The relationship between local scalp skin temperature and cutaneous perfusion during scalp cooling

Cooling the scalp during administration of chemotherapy can prevent hair loss. It reduces both skin blood flow and hair follicle temperature, thus affecting drug supply and drug effect in the hair follicle. The extent to which these mechanisms contribute to the hair preservative effect of scalp cooling remains unknown. The purpose of this study was to establish a relationship between local scalp skin temperature and cutaneous blood flow during scalp cooling. We measured skin temperature and cutaneous perfusion during a cooling and re-warming experiment. Experiments on a single subject showed that the measurements were reproducible and that the response was identical for the two positions that were measured. Inter-subject variability was investigated on nine subjects. We found that for the first 10 °C of cooling, perfusion of the scalp skin decreases to below 40%. Perfusion can be further reduced to below 30% by a few degrees more cooling, but a plateau is reached after that. We found that a generally accepted relation in thermal physiology between temperature and perfusion (i.e. Q10 relation) does not describe the data well, but we found an alternative relation that describes the average behavior significantly better

Development of a patient-reported palliative care-specific health classification system: the POS-E

BackgroundGeneric preference-based measures are commonly used to estimate quality-adjusted life-years (QALYs) to inform resource-allocation decisions. However, concerns have been raised that generic measures may be inappropriate in palliative care.ObjectiveOur objective was to derive a health-state classification system that is amenable to valuation from the ten-item Palliative Care Outcome Scale (POS), a widely used patient-reported outcome measure in palliative care.MethodsThe dimensional structure of the original POS was assessed using factor analysis. Item performance was assessed, using Rasch analysis and psychometric criteria, to enable the selection of items that represent the dimensions covered by the POS. Data from six studies of patients receiving palliative care were combined (N = 1011) and randomly split into two halves for development and validation. Analysis was undertaken on the development data, and results were validated by repeating the analysis with the validation dataset.ResultsFollowing Rasch and factor analyses, a classification system of seven items was derived. Each item had two to three levels. Rasch threshold map helped identify a set of 14 plausible health states that can be used for the valuation of the instrument to derive a preference-based index.ConclusionCombining factor analysis and Rasch analysis with psychometric criteria provides a valid method of constructing a classification system for a palliative care-specific preference-based measure. The next stage is to obtain preference weights so the measure can be used in economic evaluations in palliative care

Temporary streams in temperate zones: recognizing, monitoring and restoring transitional aquatic-terrestrial ecosystems

Temporary streams are defined by periodic flow cessation, and may experience partial or complete loss of surface water. The ecology and hydrology of these transitional aquatic-terrestrial ecosystems have received unprecedented attention in recent years. Research has focussed on the arid, semi-arid, and Mediterranean regions in which temporary systems are the dominant stream type, and those in cooler, wetter temperate regions with an oceanic climate influence are also receiving increasing attention. These oceanic systems take diverse forms, including meandering alluvial plain rivers, ‘winterbourne’ chalk streams, and peatland gullies. Temporary streams provide ecosystem services and support a diverse biota that includes rare and endemic specialists. We examine this biota and illustrate that temporary stream diversity can be higher than in comparable perennial systems, in particular when differences among sites and times are considered; these diversity patterns can be related to transitions between lotic, lentic, and terrestrial instream conditions. Human impacts on temperate-zone temporary streams are ubiquitous, and result from water-resource and land-use-related stressors, which interact in a changing climate to alter natural flow regimes. These impacts may remain uncharacterized due to inadequate protection of small temporary streams by current legislation, and hydrological and biological monitoring programs therefore require expansion to better represent temporary systems. Novel, temporary-stream-specific biomonitors and multi-metric indices require development, to integrate characterization of ecological quality during lotic, lentic, and terrestrial phases. In addition, projects to restore flow regimes, habitats, and communities may be required to improve the ecological quality of temporary stream

Field-Induced Magnetization Steps in Intermetallic Compounds and Manganese Oxides: The Martensitic Scenario

Field-induced magnetization jumps with similar characteristics are observed at low temperature for the intermetallic germanide Gd5Ge4and the mixed-valent manganite Pr0.6Ca0.4Mn0.96Ga0.04O3. We report that the field location -and even the existence- of these jumps depends critically on the magnetic field sweep rate used to record the data. It is proposed that, for both compounds, the martensitic character of their antiferromagnetic-to-ferromagnetic transitions is at the origin of the magnetization steps.Comment: 4 pages,4 figure

Anisotropic low field behavior and the observation of flux jumps in CeCoIn5

The magnetic behavior of the heavy fermion superconductor CeCoIn5 has been investigated. The low field magnetization data show flux jumps in the mixed state of the superconducting phase in a restricted range of temperature. These flux jumps begin to disappear below 1.7 K, and are completely absent at 1.5 K. The magnetization loops are asymmetric, suggesting that surface and geometrical factors dominate the pinning in this system. The lower critical field (Hc1), obtained from the magnetization data, shows a linear temperature dependence and is anisotropic. The calculated penetration depth is also anisotropic, which is consistent with the observation of an anisotropic superconducting gap in CeCoIn5. The critical currents, determined from the high field isothermal magnetization loops, are comparatively low (around 4000 A/cm2 at 1.6 K and 5 kOe).Comment: 4 pages 3 figure

Optic nerve head three-dimensional shape analysis

We present a method for optic nerve head (ONH) 3-D shape analysis from retinal optical coherence tomography (OCT). The possibility to noninvasively acquire in vivo high-resolution 3-D volumes of the ONH using spectral domain OCT drives the need to develop tools that quantify the shape of this structure and extract information for clinical applications. The presented method automatically generates a 3-D ONH model and then allows the computation of several 3-D parameters describing the ONH. The method starts with a high-resolution OCT volume scan as input. From this scan, the model-defining inner limiting membrane (ILM) as inner surface and the retinal pigment epithelium as outer surface are segmented, and the Bruch's membrane opening (BMO) as the model origin is detected. Based on the generated ONH model by triangulated 3-D surface reconstruction, different parameters (areas, volumes, annular surface ring, minimum distances) of different ONH regions can then be computed. Additionally, the bending energy (roughness) in the BMO region on the ILM surface and 3-D BMO-MRW surface area are computed. We show that our method is reliable and robust across a large variety of ONH topologies (specific to this structure) and present a first clinical application