121 research outputs found

    Linear Dichroism in Resonant Inelastic X-Ray Scattering to Molecular Spin-Orbit States

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    Polarization-dependent resonant inelastic x-ray scattering (RIXS) is shown to be a new probe of molecular-field effects on the electronic structure of isolated molecules. A combined experimental and theoretical analysis explains the linear dichroism observed in Cl 2p RIXS following Cl 1s excitation in HCl and CF3Cl as due to molecular-field effects, including singlet-triplet exchange, indicating polarized-RIXS provides a direct probe of spin-orbit-state populations applicable to any molecule

    Experimental and Theoretical Investigation of Molecular Field Effects by Polarization-resolved Resonant Inelastic X-ray Scattering

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    We present a combined theoretical and experimental study of molecular field effects on molecular core levels. Polarization-dependent resonant inelastic x-ray scattering is observed experimentally after resonant K-shell excitation of CF3Cl and HCl. We explain the linear dichroism observed in spin-orbit level intensities as due to molecular field effects, including singlet-triplet exchange, and interpret this behavior in terms of population differences in the 2px,y,z inner-shell orbitals. We investigate theoretically the different factors that can affect the electronic populations and the dynamical R dependence of the spin-orbit ratio. Finally, the results obtained are used to interpret the L-shell absorption spectra of the two molecules

    The journey of patients with skin diseases from the first consultation to the diagnosis in a representative sample of the European general population from the EADV burden of skin diseases study

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    Background: The journey of patients with skin diseases through healthcare has been scarcely investigated. Objective: To analyse the journey of people with skin diseases in the different healthcare environment in Europe. Methods: This multinational, cross-sectional, European study was conducted on a representative sample of the adult general population of 27 European countries. The prevalence of the most frequent skin diseases was determined. Information was collected on the patient journey from the first medical consultation to the diagnosis, and the reasons for not consulting a healthcare professional. Results: On a total of 44,689 individuals, 30.3% reported to have consulted a dermatologist during the previous 2 years. Participants consulted mainly for mole control or skin cancer screening (22.3%), followed by chronic skin diseases (16.2%). The diagnoses of acne, atopic dermatitis, psoriasis and rosacea were made most frequently by a dermatologist, while fungal skin infections were diagnosed more often by a general practitioner (GP), and sexually transmitted diseases (STD) by other specialists. The diagnosis was not always definitive at the first consultation, in particular for STD. The percentage of people who did not consult a healthcare professional for their skin disease was particularly high for acne (36.4%), alopecia (44.7%) and fungal infection (30.0%). Moreover, 17.7% of respondents with psoriasis did not consult. A high percentage of participants with alopecia thought that the disease was not worrying, while patients with psoriasis often answered that they were able to manage the disease since they had already consulted a doctor. Many patients with acne (41.1%) and fungal infection (48.2%) thought that they were able to handle the disease by themselves. Conclusion: The analysis of the self-reported medical journey of patients with common skin diseases may allow to understand the unmet needs of patients, thus improving outcomes and reducing expenses.</p

    Public perception of dermatologists in Europe:Results from a population-based survey

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    BACKGROUND: The public perception of dermatology has been poorly investigated in Europe. OBJECTIVE: To determine the general public's perception of dermatologists in Europe. METHODS: This multinational, cross-sectional study was conducted within the framework of the EADV population-based survey on the 'Burden of skin diseases in Europe'. Data were collected using a web-based online survey on a representative sample of the general populations aged 18 years or more of 27 European countries. Proportional quota sampling with replacement design was used for each country. RESULTS: A total of 44,689 adult participants responded to the questionnaire, of whom 18,004 visited a dermatologist in the preceding 3 years. The dermatologist was the second most often visited specialist among all medical specialties, with 69.7%, 72.1%, 42.1% and 78.1% of participants in Western Europe (WE), Eastern Europe (EE), Northern Europe (NE) and Southern Europe (SE), respectively, having consulted a dermatologist over the past 24 months. Most participants across all regions agreed that the dermatologist was the first healthcare provider for chronic skin diseases (61.9% in WE, 69.8% in EE, 45.7% in NE and 60.4% in SE) and for skin cancers (65.5% in WE, 67.6% in EE, 42.4% in NE and 63.0% in SE). The five most common reasons for visiting a dermatologist among all participants were: naevi check-up or skin cancer screening (20.2%), chronic skin diseases (16.5%), acute skin diseases (12.4%), cosmetic advice or procedure (10.2%), hyperpigmentation or congenital lesions (9.1%) and hair or nail disorder (7.7%). Most participants (84.6% in WE, 82.5% in EE, 78.3% in NE and 82.8% in SE) were very swatisfied/somewhat satisfied with the service provided. CONCLUSION: Our study findings underscore the central role of dermatologists in skin health and highlights them as valued and trusted care providers across Europe. Understanding the perceived position of the dermatologist is the first step in improving health policy development and implementation. Notably, access to a dermatologist was lowest in NE, probably reflecting differences in healthcare organizational structures or possibly cultural differences in healthcare seeking behaviour.</p

