Fitzpatrick & Massa is slightly favoured relative to AI/E(V - I) = 1.2899 from Fitzpatrick and significantly favoured relative the historically canonical value of AI/E(V - I) = 1.4695, from Cardelli et al. The steeper extinction curves, with lower values of AI/E(V - I), yield fits with reduced scatter, metallicity dependences to the dereddened Cepheid luminosities that are closer to values inferred in the Local Group, and that are less sensitive to the choice of reddening cut imposed in the sample selection. The increase in distance modulus to M101 when using the preferred extinction curve is Δμ ˜ 0.06 mag, resulting in the estimate of the distance modulus to M101 relative to the LMC is ΔμLMC ≈ 10.72 ± 0.03 (stat). The best-fitting metallicity dependence is dMI/d{[O/H]} ≈ (-0.38 ± 0.14 (stat)) mag dex-1.

Audit cycle of documentation in laser hair removal.

PubMed

Cohen, S N; Lanigan, S W

2005-09-01

Lasercare clinics are one of the largest providers of skin laser treatment in the United Kingdom, in both private sector and National Health Service. Laser hair removal is performed by trained nurses following written protocols. Choice of laser and fluence is tailored to Fitzpatrick skin type. We audited and re-audited documentation of six criteria in patients receiving laser hair removal (signed consent, Fitzpatrick skin type, use of appropriate laser, appropriate fluence, patient satisfaction and objective assessment) across 13 clinics at different points in time. Data were obtained on 772 treatments. Overall findings revealed excellent documentation of consent, use of appropriate laser and fluence (median 100%), good documentation of skin type (median 90%) and poor documentation of patient satisfaction and objective assessment (median 67% and 53%, respectively). Comparison between baseline and repeat audit at 6-8 months (nine clinics) showed significant improvement across clinics in these latter two criteria [patient satisfaction: odds ratio (OR) 0.38, 95% confidence interval (CI) 0.15-0.78, P=0.01; objective assessment: OR 0.23, 95% CI 0.07-0.50, P=0.0003 (Mantel-Haenszel weighted odds ratios)]. We conclude that quality of documentation was generally and consistently high in multiple clinics and that re-auditing led to significant improvement in poor scores. This simple measure could easily be implemented more widely across many disciplines.

Skin of colour: Characteristics and disease.

PubMed

Zaidi, Zohra

2017-02-01

Skin colour varies from pale white to very dark. Fitzpatrick's skin phototypes are based on the person's skin colour and its response to sun exposure in terms of burning and tanning of the skin. Fitzpatrick's type 1V-V1 is known as the skin of colour and type 1-111 is the fair or white skin. The colour of the skin and texture of the hair are the most apparent phenotype to differentiate the different races; this correlates closely with the geography and ultraviolet radiation of the sun. There are notable differences in skin disease incidence, presentation, and treatment based on skin type. Differences in skin anatomy and physiology between the fair skin and the skin of colour may explain disparities in skin disorders and provide insight into appropriate differences in the management of cutaneous disease. Differences in culture and habits may produce skin lesions unknown to the local physicians. Temperature, humidity and rainfall are closely interwoven with the fauna and flora of the area. Hot and humid climate favours bacterial and fungal infections. Today in this multicultural society due to globalization, a physician has to see patients from all over the globe. There is a need for the physicians to know the diseases of people from different racial and ethnic backgrounds for early diagnosis and treatment.

"Cold" X5 Hairlaser™ used to treat male androgenic alopecia and hair growth: an uncontrolled pilot study.

PubMed

Blum, Kenneth; Han, David; Madigan, Margaret A; Lohmann, Raquel; Braverman, Eric R

2014-02-24

Various trials have been conducted on the management and treatment of androgenic alopecia (AGA) or male pattern hair loss using a variety of laser and light sources. For this feasibility study, the population was composed of males between the ages of 20 and 60 years who have been experiencing active hair loss within the last 12 months and the diagnosis of AGA. They also had a Norwood-Hamilton classification of 3, 3A, 3 V, 4, 4A, or 5 for the hair thinning patterns and skin type I, II, III, or IV on the Fitzpatrick skin type scale. This two-arm randomized, parallel group study design employed stratifying randomization to balance treatment assignment within three investigational centers with at least 2 subjects enrolled in each Fitzpatrick skin type. A statistically significant positive trend in hair growth was observed from this pilot study, to evaluate the efficacy of the novel cold X5 hairlaser device for treating male androgenic alopecia. From the repeated measures analysis of variance, difference in mean hair counts over time was statistically significant (F = 7.70; p-value < 0.0001). Subsequent, linear regression of mean hair counts at each time point was performed, and post-hoc analysis found an increasing trend of hair growth over time that was statistically significant (p-value < 0.0001) with the estimated slope of 1.406. Increased hair counts from the baseline to the end of the 26-week period were found to be strongly significant (p-value = 0.0003). Albeit, sham device failure and resultant missing data from the control group, the positive trend hair growth, was observed due to the chronic use of X5hairlaser device. This positive benefit while in full agreement with other low laser hair devices requires intensive further investigation. NCT02067260.

Ablative fractional lasers (CO(2) and Er:YAG): a randomized controlled double-blind split-face trial of the treatment of peri-orbital rhytides.

PubMed

Karsai, Syrus; Czarnecka, Agnieszka; Jünger, Michael; Raulin, Christian

2010-02-01

Ablative fractional lasers were introduced for treating facial rhytides in an attempt to achieve results comparable to traditional ablative resurfacing but with fewer side effects. However, there is conflicting evidence on how well this goal has generally been achieved as well as on the comparative value of fractional CO(2) and Er:YAG lasers. The present study compares these modalities in a randomized controlled double-blind split-face study design. Twenty-eight patients were enrolled and completed the entire study. Patients were randomly assigned to receive a single treatment on each side of the peri-orbital region, one with a fractional CO(2) and one with a fractional Er:YAG laser. The evaluation included the profilometric measurement of wrinkle depth, the Fitzpatrick wrinkle score (both before and 3 months after treatment) as well as the assessment of side effects and patient satisfaction (1, 3, 6 days and 3 months after treatment). Both modalities showed a roughly equivalent effect. Wrinkle depth and Fitzpatrick score were reduced by approximately 20% and 10%, respectively, with no appreciable difference between lasers. Side effects and discomfort were slightly more pronounced after Er:YAG treatment in the first few days, but in the later course there were more complaints following CO(2) laser treatment. Patient satisfaction was fair and the majority of patients would have undergone the treatment again without a clear preference for either method. According to the present study, a single ablative fractional treatment session has an appreciable yet limited effect on peri-orbital rhytides. When fractional CO(2) and Er:YAG lasers are used in such a manner that there are comparable post-operative healing periods, comparable cosmetic improvement occurs. Multiple sessions may be required for full effect, which cancels out the proposed advantage of fractional methods, that is, fewer side effects and less down time.

“Cold” X5 Hairlaser™ used to treat male androgenic alopecia and hair growth: an uncontrolled pilot study

PubMed Central

2014-01-01

Background Various trials have been conducted on the management and treatment of androgenic alopecia (AGA) or male pattern hair loss using a variety of laser and light sources. Methods For this feasibility study, the population was composed of males between the ages of 20 and 60 years who have been experiencing active hair loss within the last 12 months and the diagnosis of AGA. They also had a Norwood-Hamilton classification of 3, 3A, 3 V, 4, 4A, or 5 for the hair thinning patterns and skin type I, II, III, or IV on the Fitzpatrick skin type scale. This two-arm randomized, parallel group study design employed stratifying randomization to balance treatment assignment within three investigational centers with at least 2 subjects enrolled in each Fitzpatrick skin type. Results A statistically significant positive trend in hair growth was observed from this pilot study, to evaluate the efficacy of the novel cold X5 hairlaser device for treating male androgenic alopecia. From the repeated measures analysis of variance, difference in mean hair counts over time was statistically significant (F = 7.70; p-value < 0.0001). Subsequent, linear regression of mean hair counts at each time point was performed, and post-hoc analysis found an increasing trend of hair growth over time that was statistically significant (p-value < 0.0001) with the estimated slope of 1.406. Increased hair counts from the baseline to the end of the 26-week period were found to be strongly significant (p-value = 0.0003). Conclusion Albeit, sham device failure and resultant missing data from the control group, the positive trend hair growth, was observed due to the chronic use of X5hairlaser device. This positive benefit while in full agreement with other low laser hair devices requires intensive further investigation. Trial registration NCT02067260 PMID:24559020

Microhabitat parameters and life-history characteristics of fallicambarus gordonz fitzpatrick, a crayfish associated with pitcher-plant bogs in southern Mississippi

Treesearch

Carol E. Johnston; Chester Figiel

1997-01-01

Fallicambarus gordoni, a crayfish found only in pitcher-plant bogs, is restricted to the DeSoto National Forest, Perry County, Mississippi, U.S.A. The species is active from late fall through late spring, and apparentiy estivates during the summer when bogs are dry. Ovigerous females were found in late fall and winter, and small juveniles were collected in February....

American Overstretch and the End of Hegemony

DTIC Science & Technology

2010-06-01

franchise as the dominant concern in a time of relative prosperity. A much larger factor in the start of the conflict was the political opinions...petition, signed by 21,000 British subjects, asking the Queen to intervene on their behalf over the franchise issue. Fitzpatrick was a political...one of the most cited is a lack of entrepreneurship and productivity among British workers.20 Another oft-cited example is Britain‟s adherence to

The Carnegie Supernova Project I. Methods to estimate host-galaxy reddening of stripped-envelope supernovae

NASA Astrophysics Data System (ADS)

Stritzinger, M. D.; Taddia, F.; Burns, C. R.; Phillips, M. M.; Bersten, M.; Contreras, C.; Folatelli, G.; Holmbo, S.; Hsiao, E. Y.; Hoeflich, P.; Leloudas, G.; Morrell, N.; Sollerman, J.; Suntzeff, N. B.

2018-02-01

We aim to improve upon contemporary methods to estimate host-galaxy reddening of stripped-envelope (SE) supernovae (SNe). To this end the Carnegie Supernova Project (CSP-I) SE SN photometry data release, consisting of nearly three dozen objects, is used to identify a minimally reddened sub-sample for each traditionally defined spectroscopic sub-type (i.e., SNe IIb, SNe Ib, SNe Ic). Inspection of the optical and near-infrared (NIR) colors and color evolution of the minimally reddened sub-samples reveals a high degree of homogeneity, particularly between 0 d to +20 d relative to B-band maximum. This motivated the construction of intrinsic color-curve templates, which when compared to the colors of reddened SE SNe, yields an entire suite of optical and NIR color excess measurements. Comparison of optical/optical vs. optical/NIR color excess measurements indicates the majority of the CSP-I SE SNe suffer relatively low amounts of reddening (i.e., E(B-V)host< 0.20 mag) and we find evidence for different RVhost values among different SE SN. Fitting the color excess measurements of the seven most reddened (i.e., E(B-V)host> 0.20 mag) objects with the Fitzpatrick (1999, PASP, 111, 63) reddening law model provides robust estimates of the host visual-extinction AVhost and RVhost. In the case of the SE SNe with relatively low amounts of reddening, a preferred value of RVhost is adopted for each sub-type, resulting in estimates of AVhost through Fitzpatrick (1999) reddening law model fits to the observed color excess measurements. Our analysis suggests SE SNe reside in galaxies characterized by a range of dust properties. We also find evidence that SNe Ic are more likely to occur in regions characterized by larger RVhost values compared to SNe IIb/Ib and they also tend to suffer more extinction. The later finding is consistent with work in the literature suggesting SNe Ic tend to occur in regions of on-going star formation. Based on observations collected at Las Campanas Observatory.

Melasma and assessment of the quality of life in Brazilian women*

PubMed Central

Ikino, Juliana Kida; Nunes, Daniel Holthausen; da Silva, Vanessa Priscilla Martins; Fröde, Tania Silvia; Sens, Mariana Mazzochi

2015-01-01

BACKGROUND Melasma is a chronic, acquired hyperpigmentation disease on sun-exposed areas of the skin, which affects patients' quality of life. OBJECTIVE To assess the impact on the quality of life of women living in Florianópolis, Brazil, through questionnaire (MelasQol), and investigate the clinical aspects and risk factors for melasma, correlating them with the MelasQol scores. METHODS This study was performed on 51 melasma patients cared for at the University Hospital of the Universidade Federal de Santa Catarina. The variables included were: age, gender, age of onset of melasma, Fitzpatrick phototype (I-VI), duration and family history of melasma, onset of melasma during pregnancy, use of hormonal contraceptive, thyroid disorder and distribution of melasma. The MelasQoL questionnaire, validated for Brazilian Portuguese (MelasQoL-BP), was applied. RESULTS The mean age was 38.43±6.75 years. All patients were women. The most common Fitzpatrick skin phototypes were III (49.02%) and IV (33.33%). Melasma had a mean age of onset of 29.18±7.05 years and a mean duration of 9.25±6.18 years. The majority of patients did not have familial history of melasma (50.98%). Melasma onset was associated with pregnancy (45.10%). The MelasQoL-BP analysis revealed significant emotional impact on patients, such as feeling bothered (94.11%), frustrated and embarrassed (64.71%), and depressed (52.94%) about their skin appearance, as well as unattractive (78.43%). No social impact was observed (P>0.05). CONCLUSION Melasma has a strong emotional impact on quality of life, resulting especially from feelings about skin appearance. PMID:25830989

Postinflammatory hyperpigmentation in patients with skin of color.

PubMed

Shokeen, Divya

2016-01-01

Postinflammatory hyperpigmentation (PIH) has posed a substantial challenge for patients with higher Fitzpatrick skin types, specifically types III to VI. Treatment modalities pose a number of limitations due to the number of treatments required, potential side effects, and overall efficacy. Fortunately, multiple therapies have been delineated that can be moderately to highly efficacious in treating PIH in patients with skin of color. This article will review some of these modalities and procedures for this common patient concern.

Installation of the Vaisala 4D Lightning Detection System in Brevard, Osceola, and Orange Counties Northeastern Florida. Environmental Assessment

DTIC Science & Technology

2005-08-01

are not distinguishable by plumage, and males average only slightly larger than females (Woolfenden 1978). The sexes may be differentiated by a...distinct "hiccup" call vocalized only by females (Woolfenden and Fitzpatrick 1986). Scrub-jays less than about five months of age are easily...hierarchy exists with breeding males being the most dominant, followed by helper males, breeding females , and finally, helper females (Woolfenden and

The Safety and Efficacy of Treatment With a 1,927-nm Diode Laser With and Without Topical Hydroquinone for Facial Hyperpigmentation and Melasma in Darker Skin Types.

PubMed

Vanaman Wilson, Monique J; Jones, Isabela T; Bolton, Joanna; Larsen, Lisa; Fabi, Sabrina Guillen

2018-04-13

The nonablative, fractional, 1,927-nm diode laser is theoretically a safe and effective treatment for hyperpigmentation and melasma in darker skin and may potentiate topical cosmeceutical delivery. To evaluate the use of a nonablative, fractional, 1,927-nm diode laser with and without topical 2% hydroquinone (HQ) cream for moderate-to-severe facial hyperpigmentation in Fitzpatrick skin Types III-V. Forty adults underwent 4 laser treatments at 2-week intervals and were randomized to daily application of 2% HQ cream or moisturizer. Follow-ups were conducted 4 and 12 weeks after the final laser treatment. Hydroquinone and moisturizer groups demonstrated Mottled Pigmentation Area and Severity Index improvements of approximately 50% at post-treatment Weeks 4 and 12. Blinded investigator-assessed hyperpigmentation and photodamage improved significantly for both the groups at post-treatment Weeks 4 and 12. Subject satisfaction improved significantly in both the groups by post-treatment Week 4. Although investigator-rated Global Aesthetic Improvement Scale scores were significantly better in the HQ group at post-treatment Week 12, satisfaction was higher among those using moisturizer. No adverse events were noted. The nonablative, fractional, 1,927-nm diode laser produced significant improvement in hyperpigmentation in Fitzpatrick skin Types III-V by 4 weeks, with maintenance of results at 12 weeks after treatment even without HQ.

Hubble Space Telescope observations of Orion Nebula, Helix Nebula, and NGC 6822

NASA Technical Reports Server (NTRS)

Spitzer, Lyman; Fitzpatrick, Ed

1999-01-01

This grant covered the major part of the work of the Principal Investigator and his collaborators as a Guaranteed Time Observer on the Hubble Space Telescope. The work done naturally divided itself into two portions the first being study of nebular objects and the second investigation of the interstellar medium between stars. The latter investigation was pursued through a contract with Princeton University, with Professor Lyman Spitzer as the supervising astronomer, assisted by Dr. Ed Fitzpatrick. Following the abrupt death of Professor Spitzer, his responsibilities were shifted to Dr. Fitzpatrick. When Dr. Fitzpatrick relocated to Villanova University the concluding work on that portion of this grant was concluded under a direct service arrangement. This program has been highly successful and the resulting publications in scientific journals are listed below. To the scientist, this is the bottom line, so that I shall simply try to describe the general nature of what was accomplished. There were three nebular programs conducted, one on the Orion Nebula, the second on the Helix Nebula, and the third on NGC 6822. The largest program was that on the Orion Nebula. This involved both HST observations and supporting groundbased observations obtained with a variety of instruments, including the Coude Feed Telescope at the Kitt Peak National observatory in Arizona, the Cerro Tololo observatory in Chile, and the Keck Observatory on Mauna Kea, Hawaii. Moreover, considerable theoretical modeling was done and all of the data analysis was performed at the Rice University in Houston, except for the PI's period of sabbatical leave (6-96 through 7-97) when he was based at the Max Planck Institute for Astronomy in Heidelberg, Germany. The Orion Nebula program was the most productive part, resulting in numerous papers, but more important in the discovery of a new class of objects, for which we coined the name "proplyds". The proplyds are protoplanetary disks surrounding very young stars still in the process of creation. The Orion Nebula is the residual material from a burst of star formation that occurred about 300,000 years ago. Each of these new stars has a surrounding disk of protoplanetary material. The same physics that renders the Nebula so highly visible means that the proto-planetary disks are also quite visible. With the wisdom of hindsight, we now see that this was to be expected and that we should have been searching specifically for this type of object. The discovery of these objects and their subsequent detailed investigation has lead to an accurate assessment of the frequency of protoplanetary disks in young stars and determination of the likelihood of survival of these disks into an era where planets actually form.

Photoaging Mobile Apps in School-Based Melanoma Prevention: Pilot Study.

PubMed

Brinker, Titus Josef; Brieske, Christian Martin; Schaefer, Christoph Matthias; Buslaff, Fabian; Gatzka, Martina; Petri, Maximilian Philip; Sondermann, Wiebke; Schadendorf, Dirk; Stoffels, Ingo; Klode, Joachim

2017-09-08

Around 90% of melanomas are caused by exposure to ultraviolet (UV) radiation and are therefore eminently preventable. Tanning behavior is mostly initiated in early adolescence, often with the belief that it increases attractiveness; the problems related to malignant melanoma and other skin cancers are too far in the future to fathom. Given the substantial amount of time children and adolescents spend in schools, as well as with their mobile phones, addressing melanoma prevention via both of these ways is crucial. However, no school-based intervention using mobile apps has been evaluated to date. We recently released a photoaging mobile app, in which a selfie is altered to predict future appearance dependent on UV protection behavior and skin type. In this pilot study, we aimed to use mobile phone technology to improve school-based melanoma prevention and measure its preliminary success in different subgroups of students with regard to their UV protection behavior, Fitzpatrick skin type and age. We implemented a free photoaging mobile phone app (Sunface) in 2 German secondary schools via a method called mirroring. We "mirrored" the students' altered 3-dimensional (3D) selfies reacting to touch on mobile phones or tablets via a projector in front of their whole grade. Using an anonymous questionnaire capturing sociodemographic data as well as risk factors for melanoma we then measured their perceptions of the intervention on a 5-point Likert scale among 205 students of both sexes aged 13-19 years (median 15 years). We measured more than 60% agreement in both items that measured motivation to reduce UV exposure and only 12.5% disagreement: 126 (63.0%) agreed or strongly agreed that their 3D selfie motivated them to avoid using a tanning bed, and 124 (61.7%) to increase use of sun protection. However, only 25 (12.5%) disagreed with both items. The perceived effect on motivation was increased in participants with Fitzpatrick skin types 1-2 in both tanning bed avoidance (n=74, 71.8% agreement in skin types 1-2 vs n=50, 53.8% agreement in skin types 3-6) and increased use of sun protection (n=70, 68.0% agreement in skin types 1-2 vs n=52, 55.3% agreement in skin types 3-6), and also positively correlated with higher age. We present a novel way of integrating photoaging in school-based melanoma prevention that affects the students' peer group, considers the predictors of UV exposure in accordance with the theory of planned behavior, and is particularly effective in changing behavioral predictors in fair-skinned adolescents (Fitzpatrick skin types 1-2). Further research is required to evaluate the intervention's prospective effects on adolescents of various cultural backgrounds. ©Titus Josef Brinker, Christian Martin Brieske, Christoph Matthias Schaefer, Fabian Buslaff, Martina Gatzka, Maximilian Philip Petri, Wiebke Sondermann, Dirk Schadendorf, Ingo Stoffels, Joachim Klode. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.09.2017.

Clinical Outcomes and Complications Associated with Fractional Lasers: A Review of 730 Patients.

PubMed

Cohen, Steven R; Goodacre, Ashley; Lim, Soobin; Johnston, Jennifer; Henssler, Cory; Jeffers, Brian; Saad, Ahmad; Leong, Tracy

2017-02-01

Fractional lasers were introduced to provide increased safety, while maintaining high efficacy and patient satisfaction. Patients with virtually all Fitzpatrick skin types could be safely treated using a wide spectrum of wavelengths and a broad array of skin conditions, and aging could be addressed. Although safety studies have been reported for ablative CO 2 and erbium lasers, surprisingly few data are available on adverse events and complications associated with fractional lasers. We report the frequency of adverse events, skin improvement and complications in a broad range of skin types using a standardized protocol that can be safely tailored to the patient's presenting complaints by varying the laser wavelength and number of treatments. The medical records of 730 patients (>90% females, age ranged from 50.5. to 59.9 years.) who had been treated at FACES+ Aesthetic Facility were reviewed. Patients were followed from 1 to 10 months and were reviewed to determine the frequency of complications, as well as their frequency, type, cause, treatment and resolution thereof. Patients were categorized by Fitzpatrick skin type (I-IV) to determine whether skin type was related to the frequency of complications. Improvement in skin condition (wrinkles, nasolabial folds and pigment) was rated by a technician before and after treatment using a Likert scale, 0-5, with 0 being no change and 5 being the most improvement. Seven hundred thirty patients underwent procedures using fractional lasers in our center. Procedures were carried out with 3 different laser wavelengths, depending on the condition(s) treated (wrinkling vs. pigmentation issues, etc.) and the patients' desired length of downtime. The fractional Fraxel 1927-nm laser was used in 224 patients [Fitzpatrick skin type I (2.2%), II (38.4%), III (46.0%), IV (12.5%)]; the fractional Fraxel 1550-nm laser was used in 334 [type I (4.5%), II (31.9%), III (50.0%), IV (13.3%)], and the fractional Fraxel CO 2 laser was used in 172 [type 1 (4.7%), II (49.7%), III (41.5%), IV (4.1%)]. The Fraxel CO 2 laser showed greater improvement in wrinkles and naso-labial fold (p < 0.001). The greatest improvement in pigmentation was seen with the Fraxel 1927-nm laser (p < 0.001). Adverse events and complications occurred in 31 of 730 patients (4.2%). There was no significant difference in the rate of complications among the three treatments (p = 0.26). Complications were generally minor, and all resolved completely with treatment. Complications occurred in 4.0% of patients having the fractional Fraxel 1927-nm laser, 3.3% of patients having the fractional Fraxel 1550 nm and 6.4% of patients having the fractional Fraxel CO 2 laser. Complications included 5 herpes simplex virus breakouts, 13 acne eruptions, 1 abrasion, 1 bacterial infection, 9 dermatitis, 1 drug eruption, 4 prolonged erythema, 1 hyperpigmentation, 1 increased swelling and 1 telangiectasia. There was no significant relationship between Fitzpatrick skin type and incidence of complications (p = 0.37). Fractional lasers in general have reduced complication rates, while maintaining high degrees of patient satisfaction. Since their inception in early 2004, our clinic has utilized fractional lasers to treat patients from a variety of ethnic backgrounds and diverse skin types with an overall complication rate of 4.2%, all of which resolved. Comprehensive care of patients with facial aging is not limited to surgery alone and should include these types of strategies to appropriately and safely address photo-damage and photo-aging. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Progress towards a universal family of UV-IR extinction laws

NASA Astrophysics Data System (ADS)

Maíz Apellániz, J.; Trigueros Páez, E.; Bostroem, A. K.; Barbá, R. H.; Evans, C. J.

2017-03-01

We present our progress on the study of extinction laws along three diferent lines. [a] We compare how well different families of extinction laws fit existing photometric data for Galactic sightlines and we find that the Maíz Apellániz et al. (2014) family provides better results than those of Cardelli et al. (1989) or Fitzpatrick (1999). [b] We describe the HST/STIS spectrophotometry in the 1700-10 200 Å range that we are obtaining for several tens of sightlines in 30 Doradus with the purpose of deriving an improved wavelength-detailed family of extinction laws. [c] We present the study we are conducting on the behavior of the extinction law in the infrared by combining 2MASS and WISE photometry with Spitzer and ISO spectrophotometry.

Chemistries for Protection and Decontamination

DTIC Science & Technology

2008-03-01

t i o n Measurement of Oxygen Uptake, Supported Catalyst and CEES in Solvent-Free System TDA R e s e a r c h Tests with HD • At CUBRC (Buffalo...dual gas burettes for HD tests at CUBRC . The dual burette on the left was connected to a flask with the catalyst and HD (and to an empty flask as a...Hill, Zhen Luo, Daniel Hillesheim • ECBC: Larry Procell • CUBRC : Meg Stapleton, Rich Fitzpatrick • Battelle: John Ontiveros, Walter Miller • ARO

Survey of Army Weapons Training and Weapons Training Devices.

DTIC Science & Technology

1976-04-01

er li-68 (MANICON), May 1968. AD 671 128. Nichols, Thomas C. and Theodore R. Powers. oonlig)ht and Ni t Vi1- bilitv. Research Memorandum, HumRRO...Rpsources Laboratories, Brooks AFB, Texas, 1972. GENERAL Training th.vics (Cont’d) Fitzpatrick, Robert. Toiward a Theory of Simulation. System Develop- ment...Evaluation of the Tank, Combat, Full Tracked: 105mm Gun, M60. HumPRO Consulting Report, February 1961 (FIREPOWER VIII). AD 487 893. ’ hHunt , William T

Dermatoscopy of blue vitiligo.

PubMed

Chandrashekar, L

2009-07-01

Blue vitiligo is a distinct variant of vitiligo characterized by a blue-grey appearance of the skin, which corresponds histologically with absence of epidermal melanocytes and presence of numerous dermal melanophages. A 23-year-old woman of Indian origin with Fitzpatrick skin type V presented with a 1-month history of normoaesthetic depigmented macules over the right forearm, dorsa of the hands and right areola. The macule over the right forearm had a bluish tinge. A clinical diagnosis of vitiligo vulgaris with blue vitiligo was made. Dermatoscopy of the interface between the blue macule and the hypopigmented macule revealed a linear depigmented macule in the centre with multiple blue dots and absence of epidermal melanin on the side of the blue macule, and reticular pigmentation with a few depigmented macules and scattered blue dots over the side of the hypopigmented macule. Blue vitiligo was described previously in a patient seropositive for human immunodeficiency virus, and believed to represent postinflammatory hyperpigmentation in areas bordering the vitiliginous patches as a result of psoralen ultraviolet A treatment. This case is unusual because of its rarity and the description of the associated dermatoscopical findings.

A clinical, dermoscopic, and histopathological study of Dermatosis Papulosa Nigra (DPN) - An Indian perspective.

PubMed

Bhat, Ramesh M; Patrao, Ninon; Monteiro, Rochelle; Sukumar, D

2017-09-01

Dermatosis papulosa nigra (DPN) is a benign cutaneous condition which commonly occurs in dark-skinned people, especially Asians and African Americans. Owing to its benign nature and rarity, very few studies have been conducted to date, and dermoscopic studies are practically nonexistent. To study the clinical and epidemiological characteristics of patients with dermatosis papulosa nigra (DPN) and to correlate the clinical findings with dermoscopic and histopathological findings in DPN. A total of 100 patients attending the Dermatology outpatient department at Father Muller Medical College, Mangalore, India, with clinically diagnosed dermatosis papulosa nigra were included in the study. Histopathology and dermoscopic evaluation of the lesions were done, and the characteristics seen were noted. Earlier onset of lesions was noted in our study, i.e. onset in the 4th decade as compared to the 6th decade in most other studies. A female preponderance, positive family history, history of sun exposure, and involvement of the head and neck were other significant associations. Histopathology revealed an acanthotic variant in all the lesions that were biopsied. The predominant dermoscopic finding was fissures and ridges of the cerebriform pattern followed by comedo-like openings. Dermatosis papulosa nigra is a benign unaesthetic condition seen in Fitzpatrick skin types IV-VI. The diagnosis is mainly clinical; however, in a few cases histopathology and dermoscopy aid in differentiating it from other benign and malignant tumors. Dermoscopy, in particular, being a noninvasive investigative moiety is a rapid and accurate diagnostic tool. © 2017 The International Society of Dermatology.

Prospective Evaluation of the Safety and Efficacy of a 1060-nm Large Spot Size, Vacuum-Assisted Hair Removal Diode Laser System in Asian/Pacific Fitzpatrick's Skin Types IV-V Patients.

PubMed

Tahiliani, Sushil T; Tahiliani, Harsh S

2016-11-01

Laser-based photoepilation of dark skin types demands a delicate combination of appropriate light wavelengths and spot size to achieve optimal epidermal-to-follicular energy absorption ratios. This prospective study assessed the axillary, arm, thigh, and back hair clearing ef cacy of the LightSheer In nity 1060 nm diode laser in 10 Fitzpatrick skin type IV-V patients. Each area was treated up to ve times, at 4-6-week intervals, after which immediate skin responses and adverse events were recorded. Hair count, color and coarseness were assessed before each treatment session, as well as 1, 3, and 6 months following the last session. Both patients and the treating physician rated the degree of improvement with time, and patients also ranked their satisfaction with the treatment outcome. Percent hair reduction from baseline gradually increased with treatment and peaked at 74.6%, 68.4%, and 65.7% for axillary, arm and thigh regions, respectively, 6 months following the last treatment session. Baseline hair growth patterns precluded effective selection of a representative area for hair counting. Patients satisfaction was consistently higher for axillary hair clearance rates, followed by thigh and arm responses. Throughout the follow-up period, the investigator rated 50-67% of the treated axillae as presenting "good" or "very good" hair clearance, and provided similar ratings for 67% of the treated thigh regions at both the 1 and 6 month follow-up sessions. Immediate responses to treatment were mild to moderate and short-lived and no incidents of brosis or scarring were reported. Taken together, the LightSheer In nity 1060 HS Handpiece provided for an ideal ef cacy-safety balance in treating dark-skinned patients, providing for long-term hair clearance with minimal downtime. J Drugs Dermatol. 2016;15(11):1427-1434.

Assessment of the effects of skin microneedling as adjuvant therapy for facial melasma: a pilot study.

PubMed

Lima, Emerson V A; Lima, Mariana Modesto D A; Paixão, Mauricio Pedreira; Miot, Hélio Amante

2017-11-28

Melasma is a common chronic and relapsing acquired dyschromia. Skin microneedling was reported resulting sustained long-term improvement of recalcitrant melasma, however, the exact mechanism that promotes this skin lightening is not known. This study aimed to investigate clinical and histologic alterations promoted by skin microneedling in facial melasma. Open pilot trial including six women with facial refractory melasma submitted to two sessions of microneedling (1.5 mm) each 30 days followed by daily triple combination and broad-spectrum sunscreen. Comparison of pretreatment (T0) and 15 days after last microneedling procedure (T45) was made by standardized pictures, skin colorimetry, MASI, MELASQoL and histological parameters (haematoxylin-eosin, picrosirius-red, periodic acid Schiff and Fontana-Masson staining). The age of the subjects varied from 34 to 46 years-old, the phototypes were III and IV (Fitzpatrick), and age of melasma onset was 20 to 38 years. Improvement of melasma was perceived in all subjects. There was a significant reduction of MASI score (-70%), MELASQoL (-55%) and increase in L* (+13%) colorimetric value (p < 0.03). All cases evidenced epithelium thickening, decrease in melanin pigmentation and densification of upper dermis collagen (p = 0.03). Patients were followed by 6 months under broad-spectrum sunscreen and triple combination without relapse. In addition to classic treatment (broad-spectrum sunscreen and triple combination), skin microneedling promoted clinical and histological improvement of refractory facial melasma.

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The New York Power Authority (NYPA) and Entergy Corp. of New Orleans, La., announced recently the signing of a memorandum of understanding as a step toward a contract for Entergy to provide management services to NYPA`s two nuclear power plants. The agreement is the first of its kind. NYPA is the nation`s largest state-owned electric utility and supplier of one-quarter of New York`s electricity. Its nuclear plants are Indian Point 3 (IP3) in Buchanan, Westchester County, and James A. FitzPatrick in Scriba, Oswego County. Entergy is a utility holding company and its subsidiary, Entergy Operations Inc., is widely recognized asmore » one of the leading nuclear operators in the United States. {open_quotes}NYPA`s nuclear plants are assets that belong to the people of New York,{close_quotes} said C.D. {open_quotes}Rapp{close_quotes} Rappleyea, NYPA`s chairman and CEO. {open_quotes}Our alliance with Entergy can provide the people of this state with added assurance that these plants will operate with the highest level of safety and efficiency.{close_quotes} FitzPatrick, an 800 MW boiling water reactor, has operated since 1975 and IP3, a 980 MW pressurized water reactor, since 1976. Although both are currently running well, they have had problems in recent years, and IP3 is on the US Nuclear Regulatory Commission`s (NRC) list of plants requiring increased regulatory attention. Entergy operated both types of reactors, has three single-unit sites like NYPA`s and is experienced in operating plants for different utility owners.« less

Plasma skin resurfacing: personal experience and long-term results.

PubMed

Bentkover, Stuart H

2012-05-01

This article presents a comprehensive clinical approach to plasma resurfacing for skin regeneration. Plasma technology, preoperative protocols, resurfacing technique, postoperative care, clinical outcomes, evidence-based results, and appropriate candidates for this procedure are discussed. Specific penetration depth and specific laser energy measurements are provided. Nitrogen plasma skin regeneration is a skin-resurfacing technique that offers excellent improvement of mild to moderate skin wrinkles and overall skin rejuvenation. It also provides excellent improvement in uniformity of skin color and texture in patients with hyperpigmentation with Fitzpatrick skin types 1 through 4. Copyright © 2012 Elsevier Inc. All rights reserved.

Treatment of melasma with low fluence, large spot size, 1064-nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the treatment of melasma in Fitzpatrick skin types II-IV.

PubMed

Brown, Alia S; Hussain, Mussarat; Goldberg, David J

2011-12-01

Melasma is a common condition affecting over six million American women. Treatment of dermal or combined melasma is difficult and does not respond well to conventional topical therapies. Various light sources have been used recently in the treatment of melasma including fractionated ablative and non-ablative lasers as well as intense pulse light. We report the use of low fluence, large spot size Q-switched, Nd:Yag laser for the treatment of melasma in skin types II-IV.

Skin phototyping in a Chinese female population: analysis of four hundred and four cases from four major cities of China.

PubMed

Liu, W; Lai, W; Wang, X M; Li, L; Tian, Y; Lu, Y; Wu, Y Y; Li, Y; Zhang, P; Wu, Y; Chen, L

2006-08-01

The sun-reactive skin types in 404 Chinese females living in different cities were investigated in this study. A questionnaire was designed according to the original concept of skin types proposed by Fitzpatrick and the investigation was conducted in two ways: self-administered reporting and then a personal interview. Minimal erythema dose (MED) and minimal persistent pigmentation dose (MPPD) were also measured in part of the volunteers with a standard solar simulator. The results show that in the way of personal interview, the predominant skin type of the investigated group is type III (71.4%), and then type II (14.7%) and type IV (14.2%), while in the self-reporting manner, the result is as follows: type III, 74.3%, type II, 25.6% and type IV, 1%. There are no skin type I, V or VI in the studied group. MED and MPPD from the same population show some relevance to the skin types, e.g. with the change of skin type from Type II to IV, the mean value of MED increases gradually and the MPPD decreases slightly. From the study we concluded that the skin types of the investigated Chinese females are principally type III (more than 70%), and then type II and type IV. The different ways of answering the questionnaire did not affect the results remarkably. The measurements of photobiology parameters confirmed that there is a certain correlation between skin types and MED or MPPD determined in this group of volunteers.

Skin bleaching: highlighting the misuse of cutaneous depigmenting agents.

PubMed

Dadzie, O E; Petit, A

2009-07-01

Hydroquinone and other cutaneous depigmenting agents are widely used by dermatologists to treat pigmentary disorders. On 29 August 2006, the US Food and Drug Administration (FDA) published a monograph in the US Federal Register proposing to ban all hydroquinone products that have not been approved via a New Drug Application process. Reports in the scientific literature on the occurrence of exogenous ochronosis, in relation to the use of hydroquinone, was one of the concerns expressed by the FDA in relation to this agent. However, a review of the English-language scientific literature reveals that most of the reported cases of hydroquinone-induced exogenous ochronosis occurs in Africa, where the cultural practice of skin bleaching is highly prevalent. Skin bleaching is the practice of applying hydroquinone and/or other depigmenting agents to specific or widespread areas of the body, the primary function being to lighten normally dark skin. This practice typically occurs in men and women with Fitzpatrick skin phototypes IV to VI. It is a dangerous practice associated with a diverse range of side-effects, including mercury poisoning. Thus, this current discussion within the dermatological community on the safety of hydroquinone provides a unique opportunity to raise awareness about skin bleaching.

FitzPatrick Lecture: King George III and the porphyria myth - causes, consequences and re-evaluation of his mental illness with computer diagnostics.

PubMed

Peters, Timothy

2015-04-01

Recent studies have shown that the claim that King George III suffered from acute porphyria is seriously at fault. This article explores some of the causes of this misdiagnosis and the consequences of the misleading claims, also reporting on the nature of the king's recurrent mental illness according to computer diagnostics. In addition, techniques of cognitive archaeology are used to investigate the nature of the king's final decade of mental illness, which resulted in the appointment of the Prince of Wales as Prince Regent. The results of this analysis confirm that the king suffered from bipolar disorder type I, with a final decade of dementia, due, in part, to the neurotoxicity of his recurrent episodes of acute mania. © 2015 Royal College of Physicians.

Enhanced high-energy protocol using a fractional bipolar radiofrequency device combined with bipolar radiofrequency and infrared light for improving facial skin appearance and wrinkles.

PubMed

Gold, Michael H; Biesman, Brian S; Taylor, Mark

2017-06-01

Fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light have been shown in previous trials to safely and effectively improve the appearance of facial wrinkles. To evaluate a high-energy protocol with combined bipolar radiofrequency and infrared light energies for improvement in photoaged facial skin. Seventy-two patients presenting with mild to moderate facial wrinkles underwent a single full-face treatment (n=54) or two treatments (n=18) at 6-week intervals. Independent blinded assessment and investigator assessment were performed, using the Fitzpatrick Wrinkle and Elastosis Scale (0-9) and the Global Aesthetic Improvement scale. Patients also completed a self-assessment questionnaire concerning satisfaction with the treatment. All patients achieved some degree of improvement in their wrinkles and skin appearance, following a single treatment or two treatments with the enhanced-energy protocol. Blinded evaluation demonstrated 71% and 70% of the patients showing improvement of one unit or greater on the Fitzpatrick Scale, at the 12-week and 24-week follow-ups post-treatment, respectively. Similar results were reported by investigators. Under the Global Aesthetic Improvement Scale, investigators observed 87%, 91% and 81% of patients showing improvement at the 6-, 12-, and 24-week post-treatment end, respectively. Patients tolerated the treatments well and were satisfied with the clinical results. The enhanced-energy treatment protocol, with fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light applications, yields significant improvement of skin texture, wrinkling, and overall appearance following a single treatment. The results appear gradually over time and are maintained for at least 6 months' post-treatment. © 2017 Wiley Periodicals, Inc.

Accelerated tattoo removal with acoustic shock wave therapy in conjunction with a picosecond laser.

PubMed

Vangipuram, Ramya; Hamill, Selina S; Friedman, Paul M

2018-06-25

Conventional tattoo removal consists of single-pass treatments, spaced 7-8 weeks apart, for a total of 7-10 sessions. A major limiting factor of this procedure is the development of cavitation bubbles and vacuoles within the epidermis and dermis that result from the rapid heating of tattoo particles by the laser. While multiple-pass methods using the R20 protocol or the PFD patch enhance tattoo removal through epidermal clearance, they have no effect on deep-intradermal pigment associated vacuoles that arise from treatment with lasers such as the Q-switched laser. A 28-year-old female with Fitzpatrick skin Type V presented for treatment of a 6-year-old professional black tattoo on the left ventral wrist. She underwent three treatment sessions at 6-8 week intervals using a commercial 1,064-nm picosecond Nd:YAG laser (PicoWay; Candela, Wayland, MA) and a perfluorodecalin (PFD) patch (Merz; Raleigh, NC). At each treatment session, she received two passes with 1,064-nm, 4-mm spot size, a fluence ranging from 2.8 to 3.2 J/cm 2 and a laser repetition rate of 2 Hz. Between laser passes and following the final laser pass, the medial portion of the tattoo was treated with acoustic shock wave therapy (ASWT) using the Zwave device (Zimmer Medizin Systems; Irvine, CA) with 90 mJ, 22 Hz, and 1,200 pulses. After three treatment sessions, there was 80% clearance of the medial portion of the tattoo that received the ASWT compared with 60% clearance of the lateral portion of the tattoo that was treated with the picosecond 1,064-nm Nd:YAG laser and PFD patch alone. In the days following each treatment session, the patient noted consistently less edema, erythema and epidermal crusting on the portion of the tattoo that received the ASWT. We report a case of 80% tattoo clearance with ASWT in a patient with Fitzpatrick type V skin compared with 60% clearance with the picosecond 1064-nm Nd:YAG laser and PFD patch alone. The concurrent use of the PFD patch, which facilitated multi-pass treatments, may have also increased tattoo fading in this patient. ASWT may enhance tattoo clearance by increasing lymphatic drainage and increasing metabolic activity in the treated area, thereby accelerating the clearance of dermal pigment vacuoles produced by the picosecond laser and minimizing epidermal side effects such as erythema, edema, and crusting. Lasers Surg. Med. 9999:1-3, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

Tanning bed exposure increases the risk of malignant melanoma.

PubMed

Ting, William; Schultz, Kara; Cac, Natalie N; Peterson, Michael; Walling, Hobart W

2007-12-01

Epidemiologic studies have associated tanning bed exposure and cutaneous melanoma. The relationship between the extent of tanning bed exposure and the risk of melanoma has not been elucidated in detail. Surveys assessing the extent of tanning bed exposure and the history of skin cancer, including malignant melanoma, were collected from academic dermatology clinic patients (n = 1518). Of these, 551 (36.3%) completed all components of the survey. The available medical records, including pathology reports (n = 501; 33%), were reviewed to confirm cases of skin cancer. Data on potential confounding factors, including indoor vs. outdoor occupation and leisure activities, Fitzpatrick skin type, history of blistering sunburn, use of sunscreen and sun protective clothing, history of phototherapy, and level of education, were assessed and compared. Of the patients surveyed, 487 (32.1%) reported tanning bed exposure. Women aged 45 years or younger accounted for about 60% of all tanning bed users. Seventy-nine cases of malignant melanoma were reported, 22 in women aged 45 years or younger. In the entire cohort, the "ever-use" of tanning beds was found to be a significant risk factor for the development of melanoma [P < 0.05; odds ratio (OR), 1.64; 95% confidence interval (95% CI), 1.01-2.67]. The risk was greater in women aged 45 years or younger (P < 0.05; OR, 3.22; 95% CI, 1.01-11.46). Patients with a history of melanoma were significantly more likely to report tanning bed sessions exceeding 20 min (P < 0.01; OR, 3.18; 95% CI, 1.48-6.82); this association was even stronger for women aged 45 years or younger (OR, 4.12; 95% CI, 1.41-12.02). The study was subject to recall bias, included only patients at a midwestern academic practice, and had a relatively low response rate. Exposure to tanning beds increases the risk of malignant melanoma, especially in women aged 45 years or younger. These findings reinforce the hazards of tanning bed exposure.

Non-contact measurement of oxygen saturation with an RGB camera

PubMed Central

Guazzi, Alessandro R.; Villarroel, Mauricio; Jorge, João; Daly, Jonathan; Frise, Matthew C.; Robbins, Peter A.; Tarassenko, Lionel

2015-01-01

A novel method (Sophia) is presented to track oxygen saturation changes in a controlled environment using an RGB camera placed approximately 1.5 m away from the subject. The method is evaluated on five healthy volunteers (Fitzpatrick skin phenotypes II, III, and IV) whose oxygen saturations were varied between 80% and 100% in a purpose-built chamber over 40 minutes each. The method carefully selects regions of interest (ROI) in the camera image by calculating signal-to-noise ratios for each ROI. This allows it to track changes in oxygen saturation accurately with respect to a conventional pulse oximeter (median coefficient of determination, 0.85). PMID:26417504

A Systems Evaluation of the Environmental Impact of the Aubrey Reservoir Project on Elm Fork of the Trinity River in North Texas.

DTIC Science & Technology

1972-06-01

JUN 72 L C FITZPATRICK , R L ABSHI RE. L G KNOX D AC W 3-72-C-X052 4 mhhho hhEEE I lffllffllfNOlf NElf mohEEEEEshhhEE EhmhhEEEmhEEEE mhEmhEEEEEmhhI...C-0052, on 30 June 1972. I f’v IabnC Wer’Ye td so; itsj 81 3 3 063 - I _rj_,CLASSIFICATION OF THIS PAGE (When Dole Kntored) REPORT DOCUMENTATION PAGE...Engineers June 1972 Engineering Division, Plng Br, SWFED-P I . NUMBER OFPAGES P. 0. Box 17300, Fort Worth, Texas 76102 339 14. MONITORING AGENCY NAME

Testing Two Alternative Pathological Personality Measures in the Assessment of Psychopathy: An Examination of the Snap and DAPP-BQ.

PubMed

Pryor, Lauren R; Miller, Joshua D; Gaughan, Eric T

2009-02-01

The current study examined the interrelations between two measures of pathological personality, the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993) and the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ; Livesley, 1990), and their respective relations with psychopathy. Two hundred and twenty-nine undergraduate students completed the SNAP, DAPP-BQ, and two self-report psychopathy inventories, the Levenson Self-Report Psychopathy Scale (LSRP; Levenson, Kiehl, & Fitzpatrick, 1995) and the Psychopathic Personality Inventory-Revised (PPI-R; Lilienfeld & Widows, 2005). Results revealed good convergence between conceptually related SNAP and DAPP-BQ subscales. Both the SNAP and DAPP-BQ accounted for a substantial amount of variance in psychopathy scores although the DAPP-BQ accounted for a larger percentage of the variance and demonstrated greater incremental validity. Results suggest that both measures can be successfully used to assess traits associated with psychopathy.

Hysteresis in the tearing mode locking/unlocking due to resonant magnetic perturbations in EXTRAP T2R

NASA Astrophysics Data System (ADS)

Fridström, R.; Frassinetti, L.; Brunsell, P. R.

2015-10-01

The physical mechanisms behind the hysteresis in the tearing mode locking and unlocking to a resonant magnetic perturbation (RMP) are experimentally studied in EXTRAP T2R reversed-field pinch. The experiments show that the electromagnetic and the viscous torque increase with increasing perturbation amplitude until the mode locks to the wall. At the wall-locking, the plasma velocity reduction profile is peaked at the radius where the RMP is resonant. Thereafter, the viscous torque drops due to the relaxation of the velocity in the central plasma. This is the main reason for the hysteresis in the RMP locking and unlocking amplitude. The increased amplitude of the locked tearing mode produces further deepening of the hysteresis. Both experimental results are in qualitative agreement with the model in Fitzpatrick et al (2001 Phys. Plasmas 8 4489)

Trajectories of Marital Conflict Across the Life Course: Predictors and Interactions With Marital Happiness Trajectories

PubMed Central

Kamp Dush, Claire M.; Taylor, Miles G.

2011-01-01

Using typologies outlined by Gottman and Fitzpatrick as well as institutional and companionate models of marriage, the authors conducted a latent class analysis of marital conflict trajectories using 20 years of data from the Marital Instability Over the Life Course study. Respondents were in one of three groups: high, medium (around the mean), or low conflict. Several factors predicted conflict trajectory group membership; respondents who believed in lifelong marriage and shared decisions equally with their spouse were more likely to report low and less likely to report high conflict. The conflict trajectories were intersected with marital happiness trajectories to examine predictors of high and low quality marriages. A stronger belief in lifelong marriage, shared decision making, and husbands sharing a greater proportion of housework were associated with an increased likelihood of membership in a high happiness, low conflict marriage, and a decreased likelihood of a low marital happiness group. PMID:22328798

Lack of correlation between minimal erythema dose and skin phototype in a Colombian scholar population.

PubMed

Sanclemente, Gloria; Zapata, José-F; García, José-J; Gaviria, Angela; Gómez, Luis-F; Barrera, Marcela

2008-11-01

Sun exposure and skin phototype are the most relevant risk factors for skin cancer. Colombia has high levels of ultraviolet radiation during the whole year, therefore, both, high UVI's and outdoor worker's daily activities, in our country are very important risk factors for the development of cutaneous cancer. To date no study has evaluated the usefulness of Fitzpatrick's skin phototype classification in Colombians and its correlation with the minimal erythema dose (MED) and constitutional skin color. Such information is gaining importance in other nations due to the fact that several country's population is becoming more ethnically diverse. To determine the skin phototype, accumulated sun exposure, sun protection behavior, MED and phenotype in a Colombian school population. Last year high school students from the western Antioquia were invited to participate by phone and letter through their respective school directors. A self-questionnaire was handled to each student. A representative sample of the universe was selected for a medical examination by a dermatologist in order to validate the results of the self-questionnaire. The constitutional skin color was determined with the chromameter CR 300 Minolta. The MED was defined as the minimal dose of UVB being able to induce erythema 24 h later. Eight schools of the area agreed to participate in the study, and a total of 911 students (58% girls and 42% boys) filled-out the self-questionnaire. Sun exposure in the majority of individuals was in a level between moderate and very high. Ninety percent of students do not use any sun protection device or cream. Only a 50% of concordance between self-assessed skin phototype vs. medical skin phototype was found, and the highest concordance corresponded to skin phototype II (82%). There was a marked difference in skin photosensitivity of Colombians compared with reports in Caucasians. We observed a marked overlapping in MED's and L* values in phototypes II and III. The Fitzpatrick's classification was not useful in Hispanic populations such as ours. Therefore, a new skin-phototype classification system is required. In our population the constitutional color was a good predictor of the MED but it did not correlate with skin phototype. The self-assessed questionnaire method was not useful to determine skin cancer risk in our population. The majority of this population has light skin phototypes and is highly exposed to solar UV radiation without proper protection.

Generation Y Perspectives

NASA Technical Reports Server (NTRS)

Fitzpatrick, Garret; Painting, Kristen; Barrera, Aaron; Skytland, Nick

2008-01-01

Are you familiar with the famed Generation Y, or "Gen Yers?" Generation Y is projected to be 47 percent of the workforce by 2014. They were born roughly between 1977 and 2000, but that is definitely not their only defining factor. But who is this group, and what do they have to do with the future of the space program and the Johnson Space Center (JSC)? During 2007, a group of Gen Yers at JSC participated on a committee to address the NASA Headquarters strategic communications plan. Fitzpatrick, along with his co-authors, created a presentation to share the Gen Yers' perspective on their generation in conjunction with the strategic communications strategy released. This knowledge capture (KC) event is that presentation.

Screening Effect of Plasma Flow on RMP Penetration in EXTRAP T2R

NASA Astrophysics Data System (ADS)

Frassinetti, Lorenzo; Olofsson, Erik; Brunsell, Per; Menmuir, Sheena; Drake, James

2011-10-01

The penetration of resonant magnetic perturbations (RMP) can be screened by plasma flow and the understanding of this phenomenon is important for ELM mitigation techniques. This work studies the screening effect in EXTRAP T2R. EXTRAP T2R is equipped with a feedback system able to suppress all error fields and to produce one or more external perturbations in a controlled fashion. The EXTRAP T2R feedback system is used to generate a RMP that interacts with the dynamics of its corresponding tearing mode (TM). The level of RMP penetration is quantified by analyzing the RMP effect on the TM amplitude and velocity. To study the screening effect, the flow is changed by applying a second perturbation that is non resonant (non-RMP). This produces the flow reduction without perturbing significantly the other parameters. By modifying the amplitude of the non-RMP, an experimental study of the flow effect on the RMP penetration is performed. Experimental results are compared with the model described in [Fitzpatrick R et al., Phys. Plasmas 8, 4489 (2001)].

Nonablative 1927 nm fractional resurfacing for the treatment of facial photopigmentation.

PubMed

Brauer, Jeremy A; McDaniel, David H; Bloom, Bradley S; Reddy, Kavitha K; Bernstein, Leonard J; Geronemus, Roy G

2014-11-01

Long-term exposure to sunlight, including ultraviolet A and B, produces signs associated with photoaging and photodamage, including laxity and discoloration of the skin. Initial laser treatment for dyspigmentation included the use of ablative lasers, followed by Q-switched lasers and more recently fractional lasers. We investigated the safety and efficacy of a fractionated 1927nm non-ablative thulium laser for the treatment of photo-induced pigmentation. Prospective multi-center study of subjects with clinically identifiable photopigmentation. The study protocol was approved by BioMed Institutional Review Board (San Diego, CA). Subjects received two treatments with a non-ablative 1927nm fractionated thulium laser (Fraxel Dual 1550/1927 Laser System, Solta, Hayward CA), energy level of 10mJ, coverage of 40% and 4-6 passes. Subject pain, erythema and edema were recorded immediately after treatment. Two dimensional photography was obtained before each treatment and at one and three month follow up visits. Independent blinded physician assessment was performed evaluating overall improvement in appearance as well as pigment specific improvement. Forty men and women, ages 30 to 80 years, Fitzpatrick skin types I-IV, with photo-induced facial pigmentation were enrolled and treated, and 39 completed the three month follow up visit. Mean pain sensation for subjects during laser treatments was reported to be 4.3 on a 10-point scale. Mean scores for erythema, edema, and skin roughness throughout all treatments indicated moderate erythema, mild edema and mild skin roughness. Assessment of overall improvement was graded as moderate to very significant in 82% of subjects at one month and in 69% of subjects at three months after the second treatment. Assessment of lentigines and ephelides demonstrated moderate to very significant improvement in approximately 68% of subjects at the one month and in 51% of subjects at three months after the second treatment. Independent blinded physician assessment of randomized photography also demonstrated a durable response at three month follow up visit. Treatment was well tolerated and no serious adverse events related to treatment were observed or reported. Study limitations included a limited number of male subjects, lack of Fitzpatrick skin types V and VI, and decrease in improvement at 3 months post-treatment. Two treatments with a 1927nm non-ablative fractionated thulium laser produced moderate to marked improvement in overall appearance and pigmentation with high patient satisfaction. The response to treatment was maintained at one and three months follow up.

In vivo animal histology and clinical evaluation of multisource fractional radiofrequency skin resurfacing (FSR) applicator.

PubMed

Sadick, Neil S; Sato, Masaki; Palmisano, Diana; Frank, Ido; Cohen, Hila; Harth, Yoram

2011-10-01

Acne scars are one of the most difficult disorders to treat in dermatology. The optimal treatment system will provide minimal downtime resurfacing for the epidermis and non-ablative deep volumetric heating for collagen remodeling in the dermis. A novel therapy system (EndyMed Ltd., Cesarea, Israel) uses phase-controlled multi-source radiofrequency (RF) to provide simultaneous one pulse microfractional resurfacing with simultaneous volumetric skin tightening. The study included 26 subjects (Fitzpatrick's skin type 2-5) with moderate to severe wrinkles and 4 subjects with depressed acne scars. Treatment was repeated each month up to a total of three treatment sessions. Patients' photographs were graded according to accepted scales by two uninvolved blinded evaluators. Significant reduction in the depth of wrinkles and acne scars was noted 4 weeks after therapy with further improvement at the 3-month follow-up. Our data show the histological impact and clinical beneficial effects of simultaneous RF fractional microablation and volumetric deep dermal heating for the treatment of wrinkles and acne scars.

Problems and complications of full-face carbon dioxide laser resurfacing for pathological lesions of the skin.

PubMed

Read-Fuller, Andrew M; Yates, David M; Vu, David D; Hoopman, John E; Finn, Richard A

2017-01-01

Facial resurfacing with a CO 2 laser has been used for treatment of pathologic lesions and for cosmetic purposes. Postoperative complications and problems after laser resurfacing include infections, acneiform lesions, and pigment changes. This retrospective study describes the most common problems and complications in 105 patients and assesses postoperative pain in 38 patients. All patients received CO 2 laser resurfacing for treatment of malignant/premalignant lesions and had postoperative follow-up to assess problems and complications. Some had follow-up to assess postoperative pain. All patients had Fitzpatrick I-III skin types and underwent the same perioperative care regimen. There were 11 problems and 2 complications. Problems included infection, acneiform lesion/milia, and uncontrolled postoperative pain. Complications included hyperpigmentation. Among the postoperative pain group, 53% reported no pain and the rest had mild or moderate pain. Complications are rare. Infection and acneiform lesions/milia were the most common problems, as previously reported. Most patients do not experience postoperative pain. Copyright © 2016 Elsevier Inc. All rights reserved.

Novel Approach to Treating Androgenetic Alopecia in Females With Photobiomodulation (Low-Level Laser Therapy).

PubMed

Friedman, Shelly; Schnoor, Patricia

2017-06-01

Photobiomodulation, also referred to as low-level laser therapy (LLLT), has been studied and used for (among other diseases) the promotion of hair regrowth. A clinical study was developed to define the physiologic effects that occur when the human hair follicle and surrounding tissue structures are exposed to laser light using a novel device that is fitted with an array of laser diode sources operating at 650 nm and placed inside a sports cap to promote discretion while in use. The study demonstrates that low-level laser treatment of the scalp every other day for 17 weeks using the HANDI-DOME LASER device is a safe and effective treatment for androgenetic alopecia in healthy females between the ages of 18 to 60 with Fitzpatrick skin Types I to IV and Ludwig-Savin Baldness Scale I-2 to II-2 baldness patterns. Subjects receiving LLLT at 650 nm achieved a 51% increase in hair counts as compared with sham-treated control patients in this multicenter randomized controlled trial. These results suggest that the emerging technology of low-level laser therapy may play a potentially significant role in health care providers' armamentarium for the disease androgenic alopecia.

Are there mechanistic differences between ultraviolet and visible radiation induced skin pigmentation?

PubMed

Ramasubramaniam, Rajagopal; Roy, Arindam; Sharma, Bharati; Nagalakshmi, Surendra

2011-12-01

Most of the studies on sunlight-induced pigmentation of skin are mainly focused on ultraviolet (UV) radiation-induced pigmentation and ways to prevent it. Recent studies have shown that the visible component of sunlight can also cause significant skin pigmentation. In the current study, the extent of pigmentation induced by UV and visible regions of sunlight in subjects with Fitzpatrick skin type IV-V was measured and compared with pigmentation induced by total sunlight. The immediate pigment darkening (IPD) induced by the visible fraction of sunlight is not significantly different from that induced by the UV fraction. However, the persistent pigment darkening (PPD) induced by visible fraction of sunlight in significantly lower than that induced by the UV fraction. The dose responses of IPD induced by UV, visible light and total sunlight suggest that both UV and visible light interact with the same precursor although UV is 25 times more efficient in inducing pigmentation per J cm(-2) of irradiation compared to visible radiation. The measured diffused reflection spectra and decay kinetics of UV and visible radiation-induced pigmentation are very similar, indicating that the nature of the transient and persistent species involved in both the processes are also likely to be same.

Reconstructive methods in Mohs micrographic surgery in Uruguay: A bidirectional descriptive cohort analysis.

PubMed

Navarrete, J; Magliano, J; Martínez, M; Bazzano, C

2018-04-01

The primary goal of Mohs micrographic surgery (MMS) is to completely excise a cancerous lesion and a wide range of reconstructive techniques of varying complexity are used to close the resulting wound. In this study, we performed a descriptive analysis of patients who underwent MMS, with a focus on wound closure methods. We conducted a bidirectional descriptive cohort analysis of all MMS procedures performed by a single surgeon between November 2013 and April 2016. Cosmetic outcomes were photographically assessed by a dermatologist after a minimum follow-up of 90 days. We analyzed 100 MMS procedures in 71 patients with a median age of 73 years. The tumors were basal cell carcinoma (70%), squamous cell carcinoma (29%), and dermatofibrosarcoma protuberans (1%); 75% were located on the head and neck. The reconstructive techniques used were flap closure (48%), simple closure (36%), closure by second intention (11%), and other (5%). Cosmetic outcomes were assessed for 70 procedures (47 patients) and the results were rated as excellent in 20% of cases, very good in 40%, good in 20%, moderate in 17%, and bad/very bad in 2.9%. No significant associations were observed between cosmetic outcome and sex, Fitzpatrick skin type, hypertension, diabetes mellitus, or smoking. Worse outcomes, however, were significantly associated with larger tumor areas and defects, location on the trunk, and flap and second-intention closure. Although there was a tendency to use simple wound closure for lesions located on the trunk and surgical defects of under 4.4cm 2 , the choice of reconstructive technique should be determined by individual circumstances with contemplation of clinical and tumor-related factors and the preference and experience of the surgeon. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

The determination of ultraviolet extinction from the optical and near-infrared

NASA Technical Reports Server (NTRS)

Cardelli, Jason A.; Clayton, Geoffrey C.; Mathis, John S.

1988-01-01

The correlation of optical-near-infrared photometry for a sample of stars with well-determined ultraviolet extinction is examined. A good correlation is found; in particular, it is found that the value of total-to-selective extinction correlates well with the level of linear UV background extinction found from the UV curve parameterization of Fitzpatrick and Massa. An analytic expression is given for an improved estimate for the UV extinction law that can be obtained from optically determined values of R. For R values outside the range R = 3.1 -3.5, use of the analytic expressions given here will result in a more accurate representation of the applicable UV extinction than using the standard techniques of assuming the average curve or 'ironing out' the bump.

Nonablative fractional laser resurfacing in Asian skin--a review.

PubMed

Sachdeva, Silonie

2010-12-01

Skin resurfacing has been a part of cosmetic dermatology for more than two decades now, and most of it has been ablative with traditional aggressive lasers including the CO(2) and erbium. The last few years have seen a revolutionary change with the invention of nonablative lasers for skin tightening. Fractional resurfacing is a new concept of cutaneous remodeling whereby laser-induced zones of microthermal injury are surrounded by normal untreated tissue that helps in quicker healing. The various wavelengths used are 1320, 1440, and 2940 nm with depth of penetration ranging from 25 μ to 1.2 mm. This article reviews the history of nonablative fractional laser resurfacing, its indications, contraindications, and a review of use in Asian skin with Fitzpatrick type III-VI. © 2010 Wiley Periodicals, Inc.

Correlation of histological findings of single session Er:YAG skin fractional resurfacing with various passes and energies and the possible clinical implications.

