Photodynamic Therapy for the Treatment of Acne Vulgaris

Acne vulgaris is a common condition affecting populations and age groups in varying severities worldwide. Traditional approaches to treating acne vulgaris have long consisted of the use of retinoids and antimicrobials. With high prevalence rates of acne vulgaris and its growing resistance to antibiotics, it is important to find alternative treatment options to mitigate this complication. Photodynamic therapy (PDT) has been successfully used in other disease processes and has been recently introduced for the treatment of acne vulgaris. PDT’s proposed mechanisms include inhibiting Propionibacterium acnes proliferation and promoting healthy tissue growth by altering gene expression of P. acnes and reducing tissue inflammation. With varying lasers and light sources, the approach to acne vulgaris treatment is complex and evolving. Our research consisted of a meta-analysis to evaluate PDT’s effectiveness and determine its practicality in the treatment of common acne. Data showed positive results from a multitude of PDT lasers utilized. From our research, it is suggested that PDT is effective at treating acne vulgaris but needs to be tailored to each patient in order to see optimal results. By giving dermatologists another tool in the treatment of acne vulgaris, it will distance patients from the chronic use of antimicrobials

A Framework to Prioritise Health Research Proposals for Funding: Integrating Value for Money

© 2019, Springer Nature Switzerland AG. When making funding decisions, research organisations largely consider the merits (e.g. scientific rigour and feasibility) of submitted research proposals; yet, there is often little or no reference to their value for money. This may be attributed to the challenges of assessing and integrating value of research into existing research prioritisation processes. We propose a framework that considers both the merits of research and its value for money to guide health research funding decisions. A practical framework is developed based on current processes followed by funding organizations for assessing investigator-initiated research proposals, and analytical methods for evaluating the expected value of research. We apply the analytical methods to estimate the expected return on investment of two real-world grant applications. The framework comprises four sequential steps: (1) initial screening of applications for eligibility and completeness; (2) merit assessment of eligible proposals; (3) estimating the expected value of research for the shortlisted proposals that pass the first two steps and ranking of proposals based on return on investment; and (4) selecting research proposals for funding. We demonstrate how the expected value for money can be efficiently estimated using certain information provided in funding applications. The proposed framework integrates value-for-money assessment into the existing research prioritisation processes. Considering value for money to inform research funding decisions is vital to achieve efficient utilisation of research budgets and maximise returns on research investments

Directing research funds to the right research projects: A review of criteria used by research organisations in Australia in prioritising health research projects for funding

© Author(s) (or their employer(s)) 2018. Objectives Healthcare budgets are limited, and therefore, research funds should be wisely allocated to ensure high-quality, useful and cost-effective research. We aimed to critically review the criteria considered by major Australian organisations in prioritising and selecting health research projects for funding. Methods We reviewed all grant schemes listed on the Australian Competitive Grants Register that were health-related, active in 2017 and with publicly available selection criteria on the funders' websites. Data extracted included scheme name, funding organisation, selection criteria and the relative weight assigned to each criterion. Selection criteria were grouped into five representative domains: Relevance, appropriateness, significance, feasibility (including team quality) and cost-effectiveness (ie, value for money). Results Thirty-six schemes were included from 158 identified. One-half of the schemes were under the National Health and Medical Research Council. The most commonly used criteria were research team quality and capability (94%), research plan clarity (94%), scientific quality (92%) and research impact (92%). Criteria considered less commonly were existing knowledge (22%), fostering collaboration (22%), research environment (19%), value for money (14%), disease burden (8%) and ethical/moral considerations (3%). In terms of representative domains, relevance was considered in 72% of the schemes, appropriateness in 92%, significance in 94%, feasibility in 100% and cost-effectiveness in 17%. The relative weights for the selection criteria varied across schemes with 5%-30% for relevance, 20%-60% for each appropriateness and significance, 20%-75% for feasibility and 15%-33% for cost-effectiveness. Conclusions In selecting research projects for funding, Australian research organisations focus largely on research appropriateness, significance and feasibility; however, value for money is most often overlooked. Research funding decisions should include an assessment of value for money in order to maximise return on research investment