    Quality of life and stigmatization in people with skin diseases in Europe:A large survey from the ‘burden of skin diseases’ EADV project

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    Background: Several large studies on the burden of skin diseases have been performed in patients recruited in hospitals or clinical centres, thus missing people with skin diseases who do not undergo a clinical consultation. Objectives: To evaluate the burden of the most common dermatological diseases in adult patients across Europe, in terms of quality of life, work life, and stigmatization. Methods: Population-based survey on a representative sample of the European general population aged 18 years or older. Participants who declared to have had one or more skin problem or disease during the previous 12 months completed the Dermatology Life Quality Index questionnaire, and answered questions regarding the impact of their skin disease on daily and work life, anxiety/depression, and stigmatization. Results: The study population included 19,915 individuals, 44.7% of whom were men. Quality of life was particularly impaired in people with hidradenitis suppurativa (HS), and sexually transmitted diseases. About a half of participants with acne, alopecia, or chronic urticaria, and about 40% of those with atopic dermatitis (AD), skin cancers, or psoriasis reported a modest to extremely large effect of the disease on their quality of life. Overall, 88.1% of participants considered their skin disease as embarrassing in personal life and 83% in work life. About half of the respondents reported sleeping difficulty, feeling tired, and impact of the disease on taking care of themselves. Concerning stigmatization, 14.5% felt to have been rejected by others because of the skin disease, and 19.2% to have been looked at with disgust. Anxiety and depression were frequently reported by patients with all the diseases. Conclusions: Skin diseases may heavily affect patients' daily and work life, and cause feelings of stigmatization. An early intervention is needed to avoid consequences on the patients' life course.</p

    The prevalence of skin diseases in Greece, impact on quality of life and stigmatization:A population-based survey study

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    Background: There is no population-based evidence on the prevalence and impact of skin diseases in Greece. Objectives: To describe the prevalence of 12 main skin diseases and their impact on quality of life (QoL) and feelings of stigmatization in the Greek population. Methods: A population-based survey in an adult Greek representative sample was carried out as part of the multinational ‘EADV burden of skin diseases study’. Quality of life (QOL) was measured using the Dermatology Life Quality Index (DLQI) and the Visual Analogue Scale (VAS) from the EuroQol-5D (EQ. 5D) questionnaires. Results: In 1010 participants, 47.8% (n = 483) declared at least one skin disease or condition or skin-related unpleasant sensation in the last 12 months. Fungal skin infection was reported with the higher prevalence (7.5%), followed by alopecia (5.7%), atopic dermatitis (5%), acne (3.6%), sexually transmitted diseases (2.7%), psoriasis (2.2%) chronic urticaria (1.5%), rosacea (1.3%), nonmelanoma skin cancer (1.5%), vitiligo (0.6%), cutaneous melanoma (0.6%) and hidradenitis suppurativa (0.3%). Mean VAS-EQ. 5D and DLQI scores were 77.8 and 2.2, respectively. Among those reporting at least one skin problem, 68.1% reported an impact of the skin condition on their personal life and 51% reported an impact on time to take care of themselves. Regarding the impact on work-life decisions, 22.2% reoriented their professional activity, 13% were refused a professional offer, 22.2% did not get the job they hoped to and 16.7% chose their work with their skin problem in mind. Regarding feelings of stigmatization, 12% felt left out/rejected by others, 6.6% were refused access to leisure facilities and 9.8% reported the impression to be looked at with disgust. Conclusions: Our population-based study provides new information on the prevalence of skin diseases in the Southern European country of Greece and highlights the impact of prevalent skin disease on life-altering decisions and stigmatization.</p

    The prevalence of skin diseases in Greece, impact on quality of life and stigmatization:A population-based survey study

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    Background: There is no population-based evidence on the prevalence and impact of skin diseases in Greece. Objectives: To describe the prevalence of 12 main skin diseases and their impact on quality of life (QoL) and feelings of stigmatization in the Greek population. Methods: A population-based survey in an adult Greek representative sample was carried out as part of the multinational ‘EADV burden of skin diseases study’. Quality of life (QOL) was measured using the Dermatology Life Quality Index (DLQI) and the Visual Analogue Scale (VAS) from the EuroQol-5D (EQ. 5D) questionnaires. Results: In 1010 participants, 47.8% (n = 483) declared at least one skin disease or condition or skin-related unpleasant sensation in the last 12 months. Fungal skin infection was reported with the higher prevalence (7.5%), followed by alopecia (5.7%), atopic dermatitis (5%), acne (3.6%), sexually transmitted diseases (2.7%), psoriasis (2.2%) chronic urticaria (1.5%), rosacea (1.3%), nonmelanoma skin cancer (1.5%), vitiligo (0.6%), cutaneous melanoma (0.6%) and hidradenitis suppurativa (0.3%). Mean VAS-EQ. 5D and DLQI scores were 77.8 and 2.2, respectively. Among those reporting at least one skin problem, 68.1% reported an impact of the skin condition on their personal life and 51% reported an impact on time to take care of themselves. Regarding the impact on work-life decisions, 22.2% reoriented their professional activity, 13% were refused a professional offer, 22.2% did not get the job they hoped to and 16.7% chose their work with their skin problem in mind. Regarding feelings of stigmatization, 12% felt left out/rejected by others, 6.6% were refused access to leisure facilities and 9.8% reported the impression to be looked at with disgust. Conclusions: Our population-based study provides new information on the prevalence of skin diseases in the Southern European country of Greece and highlights the impact of prevalent skin disease on life-altering decisions and stigmatization.</p