PubMed

Trelles, Mario A; Vélez, Mariano; Mordon, Serge

2008-03-01

Ablative fractional resurfacing shows promise for skin resurfacing and tightening and also to improve treatment of epidermal and dermal pigmentary disorders. This study aimed at determining any correlation between epidermal ablation and effects on the dermis when using an Er:YAG laser in ablative fractional resurfacing mode. Ten female subjects participated in the study, mean age 52 years, Skin phototypes: 1 Fitzpatrick type II; 8 type III and 1 type IV. The degree of wrinkles (Glogau scale II or III) was similar in all cases. The laser used was the Pixel Er:YAG system (Alma Lasertrade mark, Israel) which delivers the laser beam via a hand-piece equipped with a beam splitter to divide the 2,940 nm beam into various microbeams of 850 microm in diameter in an 11 mmx11 mm treatment area. Using a constant energy of 1,400 mJ/cm(2), on a test area of 4 cmx2 cm. Two, 4, 6, and 8 passes on the preauricular area of the face were evaluated immediately after treatment. In all cases, the handpiece was kept in the same position, and rotated slightly around its perpendicular axis between passes, then moved on to the next spot. Biopsies were performed and tissue samples were routinely processed and stained with hematoxylin and eosin (H&E). No patient reported any noticeable discomfort, even at 8 passes. The histological findings revealed that, independent of the degree of the wrinkles, more laser passes produced more ablative removal of the epidermis. Residual thermal damage (RTD) with 2 laser passes was not observed but with 4 and 6 passes increased thermal effects and vacuole formation in the epidermal cells were noticed. With 8 laser passes, total epidermal removal was seen together with frank RTD-related changes in the upper part of the papillary dermis. In this study, we have demonstrated that high density fractional Er:YAG laser energy in a single session with multiple passes targeted not only the skin surface with elimination of the epidermis, but could also achieve heat deposition in the upper dermis. When performing ablative fractional resurfacing with an Er:YAG laser, treatment of varying degrees of damage could be achieved by varying the number of passes. (c) 2008 Wiley-Liss, Inc.

Superficial chemical peeling with salicylic Acid in facial dermatoses.

PubMed

Bari, Arfan Ul; Iqbal, Zafar; Rahman, Simeen Ber

2007-04-01

To determine the effectiveness of salicylic acid chemical peeling in common dermatological conditions affecting face in people with predominant Fitzpatrick skin type IV and V. An interventional, quasi-experimental study. Military Hospital, Rawalpindi and PAF Hospital, Sargodha, from July 2002 to June 2003. A total of 167 patients of either gender, aged between 13 to 60 years, having some facial dermatoses (melasma, acne vulgaris, postinflammatory hyperpigmentations, freckles, fine lines and wrinkles, post-inflammatory scars, actinic keratoses, and plane facial warts) were included. A series of eight weekly hospital based peeling sessions was conducted in all patients under standardized conditions with 30% salicylic acid. Clinical improvement in different disorders was evaluated by change in MASI score, decrease in the size of affected area and % reduction in lesions count. McNemar test was applied for data analysis. Majority of the patients showed moderate to excellent response. There was 35% to 63% improvement (p<0.05) in all dermatoses. Significant side effects, as feared in Asian skins were not observed. Chemical peeling with salicylic acid is an effective and safe treatment modality in many superficial facial dermatoses.

Effects of 1,540-nm Fractional Nonablative Erbium and 2,940-nm Fractional Ablative Erbium on p53 Epidermal Expression After 3 months: A Split-Face Interventional Study.

PubMed

Borges, Juliano; Araújo, Luciana; de Oliveira, Rodrigo P B; Manela-Azulay, Monica

2018-04-16

Expression of p53 by keratinocytes may be important in the pathogenesis of skin cancer induced by ultraviolet light. We used side-by-side nonablative and ablative erbium fractional laser resurfacing to assess the effects on expression of p53 by facial keratinocytes. Ten female patients (age range, 50-63 years) with Fitzpatrick skin Types I-IV and clinical signs of photoaging underwent erbium fractional laser resurfacing (nonablative, 1,540-nm; ablative, 2,940-nm) on opposite sides of the face. Skin biopsies were obtained before treatment and 3 months after treatment for comparison with control biopsies of face and inner arm, quantifying p53 in immunostained tissue sections. Only ablative (2,940-nm) treatments produced a statistically significant reduction in p53 scoring after 3 months. The histologic appearance of skin after ablative resurfacing more closely resembled inner arm skin (rather than facial skin) of control subjects. Epidermal repopulation with p53-negative keratinocytes through ablative erbium fractional laser resurfacing may diminish the risk of eventual malignancy in photoaged skin.

Perioral Rejuvenation With Ablative Erbium Resurfacing.

PubMed

Cohen, Joel L

2015-11-01

Since the introduction of the scanning full-field erbium laser, misconceptions regarding ablative erbium resurfacing have resulted in its being largely overshadowed by ablative fractional resurfacing. This case report illustrates the appropriateness of full-field erbium ablation for perioral resurfacing. A patient with profoundly severe perioral photodamage etched-in lines underwent full-field ablative perioral resurfacing with an erbium laser (Contour TRL, Sciton Inc., Palo Alto, CA) that allows separate control of ablation and coagulation. The pre-procedure consultations included evaluation of the severity of etched-in lines, and discussion of patient goals, expectations, and appropriate treatment options, as well as a review of patient photos and post-treatment care required. The author generally avoids full-field erbium ablation in patients with Fitzpatrick type IV and above. For each of 2 treatment sessions (separated by approximately 4 months), the patient received (12 cc plain 2% lidodaine) sulcus blocks before undergoing 4 passes with the erbium laser at 150 μ ablation, no coagulation, and then some very focal 30 μ ablation to areas of residual lines still visualized through the pinpoint bleeding. Similarly, full-field ablative resurfacing can be very reliable for significant wrinkles and creping in the lower eyelid skin--where often a single treatment of 80 μ ablation, 50 μ coagulation can lead to a nice improvement. Standardized digital imaging revealed significant improvement in deeply etched rhytides without significant adverse events. For appropriately selected patients requiring perioral (or periorbital) rejuvenation, full-field ablative erbium resurfacing is safe, efficacious and merits consideration.

Hyperpigmentation therapy: a review.

PubMed

Desai, Seemal R

2014-08-01

With an increasing number of multicultural patients and those of different backgrounds presenting in dermatology clinics, issues facing patients with higher Fitzpatrick skin classifications, often referred to as skin of color patients, are on the rise. Knowledge of the diagnostic dilemmas, cutting edge treatment options, and latest clinical research in the diagnosis and management of cutaneous anomalies in skin of color patients is of paramount importance. Of the most common complaints in patients with skin of color is hyperpigmentation. Despite the availability of multiple treatments for the condition, hyperpigmentation continues to present clinical management challenges for dermatologists. Difficulty may be traced to physician or patient reluctance to use certain agents or interventions, failure to identify and avoid contributing factors, and insufficient attention paid to the psychosocial aspects of the disease. This review addresses a variety of issues including the diagnosis and management of hyperpigmentation.

Chemical peels.

PubMed

Jackson, Adrianna

2014-02-01

Chemical peels are a method of resurfacing with a long-standing history of safety in the treatment of various skin conditions. This article reviews the classification of different chemical agents based on their depth of injury. The level of injury facilitates cell turnover, epidermal thickening, skin lightening, and new collagen formation. Preprocedural, periprocedural, and postprocedural skin care are briefly discussed. To select the appropriate chemical peel, the provider should evaluate the patient's expectations, medical history, skin type, and possible complications to determine the best chemical peel to achieve the desired results. Patients with Fitzpatrick skin types IV to VI have increased risk of dyspigmentation, hypertrophic, and keloid scarring. These individuals respond well to superficial and medium-depth chemical peels. Advances in the use of combination peels allow greater options for skin rejuvenation with less risk of complications. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Melasma: a clinical and epidemiological review*

PubMed Central

Handel, Ana Carolina; Miot, Luciane Donida Bartoli; Miot, Hélio Amante

2014-01-01

Melasma is a chronic acquired hypermelanosis of the skin, characterized by irregular brown macules symmetrically distributed on sun-exposed areas of the body, particularly on the face. It is a common cause of demand for dermatological care that affects mainly women (especially during the menacme), and more pigmented phenotypes (Fitzpatrick skin types III-V). Due to its frequent facial involvement, the disease has an impact on the quality of life of patients. Its pathogeny is not yet completely understood, although there are some known triggering factors such as sun exposure, pregnancy, sexual hormones, inflammatory processes of the skin, use of cosmetics, steroids, and photosensitizing drugs. There is also a clear genetic predisposition, since over 40% of patients reported having relatives affected with the disease. In this manuscript, the authors discuss the main clinical and epidemiological aspects of melasma. PMID:25184917

BWR Servicing and Refueling Improvement Program: Phase I summary report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Perry, D.R.

1978-09-01

Under the U.S. Department of Energy sponsorship, General Electric Co. (GE) undertook a study of boiling water reactor (BWR) refueling outages for the purpose of recommending the development and demonstration of critical path time savings improvements. The Tennessee Valley Authority (TVA) joined the study as a subcontractor, providing monitoring assistance and making the Browns Ferry Site available for improvement demonstrations. Agreement was also reached with Georgia Power Co., Power Authority of the State of New York, and Commonwealth Edison Co. for monitoring and data collection at Hatch 1, FitzPatrick, and Quad Cities 1 nuclear plants, respectively. The objective was tomore » identify, develop, and demonstrate improved refueling, maintenance, and inspection procedures and equipment. The improvements recommended in this study are applicable to BWR nuclear plants currently in operation as well as those in the design and construction phases. The recommendations and outage information can be used as a basis to plan and conduct the first outages of new plants and to improve the planning and facilities of currently operating plants. Many of the recommendations can readily be incorporated in plants currently in the design and construction phases as well as in the design of future plants. Many of these recommended improvements can be implemented immediately by utilities without further technical development.« less

Comparison study of a long-pulse pulsed dye laser and a long-pulse pulsed alexandrite laser in the treatment of port wine stains.

PubMed

Li, Li; Kono, Taro; Groff, William Frederick; Chan, Henry H; Kitazawa, Yoshihiko; Nozaki, Motohiro

2008-03-01

Port wine stains (PWSs) are commonly treated by the pulsed dye laser. Recently, a long-pulse pulsed alexandrite laser was used to treat bulky vascular malformations. In the present study, we compare the efficacy and complications of the long-pulse pulsed dye laser (LPPDL) and the long-pulse pulsed alexandrite laser (LPPAL) in the treatment of PWSs. Eleven patients with Fitzpatrick skin types III-IV were enrolled in this study. One section of each patient's PWS was treated with LPPDL and another section was treated with LPPAL. The patients' PWSs were evaluated for efficacy of elimination of erythema and for treatment-related side effects. Both LPPDL and LPPAL treatment are effective in the treatment of PWSs. Hyperpigmentation was seen in two areas treated with LPPDL and in three areas treated with LPPAL. Hypopigmentation was seen in one area treated with LPPAL, but not in any of the areas treated with LPPDL. There was no scarring. LPPAL works best with hypertrophic, purple PWSs, while LPPDL yields better clinical improvements with the flat, pink PWSs. Targeting of deoxyhemoglobin, deeper penetration, and higher fluence may explain the effectiveness of LPPAL in purple, hypertrophic PWSs. However, there is a risk of dyspigmentation when using the LPPAL.

Novel use of non-ablative fractional photothermolysis for café-au-lait macules in darker skin types.

PubMed

Balaraman, Brundha; Ravanfar-Jordan, Parisa; Friedman, Paul M

2017-01-01

The removal of café-au-lait macules (CALMs) in patients with darker skin phototypes poses a significant challenge due to limited available therapeutic options and increased risk of adverse effects, including permanent scarring and further dyspigmentation. Herein, we demonstrate the novel use of non-ablative fractional photothermolysis for the safe removal of CALMs in individuals with Fitzpatrick skin type (FST) IV-V. Retrospective analysis of four patients (FST IV-V) with CALMs revealed that three of these patients had greater than 50% clearance after multiple treatment sessions with the non-ablative fractional 1,550-nm erbium-doped fiber laser. This report demonstrates the utility and safety of non-ablative fractional resurfacing in the treatment of CALMs in darker skin phototypes. Lasers Surg. Med. 49:84-87, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Spent fuel cask handling at an operating nuclear power plant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pal, A.C.

1988-01-01

The importance of spent fuel handling at operating nuclear power plants cannot be overstated. Because of its highly radioactive nature, however, spent fuel must be handled in thick, lead-lined containers or casks. Thus, all casks for spent fuel handling are heavy loads by the US Nuclear Regulatory Commission's definition, and any load-drop must be evaluated for its potential to damage safety-related equipment. Nuclear Regulatory Guide NUREG-0612 prescribes the regulatory requirements of alternative heavy-load-handling methodologies such as (a) by providing cranes that meet the requirements of NUREG-0554, which shall be called the soft path, or (b) by providing protective devices atmore » all postulated load-drop areas to prevent any damage to safety-related equipment, which shall be called the hard path. The work reported in this paper relates to cask handling at New York Power Authority's James A. FitzPatrick (JAF) plant.« less

Celebrating 40 Years of the Midwest Nursing Research Society.

PubMed

Hershberger, Patricia E; Wynd, Christine A; Glass, Laurie K; O'Connell, Karen M; Fitzpatrick, Joyce J; Bergstrom, Nancy; Lusk, Sally Lechlitner

2017-05-01

The Midwest Nursing Research Society (MNRS) recently held its 40th annual conference and celebrated four decades of nursing research in the Midwest. MNRS continues to be one of the largest nursing research societies in the United States. Over the years, a vast majority of programmatic initiatives included education and tangible support for novice and experienced nurse researchers. In this article, the background for development of MNRS is reviewed with examination of driving forces that led to its creation. Three past presidents, Dr. Joyce Fitzpatrick, the first President of MNRS (1980-1981); Dr. Nancy Bergstrom, the eighth President (1993-1995); and Dr. Sally Lusk, the 14th President (2005-2007), discuss challenges, opportunities, and the exceptional progress made toward fostering excellence in nursing research for the Midwest and contributing to nursing science on a national and global scale. Lessons from the past as well as opportunities for the future are addressed.

Successful and safe use of Q-switched lasers in the treatment of nevus of Ota in children with phototypes IV-VI.

PubMed

Belkin, Daniel A; Jeon, Hana; Weiss, Elliot; Brauer, Jeremy A; Geronemus, Roy G

2018-01-01

Nevus of Ota represents congenital dermal melanocytosis in a trigeminal distribution, most commonly occurring in Asian individuals and other individuals with skin of color. Evidence suggests early treatment is beneficial. Multiple reports have shown efficacy and safety of Q-switched laser treatment in adults. There is little data on children and in non-Asian skin types. This series was done to demonstrate safe and effective use of Q-switched laser therapy in children of multiple skin types. Retrospective case series. This was a chart review of patients under 18 years old who presented to our practice from 2002 to 2015 with a clinical diagnosis of nevus of Ota who were treated with Q-switched lasers (694 and 1,064 nm). Patients were treated without the use of general anesthesia or sedation, and corneal shields were used in appropriate cases. Percentage of improvement as well as side effects were rated by five physicians independently. Improvement, when present, was rated in quartiles (1-25%, 26-50%, 51-75%, and 76-100% improvement). Twenty-four children were included. The average age at the start of treatment was 3.9 years old (range of 3 months to 12.4 years), and patients had Fitzpatrick skin types IV through VI. The mean number of treatments was 9.3. Assessment revealed excellent response (76-100% improvement) in 70% of patients and good to excellent response (51-100% improvement) in 86%. Two patients (8%) had post-inflammatory hyperpigmentation, one of whom also had focal hypopigmentation. Treatment of nevus of Ota with Q-switched lasers in children with skin of color, without general anesthesia or sedation, is safe and effective. Early intervention should be encouraged for better efficacy and to prevent psychosocial distress in later childhood and adulthood. Lasers Surg. Med. 50:56-60, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Assessing invariance across sex and race/ethnicity in measures of youth psychopathic characteristics.

PubMed

Horan, Jacqueline M; Brown, Joshua L; Jones, Stephanie M; Aber, J Lawrence

2015-06-01

The aim of this study was to assess the measurement invariance of 2 commonly used measures of youth psychopathic characteristics across sex and racial/ethnic groups. Among a community sample of Hispanic and Black adolescents (N = 355; 50.5% female; mean age = 15.09) and their parents, this study tested the configural and metric invariance of the Levenson Self-Report Psychopathy Scale (LSRP; Levenson, Fitzpatrick, & Kiehl, 1995) and the parent-report version of the Inventory of Callous-Unemotional Traits (Frick, 2004). Preliminary analyses indicated that the adolescents in the present study reported similar rates of psychopathic characteristics as those reported by other studies of adolescents and young adults. Results of the multigroup invariance analyses indicated that these measures are invariant across sex and between Hispanic and Black youth. In addition, further analyses assessing associations between these measures and a number of behavioral and emotional characteristics indicated that scores on the LSRP Scale and Callous-Unemotional Traits demonstrate good convergent and discriminant validity with few differences by sex or race/ethnicity. To date, research on psychopathy has focused predominantly on samples of White males. Therefore, it is important that research examines the equivalence of measures of psychopathic characteristics across different populations, so that accurate assessments can be made to inform intervention and treatment efforts. (c) 2015 APA, all rights reserved).

Epidemiology of melasma in Brazilian patients: a multicenter study.

PubMed

Hexsel, Doris; Lacerda, Davi A; Cavalcante, Andrea S; Machado Filho, Carlos A S; Kalil, Célia Luiza P V; Ayres, Eloísa L; Azulay-Abulafia, Luna; Weber, Magda B; Serra, Marcio S; Lopes, Nádya F P; Cestari, Tania F

2014-04-01

Melasma is an acquired, irregularly patterned, light to dark-brown hypermelanosis, with symmetric distribution mostly over the face. The aim of this study was to evaluate clinical characteristics and factors related to melasma in Brazilian patients. This was a cross-sectional, multicenter study performed in Brazil. Investigators examined and questioned 953 patients over 18 years of age on clinical characteristics and other factors related to their melasma. Melasma was more prevalent in women (97.5%) and in Fitzpatrick skin phototypes II (12.8%), III (36.3%), and IV (39.7%). Skin phototypes II and III and family history of melasma had early onset of the disorder when compared with skin phototypes IV, V, and VI (P<0.0001). Similar results were also observed when these same groups were compared with the absence of family history (P<0.0001). Extra-facial melasma was more frequent in postmenopausal women compared with those who were not experiencing menopause (14.2% vs. 3.5%, P<0.0001). Data suggested that the age of melasma onset are related to skin phototypes and family history. Additionally, extra-facial melasma was more common in menopausal women. This is the first study on the epidemiology of melasma in Brazil involving a large sample of the population. These data can be a source of new relevant research on the cause and development of melasma. © 2013 The International Society of Dermatology.

Clinical and Histological Evaluations of Enlarged Facial Skin Pores After Low Energy Level Treatments With Fractional Carbon Dioxide Laser in Korean Patients.

PubMed

Kwon, Hyuck Hoon; Choi, Sun Chul; Lee, Won-Yong; Jung, Jae Yoon; Park, Gyeong-Hun

2018-03-01

Enlarged facial pores can be an early manifestation of skin aging and they are a common aesthetic concern for Asians. However, studies of improving the appearance of enlarged pores have been limited. The authors aimed to study the application of CO2 fractional laser treatment in patients with enlarged facial pores. A total of 32 patients with dilated facial pores completed 3 consecutive sessions of low energy level treatments with a fractional CO2 laser at 4-week intervals. Image analysis was performed to calculate the number of enlarged pores before each treatment session and 12 weeks after the final treatment. After application of laser treatments, there was a significant decrease in the number of enlarged pores. The mean number of enlarged pores was decreased by 28.8% after the second session and by 54.5% at post-treatment evaluation. Post-treatment side effects were mild and transitory. Histological and immunohistochemical analyses demonstrated clear increases in the number of collagen fibers and the expression of transforming growth factor-β1. The short-term results showed that treatment with low energy level CO2 fractional laser therapy could be a safe and effective option for patients with Fitzpatrick skin Types III and IV who are concerned with enlarged pores.

A Single Center, Prospective, Randomized, Sham-Controlled, Double-Blinded, Split-Face Trial Using Microinjections of Transparent Hyaluronic Acid Gel for Cheek Rejuvenation.

PubMed

Jones, Isabela T; Vanaman Wilson, Monique J; Bolton, Joanna; Zaleski-Larsen, Lisa; Wu, Douglas C; Goldman, Mitchel P

2018-06-01

"Skin boosting" with injections of hyaluronic acid has been demonstrated to improve aged skin. The aim of this study was to determine the efficacy and safety of small-particle hyaluronic acid with lidocaine (SP-HAL) microaliquots for the correction of fine lines of the cheeks. Twenty subjects with mild to moderate static mid to lower cheek rhytides were enrolled. The right or left cheek was randomized to receive 1 mL of SP-HAL using a microdroplet technique, with the contralateral cheek treated with sham injection of sterile normal saline. The degree of cheek wrinkling and elastosis based on the Fitzpatrick-Goldman Wrinkle and Elastosis Scale was assessed at baseline and 7, 14, 30, 90, and 180 days after treatment. Subjects rated their satisfaction at days 90 and 180. Fourteen patients completed the study. There were no statistically significant improvements in wrinkling or elastosis of the SP-HAL-treated cheek or control cheek at any time point. In addition, there were no significant differences in wrinkling, elastosis, or patient satisfaction between the treatment cheek and control cheek. One treatment of intradermal microdroplet injections of SP-HAL to the mid to lower cheek failed to show superiority over normal saline in improving clinical signs of skin wrinkling and elastosis.

Lactic acid peeling in superficial acne scarring in Indian skin.

PubMed

Sachdeva, Silonie

2010-09-01

Chemical peeling with both alpha and beta hydroxy acids has been used to improve acne scarring with pigmentation. Lactic acid, a mild alpha hydroxy acid, has been used in the treatment of various dermatological indications but no study is reported in acne scarring with pigmentation. To evaluate the efficacy and safety of full strength pure lactic acid 92% (pH 2.0) chemical peel in superficial acne scarring in Indian skin. Seven patients, Fitzpatrick skin type IV-V, in age group 20-30 years with superficial acne scarring were enrolled in the study. Chemical peeling was done with lactic acid at an interval of 2 weeks to a maximum of four peels. Pre- and post-peel clinical photographs were taken at every session. Patients were followed every month for 3 months after the last peel to evaluate the effects. At the end of 3 months, there was definite improvement in the texture, pigmentation, and appearance of the treated skin, with lightening of scars. Significant improvement (greater than 75% clearance of lesions) occurred in one patient (14.28%), good improvement (51-75% clearance) in three patients (42.84%), moderate improvement (26-50% clearance) in two patients (28.57%), and mild improvement (1-25% clearance) in one patient (14.28%). © 2010 Wiley Periodicals, Inc.

Q-Switched 660-nm Versus 532-nm Nd: YAG Laser for the Treatment for Facial Lentigines in Asian Patients: A Prospective, Randomized, Double-Blinded, Split-Face Comparison Pilot Study.

PubMed

Noh, Tai Kyung; Chung, Bo Young; Yeo, Un Cheol; Chang, SeoYoun; Lee, Mi Woo; Chang, Sung Eun

2015-12-01

Q-switched (QS) 532-nm lasers are widely used to treat solar lentigines. To compare the efficacy and safety of 660-nm and 532-nm QS neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers in the treatment for lentigines in Asians. The halves of each face (randomly chosen) of 8 Korean Fitzpatrick Skin Type III-IV women with facial solar lentigines were treated with either 660-nm or 532-nm lasers. Pigmentation was measured objectively using a profilometric skin analysis tool and subjectively using the pigmentation area and severity index (PSI) score, global assessment of the aesthetic improvement scale (GAIS), and a patient satisfaction score at Weeks 4 and 8. Seven patients completed the study. No significant differences were found in the PSI, GAIS, patient satisfaction score, and melanin average score between the lasers. The melanin average level was significantly reduced by the 660-nm laser but not the 532-nm laser at Week 8 compared with the baseline. Both 660-nm and 532-nm QS Nd:YAG lasers effectively reduce pigmentation for up to 8 weeks with high patient satisfaction. The new 660-nm laser therefore increases the treatment options for lentigines in Asian skin.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bonzon, L. L.; Hente, D. B.; Kukreti, B. M.

The seismic-fragility response of naturally-aged, nuclear station, safety-related batteries is of interest for two reasons: (1) to determine actual failure modes and thresholds; and (2) to determine the validity of using the electrical capacity of individual cells as an indicator of the end-of-life of a battery, given a seismic event. This report covers the first test series of an extensive program using 12-year old, lead-calcium, Gould NCX-2250 cells, from the James A. Fitzpatrick Nuclear Power Station operated by the New York Power Authority. Seismic tests with three cell configurations were performed using a triaxial shake table: single-cell tests, rigidly mounted;more » multi-cell (three) tests, mounted in a typical battery rack; and single-cell tests specifically aimed towards examining propagation of pre-existing case cracks. In general the test philosophy was to monitor the electrical properties including discharge capacity of cells through a graduated series of g-level step increases until either the shake-table limits were reached or until electrical failure of the cells occurred. Of nine electrically active cells, six failed during seismic testing over a range of imposed g-level loads in excess of a 1-g ZPA. Post-test examination revealed a common failure mode, the cracking at the abnormally brittle, positive lead bus-bar/post interface; further examination showed that the failure zone was extremely coarse grained and extensively corroded. Presently accepted accelerated-aging methods for qualifying batteries, per IEEE Std. 535-1979, are based on plate growth, but these naturally-aged 12-year old cells showed no significant plate growth.« less

Predictors of skin cancer screening practice and attitudes in primary care.

PubMed

Rodriguez, Georgette L; Ma, Fangchao; Federman, Daniel G; Rouhani, Panta; Chimento, Stacy; Multach, Mark; Kirsner, Robert S

2007-11-01

Physician visits provide invaluable opportunities to screen patients for skin cancer, yielding earlier detection and improved survival. We sought to assess frequency of skin cancer screening by full body skin examinations (FBSE) by primary care physicians, patient attitudes toward FBSE, and risk factors for cutaneous malignancy. Questionnaires were distributed to patients at primary care and dermatology clinics. A total of 426 participants were surveyed. Overall, 20% of patients reported having undergone regular FBSE by their primary care physician. Sex, race, personal skin cancer history, and Fitzpatrick skin type were predictive of whether a FBSE was performed by a patient's primary care physician. Men were more likely to report having undergone a FBSE (22% vs 19%; P < .01); women were more likely to report feeling embarrassed by a FBSE (15% vs 4%; P < .01). This study was conducted at a single site academic center. Although low rates of skin cancer screening are reported by patients, those at higher risk are being screened more frequently. Sex disparity exists, and as both male and female patients have a strong preference to undergo FBSE, unmet opportunities for skin cancer prevention should be maximized.

A comparative study with a 755 nm picosecond Alexandrite laser with a diffractive lens array and a 532 nm/1064 nm Nd:YAG with a holographic optic.

PubMed

Tanghetti Md, Emil; Jennings, John

2018-01-01

This study was performed to better understand the cutaneous effects of using a fractional picosecond laser at 755 nm with a diffractive lens array and a picosecond Nd:YAG laser at 532 mn and 1064 nm with a holographic optic. We characterized the injuries created by these devices on skin clinically and histologically over 24 hours. With this information we modeled the effects of these devices on a cutaneous target. Eight patients, representing Fitzpatrick skin types I-VI, were treated on their backs with a picosecond Alexandrite laser with a diffractive lens array, as well as a picosecond Nd:YAG laser at 532 nm and 1064 nm with a holographic optic. Photographs were taken 15 minutes and 24 hours after treatments. Punch biopsies were obtained at 24 hours and examined histologically. Treatment with the picosecond Nd:YAG laser at both 532 nm and 1064 nm with the holographic optic revealed erythema and small scatted areas of petechial hemorrhage areas immediately and in many cases at 24 hours after treatment. The 755 nm picosecond Alexandrite laser with diffractive lens array produced erythema immediately after treatment, which largely dissipated 24 hours later. Histologies revealed intra-epidermal vacuoles with all three wavelengths. Fractional picosecond Nd:YAG laser at 532 nm and 1064 nm with the holographic optic showed focal areas of dermal and intra-epidermal hemorrhage with areas of vascular damage in some patients. This study demonstrates that both fractional picosecond devices produce vacuoles in the skin, which are most likely due to areas of laser induced optical breakdown (LIOB). In the patients (skin type II-IV) we observed scatter areas of hemorrhage in the skin, due to vascular damage with the 532 nm and 1064 nm, but not with 755 nm wavelengths. Lasers Surg. Med. 50:37-44, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

A new argon gas-based device for the treatment of keloid scars with the use of intralesional cryotherapy.

PubMed

van Leeuwen, Michiel C E; Bulstra, Anne-Eva J; van Leeuwen, Paul A M; Niessen, Frank B

2014-12-01

Intralesional (IL) cryotherapy is a new promising technique for the treatment of keloid scars, in which the scar is frozen from inside. Multiple devices are available, mostly based on a simple liquid nitrogen Dewar system, which have a limited freezing capacity. Argon gas-based systems ensure accurate and highly controlled freezing and have shown to be effective within the field of oncologic surgery. However, this technique has never been used for the treatment of keloid scars. This prospective study evaluates an argon gas-based system for the treatment of keloids in a patient population including all Fitzpatrick skin types with a 1-year follow-up. Twenty-five patients with 30 keloid scars were included and treated with a device called Seednet (Galil Medical, Yokneam, Israel). Scar quality and possible scar recurrence were assessed before treatment and post treatment (6 and 12 months) with objective devices determining scar color, scar elasticity, scar volume, and patient's skin type. In addition, scars were evaluated using the Patient and Observer Scar Assessment Scale. After 12 months, a significant volume reduction of 62% was obtained, p = 0.05. Moreover, complaints of pain and itching were alleviated and scar quality had improved according to the Patient and Observer Scar Assessment Scale. Scar pigmentation recovered in 62% of all keloid scars within 12 months. Five out of 30 (17%) scars recurred within 12 months, three of which had previously been treated with liquid nitrogen-based IL cryotherapy. Both recurrent and persistent hypopigmentation were mainly seen in Afro-American patients. IL cryotherapy with the use of an argon gas-based system proves to be effective in the treatment of keloid scars, yielding volume reduction and low recurrence rates. Although hypopigmentation recovered in most cases, it is strongly related to non-Caucasian patients. Finally, additional treatment of keloid scars previously unresponsive to IL cryotherapy is predisposed to a high recurrence rate. NCT02063243. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Efficacy of custom-made pressure clips for ear keloid treatment after surgical excision.

PubMed

Tanaydin, V; Beugels, J; Piatkowski, A; Colla, C; van den Kerckhove, E; Hugenholtz, G C G; van der Hulst, R R

2016-01-01

Mechanical pressure is increasingly applied as a means to prevent or treat keloid scars. The aim of this study is to analyze the long-term efficacy of our custom-molded pressure-adjustable earclips to prevent keloid recurrence after surgical excision. Using our custom-molded earclip, 88 patients who had undergone ear surgery for keloid scars were treated for 12 h a day for 6-18 months. The mean follow-up was 6.5 years. The primary outcome was the recurrence of keloids with patient satisfaction being the secondary outcome as assessed by Patient and Observer Scale (POSAS). Keloid scars did not recur in 70.5% of treated patients. The Fitzpatrick scale, which classifies human skin by type, was significantly different between the recurrence and nonrecurrence group. Differences in other patient characteristics were not found between both groups. All parameters mentioned in the POSAS patient scale drastically improved after therapy. There were no severe side effects observed after the therapy. Our pressure-adjustable earclip model is an effective tool in the prevention of ear keloid recurrence and is associated with high patient satisfaction. Its benefits should prompt further studies on its value as an adjuvant therapy to surgery in keloid treatment. Level III on the Evidence Rating Scale for Therapeutic Studies. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Mexametric and cutometric assessment of the signs of aging of the skin area around the eyes after the use of non-ablative fractional laser, non-ablative radiofrequency and intense pulsed light.

PubMed

Kołodziejczak, Anna Maria; Rotsztejn, Helena

2017-03-01

The assessment of the signs of aging within eyes area in cutometric (skin elasticity) and mexametric (discoloration and severity of erythema) examination after the treatment with: non-ablative fractional laser, non-ablative radiofrequency (RF) and intense light source (IPL). This study included 71 patients, aged 33-63 years (the average age was 45.81) with Fitzpatrick skin type II and III. 24 patients received 5 successive treatment sessions with a 1,410-nm non-ablative fractional laser in two-week intervals, 23 patients received 5 successive treatment sessions with a non-ablative RF in one-week intervals and 24 patients received 5 successive treatment sessions with an IPL in two-week intervals. The treatment was performed for the skin in the eye area. The Cutometer and Mexameter (Courage + Khazaka electronic) reference test was used as an objective method for the assessment of skin properties: elasticity, skin pigmentation and erythema. Measurements of skin elasticity were made in three or four sites within eye area. The results of cutometric measurements for R7 showed the improvement in skin elasticity in case of all treatment methods. The largest statistically significant improvement (p < .0001) was observed in case of laser and RF, during treatment sessions, at sites at upper and lower eyelid. The smallest change in skin elasticity for the laser, RF and IPL - p = .017, p = .003 and p = .001, respectively-was observed in a site within the outer corner of the eye. In all sites of measurements and for all methods, the greatest improvement in skin elasticity was demonstrated between the first and second measurement (after 3rd procedures). The majority of the results of mexametric measurements-MEX (melanin level) and ERYT (the severity of erythema) are statistically insignificant. Fractional, non-ablative laser, non-ablation RF and intense light source can be considered as methods significantly affecting elasticity and to a lesser extent erythema and skin pigmentation around the eyes. Fractional non-ablative laser is a method which, in comparison to other methods, has the greatest impact on skin viscoelasticity. These procedures are well tolerated and are associated with a low risk of side effects. © 2017 Wiley Periodicals, Inc.

Assessment of a Comprehensive Anti-Aging Neck Cream.

PubMed

Saxena, Subhash J; Duque, Deysi; Schirripa, Michael J

2015-09-01

With many effective anti-aging solutions for the face, consumer focus is now turning to other parts of the body including the delicate skin on the neck. This study investigates the effect of a new neck cream on the appearance of texture, fine lines and wrinkles, laxity, and hydration. 85 adult females ages 35-65 with Fitzpatrick skin types I through IV applied the test neck cream twice daily for a 3-month study period. Screening was conducted at Baseline, 2, 30, 60, and 90 days via a virtual trial. Subjects rated satisfaction in each of 4 anti-aging categories including hydration, texture, appearance of wrinkles, and appearance of laxity as well as three product attributes including application, feel, and smell. Improvement was statistically significant for all measured categories (hydration, texture, appearance of wrinkles, and appearance of laxity) with 94% of study subjects noting improvement in one or more of the measured categories. Further, the quantity of "Satisfied" and "Highly Satisfied" assessments increased 8-fold from baseline with a 94x increase in the quantity of "Highly Satisfied" assessments. The results demonstrate the product's rapid and continuing ability to improve the self-perceived signs of aging in the neck area including improvement in skin texture on the neck and a reduction in the appearance of wrinkles and laxity along the jawline. Future studies are recommended to determine the primary action mechanisms and to assess the degree of improvement by blinded physician assessment.

Predictors and correlates of serum 25-hydroxyvitamin D concentrations in young women: results from the Safe-D study.

PubMed

Callegari, Emma T; Garland, Suzanne M; Gorelik, Alexandra; Reavley, Nicola J; Wark, John D

2017-08-01

Vitamin D deficiency is a global public health concern. Studies of serum 25-hydroxyvitamin D (25(OH)D) determinants in young women are limited and few include objective covariates. Our aims were to define the prevalence of vitamin D deficiency and examine serum 25(OH)D correlates in an exploratory study of women aged 16-25 years. We studied 348 healthy females living in Victoria, Australia, recruited through Facebook. Data collected included serum 25(OH)D assayed by liquid chromatography-tandem MS, relevant serum biochemistry, soft tissue composition by dual-energy X-ray absorptiometry, skin melanin density, Fitzpatrick skin type, sun exposure using UV dosimeters and lifestyle factors. Mean serum 25(OH)D was 68 (sd 27) nmol/l and 26 % were vitamin D deficient (25(OH)D 2 h in the sun in summer daily, holidaying in the most recent summer period, serum Fe levels, height and multivitamin use were positively associated with 25(OH)D. Fat mass and a blood draw in any season except summer was inversely associated with 25(OH)D. Vitamin D deficiency is common in young women. Factors such as hormonal contraception, sun exposure and sun-related attitudes, as well as dietary supplement use are essential to consider when assessing vitamin D status. Further investigation into methods to safely optimise vitamin D status and to improve understanding of the impact of vitamin D status on long-term health outcomes is required.

The fundamentals of integrating service in a post-licensure RN to BSN program.

PubMed

Washington-Brown, Linda; Ritchie, Arlene

2014-01-01

Integrating service in a post-licensure registered nurse to bachelor of science in nursing (RN to BSN) program provides licensed registered nurse (RN) students the opportunity to learn, develop, and experience different cultures while serving the community and populations in need (McKinnon & Fitzpatrick, 2012). Service to the community, integrated with academic learning can be applied in a wide variety of settings, including schools, universities, and community faith-based organizations. Academic service-learning (ASL) can involve a group of students, a classroom, or an entire school. In the RN to BSN program, the authors use a student-directed service learning approach that integrates service-learning throughout the curriculum. RN students are introduced to service-learning at program orientation prior to the start of classes and receive reinforcement and active engagement throughout the curriculum. The students and volunteer agencies receive and give benefits from the services provided and the life lessons gained through mentorship, education, and hands-on experiences.

Massive star evolution and SN 1987A

NASA Technical Reports Server (NTRS)

Arnett, David

1991-01-01

The evolution of massive stars through hydrogen and helium burning is addressed. A set of stellar evolutionary sequences for mass/solar mass of 15, 20, and 25, and metallicity of 0.002, 0.005, 0.007, 0.010, and 0.20 are presented; semiconvection is restricted to operating slower than the local thermal time scale. Using these sequences, simple models of the massive star content of the LMC are found to agree moderately well with the new observational data of Fitzpatrick and Garmany (1990). LMC supergiants were detected only in their postmain-sequence phases, so that 5-10 times more massive stars are there but not identified as such. It is argued that SN 1987A exhibits the normal evolution of a single star of about 20 solar mases having LMC abundances. Despite the variety of envelope behavior, the structure of the core at collapse is rather similar for the stars of a given mass. Variations due to different rates of mass loss are likely to be larger than those due to composition.

VizieR Online Data Catalog: Silicon depletion in the interstellar medium (Haris+, 2016)

NASA Astrophysics Data System (ADS)

Haris, U.; Parvathi, V. S.; Gudennavar, S. B.; Bubbly, S. G.; Murthy, J.; Sofia, U. J.

2018-03-01

Gudennavar et al. (2012, J/ApJS/199/8) compiled absorption line data for 3008 stars of which 131 sight lines included silicon column densities that were taken over 30 years of observations (Table 1). Most of the silicon lines (84) in our sample have come from van Steenberg & Shull (1988ApJS...67..225V) who used archival observations from the International Ultraviolet Explorer (IUE) to derive column densities to a number of different species. Most of the other observations (36) were made using the Goddard High Resolution Spectrograph (Spitzer & Fitzpatrick 1995ApJ...445..196S; Savage & Sembach 1996ARA&A..34..279S; Redfield & Linsky 2004ApJ...602..776R) or the Space Telescope Imaging Spectrograph (Sonnentrucker et al. 2003ApJ...596..350S; Gnacinski & Krogulec 2006AcA....56..373G; Miller et al. 2007ApJ...659..441M) with higher resolution and better signal-to-noise. (3 data files).

30 Doradus - Ultraviolet and optical stellar photometry

NASA Technical Reports Server (NTRS)

Hill, Jesse K.; Bohlin, Ralph C.; Cheng, Kwang-Ping; Fanelli, Michael N.; Hintzen, Paul; O'Connell, Robert W.; Roberts, Morton S.; Smith, Andrew M.; Smith, Eric P.; Stecher, Theodore P.

1993-01-01

Ultraviolet Imaging Telescope (UIT) UV magnitudes in four bands, together with optical B magnitudes, are presented for up to 314 early-type stars located in a 9.7 x 9.7 arcmin field centered on R136. The magnitudes have an rms uncertainty estimated at 0.10 mag from a comparison between the UIT magnitudes and the IUE spectra. Spectral types and E(B-V) color excesses are estimated. The mean color excesses following the two extinction curves agree well with the predictions of the two-component extinction model of Fitzpatrick and Savage (1984). However, the degree of nebular extinction is found to vary systematically by large amounts over the 30 Dor field. The minimum of nebular extinction in the central parts of the nebula suggests that dust has been expelled from this region by stellar winds. It is suggested that the form of the UV extinction curve can be understood as a consequence of the evolutionary state of the stellar population responsible for making the dust grains.

Managing the Lower Eyelid Complex in the Thick-Skinned Patient.

PubMed

Floyd, Elizabeth Mia; Perkins, Stephen W

2018-02-01

Thick skin presents a unique set of challenges within the realm of facial plastic surgery, and addressing the lower lid complex is no exception. There are several procedures for addressing the lower lids, the first and foremost being lower lid blepharoplasty. However, the remaining procedures combined with surgical techniques have exclusive implications in thick skin. Understanding the anatomy and various techniques that can be applied to thick skin can help achieve aesthetically more pleasing results in comparison to those of thin skin. As will be discussed in this article, patients with skin color of Fitzpatrick's grade III or higher have several characteristics associated with their skin, including thicker dermis as well as different patterns of aging, which have implications for addressing the lower lid complex. The senior author has extensive experience performing lower lid procedures and seeks to impart how best to understand and adapt for these differences to allow for the best aesthetic result. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The influences of skin visco-elasticity, hydration level and aging on the formation of wrinkles: a comprehensive and objective approach.

PubMed

Choi, Jae Woo; Kwon, Soon Hyo; Huh, Chang Hun; Park, Kyoung Chan; Youn, Sang Woong

2013-02-01

Various skin parameters including skin visco-elasticity and hydration level affect the formation of wrinkles. The aim of this study was to investigate the comprehensive and objective relationship between age, skin visco-elasticity, hydration level, and the occurrence of wrinkles using bioengineering equipments for the first time. A total number of 97 healthy women were included in this study. Age, Fitzpatrick skin type, skin mechanical parameters obtained with Cutometer(R0~R9), hydration level measured with Corneometer, as well as wrinkle parameters (SEsm, SEr, SEsc, and SEw) assessed with Visioscan, were analyzed with the Pearson's correlation test. The skin fluidity (R6) increased while the elastic recovery ratio (R7) decreased with the age. The wrinkle parameter (SEw) also increased with the age. The higher skin hysteresis values (R4 and R9) coincided with the higher SEw values. Skin hydration significantly lowered the hysteresis (R9), the wrinkles (SEw), and the depth of wrinkle furrows (R3mr). The elderly have less elastic skin and more wrinkles. Skin hysteresis most closely related with the degree of wrinkles. Drier skin showed more wrinkles and deeper furrows, with wider intervals. On the basis of these objective findings, we propose several skin parameters associated with wrinkles, and hypothesize the mechanism of wrinkle generation. © 2012 John Wiley & Sons A/S.

Safety and efficacy of 2,790-nm laser resurfacing for chest photoaging.

PubMed

Grunebaum, Lisa D; Murdock, Jennifer; Cofnas, Paul; Kaufman, Joely

2015-01-01

Chest photodamage is a common cosmetic complaint. Laser treatment of the chest may be higher risk than other areas. The objective of this study was to assess the safety and efficacy of 2,790-nm chest resurfacing for photodamage. Twelve patients with Fitzpatrick skin types I-III were enrolled in this university IRB-approved study. Photo documentation was obtained at baseline and each visit. A test spot with the 2,790-nm resurfacing laser was performed on the chest. Patients who did not have adverse effects from the test spot went on to have a full chest resurfacing procedure. Patients were instructed on standardized aftercare, including sunscreen. A 5-point healing and photodamage improvement scale was used to rate improvement by both investigators and the patients and was obtained at 2 weeks, 1 month, 2 months, and 3 months. One pass chest treatment with the 2,790-nm resurfacing laser at fluences greater than or equal to 3.0 mJ with 10% overlap leads to unacceptable rates of hyperpigmentation. Double pass chest treatment at fluences less than or equal to 2.5 mJ with 10% overlap leads to mild improvement in chest photodamage parameters without significant or persistent adverse effects. Laser treatment of aging/photodamaged chest skin remains a challenge due to the delicacy of chest skin. Mild improvement may be obtained with double pass resurfacing with the 2,790-nm wavelength.

Efficacy of mesotherapy in facial rejuvenation: a histological and immunohistochemical evaluation

PubMed Central

El-Domyati, Moetaz; El-Ammawi, Tarek S.; Moawad, Osama; El-Fakahany, Hasan; Medhat, Walid; Mahoney, Mỹ G.; Uitto, Jouni

2012-01-01

Background Mesotherapy, commonly known as “biorejuvenation” or “biorevitalization”, is a technique used to rejuvenate the skin by means of a transdermal injection of a multivitamin solution and natural plant extracts that are thought to improve the signs of skin aging. Objectives This prospective study aimed to evaluate the clinical effect of mesotherapy applied to periorbital wrinkles and to quantitatively evaluate histological changes in the skin occurring in response to the same treatment. Methods Six volunteers with Fitzpatrick skin types III or IV and Glogau class I–III wrinkles were subjected to a three-month course of mesotherapy injections in the periocular area (six sessions administered at two-week intervals). Standard photographs and skin biopsies were obtained from the treatment area at baseline, at the end of treatment, and at three months post-treatment. Quantitative evaluation of collagen types I, III, and VII, newly synthesized collagen, total elastin, and tropoelastin was performed using a computerized morphometric analysis. Results The clinical evaluation of volunteers at baseline, end of treatment, and three months post-treatment revealed no significant differences. Histological and immunostaining analysis of collagen types I, III, and VII, newly synthesized collagen, total elastin, and tropoelastin showed no statistically significant changes (P > 0.05) after mesotherapy injection. Conclusions The present study indicates that mesotherapy for skin rejuvenation does not result in statistically significant histological changes or clinical improvement. PMID:22788806

Retrospective Analysis of Endemic Melasma Patients

PubMed Central

Demirkan, Serkan; Gündüz, Özgür; Sayan, Cemile Dayangan

2017-01-01

Melasma is an acquired diffuse hypermelanosis characterized by localized, symmetrical, irregular, light-to-dark brown maculae occurring in sun-exposed areas of skin. The aim of this retrospective study was to determine demographics of patients, analysis of etiologic factors, clinical features, efficacy and side effects of available topical treatments due to high incidence of melasma patients. In this study melasma patients in Birecik State Hospital were investigated retrospectively. Between January 2014 and October 2015, 1008 patients had diagnosis of melasma in 49,809 applications of 24,603 different patients who admitted to Dermatology Outpatient Clinics. Of the 1008 patients, 263 had completed 3-month treatment period. These patients did not receive treatment in June, July, August and September. All melasma patients were rural and dealing with agriculture. There was no significant difference between female and male patients in terms of age. Of the 253 female melasma patients, only 2 of them had not child and none of them were using hormone drug. Of the 263 patients with melasma, Fitzpatrick skin type was 3 in 79 (30%) patients, 4 in 184 (70%) patients. Şanliurfa city showed higher fertility rate, sun exposure, and skin type than Turkey as a whole. These predisposing factors may explain higher melasma occurrence in Şanliurfa. Patient information about preventive measures and treatment play important role in treatment of cosmetic condition. The most important measure seems to advise patients about sun-protection especially during pregnancy. PMID:28652905

Electro-optical Synergy Technique

PubMed Central

El-Domyati, Moetaz; El-Ammawi, Tarek S.; Medhat, Walid; Moawad, Osama; Mahoney, My G.

2010-01-01

Objectives: Electro-optical synergy technology is one of the most recently described methods for nonablative skin rejuvenation. The aim of this study is to evaluate the effects of electro-optical synergy on connective tissue composition by histological and immunohistochemical techniques coupled with computerized morphometric analysis. Design: A prospective clinical study. Participants: Six volunteers with Fitzpatrick skin types 3 to 4 and Glogau class I to II wrinkles were subjected to three months (6 sessions at 2-week intervals) of electro-optical synergy treatment. Measurements: Standard photographs and skin biopsies were obtained at baseline as well as three and six months after the start of treatment. The authors performed quantitative evaluation of total elastin, tropoelastin, collagen types I, III, and VII, and newly synthesized collagen. Results: Noticeable clinical and histological improvement was observed after electro-optical synergy treatment. A statistically significant increase in the means of collagen types I, III, and VII, as well as newly synthesized collagen, together with increased levels of tropoelastin, were detected, while the mean level of total elastin was significantly decreased at the end of treatment and three months post-treatment. Conclusion: Electro-optical synergy is an effective treatment for contouring facial skin laxity. This modality stimulates the repair processes and reverses the clinical, as well as the histopathological, signs of aging with the advantage of being a relatively risk-free procedure with minimal patient recovery time. PMID:21203352

Sunscreen Use on the Dorsal Hands at the Beach

PubMed Central

Warren, Donald B.; Riahi, Ryan R.; Hobbs, Jason B.; Wagner, Richard F.

2013-01-01

Background. Since skin of the dorsal hands is a known site for the development of cutaneous squamous cell carcinoma, an epidemiologic investigation was needed to determine if beachgoers apply sunscreen to the dorsal aspect of their hands as frequently as they apply it to other skin sites. Aim. The aim of the current study was to compare the use of sunscreen on the dorsal hands to other areas of the body during subtropical late spring and summer sunlight exposure at the beach. Materials and Methods. A cross-sectional survey from a convenience sample of beachgoers was designed to evaluate respondent understanding and protective measures concerning skin cancer on the dorsal hands in an environment with high natural UVR exposure. Results. A total of 214 surveys were completed and analyzed. Less than half of subjects (105, 49%) applied sunscreen to their dorsal hands. Women applied sunscreen to the dorsal hands more than men (55% women versus 40% men, P = 0.04). Higher Fitzpatrick Skin Type respondents were less likely to protect their dorsal hands from ultraviolet radiation (P = 0.001). Conclusions. More public education focused on dorsal hand protection from ultraviolet radiation damage is necessary to reduce the risk for squamous cell carcinomas of the hands. PMID:23840956

Effectiveness, safety, and effect on quality of life of topical salicylic acid peels for treatment of postinflammatory hyperpigmentation in dark skin.

PubMed

Joshi, Smita S; Boone, Susan L; Alam, Murad; Yoo, Simon; White, Lucile; Rademaker, Alfred; Helenowski, Irene; West, Dennis P; Kundu, Roopal V

2009-04-01

There are no randomized split-face model studies investigating treatments for postinflammatory hyperpigmentation (PIH) in dark skin. To assess the efficacy, safety, and effect on quality of life of salicylic acid peels for PIH in dark skin. Ten subjects with Fitzpatrick skin phototypes IV to VI were randomized to receive two 20% salicylic acid peels followed by three 30% salicylic acid peels to half of the face. The contralateral half remained untreated. Response was evaluated by photography reviewed by three blinded dermatologists. The Visual Analog Scale, Dermatology Life Quality Index (DLQI), and treatment quality questionnaire were administered. Improvement of PIH on the treatment side according to each rater (p=.81, p=.81, p=.42) and according to the raters combined (p=.11) approached but did not reach statistical significance. Subjects' Visual Analog Scale scores indicated significantly greater improvement of PIH on the treatment side than in the control (p=.004). Quality of life measured according to the DLQI improved after treatment but not statistically significantly so (p=.13). Treatment had no significant adverse effects. Salicylic acid peels are safe in this population. Although patients rated them as clinically effective, blinded raters found a brief series of peels to have less efficacy. Measured quality of life improved nominally.

In vivo measurements of cutaneous melanin across spatial scales: using multiphoton microscopy and spatial frequency domain spectroscopy.

PubMed

Saager, Rolf B; Balu, Mihaela; Crosignani, Viera; Sharif, Ata; Durkin, Anthony J; Kelly, Kristen M; Tromberg, Bruce J

2015-06-01

The combined use of nonlinear optical microscopy and broadband reflectance techniques to assess melanin concentration and distribution thickness in vivo over the full range of Fitzpatrick skin types is presented. Twelve patients were measured using multiphoton microscopy (MPM) and spatial frequency domain spectroscopy (SFDS) on both dorsal forearm and volar arm, which are generally sun-exposed and non-sun-exposed areas, respectively. Both MPM and SFDS measured melanin volume fractions between (skin type I non-sun-exposed) and 20% (skin type VI sun exposed). MPM measured epidermal (anatomical) thickness values ~30-65 μm, while SFDS measured melanin distribution thickness based on diffuse optical path length. There was a strong correlation between melanin concentration and melanin distribution (epidermal) thickness measurements obtained using the two techniques. While SFDS does not have the ability to match the spatial resolution of MPM, this study demonstrates that melanin content as quantified using SFDS is linearly correlated with epidermal melanin as measured using MPM (R² = 0.8895). SFDS melanin distribution thickness is correlated to MPM values (R² = 0.8131). These techniques can be used individually and/or in combination to advance our understanding and guide therapies for pigmentation-related conditions as well as light-based treatments across a full range of skin types.

Colour Counts: Sunlight and Skin Type as Drivers of Vitamin D Deficiency at UK Latitudes.

PubMed

Webb, Ann R; Kazantzidis, Andreas; Kift, Richard C; Farrar, Mark D; Wilkinson, Jack; Rhodes, Lesley E

2018-04-07

Sunlight exposure, with resulting cutaneous synthesis, is a major source of vitamin D for many, while dietary intake is low in modern diets. The constitutive pigment in skin determines skin type, observed as white, brown, or black skin. The melanin pigment absorbs ultraviolet radiation (UVR) and protects underlying skin from damage caused by UVR. It also reduces the UVR available for vitamin D synthesis in the skin. It has been shown that the white-skinned population of the UK are able to meet their vitamin D needs with short, daily lunchtime exposures to sunlight. We have followed the same methodology, based on a 10-year UK all-weather UVR climatology, observation (sun exposure, diet, vitamin D status), and UVR intervention studies with Fitzpatrick skin type V (brown) adults, to determine whether sunlight at UK latitudes could provide an adequate source of vitamin D for this section of the population. Results show that to meet vitamin D requirements, skin type V individuals in the UK need ~25 min daily sunlight at lunchtime, from March to September. This makes several assumptions, including that forearms and lower legs are exposed June-August; only exposing hands and face at this time is inadequate. For practical and cultural reasons, enhanced oral intake of vitamin D should be considered for this population.

Melanoma risk prediction using a multilocus genetic risk score in the Women's Health Initiative cohort.

PubMed

Cho, Hyunje G; Ransohoff, Katherine J; Yang, Lingyao; Hedlin, Haley; Assimes, Themistocles; Han, Jiali; Stefanick, Marcia; Tang, Jean Y; Sarin, Kavita Y

2018-07-01

Single-nucleotide polymorphisms (SNPs) associated with melanoma have been identified though genome-wide association studies. However, the combined impact of these SNPs on melanoma development remains unclear, particularly in postmenopausal women who carry a lower melanoma risk. We examine the contribution of a combined polygenic risk score on melanoma development in postmenopausal women. Genetic risk scores were calculated using 21 genome-wide association study-significant SNPs. Their combined effect on melanoma development was evaluated in 19,102 postmenopausal white women in the clinical trial and observational study arms of the Women's Health Initiative dataset. Compared to the tertile of weighted genetic risk score with the lowest genetic risk, the women in the tertile with the highest genetic risk were 1.9 times more likely to develop melanoma (95% confidence interval 1.50-2.42). The incremental change in c-index from adding genetic risk scores to age were 0.075 (95% confidence interval 0.041-0.109) for incident melanoma. Limitations include a lack of information on nevi count, Fitzpatrick skin type, family history of melanoma, and potential reporting and selection bias in the Women's Health Initiative cohort. Higher genetic risk is associated with increased melanoma prevalence and incidence in postmenopausal women, but current genetic information may have a limited role in risk prediction when phenotypic information is available. Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Multifractional microablative laser combined with spacially modulated ablative (SMA) technology for facial skin rejuvenation.

PubMed

Hersant, Barbara; SidAhmed-Mezi, Mounia; Chossat, Adrien; Meningaud, Jean Paul

2017-01-01

Due to the increasing demand for aesthetic procedures, especially facial aesthetic surgery, a new laser technology has been developed for facial skin rejuvenation and wrinkle treatment. The aim of this study was to objectively and subjectively assess the clinical efficacy and safety of Erbium:YAG laser combined with Spatially Modulated Ablation (Er:YAG + SMA) on facial skin rejuvenation. Patients with Fitzpatrick skin type's I-IV were prospectively included. Inclusion criteria consisted of having wrinkles and irregular skin texture. All patients underwent two Er:YAG + SMA sessions (1 month apart) to stimulate tissue regeneration. Er:YAG laser emits wavelength at 2,940 nm and when combined with SMA, a resonance effect is produced in the dermis to promote tissue regeneration. Facial skin elasticity and firmness were objectively assessed by Cutometer at baseline and month 6 (M6). Aesthetic improvement was qualitatively assessed using digital photographs. Patient satisfaction with regard to their facial appearance was self-assessed using the validated FACE-Q scale and the patient-perceived age VAS scale at baseline, M1, and M6. Side effects were investigated after each session. Thirty-four patients were included, 50% (18 patients) had Fitzpatrick skin type III and 41% (14 patients) were smokers. Skin elasticity indices were significantly improved: from 0.335 ± 0.015 at baseline to 0.387 ± 0.021 at M6 (P = 0.05*) for R5 (net elasticity). Skin firmness was assessed through R7 (biological elasticity) and R6 (viscoelastic ratio) at baseline and M6: a significant increase from 0.235 ± 0.01 to 0.2709 ± 0.009 (P < 0.03**) and decrease from 0.486 ± 0.022 to 0.3918 ± 0.023 (P < 0.006***) were respectively observed. A negative value for R6 corresponded to an improved skin condition. The FACE-Q scores were significantly increased from 39.4 ± 6.7 at baseline to 45.4 ± 9.1 at M1 (P < 0.006***) and 50.4 ± 9.8 at M6 (P < 0.0001***), reflecting wrinkle reduction and enhanced rejuvenation. According to the age appraisal VAS scale, results showed that patients felt younger by -2.92 years at M1 (P < 0.0001***) and -4.13 years (P < 0.0001***) at M6. No adverse reaction was reported. The Er:YAG + SMA technology offers an effective and safe treatment alternative for facial skin rejuvenation. It reduces the recovery time compared to conventional lasers such as carbon dioxide laser. Lasers Surg. Med. 49:78-83, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Disparity in Cutaneous Pigmentary Response to LED vs Halogen Incandescent Visible Light: Results from a Single Center, Investigational Clinical Trial Determining a Minimal Pigmentary Visible Light Dose.

PubMed

Soleymani, Teo; Cohen, David E; Folan, Lorcan M; Okereke, Uchenna R; Elbuluk, Nada; Soter, Nicholas A

2017-11-01

Background: While most of the attention regarding skin pigmentation has focused on the effects of ultraviolet radiation, the cutaneous effects of visible light (400 to 700nm) are rarely reported. The purpose of this study was to investigate the cutaneous pigmentary response to pure visible light irradiation, examine the difference in response to different sources of visible light irradiation, and determine a minimal pigmentary dose of visible light irradiation in melanocompetent subjects with Fitzpatrick skin type III - VI. The study was designed as a single arm, non-blinded, split-side dual intervention study in which subjects underwent visible light irradiation using LED and halogen incandescent light sources delivered at a fluence of 0.14 Watts/cm2 with incremental dose progression from 20 J/cm2 to 320 J/cm2. Pigmentation was assessed by clinical examination, cross-polarized digital photography, and analytic colorimetry. Immediate, dose-responsive pigment darkening was seen with LED light exposure in 80% of subjects, beginning at 60 Joules. No pigmentary changes were seen with halogen incandescent light exposure at any dose in any subject. This study is the first to report a distinct difference in cutaneous pigmentary response to different sources of visible light, and the first to demonstrate cutaneous pigment darkening from visible LED light exposure. Our findings raise the concern that our increasing daily artificial light surroundings may have clandestine effects on skin biology.

J Drugs Dermatol. 2017;16(11):1105-1110.

Safety and effectiveness of hyaluronic acid fillers in skin of color.

PubMed

Grimes, Pearl E; Thomas, Jane A; Murphy, Diane K

2009-09-01

To assess the safety and effectiveness of hyaluronic acid (HA) fillers in skin of color. Two prospective studies followed up subjects with Fitzpatrick skin phototypes of IV, V, or VI for 24 weeks after dermal filler injections. In a double-blind, randomized study, subjects were injected with one of three high concentration (24 mg/mL) HA fillers (Juvéderm Ultra, Ultra Plus, and 30) in one nasolabial fold and Zyplast collagen in the other. In an open-label, randomized study, subjects received one of three low concentration (5.5 mg/mL) HA fillers (Hylaform, Hylaform Plus, and Captique) in both nasolabial folds. A total of 160 subjects (a subset of 439 study subjects) were randomized and treated with one of the three high concentration fillers, and 119 subjects were randomized and treated with one of the three low concentration fillers. For subjects treated with the high concentration fillers there were no occurrences of hypersensitivity or hypertrophic scarring, and no increased incidence of hyperpigmentation or hypopigmentation in non-Caucasian vs. Caucasian subjects. For subjects treated with the low concentration fillers there were no occurrences of keloid formation, hypertrophic scarring, hypopigmentation, hypersensitivity, and three instances of mild hyperpigmentation. For all of the fillers the majority of subjects maintained >/=1 point improvement in nasolabial fold severity scores through 24 weeks. All of the HA fillers were well tolerated in individuals with skin of color and demonstrated effectiveness throughout the 24 week period. Furthermore, the fillers provided smooth, natural-looking wrinkle correction in darker skin types.

Investigator-Blinded, Single-Center Study to Evaluate the Efficacy and Tolerability of a 4% Hydroquinone Skin Care System Plus 0.02% Tretinoin Cream in Mild-to-Moderate Melasma and Photodamage.

PubMed

Rendon, Marta; Dryer, Laurence

2016-04-01

To evaluate the treatment of mild-to-moderate epidermal melasma and photodamage using a 4% hydroquinone skin care system plus tretinoin 0.02% cream. Single-center, investigator-blinded study in 39 adult females with mild-to-moderate epidermal melasma, mild-to-marked pigmentation intensity, and Fitzpatrick skin type III to VI treated for 24 weeks. Improvements in melasma severity, pigmentation intensity, photodamage, and patient satisfaction were assessed at weeks 4, 8, 12, 18, and 24. Cutaneous tolerability was assessed by investigator (erythema, dryness, peeling) and patients (burning and stinging). Adverse events (AEs) were monitored throughout. Melasma severity, pigmentation intensity, and melasma area and severity index (MASI) scores relative to baseline were all significantly reduced from week 4 onward (P<.001). In addition, signs of facial photodamage were significantly improved. At week 24, 87.9% of patients were "satisfied" or "very satisfied" with the overall treatment effectiveness and Quality of Life (QoL) was much improved. No patient discontinued due to lack of efficacy or treatment-related AEs. One patient (2.8%) reported severe cutaneous intolerability (erythema at week 4). Treating mild-to-moderate melasma using a 4% hydroquinone skin care system plus 0.02% tretinoin cream can significantly reduce the severity and intensity of melasma and associated pigmentation, and improve signs of photodamage within four weeks. Treatment was generally well tolerated and associated with high levels of patient satisfaction.

Safety, efficacy, and usage compliance of home-use device utilizing RF and light energies for treating periorbital wrinkles.

