Danielshead9184

This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Lymphomatoid papulosis (LyP) is a self-limiting cutaneous T-cell lymphoproliferative disorder that may progress into malignant lymphoma. Most of the previously reported associated lymphomas are primary cutaneous anaplastic large-cell lymphoma and mycosis fungoides with a low mortality rate. We report a case of primary cutaneous peripheral T-cell lymphoma, not otherwise specified (pcPTCL-NOS), associated with LyP after long-term follow up. The patient was a 79-year old Japanese man followed up for 9 years. He suddenly developed a 3-cm ulcerated lesion on his forehead, which was diagnosed as an exacerbation of LyP. The lesion regressed after conservative treatment, but the patient soon developed multifocal pcPTCL-NOS. Thereafter, the patient developed pneumonia and cerebral infarction and died within a few months of the onset of malignant lymphoma. Aggressive cutaneous lymphoma may develop in LyP patients. The present case re-emphasizes the need for careful follow up of patients with persistent LyP. © 2020 Japanese Dermatological Association.The electroreduction of small molecules to high value-added chemicals is considered as a promising way toward the capture and utilization of atmospheric small molecules. Discovering cheap and efficient electrocatalysts with simultaneously high activity, selectivity, durability, and even universality is desirable yet challenging. Herein, it is demonstrated that Bi2 Te3 nanoplates (NPs), cheap and noble-metal-free electrocatalysts, can be adopted as highly universal and robust electrocatalysts, which can efficiently reduce small molecules (O2 , CO2 , and N2 ) into targeted products simultaneously. They can achieve excellent activity, selectivity and durability for the oxygen reduction reaction with almost 100% H2 O2 selectivity, the CO2 reduction reaction with up to 90% Faradaic efficiency (FE) of HCOOH, and the nitrogen reduction reaction with 7.9% FE of NH3 . After electrochemical activation, an obvious Te dissolution happens on the Bi2 Te3 NPs, creating lots of Te vacancies in the activated Bi2 Te3 NPs. Theoretical calculations reveal that the Te vacancies can modulate the electronic structures of Bi and Te. Such a highly electroactive surface with a strong preference in supplying electrons for the universal reduction reactions improves the electrocatalytic performance of Bi2 Te3 . The work demonstrates a new class of cheap and versatile catalysts for the electrochemical reduction of small molecules with potential practical applications. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Quantifying trends in ecosystem extent is essential to understanding the status of ecosystems. Estimates of ecosystem loss are widely used for tracking progress towards conservation targets, monitoring deforestation, and identifying ecosystems undergoing rapid change. Satellite remote sensing has become an important source of information for estimating these variables, owing to a near-continuous record of changes of the Earth's land cover since the 1970s and comprehensive coverage of Earth's natural environments. Despite the regular acquisition of satellite data over time, many studies of change in ecosystem extent use only static 'snapshots', discarding considerable amounts of data in the process. This approach requires perfect images and limits the ability to explicitly estimate trend uncertainty and significance. Assessing the accuracy of multiple snapshots also requires time-series reference data which is often very costly and sometimes impossible. Here we describe a new method of estimating trends in ecoa can be used to estimate ecosystem-extent trends and quantifies uncertainty to support informed decisions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Choroidal neovascularization (CNV) is an important characteristic of advanced wet age-related macular degeneration (AMD), and leads to severe visual impairment among elderly patients. Previous studies have demonstrated that melatonin induces several biological effects related to antioxidation, anti-inflammation and anti-angiogenesis. However, the role of melatonin in CNV, and its underlying mechanisms, has not been investigated thus far. In this study, we found that melatonin administration significantly reduced the scale and volume of CNV lesions, suppressed vascular leakage, and inhibited the capacity of vascular proliferation in the laser-induced mouse CNV model. Additionally, the results also show that the melatonin-treated retinal microglia in the laser-induced mice exhibited enhanced expression of M1 type markers, such as iNOS, CCL-3, CCL-5 and TNF-α , as well as decreased production of M2 type markers, such as Arg-1, Fizz-1, IL-10, YM-1 and CD206, indicating that melatonin switched the macrophage/microglia polarization from pro-angiogenic M2 phenotype to anti-angiogenic M1 phenotype. Furthermore, the RhoA/ROCK signaling pathway was activated during CNV formation, yet was suppressed after an intraperitoneal injection of melatonin. In conclusion, melatonin attenuated CNV, reduced vascular leakage and inhibited vascular proliferation by switching the macrophage/microglia polarization from M2 phenotype to M1 phenotype via inhibition of RhoA/ROCK signaling pathway in CNV. This suggests that melatonin could be a novel agent for the treatment of AMD. This article is protected by copyright. All rights reserved.A standard lumbar puncture may be impossible for many anatomic or technical reasons. Previous accounts of caudal epidural anesthesia and other procedures via the sacral hiatus prompted us to test if image-guided percutaneous trans-sacral hiatus access to the lumbosacral subarachnoid cistern would be anatomically feasible. To study vertebral canal morphometry and curvature, we analyzed midsagittal CT-myelogram images of 40 normal subjects and digitally measured