Unmet clinical needs and burden of disease in hidradenitis suppurativa: real-world experience from EU5 and US

Background Hidradenitis suppurativa (HS) is a chronic, inflammatory, debilitating skin disease characterized by painful deep lesions and associated with substantial disease burden. Objectives The objective of this study was to describe physician- and patient-reported clinical unmet needs from a real-world perspective. Methods This study used data from the Adelphi HS Disease Specific Programme, a point-in-time survey of dermatologists and their patients with HS in Europe and the United States. Dermatologists completed patient record forms (PRFs) for 5–7 consecutively consulting patients with HS; patients or carers of patients also optionally completed a patient/carer self-completion questionnaire (PSC/CSC). Data collection included demographics, symptomatology and impact on quality of life (QoL). Results Dermatologists (N = 312) completed PRFs for 1787 patients with HS; patient- and carer-reported questionnaires (PSC/CSC) were completed for 33.1% (591/1787) of patients. The mean age was 34.4 ± 12.2 years and 57.6% of patients were female (1029/1787). Physician-judged disease severity at sampling was categorized as mild in 66.0% (1179/1787), moderate in 29.3% (523/1787) and severe in 4.7% (85/1787) of patients. Deterioration or unstable condition over the previous 12 months was described by 17.1% [235/1372] and 12.6% [41/325] of physician- and patient/carer-reported cases, respectively. Despite receiving treatment, high proportions of patients still experienced symptoms at sampling (general pain/discomfort [49.5%, 885/1787]; inflammation/redness of lesions/abscesses [46.1%, 823/1787] and itching [29.9%, 535/1787]); these symptoms were more frequent in patients with moderate or severe disease. Patients reported a mean Dermatology Life Quality Index score of 5.9 ± 5.4 (555/591; mild, 4.1 ± 4.3; moderate, 9.4 ± 5.4; severe, 13.3 ± 5.5) and a mean Hidradenitis Suppurativa Quality of Life score of 11.0 ± 10.6 (518/591; mild, 7.6 ± 8.3; moderate, 17.7 ± 10.0; severe, 31.0 ± 15.4) indicating a substantial impact on QoL. Conclusions Patients with HS experienced a high disease burden despite being actively treated by a dermatologist. This study demonstrates that the burden of HS disease is generally poorly managed with a considerable impact observed on patients' QoL

Editorial Perspective: Speaking up for developmental language disorder - the top 10 priorities for research

Developmental language disorder (DLD) is one of the most common neurodevelopmental conditions, yet is chronically underserved, with far fewer children receiving clinical services than expected from prevalence estimates, and very little research attention relative to other neurodevelopmental conditions of similar prevalence and severity. This editorial describes a research priority-setting exercise undertaken by the Royal College of Speech and Language Therapists, which aims to redress this imbalance. From consultations with researchers, practitioners and individuals with lived experience, 10 research priorities emerge. Our goal is to share these priorities with the wider research community, to raise awareness and encourage research collaboration to improve outcomes for young people with DLD

Rapid Plant Identification Using Species- and Group-Specific Primers Targeting Chloroplast DNA

Plant identification is challenging when no morphologically assignable parts are available. There is a lack of broadly applicable methods for identifying plants in this situation, for example when roots grow in mixture and for decayed or semi-digested plant material. These difficulties have also impeded the progress made in ecological disciplines such as soil- and trophic ecology. Here, a PCR-based approach is presented which allows identifying a variety of plant taxa commonly occurring in Central European agricultural land. Based on the trnT-F cpDNA region, PCR assays were developed to identify two plant families (Poaceae and Apiaceae), the genera Trifolium and Plantago, and nine plant species: Achillea millefolium, Fagopyrum esculentum, Lolium perenne, Lupinus angustifolius, Phaseolus coccineus, Sinapis alba, Taraxacum officinale, Triticum aestivum, and Zea mays. These assays allowed identification of plants based on size-specific amplicons ranging from 116 bp to 381 bp. Their specificity and sensitivity was consistently high, enabling the detection of small amounts of plant DNA, for example, in decaying plant material and in the intestine or faeces of herbivores. To increase the efficacy of identifying plant species from large number of samples, specific primers were combined in multiplex PCRs, allowing screening for multiple species within a single reaction. The molecular assays outlined here will be applicable manifold, such as for root- and leaf litter identification, botanical trace evidence, and the analysis of herbivory