PubMed

Gold, Michael H; Biron, Julie; Levi, Liora; Sensing, Whitney

2017-03-01

The aging process is often associated with undesirable effects on facial skin such as skin redundancy, reduction of elasticity, and increased wrinkling. Radiofrequency (RF) and light-emitting diodes (LEDs) are widely used, clinically proven technologies for skin rejuvenation. This study aimed to evaluate the safety, efficacy, and usage compliance of the home-use device, utilizing RF and LED energies, for self-treatment of periorbital wrinkles and improvement of skin appearance. Thirty-three subjects performed 21 treatment sessions every other day, over 6 weeks on the periorbital areas. In addition, two maintenance treatments were conducted 1 and 2 months following treatment end. Each subject served as his/her own control, comparing results before treatment, and 3 months following treatment end. Thirty subjects completed the study. A blinded, independent photographs assessment of three dermatologists demonstrated an average reduction of 1.49 Fitzpatrick scores (P < 0.001). Analysis revealed improvement (downgrade of at least 1 score) in almost all subjects. No unexpected adverse events were reported. Post-treatment erythema was seen in all subjects and disappeared within 1 h. In some subjects, post-treatment edema was detected and resolved within 24 h. High satisfaction with the device operation, ease of treatments, safety, and wrinkle reduction was reported. The Silk'n Home Skin Tightening (HST) device offers a safe and effective in-home noninvasive technique to improve the appearance of age-related periorbital wrinkles. © 2016 Wiley Periodicals, Inc.

Split-face comparative study of 1550 nm fractional photothermolysis and trichloroacetic acid 15% chemical peeling for facial melasma in Asian skin.

PubMed

Hong, Seung-Phil; Han, Seung-Seog; Choi, Seok-Joo; Kim, Myoung-Shin; Won, Chong-Hyun; Lee, Mi-Woo; Choi, Jee-Ho; Moon, Kee-Chan; Kim, Youn Jin; Chang, Sung-Eun

2012-04-01

Fractional photothermolysis (FP) therapy and chemical peels have been reported to be effective in patients with recalcitrant melasma. However, there is little information to compare the efficacy of single treatment session in Asian women. The aim of this study was to examine the efficacy, long-lasting outcomes and safety of a single session of 1550-nm erbium-doped FP in Asian patients, compared with trichloroacetic acid (TCA) peel with a medium depth. Eighteen Korean women (Fitzpatrick skin type III or IV) with moderate-to-severe bilateral melasma were randomly treated with a single session of 1550-nm FP on one cheek, and with a 15% TCA peel on the other cheek. Outcome measures included an objective melasma area severity index and subjective patient-rated overall improvement at 4 and 12 weeks after treatment. Melasma lesions were significantly improved 4 weeks after either treatment, but melasma recurred at 12 weeks. Post-inflammatory hyperpigmentation developed in 28% of patients at 4 weeks but resolved in all but one patient by 12 weeks. There was no difference between FP treatment and TCA peeling with respect to any outcome measure. FP laser and TCA peel treatments were equally effective and safe when used to treat moderate-to-severe melasma, but neither treatment was long-lasting. We suggest that multiple or periodic maintenance treatments and/or supplemental procedures may be required for the successful treatment of melasma in Asian women.

Micropunch blepharopeeling versus blepharoplasty; what is the best procedure for upper eyelid rejuvenation?

PubMed

Asilian, Ali; Bafandeh, Behzad; Shahmoradi, Zabihollah; Faghihi, Gita; Bostakian, Anis; Mozafarpoor, Samaneh; Hosseini, Sayed Mohsen

2018-05-17

Periocular rejuvenation is the most common aesthetic plastic surgery. The aim of this study was to determine effects of micropunch blepharopeeling (MBP) approach vs blepharoplasty (BP) in periocular rejuvenation. This is a clinical trial study on 22 patients who underwent periorbital rejuvenation referred to University Skin Clinics. Patients were randomly divided into two groups of blepharoplasty or micropunch blepharopeeling. After procedure, all patients were followed in 2 weeks and 2 months and were asked about complications. Patients' satisfaction was scored based on 5-grade scale. Physician satisfaction was assessed based on patients' photographs taken before and 2 months after surgery based on 4-grade scale. The mean age of group MBP was 48.45 ± 7.71 and group BP was 45.45 ± 7.20 (P-value = .36) and Fitzpatrick skin type was not significantly different. Scar was significantly different between groups that 4 (36.4%) patients of BP complained from scars, while none of MBP had significant scar (P-value = .04). Patients were statistically more satisfied with MBP in terms of symmetry, pain, and scar (P-value = .048, .040, and<.001, respectively). Also, MBP was significantly more satisfying for physicians in terms of symmetry and scar (P-value = .047 and <.001, respectively). Micropunch blepharopeeling can be considered as an acceptable procedure of upper eyelid rejuvenation mentioned by patients and physicians. Micropunch blepharopeeling causes fewer scars, better symmetry, and less pain. © 2018 Wiley Periodicals, Inc.

New application of the long-pulsed Nd-YAG laser as an ablative resurfacing tool for skin rejuvenation: a 7-year study.

PubMed

Alshami, Mohammad Ali

2013-09-01

Carbon dioxide (CO2 ) and erbium-yttrium aluminum garnet (Er-YAG) lasers are the gold standards in ablative skin resurfacing. Neodymium-doped yttrium aluminum garnet (Nd-YAG) laser is considered a nonablative skin resurfacing laser whose usage is limited due to its high cost. To assess the efficacy and safety of Nd-YAG as an ablative resurfacing laser and to compare the results with those previously published for CO2 and Erbium-YAG lasers. A total of 296 patients (251 female and 45 male) with Fitzpatrick skin types III-IV and dermatological conditions amenable to ablative skin resurfacing participated in this study. Nd-YAG laser parameters assessed were wavelength (1064 nm), pulse duration (5 ms), fluence (10 J/cm(2) ), and spot size (8-10 mm). Efficacy of Nd-YAG laser was assessed by comparing pre- and posttreatment photographs. An improvement of 30-80% was observed in treated patients. The degree of improvement correlated positively with the number of laser sessions. The most common side effect was hyperpigmentation. Other side effects were less common and mild in intensity compared with published results for gold standard ablative lasers. Not only was the Nd-YAG laser found to be as effective as Er-YAG and CO2 lasers, but treated patients also had shorter recovery and treatment times, and at lower cost. © 2013 Wiley Periodicals, Inc.

Large Magellanic Cloud helium-rich peculiar blue supergiants and SN 1987A

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tuchman, Y.; Wheeler, J.C.

1990-11-01

The theoretical distribution of massive stars in the H-R diagram is compared to the revised data of Fitzpatrick and Garmany for the LMC. Preferred models of about 20 M solar masses undergo a thermal contraction at T(eff) about 35,000 K at the end of core hydrogen burning but reestablish thermal equilibrium to the red of the main sequence at T(eff) about 20,000 K after ignition of a hydrogen-burning shell. They then evolve on a nuclear time scale to T(eff) about 6000 K where they lose thermal equilibrium and jump to the Hayashi track. The theoretical and observed distributions agree withmore » two significant exceptions: the blue thermal contraction gap is overpopulated compared to the theory, and there is a ledge crossing the center of the H-R diagram. The hypothesis that some of the observed stars in the blue gap are secondaries that have accreted helium-rich matter from deep within the hydrogen envelope of a red supergiant primary is explored. Some preliminary observational justification is given. 27 refs.« less

Current Status of Fractional Laser Resurfacing.

PubMed

Carniol, Paul J; Hamilton, Mark M; Carniol, Eric T

2015-01-01

Fractional lasers were first developed based on observations of lasers designed for hair transplantation. In 2007, ablative fractional laser resurfacing was introduced. The fractionation allowed deeper tissue penetration, leading to greater tissue contraction, collagen production and tissue remodeling. Since then, fractional erbium:YAG resurfacing lasers have also been introduced. These lasers have yielded excellent results in treating photoaging, acne scarring, and dyschromia. With the adjustment of microspot density, pulse duration, number of passes, and fluence, the surgeon can adjust the treatment effects. These lasers have allowed surgeons to treat patients with higher Fitzpatrick skin types (types IV to VI) and greater individualize treatments to various facial subunits. Immunohistochemical analysis has demonstrated remodeling effects of the tissues for several months, producing longer lasting results. Adjuvant treatments are also under investigation, including concomitant face-lift, product deposition, and platelet-rich plasma. Finally, there is a short recovery time from treatment with these lasers, allowing patients to resume regular activities more quickly. Although there is a relatively high safety profile for ablative fractionated lasers, surgeons should be aware of the limitations of specific treatments and the associated risks and complications.

Salicylic acid as a peeling agent: a comprehensive review

PubMed Central

Arif, Tasleem

2015-01-01

Salicylic acid has been used to treat various skin disorders for more than 2,000 years. The ability of salicylic acid to exfoliate the stratum corneum makes it a good agent for peeling. In particular, the comedolytic property of salicylic acid makes it a useful peeling agent for patients with acne. Once considered as a keratolytic agent, the role of salicylic acid as a desmolytic agent, because of its ability to disrupt cellular junctions rather than breaking or lysing intercellular keratin filaments, is now recognized and is discussed here. Salicylic acid as a peeling agent has a number of indications, including acne vulgaris, melasma, photodamage, freckles, and lentigines. The efficacy and safety of salicylic acid peeling in Fitzpatrick skin types I–III as well as in skin types V and VI have been well documented in the literature. This paper reviews the available data and literature on salicylic acid as a peeling agent and its possible indications. Its properties, efficacy and safety, the peeling procedure, and possible side effects are discussed in detail. An account of salicylism is also included. PMID:26347269

Salicylic acid as a peeling agent: a comprehensive review.

PubMed

Arif, Tasleem

2015-01-01

Salicylic acid has been used to treat various skin disorders for more than 2,000 years. The ability of salicylic acid to exfoliate the stratum corneum makes it a good agent for peeling. In particular, the comedolytic property of salicylic acid makes it a useful peeling agent for patients with acne. Once considered as a keratolytic agent, the role of salicylic acid as a desmolytic agent, because of its ability to disrupt cellular junctions rather than breaking or lysing intercellular keratin filaments, is now recognized and is discussed here. Salicylic acid as a peeling agent has a number of indications, including acne vulgaris, melasma, photodamage, freckles, and lentigines. The efficacy and safety of salicylic acid peeling in Fitzpatrick skin types I-III as well as in skin types V and VI have been well documented in the literature. This paper reviews the available data and literature on salicylic acid as a peeling agent and its possible indications. Its properties, efficacy and safety, the peeling procedure, and possible side effects are discussed in detail. An account of salicylism is also included.

Chemical peeling in ethnic/dark skin.

PubMed

Roberts, Wendy E

2004-01-01

Chemical peeling for skin of color arose in ancient Egypt, Mesopotamia, and other ancient cultures in and around Africa. Our current fund of medical knowledge regarding chemical peeling is a result of centuries of experience and research. The list of agents for chemical peeling is extensive. In ethnic skin, our efforts are focused on superficial and medium-depth peeling agents and techniques. Indications for chemical peeling in darker skin include acne vulgaris, postinflammatory hyperpigmentation, melasma, scarring, photodamage, and pseudofolliculitis barbae. Careful selection of patients for chemical peeling should involve not only identification of Fitzpatrick skin type, but also determining ethnicity. Different ethnicities may respond unpredictably to chemical peeling regardless of skin phenotype. Familiarity with the properties each peeling agent used is critical. New techniques discussed for chemical peeling include spot peeling for postinflammatory hyperpigmentation and combination peels for acne and photodamage. Single- or combination-agent chemical peels are shown to be efficacious and safe. In conclusion, chemical peeling is a treatment of choice for numerous pigmentary and scarring disorders arising in dark skin tones. Familiarity with new peeling agents and techniques will lead to successful outcomes.

A randomized controlled trial of skin care protocols for facial resurfacing: lessons learned from the Plastic Surgery Educational Foundation's Skin Products Assessment Research study.

PubMed

Pannucci, Christopher J; Reavey, Patrick L; Kaweski, Susan; Hamill, Jennifer B; Hume, Keith M; Wilkins, Edwin G; Pusic, Andrea L

2011-03-01

The Skin Products Assessment Research Committee was created by the Plastic Surgery Educational Foundation in 2006. The Skin Products Assessment Research study aims were to (1) develop an infrastructure for Plastic Surgery Educational Foundation-conducted, industry-sponsored research in facial aesthetic surgery and (2) test the research process by comparing outcomes of the Obagi Nu-Derm System versus conventional therapy as treatment adjuncts for facial resurfacing procedures. The Skin Products Assessment Research study was designed as a multicenter, double-blind, randomized, controlled trial. The study was conducted in women with Fitzpatrick type I to IV skin, moderate to severe facial photodamage, and periocular and/or perioral fine wrinkles. Patients underwent chemical peel or laser facial resurfacing and were randomized to the Obagi Nu-Derm System or a standard care regimen. The study endpoints were time to reepithelialization, erythema, and pigmentation changes. Fifty-six women were enrolled and 82 percent were followed beyond reepithelialization. There were no significant differences in mean time to reepithelialization between Obagi Nu-Derm System and control groups. The Obagi Nu-Derm System group had a significantly higher median erythema score on the day of surgery (after 4 weeks of product use) that did not persist after surgery. Test-retest photographic evaluations demonstrated that both interrater and intrarater reliability were adequate for primary study outcomes. The authors demonstrated no significant difference in time to reepithelialization between patients who used the Obagi Nu-Derm System or a standard care regimen as an adjunct to facial resurfacing procedures. The Skin Products Assessment Research team has also provided a discussion of future challenges for Plastic Surgery Educational Foundation-sponsored clinical research for readers of this article.

Efficacy of Intense-pulsed Light Therapy with Topical Benzoyl Peroxide 5% versus Benzoyl Peroxide 5% Alone in Mild-to-moderate Acne Vulgaris: A Randomized Controlled Trial.

PubMed

Mokhtari, Fatemeh; Gholami, Maryam; Siadat, Amir Hossein; Jafari-Koshki, Tohid; Faghihi, Gita; Nilforoushzadeh, Mohammad Ali; Hosseini, Sayed Mohsen; Abtahi-Naeini, Bahareh

2017-01-01

Acne vulgaris is a disease of pilosebaceous unit with multifactorial pathogenesis and threats patients' social functioning. There is a growing research to find faster, more effective, and easy to use treatments. The aim of this study is to evaluate the efficacy of benzoyl peroxide 5% (BP) with and without concomitant intense-pulsed light (IPL) therapy in mild-to-moderate acne vulgaris. In this controlled trial, 58 eligible patients with mild-to-moderate acne and Fitzpatrick skin phototype III and IV were randomly allocated to two groups. All patients were asked to use a thin layer of BP every night. The IPL therapy was administered at the end of first, 2 nd , and 3 rd months. Acne Global Severity Scale (AGSS), Acne Severity Index (ASI), and total lesion counting (TLC) along with patient satisfaction were recorded. Patients were also examined 1 month after the final therapeutic visit. The IPL group showed greater reduction in AGSS ( P < 0.001) and TLC ( P = 0.005) than the control group. However, the difference in ASI was not significant ( P = 0.12). Patients in IPL groups were more satisfied than control group ( P < 0.001). Adding IPL to BP can result better response to BP alone. In acne treatment, combination therapy such as IPL and other topical agents should be kept in mind.

Treating epidermal melasma with a 4% hydroquinone skin care system plus tretinoin cream 0.025%.

PubMed

Grimes, Pearl; Watson, JoAnne

2013-01-01

We sought to evaluate the efficacy and tolerability of treating melasma using a 4% hydroquinone skin care system, including a proprietary cleanser, toner, 4% hydroquinone, exfoliation enhancer, and sunscreen, plus tretinoin cream 0.025%. Together these products offer not only treatment of melasma but also a complete skin care regimen. Twenty participants with mild or moderate epidermal melasma with Fitzpatrick skin types III to VI were instructed to use the hydroquinone skin care system and tretinoin cream for 12 weeks. Melasma severity, melasma pigmentation intensity, and melasma area and severity index (MASI) score were significantly reduced from week 4 onward relative to baseline (P < or = .01). The proportion of participants who felt embarrassed or self-conscious about their skin very much or a lot declined from 80% (16/20) to 20% (4/20) between baseline and week 12. Similarly, the proportion of those who made very much or a lot of effort to hide their skin discoloration declined from 90% (18/20) to 37% (7/19). In total, 85% (17/20) of participants were satisfied with the overall effectiveness of the study treatment. Three participants had adverse events probably related to treatment (dryness, erythema, peeling, and stinging sensation). The 4% hydroquinone skin care system plus tretinoin cream 0.025% is effective and well-tolerated in the treatment of melasma.

Multiple spatially resolved reflection spectroscopy for in vivo determination of carotenoids in human skin and blood

NASA Astrophysics Data System (ADS)

Darvin, Maxim E.; Magnussen, Björn; Lademann, Juergen; Köcher, Wolfgang

2016-09-01

Non-invasive measurement of carotenoid antioxidants in human skin is one of the important tasks to investigate the skin physiology in vivo. Resonance Raman spectroscopy and reflection spectroscopy are the most frequently used non-invasive techniques in dermatology and skin physiology. In the present study, an improved method based on multiple spatially resolved reflection spectroscopy (MSRRS) was introduced. The results obtained were compared with those obtained using the ‘gold standard’ resonance Raman spectroscopy method and showed strong correlations for the total carotenoid concentration (R  =  0.83) as well as for lycopene (R  =  0.80). The measurement stability was confirmed to be better than 10% within the total temperature range from 5 °C to  +  30 °C and pressure contact between the skin and the MSRRS sensor from 800 Pa to 18 000 Pa. In addition, blood samples taken from the subjects were analyzed for carotenoid concentrations. The MSRRS sensor was calibrated on the blood carotenoid concentrations resulting in being able to predict with a correlation of R  =  0.79. On the basis of blood carotenoids it could be demonstrated that the MSRRS cutaneous measurements are not influenced by Fitzpatrick skin types I-VI. The MSRRS sensor is commercially available under the brand name biozoom.

Chemical peels for melasma in dark-skinned patients.

PubMed

Sarkar, Rashmi; Bansal, Shuchi; Garg, Vijay K

2012-10-01

Melasma is a common disorder of hyperpigmentation, which has a severe impact on the quality of life. Inspite of tremendous research, the treatment remains frustrating both to the patient and the treating physician. Dark skin types (Fitzpatrick types IV to VI) are especially difficult to treat owing to the increased risk of post-inflammatory hyperpigmentation (PIH). The treatment ranges from a variety of easily applied topical therapies to agents like lasers and chemical peels. Peels are a well-known modality of treatment for melasma, having shown promising results in many clinical trials. However, in darker races, the choice of the peeling agent becomes relatively limited; so, there is the need for priming agents and additional maintenance peels. Although a number of new agents have come up, there is little published evidence supporting their use in day-to -day practice. The traditional glycolic peels prove to be the best both in terms of safety as well as efficacy. Lactic acid peels being relatively inexpensive and having shown equally good results in a few studies, definitely need further experimentation. We also recommend the use of a new peeling agent, the easy phytic solution, which does not require neutralisation unlike the traditional alpha-hydroxy peels. The choice of peeling agent, the peel concentration as well as the frequency and duration of peels are all important to achieve optimum results.

Chemical Peels for Melasma in Dark-Skinned Patients

PubMed Central

Sarkar, Rashmi; Bansal, Shuchi; Garg, Vijay K

2012-01-01

Melasma is a common disorder of hyperpigmentation, which has a severe impact on the quality of life. Inspite of tremendous research, the treatment remains frustrating both to the patient and the treating physician. Dark skin types (Fitzpatrick types IV to VI) are especially difficult to treat owing to the increased risk of post-inflammatory hyperpigmentation (PIH). The treatment ranges from a variety of easily applied topical therapies to agents like lasers and chemical peels. Peels are a well-known modality of treatment for melasma, having shown promising results in many clinical trials. However, in darker races, the choice of the peeling agent becomes relatively limited; so, there is the need for priming agents and additional maintenance peels. Although a number of new agents have come up, there is little published evidence supporting their use in day-to -day practice. The traditional glycolic peels prove to be the best both in terms of safety as well as efficacy. Lactic acid peels being relatively inexpensive and having shown equally good results in a few studies, definitely need further experimentation. We also recommend the use of a new peeling agent, the easy phytic solution, which does not require neutralisation unlike the traditional alpha-hydroxy peels. The choice of peeling agent, the peel concentration as well as the frequency and duration of peels are all important to achieve optimum results. PMID:23378706

In vivo measurements of cutaneous melanin across spatial scales: using multiphoton microscopy and spatial frequency domain spectroscopy

PubMed Central

Saager, Rolf B.; Balu, Mihaela; Crosignani, Viera; Sharif, Ata; Durkin, Anthony J.; Kelly, Kristen M.; Tromberg, Bruce J.

2015-01-01

Abstract. The combined use of nonlinear optical microscopy and broadband reflectance techniques to assess melanin concentration and distribution thickness in vivo over the full range of Fitzpatrick skin types is presented. Twelve patients were measured using multiphoton microscopy (MPM) and spatial frequency domain spectroscopy (SFDS) on both dorsal forearm and volar arm, which are generally sun-exposed and non-sun-exposed areas, respectively. Both MPM and SFDS measured melanin volume fractions between ∼5% (skin type I non-sun-exposed) and 20% (skin type VI sun exposed). MPM measured epidermal (anatomical) thickness values ∼30–65  μm, while SFDS measured melanin distribution thickness based on diffuse optical path length. There was a strong correlation between melanin concentration and melanin distribution (epidermal) thickness measurements obtained using the two techniques. While SFDS does not have the ability to match the spatial resolution of MPM, this study demonstrates that melanin content as quantified using SFDS is linearly correlated with epidermal melanin as measured using MPM (R2=0.8895). SFDS melanin distribution thickness is correlated to MPM values (R2=0.8131). These techniques can be used individually and/or in combination to advance our understanding and guide therapies for pigmentation-related conditions as well as light-based treatments across a full range of skin types. PMID:26065839

Non-ablative fractional resurfacing of surgical and post-traumatic scars.

PubMed

Vasily, David B; Cerino, Mary E; Ziselman, Ethel M; Zeina, S Tannous

2009-11-01

Non-ablative, fractional lasers generate microscopic columns of coagulated tissue through the epidermis and dermis to evoke a wound healing response. In this study, the authors examined the efficacy and safety of the non-ablative 1540 nm erbium:glass fractional laser in the treatment of surgical and post-traumatic scars. Clinical studies were conducted on a range of surgical and post-traumatic scars with a 1540 nm erbium:glass fractional laser varying energy, pulse widths, treatment passes, and number of treatments. A histological study was conducted on a postsurgical scar to follow the time course of healing post-treatment and the impact of the fractional treatment on normalization of scar tissue, as compared to baseline histology of the scar. Histologic findings demonstrated rapid re-epithelialization of the epidermis within 72 hours of treatment. Remodeling of scar tissue with renewal and reorganization of collagen fibers in the dermis was noted two weeks post-treatment. Clinical subjects, with Fitzpatrick skin types II-V, received three to seven treatments with microbeam energies up to 60 mJ/pb and five passes. Relative to baseline, 73% of treated scars improved 50% or more and 43% improved 75% or more. Side effects included mild swelling (95% of subjects), erythema (94%) and purpura (5%), which all resolved within two to three days. Downtime was minimal-to-none for all subjects. These data illustrate the safety and efficacy of the 1540 nm erbium:glass fractional laser in the treatment of surgical and post-traumatic scars. Practitioners can vary energy and microbeam density in order to tailor the treatment to reflect the individual scar characteristics.

Strategies for Optimal Implementation of Simulated Clients for Measuring Quality of Care in Low- and Middle-Income Countries.

PubMed

Fitzpatrick, Anne; Tumlinson, Katherine

2017-03-24

The use of simulated clients or "mystery clients" is a data collection approach in which a study team member presents at a health care facility or outlet pretending to be a real customer, patient, or client. Following the visit, the shopper records her observations. The use of mystery clients can overcome challenges of obtaining accurate measures of health care quality and improve the validity of quality assessments, particularly in low- and middle-income countries. However, mystery client studies should be carefully designed and monitored to avoid problems inherent to this data collection approach. In this article, we discuss our experiences with the mystery client methodology in studies conducted in public- and private-sector health facilities in Kenya and in private-sector facilities in Uganda. We identify both the benefits and the challenges in using this methodology to guide other researchers interested in using this technique. Recruitment of appropriate mystery clients who accurately represent the facility's clientele, have strong recall of recent events, and are comfortable in their role as undercover data collectors are key to successful implementation of this methodology. Additionally, developing detailed training protocols can help ensure mystery clients behave identically and mimic real patrons accurately while short checklists can help ensure mystery client responses are standardized. Strict confidentiality and protocols to avoid unnecessary exams or procedures should also be stressed during training and monitored carefully throughout the study. Despite these challenges, researchers should consider mystery client designs to measure actual provider behavior and to supplement self-reported provider behavior. Data from mystery client studies can provide critical insight into the quality of service provision unavailable from other data collection methods. The unique information available from the mystery client approach far outweighs the cost. © Fitzpatrick and Tumlinson.

Non-insulated smooth motion, micro-needles RF fractional treatment for wrinkle reduction and lifting of the lower face: International study.

PubMed

Gold, Michael; Taylor, Mark; Rothaus, Kenneth; Tanaka, Yohei

2016-10-01

Skin aging occurs through both intrinsic and extrinsic processes. Fractional radiofrequency (RF) with a microneedling array is the newest form of fractional therapy to be useful in treating aging skin. The current study utilized a noninsulated fractional RF microneedling system. This multicenter clinical trial saw 49 patients complete 3 monthly treatments with the new fractional RF microneedling treatments and be followed for 3 months following their last treatment. Pain during treatment was recorded as well as overall improvement using a GAIS scale. Adverse events were also noted. Forty-nine patients completed all of the treatments and follow-ups. Mild to moderate erythema were reported immediately after treatment which lasted up to 12 hours after the treatment. Pain, as measured on a 1-10 VAS, was noted to 4, on average. The average Fitzpatrick's wrinkle scale score at baseline was 5.04 ± 1.22, 1 month after 3 treatments 3.829 ± 1.69 and 3 months after 3 treatments 3.5 ± 1.66. These results are statistically highly significant (correlated T-test, P < 0.001). Improvement was shown in 100% of patients while 65% of patients had significant improvement (GAIS levels 3-5). Significant skin tightening and skin lifting were also observed. No unusual adverse events were noted throughout the course of the study. This multicenter study showed significant wrinkle reduction, skin tightening, and lifting of the mid and lower face with the noninsulated fractional RF microneedling system. Lasers Surg. Med. 48:727-733, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Early use of CO2 lasers and silicone gel on surgical scars: Prospective study.

PubMed

Alberti, Luiz Ronaldo; Vicari, Eduardo Faria; De Souza Jardim Vicari, Roselaine; Petroianu, Andy

2017-08-01

Some publications have shown good aesthetic results for scars through the early application of fractional CO 2 lasers on elective surgery scars. The aim of this randomized, double-blinded clinical trial was to compare the aesthetic quality of the scar from a group of patients submitted to super-pulsed fractional CO 2 laser applications (10,600 nm fractional CO 2 , set at a density of 20% and an energy of 10 mJ, a scanner of 03 × 03 mm, and a pulse repetition time of 0.3 seconds) in contrast with the other group that used only the silicone gel on the scar after plastic surgery. A prospective study was conducted by analyzing 42 patients with recent scars of up to three weeks in patients with a I-IV Fitz-Patrick skin phototype. The scars were evaluated aesthetically in the second and sixth months by applying the Vancouver scale. At 2 months of treatment, the statistical data showed a discrete superiority in the LASER group's treatment, as compared to that of the SILICONE group, in both percentage and significance concerning flexibility (P = 0.05) and pigmentation (P = 0.01). Laser group presented better results in the sixth month (P = 0,03). The early use of the fractional CO 2 laser contributed to improving the aesthetic quality of scars from elective surgeries in the second and in the 6th months. Lasers Surg. Med. 49:570-576, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Ultrastructural study on the retinal pigment epithelium of human embryos, with special reference to quantitative study on the development of melanin granules.

PubMed

Oguni, M; Tanaka, O; Shinohara, H; Yoshioka, T; Setogawa, T

1991-01-01

The development of the retinal pigment epithelium (RPE) was studied ultrastructurally, using 13 externally normal human embryos, Carnegie stages ranging from 13 to 23 (4-8 week of gestation). Melanosomes in the peripheral and posterior RPE were classified according to Fitzpatrick et al. The melanosome of phase I is formed from the Golgi complex and parcelled off into small vesicles. The vesicle enlarges and elongates to form an oval organelle with membranous structures in it (phase II melanosome). Subsequently, melanin deposits on the membranous structures of the melanosomes (phase III melanosomes), and the completion of this process produces a uniformly electrondense granule without discernible internal structures (phase IV melanosome). Melanosomes of phases III and IV appeared in the RPE at stage 15. As the embryonic stage advanced, the ratio of phase II melanosomes decreased and that of phase IV melanosomes increased. The number of phase III melanosomes reached a peak in the peripheral and posterior RPE at stages 15 and 18, respectively. After stage 17, the increase in melanosomes and intracellular organelles was more prominent in the posterior than in the peripheral RPE. During stages 13 and 15, gap junctions were present not only in the apical but also basal plasma membranes of the RPE. At stage 20, gap junctions in the basal plasma membrane disappeared except for the transitional areas from the RPE to the neural retina (NR). In addition, gap junctions were observed between NR and RPE only in the peripheral region at stage 20. The morphological and quantitative differences in the peripheral and posterior RPE in the embryonic period are discussed.

A randomized controlled double blind investigation of the effects of Vitamin D dietary supplementation in subjects with atopic dermatitis

PubMed Central

Hata, Tissa R.; Audish, David; Kotol, Paul; Coda, Alvin; Kabigting, Filamer; Miller, Jeremiah; Alexandrescu, Doru; Boguniewicz, Mark; Taylor, Patricia; Aertker, Leela; Kesler, Karen; Hanifin, Jon M.; Leung, Donald Y.M.; Gallo, Richard L.

2013-01-01

Background Subjects with atopic dermatitis (AD) have defects in antimicrobial peptide (AMP) production possibly contributing to an increased risk of infections. In laboratory models, vitamin D can alter innate immunity by increasing AMP production. Objective To determine if AD severity correlates with baseline vitamin D levels, and to test whether supplementation with oral vitamin D alters AMP production in AD skin. Methods This was a multi-center, placebo controlled, double-blind study in 30 subjects with AD, 30 non-atopic subjects, and 16 subjects with psoriasis. Subjects were randomized to receive either 4000 IU of cholecalciferol or placebo for 21 days. At baseline and day 21, levels of 25-hydroxyvitamin D (25OHD), cathelicidin, HBD-3, IL-13, and Eczema Area and Severity Index (EASI) and Rajka-Langeland scores were obtained. Results At baseline, 20% of AD subjects had serum 25OHD below 20 ng/ml. Low serum 25OHD correlated with increased Fitzpatrick Skin Type and elevated BMI, but not AD severity. After 21 days of oral cholecalciferol, mean serum 25OHD increased, but there was no significant change in skin cathelicidin, HBD-3, IL-13, or EASI scores. Conclusions This study illustrated that darker skin types and elevated BMI are important risk factors for vitamin D deficiency in subjects with AD, and highlighted the possibility that seasonality and locale may be potent contributors to cathelicidin induction through their effect on steady state 25OHD levels. Given the molecular links between vitamin D and immune function, further study of vitamin D supplementation in subjects with AD is warranted. PMID:23638978

Ablative fractional carbon dioxide laser combined with intense pulsed light for the treatment of photoaging skin in Chinese population: A split-face study.

PubMed

Mei, Xue-Ling; Wang, Li

2018-01-01

Intense pulsed light (IPL) is effective for the treatment of lentigines, telangiectasia, and generalized erythema, but is less effective in the removal of skin wrinkles. Fractional laser is effective on skin wrinkles and textural irregularities, but can induce postinflammatory hyperpigmentation (PIH), especially in Asians. This study evaluated the safety and efficacy of ablative fractional laser (AFL) in combination with IPL in the treatment of photoaging skin in Asians.This study included 28 Chinese women with Fitzpatrick skin type III and IV. The side of the face to be treated with IPL alone (3 times) or AFL in combination with IPL (2 IPL treatments and 1 AFL treatment) was randomly selected. Skin conditions including hydration, transepidermal water loss, elasticity, spots, ultraviolet spots, brown spots, wrinkle, texture, pore size and red areas, as well as adverse effects were evaluated before the treatment and at 30 days after the treatment.Compared with IPL treatment alone, AFL in combination with IPL significantly increased elasticity, decreased pore size, reduced skin wrinkles, and improved skin texture (P = .004, P = .039, P = .015, and P = .035, respectively). Both treatment protocols produced similar effects in relation to the improvement of photoaging-induced pigmentation. The combined therapy did not impair epidermal barrier function. No postoperative infection, hypopigmentation, or scarring occurred after IPL and AFL treatments. PIH occurred at 1 month after AFL treatment and disappeared at 30 days after completion of the combined therapy.AFL in combination with IPL is safe and effective for photoaging skin in Asians. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Demographic Differences in Sun Protection Beliefs and Behavior: A Community-Based Study in Shanghai, China

PubMed Central

Yan, Shuxian; Xu, Feng; Yang, Chunxue; Li, Fei; Fan, Jing; Wang, Linggao; Cai, Minqiang; Zhu, Jianfeng; Kan, Haidong; Xu, Jinhua

2015-01-01

Objective: We want to know the attitudes and behaviors towards UV protection and we want to analyze the difference between different Chinese demographic groups in this study. Methods: A community-based study was undertaken in Shanghai from October 2009 to January 2010. The participants, ages 20–60 years old, were screened by cluster sampling and were investigated through interviews at their own homes. Personal basic information and questions pertaining to their knowledge and attitudes towards sunlight and sun protective activities were included in the questionnaire. Results: We completed 5964 questionnaires (2794 men and 3170 women). Eighty-six percent of the respondents belonged to Fitzpatrick skin type IV. Knowledge about UV-induced risks was known by more than half of the participants. However, only one-third of the participants thought they needed sun protection in winter and indoors or in vehicles, and 27% of the participants acknowledged tanning was not favorable. The attitudes towards sun exposure varied greatly, showing significant differences based on gender, age, socioeconomic groups and skin type groups (p < 0.05). Fifty-five percent of the participants never use an umbrella under sunlight, only 26.5% of the respondents wear hats, and 21.3% of the participants applied sunscreen. Females and individuals of a younger age and higher education level were more likely to perform sun-protective behaviors than males and those of an older age and lower education level (p < 0.001). Conclusion: There is a deficit in the use of sun protection existing in our surveyed Chinese population, especially in males and lower socioeconomic population, which could allow for planning prevention campaigns and exploring sun-preventive products. PMID:25794187

Nonablative 1550-nm fractional laser therapy versus triple topical therapy for the treatment of melasma: a randomized controlled pilot study.

PubMed

Kroon, Marije W; Wind, Bas S; Beek, Johan F; van der Veen, J P Wietze; Nieuweboer-Krobotová, Ludmila; Bos, Jan D; Wolkerstorfer, Albert

2011-03-01

Various treatments are currently available for melasma. However, results are often disappointing. We sought to assess the efficacy and safety of nonablative 1550-nm fractional laser therapy and compare results with those obtained with triple topical therapy (the gold standard). Twenty female patients with moderate to severe melasma and Fitzpatrick skin types II to V were treated either with nonablative fractional laser therapy or triple topical therapy (hydroquinone 5%, tretinoin 0.05%, and triamcinolone acetonide 0.1% cream) once daily for 8 weeks in a randomized controlled observer-blinded study. Laser treatment was performed every 2 weeks for a total of 4 times. Physician Global Assessment was assessed at 3 weeks, 3 months, and 6 months after the last treatment. Physician Global Assessment improved (P < .001) in both groups at 3 weeks. There was no difference in Physician Global Assessment between the two groups. Mean treatment satisfaction and recommendation were significantly higher in the laser group at 3 weeks (P < .05). However, melasma recurred in 5 patients in both groups after 6 months. Side effects in the laser group were erythema, burning sensation, facial edema, and pain; in the triple group side effects were erythema, burning, and scaling. Limitations were: small number of patients; only one set of laser parameters; and a possible difference in motivation between groups. Nonablative fractional laser therapy is safe and comparable in efficacy and recurrence rate with triple topical therapy. It may be a useful alternative treatment option for melasma when topical bleaching is ineffective or not tolerated. Different laser settings and long-term maintenance treatment should be tested in future studies. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ekkebus, Allen E

Oak Ridge National Laboratory hosted two workshops in April 2007 relevant to nuclear engineering education. In the Neutron Stress, Texture, and Phase Transformation for Industry workshop [http://neutrons.ornl.gov/workshops/nst2/], several invited speakers gave examples of neutron stress mapping for nuclear engineering applications. These included John Root of National Research Council of Canada, Mike Fitzpatrick of the UK's Open University, and Yan Gao of GE Global Research on their experiences with industrial and academic uses of neutron diffraction. Xun-Li Wang and Camden Hubbard described the new instruments at ORNL that can be used for such studies. This was preceded by the Neutrons formore » Materials Science and Engineering educational symposium [http://neutrons.ornl.gov/workshops/edsym2007]. It was directed to the broad materials science and engineering community based in universities, industry and laboratories who wish to learn what the neutron sources in the US can provide for enhancing the understanding of materials behavior, processing and joining. Of particular interest was the presentation of Donald Brown of Los Alamos about using 'Neutron diffraction measurements of strain and texture to study mechanical behavior of structural materials.' At both workshops, the ORNL neutron scattering instruments relevant to nuclear engineering studies were described. The Neutron Residual Stress Mapping Facility (NRSF2) is currently in operation at the High Flux Isotope Reactor; the VULCAN Engineering Materials Diffractometer will begin commissioning in 2008 at the Spallation Neutron Source. For characteristics of these instruments, as well as details of other workshops, meetings, capabilities, and research proposal submissions, please visit http://neutrons.ornl.gov. To submit user proposals for time on NRSF2 contact Hubbard at hubbardcr@ornl.gov.« less

Evaluation of a combined laser-radio frequency device (Polaris WR) for the nonablative treatment of facial wrinkles.

PubMed

Kulick, Michael

2005-06-01

Nonablative wrinkle reduction or skin tightening is desired by individuals who, ideally, hope to have the skin improvement associated with chemical or laser ablative techniques but without the undesirable recovery process. Electro-optical synergy (ELOS) technology that combines radio frequency (RF) and diode laser energy (900 nm) was used to treat 15 patients in this IRB sanctioned study. Energy settings were based on the depth of wrinkles (the greater the depth and concentration of wrinkles, the higher the RF setting) and ranged from 50-100 J/cm2 RF and 15 J/cm2 for the optical, laser component. Patients received three full-face treatments, and results were evaluated by comparison of standardized photographs and patient questionnaire given prior to each treatment and one month after the third treatment. The primary investigator and three other "blinded" physicians evaluated these photographs using Fitzpatrick's wrinkle classification to assess the improvement, if any, between the initial and final visit. Eight patients completed the study. Explanation for the exclusion of the remaining six patients were: one decided to have surgery, two felt the treatment was too painful, and three moved out of the area. Following treatment, all patients had mild swelling (resolved <48 hours) and skin hyperemia (resolved <24 hours). Results observed one month after the last treatment in eight patients demonstrated an average of 25% reduction in skin wrinkles (range 14%-32%). There were no adverse side effects. The major concern of the patients was the discomfort associated with the treatment. As part of an FDA investigation to assess efficacy, long-term follow-up was not a part of this study protocol.

Why threefold-replication of families?

NASA Astrophysics Data System (ADS)

Fitzpatrick, Gerald L.

1998-04-01

In spite of the many successes of the standard model of particle physics, the observed proliferation of matter-fields, in the form of ``replicated'' generations or families, is a major unsolved problem. In this paper, I explore some of the algebraic, geometric and physical consequences of a new organizing principle for fundamental fermions (quarks and leptons)(Gerald L. Fitzpatrick, phThe Family Problem--New Internal Algebraic and Geometric Regularities), Nova Scientific Press, Issaquah, Washington, 1997. Read more about this book (ISBN 0--9655695--0--0) and its subject matter at: http://www.tp.umu.se/TIPTOP and/or http://www.amazon.com.. The essence of the new organizing principle is the idea that the standard-model concept of scalar fermion numbers f can be generalized. In particular, a ``generalized fermion number,'' which consists of a 2× 2 matrix F that ``acts'' on an internal 2-space, instead of spacetime, is taken to describe certain internal properties of fundamental fermions. This generalization automatically introduces internal degrees of freedom that ``explain,'' among other things, family replication and the number (three) of families observed in nature.

Nodal Green’s Function Method Singular Source Term and Burnable Poison Treatment in Hexagonal Geometry

DOE Office of Scientific and Technical Information (OSTI.GOV)

A.A. Bingham; R.M. Ferrer; A.M. ougouag

2009-09-01

An accurate and computationally efficient two or three-dimensional neutron diffusion model will be necessary for the development, safety parameters computation, and fuel cycle analysis of a prismatic Very High Temperature Reactor (VHTR) design under Next Generation Nuclear Plant Project (NGNP). For this purpose, an analytical nodal Green’s function solution for the transverse integrated neutron diffusion equation is developed in two and three-dimensional hexagonal geometry. This scheme is incorporated into HEXPEDITE, a code first developed by Fitzpatrick and Ougouag. HEXPEDITE neglects non-physical discontinuity terms that arise in the transverse leakage due to the transverse integration procedure application to hexagonal geometry andmore » cannot account for the effects of burnable poisons across nodal boundaries. The test code being developed for this document accounts for these terms by maintaining an inventory of neutrons by using the nodal balance equation as a constraint of the neutron flux equation. The method developed in this report is intended to restore neutron conservation and increase the accuracy of the code by adding these terms to the transverse integrated flux solution and applying the nodal Green’s function solution to the resulting equation to derive a semi-analytical solution.« less

Trichloroacetic Acid Versus Salicylic Acid in the Treatment of Acne Vulgaris in Dark-Skinned Patients.

PubMed

Abdel Meguid, Azza Mahfouz; Elaziz Ahmed Attallah, Dalia Abd; Omar, Howida

2015-12-01

Treatment options for acne include chemical peeling. Trichloroacetic acid (TCA) has been used for treating acne. The ability of TCA to diminish corneocyte cohesion and keratinocyte plugging addresses this mode of treatment. Salicylic acid is an excellent keratolytic agent. It is believed to function through solubilization of intercellular cement, thereby reducing corneocyte adhesion. Comparing the therapeutic efficacy of TCA 25% peels with those of salicylic acid 30% in patients with acne vulgaris. Twenty patients, Fitzpatrick skin Types III to V with facial acne, were enrolled. Twenty-five percent of TCA was applied to the right half of the face and 30% salicylic acid to the left half at 2-week interval for 2 months. Total improvement was more frequent with salicylic acid peeling (95%) versus (85%) with TCA. Total comedones improvement was more frequent with TCA peeling (80%) versus (70%) with salicylic acid. Improvement of inflammatory lesions was more frequent among the side treated with salicylic acid (85%) versus (80%) with TCA peeling. However, the results did not reach the statistical significance level. Trichloroacetic acid is more superior in treating comedonal lesions, whereas salicylic is more superior in treating inflammatory lesions, without significant different between their results.

Efficacy of Intense-pulsed Light Therapy with Topical Benzoyl Peroxide 5% versus Benzoyl Peroxide 5% Alone in Mild-to-moderate Acne Vulgaris: A Randomized Controlled Trial

PubMed Central

Mokhtari, Fatemeh; Gholami, Maryam; Siadat, Amir Hossein; Jafari-Koshki, Tohid; Faghihi, Gita; Nilforoushzadeh, Mohammad Ali; Hosseini, Sayed Mohsen; Abtahi-Naeini, Bahareh

2017-01-01

Objective: Acne vulgaris is a disease of pilosebaceous unit with multifactorial pathogenesis and threats patients' social functioning. There is a growing research to find faster, more effective, and easy to use treatments. The aim of this study is to evaluate the efficacy of benzoyl peroxide 5% (BP) with and without concomitant intense-pulsed light (IPL) therapy in mild-to-moderate acne vulgaris. Methods: In this controlled trial, 58 eligible patients with mild-to-moderate acne and Fitzpatrick skin phototype III and IV were randomly allocated to two groups. All patients were asked to use a thin layer of BP every night. The IPL therapy was administered at the end of first, 2nd, and 3rd months. Acne Global Severity Scale (AGSS), Acne Severity Index (ASI), and total lesion counting (TLC) along with patient satisfaction were recorded. Patients were also examined 1 month after the final therapeutic visit. Findings: The IPL group showed greater reduction in AGSS (P < 0.001) and TLC (P = 0.005) than the control group. However, the difference in ASI was not significant (P = 0.12). Patients in IPL groups were more satisfied than control group (P < 0.001). Conclusion: Adding IPL to BP can result better response to BP alone. In acne treatment, combination therapy such as IPL and other topical agents should be kept in mind. PMID:29417078

Non-ablative fractional resurfacing in combination with topical tretinoin cream as a field treatment modality for multiple actinic keratosis: a pilot study and a review of other field treatment modalities.

PubMed

Prens, Sebastiaan P; de Vries, Karin; Neumann, H A Martino; Prens, Errol P

2013-06-01

Actinic keratoses (AK) are premalignant lesions occurring mainly in sun-damaged skin. Current topical treatment options for AK and photo-damaged skin such as liquid nitrogen and electrosurgery are not suitable for field treatment. Otherwise, therapies suitable for field treatment bring along considerable patient discomfort. Non-ablative fractional resurfacing has emerged as a logical treatment option especially for field treatment of AK. To evaluate the clinical efficacy of fractional laser therapy for clearing AK and improving skin quality. To compare patient friendliness of the "fractional" therapy with those reported for other field treatment modalities. Ten patients with Fitzpatrick skin type I to III with multiple AK and extensive sun-damaged skin, received 5-10 sessions with a 4-week interval using a 1550 nm Erbium-Glass Fractionated laser (Sellas, Korea). Four weeks and 24 weeks after the last treatment the clinical results were evaluated by an independent physician. The mean degree of improvement, in terms of reduction in the number of AK and improvement of skin texture, was 54% on a 4 point PGA scale, and persisted for approximately 6 months. The biggest advantage of fractional laser treatment, besides the eradication of AK and a clear rejuvenation effect, is the absence of "downtime". Fractional non-ablative resurfacing induces significant reduction in the number of AK and improves the skin quality. Also all patients preferred fractional laser therapy above other AK treatment modalities.

Prevalence of Vitamin D Deficiency and Its Associations with Skin Color in Pregnant Women in the First Trimester in a Sample from Switzerland.

PubMed

Richard, Aline; Rohrmann, Sabine; Quack Lötscher, Katharina C

2017-03-10

Vitamin D deficiency in pregnancy has negative clinical consequences, such as associations with glucose intolerance, and has been shown to be distributed differently in certain ethnic groups. In some countries, a difference in the rate of vitamin D deficiency was detected in pregnant women depending on their skin color. We examined the prevalence of vitamin D deficiency (<20 ng/mL) in women in early pregnancy in Switzerland and evaluated the association of skin color with vitamin D deficiency. In a single-center cohort study, the validated Fitzpatrick scale and objective melanin index were used to determine skin color. Of the 204 pregnant women included, 63% were vitamin D deficient. The mean serum 25-hydroxyvitamin D concentration was 26.1 ng/mL (95% confidence interval (CI) 24.8-27.4) in vitamin D-sufficient women and 10.5 ng/mL (95% CI 9.7-11.5) in women with deficiency. In the most parsimonious model, women with dark skin color were statistically significantly more often vitamin D deficient compared to women with light skin color (OR 2.60; 95% CI 1.08-6.22; adjusted for age, season, vitamin D supplement use, body mass index, smoking, parity). This calls for more intense counseling as one policy option to improve vitamin D status during pregnancy, i.e., use of vitamin D supplements during pregnancy, in particular for women with darker skin color.

Conventional diamond fraise vs manual spot dermabrasion with drywall sanding screen for scars from skin cancer surgery.

PubMed

Gillard, Montgomery; Wang, Timothy S; Boyd, Charles M; Dunn, Rodney L; Fader, Darrell J; Johnson, Timothy M

2002-08-01

To directly compare cosmetic improvement and postoperative sequelae resulting from dermabrasion of surgical scars with conventional motor-powered diamond fraise vs manual dermabrasion with medium-grade drywall sanding screen. Patients were randomly assigned to receive treatment with conventional diamond fraise dermabrasion to one half of the scar and manual dermabrasion with a drywall sanding screen to the other half in a prospective, comparative clinical study. Blinded observers assessed clinical variables during a 6-month follow-up period. University hospital/cancer center-based cutaneous surgery unit. Twenty-one healthy volunteers, Fitzpatrick skin type I to III, with contour irregularities resulting from granulation (7 patients) or reconstruction (14 patients) after skin cancer excision. One half of the patient's scar was treated with motor-powered diamond fraise dermabrasion and the other half was treated with manual dermabrasion with medium-grade drywall sanding screen. Correction of contour, scarline visibility, time to reepithelialization, presence or absence of milia, degree of postoperative erythema, hypertrophic scarring, patients' subjective reports of postoperative pain, and presence of pigmentary changes were observed for both methods. Standardized scoring systems were used to quantify outcome measures. According to the standardized scoring systems, no differences were found between the 2 methods at any point. In addition, no significant differences were found between the methods for any measure at any of the time points. Both dermabrasion techniques are equally effective in improving the cosmetic appearance of surgical scars.

Radiofrequency facial rejuvenation: evidence-based effect.

PubMed

el-Domyati, Moetaz; el-Ammawi, Tarek S; Medhat, Walid; Moawad, Osama; Brennan, Donna; Mahoney, My G; Uitto, Jouni

2011-03-01

Multiple therapies involving ablative and nonablative techniques have been developed for rejuvenation of photodamaged skin. Monopolar radiofrequency (RF) is emerging as a gentler, nonablative skin-tightening device that delivers uniform heat to the dermis at a controlled depth. We evaluated the clinical effects and objectively quantified the histologic changes of the nonablative RF device in the treatment of photoaging. Six individuals of Fitzpatrick skin type III to IV and Glogau class I to II wrinkles were subjected to 3 months of treatment (6 sessions at 2-week intervals). Standard photographs and skin biopsy specimens were obtained at baseline, and at 3 and 6 months after the start of treatment. We performed quantitative evaluation of total elastin, collagen types I and III, and newly synthesized collagen using computerized histometric and immunohistochemical techniques. Blinded photographs were independently scored for wrinkle improvement. RF produced noticeable clinical results, with high satisfaction and corresponding facial skin improvement. Compared with the baseline, there was a statistically significant increase in the mean of collagen types I and III, and newly synthesized collagen, while the mean of total elastin was significantly decreased, at the end of treatment and 3 months posttreatment. A limitation of this study is the small number of patients, yet the results show a significant improvement. Although the results may not be as impressive as those obtained by ablative treatments, RF is a promising treatment option for photoaging with fewer side effects and downtime. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Prospective Investigation of 25(OH)D3 Serum Concentration Following UVB Narrow Band Phototherapy in Patients with Psoriasis and Atopic Dermatitis.

PubMed

Weinhold, Annett; Obeid, Rima; Vogt, Thomas; Reichrath, Jörg

2016-03-01

Vitamin D deficiency represents a major health issue. It is a worldwide endemic and is associated with a broad variety of severe diseases. The skin is a key tissue for the human body's vitamin D endocrine system. It represents a target tissue for biologically active vitamin D metabolites. Approximately 90% of the human body's requirements of vitamin D have to be synthesised in the skin by the action of UVB-radiation. However, individual factors that influence a person's cutaneous synthesis of vitamin D are still not well understood. In our present prospective study we investigated the effect of UVB narrow band (UVBnb, 311 nm) and PUVA phototherapy on 25(OH)D3 serum concentration, in patients with psoriasis, atopic dermatitis and a few cases with other dermatoses (n=41). We found that two weeks of UVBnb treatment resulted in an increase of 25(OH)D3 serum concentration from 11.4 to 20.5 ng/ml (p<0.001), while in contrast PUVA-treatment did not significantly alter vitamin D status. These findings question the hypothesis of a relevant vitamin D metabolizing effect of UVA. Psoriasis patients showed a trend for a stronger increase in 25(OH)D3 serum levels following UVBnb compared to patients with atopic dermatitis. Patients with relatively low baseline serum 25(OH)D3 concentrations had a stronger increase in 25(OH)D3 concentrations compared to patients with relatively high 25(OH)D serum concentrations. In general patients with skin types (Fitzpatrick) I and II (median=14.3 ng/ml) had a higher baseline of 25(OH)D3 serum concentration compared to patients with skin types III (median=11.2 ng/ml) or IV-V (median=12.3 ng/ml), although these differences were not statistically significant (p=0.106). Baseline 25(OH)D3 serum concentrations were correlated with presence of genetic variants (SNPs of VDR, CYP2R1, VDBP/GC) that influence vitamin D status, and with other individual factors such as body mass index, age and gender. We also investigated the effect of phototherapy on blood pressure and a variety of laboratory parameters such as CRP, HbA1c, LDL, HDL, triglycerides and cholesterol. In conclusion, our pilot study shows that UVBnb phototherapy efficiently increases 25(OH)D3 serum concentration and reports interesting preliminary findings that have to be re-evaluated in larger follow-up studies. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Skin acceptability of a cosmetic moisturizer formulation in female subjects with sensitive skin.

PubMed

Nisbet, Stephanie J

2018-01-01

This 3-week, open-label, noncomparative clinical study evaluated the skin acceptability of a cosmetic moisturizer in subjects with sensitive skin, by monitoring adverse events (AEs) and cutaneous discomfort related to normal usage. Female subjects aged between 18-60 years, with Fitzpatrick phototype classification I-IV and sensitive skin, verified by a positive reaction on the stinging test at screening, were included. Subjects applied the moisturizer to their face and body twice daily for 21±2 days at home and recorded study product usage and feelings of cutaneous discomfort (eg, dryness, prickling, stinging, and itching) in a diary; any AEs were reported to the clinic. At study end, skin acceptability of the moisturizer was investigator-assessed based on the nature of AEs and subjects' self-reported feelings of discomfort, and by clinical evaluation of skin reactions in the area of moisturizer application (appearance of erythema, formation of edema, and skin desquamation; scored according to an adapted Draize and Kligman scale). Only subjects with a treatment compliance of ≥80% were included in the final analysis. In total, 35 subjects initiated and completed the study; all were compliant to the minimum study product usage. Per investigator clinical dermatological assessment at study end, none of the 35 subjects had skin reactions in the area of moisturizer application and there were no reported AEs. One subject reported sensations of mild prickling and itching immediately after applying the moisturizer (not classified as AEs), which spontaneously remitted after complete absorption of the product and were noted only in exposed areas. These events were considered by the investigator as being possibly/probably related to the use of study product; however, no clinical signs of skin reaction were observed in the exposed areas. This cosmetic moisturizer appears generally well tolerated and suitable for topical use in subjects with sensitive skin.

Skin acceptability of a cosmetic moisturizer formulation in female subjects with sensitive skin

PubMed Central

Nisbet, Stephanie J

2018-01-01

Purpose This 3-week, open-label, noncomparative clinical study evaluated the skin acceptability of a cosmetic moisturizer in subjects with sensitive skin, by monitoring adverse events (AEs) and cutaneous discomfort related to normal usage. Materials and methods Female subjects aged between 18–60 years, with Fitzpatrick phototype classification I–IV and sensitive skin, verified by a positive reaction on the stinging test at screening, were included. Subjects applied the moisturizer to their face and body twice daily for 21±2 days at home and recorded study product usage and feelings of cutaneous discomfort (eg, dryness, prickling, stinging, and itching) in a diary; any AEs were reported to the clinic. At study end, skin acceptability of the moisturizer was investigator-assessed based on the nature of AEs and subjects’ self-reported feelings of discomfort, and by clinical evaluation of skin reactions in the area of moisturizer application (appearance of erythema, formation of edema, and skin desquamation; scored according to an adapted Draize and Kligman scale). Only subjects with a treatment compliance of ≥80% were included in the final analysis. Results In total, 35 subjects initiated and completed the study; all were compliant to the minimum study product usage. Per investigator clinical dermatological assessment at study end, none of the 35 subjects had skin reactions in the area of moisturizer application and there were no reported AEs. One subject reported sensations of mild prickling and itching immediately after applying the moisturizer (not classified as AEs), which spontaneously remitted after complete absorption of the product and were noted only in exposed areas. These events were considered by the investigator as being possibly/probably related to the use of study product; however, no clinical signs of skin reaction were observed in the exposed areas. Conclusion This cosmetic moisturizer appears generally well tolerated and suitable for topical use in subjects with sensitive skin. PMID:29750047

Improvement of Atrophic Acne Scars in Skin of Color Using Topical Synthetic Epidermal Growth Factor (EGF) Serum: A Pilot Study.

PubMed

Stoddard, Marie Alexia; Herrmann, Jennifer; Moy, Lauren; Moy, Ronald

2017-04-01

BACKGROUND: Atrophic scarring in skin of color is a common, permanent, and distressing result of uncontrolled acne vulgaris. Ablative lasers and chemical peels are frequently used to improve the appearance of atrophic scars, primarily through the stimulation of collagen and elastin; however, these treatment modalities are associated with risks, such as dyspigmentation and hypertrophic scarring, especially in patients with darker skin.

OBJECTIVE: We evaluated the efficacy of topically applied synthetic epidermal growth factor (EGF) serum in reducing the appearance of atrophic acne scars in skin of color.

METHODS: A single-center clinical trial was performed on twelve healthy men and women (average age 32.5) with Fitzpatrick Type IV-V skin and evidence of facial grade II-IV atrophic acne scars. Subjects applied topical EGF serum to the full-face twice daily for 12 weeks. Scar improvement was investigated at each visit using an Investigator Global Assessment (IGA), a Goodman grade, clinical photography, and patient self-assessment.

RESULTS: Eleven subjects completed the trial. Compared to baseline, there was an improvement in mean IGA score from 3.36 (SEM = 0.15) to 2.18 (SEM = 0.33). Mean Goodman grade was reduced from 2.73 (SEM = 0.19) to 2.55 (SEM = 0.21). Of the eleven pairs of before and after photographs, nine were correctly chosen as the post-treatment image by a blind investigator. On self-assessment, 81% reported a "good" to "excellent" improvement in their scars compared to baseline (P = 0.004).

CONCLUSION: Topical EGF may improve the appearance of atrophic acne scars in skin of color. Additional, larger studies should be conducted to better characterize improvement.

J Drugs Dermatol. 2017;16(4):322-326.

Assessment of the influence of gender and skin color on the preference of tooth shade in Saudi population.

PubMed

Labban, Nawaf; Al-Otaibi, Hanan; Alayed, Abdulaziz; Alshankiti, Khaled; Al-Enizy, Mohammad A

2017-07-01

The aim of the study was to evaluate the influence of gender and skin color on the preference of different teeth shades in general population. Two standardized frontal smile photographs of male and female subjects were manipulated using photoshop to represent 4 skin colors [(type II, III, IV, and V) (Fitzpatrick scale)]. The teeth shades under each skin color were digitally manipulated to represent one of 6 teeth shades (BL1, BL2, BL3, BL4, B1 and A1). A questionnaire assessed demographic characteristics (age, nationality, gender, education level, occupation, and income) along with the satisfaction of their smiles. Male and female set of pictures with combination of skin colors and teeth shades were presented and participants were asked to select the most esthetically pleasing teeth shade with regard to gender and skin color. Cross-tabulations and chi-squared tests were used to perform the statistical analyses ( α  = 0.05). Three hundred and thirty-six (60.4% male; 39.6% female) individuals participated in the study. The difference in the preferred teeth shades was significant among the male and female photographs across all skin colors ( p  < 0.05). Lighter teeth shades were preferred among female subjects compared to male subjects with the same skin color. In addition, lighter teeth shades were preferred among subjects with a lighter skin color and vice versa ( p  < 0.05). Gender and skin color influences the perception of teeth shades among general population. Therefore, lighter tooth shades (BL1, BL2) for lighter skin color and comparatively darker tooth shades (BL4, B1, A1) for darker skin individuals should be prescribed as these are perceived as natural among Saudi population.

Efficacy of Punch Elevation Combined with Fractional Carbon Dioxide Laser Resurfacing in Facial Atrophic Acne Scarring: A Randomized Split-face Clinical Study

PubMed Central

Faghihi, Gita; Nouraei, Saeid; Asilian, Ali; Keyvan, Shima; Abtahi-Naeini, Bahareh; Rakhshanpour, Mehrdad; Nilforoushzadeh, Mohammad Ali; Hosseini, Sayed Mohsen

2015-01-01

Background: A number of treatments for reducing the appearance of acne scars are available, but general guidelines for optimizing acne scar treatment do not exist. The aim of this study was to compare the clinical effectiveness and side effects of fractional carbon dioxide (CO2) laser resurfacing combined with punch elevation with fractional CO2 laser resurfacing alone in the treatment of atrophic acne scars. Materials and Methods: Forty-two Iranian subjects (age range 18–55) with Fitzpatrick skin types III to IV and moderate to severe atrophic acne scars on both cheeks received randomized split-face treatments: One side received fractional CO2 laser treatment and the other received one session of punch elevation combined with two sessions of laser fractional CO2 laser treatment, separated by an interval of 1 month. Two dermatologists independently evaluated improvement in acne scars 4 and 16 weeks after the last treatment. Side effects were also recorded after each treatment. Results: The mean ± SD age of patients was 23.4 ± 2.6 years. Clinical improvement of facial acne scarring was assessed by two dermatologists blinded to treatment conditions. No significant difference in evaluation was observed 1 month after treatment (P = 0.56). Their evaluation found that fractional CO2 laser treatment combined with punch elevation had greater efficacy than that with fractional CO2 laser treatment alone, assessed 4 months after treatment (P = 0.02). Among all side effects, coagulated crust formation and pruritus at day 3 after fractional CO2 laser treatment was significant on both treatment sides (P < 0.05). Conclusion: Concurrent use of fractional laser skin resurfacing with punch elevation offers a safe and effective approach for the treatment of acne scarring. PMID:26538695

Combination laser treatment for immediate post-surgical scars: a retrospective analysis of 33 immature scars.

PubMed

Lee, Yongsoo; Kim, Wooram

2017-07-01

The application of laser treatments beginning on the day of stitch removal has been demonstrated to improve scar quality. However, there are few guidelines for the treatment of immature scars (ISs), which are defined as "scars whose features are not yet expressed." The purpose of this study was to extract information about early combination laser treatment (CLT) beyond what is currently known by analyzing 33 pairs of pre-treatment and post-treatment photographs of ISs. Two hundred fifty medical records of patients with scars were reviewed, and 33 scars were included in the study. The included scars were treated with vascular lasers (585 or 532 nm) followed by 1550-nm fractional lasers from May 2014 to July 2015 (fewer than 52 days after stitch removal, Fitzpatrick's skin types III-IV, mean age = 16.0 years). Blinded evaluators (one plastic surgeon and two dermatologists) evaluated the pre-treatment and post-treatment photographs. The pre-treatment photographs were scored on a spectrum from "0," when no difference with the surrounding unaffected skin was observed, to "100," when the worst scarring was present. The pre-treatment and post-treatment photographs were compared, and the results were graded on a spectrum from 0, when no difference between the pre-treatment and post-treatment photographs was observed, to 100, when no difference was observed between the post-treatment skin and the surrounding unaffected skin. Statistical analyses were performed with PASW 17.0, SPSS Korea, Seoul, Korea (p < 0.05). The improvement scores (ImS) and weighted scores (Wtd: i.e., weighted according to the pre-treatment scores) were used as dependent variables. The average improvement score was 87.98 (median = 90). Seventeen cases were scored as 100-point improvements. The facial and non-facial scars exhibited differences in the ImS and Wtd scores. The Wtd scores were negatively correlated with the temporal gap (in days) between stitch removal and the beginning of CLT. No significant difference in the Wtd scores was demonstrated between the two vascular laser groups. Patient age and Wtd score were negatively correlated, and a significant difference was observed in the Wtd scores between the age groups (≥15 and <15 years old). CLT for ISs results in excellent outcomes. Better results are achieved with earlier CLT initiation following stitch removal. Better outcomes can be expected for younger patients and for facial scars. We found that 532 and 585-nm lasers are equally effective for CLT of ISs.

Fractional non-ablative laser treatment at 1410 nm wavelength for periorbital wrinkles - reviscometrical and clinical evaluation.

