Photodynamic therapy leads to significant improvement of actinic keratosis area and severity index (AKASI)

Background: Actinic keratosis area and severity index (AKASI) is a new quantitative tool for assessing AK severity on the head and can be used to monitor outcomes of different therapies. The aim of this study was to determine treatment outcomes of AK applying AKASI three months after conventional photodynamic therapy (PDT). Methods: We performed a retrospective analysis of patients who have undergone PDT on the head and had a documented AKASI evaluation prior to PDT and at follow-up visits. Results: Of the 33 patients included, 32 (97.0%) patients showed an AKASI reduction and 1 (3.0%) patient an increase of AKASI at follow-up visits compared to baseline. The median (range) follow-up period was 96 days (70-161). The median difference of AKASI values between both visits was 73.7% (-34.8-100.0%). The Wilcoxon test showed highly significant differences (P < 0.0001) between visits. 14 (42.4%) patients showed an AKASI 100 (complete clearance), 16 (48.5%) an AKASI 75 and 24 (72.7%) an AKASI 50, respectively. The Mann-Whitney U test showed in a subgroup analysis of patients with a positive history of at least more than one intervention and treatment naïve patients significant differences in these two groups (P = 0.0302). Conclusions: AKASI represents a feasible and comparable tool for objectively assessing field-directed treatment modalities such as PDT in daily routine. The establishment of AKASI 50, 75, 100 serves as an objective measure to compare treatment outcomes to baseline severity of AK

Microlaser-based contractility sensing in single cardiomyocytes and whole hearts

Microscopic whispering gallery mode lasers detect minute changes in cellular refractive index inside individual cardiac cells and in live zebrafish. We show that these signals encode cardiac contractility that can be used for intravital sensing.Postprin

European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 1: treatment delivery and established indications – actinic keratoses, Bowen''s disease and basal cell carcinomas

Topical photodynamic therapy (PDT) is a widely approved therapy for actinic keratoses, Bowen''s disease (squamous cell carcinoma in situ), superficial and certain thin basal cell carcinomas. Recurrence rates when standard treatment protocols are used are typically equivalent to existing therapies, although inferior to surgery for nodular basal cell carcinoma. PDT can be used both as lesional and field therapies and has the potential to delay/reduce the development of new lesions. A protocol using daylight to treat actinic keratoses is widely practised, with conventional PDT using a red light after typically a 3-h period of occlusion employed for other superficial skin cancer indications as well as for actinic keratoses when daylight therapy is not feasible. PDT is a well-tolerated therapy although discomfort associated with conventional protocol may require pain-reduction measures. PDT using daylight is associated with no or minimal pain and preferred by patient. There is an emerging literature on enhancing conventional PDT protocols or combined PDT with another treatment to increase response rates. This guideline, published over two parts, considers all current approved and emerging indications for the use of topical PDT in dermatology, prepared by the PDT subgroup of the European Dermatology Forum guidelines committee. It presents consensual expert recommendations reflecting current published evidence

Geological controls on the geometry of incised-valley fills: Insights from a global dataset of late-Quaternary examples

Incised valleys that develop due to relative sea-level change are common features of continental shelves and coastal plains. Assessment of the factors that control the geometry of incised-valley fills has hitherto largely relied on conceptual, experimental or numerical models, else has been grounded on case studies of individual depositional systems. Here, a database-driven statistical analysis of 151 late-Quaternary incised-valley fills has been performed, the aim being to investigate the geological controls on their geometry. Results of this analysis have been interpreted with consideration of the role of different processes in determining the geometry of incised-valley fills through their effect on the degree and rate of river incision, and on river size and mobility. The studied incised-valley fills developed along active margins are thicker and wider, on average, than those along passive margins, suggesting that tectonic setting exerts a control on the geometry of incised-valley fills, likely through effects on relative sea-level change and river behaviour, and in relation to distinct characteristics of basin physiography, water discharge and modes of sediment delivery. Valley-fill geometry is positively correlated with the associated drainage-basin size, confirming the dominant role of water discharge. Climate is also inferred to exert a potential control on valley-fill dimensions, possibly through modulations of temperature, peak precipitation, vegetation and permafrost, which would in turn affect water discharge, rates of sediment supply and valley-margin stability. Shelves with slope breaks that are currently deeper than 120 m contain incised-valley fills that are thicker and wider, on average, than those hosted on shelves with breaks shallower than 120 m. No correlation exists between valley-fill thickness and present-day coastal-prism convexity, which is measured as the difference in gradient between lower coastal plains and inner shelves. These findings challenge some concepts embedded in sequence stratigraphic thinking, and have significant implications for analysis and improved understanding of source-to-sink sediment route-ways, and for attempting predictions of the occurrence and characteristics of hydrocarbon reservoirs

Multiwavelength studies of MHD waves in the solar chromosphere: An overview of recent results

The chromosphere is a thin layer of the solar atmosphere that bridges the relatively cool photosphere and the intensely heated transition region and corona. Compressible and incompressible waves propagating through the chromosphere can supply significant amounts of energy to the interface region and corona. In recent years an abundance of high-resolution observations from state-of-the-art facilities have provided new and exciting ways of disentangling the characteristics of oscillatory phenomena propagating through the dynamic chromosphere. Coupled with rapid advancements in magnetohydrodynamic wave theory, we are now in an ideal position to thoroughly investigate the role waves play in supplying energy to sustain chromospheric and coronal heating. Here, we review the recent progress made in characterising, categorising and interpreting oscillations manifesting in the solar chromosphere, with an impetus placed on their intrinsic energetics.Comment: 48 pages, 25 figures, accepted into Space Science Review

Student Experiences of Multidisciplinarity in the Undergraduate Geography Curriculum

This paper explores the student experience of multidisciplinarity within the undergraduate Geography curriculum. It considers the drivers that have underpinned this development before considering the findings of research into student experiences in two universities in the south of England. The results suggest that most students view this development positively and recognize a number of advantages that it brings, citing expanded opportunities for learning, working with people from other disciplines, expansion of perspectives and perceived benefits to employability. However, for a minority this development is more problematic. The research points here to issues with specialist knowledge and disciplinary pedagogies, social issues within the classroom and class organization and some reservations regarding groupwork. The paper concludes with a series of recommendations

Physics of Solar Prominences: I - Spectral Diagnostics and Non-LTE Modelling

This review paper outlines background information and covers recent advances made via the analysis of spectra and images of prominence plasma and the increased sophistication of non-LTE (ie when there is a departure from Local Thermodynamic Equilibrium) radiative transfer models. We first describe the spectral inversion techniques that have been used to infer the plasma parameters important for the general properties of the prominence plasma in both its cool core and the hotter prominence-corona transition region. We also review studies devoted to the observation of bulk motions of the prominence plasma and to the determination of prominence mass. However, a simple inversion of spectroscopic data usually fails when the lines become optically thick at certain wavelengths. Therefore, complex non-LTE models become necessary. We thus present the basics of non-LTE radiative transfer theory and the associated multi-level radiative transfer problems. The main results of one- and two-dimensional models of the prominences and their fine-structures are presented. We then discuss the energy balance in various prominence models. Finally, we outline the outstanding observational and theoretical questions, and the directions for future progress in our understanding of solar prominences.Comment: 96 pages, 37 figures, Space Science Reviews. Some figures may have a better resolution in the published version. New version reflects minor changes brought after proof editin

An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types