Therapeutic targets in the management of striae distensae: A systematic review

BackgroundStriae distensae are permanent dermal lesions that can cause significant psychosocial distress. A detailed understanding of the numerous treatment modalities available is essential to ensuring optimal patient outcomes.ObjectiveOur objective was to evaluate and summarize the different treatment methods for striae distensae by linking their proposed modes of action with the histopathogenesis of the condition to guide patient treatment.MethodsA systematic review of the literature was performed with no limits placed on publication date. Relevant studies were assigned a level of evidence by the authors.ResultsNinety-two articles were identified, with 74 being eligible for quality assessment. The majority of treatments aim to increase collagen production. The use of vascular lasers can reduce erythema in striae rubrae by targeting hemoglobin, whereas increasing melanin through methods such as ultraviolet light is a major focus for treatment of striae albae. Despite some topical treatments being widely used, uncertainty regarding their mode of action remains. No treatment has proved to be completely effective.LimitationsLimitations of the study include low-quality evidence, small sample sizes, and varying treatment protocols and outcome measures, along with concerns regarding publication bias.ConclusionsFurther randomized, controlled trials are needed before definitive conclusions and recommendations can be made.<br/

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Navigating the Looking Glass:Severing the Lawyer's Head in <i>Arkham Asylum</i>

Reading Arkham Asylum jurisprudentially, we encounter a story of the meeting of reason and unreason in the context of justice – of conscious law and its unconscious threat. Batman’s exploration of the Asylum is symbolic of the legal unconscious, and reflects the processes of repression that can be seen in dominant legal knowledge. A threat to this dominant knowledge can be seen in Two-Face’s reliance on his coin to ‘judge’ his victims. Moreover, Arkham Asylum configures the threat of law’s unconscious as the lawyer’s severed head inside the house of law. Ultimately, Batman’s journey through Arkham Asylum reminds law of the aesthetic and irrational contexts that it strives to deny and from which it seeks to defend itself – and that cultural legal studies explores. It recalls the unreason outside law’s logic, the chaos outside its order, the madness outside its sanity. The lesson of Batman’s encounters in the Asylum is that we should remember the ‘madness’ outside the legal order, and thus recognise that law is always already more than its conscious ‘sanity’ can contain

The Influence of Iron in Minimizing the Microstructural Anisotropy of Ti-6Al-4V Produced by Laser Powder-Bed Fusion

There remains a significant challenge in adapting alloys for metal based Additive Manufacturing (AM). Adjusting alloy composition to suit the process, particularly under regimes close to industrial practice, is therefore a potential solution. With the aim of designing new Ti-based alloys of superior mechanical properties for use in laser powder-bed fusion, this research investigates the influence of Fe on the microstructural development of Ti-6Al-4V. The operating mechanisms that govern the relationship between the alloy composition (and Fe in particular) and the grain size are explored using EBSD, TEM and in-situ high-energy synchrotron X-ray diffraction. It was found that Fe additions up to 3 wt% lead to a progressive refinement of the microstructure. By exploiting the cooling rates of AM and suitable amount of Fe additions, it was possible to obtain microstructures that can be optimized by heat treatment without obvious precipitation of detrimental brittle phases. The resulting microstructure consists of a desirable and well studied fully laminar α+ β structure in refined prior-β grains

Genomic Characterization of Interspecific Hybrids and an Admixture Population Derived from Panicum amarum × \u3cem\u3eP. virgatum\u3c/em\u3e

Switchgrass (Panicum virgatum L.) and its relatives are regarded as top bioenergy crop candidates; however, one critical barrier is the introduction of useful genetic diversity and the development of new cultivars and hybrids. Combining genomes from related cultivars and species provides an opportunity to introduce new traits. In switchgrass, a breeding advantage would be achieved by combining the genomes of intervarietal ecotypes or interspecific hybrids. The recovery of wide crosses, however, is often tedious and may involve complicated embryo rescue and numerous backcrosses. Here, we demonstrate a straightforward approach to wide crosses involving the use of a selectable transgene for recovery of interspecific [P. virgatum cv. Alamo × Panicum amarum Ell. var amarulum or Atlantic Coastal Panicgrass (ACP)] F1 hybrids followed by backcrossing to generate a nontransgenic admixture population. A nontransgenic herbicide-sensitive (HbS) admixture population of 83 F1BC1 progeny was analyzed by genotyping-by-sequencing (GBS) to characterize local ancestry, parental contribution, and patterns of recombination. These results demonstrate a widely applicable breeding strategy that makes use of transgenic selectable resistance to identify and recover true hybrids