PubMed

Augustyniak, Anna; Rotsztejn, Helena

2016-10-01

The aim of the research was to establish the influence of 1410-nm fractional non-ablative laser treatment on skin aging in the eye area. The reviscometer reference test is an objective method of estimating the flexibility of the skin. The photographic records were used as the auxiliary method of the therapy quality effectiveness. The study involved the group of 13 people (12 females and 1 male, aged 33-47 with prototype II and III according to the Fitzpatrick scale), who underwent two sessions of fractional non-ablative laser therapy (wavelength of 1410 nm) with a 2-week interval. In order to evaluate the effectiveness of the quality of the treatment a reviscometer probe was used to measure the skin elasticity (Reviscometer RVM 600). The measurements were taken twice: directly before and two weeks after the treatment. Furthermore, to facilitate the clinical evaluation an anonymous photographical documentation was prepared. An improvement of the skin flexibility in the eye area was observed and the fact was confirmed by values obtained using the reviscometer probe (significant statistic differences: P < 0.0001) as well as clinical assessment based on photographical records. On the basis of the reviscometer measurements analysis and photographical records, 1410-nm fractional non-ablative laser treatment appears to be an efficient method contributing to the improvement of the skin flexibility of the eyes area as well as to the reduction of the number of wrinkles. The post-treatment observation proves that the method is well-tolerated in the sensitive eyes area and does not cause any significant side effects.

The influence of API concentration on the roller compaction process: modeling and prediction of the post compacted ribbon, granule and tablet properties using multivariate data analysis.

PubMed

Boersen, Nathan; Carvajal, M Teresa; Morris, Kenneth R; Peck, Garnet E; Pinal, Rodolfo

2015-01-01

While previous research has demonstrated roller compaction operating parameters strongly influence the properties of the final product, a greater emphasis might be placed on the raw material attributes of the formulation. There were two main objectives to this study. First, to assess the effects of different process variables on the properties of the obtained ribbons and downstream granules produced from the rolled compacted ribbons. Second, was to establish if models obtained with formulations of one active pharmaceutical ingredient (API) could predict the properties of similar formulations in terms of the excipients used, but with a different API. Tolmetin and acetaminophen, chosen for their different compaction properties, were roller compacted on Fitzpatrick roller compactor using the same formulation. Models created using tolmetin and tested using acetaminophen. The physical properties of the blends, ribbon, granule and tablet were characterized. Multivariate analysis using partial least squares was used to analyze all data. Multivariate models showed that the operating parameters and raw material attributes were essential in the prediction of ribbon porosity and post-milled particle size. The post compacted ribbon and granule attributes also significantly contributed to the prediction of the tablet tensile strength. Models derived using tolmetin could reasonably predict the ribbon porosity of a second API. After further processing, the post-milled ribbon and granules properties, rather than the physical attributes of the formulation were needed to predict downstream tablet properties. An understanding of the percolation threshold of the formulation significantly improved the predictive ability of the models.

Fundamental Fermions (e.g. Neutrinos) as Topological Objects

NASA Astrophysics Data System (ADS)

Fitzpatrick, Gerald L.

1999-05-01

A new internal ``macroscopic'' description of fundamental fermions based on a matrix-generalization (F) of the scalar fermion-number f, predicts that only three families of quarks and leptons, and their associated neutrinos (ν_e, ν_μ and ν_τ), exist [1]. Moreover, this description places important phtopological constraints on neutrino mixtures [2]. With respect to F, the topology of the νe (ν_μ or ν_τ) is that of a cylinder (Möbius strip). Assuming that topology-changing neutrino-neutrino transitions are suppressed (e.g., one cannot continuously deform a donut into a sphere), while topology-maintaining transitions are relatively enhanced, one may have an explanation for short-distance observations of (nearly) maximal ν_μ-ν_τ mixing [3]. To test this idea, simple topological arguments were used to deduce a matrix describing long-distance neutrino mixtures, which is phidentical to that proposed by Georgi and Glashow on different grounds [4]. Experimental confirmation of this prediction would support the new description, which requires the νe and (ν_μ or ν_τ) to start ``life'' as topologically-distinct quantum objects.l [1] http://www.amazon.com/exec/obidos/ISBN=0965569500, [2] G. L. Fitzpatrick, aps1999feb12\\underbar001 at http://publish.aps.org/eprint/, [3] hep-ex/981001, [4] hep-ph/9808293, p. 5, Eq. 20.

An examination of the structure of self-report psychopathy measures and their relations with general traits and externalizing behaviors.

PubMed

Seibert, L Alana; Miller, Joshua D; Few, Lauren R; Zeichner, Amos; Lynam, Donald R

2011-07-01

Self-report assessment of psychopathy is plagued by inconsistencies among the relations of the various psychopathy factors. We examined the factor structure of 3 prominent self-report measures of psychopathy-the Self-Report Psychopathy Scale-III (SRP-III; Williams, Paulhus, & Hare, 2007), the Levenson Self-Report Psychopathy Scale (LSRP; Levenson, Kiehl, & Fitzpatrick, 1995), and the Psychopathic Personality Inventory-R (PPI-R; Lilienfeld & Widows, 2005). A coherent 4-factor structure resulted from conducting an exploratory factor analysis (EFA) of the psychopathy subscales along with the domains from the five-factor model. Two of these factors were consistent with traditional conceptualizations of a 2-factor structure of psychopathy (i.e., Factor 1, which loaded negatively with Agreeableness; Factor 2, which loaded negatively with Conscientiousness), while 2 additional factors emerged, 1 of which emphasized low Neuroticism and 1 of which emphasized traits related to novelty/reward-seeking and dominance-related personality traits (high Extraversion). We also investigated the relations of these factors with a variety of externalizing behaviors (EB). The psychopathy scales indicative of interpersonal antagonism (i.e., Factor 1) were most consistently and strongly related to EB. Our findings are discussed in terms of the importance of a trait-based perspective in the assessment of psychopathy.

MEASURING REDDENING WITH SLOAN DIGITAL SKY SURVEY STELLAR SPECTRA AND RECALIBRATING SFD

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schlafly, Edward F.; Finkbeiner, Douglas P.

2011-08-20

We present measurements of dust reddening using the colors of stars with spectra in the Sloan Digital Sky Survey. We measure reddening as the difference between the measured and predicted colors of a star, as derived from stellar parameters from the Sloan Extension for Galactic Understanding and Exploration Stellar Parameter Pipeline. We achieve uncertainties of 56, 34, 25, and 29 mmag in the colors u - g, g - r, r - i, and i - z, per star, though the uncertainty varies depending on the stellar type and the magnitude of the star. The spectrum-based reddening measurements confirm ourmore » earlier 'blue tip' reddening measurements, finding reddening coefficients different by -3%, 1%, 1%, and 2% in u - g, g - r, r - i, and i - z from those found by the blue tip method, after removing a 4% normalization difference. These results prefer an R{sub V} = 3.1 Fitzpatrick reddening law to O'Donnell or Cardelli et al. reddening laws. We provide a table of conversion coefficients from the Schlegel et al. (SFD) maps of E(B - V) to extinction in 88 bandpasses for four values of R{sub V} , using this reddening law and the 14% recalibration of SFD first reported by Schlafly et al. and confirmed in this work.« less

General relativistic description of the observed galaxy power spectrum: Do we understand what we measure?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yoo, Jaiyul

2010-10-15

We extend the general relativistic description of galaxy clustering developed in Yoo, Fitzpatrick, and Zaldarriaga (2009). For the first time we provide a fully general relativistic description of the observed matter power spectrum and the observed galaxy power spectrum with the linear bias ansatz. It is significantly different from the standard Newtonian description on large scales and especially its measurements on large scales can be misinterpreted as the detection of the primordial non-Gaussianity even in the absence thereof. The key difference in the observed galaxy power spectrum arises from the real-space matter fluctuation defined as the matter fluctuation at themore » hypersurface of the observed redshift. As opposed to the standard description, the shape of the observed galaxy power spectrum evolves in redshift, providing additional cosmological information. While the systematic errors in the standard Newtonian description are negligible in the current galaxy surveys at low redshift, correct general relativistic description is essential for understanding the galaxy power spectrum measurements on large scales in future surveys with redshift depth z{>=}3. We discuss ways to improve the detection significance in the current galaxy surveys and comment on applications of our general relativistic formalism in future surveys.« less

The linear tearing instability in three dimensional, toroidal gyro-kinetic simulations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hornsby, W. A., E-mail: william.hornsby@ipp.mpg.de; Migliano, P.; Buchholz, R.

2015-02-15

Linear gyro-kinetic simulations of the classical tearing mode in three-dimensional toroidal geometry were performed using the global gyro-kinetic turbulence code, GKW. The results were benchmarked against a cylindrical ideal MHD and analytical theory calculations. The stability, growth rate, and frequency of the mode were investigated by varying the current profile, collisionality, and the pressure gradients. Both collisionless and semi-collisional tearing modes were found with a smooth transition between the two. A residual, finite, rotation frequency of the mode even in the absence of a pressure gradient is observed, which is attributed to toroidal finite Larmor-radius effects. When a pressure gradientmore » is present at low collisionality, the mode rotates at the expected electron diamagnetic frequency. However, the island rotation reverses direction at high collisionality. The growth rate is found to follow a η{sup 1∕7} scaling with collisional resistivity in the semi-collisional regime, closely following the semi-collisional scaling found by Fitzpatrick. The stability of the mode closely follows the stability analysis as performed by Hastie et al. using the same current and safety factor profiles but for cylindrical geometry, however, here a modification due to toroidal coupling and pressure effects is seen.« less

Locked modes in two reversed-field pinch devices of different size and shell system

NASA Astrophysics Data System (ADS)

Malmberg, J.-A.; Brunsell, P. R.; Yagi, Y.; Koguchi, H.

2000-10-01

The behavior of locked modes in two reversed-field pinch devices, the Toroidal Pinch Experiment (TPE-RX) [Y. Yagi et al., Plasma Phys. Control. Fusion 41, 2552 (1999)] and Extrap T2 [J. R. Drake et al., in Plasma Physics and Controlled Nuclear Fusion Research 1996, Montreal (International Atomic Energy Agency, Vienna, 1996), Vol. 2, p. 193] is analyzed and compared. The main characteristics of the locked mode are qualitatively similar. The toroidal distribution of the mode locking shows that field errors play a role in both devices. The probability of phase locking is found to increase with increasing magnetic fluctuation levels in both machines. Furthermore, the probability of phase locking increases with plasma current in TPE-RX despite the fact that the magnetic fluctuation levels decrease. A comparison with computations using a theoretical model estimating the critical mode amplitude for locking [R. Fitzpatrick et al., Phys. Plasmas 6, 3878 (1999)] shows a good correlation with experimental results in TPE-RX. In Extrap T2, the magnetic fluctuations scale weakly with both plasma current and electron densities. This is also reflected in the weak scaling of the magnetic fluctuation levels with the Lundquist number (˜S-0.06). In TPE-RX, the corresponding scaling is ˜S-0.18.

Improvement of bone disease by imiglucerase (Cerezyme) therapy in patients with skeletal manifestations of type 1 Gaucher disease: results of a 48-month longitudinal cohort study

PubMed Central

Sims, KB; Pastores, GM; Weinreb, NJ; Barranger, J; Rosenbloom, BE; Packman, S; Kaplan, P; Mankin, H; Xavier, R; Angell, J; Fitzpatrick, MA; Rosenthal, D

2008-01-01

Sims KB, Pastores GM, Weinreb NJ, Barranger J, Rosenbloom BE, Packman S, Kaplan P, Mankin H, Xavier R, Angell J, Fitzpatrick MA, Rosenthal D. Improvement of bone disease by imiglucerase (Cerezyme) therapy in patients with skeletal manifestations of type 1 Gaucher disease: results of a 48-month longitudinal cohort study. Clin Genet 2008: 73: 430–440. © Blackwell Munksgaard, 2008 Progressive skeletal disease accounts for some of the most debilitating complications of type 1 Gaucher disease. In this 48-month, prospective, non-randomized, open-label study of the effect of enzyme replacement therapy on bone response, 33 imiglucerase-naïve patients (median age 43 years with one or more skeletal manifestations such as osteopenia, history of bone crisis, or other documented bone pathology) received imiglucerase 60 U/kg/2 weeks. Substantial improvements were observed in bone pain (BP), bone crises (BC), and bone mineral density (BMD). Improvements in BP were observed at 3 months (p < 0.001 vs baseline) and continued progressively throughout the study, with 39% of patients reporting pain at 48 months vs 73% at baseline. Eleven of the 13 patients with a pre-treatment history of BC had no recurrences. Biochemical markers for bone formation increased; markers for bone resorption decreased. Steady improvement of spine and femoral neck BMD, measured using dual-energy X-ray absorptiometry was noted. Mean Z score for spine increased from −0.72 ± 1.302 at baseline to near-normal levels (−0.09 ± 1.503) by month 48 (p = 0.042) and for femoral neck from −0.59 ± 1.352 to −0.17 ± 1.206 (p = 0.035) at month 36. This increase was sustained at 48 months. With imiglucerase treatment, patients should anticipate resolution of BC, rapid improvement in BP, increases in BMD, and decreased skeletal complications. PMID:18312448

Estimating Pesticide Exposure from Dietary Intake and Organic Food Choices: The Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Beresford, Shirley A.A.; Fenske, Richard A.; Fitzpatrick, Annette L.; Lu, Chensheng; Nettleton, Jennifer A.; Kaufman, Joel D.

2015-01-01

Background Organophosphate pesticide (OP) exposure to the U.S. population is dominated by dietary intake. The magnitude of exposure from diet depends partly on personal decisions such as which foods to eat and whether to choose organic food. Most studies of OP exposure rely on urinary biomarkers, which are limited by short half-lives and often lack specificity to parent compounds. A reliable means of estimating long-term dietary exposure to individual OPs is needed to assess the potential relationship with adverse health effects. Objectives We assessed long-term dietary exposure to 14 OPs among 4,466 participants in the Multi-Ethnic Study of Atherosclerosis, and examined the influence of organic produce consumption on this exposure. Methods Individual-level exposure was estimated by combining information on typical intake of specific food items with average OP residue levels on those items. In an analysis restricted to a subset of participants who reported rarely or never eating organic produce (“conventional consumers”), we assessed urinary dialkylphosphate (DAP) levels across tertiles of estimated exposure (n = 480). In a second analysis, we compared DAP levels across subgroups with differing self-reported organic produce consumption habits (n = 240). Results Among conventional consumers, increasing tertile of estimated dietary OP exposure was associated with higher DAP concentrations (p < 0.05). DAP concentrations were also significantly lower in groups reporting more frequent consumption of organic produce (p < 0.02). Conclusions Long-term dietary exposure to OPs was estimated from dietary intake data, and estimates were consistent with DAP measurements. More frequent consumption of organic produce was associated with lower DAPs. Citation Curl CL, Beresford SA, Fenske RA, Fitzpatrick AL, Lu C, Nettleton JA, Kaufman JD. 2015. Estimating pesticide exposure from dietary intake and organic food choices: the Multi-Ethnic Study of Atherosclerosis (MESA). Environ Health Perspect 123:475–483; http://dx.doi.org/10.1289/ehp.1408197 PMID:25650532

The Efficacy and Safety of Topical Dapsone Gel, 5% for the Treatment of Acne Vulgaris in Adult Females With Skin of Color.

PubMed

Alexis, Andrew F; Burgess, Cheryl; Callender, Valerie D; Herzog, Jo L; Roberts, Wendy E; Schweiger, Eric S; Stockton, Toni C; Gallagher, Conor J

2016-02-01

Topical dapsone gel, 5% is approved for treatment of acne vulgaris but has not been studied specifically in women with skin of color (SOC; Fitzpatrick skin types IV, V, or VI). Evaluate safety and efficacy of dapsone gel, 5% applied topically twice daily for 12 weeks in women with SOC. Females with SOC aged 18 years and older with facial acne participated in a multicenter, open-label, single-group, 12-week pilot study of twice-daily monotherapy with dapsone gel, 5%. The investigator-rated 5-point Global Acne Assessment Score (GAAS) was used to assess efficacy. The impact of acne on subjects was assessed using the validated Acne Symptom and Impact Scale (ASIS). The study enrolled and treated 68 women with SOC and facial acne. GAAS decreased significantly from baseline to week 12 (mean, -1.2 [95% CI, -1.4, -1.0]; P<.001), a 39.0% improvement. Overall, 42.9% of subjects were responders based on a GAAS of 0 or 1 at week 12. Subjects also experienced significant reductions in mean total lesions (52% decrease), inflammatory lesions (65%), and comedo counts (41%; all P<.001). Dapsone gel, 5% monotherapy was associated with significant improvement in subject-assessed acne signs (P<.001) and impact on quality of life (QOL; P<.001), based on ASIS. Dapsone gel, 5% used twice daily was well tolerated, with no treatment-related adverse events. The local dermal tolerability scores tended to remain stable or decrease from baseline to week 12. Monotherapy with dapsone gel, 5% administered twice daily was safe and effective for treatment of facial acne in women with SOC. Significant improvement in overall acne severity and both inflammatory lesions and comedones was observed. Further, study subjects reported considerable improvement in both acne signs and impact on QOL.

Efficacy of fractionated microneedle radiofrequency with and without adding subcision for the treatment of atrophic facial acne scars: A randomized split-face clinical study.

PubMed

Faghihi, Gita; Poostiyan, Nazila; Asilian, Ali; Abtahi-Naeini, Bahareh; Shahbazi, Masoom; Iraji, Fariba; Fatemi Naeini, Farahnaz; Nilforoushzadeh, Mohammad Ali

2017-06-01

There is no gold standard treatment for facial acne scars, and overall, little literature exists about the combination therapy for treatment of acne scar. The aim of this study was to evaluate the efficacy of fractionated microneedle radiofrequency (FMR) vs FMR combined with subcision for the treatment of atrophic acne scars. This was a randomized, split-face clinical study of 25 patients with II-IV Fitzpatrick skin types with moderate to severe facial atrophic acne scars. Initially, standard subcision by Nokor needle was performed on one side. Two weeks after subcision, FMR treatment was performed on both cheeks of each participant. Second and third FMR treatment sessions were performed within 4-week intervals. Two-blinded dermatologists performed clinical assessments using a quartile grading scale, and patients were also asked to judge their satisfaction using a visual analog scale (VAS) scoring system. The age of the patients varied from 24 to 40 years (mean: 30.08±4.94 years). Only nine patients (36%) were males. Clinical assessment by two-blinded dermatologists showed statistically significant improvement in the combination (FMR+subcision) group (P=.009). Patient satisfaction was statistically significantly better in the combination group (P=.001). A darkening of skin phototype was associated with a decrease in patient's satisfaction VAS score (P=.07). The combination of subcision and FMR is a safe and effective modality for mixed type acne scars. Additional randomized clinical study with long-term follow-up is necessary for further evaluation of FMR in combination with other procedures. The full trial protocol can be accessed in: http://www.irct.ir/searchresult.php?keyword=%20%20IRCT2016103130597N1&id=30597&number=1&field=a&prt=1&total=1&m=1. The clinical trial registration number is IRCT2016103130597N1. © 2017 Wiley Periodicals, Inc.

Assessment of clinical effects and safety of an oral supplement based on marine protein, vitamin C, grape seed extract, zinc, and tomato extract in the improvement of visible signs of skin aging in men

PubMed Central

Costa, Adilson; Pegas Pereira, Elisangela Samartin; Assumpção, Elvira Cancio; Calixto dos Santos, Felipe Borba; Ota, Fernanda Sayuri; de Oliveira Pereira, Margareth; Fidelis, Maria Carolina; Fávaro, Raquel; Barros Langen, Stephanie Selma; Favaro de Arruda, Lúcia Helena; Abildgaard, Eva Nydal

2015-01-01

Background Skin aging is a natural process that may be aggravated by environmental factors. Topical products are the conventional means to combat aging; however, the use of oral supplements is on the rise to assist in the management of aged skin. Objective The purpose of this study was to assess the effects and safety of an oral supplement containing (per tablet) marine protein (105 mg), vitamin C (27 mg), grape seed extract (13.75 mg), zinc (2 mg), and tomato extract (14.38 mg) in the improvement of skin aging in men. Methods This single-center, open-label, quasi-experimental clinical study enrolled 47 male subjects, aged 30–45 years, with phototypes I–IV on the Fitzpatrick scale. Subjects received two tablets of the oral supplement for 180 consecutive days. Each subject served as their own control. Clinical assessments were made by medical personnel and by the subjects, respectively. Objective assessments were carried out through pH measurements, sebumetry, corneometry, ultrasound scanning, skin biopsies, and photographic images. Results Forty-one subjects (87%) completed the study. Clinical improvements on both investigator- and subject-rated outcomes were found for the following parameters: erythema, hydration, radiance, and overall appearance (P<0.05). The objective measurements in the facial skin showed significant improvements from baseline in skin hydration (P<0.05), dermal ultrasound density (P<0.001), and reduction of skin pH (P<0.05). No statistical improvement in relation to sebum was found. The photographic assessment showed an improvement in the overall appearance. The results of the objective measurements were found to be correlated with the subjects’ satisfaction by an increase of collagen and elastic fibers. Conclusion The use of an oral supplement based on a unique biomarine complex, vitamin C, grape seed extract, zinc, and tomato extract produced improvements in the signs of skin aging in men. PMID:26170708

Novel Gene Expression Profile of Women with Intrinsic Skin Youthfulness by Whole Transcriptome Sequencing

PubMed Central

Xu, Jin; Spitale, Robert C.; Guan, Linna; Flynn, Ryan A.; Torre, Eduardo A.; Li, Rui; Raber, Inbar; Qu, Kun; Kern, Dale; Knaggs, Helen E.; Chang, Howard Y.; Chang, Anne Lynn S.

2016-01-01

While much is known about genes that promote aging, little is known about genes that protect against or prevent aging, particularly in human skin. The main objective of this study was to perform an unbiased, whole transcriptome search for genes that associate with intrinsic skin youthfulness. To accomplish this, healthy women (n = 122) of European descent, ages 18–89 years with Fitzpatrick skin type I/II were examined for facial skin aging parameters and clinical covariates, including smoking and ultraviolet exposure. Skin youthfulness was defined as the top 10% of individuals whose assessed skin aging features were most discrepant with their chronological ages. Skin biopsies from sun-protected inner arm were subjected to 3’-end sequencing for expression quantification, with results verified by quantitative reverse transcriptase-polymerase chain reaction. Unbiased clustering revealed gene expression signatures characteristic of older women with skin youthfulness (n = 12) compared to older women without skin youthfulness (n = 33), after accounting for gene expression changes associated with chronological age alone. Gene set analysis was performed using Genomica open-access software. This study identified a novel set of candidate skin youthfulness genes demonstrating differences between SY and non-SY group, including pleckstrin homology like domain family A member 1 (PHLDA1) (p = 2.4x10-5), a follicle stem cell marker, and hyaluronan synthase 2-anti-sense 1 (HAS2-AS1) (p = 0.00105), a non-coding RNA that is part of the hyaluronan synthesis pathway. We show that immunologic gene sets are the most significantly altered in skin youthfulness (with the most significant gene set p = 2.4x10-5), suggesting the immune system plays an important role in skin youthfulness, a finding that has not previously been recognized. These results are a valuable resource from which multiple future studies may be undertaken to better understand the mechanisms that promote skin youthfulness in humans. PMID:27829007

High-definition optical coherence tomography intrinsic skin ageing assessment in women: a pilot study.

PubMed

Boone, M A L M; Suppa, M; Marneffe, A; Miyamoto, M; Jemec, G B E; Del Marmol, V

2015-10-01

Several non-invasive two-dimensional techniques with different lateral resolution and measurable depth range have proved to be useful in assessing and quantifying morphological changes in skin ageing. Among these, only in vivo microscopy techniques permit histometric measurements in vivo. Qualitative and quantitative assessment of chronological (intrinsic) age-related (IAR) morphological changes of epidermis, dermo-epidermal junction (DEJ), papillary dermis (PD), papillary-reticular dermis junction and reticular dermis (RD) have been performed by high-definition optical coherence tomography in real time 3-D. HD-OCT images were taken at the internal site of the right upper arm. Qualitative HD-OCT IAR descriptors were reported at skin surface, at epidermal layer, DEJ, PD and upper RD. Quantitative evaluation of age-related compaction and backscattered intensity or brightness of different skin layers was performed by using the plugin plot z-axis profile of ImageJ(®) software permitting intensity assessment of HD-OCT (DICOM) images (3-D images). Analysis was in blind from all clinical information. Sixty, fair-skinned (Fitzpatrick types I-III) healthy females were analysed retrospectively in this study. The subjects belonged to three age groups: twenty in group I aged 20-39, twenty in group II aged 40-59 and twenty in group III aged 60-79. Only intrinsic ageing in women has been studied. Significant age-related qualitative and quantitative differences could be noticed. IAR changes in dermal matrix fibers morphology/organisation and in microvasculature were observed. The brightness and compaction of the different skin layers increased significantly with intrinsic skin ageing. The depth of visibility of fibers in RD increased significantly in the older age group. In conclusion, HD-OCT allows 3-D in vivo and real time qualitative and quantitative assessment of chronological (intrinsic) age-related morphological skin changes at high resolution from skin surface to a depth of the superficial reticular dermis.

Risk factors for antenatal hypovitaminosis D in an urban district in Malaysia.

PubMed

Bukhary, Noriklil Bukhary Ismail; Isa, Zaleha Md; Shamsuddin, Khadijah; Lin, Khor Geok; Mahdy, Zaleha Abdullah; Hassan, Haslinda; Yeop, Noor Sharifatul Hana

2016-07-13

Pregnant women form one of the high risk groups facing hypovitaminosis D. Low level of vitamin D will affect directly or indirectly both mother and fetus. Screening vitamin D in the first trimester of pregnancy is important to determine the necessary preventive action. Therefore, this study was aimed to determine the prevalence of hypovitaminosis D and its risk factors among pregnant women in the first trimester. A cross sectional study was carried out among first trimester pregnant women during their first antenatal visit. Samples were taken from different ethnicities in an urban district in Malaysia. A total of 396 respondents (99 % response rate) aged 18-40 years completed self-administered and guided questionnaire (characteristics and risk factors), validated semi-quantitative food frequency questionnaire for vitamin D in Malaysia (FFQ vitamin D/My), anthropometric measures (weight and height), blood test for serum 25(OH)D, skin measurement using Mexameter (MX 18) and Fitzpatrick Skin Type Chart Measurement (FSTCM). Data were analyzed to determine the association between risk factors and hypovitaminosis D. The prevalence of hypovitaminosis D (serum 25(OH)D < 50 nmol/L) was 90.4 % (358). The mean age of respondents was 28.06 ± 4.09 years old. The independent predictors of hypovitaminosis D were Malay ethnicity (OR 33.68; 95 % CI: 12.81, 88.56), Indian ethnicity (OR 16.86; 95 % CI: 3.78,75.20), secondary education (OR 12.12; 95 % CI: 2.71, 54.16) and tertiary education (OR 14.38; 95 % Cl: 3.31, 62.45). Awareness should be raised among Malay and Indian pregnant women with secondary and tertiary education who consumed vitamin D (especially milk) poorly in order to prevent adverse health outcomes. Further studies need to be conducted among health care workers to determine their level of knowledge related to vitamin D, as they are front liner in detecting the hypovitaminosis D.

Potential health benefits from the flavonoids in grape products on vascular disease.

PubMed

Folts, John D

2002-01-01

In the dog, monkey, a nd human we have shown that 5 ml/kg of red wine or 5-10 ml/kg of purple grape juice but not orange or grapefruit juice inhibits platelet activity, and protects against epinephrine activation of platelets. Red wine and purple grape juice enhances platelet and endothelial production of nitric oxide (Fitzpatrick et al., 1993, Parker et al., 2000). This is thought to be one of the mechanisms whereby purple grape juice significantly improved endothelial function in 15 patients with coronary artery disease. The consumption of purple grape juice by the patients also offered increased protection against LDL cholesterol oxidation, even though all the patients were also taking another antioxidant vitamin E, 400 IU/day. The number of people and animals in these studies was small; however, each one acted as their own control as measurements were made in each before, and then after consumption of red wine or purple grape juice. Thus these studies are thought to be significant. We feel that the results of these studies are encouraging and justify further research on larger numbers of subjects. This suggests that the flavonoids in purple grape juice and red wine may inhibit the initiation of atherosclerosis by one or more of the mechanisms described above. It will take years to fully characterize the potential benefits of daily consumption of red wine or purple grape juice for maintaining a healthy heart. Based on the existing evidence of antiplatelet and antioxidant benefits and improved endothelial function from red wine and purple grape juice, it seems reasonable to suggest that moderate amounts of red wine or purple grape juice be included among the 5-7 daily servings of fruits and vegetables per day as recommended by the American Heart Association to help reduce the risk of developing cardiovascular disease.

Development of a core outcome set for clinical trials in facial aging: study protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey.

PubMed

Schlessinger, Daniel I; Iyengar, Sanjana; Yanes, Arianna F; Henley, Jill K; Ashchyan, Hovik J; Kurta, Anastasia O; Patel, Payal M; Sheikh, Umar A; Franklin, Matthew J; Hanna, Courtney C; Chen, Brian R; Chiren, Sarah G; Schmitt, Jochen; Deckert, Stefanie; Furlan, Karina C; Poon, Emily; Maher, Ian A; Cartee, Todd V; Sobanko, Joseph F; Alam, Murad

2017-08-01

Facial aging is a concern for many patients. Wrinkles, loss of volume, and discoloration are common physical manifestations of aging skin. Genetic heritage, prior ultraviolet light exposure, and Fitzpatrick skin type may be associated with the rate and type of facial aging. Although many clinical trials assess the correlates of skin aging, there is heterogeneity in the outcomes assessed, which limits the quality of evaluation and comparison of treatment modalities. To address the inconsistency in outcomes, in this project we will develop a core set of outcomes that are to be evaluated in all clinical trials relevant to facial aging. A long list of measureable outcomes will be created from four sources: (1) systematic medical literature review, (2) patient interviews, (3) other published sources, and (4) stakeholder involvement. Two rounds of Delphi processes with homogeneous groups of physicians and patients will be performed to prioritize and condense the list. At a consensus meeting attended by physicians, patients, and stakeholders, outcomes will be further condensed on the basis of participant scores. By the end of the meeting, members will vote and decide on a final recommended set of core outcomes. Subsequent to this, specific measures will be selected or created to assess these outcomes. The aim of this study is to develop a core outcome set and relevant measures for clinical trials relevant to facial aging. We hope to improve the reliability and consistency of outcome reporting of skin aging, thereby enabling improved evaluation of treatment efficacy and patient satisfaction. Core Outcome Measures in Effectiveness Trials (COMET) Initiative, accessible at http://www.comet-initiative.org/studies/details/737 . Core Outcomes Set Initiative, (CSG-COUSIN) accessible at https://www.uniklinikum-dresden.de/de/das-klinikum/universitaetscentren/zegv/cousin/meet-the-teams/project-groups/core-outcome-set-for-the-appearance-of-facial-aging . Protocol version date is 28 July 2016.

Mechanism of Flavoprotein l-6-Hydroxynicotine Oxidase: pH and Solvent Isotope Effects and Identification of Key Active Site Residues.

PubMed

Fitzpatrick, Paul F; Chadegani, Fatemeh; Zhang, Shengnan; Dougherty, Vi

2017-02-14

The flavoenzyme l-6-hydroxynicotine oxidase is a member of the monoamine oxidase family that catalyzes the oxidation of (S)-6-hydroxynicotine to 6-hydroxypseudooxynicotine during microbial catabolism of nicotine. While the enzyme has long been understood to catalyze oxidation of the carbon-carbon bond, it has recently been shown to catalyze oxidation of a carbon-nitrogen bond [Fitzpatrick, P. F., et al. (2016) Biochemistry 55, 697-703]. The effects of pH and mutagenesis of active site residues have now been utilized to study the mechanism and roles of active site residues. Asn166 and Tyr311 bind the substrate, while Lys287 forms a water-mediated hydrogen bond with flavin N5. The N166A and Y311F mutations result in ∼30- and ∼4-fold decreases in k cat /K m and k red for (S)-6-hydroxynicotine, respectively, with larger effects on the k cat /K m value for (S)-6-hydroxynornicotine. The K287M mutation results in ∼10-fold decreases in these parameters and a 6000-fold decrease in the k cat /K m value for oxygen. The shapes of the pH profiles are not altered by the N166A and Y311F mutations. There is no solvent isotope effect on the k cat /K m value for amines. The results are consistent with a model in which both the charged and neutral forms of the amine can bind, with the former rapidly losing a proton to a hydrogen bond network of water and amino acids in the active site prior to the transfer of hydride to the flavin.

MONSTER IN THE DARK: THE ULTRALUMINOUS GRB 080607 AND ITS DUSTY ENVIRONMENT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Perley, D. A.; Morgan, A. N.; Miller, A. A.

2011-02-15

We present early-time optical through infrared photometry of the bright Swift gamma-ray burst (GRB) 080607, starting only 6 s following the initial trigger in the rest frame. Complemented by our previously published spectroscopy, this high-quality photometric data set allows us to solve for the extinction properties of the redshift 3.036 sightline, giving perhaps the most detailed information to date on the ultraviolet continuum absorption properties of any sightline outside our Local Group. The extinction properties are not adequately modeled by any ordinary extinction template (including the average Milky Way, Large Magellanic Cloud, and Small Magellanic Cloud curves), partially because themore » 2175 A feature (while present) is weaker by about a factor of two than when seen under similar circumstances locally. However, the spectral energy distribution is exquisitely fitted by the more general Fitzpatrick and Massa parameterization of Local-Group extinction, putting it in the same family as some peculiar Milky Way extinction curves. After correcting for this (considerable, A{sub V} = 3.3 {+-} 0.4 mag) extinction, GRB 080607 is revealed to have been among the most optically luminous events ever observed, comparable to the naked-eye burst GRB 080319B. Its early peak time (t{sub rest} < 6 s) indicates a high initial Lorentz factor ({Gamma}>600), while the extreme luminosity may be explained in part by a large circumburst density. Only because of its early high luminosity could the afterglow of GRB 080607 be studied in such detail in spite of the large attenuation and great distance, making this burst an excellent prototype for the understanding of other highly obscured extragalactic objects, and of the class of 'dark' GRBs in particular.« less

Interstellar extinction curve variations towards the inner Milky Way: a challenge to observational cosmology

NASA Astrophysics Data System (ADS)

Nataf, David M.; Gonzalez, Oscar A.; Casagrande, Luca; Zasowski, Gail; Wegg, Christopher; Wolf, Christian; Kunder, Andrea; Alonso-Garcia, Javier; Minniti, Dante; Rejkuba, Marina; Saito, Roberto K.; Valenti, Elena; Zoccali, Manuela; Poleski, Radosław; Pietrzyński, Grzegorz; Skowron, Jan; Soszyński, Igor; Szymański, Michał K.; Udalski, Andrzej; Ulaczyk, Krzysztof; Wyrzykowski, Łukasz

2016-03-01

We investigate interstellar extinction curve variations towards ˜4 deg2 of the inner Milky Way in VIJKs photometry from the OGLE-III (third phase of the Optical Gravitational Lensing Experiment) and VVV (VISTA Variables in the Via Lactea) surveys, with supporting evidence from diffuse interstellar bands and F435W, F625W photometry. We obtain independent measurements towards ˜2000 sightlines of AI, E(V - I), E(I - J) and E(J - Ks), with median precision and accuracy of 2 per cent. We find that the variations in the extinction ratios AI/E(V - I), E(I - J)/E(V - I) and E(J - Ks)/E(V - I) are large (exceeding 20 per cent), significant and positively correlated, as expected. However, both the mean values and the trends in these extinction ratios are drastically shifted from the predictions of Cardelli and Fitzpatrick, regardless of how RV is varied. Furthermore, we demonstrate that variations in the shape of the extinction curve have at least two degrees of freedom, and not one (e.g. RV), which we confirm with a principal component analysis. We derive a median value of = 13.44, which is ˜60 per cent higher than the `standard' value. We show that the Wesenheit magnitude WI = I - 1.61(I - J) is relatively impervious to extinction curve variations. Given that these extinction curves are linchpins of observational cosmology, and that it is generally assumed that RV variations correctly capture variations in the extinction curve, we argue that systematic errors in the distance ladder from studies of Type Ia supernovae and Cepheids may have been underestimated. Moreover, the reddening maps from the Planck experiment are shown to systematically overestimate dust extinction by ˜100 per cent and lack sensitivity to extinction curve variations.

A novel method for real-time skin impedance measurement during radiofrequency skin tightening treatments.

PubMed

Harth, Yoram; Lischinsky, Daniel

2011-03-01

The thermal effects of monopolar and bipolar radiofrequency (RF) have been proven to be beneficial in skin tightening. Nevertheless, these effects were frequently partial or unpredictable because of the uncontrolled nature of monopolar or unipolar RF and the superficial nature of energy flow for bipolar or tripolar configurations. One of the hypotheses for lack or predictability of efficacy of the first-generation RF therapy skin tightening systems is lack of adaptation of delivered power to differences in individual skin impedance. A novel multisource phase-controlled system was used (1 MHz, power range 0-65 W) for treatment and real-time skin impedance measurements in 24 patients (EndyMed PRO™; EndyMed, Cesarea, Israel). This system allows continuous real-time measurement of skin impedance delivering constant energy to the patient skin independent of changes in its impedance. More than 6000 unique skin impedance measurements on 22 patients showed an average session impedance range was 215-584 Ohm with an average of 369 Ohm (standard deviation of 49 Ohm). Analyzing individual pulses (total of 600 readings) showed a significant decrease in impedance during the pulse. These findings validate the expected differences in skin impedance between individual patients and in the same patients during the treatment pulse. Clinical study on 30 patients with facial skin aging using the device has shown high predictability of efficacy (86.7% of patients had good results or better at 3 months' follow-up [decrease of 2 or more grades in Fitzpatrick's wrinkle scale]). The real-time customization of energy according to skin impedance allows a significantly more accurate and safe method of nonablative skin tightening with more consistent and predictable results. © 2011 Wiley Periodicals, Inc.

Open-Label Treatment of Moderate or Marked Melasma with a 4% Hydroquinone Skin Care System Plus 0.05% Tretinoin Cream

PubMed Central

Rendon, Marta; Dibernardo, Barry; Bruce, Suzanne; Lucas-Anthony, Chere; Watson, Joanne

2013-01-01

Objective: To evaluate treating epidermal melasma using a 4% hydroquinone skin care system plus tretinoin 0.05% cream. Design: Multicenter open-label study with all patients receiving above-mentioned treatment for up to 24 weeks. Setting: Private dermatology and plastic surgery clinics and clinical research facilities. Participants: Thirty-seven adult females with moderate or marked epidermal melasma, melasma pigmentation of mild-to-marked intensity and Fitzpatrick skin type III to VI. Measurements: Melasma severity melasma pigmentation intensity melasma improvement, patient satisfaction, quality-of-life measures, erythema, dryness, peeling, burning/stinging. Results: No patient discontinued due to lack of efficacy or treatment-related adverse events. Treatment was associated with a significant reduction from baseline in melasma severity and melasma pigmentation intensity from Week 4 onward (P≤0.001), and 100 percent of patients showed improvement from Week 8 onward. At Week 24, 100 percent of patients were “satisfied” or “very satisfied” with the overall effectiveness of their treatment. Patients’ quality of life also improved (e.g., the proportion of patients feeling embarrassed or self-conscious about their skin “a lot” or “very much” declined from 78 percent at baseline to four percent at Week 24). Mean and median scores for erythema, dryness, peeling, and burning/stinging did not exceed trace levels. Conclusion: Treating moderate-to-severe melasma using the 4% hydroquinone skin care system plus 0.05% tretinoin can significantly reduce the severity of melasma and the intensity of melasma pigmentation within four weeks. Treatment was generally well tolerated and associated with an improved quality of life and high levels of patient satisfaction. PMID:24307923

Economic and Market Challenges Facing the U.S. Nuclear Commercial Fleet

DOE Office of Scientific and Technical Information (OSTI.GOV)

Szilard, Ronaldo; Sharpe, Phil; Kee, Edward

This report identifies underlying economic and electricity market factors that have led to early retirements of U.S. operating nuclear power plants, assesses the Gap between operating revenues and operating costs for selected nuclear power plants, and discusses a range of actions that might be taken to stop early retirement of operating nuclear power plants. The Kewaunee and Vermont Yankee nuclear power plants were retired early for economic and financial reasons. Early retirement has been announced or proposed for Clinton and Quad Cities in Illinois, Fitzpatrick and Ginna in New York, Fort Calhoun in Nebraska. Other nuclear power plants, including Palisades,more » Davis-Besse, Prairie Island, and Three Mile Island Unit 1, have been identified as facing financial stress that might lead to early retirement. The early retirement of operating nuclear power plants will mean the loss of a large amount of zero-emission electricity, inconsistent with the goal of reducing carbon emissions in the electricity sector. This report provides a high-level view of the major factors driving early retirement: • The U.S. market and private ownership approach to the electricity sector; • Low electricity market prices resulting from low natural gas prices, low demand growth, increased penetration of renewable generation, and negative electricity market prices; and • No compensation to nuclear power plants for public benefits including zero-emission electricity.« less

Managing actinic keratosis in primary care.

PubMed

Salmon, Nicola; Tidman, Michael J

2016-10-01

Actinic, or solar, keratosis is caused by chronic ultraviolet-induced damage to the epidermis. In the UK, 15-23% of individuals have actinic keratosis lesions. Risk factors include: advanced age; male gender; cumulative sun exposure or phototherapy; Fitzpatrick skin phototypes I-II; long-term immuno-suppression and genetic syndromes e.g. xeroderma pigmentosum and albinism. Actinic keratoses are regarded by some authorities as premalignant lesions that may transform into invasive squamous cell carcinoma (SCC) and by others as in situ SCC that may progress to an invasive stage. The risk of malignant change appears low; up to 0.5% per lesion per year. Up to 20-30% of lesions may spontaneously regress but in the absence of any reliable prognostic clinical indicators regarding malignant potential active treatment is considered appropriate. Actinic keratosis lesions may present as discrete hyperkeratotic papules, cutaneous horns, or more subtle flat lesions on sun-exposed areas of skin. The single most helpful diagnostic sign is an irregularly roughened surface texture: a sandpaper-like feel almost always indicates actinic damage. Dermatoscopy can be helpful in excluding signs of basal cell carcinoma when actinic keratosis is non-keratotic. It is always important to consider the possibility of SCC. The principal indication for referral to secondary care is the possibility of cutaneous malignancy. However, widespread and severe actinic damage in patients who are immunosuppressed is also a reason for referral.

Tearing mode dynamics and locking in the presence of external magnetic perturbations

NASA Astrophysics Data System (ADS)

Fridström, R.; Munaretto, S.; Frassinetti, L.; Chapman, B. E.; Brunsell, P. R.; Sarff, J. S.

2016-06-01

In normal operation, Madison Symmetric Torus (MST) [R. N. Dexter et al., Fusion Technol. 19, 131 (1991)] reversed-field pinch plasmas exhibit several rotating tearing modes (TMs). Application of a resonant magnetic perturbation (RMP) results in braking of mode rotation and, if the perturbation amplitude is sufficiently high, in a wall-locked state. The coils that produce the magnetic perturbation in MST give rise to RMPs with several toroidal harmonics. As a result, simultaneous deceleration of all modes is observed. The measured TM dynamics is shown to be in qualitative agreement with a magnetohydrodynamical model of the RMP interaction with the TM [R. Fitzpatrick, Nucl. Fusion 33, 1049 (1993)] adapted to MST. To correctly model the TM dynamics, the electromagnetic torque acting on several TMs is included. Quantitative agreement of the TM slowing-down time was obtained for a kinematic viscosity in the order of νki n≈10 -20 m2/s. Analysis of discharges with different plasma densities shows an increase of the locking threshold with increasing density. Modeling results show good agreement with the experimental trend, assuming a density-independent kinematic viscosity. Comparison of the viscosity estimates in this paper to those made previously with other techniques in MST plasmas suggests the possibility that the RMP technique may allow for estimates of the viscosity over a broad range of plasmas in MST and other devices.

An evaluation of the effect of a topical product containing salicin on the visible signs of human skin aging.

PubMed

Gopaul, Remona; Knaggs, Helen E; Lephart, Janet F; Holley, Kara C; Gibson, Erica M

2010-09-01

There are many different visible signs of skin aging. These include wrinkles, hyperpigmentation, lack of firmness, poor texture, enlarged pores, and dryness. While there are many topical agents that claim to deliver wide-spectrum anti-aging benefits, few target all of the signs of skin aging to the same extent. Salicin, an extract from white willow bark, has been researched as a potent anti-inflammatory agent when taken orally. Based on unpublished in-house comprehensive consumer clinical studies, it is believed salicin may have anti-aging capabilities when applied topically to human skin. This research evaluated the effect of a topical serum formulation containing salicin at 0.5% on the visible signs of skin aging. This single-center study enrolled 30 female subjects, showing mild to moderate signs of aging, between the ages of 35 and 70 having Fitzpatrick skin types ranging between I and IV. Subjects used the study serum product containing 0.5% salicin on their face twice daily for 12 weeks. Ordinal grading on a nine-point scale (0 = none, 1-3 = mild, 4-6 = moderate, 7-9 = severe) of facial fine lines, molted pigmentation, uneven skin tone, tactile roughness, global firmness appearance, jaw-line contour, radiance, and overall appearance was performed by investigator at baseline, week 1, week 4, week 8, and week 12. Digital photography, ultrasound, cutometry, and corneometry measurements were also performed at each time point. Twenty-nine of 30 subjects successfully completed the study. No tolerability issues were reported. The clinical investigator found statistically significant improvements in wrinkles, tactile roughness, pore size, radiance, and overall appearance at week 1 time point (P ≤ 0.05) against baseline and statistically significant improvements in mottled pigmentation, global firmness, and jaw-line contour at week 4 time point (P ≤ 0.05) against baseline. Cutometry, corneometry, and ultrasound measurements showed significant improvements at week 12 time point (P ≤ 0.05) against baseline. Based on the findings from this study, it can be concluded that salicin has the ability to reduce the visible signs of skin aging when applied topically. © 2010 Wiley Periodicals, Inc.

Spectroscopic Investigation of O-,M-, and P-Cyanostyrenes

NASA Astrophysics Data System (ADS)

Korn, Joseph A.; Knezz, Stephanie N.; McMahon, Robert J.; Zwier, Timothy S.

2014-06-01

The atmosphere of Titan contains nitrogen, methane, and a rich mixture of more complex hydrocarbons and nitriles produced by photochemical processing. Data from the 2005 Cassini-Huygens mission suggests that among the more complex compounds are substituted benzenes that are themselves precursors to large polymeric tholins. Nitriles are particularly prevalent in Titan's atmosphere due to the dominance of N2 in the atmosphere. The cyanostyrenes are of particular interest, in part because they have the same molecular formula (C9H7N) as quinoline, a prototypical heteroaromatic, and therefore could engage in photochemical isomerization to form this molecule of significant pre-biotic relevance. As a first step in understanding the pathways leading to heteroaromatics, we have studied the isotope-selective spectroscopy of o-,m-, and p-cyanostyrene under jet-cooled conditions relevant to Titan's atmosphere. In this talk, the excitation and emission spectra for the three isomers will be presented. Using a combination of resonant two-photon ionization, LIF excitation, and dispersed fluorescence spectroscopies, the vibronic spectroscopy of the three isomers were recorded and compared. The meta isomer has two conformational isomers, which have been distinguished and studied using hole-burning methods. The talk will compare and contrast the UV spectral signatures of the set of structural and conformational isomers of the cyanostyrenes, using the ethynylstyrene counterparts as points of comparison. Sebree, J. A.; Kidwell, N. M.; Selby, T. M.; Amberger, B. K.; McMahon, R. J.; Zwier, T. S., Photochemistry of Benzylallene: Ring-Closing Reactions to Form Naphthalene. Journal of the American Chemical Society 2012, 134 (2), 1153-1163. Selby, T. M.; Clarkson, J. R.; Mitchell, D.; Fitzpatrick, J. A. J.; Lee, H. D.; Pratt, D. W.; Zwier, T. S., Isomer-Specific Spectroscopy and Conformational Isomerization Energetics of o-, m-, and p-Ethynylstyrenes. The Journal of Physical Chemistry A 2005, 109 (20), 4484-4496.

The Safety and Efficacy of the 1540nm Non-Ablative Fractional XD Probe of Star Lux 500 Device in the Treatment of Striae Alba: Before-After Study.

PubMed

Malekzad, Farhad; Shakoei, Safoura; Ayatollahi, Azin; Hejazi, Somayeh

2014-01-01

Striae distensae (SD) are a frequent skin condition for which treatment remains a challenge. The 1540-nm non-ablative fractional laser (Star Lux 500) has been shown to improve atrophic scars by increasing the amount of dermal collagen. To assess the safety and efficacy of the Star Lux 500 laser in the treatment of mature hypopigmented striae in Persian people (Striae Alba). Ten women aged 26-50 years with SD and Fitzpatrick skin types III-V were enrolled in the study. The exclusion criteria were a history of keloids, photosensitivity and collagen, elastin disorders as well as history of other striae treatment within one year. The lesions were treated with non-ablative fractional laser 1540nm, and a total of four treatments were given at 4-week intervals. Clinical standard photographs were taken before each treatment. Also, patients were followed up at 3 months after the last treatment. Clinical improvement was assessed by comparing baseline and post-treatment photographs by two independent blinded physicians using grading scale. Treatment efficacy analysis was performed via the comparison between the images taken before and after each treatment session. There was a clinically appreciable improvement in striae ranging from 1 to 24%. A significant improvement in striae between the 16-week treatment and the 4-week treatment was identified (P<0.0001). Three months after the final treatment, patients showed noticeable improvement in the striae, compared with baseline (P<0.048). Mild post inflammatory hyperpigmentation was observed in one patient after the 8-week treatment and mild to moderate acne occurred in another patient after 4 weeks of treatment. Therapy with Star lux 500 laser had clinically and statistically striae improvement with no adverse events. This may be a safe and an effective treatment modality for Striae Alba lesions.

Multiple minimally invasive Erbium:YAG laser mini-peels for skin rejuvenation: An objective assessment

PubMed Central

El-Domyati, Moetaz; El-Ammawi, Tarek S.; Medhat, Walid; Moawad, Osama; Mahoney, Mỹ G.; Uitto, Jouni

2012-01-01

Summary Background As the demand for minimally invasive rejuvenation is increasing, micro-peel resurfacing using Erbium:Yttrium Aluminium Garnet (Er:YAG ) laser 2940 nm has been reported for the treatment of photoaged skin without ablation of the epidermis. However, little is known about the efficacy and underlying histologic changes associated with this type of treatment. Aims The purpose of this study is to evaluate the clinical effect and objectively quantify the histological changes in response to multiple sessions of Er:YAG laser 2940 nm mini-peels. Patients and methods Six female volunteers of Fitzpatrick skin type III-IV and Glogau’s class I-III wrinkles were subjected to six microresurfacing peels at 2-week intervals using Er:YAG 2940 nm laser at sub-ablative fluences of 2 - 3 J/cm2 to treat periorbital rhytides. Quantitative evaluation of collagen types I, III and VII, newly synthesized collagen, total elastin and tropoelastin was performed by histochemistry and immunohistochemistry coupled with computerized morphometric analysis at base line, end of treatment, and three months post treatment. Results Compared to the base line, evaluation of volunteers revealed obvious clinical improvement in response to Er:YAG mini-peels. Collagen types I, III, and VII, as well as newly synthesized collagen, together with tropoelastin showed a statistically significant increase in response to treatment, while the mean level of total elastin was significantly decreased in response to treatment. However, this was followed by regression of improvement at 3 months post treatment, but was still better than baseline. Conclusions The present study revealed that multiple Er:YAG mini-peels is a promising treatment option for photoaging as it reverses the signs of photoaged skin with little downtime and side effects. However, to maintain the short term improvement achieved after treatment, continued Er:YAG 2940 nm laser mini-peels is required. PMID:22672276

Epidemiological profile of nonmelanoma skin cancer in renal transplant recipients: experience of a referral center*

PubMed Central

Ferreira, Flávia Regina; Ogawa, Marilia Marufuji; Nascimento, Luiz Fernando Costa; Tomimori, Jane

2014-01-01

BACKGROUND Nonmelanoma skin cancer is the most common form of cancer in humans and also the malignant disease that is increasingly common among kidney transplant recipients. OBJECTIVE To determine the epidemiological characteristics of renal transplant recipients with nonmelanoma skin cancer seen at a referral transplantation center. METHODS Cross-sectional descriptive study with renal transplant recipients presenting nonmelanoma skin cancer, treated at a transplantation referral center between 08/01/2004 and 08/31/2009. Analyzed variables were: gender, age, skin phototype, occupational and recreational sun exposure, use of photoprotection, personal and family history of non-melanoma skin cancer, clinical type and location, time between transplantation and the appearance of the first nonmelanoma skin cancer, occurrence of viral warts, timing of transplantation, type of donor, cause of kidney failure, previous transplants, comorbidities, pre-transplant dialysis, type and duration of dialysis. RESULTS 64 subjects were included. Males - 71.9%; low skin phototypes (up to Fitzpatrick III) - 89%; mean age - 57.0 years - and mean age at transplant - 47.3 years; sun exposure - 67.2% occupational - and 64.1% recreational; photoprotection - 78.2% (although only 34.4% in a regular manner); squamous cell carcinoma - 67.2%; squamous cell carcinoma/basal cell carcinoma ratio - 2:1; personal history of nonmelanoma skin cancer - 25% - and family history - 10.9%; location at photoexposed area - 98.4%; average latency time between transplantation and first nonmelanoma skin cancer appearance - 78.3 months; viral warts (HPV) after transplant - 53.1%; average timing of transplantation - 115.5 months; living donor - 64.1%; triple regimen (antirejection) - 73.2%; comorbidities - 92.2%; pre-transplant dialysis - 98.4%; hemodialysis - 71.7%; average duration of dialysis - 39.1 months; previous transplants - 3.1%; hypertension as cause of renal failure - 46.9%. CONCLUSION This study allowed the epidemiological characterization of a population of kidney transplant recipients with nonmelanoma skin cancer. PMID:25184913

Temporal variation of optimal UV exposure time over Korea: risks and benefits of surface UV radiation

NASA Astrophysics Data System (ADS)

Lee, Y. G.; Koo, J. H.

2015-12-01

Solar UV radiation in a wavelength range between 280 to 400 nm has both positive and negative influences on human body. Surface UV radiation is the main natural source of vitamin D, providing the promotion of bone and musculoskeletal health and reducing the risk of a number of cancers and other medical conditions. However, overexposure to surface UV radiation is significantly related with the majority of skin cancer, in addition other negative health effects such as sunburn, skin aging, and some forms of eye cataracts. Therefore, it is important to estimate the optimal UV exposure time, representing a balance between reducing negative health effects and maximizing sufficient vitamin D production. Previous studies calculated erythemal UV and vitamin-D UV from the measured and modelled spectral irradiances, respectively, by weighting CIE Erythema and Vitamin D3 generation functions (Kazantzidis et al., 2009; Fioletov et al., 2010). In particular, McKenzie et al. (2009) suggested the algorithm to estimate vitamin-D production UV from erythemal UV (or UV index) and determined the optimum conditions of UV exposure based on skin type Ⅱ according to the Fitzpatrick (1988). Recently, there are various demands for risks and benefits of surface UV radiation on public health over Korea, thus it is necessary to estimate optimal UV exposure time suitable to skin type of East Asians. This study examined the relationship between erythemally weighted UV (UVEry) and vitamin D weighted UV (UVVitD) over Korea during 2004-2012. The temporal variations of the ratio (UVVitD/UVEry) were also analyzed and the ratio as a function of UV index was applied in estimating the optimal UV exposure time. In summer with high surface UV radiation, short exposure time leaded to sufficient vitamin D and erythema and vice versa in winter. Thus, the balancing time in winter was enough to maximize UV benefits and minimize UV risks.

Relationship between tooth value and skin color in patients visiting Royal Medical Services clinics of Jordan.

PubMed

Al-Nsour, Hind Fahed; Al-Zoubi, Tamara Trad; Al-Rimawi, Ali Salaheddin

2018-03-01

Facial and dental aesthetics are becoming of great concern for patients, especially for the younger generation. Tooth color matching and selection is considered a vital element in order to create an attractive beautiful smile. The importance of tooth color matching is to adjust tooth colors to obtain a good match with adjacent teeth and the skin. This is considered a challenge especially if adjacent teeth were lost or records of patients' teeth color were not available. The aim of this study was to determine the relationship between skin complexion and tooth value in a Jordanian population. A cross-sectional study of 520 individuals who were randomly selected and belonging to different age groups, ranging from 15-65 years, with equal sex distribution. These patients visited the dental clinics at different Jordanian military hospitals. The study was carried out over a period of one year from 2015 to 2016. The randomly selected sample was examined by one researcher. Shade of the middle third of the labial surface of central incisor was determined visually using VITA tooth guide, 3D-MASTER shade guide. Tooth shades were divided into two categories according to their value. The skin complexion was identified using Fitzpatrick skin type test, and was categorized into two categories (fair and dark). Data were statistically analyzed using Epi Info version 6. A statistically significant tooth shade value difference was discovered among subjects of different skin color (p<0.0001). Individuals with dark skin tend to have lighter teeth, while individuals with light skin tend to have darker teeth. Out of the 304 participants that were with dark complexion 274 (90%) have light teeth, and only 30 (10%) were with dark teeth. Out of the 216 participants with light complexion 172 (80%) have dark teeth and only 44 (20%) have light teeth. Within the limitation of this study, there was an inverse relation between skin complexion and tooth value among a Jordanian population. Thus, considering the skin complexion when choosing tooth shades is helpful in achieving a pleasing good-looking smile, yet further investigations in this field must be carried out.

Protective effects of a topical antioxidant mixture containing vitamin C, ferulic acid, and phloretin against ultraviolet-induced photodamage in human skin.

PubMed

Oresajo, Christian; Stephens, Thomas; Hino, Peter D; Law, Robert M; Yatskayer, Margarita; Foltis, Peter; Pillai, Sreekumar; Pinnell, Sheldon R

2008-12-01

Ultraviolet (UV) irradiation of the skin leads to acute inflammatory reactions, such as erythema, sunburn, and chronic reactions, including premature skin aging and skin cancer. In this study, the effects of a topical antioxidant mixture consisting of vitamin C, ferulic acid, and phloretin on attenuating the harmful effects of UV irradiation on normal healthy volunteers were studied using biomarkers of skin damage. Ten subjects (age, 18-60 years; Fitzpatrick skin types II and III) were randomized and treated with antioxidant product or vehicle control on the lower back for four consecutive days. On day 3, the minimal erythema dose (MED) was determined for each subject at a different site on the back. On day 4, the two test sites received solar-simulated UV irradiation 1-5x MED at 1x MED intervals. On day 5, digital images were taken, and 4-mm punch biopsies were collected from the two 5x MED test sites and a control site from each subject for morphology and immunohistochemical studies. UV irradiation significantly increased the erythema of human skin in a linear manner from 1x to 5x MED. As early as 24 h after exposure to 5x MEDs of UV irradiation, there were significant increases in sunburn cell formation, thymine dimer formation, matrix metalloproteinase-9 expression, and p53 protein expression. All these changes were attenuated by the antioxidant composition. UV irradiation also suppressed the amount of CD1a-expressing Langerhans cells, indicating immunosuppressive effects of a single 5x MED dose of UV irradiation. Pretreatment of skin with the antioxidant composition blocked this effect. This study confirms the protective role of a unique mixture of antioxidants containing vitamin C, ferulic acid, and phloretin on human skin from the harmful effects of UV irradiation. Phloretin, in addition to being a potent antioxidant, may stabilize and increase the skin availability of topically applied vitamin C and ferulic acid. We propose that antioxidant mixture will complement and synergize with sunscreens in providing photoprotection for human skin.

Milky Way Tomography IV: Dissecting Dust

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berry, Michael; /Washington U., Seattle, Astron. Dept. /Rutgers U., Piscataway; Ivezic, Zeljko

2011-11-01

We use SDSS photometry of 73 million stars to simultaneously obtain best-fit main-sequence stellar energy distribution (SED) and amount of dust extinction along the line of sight towards each star. Using a subsample of 23 million stars with 2MASS photometry, whose addition enables more robust results, we show that SDSS photometry alone is sufficient to break degeneracies between intrinsic stellar color and dust amount when the shape of extinction curve is fixed. When using both SDSS and 2MASS photometry, the ratio of the total to selective absorption, R{sub V}, can be determined with an uncertainty of about 0.1 for mostmore » stars in high-extinction regions. These fits enable detailed studies of the dust properties and its spatial distribution, and of the stellar spatial distribution at low Galactic latitudes (|b| < 30{sup o}). Our results are in good agreement with the extinction normalization given by the Schlegel et al. (1998, SFD) dust maps at high northern Galactic latitudes, but indicate that the SFD extinction map appears to be consistently overestimated by about 20% in the southern sky, in agreement with recent study by Schlafly et al. (2010). The constraints on the shape of the dust extinction curve across the SDSS and 2MASS bandpasses disfavor the reddening law of O'Donnell (1994), but support the models by Fitzpatrick (1999) and Cardelli et al. (1989). For the latter, we find a ratio of the total to selective absorption to be R{sub V} = 3.0 {+-} 0.1(random) {+-} 0.1 (systematic) over most of the high-latitude sky. At low Galactic latitudes (|b| < 5{sup o}), we demonstrate that the SFD map cannot be reliably used to correct for extinction because most stars are embedded in dust, rather than behind it, as is the case at high Galactic latitudes. We analyze three-dimensional maps of the best-fit R{sub V} and find that R{sub V} = 3.1 cannot be ruled out in any of the ten SEGUE stripes at a precision level of {approx} 0.1 - 0.2. Our best estimate for the intrinsic scatter of R{sub V} in the regions probed by SEGUE stripes is {approx} 0.2. We introduce a method for efficient selection of candidate red giant stars in the disk, dubbed 'dusty parallax relation', which utilizes a correlation between distance and the extinction along the line of sight. We make these best-fit parameters, as well as all the input SDSS and 2MASS data, publicly available in a user-friendly format. These data can be used for studies of stellar number density distribution, the distribution of dust properties, for selecting sources whose SED differs from SEDs for high-latitude main sequence stars, and for estimating distances to dust clouds and, in turn, to molecular gas clouds.« less

THE MILKY WAY TOMOGRAPHY WITH SLOAN DIGITAL SKY SURVEY. IV. DISSECTING DUST

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berry, Michael; Ivezic, Zeljko; Brooks, Keira J.

2012-10-01

We use Sloan Digital Sky Survey (SDSS) photometry of 73 million stars to simultaneously constrain best-fit main-sequence stellar spectral energy distribution (SED) and amount of dust extinction along the line of sight toward each star. Using a subsample of 23 million stars with Two Micron All Sky Survey (2MASS) photometry, whose addition enables more robust results, we show that SDSS photometry alone is sufficient to break degeneracies between intrinsic stellar color and dust amount when the shape of extinction curve is fixed. When using both SDSS and 2MASS photometry, the ratio of the total to selective absorption, R{sub V} ,more » can be determined with an uncertainty of about 0.1 for most stars in high-extinction regions. These fits enable detailed studies of the dust properties and its spatial distribution, and of the stellar spatial distribution at low Galactic latitudes (|b| < 30 Degree-Sign ). Our results are in good agreement with the extinction normalization given by the Schlegel et al. (SFD) dust maps at high northern Galactic latitudes, but indicate that the SFD extinction map appears to be consistently overestimated by about 20% in the southern sky, in agreement with recent study by Schlafly et al. The constraints on the shape of the dust extinction curve across the SDSS and 2MASS bandpasses disfavor the reddening law of O'Donnell, but support the models by Fitzpatrick and Cardelli et al. For the latter, we find a ratio of the total to selective absorption to be R{sub V} = 3.0 {+-} 0.1(random){+-}0.1 (systematic) over most of the high-latitude sky. At low Galactic latitudes (|b| < 5 Degree-Sign ), we demonstrate that the SFD map cannot be reliably used to correct for extinction because most stars are embedded in dust, rather than behind it, as is the case at high Galactic latitudes. We analyze three-dimensional maps of the best-fit R{sub V} and find that R{sub V} = 3.1 cannot be ruled out in any of the 10 SEGUE stripes at a precision level of {approx}0.1-0.2. Our best estimate for the intrinsic scatter of R{sub V} in the regions probed by SEGUE stripes is {approx}0.2. We introduce a method for efficient selection of candidate red giant stars in the disk, dubbed 'dusty parallax relation', which utilizes a correlation between distance and the extinction along the line of sight. We make these best-fit parameters, as well as all the input SDSS and 2MASS data, publicly available in a user-friendly format. These data can be used for studies of stellar number density distribution, the distribution of dust properties, for selecting sources whose SED differs from SEDs for high-latitude main-sequence stars, and for estimating distances to dust clouds and, in turn, to molecular gas clouds.« less

Optical-NIR dust extinction towards Galactic O stars

NASA Astrophysics Data System (ADS)

Maíz Apellániz, J.; Barbá, R. H.