sacral curvatures between S1 to S5 and S2 to S4 using two methods whereby a lower angle signifies a straighter sacrum. We measured midsagittal vertebral canal area, hiatus width, dural sac termination levels, and distance from sacral hiatus to the dural sac tip (needle distance). Subjects were FM=2515, with a mean age of 44.9 years. The two S1-S5 full sacral curvature mean angles were 57.3° and 60.4°. Almost all sacral hiatuses were at S4, and dural sac terminations were at S1-S2. click here The mean S2-S4 sacral curvature was 25.1°, and the mean needle distance was 57.7mm. Using two-way ANOVA, there were significant sex differences for needle distances (p=.001), and full and limited sacral curvatures (p=.02, and p=.046, respectively). There were no significant linear regression correlations between age and sacral curvature, needle distance, canal area, or hiatus width. Therefore, despite a frequently prominent full sacral curvature, the combination of S1-S2 dural sac termination plus a relatively straight trajectory of the lower vertebral canal between S2 and S4 support the theoretical feasibility of percutaneous trans-sacral hiatus and vertebral canal access to the lumbosacral cistern using a standard spinal needle. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Boot camp style courses for graduating students provide intensive, timely training to help improve and polish clinical and communication skills before transitioning to the intern role. At our institution, we offer an annual two-week pediatric boot camp elective for graduating medical students entering into pediatric residencies each spring that uses a combination of simulation, patient encounters and classroom-based sessions. However, medical students graduating in 2020 were removed from all patient care activities for their final quarter because of the COVID-19 pandemic, limiting many planned "just in time" experiences. This article is protected by copyright. All rights reserved.Landscape planning that ensures the ecological integrity of ecosystems is critical in the face of rapid, human driven habitat conversion and development pressure. Wildlife tracking data provide unique and valuable information on animal distribution and location specific behaviors that can serve to increase the efficacy of such planning efforts. Given the spatio-temporal complexity inherent to animal movements, the interaction between movement behavior and a location is often oversimplified in commonly applied analyses of tracking data. Here, we jointly analyze GPS tracking derived metrics of intensity of use, structural properties (based on network theory), and properties of the movement path (speed and directionality) using machine learning to define homogeneous spatial movement types. We applied our approach to a long-term tracking dataset of over 130 African elephants (Loxodonta africana) in an area facing emerging pressures from infrastructure development. We identified five unique location specific movement categories displayed by elephants, generally defined as high, mid, and low use intensity, and two types of connectivity corridors associated with fast and slow movements. High use and slow movement corridors were associated with similar landscape characteristics associated to productive areas near water, while low use and fast corridors were characterized by low productivity areas further from water. By combining information on intensity of use, movement path properties, and structural aspects of movement across the landscape, our approach provides explicit definition of the functional role of areas for movement across the landscape which we term the "movescape". This combined, high resolution information regarding wildlife space use offers mechanistic information that can progress landscape planning efforts. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Because of their innate ability to store and then release energy, long-persistent luminescence (LPL) materials have garnered strong research interest in a wide range of multidisciplinary fields, such as biomedical sciences, theranostics, and photonic devices. Although many inorganic LPL systems with afterglow durations of up to hours and days have been reported, organic systems have had difficulties reaching similar timescales. In this work, a design principle based on the successes of inorganic systems to produce an organic LPL (OLPL) system through the use of a strong organic electron trap is proposed. The resulting system generates detectable afterglow for up to 7 h, significantly longer than any other reported OLPL system. The design strategy demonstrates an easy methodology to develop organic long-persistent phosphors, opening the door to new OLPL materials. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.BACKGROUND Mental health problems are one of the most pressing public health concerns of our time. Sweden has seen a sharp increase in mental disorders among children and youth during the last decade. The evidence base for treatment of psychiatric conditions has developed strongly. Clinical practice guidelines aim to compile such evidence and support healthcare professionals in evidence-based clinical decision-making. In Sweden, the national guidelines for the treatment of depression and anxiety disorders in children and adolescents were launched in 2010. The aim of this study was two folded, (i) to explore to what extent these guidelines were known and adhered to by health professionals in Child and Adolescent Mental Health Services and (ii) to investigate factors influencing implementation of the guidelines informed by the Consolidated Framework for Implementation Research. METHODS A qualitative approach was used, and data were collected through interviews with 18 health professionals in Child Mental Health Services in Sweden and a combination of conventional and directed content analyses was used.