International bullous diseases group: consensus on diagnostic criteria for epidermolysis bullosa acquisita

BACKGROUND: Epidermolysis bullosa acquisita (EBA) is a complex autoimmune bullous disease disease with variable clinical presentations and multiple possible diagnostic tests, making an international consensus on the diagnosis of EBA essential. ----- OBJECTIVES: To obtain an international consensus on the clinical and diagnostic criteria for EBA. ----- METHODS: The International Bullous Diseases Group (IBDG) met three times to discuss the clinical and diagnostic criteria for EBA. For the final voting exercise, 22 experts from 14 different countries voted on 50 different items. When > 30% disagreed with a proposal, a discussion was held and re-voting carried out. ----- RESULTS: In total, 48 of 50 proposals achieved consensus after discussion. This included nine diagnostic criteria, which are summarized in a flow chart. The IBDG was unable to determine one procedure that would be applicable worldwide. A limitation of the study is that differential diagnosis of bullous systemic lupus erythematosus has not been addressed. ----- CONCLUSIONS: This first international consensus conference established generally agreed-upon clinical and laboratory criteria defining the clinical classification of and diagnostic testing for EBA. Holding these voting exercises in person with the possibility of discussion prior to voting has advantages in reaching consensus over Delphi exercises with remote voting

On the mechanisms governing gas penetration into a tokamak plasma during a massive gas injection

A new 1D radial fluid code, IMAGINE, is used to simulate the penetration of gas into a tokamak plasma during a massive gas injection (MGI). The main result is that the gas is in general strongly braked as it reaches the plasma, due to mechanisms related to charge exchange and (to a smaller extent) recombination. As a result, only a fraction of the gas penetrates into the plasma. Also, a shock wave is created in the gas which propagates away from the plasma, braking and compressing the incoming gas. Simulation results are quantitatively consistent, at least in terms of orders of magnitude, with experimental data for a D 2 MGI into a JET Ohmic plasma. Simulations of MGI into the background plasma surrounding a runaway electron beam show that if the background electron density is too high, the gas may not penetrate, suggesting a possible explanation for the recent results of Reux et al in JET (2015 Nucl. Fusion 55 093013)

Mechanisms of human skin cell motility

The extracellular matrix (ECM) in contact with the cells and the soluble growth factors (GFs) binding to their cell surface receptors are the two main signals that directly regulate cell motility. Human keratinocytes and dermal fibroblasts are two primary cell types in skin that must undergo migration for skin wounds to heal. In this cell migration, ECMs play an “active” role by providing the cells with both focal adhesions and a migration-initiating signal, even in the absence of GFs. In contrast, GFs cannot initiate cell migration in the absence of a pro-migratory ECM. Rather, GFs play a “passive” role by enhancing the ECM-initiated motility and giving the moving cells directionality. Inside the cells, the initiation signal of the ECM and the optimization signals of the GFs are propagated by both overlapping and discrete signaling networks. However, activation of no single signaling pathway by itself is sufficient to replace the role of ECMs or GFs. This review focuses on our current understanding of both the individual and the combined functions of ECMs and GFs in the control of skin cell motility. An abbreviation of the terminologies used in this article is provided