2018-05-01

Context. O stars are excellent tracers of the intervening ISM because of their high luminosity, blue intrinsic SED, and relatively featureless spectra. We are currently conducting the Galactic O-Star Spectroscopic Survey (GOSSS), which is generating a large sample of O stars with accurate spectral types within several kpc of the Sun. Aims: We aim to obtain a global picture of the properties of dust extinction in the solar neighborhood based on optical-NIR photometry of O stars with accurate spectral types. Methods: We have processed a carefully selected photometric set with the CHORIZOS code to measure the amount [E(4405 - 5495)] and type [R5495] of extinction towards 562 O-type stellar systems. We have tested three different families of extinction laws and analyzed our results with the help of additional archival data. Results: The Maíz Apellániz et al. (2014, A&A, 564, A63) family of extinction laws provides a better description of Galactic dust that either the Cardelli et al. (1989, ApJ, 345, 245) or Fitzpatrick (1999, PASP, 111, 63) families, so it should be preferentially used when analysing samples similar to the one in this paper. In many cases O stars and late-type stars experience similar amounts of extinction at similar distances but some O stars are located close to the molecular clouds left over from their births and have larger extinctions than the average for nearby late-type populations. In qualitative terms, O stars experience a more diverse extinction than late-type stars, as some are affected by the small-grain-size, low-R5495 effect of molecular clouds and others by the large-grain-size, high-R5495 effect of H II regions. Late-type stars experience a narrower range of grain sizes or R5495, as their extinction is predominantly caused by the average, diffuse ISM. We propose that the reason for the existence of large-grain-size, high-R5495 regions in the ISM in the form of H II regions and hot-gas bubbles is the selective destruction of small dust grains by EUV photons and possibly by thermal sputtering by atoms or ions. Table 1 is only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/613/A9

THE BLUE TIP OF THE STELLAR LOCUS: MEASURING REDDENING WITH THE SLOAN DIGITAL SKY SURVEY

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schlafly, Edward F.; Finkbeiner, Douglas P.; Juric, Mario

2010-12-10

We present measurements of reddening due to dust using the colors of stars in the Sloan Digital Sky Survey (SDSS). We measure the color of main-sequence turnoff stars by finding the 'blue tip' of the stellar locus: the prominent blue edge in the distribution of stellar colors. The method is sensitive to color changes of order 18, 12, 7, and 8 mmag of reddening in the colors u - g, g - r, r - i, and i - z, respectively, in regions measuring 90' by 14'. We present maps of the blue tip colors in each of these bandsmore » over the entire SDSS footprint, including the new dusty southern Galactic cap data provided by the SDSS-III. The results disfavor the best-fit O'Donnell and Cardelli et al. reddening laws, but are described well by a Fitzpatrick reddening law with R{sub V} = 3.1. The Schlegel et al. (SFD) dust map is found to trace the dust well, but overestimates reddening by factors of 1.4, 1.0, 1.2, and 1.4 in u - g, g - r, r - i, and i - z largely due to the adopted reddening law. In select dusty regions of the sky, we find evidence for problems in the SFD temperature correction. A dust map normalization difference of 15% between the Galactic north and south sky may be due to these dust temperature errors.« less

Aeroacoustics research in Europe: The CEAS-ASC report on 2013 highlights

NASA Astrophysics Data System (ADS)

Bennett, G. J.; Kennedy, J.; Meskell, C.; Carley, M.; Jordan, P.; Rice, H.

2015-03-01

The Council of European Aerospace Societies (CEAS) Aeroacoustics Specialists Committee (ASC) supports and promotes the interests of the scientific and industrial aeroacoustics community on an European scale and European aeronautics activities internationally. In this context, "aeroacoustics" encompasses all aerospace acoustics and related areas. Each year the committee highlights some of the research and development projects in Europe. This paper is a report on highlights of aeroacoustics research in Europe in 2013, compiled from information provided to the ASC of the CEAS. During 2013, a number of research programmes involving aeroacoustics were funded by the European Commission. Some of the highlights from these programmes are summarised in this paper, as well as highlights from other programmes funded by national programmes or by industry. Furthermore, a concise summary of the CEAS-ASC workshop "Atmospheric and Ground Effects on Aircraft Noise" held in Seville, Spain in September 2013 is included in this report. Enquiries concerning all contributions should be addressed to the authors who are given at the end of each subsection. This issue of the "highlights" paper is dedicated to the memory of Prof. John A. Fitzpatrick, Professor of Mechanical Engineering, Trinity College Dublin, and a valued member of the Aeroacoustics Specialists Committee. John passed away in September 2012 and is fondly missed across the globe by the friends he made in the Aeroacoustics Community. This paper is edited by PhD graduates and colleagues of John's who conduct research in aeroacoustics, inspired by his thirst for knowledge.

DOE Office of Scientific and Technical Information (OSTI.GOV)

W. L. Poe, Jr.; P.F. Wise

The U.S. Department of Energy (DOE) is preparing a proposal to construct, operate 2nd monitor, and eventually close a repository at Yucca Mountain in Nye County, Nevada, for the geologic disposal of spent nuclear fuel (SNF) and high-level radioactive waste (HLW). As part of this effort, DOE has prepared a viability assessment and an assessment of potential consequences that may exist if the repository is not constructed. The assessment of potential consequences if the repository is not constructed assumes that all SNF and HLW would be left at the generator sites. These include 72 commercial generator sites (three commercial facilitymore » pairs--Salem and Hope Creek, Fitzpatrick and Nine Mile Point, and Dresden and Morris--would share common storage due to their close proximity to each other) and five DOE sites across the country. DOE analyzed the environmental consequences of the effects of the continued storage of these materials at these sites in a report titled Continued Storage Analysis Report (CSAR; Reference 1 ) . The CSAR analysis includes a discussion of the degradation of these materials when exposed to the environment. This document describes the environmental parameters that influence the degradation analyzed in the CSAR. These include temperature, relative humidity, precipitation chemistry (pH and chemical composition), annual precipitation rates, annual number of rain-days, and annual freeze/thaw cycles. The document also tabulates weather conditions for each storage site, evaluates the degradation of concrete storage modules and vaults in different regions of the country, and provides a thermal analysis of commercial SNF in storage.« less

Safety and Efficacy of a Non-Invasive 1060 nm Diode Laser for Fat Reduction of the Abdomen.

PubMed

Bass, Lawrence S; Doherty, Sean T

2018-01-01

Changes in temperature are known to produce apoptosis in adipocytes. This study examines the use of a non-invasive treatment that applies 1060 nm laser energy transcutaneously to hyperthermically induce disruption of fat cells in the abdomen. Thirty-five subjects received application of 1060 nm laser on the abdomen for fat reduction. Ultrasound images and high-resolution two-dimensional photography were recorded at baseline, 6 weeks, and 12 weeks post treatment. Subjects maintained a stable diet and exercise routine throughout the course of the study. Weight was recorded at baseline and each follow-up visit. Three board certified dermatologists were trained as blinded evaluators and tasked with identifying before and after photographs from randomized, paired baseline, and 12-week photographs. Ultrasound images were used to measure the fat thickness change from baseline at 6 and 12 weeks. Level of patient satisfaction was graded at 12 weeks using a 6 point Likert scale. 23% of subjects were Fitzpatrick IV-VI. Blinded evaluators correctly identified the post-treatment photograph 95% of the time (88%, 97%, and 100%). Mean reduction in fat layer thickness from baseline was statistically significant (P less than 0.001) at both 6 weeks (1.5 +/-1.23 mm) and 12 weeks (2.65 +/-1.41 mm). Mean weight change was +0.1 lb. Side effects were mild to moderate including edema, tenderness, and induration mostly resolving within 1-3 weeks post treatment. No serious adverse events were reported. 1060 nm based laser treatment can consistently reduce the fat contour in the abdomen with an excellent safety profile in all skin types. The study met all three of its prospectively defined endpoints of success.

J Drugs Dermatol. 2018;17(1):106-112.

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Bacillus coagulans GBI-30, 6086 limits the recurrence of Clostridium difficile-Induced colitis following vancomycin withdrawal in mice.

PubMed

Fitzpatrick, Leo R; Small, Jeffrey S; Greene, Wallace H; Karpa, Kelly D; Farmer, Sean; Keller, David

2012-10-22

Recently, we found that the probiotic strain Bacillus coagulans GBI-30, 6086 (GanedenBC30) improved indices of Clostridium difficile (C. difficile)-induced colitis in mice (Fitzpatrick et al., Gut Pathogens, 2011). Our goal was to determine if BC30 could also prevent the recurrence of C. difficile-induced colitis in mice, following initial treatment with vancomycin. During study days 0 through 5, mice were treated with antibiotics. On day 6, the C. difficile strain VPI 10463 was given by oro-gastric gavage at ≈ 5x104 CFU to induce colitis. Mice were treated on study days 6 to 10 with vancomycin (50 mg/kg) (vanco) or vehicle (saline) by gavage. On days 10 to16, mice were dosed by gavage with saline vehicle or BC30 (2 x 109 CFU per day). Mice were monitored for mortality, weight loss and diarrhea. On study days 14, 16 and 17, stools and colons were collected for analyzing other parameters of colitis. The mean stool consistency score in Vehicle/C.difficile/Vanco mice increased from 0.4 (day 10) to a range of 1.1 to 1.4 (days 14 to 17), indicating the recurrence of colitis. On days 13 through 17, the stool consistency scores for the vancomycin/BC30 mice were significantly lower (p< 0.05) than for the vancomycin/vehicle cohort of animals. On day 17, 88.9% of mice treated with BC30 had normal stools, while this value was 0% with vehicle treatment (p value = 0.0004). Colonic myeloperoxidase (Units/2 cm colon) was significantly (p < 0.05) reduced from 4.3 ± 0.7 (Vehicle/C.difficile/Vanco) to 2.6 ± 0.2 (BC30/C. Difficle/Vanco). The colonic histology score and Keratinocyte derived-chemokine level in the colon were also lower in BC30 treated mice. In BC30-treated mice, there was evidence of better stool consistency, as well as improved biochemical and histological indices of colitis, following initial treatment of animals with vancomycin. BC30 limited the recurrence of CD-induced colitis following vancomycin withdrawal in mice.

Bacillus coagulans GBI-30, 6086 limits the recurrence of Clostridium difficile-Induced colitis following vancomycin withdrawal in mice

PubMed Central

2012-01-01

Background Recently, we found that the probiotic strain Bacillus coagulans GBI-30, 6086 (GanedenBC30) improved indices of Clostridium difficile (C. difficile)-induced colitis in mice (Fitzpatrick et al., Gut Pathogens, 2011). Our goal was to determine if BC30 could also prevent the recurrence of C. difficile-induced colitis in mice, following initial treatment with vancomycin. During study days 0 through 5, mice were treated with antibiotics. On day 6, the C. difficile strain VPI 10463 was given by oro-gastric gavage at ≈ 5x104 CFU to induce colitis. Mice were treated on study days 6 to 10 with vancomycin (50 mg/kg) (vanco) or vehicle (saline) by gavage. On days 10 to16, mice were dosed by gavage with saline vehicle or BC30 (2 x 109 CFU per day). Mice were monitored for mortality, weight loss and diarrhea. On study days 14, 16 and 17, stools and colons were collected for analyzing other parameters of colitis. Results The mean stool consistency score in Vehicle/C.difficile/Vanco mice increased from 0.4 (day 10) to a range of 1.1 to 1.4 (days 14 to 17), indicating the recurrence of colitis. On days 13 through 17, the stool consistency scores for the vancomycin/BC30 mice were significantly lower (p< 0.05) than for the vancomycin/vehicle cohort of animals. On day 17, 88.9% of mice treated with BC30 had normal stools, while this value was 0% with vehicle treatment (p value = 0.0004). Colonic myeloperoxidase (Units/2 cm colon) was significantly (p < 0.05) reduced from 4.3 ± 0.7 (Vehicle/C.difficile/Vanco) to 2.6 ± 0.2 (BC30/C. Difficle/Vanco). The colonic histology score and Keratinocyte derived-chemokine level in the colon were also lower in BC30 treated mice. Summary In BC30-treated mice, there was evidence of better stool consistency, as well as improved biochemical and histological indices of colitis, following initial treatment of animals with vancomycin. Conclusion BC30 limited the recurrence of CD-induced colitis following vancomycin withdrawal in mice. PMID:23088680

A single-center, pilot study evaluating a novel TriHex peptide- and botanical-containing eye treatment compared to baseline.

PubMed

Reivitis, Alex; Karimi, Kian; Griffiths, Chester; Banayan, Ashley

2018-04-16

Topical treatments containing tripeptide and hexapeptide (TriHex technology) have been proven to contribute to youthful skin by clearing the extracellular matrix and stimulating collagen and elastin production. Evaluate the efficacy of a novel eye treatment containing TriHex peptides and other synergistic ingredients for the daily treatment of fine lines/crow's feet around the eyes, under eye hollowing, under eye bags, and dark circles. In this study, 10 subjects (9 female and 1 male) aged 30-60 of Fitzpatrick skin type I, II, or III were selected to use an eye treatment containing TriHex peptides and active botanicals (Alastin Restorative Eye Treatment with TriHex Technology™, ALASTIN Skincare, Inc., Carlsbad, CA) twice daily for 12 weeks. Subjects were photographed and evaluated at baseline, week 4, week 8, and week 12 by a board-certified facial plastic surgeon. Using an adjusted Griffiths scale (0 = none, best possible condition and 9 = severe, worst possible condition), subjects were evaluated on severity of fine lines/crow's feet, under eye hollowing, under eye bags, and dark circles at each visit. Subjects completed a "Subject Questionnaire" at week 4, week 8, and week 12 pertaining to the subject's observations and perceived improvement of these measures. Based on the investigator's assessments, overall improvement in periocular skin was noted for all 10 subjects. Over the course of 12 weeks, raw scores significantly decreased indicating reduction of lines/crow's feet (41% improvement), under eye hollowing (29% improvement), under eye bags (48% improvement), and dark circles (39% improvement). Based on the "Subject Questionnaire," all subjects noted overall improvement of the appearance of skin around the eyes. Based on the findings of this study, this eye treatment containing TriHex peptides and active botanicals is an effective stand-alone treatment for the rejuvenation of periocular skin. When used twice daily, this product can reduce the appearance of lines/crow's feet, under eye hollowing, under eye bags, and dark circles. © 2018 Wiley Periodicals, Inc.

Update on the Purdue University 2-second Drop Tower

NASA Astrophysics Data System (ADS)

Collicott, Steven

A small drop tower of approximately one second drop duration was built in the School of Aero-nautics and Astronautics at Purdue University beginning in 1998 and operated until summer 2007. This inexpensive tower in an old airplane hanger, was built largely by Yongkang Chen, now a Research Professor at Portland State University in Oregon, USA. In about 7 years of operations, the tower generated sufficient science results for Chen's PhD thesis[1] (summarized in three AIAA Journal papers[2-4]), Fitzpatrick's MS thesis[5], two industry projects for since-canceled advanced rodent habitats for ISS, and one project for NASA Marshall. In addition to the science use, Purdue undergraduate students designed, built, and performed simpler fluids experiments for their own career advancement, including a novel investigation of the impact of imperfect repeatability of initial conditions on a zero-g fluids experiment. The tower was also used for outreach to school children. It is most satisfying that Chen's PhD research in this small tower, and subsequent discussions and interactions, helped Weislogel to propose the two Vane Gap tests in his highly successful Capillary Fluids Experiment (CFE) in the International Space Station in 2006 and 2007[6]. Chen as been involved in the remodeling of these two Vane Gap cylinders for subsequent re-launch to ISS for a second round of experiments expected in 2010 and 2011. In August 2007 the School of Aeronautics and Astronautics at Purdue University moved into the new Neil Armstrong Hall of Engineering and construction on a new 2-second drop tower began. A vertical shaft of nearly 23 meters was designed into the building. An approximately 80 m2 general-use fluids lab is at the top level, and a small access room of approximately 9 m2 is at the bottom. However, construction of the new $57M building created only the space for the science facility, not the science facility itself. The science facility is under construction and this paper presents an update on progress for the micro-gravity community. The most noticeable current activity is testing of the air-bag decelerator. The tower is one that will use a free-falling experiment inside of a drag shield to avoid most aerodynamic drag. The airbag is designed from experiences of others yet the small, triangular room in which the tower terminates imposes challenges. The airbag is approximately 1.5m diameter and 1.5m tall. Initial testing led to a desire to increase vent area, and just this week the bag has returned from the shop that was modifying it. On-board computer, battery packs, lighting, and cameras have been acquired. Thanks to Lockheed Martin, one camera is 500 frames per second with 1.3 million 12-bit gray scale pixels per frame. The Spincraft company donated steel hemisphere-cylinders to serve as the nose of the drag shield. Wind tunnel and CFD modeling of the drag shield has been performed by Purdue undergraduate aerospace students. Currently the drag shield structure and experiment package structure are being design and analyzed. The experiment volume is approximately a cylinder 0.45m diameter and 0.6m tall. Tower operation is intended to commence in fall 2010 with inert package drops at full mass and full height. Developing the operations procedures, especially operational safety, are the goals of this work. First science is then expected in the winter. References 1. Y. Chen, "A Study of Capillary Flow in a Vane-wall Gap in Zero Gravity," Ph.D. thesis, School of Aeronautics and Astronautics, Purdue University. August 2003. 2. Y. Chen and S. H. Collicott, "Investigation of the Symmetric Wetting of a Vane-Wall Gap in Propellant Tanks," AIAA Journal, 42, No. 2, pp. 305-314, February 2004. 3. Y. Chen, and S. H. Collicott, "Experimental Study on the Capillary Flow in a Vane-Wall Gap Geometry," AIAA Journal, 43, No. 11, pp. 2395-2403, November, 2005. 4. Y. Chen and S. H. Collicott, "Study of Wetting in an Asymmetrical Vane-Wall Gap in Propellant Tanks," AIAA Journal, 44, 4, pp. 859-867, April 2006. 5. S. L. Fitzpatrick, "A Study of Hydrogen Peroxide Low-Gravity Control for Propellant Management Devices," MS thesis, School of Aeronautics and Astronautics, Purdue Uni-versity. May 2003. 6. M. M. Weislogel, R. Jenson, Y. Chen, S. H. Collicott, J. Klatte, and M. Dreyer. "The capillary flow experiments aboard the International Space Station: Status". Acta Astro-nautica. 65:861-869, 2009

Mechanistic and Structural Analyses of the Roles of Active Site Residues in the Yeast Polyamine Oxidase Fms1: Characterization of the N195A and D94N Enzymes†

PubMed Central

Adachi, Mariya S.; Taylor, Alexander B.; Hart, P. John; Fitzpatrick, Paul F.

2012-01-01

The flavoprotein Fms1 from Saccharomyces cerevisiae catalyzes the oxidation of spermine in the biosynthetic pathway for pantothenic acid. The same reaction is catalyzed by the mammalian polyamine and spermine oxidases. The active site of Fms1 contains three amino acid residues positioned to interact with the polyamine substrate, His67, Asn195, and Asp94. These three residues form a hydrogen-bonding triad with Asn195 the central residue. Previous studies of the effects of mutating His67 are consistent with that residue being important both for interacting with the substrate and for maintaining the hydrogen bonds in the triad (Adachi, M. S., Taylor, A. B., Hart, P. J., and Fitzpatrick, P. F. (2012) Biochemistry 51, 4888-4897). The N195A and D94N enzymes have now been characterized to evaluate their roles in catalysis. Both mutations primarily affect the reductive half-reaction. With N1-acetylspermine as substrate, the rate constant for flavin reduction decreases ~450-fold for both mutations; the effects with spermine as substrate are smaller, 20- to 40-fold. The kcat/Kamine and kcat pH profiles with N1acetylspermine are only slightly changed from the profiles for the wild-type enzyme, consistent with the pKa values arising from the amine substrate or product and not from active site residues. The structure of the N195A enzyme was determined at a resolution of 2.0 Å. The structure shows a molecule of tetraethylene glycol in the active site and establishes that the mutation has no effect on the protein structure. Overall, the results are consistent with the role of Asn195 and Asp94 being to properly position the polyamine substrate for oxidation. PMID:23034052

Mechanistic and structural analyses of the roles of active site residues in yeast polyamine oxidase Fms1: characterization of the N195A and D94N enzymes.

PubMed

Adachi, Mariya S; Taylor, Alexander B; Hart, P John; Fitzpatrick, Paul F

2012-10-30

Flavoprotein Fms1 from Saccharomyces cerevisiae catalyzes the oxidation of spermine in the biosynthetic pathway for pantothenic acid. The same reaction is catalyzed by the mammalian polyamine and spermine oxidases. The active site of Fms1 contains three amino acid residues positioned to interact with the polyamine substrate, His67, Asn195, and Asp94. These three residues form a hydrogen-bonding triad with Asn195 being the central residue. Previous studies of the effects of mutating His67 are consistent with that residue being important both for interacting with the substrate and for maintaining the hydrogen bonds in the triad [Adachi, M. S., Taylor, A. B., Hart, P. J., and Fitzpatrick, P. F. (2012) Biochemistry 51, 4888-4897]. The N195A and D94N enzymes have now been characterized to evaluate their roles in catalysis. Both mutations primarily affect the reductive half-reaction. With N(1)-acetylspermine as the substrate, the rate constant for flavin reduction decreases ~450-fold for both mutations; the effects with spermine as the substrate are smaller, 20-40-fold. The k(cat)/K(amine)- and k(cat)-pH profiles with N(1)-acetylspermine are only slightly changed from the profiles for the wild-type enzyme, consistent with the pK(a) values arising from the amine substrate or product and not from active site residues. The structure of the N195A enzyme was determined at a resolution of 2.0 Å. The structure shows a molecule of tetraethylene glycol in the active site and establishes that the mutation has no effect on the protein structure. Overall, the results are consistent with the role of Asn195 and Asp94 being to properly position the polyamine substrate for oxidation.

Facelift combined with simultaneous fractional laser resurfacing: Outcomes and complications.

PubMed

Wright, Eric J; Struck, Steve K

2015-10-01

The combination of simultaneous surgical rhytidectomy with ablative resurfacing has been a controversial procedure due to the concern of postoperative wound healing. Traditional ablative resurfacing lasers are believed to have higher rates of complications, leading to delayed healing and skin flap loss when combined with face rhytidectomy surgeries. With the development of fractionated ablative laser therapy, there has been increased interest in combining these two procedures. The objective of this study is to evaluate the clinical outcomes of patients undergoing simultaneous full-face rhytidectomy in combination with fractionated ablative skin resurfacing. A retrospective chart analysis was performed for all patients who had a combined procedure of facelift and ablative fractional laser resurfacing from 2008 to 2013 by the senior author (SKS). Postoperative recovery and complications were recorded. The surgical technique used for performing the facelift was an extended supraplatysmal dissection with SMAS plication. Fraxel Re:Pair 10,600-nm fractional carbon dioxide laser was used to perform an ablative resurfacing including the elevated skin flaps. A total of 86 patients were included. Average age was 60.01 years (range of 45-78 years). Longest follow up was five years. The average size of the elevated skin flaps was 100 cm(2). Average skin type was a Fitzpatrick type 2. All patients had complete re-epithelialization by one week after their procedure. Four patients (4.6%) experienced acne outbreaks. Four patients (4.6%) had facial erythema that persisted greater than two weeks. Of these four patients, all resolved by five weeks postoperatively. There was no delayed wound healing or skin flap loss observed. Our results indicate that simultaneous rhytidectomy with fractionated ablative laser resurfacing does not cause an increase in wound healing or skin loss. Due to improved patient outcomes with combining these procedures, we believe that this can be increasingly offered as a safe combination. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Ablative non-fractional lasers for atrophic facial acne scars: a new modality of erbium:YAG laser resurfacing in Asians.

PubMed

Lee, Sang Ju; Kang, Jin Moon; Chung, Won Soon; Kim, Young Koo; Kim, Hei Sung

2014-03-01

Atrophic facial scars which commonly occur after inflammatory acne vulgaris can be extremely disturbing to patients both physically and psychologically. Treatment with fractional laser devices has become increasingly popular, but there has been disappointment in terms of effectiveness. The objective of this study was to assess the safety and efficacy of ablative full-face resurfacing on atrophic acne scars in the Korean population. A total of 22 patients, aged 25-44 years, underwent a new modality of resurfacing combining both short-pulsed and dual-mode erbium:yttrium-aluminum garnet (Er:YAG) laser. The patients had Fitzpatrick skin types ranging from III to V. Photographs were taken before and up to 6 months after treatment. Results were evaluated for the degree of clinical improvement and any adverse events. Degree of improvement was graded using a four-point scale: poor (1) = <25%, fair (2) = 25-50%, good (3) = 51-75%, and excellent (4) = >75%. Based on the blinded photo assessments by two independent reviewers, clinically and statistically significant mean improvement of 3.41 was observed (one-sample Wilcoxon signed rank test, P < 0.001). Complete wound healing occurred between 6 and 9 days. Erythema occurred in all patients and lasted longer than 3 months in two patients (9.1%). Postinflammatory hyperpigmentation occurred in ten patients (45.5%) and lasted longer than 3 months in one patient (4.5%). One patient experienced mild hypopigmentation (4.5%). Mild to moderate acne flare-up occurred in five patients (22.7%). No other adverse effects were observed. A new modality of Er:YAG laser resurfacing combining short-pulsed and dual-mode Er:YAG laser is a safe and very effective treatment modality for atrophic facial acne scars in Asians with darker skin tones.

Altered Sleep and Affect in the Neurotensin Receptor 1 Knockout Mouse

PubMed Central

Fitzpatrick, Karrie; Winrow, Christopher J.; Gotter, Anthony L.; Millstein, Joshua; Arbuzova, Janna; Brunner, Joseph; Kasarskis, Andrew; Vitaterna, Martha H.; Renger, John J.; Turek, Fred W.

2012-01-01

Study Objective: Sleep and mood disorders have long been understood to have strong genetic components, and there is considerable comorbidity of sleep abnormalities and mood disorders, suggesting the involvement of common genetic pathways. Here, we examine a candidate gene implicated in the regulation of both sleep and affective behavior using a knockout mouse model. Design: Previously, we identified a quantitative trait locus (QTL) for REM sleep amount, REM sleep bout number, and wake amount in a genetically segregating population of mice. Here, we show that traits mapping to this QTL correlated with an expression QTL for neurotensin receptor 1 (Ntsr1), a receptor for neurotensin, a ligand known to be involved in several psychiatric disorders. We examined sleep as well as behaviors indicative of anxiety and depression in the NTSR1 knockout mouse. Measurements and Results: NTSR1 knockouts had a lower percentage of sleep time spent in REM sleep in the dark phase and a larger diurnal variation in REM sleep duration than wild types under baseline conditions. Following sleep deprivation, NTSR1 knockouts exhibited more wake and less NREM rebound sleep. NTSR1 knockouts also showed increased anxious and despair behaviors. Conclusions: Here we illustrate a link between expression of the Ntsr1 gene and sleep traits previously associated with a particular QTL. We also demonstrate a relationship between Ntsr1 and anxiety and despair behaviors. Given the considerable evidence that anxiety and depression are closely linked with abnormalities in sleep, the data presented here provide further evidence that neurotensin and Ntsr1 may be a component of a pathway involved in both sleep and mood disorders. Citation: Fitzpatrick K; Winrow CJ; Gotter AL; Millstein J; Arbuzova J; Brunner J; Kasarskis A; Vitaterna MH; Renger JJ; Turek FW. Altered sleep and affect in the neurotensin receptor 1 knockout mouse. SLEEP 2012;35(7):949-956. PMID:22754041

A Fractional Bipolar Radiofrequency Device Combined with a Bipolar Radiofrequency and Infrared Light Treatment for Improvement in Facial Wrinkles and Overall Skin Tone and Texture.

PubMed

Gold, Alan H; Pozner, Jason; Weiss, Robert

2016-10-01

A variety of techniques and energy-based technologies are currently utilized for the treatment of facial wrinkles. Fractional bipolar radiofrequency treatment and treatment with bipolar radiofrequency combined with infrared light have both been reported to be safe and effective for the non-invasive treatment of wrinkles and overall facial rejuvenation. A multicenter, prospective clinical trial evaluated a protocol of treatment with a device incorporating bipolar radiofrequency and infrared light followed by treatment with a fractional bipolar radiofrequency device for facial wrinkle reduction and improvement in the overall appearance of aged facial skin. Fifty-six patients with mild to moderate facial wrinkles received three full-face treatments (forehead, nose, cheeks, periorbital, and perioral areas) at 4 to 6 week intervals and were evaluated at 12 and 24 weeks after the last treatment. Clinical photographs at baseline and follow-ups were assessed by both the investigators and patients using the Global Aesthetic Improvement scale. Treatment safety was evaluated. Study participants also completed a satisfaction and improvement questionnaire. Fitzpatrick Wrinkling and Elastosis Score was decreased significantly at three months (P < .01; paired t test) and at six months (P < .001; paired t test) after the final treatment. Investigators' assessments of overall improvement in facial appearance, demonstrated 88% improvement at 12 weeks and 82% at 24 weeks after the final treatment. Subject evaluations were similar, consistently reporting improvement in wrinkles and overall facial skin appearance throughout the study, and high a degree of satisfaction with their final results. Subjects tolerated the procedures well, with only transient mild to moderate erythema and edema occurring in most patients, and without complications. A combined protocol of bipolar radiofrequency and infrared light treatment followed by fractionated bipolar radiofrequency treatment results in safe, well tolerated, and effective improvement in overall skin tone and texture and reduction of facial wrinkles. 4 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Side effects from intense pulsed light: Importance of skin pigmentation, fluence level and ultraviolet radiation-A randomized controlled trial.

PubMed

Thaysen-Petersen, Daniel; Erlendsson, Andres M; Nash, J F; Beerwerth, Frank; Philipsen, Peter A; Wulf, Hans C; Paasch, Uwe; Haedersdal, Merete

2017-01-01

Intense pulsed light (IPL) is a mainstream treatment for hair removal. Side effects after IPL are known, but risk factors remain to be investigated. The objective of this study was to assess the contribution of skin pigmentation, fluence level, and ultraviolet radiation (UVR) on IPL-induced side effects. The study was a blinded, randomized intra-individual controlled trial including 16 healthy subjects with Fitzpatrick Skin Types (FST) II-V. Three test areas were each divided into four sites, randomized to a single IPL exposure of 22, 34, 46 J/cm 2 or triple stacking of 46 J/cm 2 . Areas were subsequently randomized to no UVR or single solar-simulated UVR exposure of 3 Standard Erythema Dose at 30 minutes or 24 hours after IPL. Each area had a corresponding control, resulting in 15 treatment sites. Follow-up visits were scheduled up to 4 weeks after IPL. Outcome measures were: (i) blinded clinical skin reactions; (ii) objectively measured erythema and pigmentation; (iii) pain measured by visual analog scale (VAS); (iv) histology (H&E, Fontana-Masson); and (v) mRNA-expression of p53. Fifteen subjects with FST II-IV completed the protocol. IPL induced a wide range of skin reactions, including erythema (87% of subjects), purpura (27%), blisters (20%), edema (13%), crusting (13%), hyper- (60%), and hypopigmentation (20%). Darker skin pigmentation and increasing IPL fluence were determinants for IPL-induced side effects (P ≤ 0.002), while a single exposure of UVR did not exacerbate side effects (P ≥ 0.180). Clinical findings were confirmed objectively by reflectance spectrometry and qualitatively by histological changes in skin architecture, inflammatory infiltration, and pigmentation. Marker of cellular DNA damage, that is, p53, did not increase after IPL (P ≥ 0.24). Skin pigmentation and IPL fluence are major determinants of side effects after IPL exposure, while a single exposure to three SED of UVR at 30 minutes or 24 hours after IPL, does not amplify such side effects. Lasers Surg. Med. 49:88-96, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

The optimal UV exposure time for vitamin D3 synthesis and erythema estimated by UV observations in Korea

NASA Astrophysics Data System (ADS)

Lee, Y. G.; Koo, J. H.

2016-12-01

Solar UV radiation in a wavelength range between 280 to 400 nm has both positive and negative influences on human body. Surface UV radiation is the main natural source of vitamin D, providing the promotion of bone and musculoskeletal health and reducing the risk of a number of cancers and other medical conditions. However, overexposure to surface UV radiation is significantly related with the majority of skin cancer, in addition other negative health effects such as sunburn, skin aging, and some forms of eye cataracts. Therefore, it is important to estimate the optimal UV exposure time, representing a balance between reducing negative health effects and maximizing sufficient vitamin D production. Previous studies calculated erythemal UV and vitamin-D UV from the measured and modelled spectral irradiances, respectively, by weighting CIE Erythema and Vitamin D3 generation functions (Kazantzidis et al., 2009; Fioletov et al., 2010). In particular, McKenzie et al. (2009) suggested the algorithm to estimate vitamin-D production UV from erythemal UV (or UV index) and determined the optimum conditions of UV exposure based on skin type Ⅱ according to the Fitzpatrick (1988). Recently, there are various demands for risks and benefits of surface UV radiation on public health over Korea, thus it is necessary to estimate optimal UV exposure time suitable to skin type of East Asians. This study examined the relationship between erythemally weighted UV (UVEry) and vitamin D weighted UV (UVVitD) from spectral UV measurements during 2006-2010. The temporal variations of the ratio (UVVitD/UVEry) were also analyzed and the ratio as a function of UV index was applied to the broadband UV measured by UV-Biometer at 6 sites in Korea Thus, the optimal UV exposure time for vitamin D3 synthesis and erythema was estimated for diurnal, seasonal, and annual scales over Korea. In summer with high surface UV radiation, short exposure time leaded to sufficient vitamin D and erythema and vice versa in winter. Thus, the balancing time in winter was enough to maximize UV benefits and minimize UV risks.

An open-label clinical trial assessing the efficacy and safety of Bend Skincare Anti-Aging Formula on minimal erythema dose in skin.

PubMed

Morse, Nancy L; Reid, Anna-Jean; St-Onge, Marc

2018-03-01

Sunburn and other health risks associated with excess sun exposure place huge economic burdens on societies, and create discomfort and disease within susceptible individuals. Oral supplements that reduce sunburn may be advantageous. This study evaluated the safety and efficacy of Bend Skincare Anti-Aging Formula to ameliorate sunburn induced with a solar simulator. Subjects (n = 28) with Fitzpatrick skin phototypes I, II, or III took 4 capsules daily of the supplement providing 1400 mg of eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA), 120 mg of gamma-linolenic acid (GLA), 5 mg of lutein, 2.5 mg of zeaxanthin, and 1000 IU of vitamin D3 for 8 weeks. Skin on each subject's back was exposed to a progressive sequence of timed ultraviolet (UV) radiation exposure doses at baseline, and after 4- and 8-week treatment to determine their minimal erythema dose (MED). Results were compared before and after treatment using 3 paired t tests and subsequently 3 linear mixed models. Treatment significantly improved tolerance to UV exposure as evidenced by increased MED at 4 and 8 weeks compared with baseline (P < .001). This protection increased with prolonged use of Bend Skincare Anti-Aging Formula as demonstrated by progressively increased MED between baseline and 4 weeks, and again between 4 and 8 weeks (P < .001). Nearly 86% of patients responded to treatment within 4 weeks and 100% of patients responded by the end of the study, resulting in a 39% mean increase in MED at 4 weeks, and an 84% mean increase in MED at 8 weeks compared with baseline. Treatment was well tolerated with no product associated adverse events (AE) and only a few mild and expected side effects. Bend Skincare Anti-Aging Formula safely and effectively provides significant skin photoprotection that increases with continued use. © 2017 The Authors. Photodermatology, Photoimmunology & Photomedicine Published by John Wiley & Sons Ltd.

Identification of Causal Genes, Networks, and Transcriptional Regulators of REM Sleep and Wake

PubMed Central

Millstein, Joshua; Winrow, Christopher J.; Kasarskis, Andrew; Owens, Joseph R.; Zhou, Lili; Summa, Keith C.; Fitzpatrick, Karrie; Zhang, Bin; Vitaterna, Martha H.; Schadt, Eric E.; Renger, John J.; Turek, Fred W.

2011-01-01

Study Objective: Sleep-wake traits are well-known to be under substantial genetic control, but the specific genes and gene networks underlying primary sleep-wake traits have largely eluded identification using conventional approaches, especially in mammals. Thus, the aim of this study was to use systems genetics and statistical approaches to uncover the genetic networks underlying 2 primary sleep traits in the mouse: 24-h duration of REM sleep and wake. Design: Genome-wide RNA expression data from 3 tissues (anterior cortex, hypothalamus, thalamus/midbrain) were used in conjunction with high-density genotyping to identify candidate causal genes and networks mediating the effects of 2 QTL regulating the 24-h duration of REM sleep and one regulating the 24-h duration of wake. Setting: Basic sleep research laboratory. Patients or Participants: Male [C57BL/6J × (BALB/cByJ × C57BL/6J*) F1] N2 mice (n = 283). Interventions: None. Measurements and Results: The genetic variation of a mouse N2 mapping cross was leveraged against sleep-state phenotypic variation as well as quantitative gene expression measurement in key brain regions using integrative genomics approaches to uncover multiple causal sleep-state regulatory genes, including several surprising novel candidates, which interact as components of networks that modulate REM sleep and wake. In particular, it was discovered that a core network module, consisting of 20 genes, involved in the regulation of REM sleep duration is conserved across the cortex, hypothalamus, and thalamus. A novel application of a formal causal inference test was also used to identify those genes directly regulating sleep via control of expression. Conclusion: Systems genetics approaches reveal novel candidate genes, complex networks and specific transcriptional regulators of REM sleep and wake duration in mammals. Citation: Millstein J; Winrow CJ; Kasarskis A; Owens JR; Zhou L; Summa KC; Fitzpatrick K; Zhang B; Vitaterna MH; Schadt EE; Renger JJ; Turek FW. Identification of causal genes, networks, and transcriptional regulators of REM sleep and wake. SLEEP 2011;34(11):1469-1477. PMID:22043117

Crystal Structures of Intermediates in the Nitroalkane Oxidase Reaction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heroux, A.; Bozinovski, D; Valley, M

2009-01-01

The flavoenzyme nitroalkane oxidase is a member of the acyl-CoA dehydrogenase superfamily. Nitroalkane oxidase catalyzes the oxidation of neutral nitroalkanes to nitrite and the corresponding aldehydes or ketones. Crystal structures to 2.2 {angstrom} resolution or better of enzyme complexes with bound substrates and of a trapped substrate-flavin adduct are described. The D402N enzyme has no detectable activity with neutral nitroalkanes. The structure of the D402N enzyme crystallized in the presence of 1-nitrohexane or 1-nitrooctane shows the presence of the substrate in the binding site. The aliphatic chain of the substrate extends into a tunnel leading to the enzyme surface. Themore » oxygens of the substrate nitro group interact both with amino acid residues and with the 2'-hydroxyl of the FAD. When nitroalkane oxidase oxidizes nitroalkanes in the presence of cyanide, an electrophilic flavin imine intermediate can be trapped (Valley, M. P., Tichy, S. E., and Fitzpatrick, P. F. (2005) J. Am. Chem. Soc. 127, 2062-2066). The structure of the enzyme trapped with cyanide during oxidation of 1-nitrohexane shows the presence of the modified flavin. A continuous hydrogen bond network connects the nitrogen of the CN-hexyl-FAD through the FAD 2'-hydroxyl to a chain of water molecules extending to the protein surface. Together, our complementary approaches provide strong evidence that the flavin cofactor is in the appropriate oxidation state and correlates well with the putative intermediate state observed within each of the crystal structures. Consequently, these results provide important structural descriptions of several steps along the nitroalkane oxidase reaction cycle.« less

Clinical Application of 3D-CISS MRI Sequences for Diagnosis and Surgical Planning of Spinal Arachnoid Diverticula and Adhesions in Dogs.

PubMed

Tauro, Anna; Jovanovik, Jelena; Driver, Colin John; Rusbridge, Clare

2018-02-01

 Abnormalities within the spinal arachnoid space are often treated surgically, but they can be challenging to detect with conventional magnetic resonance imaging (MRI) sequences. 3D-CISS sequences are considered superior in evaluating structures surrounded by cerebrospinal fluid (CSF) due to the high signal-to-noise ratio, high contrast-to-noise ratio and intrinsic insensitivity to motion with minimal signal loss due to CSF pulsations. Our objective was to describe findings and advantages in adding 3D-CISS sequences to routine MRI in patients affected by spinal arachnoid diverticula (SAD) or arachnoid adhesions.  This article is a retrospective review of medical records of 19 dogs admitted at Fitzpatrick Referrals between 2013 and 2017 that were diagnosed with SAD and confirmed surgically. Inclusion criterions were the presence of clinical signs compatible with compressive myelopathy and an MRI diagnosis, which included the 3D-CISS sequence. Our database was searched for additional 19 dogs diagnosed with other spinal lesions other than SAD that had the same MR sequences. All MR images were anonymized and evaluated by two assessors.  3D-CISS sequence appears to improve confidence in diagnosing and surgical planning (Mann-Whitney U -test: p  < 0.0005), delineating SAD from other changes associated with abnormal CSF hydrodynamics and providing more anatomical details than conventional MRI sequences. The clinical data in combination with imaging findings would limit over interpretation, when concurrent pathology within the arachnoid space is present. Schattauer GmbH Stuttgart.

A randomized, double-blind, placebo-controlled trial of oral procyanidin with vitamins A, C, E for melasma among Filipino women.

PubMed

Handog, Evangeline B; Galang, Dulce Amor Vivan F; de Leon-Godinez, Maria Azirrel; Chan, Gertrude P

2009-08-01

Melasma is a common, acquired, symmetric hypermelanosis characterized by irregular brown to gray-brown macules on the cheeks, forehead, nasal bridge, cutaneous part of the upper lip, mandible, and the upper arms. Few trials have been conducted regarding the potential benefits of oral procyanidin in melasma. To assess the safety and efficacy of oral procyanidin + vitamins A, C, E among Filipino patients with epidermal melasma. A randomized, double-blind, placebo-controlled trial lasting 8 weeks, involving 60 adult female volunteers with bilateral epidermal melasma, Fitzpatrick skin types III-V, was conducted at the Section of Dermatology, Research Institute for Tropical Medicine, Department of Health, Manila, Philippines. Patients received either the test drug or placebo, twice daily with meals. Changes in pigmentation were measured using a mexameter, the melasma area and severity index (MASI), and a global evaluation by the patient and investigator. Safety evaluations were performed at each follow-up visit. Fifty-six patients completed the trial. Mexameter results demonstrated a significant decrease in the degree of pigmentation in the left malar (165.85 +/- 70.909) and right malar (161.33 +/- 61.824) regions (P < 0.0001). MASI scores showed a significant improvement in the left malar (2.4862 +/- 1.67816) and right malar (1.8889 +/- 1.67110) regions (P = 0.001). Procyanidin + vitamins A, C, E proved to be safe and well tolerated, with minimal adverse events. In this 8-week trial period, oral procyanidin + vitamins A, C, E proved to be safe and effective among Filipino women with epidermal melasma.

Photoaging Mobile Apps as a Novel Opportunity for Melanoma Prevention: Pilot Study

PubMed Central

Schadendorf, Dirk; Klode, Joachim; Cosgarea, Ioana; Rösch, Alexander; Jansen, Philipp; Stoffels, Ingo; Izar, Benjamin

2017-01-01

Background Around 90% of melanomas are caused by ultraviolet (UV) exposure and are therefore eminently preventable. Unhealthy tanning behavior is mostly initiated in early adolescence, often with the belief that it increases attractiveness; the problems related to skin atrophy and malignant melanoma are too far in the future to fathom. Photoaging desktop programs, in which an image is altered to predict future appearance, have been successful in positively influencing behavior in adiposity or tobacco prevention settings. Objective To develop and test a photoaging app designed for melanoma prevention. Methods We harnessed the widespread availability of mobile phones and adolescents’ interest in appearance to develop a free mobile app called Sunface. This app has the user take a self-portrait (ie, a selfie), and then photoages the image based on Fitzpatrick skin type and individual UV protection behavior. Afterward, the app explains the visual results and aims at increasing self-competence on skin cancer prevention by providing guideline recommendations on sun protection and the ABCDE rule for melanoma self-detection. The underlying aging algorithms are based on publications showing UV-induced skin damage by outdoor as well as indoor tanning. To get a first impression on how well the app would be received in a young target group, we included a total sample of 25 students in our cross-sectional pilot study with a median age of 22 (range 19-25) years of both sexes (11/25, 44% female; 14/25, 56% male) attending the University of Essen in Germany. Results The majority of enrolled students stated that they would download the app (22/25, 88%), that the intervention had the potential to motivate them to use sun protection (23/25, 92%) and that they thought such an app could change their perceptions that tanning makes you attractive (19/25, 76%). Only a minority of students disagreed or fully disagreed that they would download such an app (2/25, 8%) or that such an app could change their perceptions on tanning and attractiveness (4/25, 16%). Conclusions Based on previous studies and the initial study results presented here, it is reasonable to speculate that the app may induce behavioral change in the target population. Further work is required to implement and examine the effectiveness of app-based photoaging interventions within risk groups from various cultural backgrounds. PMID:28747297

Picosecond laser with specialized optic for facial rejuvenation using a compressed treatment interval.

PubMed

Khetarpal, Shilpi; Desai, Shraddha; Kruter, Laura; Prather, Heidi; Petrell, Kathleen; Depina, Joahinha; Arndt, Kenneth; Dover, Jeffrey S

2016-10-01

Studies using a 755 nm picosecond laser with a focus lens array have been reported to be effective for facial wrinkles and pigmentation. This study reports the safety and efficacy using a shorter interval of 2-3 weeks between treatments. Nineteen female subjects and one male subject, primarily Fitzpatrick skin types II and III (one skin type I), who had mild to moderate wrinkles and sun-induced pigmentation were enrolled and treated using the 755 nm PicoSure Laser with focus lens array. The skin was cleansed then wiped with an alcohol wipe prior to treatment. Lidocaine 30% ointment and/or forced air cooling could be used to increase subject comfort. Adjacent pulses, with minimal overlap (10% or less), were delivered to the full face. Subjects received four treatments, performed at 2-3-week intervals. The laser energy used was 0.71 J/cm 2 . The physician administered 3-7 passes with an average total of 6,253 pulses per treatment. Follow-up visits occurred at 1 and 3 months post-last treatment at which the physician scored satisfaction and improvement and subjects scored satisfaction and likelihood to recommend to others. The most common side effects were mild swelling, pain, redness, and crusting, most of which subsided within hours of the treatment, with the latest resolving within 48 hours. This is similar to a previous reported study (Weiss et al. ASLMS 2015) where treatments were performed every 6 weeks with side effects resolving within 24 hours. At the 1 and 3 month follow-up visits, 94% (n = 19) and 93% (n = 15) of subjects scored themselves as satisfied or extremely satisfied with their overall results and 81% and 93% were likely to recommend the treatment based on global assessment, respectively. The treating physician was satisfied with 93% of subject's overall results. Three blinded evaluators were able to correctly identify the baseline from post-treatment photographs in 77% of the subjects at the 1 month follow-up and 69% of the subjects at the 3 month follow-up, on average. The average treatment pain score was 4.2 on a 1-10 scale. A compressed treatment interval expedites results without increasing side effects and resulted in a high physician and subject satisfaction rate. Lasers Surg. Med. 48:723-726, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Exploring the Measurement Properties of the eHealth Literacy Scale (eHEALS) Among Baby Boomers: A Multinational Test of Measurement Invariance.

PubMed

Sudbury-Riley, Lynn; FitzPatrick, Mary; Schulz, Peter J

2017-02-27

The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully. The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months. Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS. We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008). To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did so based on data from 3 diverse nations and random samples drawn from an increasingly important cohort. The results give increased confidence to researchers using the scale in a range of eHealth assessment applications from primary care to health promotions. ©Lynn Sudbury-Riley, Mary FitzPatrick, Peter J Schulz. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 27.02.2017.

Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: a double-blind randomized clinical trial.

PubMed

Öhlund, Inger; Lind, Torbjörn; Hernell, Olle; Silfverdal, Sven-Arne; Karlsland Åkeson, Pia

2017-07-01

Background: Dark skin and low exposure to sunlight increase the risk of vitamin D insufficiency in children. Objective: The aim of the study was to evaluate the amount of vitamin D needed to ascertain that most children >4 y of age attain sufficient serum 25-hydroxyvitamin D [S-25(OH)D; i.e., ≥50 nmol/L] during winter regardless of latitude and skin color. Design: In a longitudinal, double-blind, randomized, food-based intervention study, 5- to 7-y-old children from northern (63°N) and southern (55°N) Sweden with fair ( n = 108) and dark ( n = 98) skin were included. Children, stratified by skin color by using Fitzpatrick's definition, were randomly assigned to receive milk-based vitamin D 3 supplements that provided 2 (placebo), 10, or 25 μg/d during 3 winter months. Results: Mean daily vitamin D intake increased from 6 to 17 μg and 26 μg in the intervention groups supplemented with 10 and 25 μg, respectively. In the intention-to-treat analysis, 90.2% (95% CI: 81.1%, 99.3%) of fair-skinned children randomly assigned to supplementation of 10 μg/d attained sufficient concentrations, whereas 25 μg/d was needed in dark-skinned children to reach sufficiency in 95.1% (95% CI: 88.5%, 100%). In children adherent to the study product, 97% (95% CI: 91.3%, 100%) and 87.9% (95% CI: 76.8%, 99%) of fair- and dark-skinned children, respectively, achieved sufficient concentrations if supplemented with 10 μg/d. By using 95% prediction intervals for 30 and 50 nmol S-25(OH)D/L, intakes of 6 and 20 μg/d are required in fair-skinned children, whereas 14 and 28 μg/d are required in children with dark skin. Conclusion: Children with fair and dark skin require vitamin D intakes of 20 and 28 μg/d, respectively, to maintain S-25(OH)D ≥50 nmol/L, whereas intakes of 6 and 14 μg/d, respectively, are required to maintain concentrations ≥30 nmol/L during winter. This trial was registered at clinicaltrials.gov as NCT01741324. © 2017 American Society for Nutrition.

Initial mass functions from ultraviolet stellar photometry: A comparison of Lucke and Hodge OB associations near 30 Doradus with the nearby field

NASA Technical Reports Server (NTRS)

Hill, Jesse K.; Isensee, Joan E.; Cornett, Robert H.; Bohlin, Ralph C.; O'Connell, Robert W.; Roberts, Morton S.; Smith, Andrew M.; Stecher, Theodore P.

1994-01-01

UV stellar photometry is presented for 1563 stars within a 40 minutes circular field in the Large Magellanic Cloud (LMC), excluding the 10 min x 10 min field centered on R136 investigated earlier by Hill et al. (1993). Magnitudes are computed from images obtained by the Ultraviolet Imaging Telescope (UIT) in bands centered at 1615 A and 2558 A. Stellar masses and extinctions are estimated for the stars in associations using the evolutionary models of Schaerer et al. (1993), assuming the age is 4 Myr and that the local LMC extinction follows the Fitzpatrick (1985) 30 Dor extinction curve. The estimated slope of the initial mass function (IMF) for massive stars (greater than 15 solar mass) within the Lucke and Hodge (LH) associations is Gamma = -1.08 +/- 0.2. Initial masses and extinctions for stars not within LH associations are estimated assuming that the stellar age is either 4 Myr or half the stellar lifetime, whichever is larger. The estimated slope of the IMF for massive stars not within LH associations is Gamma = -1.74 +/- 0.3 (assuming continuous star formation), compared with Gamma = -1.35, and Gamma = -1.7 +/- 0.5, obtained for the Galaxy by Salpeter (1955) and Scalo (1986), respectively, and Gamma = -1.6 obtained for massive stars in the Galaxy by Garmany, Conti, & Chiosi (1982). The shallower slope of the association IMF suggests that not only is the star formation rate higher in associations, but that the local conditions favor the formation of higher mass stars there. We make no corrections for binaries or incompleteness.

Evaluation of a Low Energy, Low Density, Non-Ablative Fractional 1927 nm Wavelength Laser for Facial Skin Resurfacing.

PubMed

Brauer, Jeremy A; Alabdulrazzaq, Hamad; Bae, Yoon-Soo Cindy; Geronemus, Roy G

2015-11-01

We investigated the safety, tolerability and efficacy of a low energy low density, non-ablative fractional 1,927-nm laser in the treatment of facial photodamage, melasma, and post inflammatory hyperpigmentation. Prospective non-randomized trial. Single center, private practice with a dedicated research department. Subjects with clinically diagnosed facial photodamage, melasma, or post inflammatory hyperpigmentation. Subjects received four to six treatments at 14-day intervals (+/- 3 days) with a low energy low density non-ablative fractional 1,927-nm laser (Solta Hayward, CA) with an energy level of 5 mJ, and density coverage of either 5%, 7.5%, or 10%, with a total of up to 8 passes. Blinded assessment of clinical photos for overall improvement at one and three months post final treatment. Investigator improvement scores, and subject pain and satisfaction scores for overall improvement were recorded as well. We enrolled 23 subjects, average age 45.0 years (range, 25-64 years), 22 with Fitzpatrick Skin Types I-IV and 1 with Type VI, with facial photodamage, melasma, or post inflammatory hyperpigmentation. Approximately 55% of subjects reported marked to very significant improvement at one and three months post final treatment. Blinded assessment of photography of 20 subjects revealed an average of moderate improvement at one-month follow up and mild to moderate improvement at three months. Average subject pain score was 3.4/10 during treatment. Favorable outcomes were demonstrated using the low energy low density, non-ablative fractional 1,927-nm laser in facial resurfacing for photodamage, melasma, and post inflammatory hyperpigmentation. Results were maintained at the 3-month follow up, as demonstrated by investigator and subject assessments, as well as blinded evaluations by three independent dermatologists utilizing photographs obtained from a standardized facial imaging device.

Comparison of self-reported signs of facial ageing among Caucasian women in Australia versus those in the USA, the UK and Canada.

PubMed

Goodman, Greg J; Armour, Katherine S; Kolodziejczyk, Julia K; Santangelo, Samantha; Gallagher, Conor J

2018-05-01

Australians are more exposed to higher solar UV radiation levels that accelerate signs of facial ageing than individuals who live in temperate northern countries. The severity and course of self-reported facial ageing among fair-skinned Australian women were compared with those living in Canada, the UK and the USA. Women voluntarily recruited into a proprietary opt-in survey panel completed an internet-based questionnaire about their facial ageing. Participants aged 18-75 years compared their features against photonumeric rating scales depicting degrees of severity for forehead, crow's feet and glabellar lines, tear troughs, midface volume loss, nasolabial folds, oral commissures and perioral lines. Data from Caucasian and Asian women with Fitzpatrick skin types I-III were analysed by linear regression for the impact of country (Australia versus Canada, the UK and the USA) on ageing severity for each feature, after controlling for age and race. Among 1472 women, Australians reported higher rates of change and significantly more severe facial lines (P ≤ 0.040) and volume-related features like tear troughs and nasolabial folds (P ≤ 0.03) than women from the other countries. More Australians also reported moderate to severe ageing for all features one to two decades earlier than US women. Australian women reported more severe signs of facial ageing sooner than other women and volume-related changes up to 20 years earlier than those in the USA, which may suggest that environmental factors also impact volume-related ageing. These findings have implications for managing their facial aesthetic concerns. © 2017 The Authors. Australasian Journal of Dermatology published by John Wiley and Sons Australia, Ltd on behalf of The Australasian College of Dermatologists.

High standards. A decade after the law went into effect, there is still debate about the pros and cons of the HIPAA privacy and electronic transaction regulations.

PubMed

Edlin, Mari; Johns, Stephanie

2006-01-01

When congress passed the Health Insurance Portability and Accountability act in 1996, the goal was to create a simpler, more standardized system that would eventually lower health care costs; reduce errors through safe, universally accepted electronic communication of health care transactions; and eliminate paper claims. Ten years later, the jury is still out on whether HIPAA has been worth the time, energy, and financial investment for insurers. That's not to say, however, that HIPAA hasn't generated benefits while also creating new challenges. "Standards made sense," says Tom Fitzpatrick, Horizon Blue Cross Blue Shield of New Jersey's director of enterprise strategic planning, "but no one ever said it would be fast, cheap, or easy. It was challenging to integrate proprietary claims systems and legacy software with the new standards that took effect in October 2003. But that wasn't the end of the story. HIPAA's privacy and security rules and the standard identifiers have meant even more upgrades and improvements and have required payers to spend millions of additional dollars over the past three years on HIPAA compliance." According to a set of quarterly surveys conducted by HIMSS/Phoenix Health Systems, progress has actually been fairly rapid. On the other hand, some things have remained much the same. In 2003, payers cited "understanding/interpreting the legal requirements" as the most difficult aspect of the HIPAA remediation process, followed by "achieving successful integration of new policies and procedures" and "resolving issues with third parties". In 2006, the barriers are similar, with users citing the same top two struggles.

Cutaneous malignant melanoma incidences analyzed worldwide by sex, age, and skin type over personal Ultraviolet-B dose shows no role for sunburn but implies one for Vitamin D3

PubMed Central

Godar, Dianne E.; Subramanian, Madhan; Merrill, Stephen J.

2017-01-01

ABSTRACT Because the incidence of cutaneous malignant melanoma (CMM) was reported to increase with increasing terrestrial UVR (290–400 nm) doses in the US back in 1975 and a recent publication showed no association exists with UVR exposure at all, we set out to fully elucidate the role of UVR in CMM. To achieve this goal, we analyzed the CMM incidences over latitude and estimated the average personal UVR dose in the US and numerous countries (> 50) on 5 continents around the world. Using data from the International Agency for Research on Cancer in 2005, we performed worldwide analysis of CMM over UVR dose by sex, age group (0–14, 15–29, 30–49, 50–69, 70–85+) and Fitzpatrick skin types I-VI. Surprisingly, increasing UVR doses, which represent erythemally-weighted doses comprised primarily of UVB (290–315 nm) radiation, did not significantly correlate with increasing CMM incidence for people with any skin type anywhere in the world. Paradoxically, we found significant correlations between increasing CMM and decreasing UVB dose in Europeans with skin types I-IV. Both Europeans and Americans in some age groups have significant increasing CMM incidences with decreasing UVB dose, which shows UVB is not the main driver in CMM and suggests a possible role for lower cutaneous vitamin D3 levels and UVA (315–400 nm) radiation. CMM may be initiated or promoted by UVA radiation because people are exposed to it indoors through windows and outdoors through some sunscreen formulations. Thus, our findings may explain why some broad-spectrum sunscreen formulations do not protect against getting CMM. PMID:28924456

Topical corticosteroids in the treatment of acute sunburn: a randomized, double-blind clinical trial.

PubMed

Faurschou, Annesofie; Wulf, Hans C

2008-05-01

To examine the effect of topical corticosteroid treatment on acute sunburn. Randomized, double-blind clinical trial. University dermatology department. Twenty healthy volunteers with Fitzpatrick skin types I (highly sensitive, always burns easily, tans minimally) through III (sun-sensitive skin, sometimes burns, slowly tans to light brown). Seven 34-cm(2) areas were marked on the upper aspect of the back of each participant. An untreated area was tested to determine UV sensitivity. Two areas were treated with excess amounts (2 mg/cm(2)) of either a moderate-potency corticosteroid or a high-potency corticosteroid 30 minutes before UV-B exposure as controls. Six or 23 hours after exposure to radiation, the remaining areas were treated with the 2 corticosteroid preparations. The sunburn improvement factor (SIF) was determined by the following equation: SIF = MED (minimal erythema dose) on treated skin/MED on nontreated skin. An SIF greater than 1 indicated an effect of topical corticosteroids in sunburn relief. The SIFs in the areas treated with either topical corticosteroid 30 minutes before UV-B exposure or high-potency corticosteroid 6 hours after UV-B exposure were significantly different from SIFs in areas that received no treatment (SIF 1.1-1.7; P < .05). Only the median SIF of 1.7 in the areas treated with high-potency corticosteroid 30 minutes before UV-B exposure was clinically relevant. The areas treated 23 hours after UV-B exposure and the areas treated with a moderate-potency corticosteroid 6 hours after UV-B exposure showed no significant reduction in redness. Treatment with topical moderate-potency or high-potency corticosteroids does not provide a clinically useful decrease in the acute sunburn reaction when applied 6 or 23 hours after UV exposure.

Flow Shear Effects in the Onset Physics of Resistive MHD Instabilities in Tokamaks. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brennan, Dylan P.

The progress in this research centers around the computational analysis of flow shear effects in the onset of a 3/2 mode driven by a 1/1 mode in DIII-D equilibria. The initial idea was to try and calculate, via nonlinear simulations with NIMROD, the effects of rotation shear on driven 3/2 and 2/1 seed island physics, in experimentally relevant DIIID equilibria. The simulations indicated that very small seed islands were directly driven, as shielding between the sawtooth and the surfaces is significant at the high Lundquist numbers of the experiment. Instead, long after the initial crash the difference in linear stabilitymore » of the 3/2, which remained prevalent despite the flattening of the core profiles from the sawtooth, contributed to a difference in the eventual seed island evolution. Essentially the seed islands grew or decayed long after the sawtooth crash, and not directly from it. Effectively the dominant 1/1 mode was found to be dragging the coupled modes surrounding it at a high rate through the plasma at their surfaces. The 1/1 mode is locked to the local frame of the plasma in the core, where the flow rate is greatest. The resonant perturbations at the surrounding surfaces propagate in the 'high slip regime' in the language of Fitzpatrick. Peaked flux averaged jxb forces (see Figs. 1 and 2) agree with localized flow modifications at the surfaces in analogy with Ebrahimi, PRL 2007. We track the mode into nonlinear saturation and have found oscillatory states in the evolution. During a visit (11/09) to Tulsa by R.J. LaHaye (GA), it became clear that similar oscillatory states are observed in DIII-D for these types of discharges.« less

Violence exposure and health related risk among African American adolescent female detainees: A strategy for reducing recidivism

PubMed Central

Woodson, Kamilah M.; Hives, Courtney; Sanders-Phillips, Kathy

2010-01-01

Juvenile crime and violent victimization continue to be significant social problems (Fitzpatrick, Piko, Wright, & LaGory, 2005); in that, adolescents, females in particular, are likely to participate in health related risk behaviors as result of having been victimized or exposed to a violent environment. Specifically, abuse, neglect, sexual molestation, poverty, and witnessing violence are well known risk factors for the development of trauma-related psychopathology and poor outcomes relative to delinquency, drug and alcohol abuse, and HIV risk behaviors (Steiner, Garcia, & Matthews, 1997). HIV infection is a common public health concern disproportionally affecting adolescent African American female detainees. This unique population has a serious history of violence exposure, which subsequently tends to lead to engaging in risky sexual behaviors, mental health problems, and abusing substances. Also, as a result of little to no intervention, this population is recidivating at an alarming rate, a problem that may further exacerbate the expression of health-related risk behaviors among African American adolescent female detainees. The authors briefly describe a pilot program to be implemented in the juvenile justice system that is based on the Model of Accumulated Risk (Garbarino, 1996), Bronfenbrenner’s Ecological Model (1994), and the Positive Youth Justice Model (Butts, Bazemore, & Meroe, 2009). The program proposes to reduce risky sexual behaviors, teach alternatives to abusing substances, treat mental health concerns, and reduce the rate of recidivism through “positive youth development”, PYD (Butts, Bazemore, & Meroe, 2009). Tying elements of wraparound services and reeducation together, this program addresses salient concerns that may have an impact on an adolescent detainees’ success following their release from prison in a holistic manner. PMID:21373205

The role of natural and UV-induced skin pigmentation on low-fluence IPL-induced side effects: a randomized controlled trial.