Using fire scars and growth release in subfossil Scots pine to reconstruct prehistoric fires

Fire scars indicating low- to moderate-intensity fires on peat deposits have been sampled from subfossil Scots pine (Pinus sylvestris L.) at sites in England, Wales and south-west Ireland. Analysis of ring-width responses to one fire event in 2800 BC illustrates its rejuvenating effect on Pinus sylvestris woodland, supporting a growing body of modern and palaeoecological data that illustrates the regenerative role played by fire in persistence of Pinus sylvestris woodland. Both the scale and timing of these fires suggest that infrequent low- to moderate-intensity fires are sufficient to stimulate Pinus sylvestris growth. This effect is shown by average increases in ring-width following the fire of between 0.62 and 1.16 mm in non-scarred trees and between 0.92 and 2.74 mm in fire-scarred individuals. Growth release in non-scarred trees may prove to be a more reliable method of detecting fire than using the relatively rare fire scars alone. Radii at time of scarring varied between 1.85 and 11.2 cm, much smaller than is predicted to survive from modern studies. © 2000 Elsevier Science B.V

Recording and Reconstruction of Wood Macrofossils in Three-Dimensions

Building on an upsurge of interest in European wetland archaeology, which has led to methodological advances in field techniques, a new palaeoecological technique is outlined to enable reconstruction of wood macrofossils in their originalin situpositions within a peat deposit. Such three-dimensional reconstruction provides data on the temporal sequence and succession of mire woodland phases; these can be related to the fossil pollen record and to evidence of past human impact. Chronology building using tree ring-width series, is facilitated, and may assist in dating site records. The technique has wider application at sites where subfossiliferous peat is underlain by sand substrates, aiding palaeoenvironmental reconstruction and interpretation of the cultural landscape. © 1995 Academic Press Limited

"The California critical thinking instruments for benchmarking, program assessment, and directing curricular change"

Charles R. Phillips is an Associate Professor of Pharmacy Administration/Dept. Chair of Pharmacy Practice, Renae J. Chesnut is Associate Dean for Academic and Student Affairs. Raylene M. Rospond is Dean, Pharmacy and Health Sciences. All three are in the College of Pharmacy and Health Sciences at Drake University. They can be contacted at: [email protected], [email protected], and [email protected]. To assess pharmacy students’ critical thinking (CT) measures and identify areas for curricular reform. Methods. Pharmacy students were given the California Critical Thinking Skills Test and Disposition Index at various points in the PharmD program. Scores were compared with a national referent group and evaluated for changes across the curriculum and between classes. Results. Students were comparable to national norms. Pretest and posttest scores for total disposition showed improvement. Scores in all subcategories except for truth-seeking were consistently above 40. The CT skills of the pharmacy students varied compared with those of referent students, but the pharmacy students’ overall score of 18 was in the 73rd percentile. Pre- and post-skills scores showed improvement. Students scoring low on the pretest improved more than those scoring high. Conclusions. Students had a consistent disposition towards CT and compared favorably to national norms. Both disposition and skills improved across the curriculum. Dimensions of critical thinking on which students score low should be areas for curricular and other program changes

Influence of hyperhomocysteinemia on the cellular redox state - Impact on homocysteine-induced endothelial dysfunction

Hyperhomocysteinemia is an independent risk factor for the development of atherosclerosis. An increasing body of evidence has implicated oxidative stress as being contributory to homocysteines deleterious effects on the vasculature. Elevated levels of homocysteine may lead to increased generation of superoxide by a biochemical mechanism involving nitric oxide synthase, and, to a lesser extent, by an increase in the chemical oxidation of homocysteine and other aminothiols in the circulation. The resultant increase in superoxide levels is further amplified by homocysteinedependent alterations in the function of cellular antioxidant enzymes such as cellular glutathione peroxidase or extracellular superoxide dismutase. One direct clinical consequence of elevated vascular superoxide levels is the inactivation of the vasorelaxant messenger nitric oxide, leading to endothelial dysfunction. Scavenging of superoxide anion by either superoxide dismutase or 4,5-dihydroxybenzene 1,3-disulfonate (Tiron) reverses endothelial dysfunction in hyperhomocysteinemic animal models and in isolated aortic rings incubated with homocysteine. Similarly, homocysteineinduced endothelial dysfunction is also reversed by increasing the concentration of the endogenous antioxidant glutathione or overexpressing cellular glutathione peroxidase in animal models of mild hyperhomocysteinemia. Taken together, these findings strongly suggest that the adverse vascular effects of homocysteine are at least partly mediated by oxidative inactivation of nitric oxide