Domain-specific risk assessment using integrated simulation: A case study of an onshore wind project

Although many quantitative risk assessment models have been proposed in literature, their use in construction practice remain limited due to a lack of domain-specific models, tools, and application examples. This is especially true in wind farm construction, where the state-of-the-art integrated Monte Carlo simulation and critical path method (MCS-CPM) risk assessment approach has yet to be demonstrated. The present case study is the first reported application of the MCS-CPM method for risk assessment in wind farm construction and is the first case study to consider correlations between cost and schedule impacts of risk factors using copulas. MCS-CPM provided reasonable risk assessment results for a wind farm project, and its use in practice is recommended. Aimed at facilitating the practical application of quantitative risk assessment methods, this case study provides a much-needed analytical generalization of MCS-CPM, offering application examples, discussion of expected results, and recommendations to wind farm construction practitioners

The influence of iron in minimizing the microstructural anisotropy of Ti-6Al-4V produced by laser powder-bed fusion

There remains a significant challenge in adapting alloys for metal-based additive manufacturing (AM). Adjusting alloy composition to suit the process, particularly under regimes close to industrial practice, is therefore a potential solution. With the aim of designing new Ti-based alloys of superior mechanical properties for use in laser powder-bed fusion, this research investigates the influence of Fe on the microstructural development of Ti-6Al-4V. The operating mechanisms that govern the relationship between the alloy composition (and Fe in particular) and the grain size are explored using EBSD, TEM, and in situ high-energy synchrotron X-ray diffraction. It was found that Fe additions up to 3 wt pct lead to a progressive refinement of the microstructure. By exploiting the cooling rates of AM and suitable amount of Fe additions, it was possible to obtain microstructures that can be optimized by heat treatment without obvious precipitation of detrimental brittle phases. The resulting microstructure consists of a desirable and well-studied fully laminar α + β structure in refined prior-β grains

New horizons in improving research capacity in English care homes for older adults

As the care home sector expands over time, the health and social care needs of both residents and staff intensify and diversify. These sector-wide changes call for significant growth in research capacity to deliver useful, pertinent and timely evidence. In this paper we highlight growing pressures in the care home sector, and the major and enduring barriers to conducting research across that sector, within homes and amongst staff, drawing primarily on our experiences conducting public health research in England. These obstacles include a lack of national infrastructure, tradition and culture, and underdeveloped systems to reimburse providers for the staff and other costs associated with research delivery. Finally, we detail short, medium and long-term actions that could enable the growth of research capacity across the sector. These include leveraging political will, remunerating and crediting research champions, and establishing a feedback loop to showcase the contribution of research in improving both quality of care and resident outcomes. Our suggested actions focus on what would be required to build research capacity in care homes in England; although these also have relevance in other countries where there is a need and wish to build research capacity in adult long-term care facilities

Generation of graded porous structures by control of process parameters in the selective laser melting of a fixed ratio salt-metal feedstock

The demonstration of salt dissolution incorporated within laser powder-bed fusion fabrication processes has allowed the creation of complex porous structures without the need for sophisticated design algorithms. This serves to simplify the process, for porous structure creation in powder-bed fabrication techniques, creating a new opportunity for the realisation of optimised structures. A new methodology is presented here in which modulation of the energy density while using a single feedstock material enables three-dimensional control of porosity, ranging from 20% to 49%. Through structured experimentation, the response of the material to varying the process parameters in selective laser melting is evaluated and nested structures of distinct densities and morphologies are created. Correlation of the process parameters with modulus and ultimate compressive stress are established. A simple-assembly algorithm was used to generate complex parts consisting of locally assigned porosities having characteristic properties