PubMed

Thaysen-Petersen, Daniel; Lin, Jennifer Y; Nash, Jf; Beerwerth, Frank; Wulf, Hans C; Philipsen, Peter A; Haedersdal, Merete

2014-02-01

The risk of adverse skin effects following light-based hair removal is greater in pigmented skin based on the theory of selective photothermolysis. Thus sunlight-induced pigment i.e., facultative pigmentation, increases the risk of adverse skin effects, perhaps disproportionately. The aim of this study was to evaluate the influence of constitutive and facultative skin pigmentation on low-fluence intense pulsed light (IPL)-induced adverse skin effects. Twenty-one subjects with Fitzpatrick skin type II-IV were enrolled. Two buttock blocks were randomized to receive 0 or 8 solar simulated ultraviolet radiation (UVR) exposures of consecutively increasing Standard Erythema Doses (2-4 SED). Each block was subdivided into four sites, randomized to receive IPL of 0, 7, 8, or 10 J/cm(2) , once a week for 3 weeks. Biopsies were taken 16-24 hours after the first IPL exposure and subjects were seen 1 and 4 weeks after the last IPL exposure. Outcome measures were: (i) skin reactions, (ii) pain, (iii) mRNA expression of pigment-markers microphthalmia-associated transcription factor (MITF) and pro-opiomelanocortin (POMC), and (iv) clinical appearance of biopsy wounds. Skin pigmentation increased after UVR (baseline median 13.8%, after UVR 28.1%, P = 0.0001) in all skin types. Subjects reported low pain intensities (median 1.5, scale 0-10) and experienced transient erythema immediately after IPL exposure. No persistent erythema, blisters, crusting, textual, or pigment changes were observed. The risk of erythema and pain intensities increased with IPL dose and skin pigmentation (P < 0.03). There was no difference in pain or skin reactions in skin with similar degree of natural and facultative pigmentation (P ≥ 0.104). Expression of cellular pigment-markers was not influenced by IPL exposure, neither in constitutive nor in facultative pigmented skin. Clinical appearance of biopsy wounds was unaffected by IPL exposure. The prevalence and intensity of low-fluence IPL-induced adverse skin effects depended on IPL dose and skin pigmentation regardless of the origin, i.e., constitutive versus UV induced. © 2013 Wiley Periodicals, Inc.

A 1-Year Follow-Up of Post-operative Scars After the Use of a 1210-nm Laser-Assisted Skin Healing (LASH) Technology: A Randomized Controlled Trial.

PubMed

Casanova, D; Alliez, A; Baptista, C; Gonelli, D; Lemdjadi, Z; Bohbot, S

2017-08-01

Laser therapies are used prophylactically for excessive scar formation. The Laser-Assisted Skin Healing treatment induces a controlled heat stress that promotes tissue regeneration. This comparative trial is the first to evaluate the performance of a new automated 1210-nm laser system, compatible with all Fitzpatrick scale phototypes. Forty women undergoing bilateral breast reduction were enrolled in this double-blinded randomized controlled trial. The horizontal sutured incision of one breast was treated with the portable 1210-nm laser while in the operating theatre. The other breast was used as the study control. Objective measurements, subjective clinical assessments and safety evaluation were carried out over 1 year by both clinicians and patients. Six weeks following surgery, better overall appearance and modified OSAS scores were reported for the laser-treated scars when compared to the control group (p = 0.024 and p = 0.079). This supports an early effect of the laser treatment during the inflammatory stage of the healing process. After a post-treatment period of 6 months, there continued to be a strong tendency in favour of the laser treatment based on the subjective scores and corroborated by the objective improvement of the treated scar volume (p = 0.038). At 1 year, the laser-treated scars continued to improve compared to the control ones in terms of volume (p = 0.004), surface (p = 0.017) and roughness (p = 0.002), and these comparatively better results were strengthened with the blind expression of patients' preference for their laser-treated scar (p = 0.025). This new 1210-nm laser treatment, used as a single session performed immediately after surgery, provides significant objective and subjective improvements in scar appearance. These data can be useful when preparing patients to undergo their surgical procedure. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Treatment of melasma in Caucasian patients using a novel 694-nm Q-switched ruby fractional laser

PubMed Central

2013-01-01

Background Melasma is a common hypermelanosis of the face. The use of a classical Q-switched ruby laser (QSRL) to treat melasma is discussed controversially and is associated with frequent adverse effects, such as hyper- or hypopigmentation. Recently a fractional-mode (FRx) QSRL was developed to minimize the adverse effects of classical QSRL. The objective of this research was to evaluate the efficacy and safety of a novel FRx-QSRL in the treatment of melasma in Caucasian patients. Methods We performed a retrospective study of 25 Caucasian melasma patients (Fitzpatrick skin types I to III). Patients received one to three FRx-QSRL treatments (Tattoostar FRx, Asclepion Laser Technologies, Jena, Germany) at pulse energies of 4 to 8 J/cm2. Three blinded investigators independently evaluated the melasma area and severity index (MASI) score before treatment and at the four- to six-week follow-ups. At additional three-month follow-ups, patients evaluated subjective improvement, pain and over-all satisfaction with the treatment according to a numeric analogue score (NAS). Side effects were documented. Results At four to six weeks post laser treatment for a mean of 1.4 sessions, we observed a significant (P = 0.0001) reduction of the MASI score from 6.54 to 1.98 (72.3%). Patients rated the pain of the intervention at a mean 2.46 points (0 = no pain; 10 = maximum pain), the improvement at a mean 5.55 points (0 = no improvement; 10 = maximum improvement) and the overall satisfaction at a mean 4.66 points (0 = not satisfied; 10 = maximum satisfaction). After three months, post-inflammatory hyperpigmentation (PIH) and/or recurring melasma were observed in 7 (28%) and 11 (44%) patients, respectively. Conclusion The 694-nm FRx-QSRL is a safe and effective option for treating melasma in Caucasian patients. Over periods of >3 months, PIH and/or recurring melasma may develop at significant rates and may reduce patient satisfaction. Multiple treatment sessions with lower pulse energies and/or a post-interventional therapy with hypopigmenting ointments and UV protection may help to minimize these complications. PMID:24225160

Treatment of melasma in Caucasian patients using a novel 694-nm Q-switched ruby fractional laser.

PubMed

Hilton, Said; Heise, Heike; Buhren, Bettina Alexandra; Schrumpf, Holger; Bölke, Edwin; Gerber, Peter Arne

2013-11-14

Melasma is a common hypermelanosis of the face. The use of a classical Q-switched ruby laser (QSRL) to treat melasma is discussed controversially and is associated with frequent adverse effects, such as hyper- or hypopigmentation. Recently a fractional-mode (FRx) QSRL was developed to minimize the adverse effects of classical QSRL. The objective of this research was to evaluate the efficacy and safety of a novel FRx-QSRL in the treatment of melasma in Caucasian patients. We performed a retrospective study of 25 Caucasian melasma patients (Fitzpatrick skin types I to III). Patients received one to three FRx-QSRL treatments (Tattoostar FRx, Asclepion Laser Technologies, Jena, Germany) at pulse energies of 4 to 8 J/cm2. Three blinded investigators independently evaluated the melasma area and severity index (MASI) score before treatment and at the four- to six-week follow-ups. At additional three-month follow-ups, patients evaluated subjective improvement, pain and over-all satisfaction with the treatment according to a numeric analogue score (NAS). Side effects were documented. At four to six weeks post laser treatment for a mean of 1.4 sessions, we observed a significant (P=0.0001) reduction of the MASI score from 6.54 to 1.98 (72.3%). Patients rated the pain of the intervention at a mean 2.46 points (0=no pain; 10=maximum pain), the improvement at a mean 5.55 points (0=no improvement; 10=maximum improvement) and the overall satisfaction at a mean 4.66 points (0=not satisfied; 10=maximum satisfaction). After three months, post-inflammatory hyperpigmentation (PIH) and/or recurring melasma were observed in 7 (28%) and 11 (44%) patients, respectively. The 694-nm FRx-QSRL is a safe and effective option for treating melasma in Caucasian patients. Over periods of >3 months, PIH and/or recurring melasma may develop at significant rates and may reduce patient satisfaction. Multiple treatment sessions with lower pulse energies and/or a post-interventional therapy with hypopigmenting ointments and UV protection may help to minimize these complications.

Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project.

PubMed

Lucas, Barbara R; Doney, Robyn; Latimer, Jane; Watkins, Rochelle E; Tsang, Tracey W; Hawkes, Genevieve; Fitzpatrick, James P; Oscar, June; Carter, Maureen; Elliott, Elizabeth J

2016-11-01

We aimed to characterise motor performance in predominantly Aboriginal children living in very remote Australia, where rates of prenatal alcohol exposure (PAE) are high. Motor performance was assessed, and the relationship between motor skills, fetal alcohol spectrum disorders (FASD) and PAE was explored. Motor performance was assessed using the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition Complete Form, in a population-based study of children born in 2002 or 2003 living in the Fitzroy Valley, Western Australia. Composite scores ≥2SD (2nd percentile) and ≥1SD (16th percentile) below the mean were used respectively for FASD diagnosis and referral for treatment. FASD diagnoses were assigned using modified Canadian Guidelines. A total of 108 children (Aboriginal: 98.1%; male: 53%) with a mean age of 8.7 years was assessed. The cohort's mean total motor composite score (mean ± SD 47.2 ± 7.6) approached the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition normative mean (50 ± 10). Motor performance was lower in children with FASD diagnosis than without (mean difference (MD) ± SD: -5.0 ± 1.8; confidence interval: -8.6 to -1.5). There was no difference between children with PAE than without (MD ± SE: -2.2 ± 1.5; confidence interval: -5.1 to 0.80). The prevalence of motor impairment (≥-2SD) was 1.9% in the entire cohort, 9.5% in children with FASD, 3.3% in children with PAE and 0.0% both in children without PAE or FASD. Almost of 10% of children with FASD has significant motor impairment. Evaluation of motor function should routinely be included in assessments for FASD, to document impairment and enable targeted early intervention.[Lucas BR, Doney R, Latimer J, Watkins RE, Tsang TW, Hawkes G, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project. Drug Alcohol Rev 2016;35:719-727]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Chocolate flavanols and skin photoprotection: a parallel, double-blind, randomized clinical trial.

PubMed

Mogollon, Jaime Andres; Boivin, Catherine; Lemieux, Simone; Blanchet, Claudine; Claveau, Joël; Dodin, Sylvie

2014-06-27

Solar ultraviolet (UV) radiation has deleterious effects on the skin, including sunburn, photoaging and cancer. Chocolate flavanols are naturally-occurring antioxidant and anti-inflammatory molecules that could play a role in preventing cutaneous UV damage. We investigated the influence of 12-week high-flavanol chocolate (HFC) consumption on skin sensitivity to UV radiation, measured by minimal erythema dose (MED). We also evaluated skin elasticity and hydration. In this 2-group, parallel, double-blind, randomized controlled trial, 74 women aged 20-65 years and Fitzpatrick skin phototypes I or II were recruited from the general community in Quebec City, for randomization to either HFC (n = 33) or low-flavanol chocolate (LFC) (n = 41). A blocked randomisation (4), considering date of entry, skin type and age as factors, generated a sequentially-numbered allocation list. Study participants and research assistants were blinded. Totally, 30 g of chocolate were consumed daily for 12 weeks, followed by a 3-week washout period. MED was assessed at baseline and at 6, 9, 12 and 15 weeks. Main outcome was changes in MED at week 12. 33 participants in the HFC group and 41 in the LFC group were analyzed with 15 weeks of follow-up. Both groups showed similarly-increased MED at 12 weeks (HFC: 0.0252 ± 0.1099 J/cm2 [mean ± standard deviation (SD)]; LFC: 0.0151 ± 0.1118; mean difference (MD): 0.0100 J/cm2; 95% confidence interval (CI): -0.0417 to 0.0618). However, after 3-week washout, the HFC group presented decreased MED (-0.0248 ± 0.1145) whereas no effect was seen in the LFC group (0.0168 ± 0.1698) (MD: -0.0417; 95% CI: -0.1106 to 0.0272). Net temple elasticity increased slightly but significantly by 0.09 ± 0.12 mm in the HFC group at 12 weeks compared to 0.02 ± 0.12 mm in the LFC group (MD: 0.06; 95% CI: 0.01 to 0.12 ). No significant adverse events were reported. Our study failed to demonstrate a statistically-significant protective effect of HFC vs. LFC consumption on skin sensitivity to UV radiation as measured by MED. ClinicalTrials.gov identifier: NCT01444625.

Photoaging Mobile Apps as a Novel Opportunity for Melanoma Prevention: Pilot Study.

PubMed

Brinker, Titus Josef; Schadendorf, Dirk; Klode, Joachim; Cosgarea, Ioana; Rösch, Alexander; Jansen, Philipp; Stoffels, Ingo; Izar, Benjamin

2017-07-26

Around 90% of melanomas are caused by ultraviolet (UV) exposure and are therefore eminently preventable. Unhealthy tanning behavior is mostly initiated in early adolescence, often with the belief that it increases attractiveness; the problems related to skin atrophy and malignant melanoma are too far in the future to fathom. Photoaging desktop programs, in which an image is altered to predict future appearance, have been successful in positively influencing behavior in adiposity or tobacco prevention settings. To develop and test a photoaging app designed for melanoma prevention. We harnessed the widespread availability of mobile phones and adolescents' interest in appearance to develop a free mobile app called Sunface. This app has the user take a self-portrait (ie, a selfie), and then photoages the image based on Fitzpatrick skin type and individual UV protection behavior. Afterward, the app explains the visual results and aims at increasing self-competence on skin cancer prevention by providing guideline recommendations on sun protection and the ABCDE rule for melanoma self-detection. The underlying aging algorithms are based on publications showing UV-induced skin damage by outdoor as well as indoor tanning. To get a first impression on how well the app would be received in a young target group, we included a total sample of 25 students in our cross-sectional pilot study with a median age of 22 (range 19-25) years of both sexes (11/25, 44% female; 14/25, 56% male) attending the University of Essen in Germany. The majority of enrolled students stated that they would download the app (22/25, 88%), that the intervention had the potential to motivate them to use sun protection (23/25, 92%) and that they thought such an app could change their perceptions that tanning makes you attractive (19/25, 76%). Only a minority of students disagreed or fully disagreed that they would download such an app (2/25, 8%) or that such an app could change their perceptions on tanning and attractiveness (4/25, 16%). Based on previous studies and the initial study results presented here, it is reasonable to speculate that the app may induce behavioral change in the target population. Further work is required to implement and examine the effectiveness of app-based photoaging interventions within risk groups from various cultural backgrounds. ©Titus Josef Brinker, Dirk Schadendorf, Joachim Klode, Ioana Cosgarea, Alexander Rösch, Philipp Jansen, Ingo Stoffels, Benjamin Izar. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 26.07.2017.

Delivering Cognitive Behavior Therapy to Young Adults With Symptoms of Depression and Anxiety Using a Fully Automated Conversational Agent (Woebot): A Randomized Controlled Trial.

PubMed

Fitzpatrick, Kathleen Kara; Darcy, Alison; Vierhile, Molly

2017-06-06

Web-based cognitive-behavioral therapeutic (CBT) apps have demonstrated efficacy but are characterized by poor adherence. Conversational agents may offer a convenient, engaging way of getting support at any time. The objective of the study was to determine the feasibility, acceptability, and preliminary efficacy of a fully automated conversational agent to deliver a self-help program for college students who self-identify as having symptoms of anxiety and depression. In an unblinded trial, 70 individuals age 18-28 years were recruited online from a university community social media site and were randomized to receive either 2 weeks (up to 20 sessions) of self-help content derived from CBT principles in a conversational format with a text-based conversational agent (Woebot) (n=34) or were directed to the National Institute of Mental Health ebook, "Depression in College Students," as an information-only control group (n=36). All participants completed Web-based versions of the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), and the Positive and Negative Affect Scale at baseline and 2-3 weeks later (T2). Participants were on average 22.2 years old (SD 2.33), 67% female (47/70), mostly non-Hispanic (93%, 54/58), and Caucasian (79%, 46/58). Participants in the Woebot group engaged with the conversational agent an average of 12.14 (SD 2.23) times over the study period. No significant differences existed between the groups at baseline, and 83% (58/70) of participants provided data at T2 (17% attrition). Intent-to-treat univariate analysis of covariance revealed a significant group difference on depression such that those in the Woebot group significantly reduced their symptoms of depression over the study period as measured by the PHQ-9 (F=6.47; P=.01) while those in the information control group did not. In an analysis of completers, participants in both groups significantly reduced anxiety as measured by the GAD-7 (F 1,54 = 9.24; P=.004). Participants' comments suggest that process factors were more influential on their acceptability of the program than content factors mirroring traditional therapy. Conversational agents appear to be a feasible, engaging, and effective way to deliver CBT. ©Kathleen Kara Fitzpatrick, Alison Darcy, Molly Vierhile. Originally published in JMIR Mental Health (http://mental.jmir.org), 06.06.2017.

Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents.

PubMed

Arnljots, Rebeka; Thorn, Jörgen; Elm, Marie; Moore, Michael; Sundvall, Pär-Daniel

2017-10-10

Residents of nursing homes may have low 25-hydroxyvitamin D (25OHD) concentrations. Associations between vitamin D and cognitive performance, dementia and susceptibility to infections are not clearly established. The aim of this study was to investigate the prevalence of vitamin D deficiency and to identify associated factors among residents of nursing homes for elderly. In this cross-sectional study blood samples for analysis of 25OHD were collected from all participating residents of Swedish nursing homes for the elderly from January to March 2012. dementia too severe to collect a blood test, terminally ill or refusing participation. Serum 25OHD concentrations. Logistic regression to evaluate factors associated with vitamin D deficiency (25OHD < 25 nmol/L). Blood samples were obtained from 545 of 901 residents of 22 nursing homes. Mean age 86 years (SD 6.9), 68% were women. Prevalence of vitamin D supplementation 17%, dementia 55%, lack of appetite ≥3 months 45% and any antibiotic treatment during the last 6 months 30%. Serum 25OHD concentrations: mean 34 nmol/L (SD 21, median 27, range 4-125), 82% (448/545) had 25OHD < 50 nmol/L and 41% (224/545) had 25OHD < 25 nmol/L. Adjusted OR (95% CI; p-value) for possible predictors of vitamin D deficiency (25OHD < 25 nmol/L): vitamin D supplementation 0.075 (0.031-0.18; p < 0.001), lack of appetite ≥3 months 0.75 (0.50-1.1; p = 0.15), hours outdoors/week 0.99 (0.96-1.0; p = 0.62), Fitzpatrick skin phototype (4-6) 0.69 (0.44-1.1; p = 0.12); dementia 2.3 (1.5-3.4; p < 0.001) and antibiotics last 6 months 1.6 (1.1-2.6; p < 0.029), adjusted for age and gender. Vitamin D deficiency was common among nursing home residents and strongly associated with dementia. Regardless of causality or not, it is important to be alert for vitamin D deficiency in nursing homes residents with dementia. As expected vitamin D supplementation was associated with less vitamin D deficiency, however lack of appetite, staying outdoors and skin phototype were not significant predictors. Antibiotic treatments during the last 6 months were associated with vitamin D deficiency, potentially supporting the hypothesis that vitamin D deficiency is associated with infections.

CELL CARCINOMA].

PubMed

Drvar, D Ledić; Lipozenčić, J; Mokos, Z Bukvić; Ilić, I; Knežević, F

2015-01-01

An increase in the incidence of cancer, in particular skin cancer, has been observed in the last few decades. Skin cancer represents a significant public health problem in Croatia and worldwide. Cutaneous squamous cell carcinoma (cSCC) is a malignant tumor arising in epidermal keratinocytes. Together with basal cell carcinoma it belongs to non-melanoma skin cancers, which are the most common cancers in humans. The lifetime risk of cSCC development in Caucasian population is nowadays estimated to about 15%, which makes it double compared to 20 years ago. The most probable causes are increased ultraviolet light (UV) exposure (exposure to artificial UV sources in suntan parlors, spending more time outdoors, changes in fashion, as well as ozone holes), and longer life expectancy. In its etiopathogenesis, important risk factors include genetic factors, fair-skin phototype, UV exposure, chronic degenerative and inflammatory conditions, chemical factors, oncogenic viruses, immunosuppression, ionizing radiation, as well as habitual risk factors. Human epidermal growth factor receptor (HER) family is involved in the control of multiple signal pathways. Their dysregulation is associated with development of many cancers such as breast carcinoma, non-small cell lung carcinoma, ovarian carcinoma, carcinoma of pancreas, head and neck carcinoma, as well as glioblastoma. The objective of our investigation was to establish if there is association of the skin phototype and UV exposure with the expression of HER receptors, Ki67 and p53 in patients with cSCC. Study group included 101 cSCC patients. Inclusion criteria were age >50, both sexes, histopathologically confirmed cSCC, no previous therapy, specimens sufficient for immunohistochemistry, and complete clinical data collected by a questionnaire. Material obtained by excisional biopsy was completely histopathologically evaluated and additional tissue slices were immunohistochemically analyzed. Statistical analysis of the sample included non-parametrical statistical methods and statistical reviews. Analysis was done using R statistical package. Statistical significance was set at p<0.05. The following skin phototypes (according to Fitzpatrick) were present in our study: 54 (53.47%) patients with phototype II and 47 (46.53%) patients with phototype III. The majority of patients (n=93; 92.08%) were exposed to increased UV radiation during lifetime. Forty (39.60%) patients had three or more sunburns during childhood. Study results showed a signifi cantly higher expression of EGFR receptors, Ki67 and protein p53 in patients with light skin phototype that had been exposed to increased UV light during lifetime or had acquired 3 or more sunburns in childhood, suggesting that UV exposure led to the induction of EGFR, Ki67 and protein p53, and consequently to development of cSCC.

Chemoprevention of Nonmelanoma Skin Cancer With Celecoxib: A Randomized, Double-Blind, Placebo-Controlled Trial

PubMed Central

Viner, Jaye L.; Pentland, Alice P.; Cantrell, Wendy; Bailey, Howard; Kang, Sewon; Linden, Kenneth G.; Heffernan, Michael; Duvic, Madeleine; Richmond, Ellen; Elewski, Boni E.; Umar, Asad; Bell, Walter; Gordon, Gary B.

2010-01-01

Background Preclinical studies indicate that the enzyme cyclooxygenase 2 plays an important role in ultraviolet-induced skin cancers. We evaluated the efficacy and safety of celecoxib, a cyclooxygenase 2 inhibitor, as a chemopreventive agent for actinic keratoses, the premalignant precursor of nonmelanoma skin cancers, and for nonmelanoma skin cancers, including cutaneous squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs). Methods A double-blind placebo-controlled randomized trial involving 240 subjects aged 37–87 years with 10–40 actinic keratoses was conducted at eight US academic medical centers. Patients were randomly assigned to receive 200 mg of celecoxib or placebo administered orally twice daily for 9 months. Subjects were evaluated at 3, 6, 9 (ie, completion of treatment), and 11 months after randomization. The primary endpoint was the number of new actinic keratoses at the 9-month visit as a percentage of the number at the time of randomization. In an intent-to-treat analysis, the incidence of actinic keratoses was compared between the two groups using t tests. In exploratory analyses, we evaluated the number of nonmelanoma skin cancers combined and SCCs and BCCs separately per patient at 11 months after randomization using Poisson regression, after adjustment for patient characteristics and time on study. The numbers of adverse events in the two treatment arms were compared using χ2 or Fisher exact tests. All statistical tests were two-sided. Results There was no difference in the incidence of actinic keratoses between the two groups at 9 months after randomization. However, at 11 months after randomization, there were fewer nonmelanoma skin cancers in the celecoxib arm than in the placebo arm (mean cumulative tumor number per patient 0.14 vs 0.35; rate ratio [RR] = .43, 95% confidence interval [CI] = 0.24 to 0.75; P = .003). After adjusting for age, sex, Fitzpatrick skin type, history of actinic keratosis at randomization, nonmelanoma skin cancer history, and patient time on study, the number of nonmelanoma skin cancers was lower in the celecoxib arm than in the placebo arm (RR = 0.41, 95% CI = 0.23 to 0.72, P = .002) as were the numbers of BCCs (RR = 0.40, 95% CI = 0.18 to 0.93, P = .032) and SCCs (RR = 0.42, 95% CI = 0.19 to 0.93, P = .032). Serious and cardiovascular adverse events were similar in the two groups. Conclusions Celecoxib may be effective for prevention of SCCs and BCCs in individuals who have extensive actinic damage and are at high risk for development of nonmelanoma skin cancers. PMID:21115882

Anti-aging proof of concept study: results and summary.

PubMed

Bruce, Suzanne; Karnik, Jwala; Dryer, Laurence; Burkholder, David

2014-09-01

The etiology of aging human skin includes intrinsic physiologic changes greatly accelerated by photoaging, predominantly through exposure to UV light. Consumer interest and demand for anti-aging skin care products is extremely high especially in light of aging populations. Prenatal (fetal) tissue has been shown to possess healing characteristics and regenerative effects. A proprietary tissue engineering technology has been developed to produce a soluble human extracellular matrix material with growth factors and proteins. Neonatal cells are cultured on microbeads under conditions of low oxygen tension. This human cell-conditioned media (hCCM) contains a variety of growth factors and cytokines similar to those found in fetal cells and has been incorporated into a topical preparation for use in facial wound healing (after laser resurfacing procedures) and improving the appearance of aging skin. The objective of this study was to observe the effects of an MRCx™-containing topical skincare regimen on subjects with demonstrated aging skin damage (photodamage) when used consistently over a 3 month time period. Female subjects age 35-65 with Fitzpatrick Skin Type I-IV and mild to moderate amounts of photodamage, fine lines, and wrinkles used Regenica® Replenishing Crème and Regenica® Renew SPF 15 for 3 months. At each visit, photos were taken of subjects while investigators completed skin grading assessments and subjects completed self-assessments. Investigator assessments included evaluation of tactile roughness, visual texture, wrinkles, blotchiness, skin tone evenness, radiance, and translucence on a 5-point scale. Subjects' self-assessments included assessment of fine lines and wrinkles, firmness, evenness of skin tone, brightness, resilience, clarity, and radiance. Changes from baseline were evaluated for each parameter and P values for changes from baseline to each study visit for investigator's assessments and to end-of-study for self-assessments were calculated. Eighteen of 21 enrolled female subjects completed the study. Three subjects chose to drop from the study. Statistically significant improvements in investigator assessments of tactile roughness, visual texture, wrinkles, blotchiness, skin tone evenness, radiance and translucency compared to baseline were observed at weeks 4, 8, and 12 after initiating treatments. Progressive improvement was seen through the last study visit (visit 5, week 12). Similar statistically significant improvements in subjects' self-assessments were seen comparing the first post-baseline visit (visit 2, week 2) to subsequent visits. 93.5 % subjects agreed (somewhat or strongly) with all of the positive subject assessment statements at week 12. Importantly, 100 % of subjects indicated at the end of the study that they would recommend the product to a friend and would want to purchase the product. No treatment-related adverse events were recorded during the study. Regenica was safe and clinically effective in reducing anti-aging effects in this group of female subjects aged 35-65 years as measured by both investigator assessments and subjects' self-assessments.

Effects of eHealth Literacy on General Practitioner Consultations: A Mediation Analysis.

PubMed

Schulz, Peter Johannes; Fitzpatrick, Mary Anne; Hess, Alexandra; Sudbury-Riley, Lynn; Hartung, Uwe

2017-05-16

Most evidence (not all) points in the direction that individuals with a higher level of health literacy will less frequently utilize the health care system than individuals with lower levels of health literacy. The underlying reasons of this effect are largely unclear, though people's ability to seek health information independently at the time of wide availability of such information on the Internet has been cited in this context. We propose and test two potential mediators of the negative effect of eHealth literacy on health care utilization: (1) health information seeking and (2) gain in empowerment by information seeking. Data were collected in New Zealand, the United Kingdom, and the United States using a Web-based survey administered by a company specialized on providing online panels. Combined, the three samples resulted in a total of 996 baby boomers born between 1946 and 1965 who had used the Internet to search for and share health information in the previous 6 months. Measured variables include eHealth literacy, Internet health information seeking, the self-perceived gain in empowerment by that information, and the number of consultations with one's general practitioner (GP). Path analysis was employed for data analysis. We found a bundle of indirect effect paths showing a positive relationship between health literacy and health care utilization: via health information seeking (Path 1), via gain in empowerment (Path 2), and via both (Path 3). In addition to the emergence of these indirect effects, the direct effect of health literacy on health care utilization disappeared. The indirect paths from health literacy via information seeking and empowerment to GP consultations can be interpreted as a dynamic process and an expression of the ability to find, process, and understand relevant information when that is necessary. ©Peter Johannes Schulz, Mary Anne Fitzpatrick, Alexandra Hess, Lynn Sudbury-Riley, Uwe Hartung. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.05.2017.

Efficacy of Trichloro-Acetic Acid Peel Alone Versus Combined Topical Magnesium Ascorbyl Phosphate for Epidermal Melasma.

PubMed

Murtaza, Fatima; Bangash, Abdur Rahim; Khushdil, Arshad; Noor, Sahibzada Mahmood

2016-07-01

To compare the efficacy in terms of reduction in melasma area and severity index (MASI) score by more than 10 of a combination of 20% trichloro-acetic acid peel plus 5% topical magnesium ascorbyl phosphate versus 20% trichloroacetic acid peel alone in the treatment of epidermal melasma. Randomized controlled trial. Department of Dermatology, Lady Reading Hospital (LRH), Peshawar, from May 2012 to May 2013. Patients aged 18 - 65 years, with Fitzpatrick skin type III-V were divided into two equal groups having 74 patients each. Detailed history was taken and Wood's lamp examination done to rule out mixed and dermal melasma. Melasma area and severity index (MASI) score was calculated for every patient. Priming was done for all patients with tretinoin cream applied once daily at night for 2 weeks, and to use a broad spectrum sun block cream before sun exposure. Patients in group Awere subjected to combined treatment, i.e. trichloro-acetic acid peel 20% (weekly) plus magnesium ascorbyl phosphate cream (applied once daily), while patients in group B were subjected to trichloro-acetic acid peel 20% (weekly) alone. Treatment was continued for 6 weeks. After completion of treatment, MASI score was recalculated. Proportion of patients with significant MASI score reduction was compared using chi-square test with significance at p < 0.05. Male and female patients were 11 (14.9%) and 63 (85.1%), respectively in group A, whereas 13 (17.6%) and 61 (82.4%) in group B. The mean age in group Awas 30.28 ±8.08 years, and 29.36 ±6.84 years in group B. Significant MASI score reduction in group Awas seen in 60 (81.1%) patients and in group B 49 (66.2%, p= 0.040). Combination of trichloro-acetic acid peel and topical magnesium ascorbyl phosphate cream was significantly more effective than trichloro-acetic acid peel alone in treatment of melasma.

High versus moderate energy use of bipolar fractional radiofrequency in the treatment of acne scars: a split-face double-blinded randomized control trial pilot study.

PubMed

Phothong, Weeranut; Wanitphakdeedecha, Rungsima; Sathaworawong, Angkana; Manuskiatti, Woraphong

2016-02-01

Bipolar fractional radiofrequency (FRF) device was firstly FDA-approved for treating atrophic acne scar in 2008 through the process of dermal coagulation and minimal epidermal ablation. The average energy at 60 mJ/pin was widely used to treat atrophic acne scars. However, the higher energy was delivered, the deeper ablation and coagulation were found. At present, the new generation of a device with bipolar FRF technology with electrode-pin tip was developed to maximize ability to deliver energy up to 100 mJ/pin. The objective of the study was to explore and compare the efficacy of utilizing high energy (100 mJ/pin) and moderate energy (60 mJ/pin) of bipolar fractional radiofrequency in treatment of atrophic acne scar in Asians. This is a split-face, double-blinded, randomized control trial, pilot study by using parallel group design technique. Thirty healthy subjects with Fitzpatrick skin phototype III-IV diagnosed as atrophic acne scares were enrolled. All subjects received four monthly sessions of bipolar FRF treatment. Left and right facial sides of individual patients were randomly assigned for different energy (high energy at 100 mJ/pin versus moderate energy at 60 mJ/pin). Acne scars improvement was blinded graded by dermatologist using global acne scarring score (GASS) which was subjectively evaluated at baseline, 1-, 3-, and 6-month follow-up. Objective scar analysis was also done using UVA-light video camera to measure scar volume, skin smoothness, and wrinkle at baseline, 3-, and 6-month follow-up after the last treatment. Side effects including pain, erythema, swelling, and crusting were also recorded. Thirty subjects completed the study with full 4-treatment course. The mean GASS of high energy side and moderate energy side was significantly reduced at 1-, 3-, and 6-month follow-up visits. At 1 month follow-visit, high energy side demonstrated significant improvement compared with moderate energy side (p = 0.03). Postinflammatory hyperpigmentation (PIH) developed in 21/120 sessions in high energy side (17.5 %) and 16/120 sessions in moderate energy side (13.3 %). Pain score and the duration of erythema after treatments were significant higher on the side that was treated with high energy. Bipolar FRF device was safe and effective in the treatment of atrophic acne scars in Asians. High energy setting demonstrated significant higher efficacy at 1 month follow-visit. However, the efficacy of both energy settings was comparable at 3- and 6-month follow-up. In addition, side effects were significantly more intense on the side treated with high energy.

The growth of human scalp hair mediated by visible red light laser and LED sources in males.

PubMed

Lanzafame, Raymond J; Blanche, Raymond R; Bodian, Adam B; Chiacchierini, Richard P; Fernandez-Obregon, Adolfo; Kazmirek, Eric R

2013-10-01

Low level laser therapy (LLLT) has been used to promote hair growth. A double-blind randomized controlled trial was undertaken to define the safety and physiologic effects of LLLT on males with androgenic alopecia. Forty-four males (18-48 yo, Fitzpatrick I-IV, Hamilton-Norwood IIa-V) were recruited. A transition zone scalp site was selected; hairs were trimmed to 3 mm height; the area was tattooed and photographed. The active group received a "TOPHAT655" unit containing 21, 5 mW lasers (655 ± 5 nm), and 30 LEDS (655 ± 20 nm), in a bicycle-helmet like apparatus. The placebo group unit appeared identical, containing incandescent red lights. Patients treated at home every other day × 16 weeks (60 treatments, 67.3 J/cm(2) irradiance/25 minute treatment), with follow up and photography at 16 weeks. A masked 2.85 cm(2) photographic area was evaluated by another blinded investigator. The primary endpoint was the percent increase in hair counts from baseline. Forty-one patients completed the study (22 active, 19 placebo). No adverse events or side effects were reported. Baseline hair counts were 162.7 ± 95.9 (N = 22) in placebo and 142.0 ± 73.0 (N = 22) and active groups respectively (P = 0.426). Post Treatment hair counts were 162.4 ± 62.5 (N = 19) and 228.7 ± 102.8 (N = 22), respectively (P = 0.0161). A 39% percent hair increase was demonstrated (28.4 ± 46.2 placebo, N = 19; 67.2 ± 33.4, active, N = 22) (P = 0.001) Deleting one placebo group subject with a very high baseline count and a very large decrease, resulted in baseline hair counts of 151.1 ± 81.0 (N = 21) and 142.0 ± 73.0 (N = 22), respectively (P = 0.680). Post treatment hair counts were 158.2 ± 61.5 (N = 18) and 228.7 ± 102.8 (N = 22) (P = 0.011), resulting in a 35% percent increase in hair growth (32.3 ± 44.2, placebo, N = 18; 67.2 ± 33.4, active, N = 22) (P = 0.003). LLLT of the scalp at 655 nm significantly improved hair counts in males with androgenetic alopecia. © 2013 Wiley Periodicals, Inc.

Individual Differences in Animal Stress Models: Considering Resilience, Vulnerability, and the Amygdala in Mediating the Effects of Stress and Conditioned Fear on Sleep

PubMed Central

Wellman, Laurie L.; Fitzpatrick, Mairen E.; Hallum, Olga Y.; Sutton, Amy M.; Williams, Brook L.; Sanford, Larry D.

2016-01-01

Study Objectives: To examine the REM sleep response to stress and fearful memories as a potential marker of stress resilience and vulnerability and to assess the role of the basolateral amygdala (BLA) in mediating the effects of fear memory on sleep. Methods: Outbred Wistar rats were surgically implanted with electrodes for recording EEG and EMG and with bilateral guide cannulae directed at the BLA. Data loggers were placed intraperitoneally to record core body temperature. After recovery from surgery, the rats received shock training (ST: 20 footshocks, 0.8 mA, 0.5-s duration, 60-s interstimulus interval) and afterwards received microinjections of the GABAA agonist muscimol (MUS; 1.0 μM) to inactivate BLA or microinjections of vehicle (VEH) alone. Subsequently, the rats were separated into 4 groups (VEH-vulnerable (VEH-Vul; n = 14), VEH-resilient (VEH-Res; n = 13), MUS-vulnerable (MUS-Vul; n = 8), and MUS-resilient (MUS-Res; n = 11) based on whether or not REM was decreased, compared to baseline, during the first 4 h following ST. We then compared sleep, freezing, and the stress response (stress-induced hyperthermia, SIH) across groups to determine the effects of ST and fearful context re-exposure alone (CTX). Results: REM was significantly reduced on the ST day in both VEH-Vul and MUS-Vul rats; however, post-ST MUS blocked the reduction in REM on the CTX day in the MUS-Vul group. The VEH-Res and MUS-Res rats showed similar levels of REM on both ST and CTX days. The effects of post-ST inactivation of BLA on freezing and SIH were minimal. Conclusions: Outbred Wistar rats can show significant individual differences in the effects of stress on REM that are mediated by BLA. These differences in REM can be independent of behavioral fear and the peripheral stress response, and may be an important biomarker of stress resilience and vulnerability. Citation: Wellman LL, Fitzpatrick ME, Hallum OY, Sutton AM, Williams BL, Sanford LD. Individual differences in animal stress models: considering resilience, vulnerability, and the amygdala in mediating the effects of stress and conditioned fear on sleep. SLEEP 2016;39(6):1293–1303. PMID:27091518

Sun Protection by Beach Umbrella vs Sunscreen With a High Sun Protection Factor: A Randomized Clinical Trial.

PubMed

Ou-Yang, Hao; Jiang, Lily I; Meyer, Karen; Wang, Steve Q; Farberg, Aaron S; Rigel, Darrell S

2017-03-01

Sun-protective behavior affects skin cancer prevention. Shade works by physically shielding skin from direct harmful UV rays; however, skin may still remain exposed to reflected and indirect UV rays. There is no current standard metric to evaluate shade for its effectiveness in sun protection, and there is insufficient clinical evidence that a beach umbrella alone can provide adequate sun protection. To directly measure sunburn protection offered by a standard beach umbrella compared with that provided by sunscreen with a high sun protection factor under actual use conditions. A single-center, evaluator-blinded, randomized clinical study was conducted from August 13 to 15, 2014, in Lake Lewisville, Texas (elevation, 159 m above sea level), among 81 participants with Fitzpatrick skin types I (n = 1), II (n = 42), and III (n = 38). Participants were randomly assigned to 2 groups: 1 using only a beach umbrella, and the other using only sunscreen with a sun protection factor of 100. All participants remained at a sunny beach for 3½ hours at midday. Clinical sunburn evaluation of each individual for all exposed body sites was conducted 22 to 24 hours after sun exposure. The shade provided by a beach umbrella or protection provided by sunscreen with a sun protection factor of 100. Sunburn on all exposed body sites 22 to 24 hours after sun exposure. Among the 81 participants (25 male and 56 female; mean [SD] age, 41 [16] years) for all body sites evaluated (face, back of neck, upper chest, arms, and legs), the umbrella group showed a statistically significant increase in clinical sunburn scores compared with baseline and had higher postexposure global scores than the sunscreen group (0.75 vs 0.05; P < .001). There was a total of 142 sunburn incidences in the umbrella group vs 17 in the sunscreen group. Thirty-two of the 41 participants (78%) in the umbrella group showed erythema in 1 or more sites vs 10 of the 40 participants (25%) in the sunscreen group (P < .001). Neither umbrella nor sunscreen alone completely prevented sunburn. A beach umbrella alone may not provide sufficient protection for extended UV exposure. It is important to educate the public that combining multiple sun protection measures may be needed to achieve optimal protection. isrctn.org Identifier: ISRCTN19177299.

Nonmelanoma Skin Cancer in Nonwhite Organ Transplant Recipients.

PubMed

Pritchett, Ellen N; Doyle, Alden; Shaver, Christine M; Miller, Brett; Abdelmalek, Mark; Cusack, Carrie Ann; Malat, Gregory E; Chung, Christina Lee

2016-12-01

Organ transplant recipients have a higher incidence of skin cancer. This risk is magnified over time and with continued exposure to immunosuppression. Skin cancer in nonwhite patients is associated with greater morbidity and mortality owing to diagnosis at a more advanced stage, which suggests that nonwhite organ transplant recipients are at even higher risk. To describe demographic and clinical factors and the incidence of skin cancer in nonwhite organ transplant recipients. We performed a retrospective medical record review of patients who were organ transplant recipients (154 were white and 259 nonwhite [black, Asian, Hispanic, Pacific Islander]) seen from November 1, 2011, to April 18, 2016 at an academic referral center. Variables were analyzed and compared between racial groups, including sex, age, race/ethnicity, Fitzpatrick type, type and location of skin cancer, type of organ transplanted, time to diagnosis of skin cancer after transplantation, and history of condyloma acuminata and/or verruca vulgaris. Most of the 413 patients (62.7%) evaluated were nonwhite organ transplant recipients; 264 were men, and 149 were women. Their mean (SD) age was 60.09 (13.59) years. Nineteen skin cancers were identified in 15 patients (5.8%) representing 3 racial/ethnic groups: black (6 patients), Asian (5), and Hispanic (4). All squamous cell carcinomas in blacks were diagnosed in the in situ stage, located on sun-protected sites, and occurred in patients whose lesions tested positive for human papilloma virus (HPV) and/or who endorsed a history of condyloma acuminata or verruca vulgaris. Most skin cancers in Asians were located on sun-exposed areas and occurred in individuals who emigrated from equatorial locations. Nonwhite organ transplant recipients are at risk for developing skin cancer posttransplantation. Follow-up in a specialized transplant dermatology center and baseline total-body skin examination should be part of posttransplantation care in all organ transplant recipients, including nonwhite patients. A thorough inspection of the groin and genitalia is imperative in black organ transplant recipients. History of HPV infection, particularly in black organ transplant recipients, and sun exposure/emigration history in Asian organ transplant recipients should be documented. Vigilant photoprotection may be of lesser importance in the prevention of skin cancer in black organ transplant recipients. Risk factors for nonwhite organ transplant recipients differ between races/ethnicities and warrant further study in efforts to better counsel and prevent skin cancer in these patients.

Chocolate flavanols and skin photoprotection: a parallel, double-blind, randomized clinical trial

PubMed Central

2014-01-01

Background Solar ultraviolet (UV) radiation has deleterious effects on the skin, including sunburn, photoaging and cancer. Chocolate flavanols are naturally-occurring antioxidant and anti-inflammatory molecules that could play a role in preventing cutaneous UV damage. We investigated the influence of 12-week high-flavanol chocolate (HFC) consumption on skin sensitivity to UV radiation, measured by minimal erythema dose (MED). We also evaluated skin elasticity and hydration. Methods In this 2-group, parallel, double-blind, randomized controlled trial, 74 women aged 20–65 years and Fitzpatrick skin phototypes I or II were recruited from the general community in Quebec City, for randomization to either HFC (n = 33) or low-flavanol chocolate (LFC) (n = 41). A blocked randomisation (4), considering date of entry, skin type and age as factors, generated a sequentially-numbered allocation list. Study participants and research assistants were blinded. Totally, 30 g of chocolate were consumed daily for 12 weeks, followed by a 3-week washout period. MED was assessed at baseline and at 6, 9, 12 and 15 weeks. Main outcome was changes in MED at week 12. Results 33 participants in the HFC group and 41 in the LFC group were analyzed with 15 weeks of follow-up. Both groups showed similarly-increased MED at 12 weeks (HFC: 0.0252 ± 0.1099 J/cm2 [mean ± standard deviation (SD)]; LFC: 0.0151 ± 0.1118; mean difference (MD): 0.0100 J/cm2; 95% confidence interval (CI): -0.0417 to 0.0618). However, after 3-week washout, the HFC group presented decreased MED (-0.0248 ± 0.1145) whereas no effect was seen in the LFC group (0.0168 ± 0.1698) (MD: -0.0417; 95% CI: -0.1106 to 0.0272). Net temple elasticity increased slightly but significantly by 0.09 ± 0.12 mm in the HFC group at 12 weeks compared to 0.02 ± 0.12 mm in the LFC group (MD: 0.06; 95% CI: 0.01 to 0.12 ). No significant adverse events were reported. Conclusion Our study failed to demonstrate a statistically-significant protective effect of HFC vs. LFC consumption on skin sensitivity to UV radiation as measured by MED. Trial registration ClinicalTrials.gov identifier: NCT01444625 PMID:24970388

Efficacy and safety of fractional Q-switched 1064-nm neodymium-doped yttrium aluminum garnet laser in the treatment of melasma in Chinese patients.

PubMed

Yue, Baishuang; Yang, Qianli; Xu, Jinhua; Lu, Zhong

2016-11-01

Melasma is an acquired disorder of symmetrical hyperpigmentation commonly seen in patients with Fitzpatrick skin types III and IV. Various novel therapeutic modalities have emerged to treat melasma. The large-spot low-fluence QS Nd:YAG laser has been widely used in Asia; however, the modality needs to be optimized because of the high recurrence rate. The objective of this study is to explore the clinical efficacy and safety of fractional-mode (Pixel) Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064-nm laser for treatment of melasma in Chinese patients. Twenty-seven patients were enrolled and completed all the treatment sessions and the 12-week follow-up. All were treated using the fractional-mode Pixel QS Nd:YAG (1064 nm) laser for eight sessions at a 2-3-week interval. Clinical photographs were taken using the Visia skin analysis imaging system. Two blinded assessors evaluated melasma area and severity index (MASI) scores before and 4 weeks after the final session. Melanin index (MI) and erythema index (EI) was measured before each treatment visit and after the final treatment. The degree of pigmentation and erythema was assessed using a tristimulus color analyzer. Physicians' global assessment (PGA) and patients' self-assessment were taken as the subjective assessments. Wilcoxon signed-rank test was performed to evaluate clinical response. Recurrence rate were also evaluated. Mean MASI scores decreased from 12.84 ± 6.89 to 7.29 ± 4.15 after treatment (p = 0.000). Seventy percent of patients got moderate to good improvements after all the treatment. Mean MI decreased significantly from 56.52 ± 23.35 to 32.75 ± 12.91 (p = 0.000). L value increased from 59.21 ± 2.22 before treatment to 61.60 ± 2.40 (p = 0.000) after therapy. The mean score of PGA was 3.76 ± 0.71, indicating a "moderate" clearance of the lesion. In patients' self-evaluations, 70 % of the patients rated the result as "good" to "remarkable." Partial recurrence was seen in 40 % patients at the 3-month follow-up. No severe adverse events were observed during the study, and the treatment was well tolerated. The fractional mode (Pixel) QS Nd:YAG 1064-nm laser is an effective and safe treatment for melasma. The recurrence rate was relatively lower than that reported in studies treating with large-spot low-fluence QS Nd:YAG laser.

The growth of human scalp hair in females using visible red light laser and LED sources.

PubMed

Lanzafame, Raymond J; Blanche, Raymond R; Chiacchierini, Richard P; Kazmirek, Eric R; Sklar, Jeffrey A

2014-10-01

Low level laser (light) therapy (LLLT) has been demonstrated to promote hair growth in males. A double-blind randomized controlled trial was undertaken to define the safety and physiologic effects of LLLT on females with androgenic alopecia. Forty-seven females (18-60 years old, Fitzpatrick I-IV, and Ludwig-Savin Baldness Scale I-2, I-3, I-4, II-1, II-2 baldness patterns) were recruited. A transition zone scalp site was selected; hairs were trimmed to 3 mm height; the area was tattooed and photographed. The active group received a "TOPHAT655" unit containing 21, 5 mW diode lasers (655 ± 5 nm) and 30 LEDS (655 ± 20 nm), in a bicycle-helmet like apparatus. The placebo group unit appeared identical, containing incandescent red lights. Patients treated at home every other day × 16 weeks (60 treatments, 67 J/cm(2) irradiance/25 minute treatment, 2.9 J dose), with follow up and photography at 16 weeks. A masked 2.85 cm(2) photographic area was evaluated by another blinded investigator. The primary endpoint was the percent increase in hair counts from baseline. Forty-two patients completed the study (24 active, 18 sham). No adverse events or side effects were reported. Baseline hair counts were 228.2 ± 133.4 (N = 18) in the sham and 209.6 ± 118.5 (N = 24) in the active group (P = 0.642). Post Treatment hair counts were 252.1 ± 143.3 (N = 18) in the sham group and 309.9 ± 166.6 (N = 24) in the active group (P = 0.235). The change in hair counts over baseline was 23.9 ± 30.1 (N = 18) in the sham group and 100.3 ± 53.4 (N = 24) in the active group (P < 0.0001). The percent hair increase over the duration of the study was 11.05 ± 48.30 (N = 18) for the sham group and 48.07 ± 17.61 (N = 24) for the active group (P < 0.001). This demonstrates a 37% increase in hair growth in the active treatment group as compared to the placebo group. LLLT of the scalp at 655 nm significantly improved hair counts in women with androgenetic alopecia at a rate similar to that observed in males using the same parameters. © 2014 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

Star Formation in NGC 4631

NASA Astrophysics Data System (ADS)

Smith, A. M.; Collins, N. R.; Bohlin, R.; Fanelli, M. N.; Neff, S. G.; O'Connell, R. W.; Roberts, M. S.; Stecher, T. P.; Waller, W. H.

1997-12-01

The group of galaxies including NGC 4631 provides an outstanding example of a galaxy interaction accompanied by intensive star formation. FUV imagery, recorded by the Ultraviolet Imaging Telescope (UIT), exhibits very bright far- ultraviolet (FUV) emission corresponding to the H II regions cataloged by Crillon and Monet (1969). This data is, in our experience, extraordinary in that NCG 4631 is observed nearly edge-on and strong attenuation of FUV light could be anticipated. Analysis of the ultraviolet imagery together with ground-based data leads to the following conclusions. The average extinction internal to the bright FUV regions is low [E(B--V) = 0.31], which combined with the optical morphology implies that the FUV bright regions are close to the edge of the galactic disk. The FUV luminosity of that part of the galaxy which can be observed is 8.2 x 10(40) ergs/s and is about a factor 6 less than the FUV luminosities of M101 and M83. FUV colors, M152-U, M152-B and M152-V, when compared to the predicted colors from cluster formation models utilizing a Salpeter IMF imply an internal extinction like that of a non-30Dor LMC extinction curve (Fitzpatrick 1985). Instantaneous burst models indicate an average age of the FUV bright regions of about 6 Myr and a total created stellar mass of 2.8 x 10(7) Msun . If the measured colors are compared to continuous star formation models, star formation beginning about 100 Myr in the past and continuing to the present with a total star formation rate in the FUV bright regions of 0.026 Msun /yr is implied. The total number of OB stars in the H II regions comprising the large ring in the eastern part of the galaxy (Rand's Shell #1, 1993) is inferred to be 20,000. This number can be compared to Rand's estimate of 10,000 to 35,000 supernova-producing OB stars which are required to impart momentum to an expanding shell of hydrogen gas.

A Topical Anti-inflammatory Healing Regimen Utilizing Conjugated Linolenic Acid for Use Post-ablative Laser Resurfacing of the Face: A Randomized, Controlled Trial

PubMed Central

Goldman, Mitchel P.

2017-01-01

Background: Fractionated, ablative lasers are usually associated with post-treatment erythema, edema, and crusting, which can last from 5 to 14 days. Conjugated linolenic acid, an omega-5 fatty acid, has significant antioxidant and anti-inflammatory properties, and has been shown to stimulate keratinocyte proliferation and epidermal regeneration. By modulating the early inflammatory milieu and directly affecting skin structure and function, conjugated linolenic acid might therefore shorten downtime following fractionated ablative laser resurfacing of the face. Objective: To evaluate the efficacy and subject satisfaction of a topical regimen containing conjugated linolenic acid derived from pomegranate seed extract in accelerating wound healing and improving skin quality following fractionated ablative laser resurfacing of the face. Materials and Methods: Thirty-four subjects were enrolled and received fractionated CO2 laser resurfacing. Subjects were randomized to use the test healing regimen (n=24) or 1% dimethicone ointment (n=10) post-procedure. The primary endpoint was the degree of erythema, edema, crusting, and exudation evaluated by a blinded clinician at post-treatment Days 1,3,7,10, 14, and 30. Secondary endpoints included a blinded evaluator assessment of the degree of wrinkling and elastosis using the Fitzpatrick-Goldman Wrinkle and Elastosis Scale; subject-assessed degree of pain, itching, tightness, oozing, and crusting; and subject overall satisfaction. Results: Subjects who applied the topical conjugated linolenic acid healing regimen experienced significantly reduced edema on post-procedure Day 3 (p=0.04), and itching on Days 1 and 3 (p=0.03 and p=0.04). Both regimens produced significant improvements in wrinkling and elastosis at Days 14 and 30 post-treatment, with conjugated linolenic acid outperforming placebo in improvements in wrinkling at Day 14. Both regimens were well tolerated with no statistical differences in adverse events or subject satisfaction. Conclusion: The topical conjugated linolenic acid formulation outperformed placebo by decreasing acute pruritus and edema, and enabling a faster positive outcome in wrinkle improvement. Additionally, topical conjugated linolenic acid does not raise any safety or tolerability issues as compared to current standard of care. PMID:29344315

A Topical Anti-inflammatory Healing Regimen Utilizing Conjugated Linolenic Acid for Use Post-ablative Laser Resurfacing of the Face: A Randomized, Controlled Trial.

PubMed

Wu, Douglas C; Goldman, Mitchel P

2017-10-01

Background: Fractionated, ablative lasers are usually associated with post-treatment erythema, edema, and crusting, which can last from 5 to 14 days. Conjugated linolenic acid, an omega-5 fatty acid, has significant antioxidant and anti-inflammatory properties, and has been shown to stimulate keratinocyte proliferation and epidermal regeneration. By modulating the early inflammatory milieu and directly affecting skin structure and function, conjugated linolenic acid might therefore shorten downtime following fractionated ablative laser resurfacing of the face. Objective: To evaluate the efficacy and subject satisfaction of a topical regimen containing conjugated linolenic acid derived from pomegranate seed extract in accelerating wound healing and improving skin quality following fractionated ablative laser resurfacing of the face. Materials and Methods: Thirty-four subjects were enrolled and received fractionated CO2 laser resurfacing. Subjects were randomized to use the test healing regimen (n=24) or 1% dimethicone ointment (n=10) post-procedure. The primary endpoint was the degree of erythema, edema, crusting, and exudation evaluated by a blinded clinician at post-treatment Days 1,3,7,10, 14, and 30. Secondary endpoints included a blinded evaluator assessment of the degree of wrinkling and elastosis using the Fitzpatrick-Goldman Wrinkle and Elastosis Scale; subject-assessed degree of pain, itching, tightness, oozing, and crusting; and subject overall satisfaction. Results: Subjects who applied the topical conjugated linolenic acid healing regimen experienced significantly reduced edema on post-procedure Day 3 ( p =0.04), and itching on Days 1 and 3 ( p =0.03 and p =0.04). Both regimens produced significant improvements in wrinkling and elastosis at Days 14 and 30 post-treatment, with conjugated linolenic acid outperforming placebo in improvements in wrinkling at Day 14. Both regimens were well tolerated with no statistical differences in adverse events or subject satisfaction. Conclusion: The topical conjugated linolenic acid formulation outperformed placebo by decreasing acute pruritus and edema, and enabling a faster positive outcome in wrinkle improvement. Additionally, topical conjugated linolenic acid does not raise any safety or tolerability issues as compared to current standard of care.

Trends in reported sun bed use, sunburn, and sun care knowledge and attitudes in a U.K. region: results of a survey of the Northern Ireland population.

PubMed

Boyle, R; O'Hagan, A H; Donnelly, D; Donnelly, C; Gordon, S; McElwee, G; Gavin, A

2010-12-01

Sunburn and sun bed use increase risk of malignant melanoma, the incidence of which continues to rise. To document trends in reported sun bed use, sunburn, and sun care knowledge and attitudes in a U.K. region where there have been 20 years of sun-related health promotion campaigns. In 2000, 2004 and 2008, a 'care in the sun' module was included in the Northern Ireland (NI) Omnibus survey. Each year 2200 subjects aged 16 years and over were randomly selected and invited to complete a sun-related questionnaire. Proportions of respondents were analysed by demographic and socioeconomic factors, with differences tested using z-tests and the χ(2) -squared test. In total, 3623 persons responded (response rate 50-59%). Skin cancer knowledge in 2008 was high at 97%. Skin type reporting was inaccurate and since 2000 has become weighted towards the darker Fitzpatrick skin types IV and V (χ(2) = 21·5, P = 0·006). Reported sunburn rose over the 8-year period to 60% in 2008, with 39% of those aged 16-24 years reporting sunburn at least once in the previous year. Twenty per cent reported sun bed use in 2008, a fall from 28% in 2004 (P = 0·01), with greater reported use among those aged 16-24 years (24%) and among women (31% vs. 9% men, P < 0·001). Tanning was reported to make respondents feel healthier (42%) and more attractive (47%), with these attitudes more likely among young women. Skin cancer and sun care knowledge is good among the NI population but reported behaviours of sun bed use and sunburn pose risks for further rises in skin cancer. Barriers for future sun care campaigns to address include poorer sun care knowledge among men, poor skin type awareness, and women's attitudes regarding the health and attractiveness of tanning. Sun bed use, although high, has fallen, possibly in response to recent campaigns. © 2010 The Authors. BJD © 2010 British Association of Dermatologists.

Comparative study of cryogen spray cooling with R-134a and R-404a: implications for laser treatment of dark human skin

NASA Astrophysics Data System (ADS)

Dai, Tianhong; Yaseen, Mohammad A.; Diagaradjane, Parmeswaran; Chang, David W.; Anvari, Bahman

2006-07-01

Cutaneous laser treatment in dark skin patients is challenging due to significant light absorption by the melanin at the basal layer of epidermis, which can result in irreversible nonspecific thermal injury to the epidermis. Cryogen spray cooling (CSC) with R-134a (boiling point ≈ -26.2°C at 1 atm), which is currently used during cutaneous laser treatment, has shown poor efficacy in protecting dark human skin. We investigated the potential of CSC with R-404a (boiling point ≈ -46.5°C at 1 atm), which has a lower boiling point than R-134a, for improved therapeutic outcome in dark human skin at three levels: in vitro (epoxy resin skin phantom), ex vivo (normal dark human skin sample), and in vivo (skin of the rabbit external ear). The skin phantom was used to acquire the surface and internal temperature profiles in response to CSC with R-134a or R-404a at various spurt durations, based upon which CSC-induced heat removal from the skin phantom was estimated using an algorithm that solved a one-dimensional inverse heat conduction problem. CSC with R-404a increased the temperature reductions within the phantom and subsequently the amount of heat removal from the phantom in comparison to that with R-134a. Normal ex vivo Fitzpatrick types V-VI human skin samples were used to investigate the thermal response of dark human skin epidermis to CSC (R-134a or R-404a) at various spurt durations in conjunction with 595-nm pulsed dye laser irradiation at various radiant exposures. Cryogen R-404a increased the threshold radiant exposures for irreversible thermal injury to the epidermis in dark pigmentation skin. No obvious CSC-induced morphological changes to human skin was observed when sprayed with R404-a spurts using durations up to 300 ms. In vivo rabbit ear vasculature was used as a model of cutaneous anomalies to assess the influences of CSC (with R-134a or R-404a) on the photothermolysis of dermal blood vessels. CSC (R-134a or R-404a) with the spurt durations of 100 to 300 ms increased the most superficial depth of thermally damaged dermal blood vessel compared with the sites without CSC, implying possible nonspecific cooling of superficial dermal blood vessels by the cryogen spurts with the settings applied.

Safety and Efficacy of a 1550nm/1927nm Dual Wavelength Laser for the Treatment of Photodamaged Skin.

PubMed

Narurkar, Vic A; Alster, Tina S; Bernstein, Eric F; Lin, Tina J; Loncaric, Anya

2018-01-01

BACKGROUND: Fractional photothermolysis (FP) is a popular treatment option for photodamaged skin and addresses shortcomings of ablative skin resurfacing and nonablative dermal remodeling. Previous studies have demonstrated that FP using the 1550nm wavelength has led to improvement of ultrastructural changes and clinical effects associated with photodamaged skin in the deeper dermal structures, while treatment with the 1927nm wavelength has shown clinical effects in the superficial dermis. Both wavelengths produce precise microscopic treatment zones (MTZs) in the skin. The two wavelengths used in combination may optimize the delivery of fractional nonablative resurfacing intended for dermal and epidermal coagulation of photodamage skin.

OBJECTIVES: To evaluate the safety and efficacy of a 1550/1927 Laser System (Fraxel Dual, Solta), using both 1550nm and 1927nm wavelengths in combination for treatment of facial and non-facial photodamage.

METHODS: Prospective, multi-center, post-market study in subjects with clinically identifiable photodamage (N=35) (Fitzpatrick skin types I-IV). Both 1550nm and 1927nm wavelengths were used at each treatment visit. Investigator assessment of the affected area(s) occurred at one week, one month and 3 months after a series of up to four treatments. Severity of adverse events (AEs) were assessed using a 4-point scale (where 0=none and 3=marked). Assessments included erythema, edema, hyperkeratosis, hyper- and hypo-pigmentation, scarring, itchiness, dryness, and flaking. Severity of photoaging, fine and coarse wrinkling, mottled hyperpigmentation, sallowness, and tactile roughness at baseline was assessed using the same scale. Investigators and subjects assessed overall appearance of photodamage and pigmentation based on a 5-point quartile improvement scale at all follow-up visits (where 0=no improvement and 4=very significant improvement [76%-100%]).

RESULTS: There was a positive treatment effect at all study visits, with moderate improvement (average reduction in severity of 21%-43%) observed 3-months after final treatment. Greatest reduction in severity of other benefit areas was at the 3-month follow-up visit, with a 21% and 30% decrease in severity in fine wrinkling and tactile roughness. No AEs or serious AEs were reported. Pain sensation during treatment was tolerable. Anticipated moderate erythema (mean score 1.6±0.5) and mild edema (mean score 0.8±0.7) were transient and resolved within 7-10 days. Anticipated and transient mild dryness (52% of subjects) and flaking (30%) were reported at the 1-week follow-up. There were no incidences of hyperkeratosis, scarring, or itchiness.

CONCLUSION: Treatments using both wavelengths associated with the combined 1550/1927 Laser System were well tolerated with limited, transient anticipated side effects and no serious AEs. Clinical efficacy in the appearance of photodamage and pigmentation was greatest following a series of up to 3 treatments.

J Drugs Dermatol. 2018;17(1):41-46.