Evidence of Spatially Extensive Resistance to PCBs in an Anadromous Fish of the Hudson River

Populations of organisms that are chronically exposed to high levels of chemical contaminants may not suffer the same sublethal or lethal effects as naive populations, a phenomenon called resistance. Atlantic tomcod (Microgadus tomcod) from the Hudson River, New York, are exposed to high concentrations of polycyclic aromatic hydrocarbons (PAHs) and bioaccumulate polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs), and polychlorinated dibenzofurans (PCDFs). They have developed resistance to PCBs and PCDDs but not to PAHs. Resistance is largely heritable and manifests at early-life-stage toxic end points and in inducibility of cytochrome P4501A (CYP1A) mRNA expression. Because CYP1A induction is activated by the aryl hydrocarbon receptor (AHR) pathway, as are most toxic responses to these compounds, we sought to determine the geographic extent of resistance to CYP1A mRNA induction by PCBs in the Hudson River tomcod population. Samples of young-of-the-year tomcod were collected from seven locales in the Hudson River, extending from the Battery at river mile 1 (RM 1) to RM 90, and from the Miramichi River, New Brunswick, Canada. Laboratory-reared offspring of tomcod adults from Newark Bay, in the western portion of the Hudson River estuary, were also used in this study. Fish were partially depurated in clean water and intraperitoneally injected with 10 ppm coplanar PCB-77, 10 ppm benzo[a]pyrene (BaP), or corn oil vehicle, and levels of CYP1A mRNA were determined. CYP1A was significantly inducible by treatment with BaP in tomcod from the Miramichi River, from laboratory-spawned offspring of Newark Bay origin, and from all Hudson River sites spanning 90 miles of river. In contrast, only tomcod from the Miramichi River displayed significantly induced CYP1A mRNA expression when treated with PCB-77. Our results suggest that the population of tomcod from throughout the Hudson River estuary has developed resistance to CYP1A inducibility and probably other toxicities mediated by the AHR pathway. Tomcod from the Hudson River may represent the most geographically expansive population of vertebrates with resistance to chemical pollutants that has been characterized

Can exercise delay transition to active therapy in men with low-grade prostate cancer? A multicentre randomised controlled trial

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Introduction Active surveillance is a strategy for managing low-risk, localised prostate cancer, where men are observed with serial prostate-specific antigen assessments to identify signs of disease progression. Currently, there are no strategies to support active surveillance compliance nor are there interventions that can prevent or slow disease progression, ultimately delaying transition to active treatment before it is clinically required. Recently, we proposed that exercise may have a therapeutic potential in delaying the need for active treatment in men on active surveillance. Methods and analysis A single-blinded, two arm, multicentre randomised controlled trial will be undertaken with 168 patients randomly allocated in a ratio of 1:1 to exercise or usual care. Exercise will consist of supervised resistance and aerobic exercise performed three times per week for the first 6 months in an exercise clinical setting, and during months 7-12, a progressive stepped down approach will be used with men transitioning to once a week supervised training. Thereafter, for months 13 to 36, the men will self-manage their exercise programme. The primary endpoint will be the time until the patients begin active therapy. Secondary endpoints include disease progression (prostate specific antigen), body composition and muscle density, quality of life, distress and anxiety and an economic analysis will be performed. Measurements will be undertaken at 6 and 12 months (postintervention) and at 24 and 36 months follow-up. The primary outcome (time to initiation of curative therapy) will be analysed using Cox proportional hazards regression. Outcomes measured repeatedly will be analysed using mixed effects models to examine between-group differences. Data will be analysed using an intention-to-treat approach. Ethics and dissemination Outcomes from the study will be published in peer-reviewed academic journals and presented in scientific, consumer and clinical meetings. Trial registration number ACTRN12618000225213