Ecological plasticity governs ecosystem services in multilayer networks

Agriculture is under pressure to achieve sustainable development goals for biodiversity and ecosystem services. Services in agro-ecosystems are typically driven by key species, and changes in the community composition and species abundance can have multifaceted effects. Assessment of individual services overlooks co-variance between different, but related, services coupled by a common group of species. This partial view ignores how effects propagate through an ecosystem. We conduct an analysis of 374 agricultural multilayer networks of two related services of weed seed regulation and gastropod mollusc predation delivered by carabid beetles. We found that weed seed regulation increased with the herbivore predation interaction frequency, computed from the network of trophic links between carabids and weed seeds in the herbivore layer. Weed seed regulation and herbivore interaction frequencies declined as the interaction frequencies between carabids and molluscs in the carnivore layer increased. This suggests that carabids can switch to gastropod predation with community change, and that link turnover rewires the herbivore and carnivore network layers affecting seed regulation. Our study reveals that ecosystem services are governed by ecological plasticity in structurally complex, multi-layer networks. Sustainable management therefore needs to go beyond the autecological approaches to ecosystem services that predominate, particularly in agriculture

Stable isotope analysis reveals whether soil-living elaterid larvae move between agricultural crops

Tracking the movement of soil-living herbivores is difficult, albeit important for understanding their spatial ecology as well as for pest management. In this study the movement of Agriotes obscurus larvae between plots harbouring isotopically different plants was examined. Neither between maize and wheat nor between maize and grassland movement could be detected. These data suggest that Agriotes larvae rarely disperse between crops as long as local food supply is sufficient. Moreover, the current approach provides a new means to study the dispersal of soil invertebrates in situ

A two-dimensional pooling approach towards efficient detection of parasitoid and pathogen DNA at low infestation rates.

Molecular methods are facing increasing application on a broad remit in ecological studies, including work on parasites, parasitoids and pathogens. These studies can entail the screening of large sample numbers to monitor the establishment of parasitoid and pathogen infection rates over extended periods of time. However, when infection or parasitism rates are low, testing many samples individually quickly becomes tedious and costly. To optimize the application of molecular diagnostics in such situations, we developed a pooling approach that is applicable to any host–pathogen and host–parasite/parasitoid system. In a first step, host individuals are pooled along the two axes of a grid and screened for pathogen/parasite DNA via multiplex PCR. Already from these results a rough estimation of the pathogen/parasitism rate in the pooled samples is possible. To determine the exact infection/parasitism rate in the sample or if it is relevant to identify the respective infected/parasitized individuals, only those samples belonging to two pathogen/parasitoid DNA-positive pools need to be retested individually. The efficacy of the pooling approach was statistically and empirically evaluated for different infestation levels using three host–parasitoid systems and a newly developed diagnostic multiplex PCR assay. The established multiplex PCR assay allows to reliably identifying three agro-economically important lepidopteran pest species (Phthorimaea operculella, Symmetrischema tangolias and Tuta absoluta) and five relevant parasitoids (Copidosoma koehleri, Apanteles subandinus, Orgilus lepidus, Dolichogenidea gelechiidivoris and Diadegma mollipla). Compared to individual testing and even to standard one-dimensional pooling approaches, the new method reduces the number of PCRs substantially. At parasitism rates <10%, the pooling approach allowed for a reduction in the screening effort for up to 90%. In general, its efficacy decreases with increasing parasitism rates with a breakeven point at about 20%. As such the pooling approach presents an efficient and sensitive means for screening of large sample numbers at low parasitism and infection rates. Since it drastically reduces time and costs in diagnostic screenings, it is especially suited for studies with limited financial resources, allowing for extended investigations and routine monitoring screenings when infection/parasitism rates are low