The growth of human scalp hair in females using visible red light laser and LED sources

PubMed Central

Lanzafame, Raymond J; Blanche, Raymond R; Chiacchierini, Richard P; Kazmirek, Eric R; Sklar, Jeffrey A

2014-01-01

Background and Objectives Low level laser (light) therapy (LLLT) has been demonstrated to promote hair growth in males. A double-blind randomized controlled trial was undertaken to define the safety and physiologic effects of LLLT on females with androgenic alopecia. Methods Forty-seven females (18–60 years old, Fitzpatrick I–IV, and Ludwig–Savin Baldness Scale I-2, I-3, I-4, II-1, II-2 baldness patterns) were recruited. A transition zone scalp site was selected; hairs were trimmed to 3 mm height; the area was tattooed and photographed. The active group received a “TOPHAT655” unit containing 21, 5 mW diode lasers (655 ± 5 nm) and 30 LEDS (655 ± 20 nm), in a bicycle-helmet like apparatus. The placebo group unit appeared identical, containing incandescent red lights. Patients treated at home every other day × 16 weeks (60 treatments, 67 J/cm2 irradiance/25 minute treatment, 2.9 J dose), with follow up and photography at 16 weeks. A masked 2.85 cm2 photographic area was evaluated by another blinded investigator. The primary endpoint was the percent increase in hair counts from baseline. Results Forty-two patients completed the study (24 active, 18 sham). No adverse events or side effects were reported. Baseline hair counts were 228.2 ± 133.4 (N = 18) in the sham and 209.6 ± 118.5 (N = 24) in the active group (P = 0.642). Post Treatment hair counts were 252.1 ± 143.3 (N = 18) in the sham group and 309.9 ± 166.6 (N = 24) in the active group (P = 0.235). The change in hair counts over baseline was 23.9 ± 30.1 (N = 18) in the sham group and 100.3 ± 53.4 (N = 24) in the active group (P < 0.0001). The percent hair increase over the duration of the study was 11.05 ± 48.30 (N = 18) for the sham group and 48.07 ± 17.61 (N = 24) for the active group (P < 0.001). This demonstrates a 37% increase in hair growth in the active treatment group as compared to the placebo group. Conclusions LLLT of the scalp at 655 nm significantly improved hair counts in women with androgenetic alopecia at a rate similar to that observed in males using the same parameters. Lasers Surg. Med. 46:601–607, 2014. © 2014 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc. PMID:25124964

THE PROPERTIES OF THE 2175 A EXTINCTION FEATURE DISCOVERED IN GRB AFTERGLOWS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zafar, Tayyaba; Watson, Darach; Eliasdottir, Ardis

The unequivocal, spectroscopic detection of the 2175 A bump in extinction curves outside the Local Group is rare. To date, the properties of the bump have been examined in only two gamma-ray burst (GRB) afterglows (GRB 070802 and GRB 080607). In this work, we analyze in detail the detections of the 2175 Angstrom-Sign extinction bump in the optical spectra of two further GRB afterglows: GRB 080605 and 080805. We gather all available optical/near-infrared photometric, spectroscopic, and X-ray data to construct multi-epoch spectral energy distributions (SEDs) for both GRB afterglows. We fit the SEDs with the Fitzpatrick and Massa model withmore » a single or broken power law. We also fit a sample of 38 GRB afterglows, known to prefer a Small Magellanic Cloud (SMC)-type extinction curve, with the same model. We find that the SEDs of GRB 080605 and GRB 080805 at two epochs are fit well with a single power law with a derived extinction of A{sub V} = 0.52{sup +0.13}{sub -0.16} and 0.50{sup +0.13}{sub -0.10}, and 2.1{sup +0.7}{sub -0.6} and 1.5 {+-} 0.2, respectively. While the slope of the extinction curve of GRB 080805 is not well constrained, the extinction curve of GRB 080605 has an unusual very steep far-UV rise together with the 2175 A bump. Such an extinction curve has previously been found in only a small handful of sightlines in the Milky Way. One possible explanation of such an extinction curve may be dust arising from two different regions with two separate grain populations, however we cannot distinguish the origin of the curve. We finally compare the four 2175 A bump sightlines to the larger GRB afterglow sample and to Local Group sightlines. We find that while the width and central positions of the bumps are consistent with what is observed in the Local Group, the relative strength of the detected bump (A{sub bump}) for GRB afterglows is weaker for a given A{sub V} than for almost any Local Group sightline. Such dilution of the bump strength may offer tentative support to a dual dust-population scenario.« less

Foraminifera and the ecology of sea grass communities since the late Cretaceous

NASA Astrophysics Data System (ADS)

Hart, Malcolm; Smart, Christopher; Jagt, John

2016-04-01

Sea grasses are marine angiosperms (plants) that, in the late Cretaceous, migrated from the land into shallow-water marine environments. They represent a distinct, but fragile, marine habitat and sea grass meadows are often regarded as biodiversity hot-spots with a range of species (including fish, sea horses and cuttlefish) using them as nurseries for their young. Foraminifera are often found associated with sea grass meadows, with the associated taxa reflecting both the environment and palaeolatitude. In the tropics and sub-tropics, miliolid foraminifera dominate (e.g., Peneroplis spp.) as do large discoidal taxa such as Marginopora and Calcarina. In temperate to cool latitudes the assemblage changes to one dominated by smaller benthic taxa, including Elphidium spp. One taxon, Elphidium crispum, is geotropic and is often found - in the summer months - to crowd the fronds of the sea grass. In the Gulpen and Maastricht formations of the Maastricht area (The Netherlands and Belgium) sea grass fossils (both fronds and rhizomes) have been recorded in association with assemblages of both larger and smaller benthic foraminifera (Hart et al., 2016). Some of the large discoidal forms (e.g., Omphalocyclus and Orbitoides/Lepidorbitoides) and the distinctive Siderolites are associated with these sea grass fossils and are suggestive of the modern sea grass communities of sub-tropical areas. While earlier records were of relatively isolated sea grasses, in September/October 2015 surfaces with abundant sea grasses were found that are suggestive of complete 'meadows'. Preservation of some silicified rhizomes indicates that silicification must have been very rapid, before any degradation or compaction of the delicate tissues. The presence of sea grass fossils and their associated benthic foraminifera is indicative of a clear, shallow-water seaway, with a maximum depth of 15-20 m. The reported variations in sea level during the latest Cretaceous cannot, therefore, have been very large as such a change in water depth would have been disastrous to such a fragile ecosystem. The fossil record of sea grasses in the Cenozoic is relatively limited, though there are some assemblages of benthic foraminifera that are suggestive of their presence, despite the lack of plant fossils. Hart, M.B., FitzPatrick, M.E.J. & Smart, C.W. 2016. The Cretaceous/Paleogene boundary: Foraminifera, sea grasses, sea level change and sequence stratigraphy. Palaeogeography, Palaeoclimatology, Palaeoecology, 441, 420-429.

REGIONAL BINNING FOR CONTINUED STORAGE OF SPENT NUCLEAR FUEL AND HIGH-LEVEL WASTES

DOE Office of Scientific and Technical Information (OSTI.GOV)

W. Lee Poe, Jr

1998-10-01

In the Continued Storage Analysis Report (CSAR) (Reference 1), DOE decided to analyze the environmental consequences of continuing to store the commercial spent nuclear fuel (SNF) at 72 commercial nuclear power sites and DOE-owned spent nuclear fuel and high-level waste at five Department of Energy sites by region rather than by individual site. This analysis assumes that three commercial facilities pairs--Salem and Hope Creek, Fitzpatrick and Nine-Mile Point, and Dresden and Moms--share common storage due to their proximity to each other. The five regions selected for this analysis are shown on Figure 1. Regions 1, 2, and 3 are themore » same as those used by the Nuclear Regulatory Commission in their regulatory oversight of commercial power reactors. NRC Region 4 was subdivided into two regions to more appropriately define the two different climates that exist in NRC Region 4. A single hypothetical site in each region was assumed to store all the SNF and HLW in that region. Such a site does not exist and has no geographic location but is a mathematical construct for analytical purposes. To ensure that the calculated results for the regional analyses reflect appropriate inventory, facility and material degradation, and radionuclide transport, the waste inventories, engineered barriers, and environmental conditions for the hypothetical sites were developed from data for each of the existing sites within the given region. Weighting criteria to account for the amount and types of SNF and HLW at each site were used in the development of the environmental data for the regional site, such that the results of the analyses for the hypothetical site were representative of the sum of the results of each actual site if they had been modeled independently. This report defines the actual site data used in development of this hypothetical site, shows how the individual site data was weighted to develop the regional site, and provides the weighted data used in the CSAR analysis. It is divided into Part 1 that defines time-dependent releases from each regional site, Part 2 that defines transport conditions through the groundwater, and Part 3 that defines transport through surface water and populations using the surface waters for drinking.« less

Methodology or method? A critical review of qualitative case study reports.

PubMed

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2014-01-01

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

Integrating Human Factors into Crew Exploration Vehicle (CEV) Design

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Holden, Kritina; Baggerman, Susan; Campbell, Paul

2007-01-01

The purpose of this design process is to apply Human Engineering (HE) requirements and guidelines to hardware/software and to provide HE design, analysis and evaluation of crew interfaces. The topics include: 1) Background/Purpose; 2) HE Activities; 3) CASE STUDY: Net Habitable Volume (NHV) Study; 4) CASE STUDY: Human Modeling Approach; 5) CASE STUDY: Human Modeling Results; 6) CASE STUDY: Human Modeling Conclusions; 7) CASE STUDY: Human-in-the-Loop Evaluation Approach; 8) CASE STUDY: Unsuited Evaluation Results; 9) CASE STUDY: Suited Evaluation Results; 10) CASE STUDY: Human-in-the-Loop Evaluation Conclusions; 11) Near-Term Plan; and 12) In Conclusion

Enhancing the quality of case studies in health services research.

PubMed Central

Yin, R K

1999-01-01

OBJECTIVE: To provide guidance on improving the quality of case studies in health services research. DATA SOURCES: Secondary data, drawing from previous case study research. RESEARCH DESIGN: Guidance is provided to two audiences: potential case study investigators (eight items) and reviewers of case study proposals (four additional items). PRINCIPAL FINDINGS: The guidance demonstrates that many operational steps can be undertaken to improve the quality of case studies. These steps have been a hallmark of high-quality case studies in related fields but have not necessarily been practiced in health services research. CONCLUSIONS: Given higher-quality case studies, the case study method can become a valuable tool for health services research. Images Figure 3 PMID:10591280

Developing the DESCARTE Model: The Design of Case Study Research in Health Care.

PubMed

Carolan, Clare M; Forbat, Liz; Smith, Annetta

2016-04-01

Case study is a long-established research tradition which predates the recent surge in mixed-methods research. Although a myriad of nuanced definitions of case study exist, seminal case study authors agree that the use of multiple data sources typify this research approach. The expansive case study literature demonstrates a lack of clarity and guidance in designing and reporting this approach to research. Informed by two reviews of the current health care literature, we posit that methodological description in case studies principally focuses on description of case study typology, which impedes the construction of methodologically clear and rigorous case studies. We draw from the case study and mixed-methods literature to develop the DESCARTE model as an innovative approach to the design, conduct, and reporting of case studies in health care. We examine how case study fits within the overall enterprise of qualitatively driven mixed-methods research, and the potential strengths of the model are considered. © The Author(s) 2015.

Case Study: Testing with Case Studies

ERIC Educational Resources Information Center

Herreid, Clyde Freeman

2015-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

Methodology or method? A critical review of qualitative case study reports

PubMed Central

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2014-01-01

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners. PMID:24809980

Case Study: Writing a Journal Case Study

ERIC Educational Resources Information Center

Prud'homme-Genereux, Annie

2016-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes incorporating a journal article into the classroom by first converting it into a case study.

Fostering Entrepreneurship through Business Incubation: The Role and Prospects of Postsecondary Vocational-Technical Education. Report 2: Case Studies.

ERIC Educational Resources Information Center

Hernandez-Gantes, Victor M.; And Others

This report presents nine case studies featuring efforts to foster community development through business incubation and entrepreneurial programs at two-year colleges. A background section discusses case description, and organization and format of case studies. The second section describes the case study design. Each case study is introduced with…

The Misconception of Case-Control Studies in the Plastic Surgery Literature: A Literature Audit.

PubMed

Hatchell, Alexandra C; Farrokhyar, Forough; Choi, Matthew

2017-06-01

Case-control study designs are commonly used. However, many published case-control studies are not true case-controls and are in fact mislabeled. The purpose of this study was to identify all case-control studies published in the top three plastic surgery journals over the past 10 years, assess which were truly case-control studies, clarify the actual design of the articles, and address common misconceptions. MEDLINE, Embase, and Web of Science databases were searched for case-control studies in the three highest-impact factor plastic surgery journals (2005 to 2015). Two independent reviewers screened the resulting titles, abstracts, and methods, if applicable, to identify articles labeled as case-control studies. These articles were appraised and classified as true case-control studies or non-case-control studies. The authors found 28 articles labeled as case-control studies. However, only six of these articles (21 percent) were truly case-control designs. Of the 22 incorrectly labeled studies, one (5 percent) was a randomized controlled trial, three (14 percent) were nonrandomized trials, two (9 percent) were prospective comparative cohort designs, 14 (64 percent) were retrospective comparative cohort designs, and two (9 percent) were cross-sectional designs. The mislabeling was worse in recent years, despite increases in evidence-based medicine awareness. The majority of published case-control studies are not in fact case-control studies. This misunderstanding is worsening with time. Most of these studies are actually comparative cohort designs. However, some studies are truly clinical trials and thus a higher level of evidence than originally proposed.

Case Study: Puttin' on the Ritz: How to Put Science into Cases

ERIC Educational Resources Information Center

Herreid, Clyde Freeman

2017-01-01

There are multiple ways to put science into a case. This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses different ways of presenting science in case studies.

Coffee, decaffeinated coffee, tea and cancer of the colon and rectum: a review of epidemiological studies, 1990-2003.

PubMed

Tavani, Alessandra; La Vecchia, Carlo

2004-10-01

The literature from 1990 to 2003 on the relation between coffee, decaffeinated coffee, tea and colorectal cancer risk has been reviewed. For the relation with coffee, three cohort (517 total cases) and nine case-control studies (7555 cases) analysed colon cancer; three cohort (307 cases) and four case-control studies (2704 cases) rectal cancer; six case-control studies (854 cases) colorectal cancer. For colon cancer most case-control studies found risk estimates below unity; the results are less clear for cohort studies. No relation emerged for rectal cancer. A meta-analysis, including five cohort and twelve case-control studies, reported a pooled relative risk of 0.76 (significant). Any methodological artefact is unlikely to account for the consistent inverse association in different countries and settings. Plausible biological explanations include coffee-related reductions of cholesterol, bile acids and neutral sterol secretion in the colon; antimutagenic properties of selected coffee components; increased colonic motility. Decaffeinated coffee was not related to either colon or rectal cancer in three case-control studies. No overall association between tea and either colon or rectal cancer risk emerged in seven cohort (1756 total cases of colon, 759 of rectal and 60 of colorectal cancer) and 12 case-control studies (8058 cases of colon, 4865 of rectal, 604 of colorectal cancer).

Al-Qaeda in Iraq (AQI): An Al-Qaeda Affiliate Case Study

DTIC Science & Technology

2017-10-01

a comparative methodology that included eight case studies on groups affiliated or associated with Al-Qaeda. These case studies were then used as a... methodology that included eight case studies on groups affiliated or associated with Al-Qaeda. These case studies were then used as a dataset for cross...Case Study Zack Gold With contributions from Pamela G. Faber October 2017 This work was performed under Federal Government

Discovering the Future of the Case Study Method in Evaluation Research.

ERIC Educational Resources Information Center

Yin, Robert K.

1994-01-01

It is assumed that evaluators of the future will still be interested in case study methodology. Scenarios that ignore a case study method, that look back to a distinctive case study method, and that see the case study method as an integrating force in the qualitative-quantitative debate are explored. (SLD)

Qualitative Case Study Research as Empirical Inquiry

ERIC Educational Resources Information Center

Ellinger, Andrea D.; McWhorter, Rochell

2016-01-01

This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

Assembling a Case Study Tool Kit: 10 Tools for Teaching with Cases

ERIC Educational Resources Information Center

Prud'homme-Généreux, Annie

2017-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. The author shares the strategies and tools that teachers can use to manage a case study classroom effectively.

Treatment of pigmentary disorders in patients with skin of color with a novel 755 nm picosecond, Q-switched ruby, and Q-switched Nd:YAG nanosecond lasers: A retrospective photographic review.

PubMed

Levin, Melissa Kanchanapoomi; Ng, Elise; Bae, Yoon-Soo Cindy; Brauer, Jeremy A; Geronemus, Roy G

2016-02-01

Laser procedures in skin of color (SOC) patients are challenging due to the increased risk of dyspigmentation and scarring. A novel 755 nm alexandrite picosecond laser has demonstrated effectiveness for tattoo removal and treatment of acne scars. No studies to date have evaluated its applications in pigmentary disorders. The purpose of this retrospective study was to evaluate the safety profile and efficacy of the picosecond alexandrite laser compared to the current standard treatment, Q-switched ruby and neodynium (Nd):YAG nanosecond lasers, for pigmentary disorders in SOC patients. A retrospective photographic and chart evaluation of seventy 755 nm alexandrite picosecond, ninety-two Q-switched frequency doubled 532 nm and 1,064 nm Nd:YAG nanosecond, and forty-seven Q-switched 694 nm ruby nanosecond laser treatments, in forty-two subjects of Fitzpatrick skin types III-VI was conducted in a single laser specialty center. The picosecond laser was a research prototype device. Treatment efficacy was assessed by two blinded physician evaluators, using a visual analog scale for percentage of pigmentary clearance in standard photographs. Subject assessment of efficacy, satisfaction, and adverse events was performed using a questionnaire survey. The most common pigmentary disorder treated was Nevus of Ota (38.1%), followed by solar lentigines (23.8%). Other pigmentary disorders included post-inflammatory hyperpigmentation, congenital nevus, café au lait macule, dermal melanocytosis, Nevus of Ito, and Becker's nevus. Clinical efficacy of the Q-switched nanosecond lasers and picosecond laser treatments were comparable for lesions treated on the face with a mean visual analog score of 2.57 and 2.44, respectively, corresponding to approximately 50% pigmentary clearance. Subject questionnaires were completed in 58.8% of the picosecond subjects and 52.0% of the Q-switched subjects. Eighty four percent of subjects receiving Q-switched nanosecond laser treatments and 50% of the subjects receiving alexandrite 755 nm picosecond laser treatments felt satisfied to completely satisfied. Side effects observed in subjects treated with the alexandrite 755 nm picosecond laser were similar to those commonly observed and reported with the nanosecond Q-switched technology. All side effects were temporary, resolving within one month, and no long-term complications were noted. All patients who were very satisfied with their picosecond laser treatment for Nevus of Ota noted a delayed improvement only after 3 months. The 755 nm alexandrite picosecond, 694 nm ruby, 532 nm, and 1064 nm neodynium:YAG nanosecond lasers appear to be safe and effective modalities for removal of pigmentary disorders in skin of color patients with no long-term complications if used appropriately. This study demonstrates the potential of the 755 nm alexandrite picosecond laser in further clinical applications beyond tattoo removal. While the Q-switched lasers were effective, promising results were also observed using an early version of the novel picosecond laser for the removal of pigmentary lesions in SOC patients. As we continue to improve our understanding of the 755 nm picosecond laser, this device may prove to be a safe and effective alternative to the Q-switched lasers for the treatment of facial pigmented lesions in patients with skin of color. © 2016 Wiley Periodicals, Inc.

The case-control design in veterinary sciences: A survey.

PubMed

Cullen, Jonah N; Sargeant, Jan M; Makielski, Kelly M; O'Connor, Annette M

2016-11-01

The case-control study design is deceptively simple. However, many design considerations influence the estimated effect measure. An investigation of case-control studies in the human health literature suggested that some of these considerations are not described in reports of case-control studies. Our hypothesis was that the majority of veterinary studies labeled as case-controls would be incident density designs, and many would not interpret the effect measure obtained from those studies as the rate ratio rather than the odds ratio. Reference databases were searched for author-designated case-control studies. A survey of 100 randomly selected studies was conducted to examine the different design options described and estimated effect measures. Of the 100 author-identified case-control studies, 83 assessed an exposure-outcome association and, of those, only 54 (65.1%) sampled the study population based on an outcome and would thus be considered case-control designs. Twelve studies were incidence density designs but none used this terminology. Of the studies that reported an odds ratio as the effect measure, none reported on additional considerations that would have enabled a more interpretable result. This survey indicated many case-control-labeled studies were not case-control designs and among case-control studies, key design aspects were not often described. The absence of information about study design elements and underlying assumptions in case-control studies limits the ability to establish the effect measured by the study and the evidentiary value of the study might be underestimated. Copyright © 2016 Elsevier B.V. All rights reserved.

Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals.

PubMed

Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

2017-01-01

Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation.

Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals

PubMed Central

Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

2017-01-01

Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation. PMID:29046660

Does Case-Study Methodology Lack Rigour? The Need for Quality Criteria for Sound Case-Study Research, as Illustrated by a Recent Case in Secondary and Higher Education

ERIC Educational Resources Information Center

Kyburz-Graber, Regula

2004-01-01

There is a tendency to use case-study research methodology for research issues aiming at simply describing a complex situation, and to draw conclusions with insufficient rigour. Sound case-study research, however, follows discriminate rules which can be described in all the dimensions of a full case-study research process. This paper examines…

[Application of nested case-control study on safe evaluation of post-marketing traditional Chinese medicine injection].

PubMed

Xiao, Ying; Zhao, Yubin; Xie, Yanming

2011-10-01

The nested case-control study design (or the case-control in a cohort study) is described here as a new study design used in safe evaluation of post-marketing traditional Chinese medicine injection. In the nested case-control study, cases of a disease that occur in a defined cohort are identified and, for each, a specified number of matched controls is selected from among those in the cohort who have not developed the disease by the time of disease occurrence in the case. For many research questions, the nested case-control design potentially offers impressive reductions in costs and efforts of data collection and analysis compared with the full cohort approach, with relatively minor loss in statistical efficiency. The nested case-control design is particularly advantageous for studies in safe evaluation of post-marketing traditional Chinese medicine injection. Some examples of the application of nested case-control study were given.

Qualitative case study methodology in nursing research: an integrative review.

PubMed

Anthony, Susan; Jack, Susan

2009-06-01

This paper is a report of an integrative review conducted to critically analyse the contemporary use of qualitative case study methodology in nursing research. Increasing complexity in health care and increasing use of case study in nursing research support the need for current examination of this methodology. In 2007, a search for case study research (published 2005-2007) indexed in the CINAHL, MEDLINE, EMBASE, PsychINFO, Sociological Abstracts and SCOPUS databases was conducted. A sample of 42 case study research papers met the inclusion criteria. Whittemore and Knafl's integrative review method guided the analysis. Confusion exists about the name, nature and use of case study. This methodology, including terminology and concepts, is often invisible in qualitative study titles and abstracts. Case study is an exclusive methodology and an adjunct to exploring particular aspects of phenomena under investigation in larger or mixed-methods studies. A high quality of case study exists in nursing research. Judicious selection and diligent application of literature review methods promote the development of nursing science. Case study is becoming entrenched in the nursing research lexicon as a well-accepted methodology for studying phenomena in health and social care, and its growing use warrants continued appraisal to promote nursing knowledge development. Attention to all case study elements, process and publication is important in promoting authenticity, methodological quality and visibility.

Online Learning and Teaching with Technology: Case Studies, Experience and Practice. Case Studies of Teaching in Higher Education.

ERIC Educational Resources Information Center

Murphy, David, Ed.; Walker, Rob, Ed.; Webb, Graham, Ed.

This book contains case studies that look at using technology in a wide range of situations, from fully online courses to more traditional face-to-face settings. The case studies deal with issues related to student interaction, teaching and assessment, planning and development, and policy. The following case studies are included: (1) "Flame…

Case Study: Mini-Case Studies: Small Infusions of Active Learning for Large-Lecture Courses

ERIC Educational Resources Information Center

Carloye, Lisa

2017-01-01

In this article, the author introduces the usage of case studies to be an excellent method for engaging students through stories. The author notes she developed a series of mini-case studies that can be implemented, with a little advance preparation, within a 10- to 15-minute window during lecture. What makes them "mini" case studies?…

Lively Discussions vs. Discussions of Substance: Making the Case for Guided Case Study.

ERIC Educational Resources Information Center

Woloshin/Lerman, Phyllis

1996-01-01

Discusses the history and purpose of the case study method used to stimulate in-class discussion. Advocates the use of the guided case study method to ensure that substantive discussions take place and provides nine steps for using the method. Includes a sample case study worksheet. (11 citations) (BCY)

Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

ERIC Educational Resources Information Center

Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

2017-01-01

Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

Implementation of case studies in undergraduate didactic nursing courses: a qualitative study.

PubMed

Dutra, Danette K

2013-07-04

The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students' levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

Implementation of case studies in undergraduate didactic nursing courses: a qualitative study

PubMed Central

2013-01-01

Background The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students’ levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Methods Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. Results The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Conclusion Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience. PMID:23826925

The Use of Case Studies in Teaching Undergraduate Neuroscience

PubMed Central

Meil, William M.

2007-01-01

Case studies have been the cornerstone of many discoveries in neurology and continue to be an indispensable source of knowledge. Attaching a name, face, and story to the study of neurological disorders makes them more “real” and memorable. This article describes the value of the case study methodology and its advantages as a pedagogical approach. It also illustrates how the seminal case of H.M. can be used to highlight the advantages and disadvantages of the case study methodology. Three exercises are described for incorporating case studies into neuroscience courses. The first exercise requires students to conduct a literature review regarding their assigned case and then design an experiment to address a lingering question regarding that neurological disorder. Survey results of 90 students provide quantitative and qualitative support for this approach. The vast majority of students indicated this exercise was a valuable learning experience; sparked interest in the topic and in biopsychology; increased their knowledge and stimulated critical thinking. The second exercise discusses how students might conduct their own case studies. The third exercise emphasizes the use of case studies as a platform to examine competing hypotheses regarding neurological conditions and their treatment. A table listing case studies appropriate for undergraduate neuroscience courses is included. Cases are categorized by the type of neurological disorder and notes regarding the nature of and content of each case are provided. PMID:23493154

Letter - Response to 'How to protect general practice from child protection'

PubMed

Lang, Danny

2011-08-18

The bad news is that the BJGP published under such a negative and provocative title without balanced debate, in contrast to the recent BMJ head-to-head debate 'Has child protection become a form of madness'.1,2 One interesting comparison made in that debate is that Sweden and Finland spend 50% more of their gross domestic product on children and families than we do in the UK, we spend 200% more than they do on social problems. In my view these figures help us understand societal attitudes that have knock-on effects through all services for children and families including general practice. The current UK GP contract is certainly not child and family friendly and it is unlikely that current NHS changes will improve matters.Mike Fitzpatrick's latest letter over-emphasises the personal while flagging up the real difficulties for general practice.3 My work as a frontline GP and my statutory role as a named doctor for safeguarding children allows me to understand these difficulties, and indeed the importance of making vulnerable adults safe that he highlights in the same Journal.4The good news is that the great majority of children grow up well and happy in their families and GP practices support them in this. I emphasise this when delivering safeguarding training to GPs. In doing this work GPs can develop a sense of why something is going wrong. With appropriate use of their knowledge, skills, and information, GPs can address the needs of children and their families across the spectrum of vulnerability and need through to abuse and neglect. There is no question that this is challenging, but in the UK all professionals are obliged by statute to fulfil our professional roles and responsibilities. Those specific to general practice are on pages 60-63 of Working Together to Safeguard Children 2012.5GP colleagues in Cornwall show appreciation of the importance of safeguarding, but many feel there is too much guidance and insufficient resources. The majority of the practices value the RCGP/NSPCC Toolkit for Safeguarding Adults and Young People, that being written for GPs by GPs helps practices establish policies and procedures on safeguarding which work.6 I commend the RCGP for grasping the safeguarding nettle, collaborating with the NSPCC to produce this toolkit, and including safeguarding as one of the ten priorities of the RCGP Child Health Strategy for 2012-15.7 Can the BJGP help the College bring this strategy forward? Up to 25% of our patients are children. They are the future of the UK.

Abu Sayyaf Group (ASG): An Al-Qaeda Associate Case Study

DTIC Science & Technology

2017-10-01

completed in August 2017. In order to conduct this assessment, CNA used a comparative methodology that included eight case studies on groups affiliated...assessment, CNA used a comparative methodology that included eight case studies on groups affiliated or associated with Al-Qaeda. These case studies ...Case Study P. Kathleen Hammerberg and Pamela G. Faber With contributions from Alexander Powell October 2017 This work was performed

OD in Schools: The State of the Art. Vol. IV: Case Studies. Final Report.

ERIC Educational Resources Information Center

Fullan, Michael; And Others

This volume, the fourth of a five-volume series, contains three onsite case studies of organization development (OD) selected from a sample of 76 school districts. The purpose of the case studies was to analyze in detail different types of OD programs and their use. Each case study represents a different OD focus: case study A involves a survey…

World Perspective Case Descriptions on Educational Programs for Adults: Cameroon.

ERIC Educational Resources Information Center

Nyemba, J. A.

This document contains two case studies of adult education programs in Cameroon. Both case studies begin with a "face sheet" on which is recorded basic information about the program and the case study itself. One case study is intended to evaluate the impact of the agricultural university center in the Dschang area from 1977-1987 and to…

Turning to Case Studies as a Mechanism for Learning in Action Learning

ERIC Educational Resources Information Center

O'Leary, Denise; Coughlan, Paul; Rigg, Clare; Coghlan, David

2017-01-01

Case studies are a useful means of capturing and sharing experiential knowledge by allowing researchers to explore the social, organisational and political contexts of a specific case. Although accounts of action learning are often reported using a case study approach, it is not common to see individual case studies being used as a learning…

Making a Case for a Blended Approach: The Need for The Design-Based Case Study

ERIC Educational Resources Information Center

Deaton, Cynthia C. M.; Malloy, Jacquelynn A.

2017-01-01

Design-based case studies address research questions that involve instructional innovations within a bounded system. This blend of case study and design-based research provides a systematic approach to examining instructional innovations that are bounded by perspective, context, and time. Design-based case studies provide a framework for engaging…

The Effect of Using Case Studies in Business Statistics

ERIC Educational Resources Information Center

Pariseau, Susan E.; Kezim, Boualem

2007-01-01

The authors evaluated the effect on learning of using case studies in business statistics courses. The authors divided students into 3 groups: a control group, a group that completed 1 case study, and a group that completed 3 case studies. Results evidenced that, on average, students whom the authors required to complete a case analysis received…

CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

EPA Science Inventory

Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

Pathology informatics fellowship retreats: The use of interactive scenarios and case studies as pathology informatics teaching tools.

PubMed

Lee, Roy E; McClintock, David S; Balis, Ulysses J; Baron, Jason M; Becich, Michael J; Beckwith, Bruce A; Brodsky, Victor B; Carter, Alexis B; Dighe, Anand S; Haghighi, Mehrvash; Hipp, Jason D; Henricks, Walter H; Kim, Jiyeon Y; Klepseis, Veronica E; Kuo, Frank C; Lane, William J; Levy, Bruce P; Onozato, Maristela L; Park, Seung L; Sinard, John H; Tuthill, Mark J; Gilbertson, John R

2012-01-01

Last year, our pathology informatics fellowship added informatics-based interactive case studies to its existing educational platform of operational and research rotations, clinical conferences, a common core curriculum with an accompanying didactic course, and national meetings. The structure of the informatics case studies was based on the traditional business school case study format. Three different formats were used, varying in length from short, 15-minute scenarios to more formal multiple hour-long case studies. Case studies were presented over the course of three retreats (Fall 2011, Winter 2012, and Spring 2012) and involved both local and visiting faculty and fellows. Both faculty and fellows found the case studies and the retreats educational, valuable, and enjoyable. From this positive feedback, we plan to incorporate the retreats in future academic years as an educational component of our fellowship program. Interactive case studies appear to be valuable in teaching several aspects of pathology informatics that are difficult to teach in more traditional venues (rotations and didactic class sessions). Case studies have become an important component of our fellowship's educational platform.

[Case-non case studies: Principles, methods, bias and interpretation].

PubMed

Faillie, Jean-Luc

2017-10-31

Case-non case studies belongs to the methods assessing drug safety by analyzing the disproportionality of notifications of adverse drug reactions in pharmacovigilance databases. Used for the first time in the 1980s, the last few decades have seen a significant increase in the use of this design. The principle of the case-non case study is to compare drug exposure in cases of a studied adverse reaction with that of cases of other reported adverse reactions and called "non cases". Results are presented in the form of a reporting odds ratio (ROR), the interpretation of which makes it possible to identify drug safety signals. This article describes the principle of the case-non case study, the method of calculating the ROR and its confidence interval, the different modalities of analysis and how to interpret its results with regard to the advantages and limitations of this design. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Environmental Technology Verification (ETV) Program Case Studies: Demonstrating Program Outcomes, Volume III

EPA Science Inventory

This booklet, ETV Program Case Studies: Demonstrating Program Outcomes, Volume III contains two case studies, addressing verified environmental technologies for decentalized wastewater treatment and converting animal waste to energy. Each case study contains a brief description ...

Joint Forces Command - Operation United Assistance Case Study: Lessons and Best Practices

DTIC Science & Technology

2016-07-01

additional and prioritized computers and access in the operations center for these mission requirements are essential. 127 JFC-OUA CASE STUDY Issue...this publication is welcomed and highly encouraged. Joint Forces Command – Operation United Assistance Case Study JFC-OUA CASE STUDY iii Foreword...Based on information drawn from various sources including after action reports, lessons learned, case studies , umbrella-week visits, and key-leader

Case Study Teaching

ERIC Educational Resources Information Center

Herreid, Clyde Freeman

2011-01-01

This chapter describes the history of case study teaching, types of cases, and experimental data supporting their effectiveness. It also describes a model for comparing the efficacy of the various case study methods. (Contains 1 figure.)

Case Studies for School Administrators: Managing Change in Education.

ERIC Educational Resources Information Center

Benham, Maenette K. P. Ah Nee

This book examines case-based learning in educational leadership courses, discusses case-based learning as an educational tool, exemplifies methods of writing a case study, and contains 14 case-studies by teachers and administrators. "Stakeholders in a House of Cards," by Audrey Burgher, discusses integrating technology with innovation.…

How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

ERIC Educational Resources Information Center

Fallek, Max

This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

[The case-case-time-control study design].

PubMed

Wang, Jing; Zhuo, Lin; Zhan, Siyan

2014-12-01

Although the 'self-matched case-only studies' (such as the case-cross-over or self-controlled case-series method) can control the time-invariant confounders (measured or unmeasured) through design of the study, however, they can not control those confounders that vary with time. A bidirectional case-crossover design can be used to adjust the exposure-time trends. In the areas of pharmaco-epidemiology, illness often influence the future use of medications, making a bidirectional study design problematic. Suissa's case-time-control design combines the case-crossover and the case-control design which could adjust for exposure-trend bias, but the control group may reintroduce selection bias, if the matching does not go well. We propose a "case-case-time-control" design which is an extension of the case-time-control design. However, rather than using a sample of external controls, we choose those future cases as controls for current cases to counter the bias that arising from temporal trends caused by exposure to the target of interest. In the end of this article we will discuss the strength and limitations of this design based on an applied example.

Real-Life Case Studies for Teachers.

ERIC Educational Resources Information Center

Hayes, William

Case studies described in this book reflect conditions present in today's public schools. Situations described in these case studies are intended to introduce education students to the variety of problems existing in today's schools. The 38 case studies highlight: student cheating; teacher's observation by administrator; inclusion; contract…

The Case Study as Research Heuristic: Lessons from the R&D Value Mapping Project.

ERIC Educational Resources Information Center

Bozeman, Barry; Klein, Hans K.

1999-01-01

Examines the role of prototype case studies as the foundation for later evaluation through two studies from the "R&D Value Mapping Project," a study that will involve more than 30 cases. Explores the usefulness of case studies in defining and assessing subsequent research efforts. (SLD)

A Careful Look at Modern Case Selection Methods

ERIC Educational Resources Information Center

Herron, Michael C.; Quinn, Kevin M.

2016-01-01

Case studies appear prominently in political science, sociology, and other social science fields. A scholar employing a case study research design in an effort to estimate causal effects must confront the question, how should cases be selected for analysis? This question is important because the results derived from a case study research program…

Case-control studies in neurosurgery.

PubMed

Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

2014-08-01

Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure/intervention and true case-control studies was strengthened (OR 0.053, 95% CI 0.0064-0.44). There was a trend toward a negative association between the use of survival analysis or Kaplan-Meier curves and true case-control studies (OR 0.13, 95% CI 0.015-1.12). True case-control studies were no more likely than their counterparts to use a potential study design "expert" (OR 1.50, 95% CI 0.57-3.95). The overall average STROBE score was 72% (range 50-86%). Examples of reporting deficiencies were reporting of bias (28%), missing data (55%), and funding (44%). The results of this analysis show that the majority of studies in the neurosurgical literature that identify themselves as "case-control" studies are, in fact, labeled incorrectly. Positive and negative predictors were identified. The authors provide several recommendations that may reverse the incorrect and inappropriate use of the term "case-control" and improve the quality of design and reporting of true case-control studies in neurosurgery.

Methodology Series Module 2: Case-control Studies.

PubMed

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias.

Arsenic Removal - Adsorptive Media and Coagulation/Filtration Case Studies - Slides

EPA Science Inventory

This presentation provides information on the results of three case studies from USEPA arsenic demonstration program. The first case study presented is on the Rimrock, AZ project that used an adsorptive media technology (E33 media) to remove arsenic. The second case study is o...

Arsenic Removal: Adsorptive Media and Coagulation/Filtration Case Studies

EPA Science Inventory

This presentation provides information on the results of three case studies from USEPA arsenic demonstration program. The first case study presented is on the Rimrock, AZ project that used an adsorptive media technology (E33 media) to remove arsenic. The second case study is on...

Putting Words in Their Mouth: Writing Dialogue for Case Studies

ERIC Educational Resources Information Center

Herreid, Clyde Freeman

2018-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This issue discusses dialogue writing guidelines most relevant to case writing.

Comparison of Estimates between Cohort and Case-Control Studies in Meta-Analyses of Therapeutic Interventions: A Meta-Epidemiological Study.

PubMed

Lanza, Amy; Ravaud, Philippe; Riveros, Carolina; Dechartres, Agnes

2016-01-01

Observational studies are increasingly being used for assessing therapeutic interventions. Case-control studies are generally considered to have greater risk of bias than cohort studies, but we lack evidence of differences in effect estimates between the 2 study types. We aimed to compare estimates between cohort and case-control studies in meta-analyses of observational studies of therapeutic interventions by using a meta-epidemiological study. We used a random sample of meta-analyses of therapeutic interventions published in 2013 that included both cohort and case-control studies assessing a binary outcome. For each meta-analysis, the ratio of estimates (RE) was calculated by comparing the estimate in case-control studies to that in cohort studies. Then, we used random-effects meta-analysis to estimate a combined RE across meta-analyses. An RE < 1 indicated that case-control studies yielded larger estimates than cohort studies. The final analysis included 23 meta-analyses: 138 cohort and 133 case-control studies. Treatment effect estimates did not significantly differ between case-control and cohort studies (combined RE 0.97 [95% CI 0.86-1.09]). Heterogeneity was low, with between-meta-analysis variance τ2 = 0.0049. Estimates did not differ between case-control and prospective or retrospective cohort studies (RE = 1.05 [95% CI 0.96-1.15] and RE = 0.99 [95% CI, 0.83-1.19], respectively). Sensitivity analysis of studies reporting adjusted estimates also revealed no significant difference (RE = 1.03 [95% CI 0.91-1.16]). Heterogeneity was also low for these analyses. We found no significant difference in treatment effect estimates between case-control and cohort studies assessing therapeutic interventions.

Global dengue death before and after the new World Health Organization 2009 case classification: A systematic review and meta-regression analysis.

PubMed

Low, Gary Kim-Kuan; Ogston, Simon A; Yong, Mun-Hin; Gan, Seng-Chiew; Chee, Hui-Yee

2018-06-01

Since the introduction of 2009 WHO dengue case classification, no literature was found regarding its effect on dengue death. This study was to evaluate the effect of 2009 WHO dengue case classification towards dengue case fatality rate. Various databases were used to search relevant articles since 1995. Studies included were cohort and cross-sectional studies, all patients with dengue infection and must report the number of death or case fatality rate. The Joanna Briggs Institute appraisal checklist was used to evaluate the risk of bias of the full-texts. The studies were grouped according to the classification adopted: WHO 1997 and WHO 2009. Meta-regression was employed using a logistic transformation (log-odds) of the case fatality rate. The result of the meta-regression was the adjusted case fatality rate and odds ratio on the explanatory variables. A total of 77 studies were included in the meta-regression analysis. The case fatality rate for all studies combined was 1.14% with 95% confidence interval (CI) of 0.82-1.58%. The combined (unadjusted) case fatality rate for 69 studies which adopted WHO 1997 dengue case classification was 1.09% with 95% CI of 0.77-1.55%; and for eight studies with WHO 2009 was 1.62% with 95% CI of 0.64-4.02%. The unadjusted and adjusted odds ratio of case fatality using WHO 2009 dengue case classification was 1.49 (95% CI: 0.52, 4.24) and 0.83 (95% CI: 0.26, 2.63) respectively, compared to WHO 1997 dengue case classification. There was an apparent increase in trend of case fatality rate from the year 1992-2016. Neither was statistically significant. The WHO 2009 dengue case classification might have no effect towards the case fatality rate although the adjusted results indicated a lower case fatality rate. Future studies are required for an update in the meta-regression analysis to confirm the findings. Copyright © 2018 Elsevier B.V. All rights reserved.

Business and Consumer Education Case Studies.

ERIC Educational Resources Information Center

Delta Pi Epsilon, Minneapolis, Minn. Phi Chapter.

This publication contains 58 case studies for classroom use in teaching various business and consumer education subjects at the high school level. A supplement to a previous Phi Chapter publication, "Office Education Case Studies" (1973), the case studies are intended to create class discussions and help students acquire the ability to analyze…

75 FR 11183 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-10

... technology. Written comments should be received within 60 days of this notice. Proposed Project Case Studies... case studies of six CPPW-funded states and 15 CPPW-funded communities. The case study sites will be... region, and targeted population. Case study information will be collected by conducting personal...

75 FR 51806 - Climate Change Vulnerability Assessment: Four Case Studies of Water Utility Practices

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-23

... case studies describing the approaches currently being taken by four water utilities to assess their... series of case studies describing the approaches currently being taken by four water utilities in the... Vulnerability Assessment: Four Case Studies of Water Utility Practices AGENCY: Environmental Protection Agency...

Natural Learning Case Study Archives

ERIC Educational Resources Information Center

Lawler, Robert W.

2015-01-01

Natural Learning Case Study Archives (NLCSA) is a research facility for those interested in using case study analysis to deepen their understanding of common sense knowledge and natural learning (how the mind interacts with everyday experiences to develop common sense knowledge). The database comprises three case study corpora based on experiences…

Paradise nearly Gained. Volume 2: Case Studies of Impact and Diversity for Frontline Management Initiative Practice.

ERIC Educational Resources Information Center

Barratt-Pugh, Llandis; Soutar, Geoffrey N.

This document presents the case studies from a multi-phase study of the impact of Australia's Frontline Management Initiative (FMI), which provides a framework for competency-based development of frontline managers in Australian enterprises. Nineteen organizational case studies and one individual case study of the FMI's impacts are included. The…

Developing and pretesting case studies in dental and dental hygiene education: using the diffusion of innovations model.

PubMed

Cragun, Deborah L; DeBate, Rita DiGioacchino; Severson, Herbert H; Shaw, Tracy; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; Brown, Kelli McCormack; Tedesco, Lisa A; Hendricson, William D

2012-05-01

Case-based learning offers exposure to clinical situations that health professions students may not encounter in their training. The purposes of this study were to apply the Diffusion of Innovations conceptual framework to 1) identify characteristics of case studies that would increase their adoption among dental and dental hygiene faculty members and 2) develop and pretest interactive web-based case studies on sensitive oral-systemic health issues. The formative study spanned two phases using mixed methods (Phase 1: eight focus groups and four interviews; Phase 2: ten interviews and satisfaction surveys). Triangulation of quantitative and qualitative data revealed the following positive attributes of the developed case studies: relative advantage of active learning and modeling; compatibility with a variety of courses; observability of case-related knowledge and skills; independent learning; and modifiability for use with other oral-systemic health issues. These positive attributes are expected to increase the likelihood that dental and dental hygiene faculty members will adopt the developed case study once it is available for use. The themes identified in this study could be applied to the development of future case studies and may provide broader insight that might prove useful for exploring differences in case study use across dental and dental hygiene curricula.

Case Study: What Makes a Good Case, Revisited: The Survey Monkey Tells All

ERIC Educational Resources Information Center

Herried, Clyde Freeman; Prud'homme-Genereux, Annie; Schiller, Nancy A.; Herreid, Ky F.; Wright, Carolyn

2016-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. In this month's issue the authors provide a more definitive answer to the "What Makes a Good Case?" question based on a just-completed Survey Monkey survey given to NCCSTS teachers.

Theoretical pluralism in psychoanalytic case studies.

PubMed

Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D

2015-01-01

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

Theoretical pluralism in psychoanalytic case studies

PubMed Central

Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.

2015-01-01

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725

[A clinical study of PC-904 in pediatrics (author's transl)].

PubMed

Hori, M; Kono, S; Hashimoto, F

1978-07-01

A clinical study of PC-904 was performed in children. The results were as follows; 1) Serum levels of PC-904 after single administration of 20 mg/kg were studied in patients by one-shot intravenous injection or drip infusion for 1 hour or 2 hours. The results obtained in this fundamental study led to the suggestion that the proper dosage in bacterial infections would be 50 approximately 100 mg/kg intravenously in 3 approximately 4 divided doses daily. 2) A clinical study of PC-904 was performed in 16 patients including acute pharyngitis and bronchitis (3 cases), acute bronchopneumonia (3 cases), pertussis pneumonia (1 case), lymphadenitis purulenta (2 cases), acute bronchopneumonia (3 cases), pertussis pneumonia (1 case), lymphadenitis purulenta (2 cases), abscess with chronic granuloma (2 cases) and urinary tract infection (5 cases). About 50 approximately 100 mg/kg of PC-904 were administered in 3 approximately 4 divided doses daily by one-shot intravenous injection. The clinical effects of 2 cases out of 16 were impossible to be evaluated, and thses cases were excluded from the clinical evaluation. Ten cases out of 14 showed excellent or good responses (efficacy rate: 71.4%). 3) The bacteriological examinations were performed and the causative or isolated organisms were determined in 11 cases. The responses were "disappeared" in 6 cases, "decreased" in 2 cases and "not disappeared" in 3 cases. 4) No side effects were observed. Abnormalities of laboratory findings were not also noticed.

Pathology analysis for mesothelioma study in the United Kingdom: Current practice and historical development.

PubMed

Case, B W

2016-01-01

Following up on the largest case-control study of malignant mesothelioma yet performed, investigators at the London School of Hygiene and Tropical Medicine assessed 1732 male and 670 female cases as of May 2013. Epidemiological findings of a subset of these were published previously, excluding patients who died or who refused to be interviewed. Pathology reports were collected for subjects, including those both eligible and ineligible for epidemiology study based on vital status. The current investigation examined 860 cases having pathology reports available. Sixty-one cases were diagnosed using cytology only, often with equivocal diagnoses, while 799 reported at least a biopsy of the tumor. Of these, 748 had pathology sufficiently detailed for evaluation. These reports were examined for basis of diagnosis, differences between study cases and ineligible cases, pathology characteristics, and immunohistochemical and other tests used. The most prominent subtype was epithelioid (64% of study cases but only 49% of ineligible cases). Biphasic subtype was present in 10% of study cases and 16% of those ineligible. Sarcomatoid subtype was present in 7% of study cases and 19% of ineligible cases, most of whom died. Twelve percent of study cases displayed no specified subtype, versus 7% of ineligible cases. Of recorded immunohistochemical stains specific for mesothelial cell origin, calretinin (95%) and CK 5/6 or CK5 alone (84%) were by far the most common. Calretinin and CK 5/6 or CK 5 alone were also most sensitive and positive in 92% of cases presenting with surgical pathology report. Ninety percent of cases had at least one immunohistochemical marker for possible lung carcinoma applied, with BER-Ep4 and TTF-1 the most frequent at 68% and CEA at 58%. TTF-1 and CEA were positive in 1% or less of cases. Patterns of use and positive and negative results for each of these as well as other immunohistochemical stains are presented and discussed, along with a brief historical description of their development and use. Possible effects of the pathologic analysis on the results of previously published and future epidemiological studies are discussed.

CRIS Case Study Materials in Ethical Decision Making.

ERIC Educational Resources Information Center

Blanning, James R.

Designed for secondary-level classroom discussion, these materials contain nine, short case studies of ethical dilemmas. The cast studies focus mainly on incidents and issues relevant to high school students. Discussion questions for each case study require students to examine the case, discuss the issue, and make an ethical decision about how…

Case Study: The Chemistry of Cocaine

ERIC Educational Resources Information Center

Dewprashad, Brahmadeo

2011-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

Interpretive Research Aiming at Theory Building: Adopting and Adapting the Case Study Design

ERIC Educational Resources Information Center

Diaz Andrade, Antonio

2009-01-01

Although the advantages of case study design are widely recognised, its original positivist underlying assumptions may mislead interpretive researchers aiming at theory building. The paper discusses the limitations of the case study design for theory building and explains how grounded theory systemic process adds to the case study design. The…

Using Case Studies in the Introductory Public Relations Course.

ERIC Educational Resources Information Center

Adams, William C.

The case study method has received increased attention at both the graduate and undergraduate levels in a number of public relations programs. Unlike the Harvard managerial-oriented case studies, the approach useful in large, introductory public relations courses stems from a simplified team approach to classroom projects, case studies in the…

Peace Corps Water/Sanitation Case Studies and Analyses. Appropriate Technologies for Development. Case Study CS-4.

ERIC Educational Resources Information Center

Talbert, Diana E., Comp.

This document provides an overview of Peace Corps water and sanitation activities, five case studies (Thailand, Yemen, Paraguay, Sierra Leone, and Togo), programming guidelines, and training information. Each case study includes: (1) background information on the country's geography, population, and economics; (2) information on the country's…

Role of matching in case-control studies of antimicrobial resistance.

PubMed

Cerceo, Elizabeth; Lautenbach, Ebbing; Linkin, Darren R; Bilker, Warren B; Lee, Ingi

2009-05-01

Of 57 case-control studies of antimicrobial resistance, matching was used in 23 (40%). Matched variables differed substantially across studies. Of these 23 matched case-control studies, 12 (52%) justified the use of matching, and 9 (39%) noted the strengths or limitations of this approach. Analysis that accounted for matching was performed in only 52% of the case-control studies.

Evaluating Creative Thinking of Rn-Bsn Students in the Course of Clinical Case Study and Practicum

ERIC Educational Resources Information Center

Ku, Ya-Lie

2015-01-01

This case study evaluated creative thinking of RN-BSN students in the course of clinical case study and practicum. Study design used quantitative and qualitative evaluations of creative thinking of RN-BSN students by triangulation method in the course of clinical case study and practicum. Sixty RN-BSN students self-perceived the changing levels of…

Schematic representation of case study research designs.

PubMed

Rosenberg, John P; Yates, Patsy M

2007-11-01

The paper is a report of a study to demonstrate how the use of schematics can provide procedural clarity and promote rigour in the conduct of case study research. Case study research is a methodologically flexible approach to research design that focuses on a particular case - whether an individual, a collective or a phenomenon of interest. It is known as the 'study of the particular' for its thorough investigation of particular, real-life situations and is gaining increased attention in nursing and social research. However, the methodological flexibility it offers can leave the novice researcher uncertain of suitable procedural steps required to ensure methodological rigour. This article provides a real example of a case study research design that utilizes schematic representation drawn from a doctoral study of the integration of health promotion principles and practices into a palliative care organization. The issues discussed are: (1) the definition and application of case study research design; (2) the application of schematics in research; (3) the procedural steps and their contribution to the maintenance of rigour; and (4) the benefits and risks of schematics in case study research. The inclusion of visual representations of design with accompanying explanatory text is recommended in reporting case study research methods.

Case Reports, Case Series - From Clinical Practice to Evidence-Based Medicine in Graduate Medical Education.

PubMed

Sayre, Jerry W; Toklu, Hale Z; Ye, Fan; Mazza, Joseph; Yale, Steven

2017-08-07

Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education. Despite their limitations, case study research is a beneficial tool and learning experience in graduate medical education and among novice researchers. The preparation and presentation of case studies can help students and graduate medical education programs evaluate and apply the six American College of Graduate Medical Education (ACGME) competencies in the areas of medical knowledge, patient care, practice-based learning, professionalism, systems-based practice, and communication. A goal in graduate medical education should be to assist residents to expand their critical thinking, problem-solving, and decision-making skills. These attributes are required in the teaching and practice of EBM. In this aspect, case studies provide a platform for developing clinical skills and problem-based learning methods. Hence, graduate medical education programs should encourage, assist, and support residents in the publication of clinical case studies; and clinical teachers should encourage graduate students to publish case reports during their graduate medical education.

Methodology Series Module 2: Case-control Studies

PubMed Central

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same ‘study base’ as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias. PMID:27057012

Case-Control Studies of Sporadic Enteric Infections: A Review and Discussion of Studies Conducted Internationally from 1990 to 2009

PubMed Central

Fullerton, Kathleen E.; Scallan, Elaine; Kirk, Martyn D.; Mahon, Barbara E.; Angulo, Frederick J.; de Valk, Henriette; van Pelt, Wilfrid; Gauci, Charmaine; Hauri, Anja M.; Majowicz, Shannon; O’Brien, Sarah J.

2015-01-01

Epidemiologists have used case-control studies to investigate enteric disease outbreaks for many decades. Increasingly, case-control studies are also used to investigate risk factors for sporadic (not outbreak-associated) disease. While the same basic approach is used, there are important differences between outbreak and sporadic disease settings that need to be considered in the design and implementation of the case-control study for sporadic disease. Through the International Collaboration on Enteric Disease “Burden of Illness” Studies (the International Collaboration), we reviewed 79 case-control studies of sporadic enteric infections caused by nine pathogens that were conducted in 22 countries and published from 1990 through to 2009. We highlight important methodological and study design issues (including case definition, control selection, and exposure assessment) and discuss how approaches to the study of sporadic enteric disease have changed over the last 20 years (e.g., making use of more sensitive case definitions, databases of controls, and computer-assisted interviewing). As our understanding of sporadic enteric infections grows, methods and topics for case-control studies are expected to continue to evolve; for example, advances in understanding of the role of immunity can be used to improve control selection, the apparent protective effects of certain foods can be further explored, and case-control studies can be used to provide population-based measures of the burden of disease. PMID:22443481

Case studies in pathophysiology: The development and evaluation of an interactive online learning environment to develop higher order thinking and argumentation

NASA Astrophysics Data System (ADS)

Titterington, Lynda C.

2007-12-01

This study presents a framework for examining the effects of higher order thinking on the achievement of allied health students enrolled in a pathophysiology course. A series of clinical case studies was developed and published in an enriched online environment that guided students through the process of developing a solution and supporting it through data analysis and interpretation. The series of case study modules scaffolded argumentation through question prompts. The modules began with a simple, direct problem and they became progressively more complex throughout the quarter. A control group was assigned a pencil-and-paper case study based upon recall. The case studies were scored for content accuracy and evidence of higher order thinking skills. Higher order thinking was measured using a rubric based upon the Toulmin argumentation pattern. The results indicated implementing a case study of either online or traditional format was associated with significant gains in achievement. The Web-enhanced case studies were associated with modest gains in knowledge acquisition. The argumentation scores across the series followed two trends: directed case studies were associated with higher levels of argumentation than ill-structured case studies, and there appeared to be an inverse relationship between the students' argumentation and content scores. The protocols developed for this study can serve as a template for a larger, extended investigation into student learning in the online environment.

[Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies].

PubMed

Müller-Staub, Maria; Stuker-Studer, Ursula

2006-10-01

Case studies, based on actual patients' situations, provide a method of clinical decision making to foster critical thinking in nurses. This paper describes the method and process of group case studies applied in continuous education settings. This method bases on Balints' case supervision and was further developed and combined with the nursing diagnostic process. A case study contains different phases: Pre-phase, selection phase, case delineation and case work. The case provider narratively tells the situation of a patient. This allows the group to analyze and cluster signs and symptoms, to state nursing diagnoses and to derive nursing interventions. Results of the case study are validated by applying the theoretical background and critical appraisal of the case provider. Learning effects of the case studies were evaluated by means of qualitative questionnaires and analyzed according to Mayring. Findings revealed the following categories: a) Patients' problems are perceived in a patient centred way, accurate nursing diagnoses are stated and effective nursing interventions implemented. b) Professional nursing tasks are more purposefully perceived and named more precise. c) Professional nursing relationship, communication and respectful behaviour with patients were perceived in differentiated ways. The theoretical framework is described in the paper "Clinical decision making and critical thinking in the nursing diagnostic process". (Müller-Staub, 2006).

A Review of Case-Based Learning Practices in an Online MBA Program: A Program-Level Case Study

ERIC Educational Resources Information Center

Lee, Seung-hee; Lee, Jieun; Liu, Xiaojing; Bonk, Curt J.; Magjuka, Richard J.

2009-01-01

This study examines how a case-based learning approach was used and facilitated in online business education. Perceptions of students and instructors regarding the practices of case-based learning in online environments are explored in terms of instructional design, facilitation, and technology support. This study finds case-based learning to be a…

In Case You Are Interested: Results of a Survey of Case Study Teachers

ERIC Educational Resources Information Center

Herreid, Clyde Freeman; Schiller, Nancy A.; Herreid, Ky F.; Wright, Carolyn

2011-01-01

Case study teaching had a long tradition in law and business before it made the jump to medical school education in the form of Problem-Based Learning (PBL) in the 1970s. Today, both the University of Delaware's Clearinghouse and the University of Buffalo's National Center for Case Study Teaching in Science (NCCSTS) have hundreds of cases and…

Teaching Business French through Case Studies: Presentation of a Marketing Case.

ERIC Educational Resources Information Center

Federico, Salvatore; Moore, Catherine

The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

Cases for the Net Generation: An Empirical Examination of Students' Attitude toward Multimedia Case Studies

ERIC Educational Resources Information Center

Sheppard, Michael; Vibert, Conor

2016-01-01

Case studies have been an important tool in business, legal, and medical education for generations of students. Traditional text-based cases tend to be self-contained and structured in such a way as to teach a particular concept. The multimedia cases introduced in this study feature unscripted web-hosted video interviews with business owners and…

Swiss Armed Forces Organizational Level Leader Development: A Qualitative Case Study

DTIC Science & Technology

2017-06-09

chapter, divided in five distinct parts, describes the chosen research methodology , explain why the qualitative case study is appropriate to conduct...research study uses a qualitative methodology by performing a qualitative case study on the organizational level leader’s development process within...develop an in-depth understsanding of the phenomen.”82 Summary This research study uses a qualitative methodology by performing a case study on the

Exchangeability in the case-crossover design

PubMed Central

Mittleman, Murray A; Mostofsky, Elizabeth

2014-01-01

In cohort and case-control studies, confounding that arises as a result of differences in the distribution of determinants of the outcome between exposure groups leading to non-exchangeability are addressed by restriction, matching or with statistical models. In case-only studies, this issue is addressed by comparing each individual with his/herself. Although case-only designs use self-matching and only include individuals who develop the outcome of interest, issues of non-exchangeability are identical to those that arise in traditional case-control and cohort studies. In this review, we describe one type of case-only design, the case-crossover design, and discuss how the concept of exchangeability can be used to understand issues of confounding, carryover effects, period effects and selection bias in case-crossover studies. PMID:24756878

Transportation planning effectiveness: twenty case studies

DOT National Transportation Integrated Search

1977-12-31

This document consists of 20 site-specific case studies of urban area experience with the Technical Study Grant Program of the Urban Mass Transportation Administration (UMTA). The objective of the case studies is to determine how the Technical Study ...

An alternative approach for socio-hydrology: case study research

NASA Astrophysics Data System (ADS)

Mostert, Erik

2018-01-01

Currently the most popular approach in socio hydrology is to develop coupled human-water models. This article proposes an alternative approach, qualitative case study research, involving a systematic review of (1) the human activities affecting the hydrology in the case, (2) the main human actors, and (3) the main factors influencing the actors and their activities. Moreover, this article presents a case study of the Dommel Basin in Belgium and the Netherlands, and compares this with a coupled model of the Kissimmee Basin in Florida. In both basins a pendulum swing from water resources development and control to protection and restoration can be observed. The Dommel case study moreover points to the importance of institutional and financial arrangements, community values, and broader social, economic, and technical developments. These factors are missing from the Kissimmee model. Generally, case studies can result in a more complete understanding of individual cases than coupled models, and if the cases are selected carefully and compared with previous studies, it is possible to generalize on the basis of them. Case studies also offer more levers for management and facilitate interdisciplinary cooperation. Coupled models, on the other hand, can be used to generate possible explanations of past developments and quantitative scenarios for future developments. The article concludes that, given the limited attention they currently get and their potential benefits, case studies deserve more attention in socio-hydrology.

Human exploration mission studies

NASA Technical Reports Server (NTRS)

Cataldo, Robert L.

1989-01-01

The Office of Exploration has established a process whereby all NASA field centers and other NASA Headquarters offices participate in the formulation and analysis of a wide range of mission strategies. These strategies were manifested into specific scenarios or candidate case studies. The case studies provided a systematic approach into analyzing each mission element. First, each case study must address several major themes and rationale including: national pride and international prestige, advancement of scientific knowledge, a catalyst for technology, economic benefits, space enterprise, international cooperation, and education and excellence. Second, the set of candidate case studies are formulated to encompass the technology requirement limits in the life sciences, launch capabilities, space transfer, automation, and robotics in space operations, power, and propulsion. The first set of reference case studies identify three major strategies: human expeditions, science outposts, and evolutionary expansion. During the past year, four case studies were examined to explore these strategies. The expeditionary missions include the Human Expedition to Phobos and Human Expedition to Mars case studies. The Lunar Observatory and Lunar Outpost to Early Mars Evolution case studies examined the later two strategies. This set of case studies established the framework to perform detailed mission analysis and system engineering to define a host of concepts and requirements for various space systems and advanced technologies. The details of each mission are described and, specifically, the results affecting the advanced technologies required to accomplish each mission scenario are presented.

How informative are case studies of spider bites in the medical literature?

PubMed

Stuber, Marielle; Nentwig, Wolfgang

2016-05-01

We analyzed the reliability and information content of 134 medical case studies on spider bites, published in 91 journal articles. Overall, we found that only 22% of these studies fulfilled the criteria for a verified spider bite. This means that the majority of such case studies cannot be attributed to a given spider species and usually not even to a spider. Their scientific value is negligible, moreover, such publications are even dangerous because they suggest incorrect conclusions. Secondly, we found that such case studies usually do not follow an obvious structure and many details on the development of symptoms, therapy and healing process are widely lacking. So even for verified spider bites, the comparability of case studies is limited. We discuss the obvious failure of a reviewing process for case studies and give recommendations how to increase the currently low information content of medical case studies on spider bites. Copyright © 2016 Elsevier Ltd. All rights reserved.

Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

PubMed

Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

2017-06-01

Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

Statin-Associated Polymyalgia Rheumatica. An Analysis Using WHO Global Individual Case Safety Database: A Case/Non-Case Approach

PubMed Central

de Jong, Hilda J. I.; Saldi, Siti R. F.; Klungel, Olaf H.; Vandebriel, Rob J.; Souverein, Patrick C.; Meyboom, Ronald H. B.; Passier, J. L. M. (Anneke); van Loveren, Henk; Tervaert, Jan Willem Cohen

2012-01-01

Objective To assess whether there is an association between statin use and the occurrence of polymyalgia rheumatic (PMR) in the spontaneous reporting database of the World Health Organisation (WHO). Methods We conducted a case/non-case study based on individual case safety reports (ICSR) in the WHO global ICSR database (VigiBase). Case reports containing the adverse event term polymyalgia rheumatica (WHOART or MedDRA Preferred Term) were defined as cases. Non-cases were all case reports containing other adverse event terms. Each case was matched to five non-cases by age, gender, and time of reporting. Case reports regarding a statin as suspected or concomitant drug were identified using the Anatomical Therapeutic Chemical (ATC) classification. Multivariate logistic regression was used to calculate reporting odds ratios (RORs) with 95% confidence intervals (CI). Results We identified 327 reports of PMR as cases and 1635 reports of other ADRs as non-cases. Among cases, statins were more frequently reported as suspected agent (29.4%) compared to non-cases (2.9%). After adjustment for several covariates, statins were significantly associated with reports of PMR (ROR 14.21; 95% CI 9.89–20.85). Conclusion The results of this study lends support to previous anecdotal case reports in the literature suggesting that the use of a statin may be associated with the occurrence of PMR. Further studies are needed to study the strength of the association in more detail and to elucidate the underlying mechanism. PMID:22844450

An Arizona Border Wall Case Study

DTIC Science & Technology

2017-12-01

WALL CASE STUDY by Justin Alexander Bristow December 2017 Thesis Advisor: Erik Dahl Second Reader: Jorge Gonzalez THIS PAGE...4. TITLE AND SUBTITLE AN ARIZONA BORDER WALL CASE STUDY 5. FUNDING NUMBERS 6. AUTHOR(S) Justin Alexander Bristow 7. PERFORMING ORGANIZATION...PAGE INTENTIONALLY LEFT BLANK iii Approved for public release. Distribution is unlimited. AN ARIZONA BORDER WALL CASE STUDY Justin Alexander

22 CFR 96.47 - Preparation of home studies in incoming cases.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Preparation of home studies in incoming cases... Cases) § 96.47 Preparation of home studies in incoming cases. (a) The agency or person ensures that a home study on the prospective adoptive parent(s) (which for purposes of this section includes the...

22 CFR 96.47 - Preparation of home studies in incoming cases.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Preparation of home studies in incoming cases... Cases) § 96.47 Preparation of home studies in incoming cases. (a) The agency or person ensures that a home study on the prospective adoptive parent(s) (which for purposes of this section includes the...

22 CFR 96.47 - Preparation of home studies in incoming cases.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Preparation of home studies in incoming cases... Cases) § 96.47 Preparation of home studies in incoming cases. (a) The agency or person ensures that a home study on the prospective adoptive parent(s) (which for purposes of this section includes the...

22 CFR 96.47 - Preparation of home studies in incoming cases.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Preparation of home studies in incoming cases... Cases) § 96.47 Preparation of home studies in incoming cases. (a) The agency or person ensures that a home study on the prospective adoptive parent(s) (which for purposes of this section includes the...

22 CFR 96.47 - Preparation of home studies in incoming cases.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Preparation of home studies in incoming cases... Cases) § 96.47 Preparation of home studies in incoming cases. (a) The agency or person ensures that a home study on the prospective adoptive parent(s) (which for purposes of this section includes the...

Security Quality Requirements Engineering (SQUARE): Case Study Phase III

DTIC Science & Technology

2006-05-01

Security Quality Requirements Engineering (SQUARE): Case Study Phase III Lydia Chung Frank Hung Eric Hough Don Ojoko-Adams Advisor...Engineering (SQUARE): Case Study Phase III CMU/SEI-2006-SR-003 Lydia Chung Frank Hung Eric Hough Don Ojoko-Adams Advisor Nancy R. Mead...1 1.1 The SQUARE Process ............................................................................... 1 1.2 Case Study Clients

Executive Headteachers: What's in a Name? Case Study Compendium

ERIC Educational Resources Information Center

Wespieser, Karen, Ed.

2016-01-01

This Case Study Compendium provides an overview of the 12 cases that were investigated as part of the study "Executive Headteachers: What's in a Name?'" (Lord et al., 2016). The case study overviews are based on in-depth analysis and research as described in the full report (ibid) and the Technical Appendix (Harland and Bernardinelli,…

Guidelines for Using Case Studies in the Teaching-Learning Process

ERIC Educational Resources Information Center

McFarlane, Donovan A.

2015-01-01

In this paper, the author expresses concerns regarding the extensive use of case studies in the college classroom and advises college and university faculties to be more careful in their selection and use of case studies as an effective­-based method of teaching. The author communicates the important role that case studies play in teaching and…

Bewitching Ideas Influence Learning: An Evaluation of an Interdisciplinary Teaching Experience

ERIC Educational Resources Information Center

Nava-Whitehead, Susan M.; Augusto, Kerri W.; Gow, Joan-Beth

2011-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. In this month's issue the authors describe an interdisciplinary approach to case study teaching that addresses the demand to balance the goals of process and content. The case study, Salem's Secrets…

78 FR 39769 - National Register of Historic Places; Notification of Pending Nominations and Related Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-02

... Chautauqua Blvd., Los Angeles, 13000513 Community Clubhouse, 1200 N. Vista St., West Hollywood, 13000510... Study House No. 23A, (Case Study House Program MPS) 2342 Rue de Anne, La Jolla, 13000520 Case Study House No. 23C, (Case Study House Program MPS) 2339 Rue de Anne, La Jolla, 13000521 Ventura County Case...

Integrated Approaches to Testing and Assessment Under ...

EPA Pesticide Factsheets

Presentation on IATA case study for phenols which is joint project with Health Canada and NCCT, presented at the OECD IATA Case Study Meeting No. 2 in Paris, France. Presentation on IATA case study for phenols which is joint project with Health Canada and NCCT, presented at the OECD IATA Case Study Meeting No. 2 in Paris, France.

Effectiveness of Three Case Studies and Associated Teamwork in Stimulating Freshman Interest in an Introduction to Engineering Course

ERIC Educational Resources Information Center

McIntyre, Joseph S.

2011-01-01

The effectiveness of three case studies and associated teamwork to stimulate interest of college freshman in engineering was investigated by observing students. Case studies were assigned as laboratory team exercises in an introduction to engineering course at Auburn University. Student interest in the case studies was evaluated qualitatively…

A Case Study of Project ATHENA: Tactical Level Technological Innovation Aboard the USS Benfold

DTIC Science & Technology

2014-12-01

case studies , grounded theory research , phenomenological research and narrative research . 13 3. Qualitative Methods : Selection The researcher’s...12 B. THE CASE STUDY METHOD 1. Introduction The case study is a type of qualitative research that enables the researcher to chronicle and...objectives and the research environment ultimately determine the

76 FR 71341 - BASINS and WEPP Climate Assessment Tools: Case Study Guide to Potential Applications

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

... report presents a series of short case studies designed to illustrate the capabilities of these tools for... change impacts on water. This report presents a series of short case studies using the BASINS and WEPP climate assessment tools. The case studies are designed to illustrate the capabilities of these tools for...

Al-Qaeda-Syria (AQS): An Al-Qaeda Affiliate Case Study

DTIC Science & Technology

2017-10-01

comparative methodology that included eight case studies on groups affiliated or associated with Al-Qaeda. These case studies were then used as a...Case Study Zack Gold With contributions from Pamela G. Faber October 2017 This work was performed under Federal Government...for Stability and Development Center for Strategic Studies REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden

Silicosis in Sandblasters: A Case Study Adapted for Use in U.S. High Schools. NIOSH Case Study in Occupational Epidemiology.

ERIC Educational Resources Information Center

Malit, Bonita D.

This document presents a case study of silicosis in sandblasters that has been adapted for instructional use in U.S. high schools. The primary objective of the case study is to teach students about epidemiology by studying an occupational hazard, disease associated with the hazard, and methods for preventing the disease. The introduction offers…

Risk Management and Performance in the Balkans Support Contract

DTIC Science & Technology

2005-01-01

Defense contracts-United States-Case studies . 2. United States. Army- Procurement-Case studies . 3. Bosnia and Hercegovina-History, Military-20ts...24 3.1. Assessment of GAO Cost Study .................................. 72 3.2. Comparison of Potential Sources of Nonperformance...accepting inappropriate risks, what can it do about it? Case studies of CSS contracts can provide some answers. In this report, we present a case study of

Putting the Learning in Case Learning? The Effects of Case-Based Approaches on Student Knowledge, Attitudes, and Engagement

ERIC Educational Resources Information Center

Krain, Matthew

2016-01-01

This study revisits case learning's effects on student engagement and assesses student learning as a result of the use of case studies and problem-based learning. The author replicates a previous study that used indirect assessment techniques to get at case learning's impact, and then extends the analysis using a pre- and post-test experimental…

Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies

ERIC Educational Resources Information Center

Pai, Aditi

2014-01-01

A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

Participative Case Studies: Integrating Case Writing and a Traditional Case Study Approach in a Marketing Context

ERIC Educational Resources Information Center

Forman, Howard

2006-01-01

Case-based pedagogy is a valuable tool for applying business concepts and theories to organizational contexts. Traditional case-based pedagogy offers such learning opportunities. What this pedagogy lacks, however, is an element of real-time experiential learning opportunities. This research focuses on the advantages of incorporating a case-writing…

In Case You Teach English: Case Studies in the English Classroom.

ERIC Educational Resources Information Center

Johannessen, Larry R.

Case studies can be a powerful strategy to use for helping students learn critical thinking processes that are key to interpreting and responding to literature and writing. Some of the major benefits of applying case methods are: cases provide an environment for active learning; they encourage the creation of a community of learners; cases help…

Using Case Studies to Enrich Field Experience.

ERIC Educational Resources Information Center

Florio-Ruane, Susan; Clark, Christopher M.

1990-01-01

This paper discusses the use of field experience in teacher education and how it can be augmented by phenomenological case studies. It summarizes a particular case study involving three teacher education classes, noting that reflective analysis of cases can prepare students to observe in the field. (SM)

Pathological characteristics and clinical specifications in gastroenteropancreatic neuroendocrine tumors: a study of 68 cases.

PubMed

Stoica-Mustafa, Elena; Pechianu, C; Iorgescu, Andreea; Hortopan, Monica; Dima, Simona Olimpia; Tomulescu, V; Dumitraşcu, T; Ungureanu, C; Andronesi, D; Popescu, I; Herlea, V

2012-01-01

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) represent a group of tumors, having their origin in cells of diffuse endocrine system, with particular clinical course, diagnosis and treatment. In our study, were included 68 patients with neuroendocrine digestive tumors admitted, diagnosed and treated in Fundeni Clinical Institute, Bucharest, in the last ten years--2000-2010 (retrospective study). Thirty-three (49%) patients were males, 35 (51%) females, and the main age was 58.9 years. In 62 (90.3%) cases was possible to find the primary tumor. The examined tumors had different localizations: pancreas--32 (47.04%) cases (head--17 (24.99%) cases, and body and tail--15 (22.05%) cases), stomach--7 (10.29%) cases, small intestine--7 (10.29%) cases, 6 (8.82%) cases--unknown primary site (diagnosis was established on metastases), right colon--6 (8.82%) cases, liver--6 (8.82%) cases, rectum--2 (2.94%) cases, and retroperitoneum--2 (2.94%) cases. Microscopic examination revealed 59 (86.8%) malignant tumors and 9 (13.2%) benign tumors. Using WHO 2000 Classification, 28 cases of malignant tumors were well-differentiated neuroendocrine carcinomas, and 31 cases were poor differentiated neuroendocrine carcinomas. From malignant cases, 25 (42.3%) have distant metastases and 15 (25.9%) lymph node metastases. Cases of gastroenteropancreatic neuroendocrine tumors included in our study had clinical and histopathological features in correspondence with data from literature--slight predominance in women, predominance in 5th and 6th decades of life, the most frequent localizations were at pancreatic level--both head and body and tail, but the rarest were in colon and retroperitoneum. Most of the cases studied, were malignant tumors, from these more than a half were poor differentiated, and a quarter of them having lymph node or distant metastases.

What Case Managers Should Know About Their Roles and Functions: A National Study From the Commission for Case Manager Certification: Part 1.

PubMed

Tahan, Hussein M; Watson, Annette C; Sminkey, Patrice V

2015-01-01

The purpose of this national role and function study was to identify the essential activities and necessary knowledge areas for effective case manager practice from the perspective of those currently functioning in various care settings and across diverse professional disciplines. The national study covered all case management practices and/or work settings across the full continuum of health care. This cross-sectional descriptive study used the practice analysis method and online survey research design. It employed a purposive sample of case managers, in which 52,370 individuals received an invitation to participate. Data collection completed over a 4-week period, resulting in 7,668 useable survey responses (nearly a 15% response rate). The study identified the common activities and knowledge areas necessary for competent and effective performance of case managers, as is highlighted in this article, which is the first of a 2-part series on the role and function study. The results informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination, as will be delineated in Part 2 of the article series, to ensure that it continues to be substantiated in current practice. Of special note are the emergence of specific activity and knowledge domains in the area of case management ethical, legal, and practice standards, and an increase in the number of employers requiring certified case managers to fill vacant positions and compensating them financially for such qualifications. This study helps keep the CCM credentialing examination evidence-based and maintain its validity for evaluating competency of case managers. Specifically, the study identified essential activities and knowledge domains that define competent case management practice. Findings can be used for developing programs and curricula for the training and development of case managers. The study instrument also can be used for further research of case management practice.

The South Carolina National Guard Secure Area Duty Officer Program: A Reserve Component Active Shooter Contingency Case Study

DTIC Science & Technology

2017-12-01

SADOP) was authorized as SCNG policy on October 3, 2015. This research constitutes a case study of the SCNG SADOP and catalogs the program from...concealed firearms carry law. C. METHODOLOGY This thesis is a single case study of SADOP, which is an exceptional case and the only one of its kind...CAROLINA NATIONAL GUARD SECURE AREA DUTY OFFICER PROGRAM: A RESERVE COMPONENT ACTIVE SHOOTER CONTINGENCY CASE STUDY by Barry N. Ramey December

Reliability of medical records in diagnosing inflammatory breast cancer in Egypt.

PubMed

Le, Lynne; Schairer, Catherine; Hablas, Ahmed; Meza, Jane; Watanabe-Galloway, Shinobu; Ramadan, Mohamed; Merajver, Sofia D; Seifeldin, Ibrahim A; Soliman, Amr S

2017-03-16

Inflammatory breast cancer (IBC) is a rare, aggressive breast cancer diagnosed clinically by the presence of diffuse erythema, peau d'orange, and edema that arise quickly in the affected breast. This study evaluated the validity of medical records in Gharbiah, Egypt in identifying clinical signs/symptoms of IBC. For 34 IBC cases enrolled in a case-control study at the Gharbiah Cancer Society and Tanta Cancer Center, Egypt (2009-2010), we compared signs/symptoms of IBC noted in medical records to those recorded on a standardized form at the time of IBC diagnosis by clinicians participating in the case-control study. We calculated the sensitivity and specificity of medical records as compared to the case-control study for recording these signs/symptoms. We also performed McNemar's tests. In the case-control study, 32 (94.1%) IBC cases presented with peau d'orange, 30 (88.2%) with erythema, and 31 (91.2%) with edema. The sensitivities of the medical records as compared to the case-control study were 0.8, 0.5, and 0.2 for peau d'orange, erythema, and edema, respectively. Corresponding specificities were 1.0, 0.5, and 1.0. p values for McNemar's test were <0.05 for all signs. Medical records had data on the extent and duration of signs for at most 27% of cases for which this information was recorded in the case-control study. Twenty-three of the 34 cases (67.6%) had confirmed diagnosis of IBC in their medical records. Medical records lacked information on signs/symptoms of IBC, especially erythema and edema, when compared to the case-control study. Deficient medical records could have implications for diagnosis and treatment of IBC and proper documentation of cases in cancer registries.

Psychological Intervention: Case Studies in School Psychological Services, Volume 3, 1979.

ERIC Educational Resources Information Center

Iowa State Dept. of Public Instruction, Des Moines. Div. of Pupil Personnel Services.

The book presents 27 case studies illustrating psychological interventions with behavior problem school children. Studies ususally introduce the target population, describe the method of psychological evaluation, report the results of treatment, and discuss the case's implications. Among cases reported are investigations of stimulant medication on…

Problems of Practice: Canadian Cases in Leadership and Policy

ERIC Educational Resources Information Center

Pollock, Katina; Ryan, James

2013-01-01

One way to support aspiring and current administrators is through the use of case study teaching (Barnes, Christensen, & Hansen, 1994). Using case studies as a teaching and learning tool helps bring real-life situations into principal preparation and support programs. Case study approaches provide students with time to interrogate contemporary…

Report on Federal Productivity. Volume 2, Productivity Case Studies.

ERIC Educational Resources Information Center

Joint Financial Management Improvement Program, Washington, DC.

Volume 2 contains 15 productivity case studies which illustrate and expand on the causal factors mentioned in volume 1. The cases illustrate many different approaches to productivity measurement improvement. The case studies are: Development of an Output-Productivity Measure for the Air Force Medical Service; Measuring Effectiveness and Efficiency…

Using full-cohort data in nested case-control and case-cohort studies by multiple imputation.

PubMed

Keogh, Ruth H; White, Ian R

2013-10-15

In many large prospective cohorts, expensive exposure measurements cannot be obtained for all individuals. Exposure-disease association studies are therefore often based on nested case-control or case-cohort studies in which complete information is obtained only for sampled individuals. However, in the full cohort, there may be a large amount of information on cheaply available covariates and possibly a surrogate of the main exposure(s), which typically goes unused. We view the nested case-control or case-cohort study plus the remainder of the cohort as a full-cohort study with missing data. Hence, we propose using multiple imputation (MI) to utilise information in the full cohort when data from the sub-studies are analysed. We use the fully observed data to fit the imputation models. We consider using approximate imputation models and also using rejection sampling to draw imputed values from the true distribution of the missing values given the observed data. Simulation studies show that using MI to utilise full-cohort information in the analysis of nested case-control and case-cohort studies can result in important gains in efficiency, particularly when a surrogate of the main exposure is available in the full cohort. In simulations, this method outperforms counter-matching in nested case-control studies and a weighted analysis for case-cohort studies, both of which use some full-cohort information. Approximate imputation models perform well except when there are interactions or non-linear terms in the outcome model, where imputation using rejection sampling works well. Copyright © 2013 John Wiley & Sons, Ltd.

Is routine postoperative gastrografin study needed after laparoscopic sleeve gastrectomy? Experience of 712 cases.

PubMed

Wahby, M; Salama, A F; Elezaby, A F; Belgrami, F; Abd Ellatif, M E; El-Kaffas, H F; Al-Katary, M

2013-11-01

The current standard of care is to perform a postoperative gastrografin study following laparoscopic sleeve gastrectomy (LSG) to detect leakage or obstruction. This study evaluated the usefulness of this routine procedure. A retrospective chart review was performed in December 2012. All patients had routine intraoperative methylene blue testing to check for possible leakage from the staple line, and any leaking points were oversewn. We also performed postoperative contrast study (gastrografin) routinely in the first 24-48 h for all patients. From June 2007 to December 2012, 712 cases underwent LSG during the study period. Patients included in this study were 556 women (78.1%) and 156 men (21.9%). The mean age was 35 years. The mean BMI was 48 kg/m2. The operative time was 107 ± 29 min, and there were no conversions to open surgery. Intraoperative methylene blue test detected leakage in 28 cases (3.93%). Postoperative contrast study (gastrografin) was negative for leakage in all cases. Computed tomography (CT) scan with oral contrast study detected leakage in 1.4% (ten cases); none of these cases were detected by regular contrast study. Our study showed that intraoperative methylene blue test for leakage is a very sensitive and effective method for detecting leakage during sleeve gastrectomy and should be done routinely in all cases. Routine postoperative contrast study is not needed to detect leakage unless clinically indicated in selected cases, and in such cases contrast-enhanced CT scans are the modality of choice.

Impact of an Engineering Case Study in a High School Pre-Engineering Course

ERIC Educational Resources Information Center

Rutz, Eugene; Shafer, Michelle

2011-01-01

Students at an all-girls high school who were enrolled in an introduction to engineering course were presented an engineering case study to determine if the case study affected their attitudes toward engineering and their abilities to solve engineering problems. A case study on power plants was implemented during a unit on electrical engineering.…

The Effectiveness of a Case Study-Based First-Year Biology Class at a Black Women's College

ERIC Educational Resources Information Center

Pai, Aditi; Benning, Tracy; Woods, Natasha; McGinnis, Gene; Chu, Joanne; Netherton, Josh; Bauerle, Cynthia

2010-01-01

The authors used a case study-based approach in the introductory biology course at Spelman College. The course taught to entering freshmen was divided into three modules--ecology, evolution, and biodiversity, each designed around a case study. They noted that (1) case study teaching was dramatically more effective than the traditional lecture…

Flawed Execution: A Case Study on Operational Contract Support

DTIC Science & Technology

2016-06-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA JOINT APPLIED PROJECT FLAWED EXECUTION: A CASE STUDY ON OPERATIONAL CONTRACT SUPPORT June 2016...applied project 4. TITLE AND SUBTITLE FLAWED EXECUTION: A CASE STUDY ON OPERATIONAL CONTRACT SUPPORT 5. FUNDING NUMBERS 6. AUTHOR(S) Scott F...unlimited FLAWED EXECUTION: A CASE STUDY ON OPERATIONAL CONTRACT SUPPORT Scott F. Taggart, Captain, United States Marine Corps Jacob Ledford

Finding The Limit: The Strategic Potential Of The Network Based Actor

DTIC Science & Technology

2016-12-01

6  E.  CASE STUDY SELECTION AND PROCESS .......................................6  1.  Selection of Baseline Case Studies: Pierre-Charles...Pathé and the Trust ..................................................................................7  2.  Selection of Test Case Studies...academic debate, which argues that non-state, network-based actors can have a strategic planning capacity. E. CASE STUDY SELECTION AND PROCESS This

Hindsight Is 20/20: A Case Study of Vision and Reading Issues Sheds Light for Teacher Education Programs

ERIC Educational Resources Information Center

Chandler, Kristie B.; Box, Jean A.

2012-01-01

This paper presents a case study designed to educate students in pre-service teacher education programs about the importance of a comprehensive eye exam. The case study chronicles a family's multi-year search for solutions to their child's reading difficulties. The research supporting the case study explores the connection between vision…

Case Studies in the Organizational Communication Course: Applying Textbook Concepts to Real Life Organizations.

ERIC Educational Resources Information Center

Byers, Peggy Yuhas

This paper urges the use of case study discussions in the organizational communication class as an effective instructional technique. The paper presents a variety of formats for bringing case studies to life for students in the organizational communication course. It first discusses sources for case studies such as the World Wide Web, local and…

WeSaySo Case Study: Designing and Implementing a Case Study for Use in an Instructional Design Class.

ERIC Educational Resources Information Center

Graves, Rick; Barnett, Mardee; Gamble, Yolanda; Kolak, Mike

A case study was used in an instructional design class to facilitate the transfer of conceptual knowledge to concrete concerns and to aid instructional technology graduate students' understanding of the steps involved in designing, analyzing, and implementing an effective needs analysis. The case study involved real events at fictitious company…

The Fish Kill Mystery: Using Case Studies in the Middle School Classroom

ERIC Educational Resources Information Center

Heid, Christy; Biglan, Barbara; Ritson, Margaret

2008-01-01

Case studies are an excellent method for engaging middle school students in the current work of scientists. Students learn to think like scientists as they decide how to investigate the dilemma presented in the case study. This article describes one such case study, the Fish Kill Mystery, which takes place at a popular vacation spot--the beaches…

Benefits from Funding the MSD Engineering List: A Fiscal Year 1999 Case Study

DTIC Science & Technology

2004-03-01

BENEFITS FROM FUNDING THE MSD ENGINEERING LIST: A FISCAL YEAR 1999 CASE STUDY THESIS...States Government. AFIT/GLM/ENS/04-03 BENEFITS FROM FUNDING THE MSD ENGINEERING LIST: A FISCAL YEAR 1999 CASE STUDY...ENS/04-03 BENEFITS FROM FUNDING THE MSD ENGINEERING LIST: A FISCAL YEAR 1999 CASE STUDY David L. Gehrich, BS Captain, USAF

Recall bias in melanoma risk factors and measurement error effects: a nested case-control study within the Norwegian Women and Cancer Study.

PubMed

Parr, Christine L; Hjartåker, Anette; Laake, Petter; Lund, Eiliv; Veierød, Marit B

2009-02-01

Case-control studies of melanoma have the potential for recall bias after much public information about the relation with ultraviolet radiation. Recall bias has been investigated in few studies and only for some risk factors. A nested case-control study of recall bias was conducted in 2004 within the Norwegian Women and Cancer Study: 208 melanoma cases and 2,080 matched controls were invited. Data were analyzed for 162 cases (response, 78%) and 1,242 controls (response, 77%). Questionnaire responses to several host factors and ultraviolet exposures collected at enrollment in 1991-1997 and in 2004 were compared stratified on case-control status. Shifts in responses were observed among both cases and controls, but a shift in cases was observed only for skin color after chronic sun exposure, and a larger shift in cases was observed for nevi. Weighted kappa was lower for cases than for controls for most age intervals of sunburn, sunbathing vacations, and solarium use. Differences in odds ratio estimates of melanoma based on prospective and retrospective measurements indicate measurement error that is difficult to characterize. The authors conclude that indications of recall bias were found in this sample of Norwegian women, but that the results were inconsistent for the different exposures.

Rethinking Case Study Methodology in Poststructural Research.

PubMed

Mohammed, Shan; Peter, Elizabeth; Gastaldo, Denise; Howell, Doris

2015-03-01

Little consideration has been given to how case study might be used in poststructural research to explore power relations that constitute a phenomenon. Many case study scholars, most notably Robert Yin, adopt a postpositivist perspective that assumes the "truth" can be accessed through applying prescriptive and rigid research techniques. Using a discussion of Michel Foucault's key theoretical ideas and the insights gained through a Foucauldian case study of people with advanced cancer who continue to receive curative treatment, the authors argue for the expansion of case study in poststructural inquiry. They propose that the use of poststructuralist case study is valuable because of the flexibility and comprehensiveness of the methodology, which allows for the exploration of a deeper understanding of the broader discourses that shape a phenomenon, as well as how power/knowledge relations shape the behaviours and perceptions of people. They also introduce the reflexive implications of poststructural case study research. Copyright© by Ingram School of Nursing, McGill University.

Case Studies in Wilderness Medicine.

ERIC Educational Resources Information Center

Gray, Melissa; Tarter, Shana Lee

Five case studies explore issues in wilderness medicine, with emphasis on evacuation decision making. The cases describe medical problems encountered during wilderness trips involving college or high school students. In each case, the situation and facts of the case are outlined, including the patient's medical history and vital signs, and at…

A Study on the Failure of Conventional Deterrence: The Case Study of the Bombardment of Yeonpyeong in 2010

DTIC Science & Technology

2016-12-01

December 2016 3. REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE A STUDY ON THE FAILURE OF CONVENTIONAL DETERRENCE: THE CASE ...Approved for public release. Distribution is unlimited A STUDY ON THE FAILURE OF CONVENTIONAL DETERRENCE: THE CASE STUDY OF THE BOMBARDMENT OF...necessary to analyze these diverse elements comprehensively. E. RESEARCH DESIGN This thesis focuses on a single case study about the bombardment of

Issues of Noncompliance. NCABR 2017 | Science Inventory ...

EPA Pesticide Factsheets

This presentation is a case study to be presented at an animal welfare conference. The purpose of the case study is to allow other animal welfare professionals a chance to work through and discuss an potential noncompliance situation. It is for practice, and to encourage people to learn from each other. Members of oversight organizations will be present to offer their perspectives on the case study as well. The purpose of this case study is to help educate other members of the animal welfare profession. This presentation is a case study to be presented at an animal welfare conference. The purpose of the case study is to allow other animal welfare professionals a chance to work through and discuss an potential noncompliance situation. It is for practice, and to encourage people to learn from each other.

Study designs may influence results: the problems with questionnaire-based case-control studies on the epidemiology of glioma.

PubMed

Johansen, Christoffer; Schüz, Joachim; Andreasen, Anne-Marie Serena; Dalton, Susanne Oksbjerg

2017-03-28

Glioma is a rare brain tumour with a very poor prognosis and the search for modifiable factors is intense. We reviewed the literature concerning risk factors for glioma obtained in case-control designed epidemiological studies in order to discuss the influence of this methodology on the observed results. When reviewing the association between three exposures, medical radiation, exogenous hormone use and allergy, we critically appraised the evidence from both case-control and cohort studies. For medical radiation and hormone replacement therapy (HRT), questionnaire-based case-control studies appeared to show an inverse association, whereas nested case-control and cohort studies showed no association. For allergies, the inverse association was observed irrespective of study design. We recommend that the questionnaire-based case-control design be placed lower in the hierarchy of studies for establishing cause-and-effect for diseases such as glioma. We suggest that a state-of-the-art case-control study should, as a minimum, be accompanied by extensive validation of the exposure assessment methods and the representativeness of the study sample with regard to the exposures of interest. Otherwise, such studies cannot be regarded as 'hypothesis testing' but only 'hypothesis generating'. We consider that this holds true for all questionnaire-based case-control studies on cancer and other chronic diseases, although perhaps not to the same extent for each exposure-outcome combination.

Comparing Management Approaches for Automatic Test Systems: A Strategic Missile Case Study

DTIC Science & Technology

2005-03-01

ground up, and is commonly conducted following five methods : ethnography , grounded theory , case study , phenomenological study , and biography...traditions frequently used (Creswell, 1998:5). The five traditions are biography, phenomenological study , grounded theory study , ethnography , and... Ethnography Biography Case Study Grounded Theory

Conceptualizing juvenile prostitution as child maltreatment: findings from the National Juvenile Prostitution Study.

PubMed

Mitchell, Kimberly J; Finkelhor, David; Wolak, Janis

2010-02-01

Two studies were conducted to identify the incidence (Study 1) and characteristics (Study 2) of juvenile prostitution cases known to law enforcement agencies in the United States. Study 1 revealed a national estimate of 1,450 arrests or detentions (95% confidence interval [CI]: 1,287-1,614) in cases involving juvenile prostitution during a 1-year period. In Study 2, exploratory data were collected from a subsample of 138 cases from police records in 2005. The cases are broadly categorized into three main types: (a) third-party exploiters, (b) solo prostitution, and (c) conventional child sexual abuse (CSA) with payment. Cases were classified into three initial categories based on police orientation toward the juvenile: (a) juveniles as victims (53%), (b) juveniles as delinquents (31%), and (c) juvenile as both victims and delinquents (16%). When examining the status of the juveniles by case type, the authors found that all the juveniles in CSA with payment cases were treated as victims, 66% in third-party exploiters cases, and 11% in solo cases. Findings indicate law enforcement responses to juvenile prostitution are influential in determining whether such youth are viewed as victims of commercial sexual exploitation or as delinquents.

Vitamin C Intake and Pancreatic Cancer Risk: A Meta-Analysis of Published Case-Control and Cohort Studies.

PubMed

Hua, Yong-Fei; Wang, Gao-Qing; Jiang, Wei; Huang, Jing; Chen, Guo-Chong; Lu, Cai-De

2016-01-01

Observational studies inconsistently reported the relationship between vitamin C intake and risk of pancreatic cancer. We conducted a meta-analysis of published case-control and cohort studies to quantify the association. Potentially eligible studies were found on PubMed and EMBASE databases through May 31, 2015. A random-effects model was assigned to compute summary point estimates with corresponding 95% confidence intervals (CIs). Subgroup and meta-regression analyses were also performed to explore sources of heterogeneity. Our final analyses included 20 observational studies comprising nearly 5 thousand cases of pancreatic cancer. When comparing the highest with the lowest categories of vitamin C intake, the summary odds ratio/relative risk for case-control studies (14 studies), cohort studies (6 studies) and all studies combined was 0.58 (95% CI: 0.52-0.66), 0.93 (95% CI: 0.78-1.11) and 0.66 (95% CI: 0.58-0.75), respectively. The difference in the findings between case-control and cohort studies was statistically significant (P < .001). Possible publication bias was shown in the meta-analysis of case-control studies. There is insufficient evidence to conclude any relationship between vitamin C intake and risk of pancreatic cancer. The strong inverse association observed in case-control studies may be affected by biases (eg, recall and selection biases) that particularly affect case-control studies and/or potential publication bias. Future prospective studies of vitamin C intake and pancreatic cancer are needed.

Using Case Studies in Calculus-based Physics

NASA Astrophysics Data System (ADS)

Katz, Debora M.

2006-12-01

Do your students believe that the physics only works in your classroom or laboratory? Or do they see that physics underlies their everyday experience? Case studies in physics help students connect physics principles to their everyday experience. For decades, case studies have been used to teach law, medicine and biology, but they are rarely used in physics. I am working on a calculus-based physics textbook for scientists and engineers. Case studies are woven into each chapter. Stop by and get a case study to test out in your classroom. I would love to get your feedback.

The lack of selection bias in a snowball sampled case-control study on drug abuse.

PubMed

Lopes, C S; Rodrigues, L C; Sichieri, R

1996-12-01

Friend controls in matched case-control studies can be a potential source of bias based on the assumption that friends are more likely to share exposure factors. This study evaluates the role of selection bias in a case-control study that used the snowball sampling method based on friendship for the selection of cases and controls. The cases selected fro the study were drug abusers located in the community. Exposure was defined by the presence of at least one psychiatric diagnosis. Psychiatric and drug abuse/dependence diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria. Cases and controls were matched on sex, age and friendship. The measurement of selection bias was made through the comparison of the proportion of exposed controls selected by exposed cases (p1) with the proportion of exposed controls selected by unexposed cases (p2). If p1 = p2 then, selection bias should not occur. The observed distribution of the 185 matched pairs having at least one psychiatric disorder showed a p1 value of 0.52 and a p2 value of 0.51, indicating no selection bias in this study. Our findings support the idea that the use of friend controls can produce a valid basis for a case-control study.

Optimal design of studies of influenza transmission in households. II: comparison between cohort and case-ascertained studies.

PubMed

Klick, B; Nishiura, H; Leung, G M; Cowling, B J

2014-04-01

Both case-ascertained household studies, in which households are recruited after an 'index case' is identified, and household cohort studies, where a household is enrolled before the start of the epidemic, may be used to test and estimate the protective effect of interventions used to prevent influenza transmission. A simulation approach parameterized with empirical data from household studies was used to evaluate and compare the statistical power of four study designs: a cohort study with routine virological testing of household contacts of infected index case, a cohort study where only household contacts with acute respiratory illness (ARI) are sampled for virological testing, a case-ascertained study with routine virological testing of household contacts, and a case-ascertained study where only household contacts with ARI are sampled for virological testing. We found that a case-ascertained study with ARI-triggered testing would be the most powerful design while a cohort design only testing household contacts with ARI was the least powerful. Sensitivity analysis demonstrated that these conclusions varied by model parameters including the serial interval and the risk of influenza virus infection from outside the household.

Evaluating psychiatric case-control studies using the STROBE (STrengthening the Reporting of OBservational Studies in Epidemiology) statement.

PubMed

Goi, Pedro Domingues; Goi, Julia Domingues; Cordini, Kariny Larissa; Ceresér, Keila Mendes; Rocha, Neusa Sica da

2014-01-01

Case-control studies are important in developing clinical and public health knowledge. The STROBE statement (STrengthening the Reporting of OBservational Studies in Epidemiology) was developed to establish a checklist of items that should be included in articles reporting observational studies. Our aim was to analyze whether the psychiatric case-control articles published in Brazilian journals with CAPES Qualis rating B1/B2 in 2009 conformed with the STROBE statement. Descriptive study on psychiatric papers published in Brazilian journals, within the Postgraduate Medical Program on Psychiatry, at Universidade Federal do Rio Grande do Sul. All psychiatric case-control studies from Brazilian Qualis B1/B2 journals of psychiatry, neurology and public health in 2009 were analyzed. The four most specific items of the STROBE statement were used to evaluate whether these studies fitted within the case-control parameters: 1) selection of cases and controls; 2) controlling for bias; 3) statistical analysis; and 4) presentation of results. Sixteen case-control studies were identified, of which eleven (68.75%) were in psychiatry-focused journals. From analysis using the STROBE statement, all of the articles conformed with item 1; two (12.5%) completely conformed with item 2; none completely conformed with item 3; and only three (18.8%) conformed with item 4. The case-control studies analyzed here did not completely conform with the four STROBE statement items for case-control design. In view of the inadequate methodology of the published studies, these findings justify focusing on research and methodology and expanding the investigations on adherence of studies to their designs.

Case Studies for Effective Business Instruction.

ERIC Educational Resources Information Center

McAlister-Kizzier, Donna

This book is designed as a resource for educators who teach business content in a variety of instructional settings. It contains case studies representing all functional areas of business, including corporate training, for grades 7 through graduate education. Chapter 1 provides an overview of the case study method. The history of the case method,…

Using Case-Based Pedagogy in the Philippines: A Narrative Inquiry

NASA Astrophysics Data System (ADS)

Arellano, Elvira L.; Barcenal, Tessie L.; Bilbao, Purita P.; Castellano, Merilin A.; Nichols, Sharon E.; Tippins, Deborah J.

2001-04-01

This study features use of case-based pedagogy as a context for exploring science teacher education reform. A central premise of the study is that science teacher education reform is a complex process characterised by the individual and collective narrative histories of teachers. The study was conducted at West Visayas State University in the Philippines as a collaborative research endeavour involving two US and four Filipino science teacher educators. The centrepiece of this study was a case experience prompted by reflection on prospective and practicing elementary teachers' written cases. Results of the study are presented here as a layered narrative. An initial layer explores how a case, written by a prospective teacher, was interwoven with her past and future life history. A second layer looks at sociocultural and professional tensions that mediated the participants' case experience. A third layer represents how the case experience provided a community that supported critical reflection among the research team members. Implications from the study emphasise that case-based pedagogy can serve as a basis for critical reflection to inform community-based approaches to science teacher education pedagogical and research reform.

A Case Study of the Degree of Collaboration Between Various Levels in the Reparable Chain in the United States Air Force

DTIC Science & Technology

2005-03-01

qualitative research methods , a case study approach was selected to conduct this research . “A case study can be defined as an empirical study ... qualitative in nature, and also described the qualitative research method chosen as a case study . From 49 there, data collection was focused upon... qualitative nature of the research , a qualitative design was used to conduct the

Response rates in case-control studies of cancer by era of fieldwork and by characteristics of study design.

PubMed

Xu, Mengting; Richardson, Lesley; Campbell, Sally; Pintos, Javier; Siemiatycki, Jack

2018-04-09

The purpose of this study was to describe time trends in response rates in case-control studies of cancer and identify study design factors that influence response rate. We reviewed 370 case-control studies of cancer published in 12 journals during indicator years in each of the last four decades. We estimated time trends of response rates and reasons for nonresponse in each of the following types of study subjects: cases, medical source controls, and population controls. We also estimated response rates according to characteristics of study context. Median response rates among cases and population controls were between 75% and 80% in the 1970s. Between 1971 and 2010, study response rates declined by 0.31% per year for cases and 0.78% for population controls. Only a minority of studies reported reasons for nonparticipation; subject refusal was the most common reported reason. Studies conducted in North America had lower median response rates than studies conducted in Europe. In-person and telephone interviews elicited higher response rates than mail questionnaires. Response rates from case-control studies of cancer have declined, and this could threaten the validity of results derived from these studies. Copyright © 2018 Elsevier Inc. All rights reserved.

Case Studies in the Field of Marketing Education: Learner Impact, Case Performance, and Cost Efficiency

ERIC Educational Resources Information Center

Spais, George S.

2005-01-01

The major objective of this study is to identify a methodology that will help educators in marketing to efficiently manage the design, impact, and cost of case studies. It is my intention is to examine the impact of case study characteristics in relation to the degree of learner involvement in the learning process. The author proposes that…

Case Studies for Management Development in Bangladesh. Fourth Book. Parepared for the World Bank/Bangladesh Management Education and Training Project.

ERIC Educational Resources Information Center

McLean, Gary N.

This document contains five case studies of management and finance situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. One to four discussion questions follow each case study. The titles and authors of the case studies on management are: "Azir Ahmed & Co.,…

Case Studies for Management Development in Bangladesh. Third Book. Prepared for the World Bank/Bangladesh Management Education and Training Project.

ERIC Educational Resources Information Center

McLean, Gary N.

This document contains 10 case studies of management situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. Two to four discussion questions follow each case study. Three case studies on the subject of pay and compensation were prepared by Abu Hossain Siddique; the…

Colombia - A Case Study in Smart Power

DTIC Science & Technology

2014-05-22

COLOMBIA–A CASE STUDY IN SMART POWER A Monograph by John P. Brady Foreign Service Officer United States Agency for...Colombia–A Case Study in Smart Power 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) John P. Brady...of Candidate: John P. Brady Monograph Title: Colombia–A Case Study in Smart Power Approved by: , Monograph Director Robert W

Incorporating ITS into transportation improvement planning : the Seattle Case Study using PRUEVIIN

DOT National Transportation Integrated Search

1998-01-01

This project explored methods to analyze ITS strategies within Major Investment Study (MIS) studies and to apply them in a case study. The case study developed methods to define alternatives, and to estimate impacts and costs at the level required fo...

Building Language Educators: The Implications of Case-Based Pedagogy Using Practicum-Based Student-Teacher-Generated Cases for Pre-Service Language Teacher Education

ERIC Educational Resources Information Center

Cournoyer, Amy Beth

2014-01-01

This case study investigated case-based pedagogy using student-teacher-generated cases as an instructional tool in the preparation of 12 pre-service ESL, Bilingual, and Modern Foreign Language teachers enrolled in a Student Teaching Seminar at a post-secondary institution. In the fall methods course, each participant generated a case study based…

Biomass production in agroforestry and forestry systems on salt-affected soils in South Asia: exploration of the GHG balance and economic performance of three case studies.

PubMed

Wicke, Birka; Smeets, Edward M W; Akanda, Razzaque; Stille, Leon; Singh, Ranjay K; Awan, Abdul Rasul; Mahmood, Khalid; Faaij, Andre P C

2013-09-30

This study explores the greenhouse gas balance and the economic performance (i.e. net present value (NPV) and production costs) of agroforestry and forestry systems on salt-affected soils (biosaline (agro)forestry) based on three case studies in South Asia. The economic impact of trading carbon credits generated by biosaline (agro)forestry is also assessed as a potential additional source of income. The greenhouse gas balance shows carbon sequestration over the plantation lifetime of 24 Mg CO2-eq. ha(-1) in a rice-Eucalyptus camaldulensis agroforestry system on moderately saline soils in coastal Bangladesh (case study 1), 6 Mg CO2-eq. ha(-1) in the rice-wheat- Eucalyptus tereticornis agroforestry system on sodic/saline-sodic soils in Haryana state, India (case study 2), and 96 Mg CO2-eq. ha(-1) in the compact tree (Acacia nilotica) plantation on saline-sodic soils in Punjab province of Pakistan. The NPV at a discount rate of 10% is 1.1 k€ ha(-1) for case study 1, 4.8 k€ ha(-1) for case study 2, and 2.8 k€ ha(-1) for case study 3. Carbon sequestration translates into economic values that increase the NPV by 1-12% in case study 1, 0.1-1% in case study 2, and 2-24% in case study 3 depending on the carbon credit price (1-15 € Mg(-1) CO2-eq.). The analysis of the three cases indicates that the economic performance strongly depends on the type and severity of salt-affectedness (which affect the type and setup of the agroforestry system, the tree species and the biomass yield), markets for wood products, possibility of trading carbon credits, and discount rate. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Case and studies].

PubMed

Schubert, András

2015-11-15

Case studies and case reports form an important and ever growing part of scientific and scholarly literature. The paper deals with the share and citation rate of these publication types on different fields of research. In general, evidence seems to support the opinion that an excessive number of such publications may negatively influence the impact factor of the journal. In the literature of scientometrics, case studies (at least the presence of the term "case study" in the titles of the papers) have a moderate share, but their citation rate is practically equal to that of other publication types.

Combining epidemiology and biomechanics in sports injury prevention research: a new approach for selecting suitable controls.

PubMed

Finch, Caroline F; Ullah, Shahid; McIntosh, Andrew S

2011-01-01

Several important methodological issues need to be considered when designing sports injury case-control studies. Major design goals for case-control studies include the accounting for prior injury risk exposure, and optimal definitions of both cases and suitable controls are needed to ensure this. This article reviews methodological aspects of published sports injury case-control studies, particularly with regard to the selection of controls. It argues for a new approach towards selecting controls for case-control studies that draws on an interface between epidemiological and biomechanical concepts. A review was conducted to identify sport injury case-control studies published in the peer-review literature during 1985-2008. Overall, 32 articles were identified, of which the majority related to upper or lower extremity injuries. Matching considerations were used for control selection in 16 studies. Specific mention of application of biomechanical principles in the selection of appropriate controls was absent from all studies, including those purporting to evaluate the benefits of personal protective equipment to protect against impact injury. This is a problem because it could lead to biased conclusions, as cases and controls are not fully comparable in terms of similar biomechanical impact profiles relating to the injury incident, such as site of the impact on the body. The strength of the conclusions drawn from case-control studies, and the extent to which results can be generalized, is directly influenced by the definition and recruitment of cases and appropriate controls. Future studies should consider the interface between epidemiological and biomechanical concepts when choosing appropriate controls to ensure that proper adjustment of prior exposure to injury risk is made. To provide necessary guidance for the optimal selection of controls in case-control studies of interventions to prevent sports-related impact injury, this review outlines a new case-control selection strategy that reflects the importance of biomechanical considerations, which ensures that controls are selected based on the presence of the same global injury mechanism as the cases. To summarize, the general biomechanical principles that should apply to the selection of controls in future case-control studies are as follows: (i) each control must have been exposed to the same global injury mechanism as the case, (e.g. head impact, fall onto outstretched arm); and (ii) intrinsic (individual) factors (e.g. age, sex, skill level) that might modify the person's response to the relevant biomechanical loads are adjusted when either selecting the controls or are in the analysis phase. The same considerations for control selection apply to other study designs such as matched cohort studies or case-crossover studies.

Improving the Effectiveness of Professional Education: Learning Managerial Accounting via a Complex Case.

ERIC Educational Resources Information Center

Carter, Melissa; And Others

To give students more experience with real situations, many professional schools use case studies in their courses. Creating complex cases, case experiences that immerse students in complex problems, rather than mere case studies that require armchair analysis should help students gain better and more integrated knowledge. Designing, implementing,…

A systematic review of occupational safety and health business cases.

PubMed

Verbeek, Jos; Pulliainen, Marjo; Kankaanpää, Eila

2009-12-01

Business cases are commonly developed as means to rationalize investment. We systematically reviewed 26 reported cases on occupational safety and health (OSH) interventions to assess if health and productivity arguments make a good business case. To be included in the review, studies had to analyze the costs and benefits, including productivity, of an OSH intervention at the enterprise level. We searched Medline and Embase for studies and used Google search in addition. Two reviewers independently selected studies and extracted data. The intervention profitability was calculated in euros (euro in 2008) as the first year's benefits minus the total intervention costs per worker. The payback period was calculated as the intervention costs divided by the first year's benefits. We found three ex-ante and 23 ex-post cases. In 20 cases, the study design was a before-after comparison without a control group. Generally a 100% reduction of injuries or sickness absence was assumed. In two cases, productivity and quality increases were very large. The main benefit was avoided sick leave. Depreciation or discounting was applied only in a minority of cases. The intervention profitability was negative in seven studies, up to euro 500 per employee in 12 studies and more than euro 500 per employee in seven studies. The payback period was less than half a year for 19 studies. Only a few studies included sensitivity analyses. Few ex-ante business cases for management decisions on OSH are reported. Guidelines for reporting and evaluation are needed. Business cases need more sound assumptions on the effectiveness of interventions and should incorporate greater uncertainty into their design. Ex-post evaluation should be based preferably on study designs that control for trends at a time different from that of the intervention.

The Use of Interrupted Case Studies to Enhance Critical Thinking Skills in Biology

PubMed Central

White, Tracy K.; Whitaker, Paul; Gonya, Terri; Hein, Richard; Kroening, Dubear; Lee, Kevin; Lee, Laura; Lukowiak, Andrea; Hayes, Elizabeth

2009-01-01

There has been a dramatic increase in the availability of case studies for use in the biology classroom, and perceptions of the effectiveness of case-study-based learning are overwhelmingly positive. Here we report the results of a study in which we evaluated the ability of interrupted case studies to improve critical thinking in the context of experimental design and the conventions of data interpretation. Students were assessed using further case studies designed to evaluate their ability to recognize and articulate problematic approaches to these elements of experimentation. Our work reveals that case studies have broad utility in the classroom. In addition to demonstrating a small but statistically significant increase in the number of students capable of critically evaluating selected aspects of experimental design, we also observed increased student engagement and documented widespread misconceptions regarding the conventions of data acquisition and analysis. PMID:23653687

Better cancer biomarker discovery through better study design.

PubMed

Rundle, Andrew; Ahsan, Habibul; Vineis, Paolo

2012-12-01

High-throughput laboratory technologies coupled with sophisticated bioinformatics algorithms have tremendous potential for discovering novel biomarkers, or profiles of biomarkers, that could serve as predictors of disease risk, response to treatment or prognosis. We discuss methodological issues in wedding high-throughput approaches for biomarker discovery with the case-control study designs typically used in biomarker discovery studies, especially focusing on nested case-control designs. We review principles for nested case-control study design in relation to biomarker discovery studies and describe how the efficiency of biomarker discovery can be effected by study design choices. We develop a simulated prostate cancer cohort data set and a series of biomarker discovery case-control studies nested within the cohort to illustrate how study design choices can influence biomarker discovery process. Common elements of nested case-control design, incidence density sampling and matching of controls to cases are not typically factored correctly into biomarker discovery analyses, inducing bias in the discovery process. We illustrate how incidence density sampling and matching of controls to cases reduce the apparent specificity of truly valid biomarkers 'discovered' in a nested case-control study. We also propose and demonstrate a new case-control matching protocol, we call 'antimatching', that improves the efficiency of biomarker discovery studies. For a valid, but as yet undiscovered, biomarker(s) disjunctions between correctly designed epidemiologic studies and the practice of biomarker discovery reduce the likelihood that true biomarker(s) will be discovered and increases the false-positive discovery rate. © 2012 The Authors. European Journal of Clinical Investigation © 2012 Stichting European Society for Clinical Investigation Journal Foundation.

Case-control vaccine effectiveness studies: Preparation, design, and enrollment of cases and controls.

PubMed

Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

2017-06-05

Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under 'real world' conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential. Published by Elsevier Ltd.

The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study Protocol

PubMed Central

Woo, Daniel; Rosand, Jonathan; Kidwell, Chelsea; McCauley, Jacob L.; Osborne, Jennifer; Brown, Mark W.; West, Sandra E.; Rademacher, Eric W.; Waddy, Salina; Roberts, Jamie N.; Koch, Sebastian; Gonzales, Nicole R.; Sung, Gene; Kittner, Steven J.; Birnbaum, Lee; Frankel, Michael; Daniel Testai, Fernando; Hall, Christiana E.; Elkind, Mitchell S. V.; Flaherty, Matthew; Coull, Bruce; Chong, Ji Y.; Warwick, Tanya; Malkoff, Marc; James, Michael L.; Ali, Latisha K.; Worrall, Bradford B.; Jones, Floyd; Watson, Tiffany; Leonard, Anne; Martinez, Rebecca; Sacco, Ralph I; Langefeld, Carl D.

2013-01-01

Background and Purpose Epidemiologic studies of intracerebral hemorrhage (ICH) have consistently demonstrated variation in incidence, location, age at presentation, and outcomes among non-Hispanic white, black, and Hispanic populations. We report here the design and methods for this large, prospective, multi-center case-control study of ICH. Methods The ERICH study is a multi-center, prospective case-control study of ICH. Cases are identified by hot-pursuit and enrolled using standard phenotype and risk factor information and include neuroimaging and blood sample collection. Controls are centrally identified by random digit dialing to match cases by age (+/−5 years), race, ethnicity, gender and metropolitan region. Results As of March 22, 2013, 1,655 cases of ICH had been recruited into the study which is 101.5% of the target for that date and 851 controls had been recruited which is 67.2% of the target for that date (1,267 controls) for a total of 2,506 subjects which is 86.5% of the target for that date (2,897 subjects). Of the 1,655 cases enrolled, 1,640 cases had the case interview entered into the database of which 628 (38%) were non-Hispanic black, 458 (28%) were non-Hispanic white and 554 (34%) were Hispanic. Of the 1,197 cases with imaging submitted, 876 (73.2%) had a 24 hour follow-up CT available In addition to CT imaging, 607 cases have had MRI evaluation. Conclusion The ERICH study is a large, case-control study of ICH with particular emphasis on recruitment of minority populations for the identification of genetic and epidemiologic risk factors for ICH and outcomes after ICH. PMID:24021679

Research participation experiences of informants of suicide and control cases: taken from a case-control psychological autopsy study of people who died by suicide.

PubMed

Wong, Paul W C; Chan, Wincy S C; Beh, Philip S L; Yau, Fiona W S; Yip, Paul S F; Hawton, Keith

2010-01-01

Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. (1) To investigate whether informants of suicide cases recruited by two approaches (coroners' court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. The acceptance rate for our original psychological autopsy study was modest. The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia.

PubMed

Roth, Daniel E; Gaffey, Michelle F; Smith-Romero, Evelyn; Fitzpatrick, Tiffany; Morris, Shaun K

2015-12-01

To explore the variability in childhood acute respiratory infection case definitions for research in low-income settings where there is limited access to laboratory or radiologic investigations. We conducted a systematic review of community-based, longitudinal studies in South Asia published from January 1990 to August 2013, in which childhood acute respiratory infection outcomes were reported. Case definitions were classified by their label (e.g. pneumonia, acute lower respiratory infection) and clinical content 'signatures' (array of clinical features that would be always present, conditionally present or always absent among cases). Case definition heterogeneity was primarily assessed by the number of unique case definitions overall and by label. We also compared case definition-specific acute respiratory infection incidence rates for studies reporting incidence rates for multiple case definitions. In 56 eligible studies, we found 124 acute respiratory infection case definitions. Of 90 case definitions for which clinical content was explicitly defined, 66 (73%) were unique. There was a high degree of content heterogeneity among case definitions with the same label, and some content signatures were assigned multiple labels. Within studies for which incidence rates were reported for multiple case definitions, variation in content was always associated with a change in incidence rate, even when the content differed by a single clinical feature. There has been a wide variability in case definition label and content combinations to define acute upper and lower respiratory infections in children in community-based studies in South Asia over the past two decades. These inconsistencies have important implications for the synthesis and translation of knowledge regarding the prevention and treatment of childhood acute respiratory infection. © 2015 John Wiley & Sons Ltd.

Study design options in evaluating gene-environment interactions: practical considerations for a planned case-control study of pediatric leukemia.

PubMed

Goodman, Michael; Dana Flanders, W

2007-04-01

We compare methodological approaches for evaluating gene-environment interaction using a planned study of pediatric leukemia as a practical example. We considered three design options: a full case-control study (Option I), a case-only study (Option II), and a partial case-control study (Option III), in which information on controls is limited to environmental exposure only. For each design option we determined its ability to measure the main effects of environmental factor E and genetic factor G, and the interaction between E and G. Using the leukemia study example, we calculated sample sizes required to detect and odds ratio (OR) of 2.0 for E alone, an OR of 10 for G alone and an interaction G x E of 3. Option I allows measuring both main effects and interaction, but requires a total sample size of 1,500 cases and 1,500 controls. Option II allows measuring only interaction, but requires just 121 cases. Option III allows calculating the main effect of E, and interaction, but not the main effect of G, and requires a total of 156 cases and 133 controls. In this case, the partial case-control study (Option III) appears to be more efficient with respect to its ability to answer the research questions for the amount of resources required. The design options considered in this example are not limited to observational epidemiology and may be applicable in studies of pharmacogenomics, survivorship, and other areas of pediatric ALL research.

A Homogenization Approach for Design and Simulation of Blast Resistant Composites

NASA Astrophysics Data System (ADS)

Sheyka, Michael

Structural composites have been used in aerospace and structural engineering due to their high strength to weight ratio. Composite laminates have been successfully and extensively used in blast mitigation. This dissertation examines the use of the homogenization approach to design and simulate blast resistant composites. Three case studies are performed to examine the usefulness of different methods that may be used in designing and optimizing composite plates for blast resistance. The first case study utilizes a single degree of freedom system to simulate the blast and a reliability based approach. The first case study examines homogeneous plates and the optimal stacking sequence and plate thicknesses are determined. The second and third case studies use the homogenization method to calculate the properties of composite unit cell made of two different materials. The methods are integrated with dynamic simulation environments and advanced optimization algorithms. The second case study is 2-D and uses an implicit blast simulation, while the third case study is 3-D and simulates blast using the explicit blast method. Both case studies 2 and 3 rely on multi-objective genetic algorithms for the optimization process. Pareto optimal solutions are determined in case studies 2 and 3. Case study 3 is an integrative method for determining optimal stacking sequence, microstructure and plate thicknesses. The validity of the different methods such as homogenization, reliability, explicit blast modeling and multi-objective genetic algorithms are discussed. Possible extension of the methods to include strain rate effects and parallel computation is also examined.

The evaluation of complex interventions in palliative care: an exploration of the potential of case study research strategies.

PubMed

Walshe, Catherine

2011-12-01

Complex, incrementally changing, context dependent and variable palliative care services are difficult to evaluate. Case study research strategies may have potential to contribute to evaluating such complex interventions, and to develop this field of evaluation research. This paper explores definitions of case study (as a unit of study, a process, and a product) and examines the features of case study research strategies which are thought to confer benefits for the evaluation of complex interventions in palliative care settings. Ten features of case study that are thought to be beneficial in evaluating complex interventions in palliative care are discussed, drawing from exemplars of research in this field. Important features are related to a longitudinal approach, triangulation, purposive instance selection, comprehensive approach, multiple data sources, flexibility, concurrent data collection and analysis, search for proving-disproving evidence, pattern matching techniques and an engaging narrative. The limitations of case study approaches are discussed including the potential for subjectivity and their complex, time consuming and potentially expensive nature. Case study research strategies have great potential in evaluating complex interventions in palliative care settings. Three key features need to be exploited to develop this field: case selection, longitudinal designs, and the use of rival hypotheses. In particular, case study should be used in situations where there is interplay and interdependency between the intervention and its context, such that it is difficult to define or find relevant comparisons.

The contribution of case study design to supporting research on Clubhouse psychosocial rehabilitation.

PubMed

Raeburn, Toby; Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle

2015-10-01

Psychosocial Clubhouses provide recovery-focused psychosocial rehabilitation to people with serious mental illness at over 300 sites in more than 30 countries worldwide. To deliver the services involved, Clubhouses employ a complex mix of theory, programs and relationships, with this complexity presenting a number of challenges to those undertaking Clubhouse research. This paper provides an overview of the usefulness of case study designs for Clubhouse researchers; and suggests ways in which the evaluation of Clubhouse models can be facilitated. The paper begins by providing a brief explanation of the Clubhouse model of psychosocial rehabilitation, and the need for ongoing evaluation of the services delivered. This explanation is followed by an introduction to case study design, with consideration given to the way in which case studies have been used in past Clubhouse research. It is posited that case study design provides a methodological framework that supports the analysis of either quantitative, qualitative or a mixture of both types of data to investigate complex phenomena in their everyday contexts, and thereby support the development of theory. As such, case study approaches to research are well suited to the Clubhouse environment. The paper concludes with recommendations for future Clubhouse researchers who choose to employ a case study design. While the quality of case study research that explores Clubhouses has been variable in the past, if applied in a diligent manner, case study design has a valuable contribution to make in future Clubhouse research.

Teaching Business Demography Using Case Studies.

PubMed

Swanson, David A; Morrison, Peter A

2010-02-01

Many faculty members consider using case studies but not all end up using them. We provide a brief review of what cases are intended to do and identify three ways in which they can be used. We then use an example to illustrate how we have used the case study method in teaching business demography. Among other benefits, we note that the case studies method not only encourages the acquisition of skills by students, but can be used to promote "deep structure learning," an approach naturally accommodates other features associated with the case studies method-the development of critical thinking skills, the use of real world problems, the emphasis of concepts over mechanics, writing and presentation skills, active cooperative learning and the "worthwhileness" of a course. As noted by others, we understand the limitations of the case study method. However, given its strengths, we believe it has a place in the instructional toolbox for courses in business demography. The fact that courses we teach is a testament to our perceived efficacy of this tool.

Rare variant association analysis in case-parents studies by allowing for missing parental genotypes.

PubMed

Li, Yumei; Xiang, Yang; Xu, Chao; Shen, Hui; Deng, Hongwen

2018-01-15

The development of next-generation sequencing technologies has facilitated the identification of rare variants. Family-based design is commonly used to effectively control for population admixture and substructure, which is more prominent for rare variants. Case-parents studies, as typical strategies in family-based design, are widely used in rare variant-disease association analysis. Current methods in case-parents studies are based on complete case-parents data; however, parental genotypes may be missing in case-parents trios, and removing these data may lead to a loss in statistical power. The present study focuses on testing for rare variant-disease association in case-parents study by allowing for missing parental genotypes. In this report, we extended the collapsing method for rare variant association analysis in case-parents studies to allow for missing parental genotypes, and investigated the performance of two methods by using the difference of genotypes between affected offspring and their corresponding "complements" in case-parent trios and TDT framework. Using simulations, we showed that, compared with the methods just only using complete case-parents data, the proposed strategy allowing for missing parental genotypes, or even adding unrelated affected individuals, can greatly improve the statistical power and meanwhile is not affected by population stratification. We conclude that adding case-parents data with missing parental genotypes to complete case-parents data set can greatly improve the power of our strategy for rare variant-disease association.

The Crucial Role of the Operational Artist: A Case Study of Operation Barbarossa

DTIC Science & Technology

2017-05-25

historical case study helps to develop a better understanding of operational art today. Future studies might focus on the limitations and opportunities...The Crucial Role of the Operational Artist: A Case Study of Operation Barbarossa A Monograph by LTC (GS) Hagen H. Ruppelt German Army...a Case Study of Operation Barbarossa 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) LTC (GS) Hagen H

A Case Study of ESD Implementation: Signs of Sustainable Leadership

ERIC Educational Resources Information Center

Iliško, Dzintra; Badyanova, Yelena

2014-01-01

This article presents a case study of two schools that were identified as a result of UNESCO associated schools survey as cases of sustainable leadership and governance. The aim of the study is to present the two cases that were crystalized in the survey carried out at end of the United Nations' "Decade of Education for Sustainable…

Two Case Studies of Beginning Teachers in State-Mandated Induction Programs: The Influence of Institutional Factors.

ERIC Educational Resources Information Center

Paulissen, Margaret O.; And Others

The Teacher Induction Study investigated 2 state-mandated beginning teacher programs and examined the translation of state policy by 4 school districts, 13 individual schools, and 32 classrooms. From the case histories of 16 teams, 2 case histories were selected for further study. One case illustrated how institutional factors influenced team…

Online Case-Based Discussions: Examining Coverage of the Afforded Problem Space

ERIC Educational Resources Information Center

Ertmer, Peggy A.; Koehler, Adrie A.

2014-01-01

Case studies hold great potential for engaging students in disciplinary content. However, little is known about the extent to which students actually cover the problem space afforded by a particular case study. In this research, we compared the problem space afforded by an instructional design case study with the actual content covered by 16…

World Perspective Case Descriptions on Educational Programs for Adults: Chile.

ERIC Educational Resources Information Center

Donoso, Patricio; Gajardo, Marcela

This document contains two case studies of adult education programs in Chile. Both case studies begin with a "face sheet" on which is recorded basic information about the program and the description. The first case study, prepared by Patricio Donoso, reports on Centro El Canelo de Nos, an inservice center for educators who work with…

Case Study: Let's Get Personal--Putting Personality into Your Cases

ERIC Educational Resources Information Center

Herreid, Clyde Freeman

2017-01-01

In this case study, the subject for discussion is the need to use teaching notes in order to add personality to case studies. Personality, it is said, is more important than policy, than demographics, than finances, or amorous peccadillos. Personality is essential. It is the interaction of people that capture our interest, yet, the question is…

78 FR 12764 - Draft Office of Health Assessment and Translation Approach for Systematic Review and Evidence...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-25

... Approach--February 2013 might be needed, OHAT plans to apply it to two case-study evaluations. One case... Availability: Draft OHAT Approach--February 2013 will be available by February 26, 2013, and case-study... framework, describe the contents in the case-study protocols, and respond to questions from the public on...