    Femtosecond Nuclear Motion of HCl Probed by Resonant X-ray Raman Scattering in the Cl 1s Region

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    Femtosecond dynamics are observed by resonant x-ray Raman scattering (RXS) after excitation along the dissociative Cl 1s→6ơ* resonance of gas-phase HCl. The short core-hole lifetime results in a complete breakdown of the common nondispersive behavior of soft-x-ray transitions between parallel potentials. We evidence a general phenomenon of RXS in the hard-x-ray region: a complete quenching of vibrational broadening. This opens up a unique opportunity for superhigh resolution x-ray spectroscopy beyond vibrational and lifetime limitations

    Comparative effectiveness of bimekizumab and ustekinumab in patients with psoriatic arthritis at 52 weeks assessed using a matching-adjusted indirect comparison

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    Introduction: A matching-adjusted indirect comparison (MAIC) was conducted to assess the relative efficacy at 52 weeks (Wk52) of bimekizumab 160 mg every 4 weeks (Q4W) and ustekinumab 45 or 90 mg every 12 weeks (Q12W) in patients with psoriatic arthritis (PsA) who were biologic disease-modifying anti-rheumatic drug naïve (bDMARD naïve) or who had a previous inadequate response or an intolerance to tumor necrosis factor inhibitors (TNFi-IR). Methods: Relevant trials were systematically identified. Individual patient data from the bimekizumab trials BE OPTIMAL (NCT03895203; N = 431) and BE COMPLETE (NCT03896581; N = 267) were matched with summary data on patients receiving ustekinumab in the PSUMMIT 1 trial (NCT01009086; 45 mg, N = 205; 90 mg; N = 204) and a subgroup of TNFi-IR patients receiving ustekinumab in the PSUMMIT 2 trial (NCT01077362; 45 mg, N = 60; 90 mg, N = 58), respectively. Patients from the bimekizumab trials were re-weighted using propensity scores to match the baseline characteristics of the ustekinumab trial patients. Adjustment variables were selected based on expert consensus (n = 5) and adherence to established MAIC guidelines. Non-placebo-adjusted comparisons of recalculated bimekizumab and ustekinumab outcomes for the American College of Rheumatology (ACR) 20/50/70 response criteria (non-responder imputation) were analyzed. Results: In patients who were bDMARD naïve, bimekizumab had a greater likelihood of response than ustekinumab at Wk52 for ACR20 (odds ratio [95% confidence interval] 45 mg: 2.14 [1.35, 3.40]; 90 mg: 1.98 [1.24, 3.16]), ACR50 (45 mg: 2.74 [1.75, 4.29]; 90 mg: 2.29 [1.48, 3.55]), and ACR70 (45 mg: 3.33 [2.04, 5.46]; 90 mg: 3.05 [1.89, 4.91]). In patients who were TNFi-IR, bimekizumab had a greater likelihood of response than ustekinumab at Wk52 for ACR20 (45 mg: 4.17 [2.13, 8.16]; 90 mg: 4.19 [2.07, 8.49]), ACR50 (45 mg: 5.00 [2.26, 11.05]; 90 mg: 3.86 [1.70, 8.79]), and ACR70 (45 mg: 9.85 [2.79, 34.79]; 90 mg: 6.29 [1.98, 20.04]). Conclusions: Using MAIC, bimekizumab showed greater efficacy than ustekinumab in achieving all ACR responses in patients with PsA who were bDMARD naïve and TNFi-IR at Wk52. Trial Registration: NCT03895203, NCT03896581, NCT01009086, NCT01077362

    Comparative effectiveness of bimekizumab and risankizumab in patients with psoriatic arthritis at 52 weeks assessed using a matching-adjusted indirect comparison

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    Introduction: The relative efficacy of bimekizumab and risankizumab in patients with PsA who were biologic disease-modifying anti-rheumatic drug naïve (bDMARD naïve) or with previous inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR) was assessed at 52 weeks (Wk52) using matching-adjusted indirect comparisons (MAIC). Methods: Relevant trials were systematically identified. For patients who were bDMARD naïve, individual patient data (IPD) from BE OPTIMAL (NCT03895203; N = 431) were matched with summary data from KEEPsAKE-1 (NCT03675308; N = 483). For patients who were TNFi-IR, IPD from BE COMPLETE (NCT03896581; N = 267) were matched with summary data from the TNFi-IR patient subgroup in KEEPsAKE-2 (NCT03671148; N = 106). To adjust for cross-trial differences, patients from the bimekizumab trials were re-weighted to match the baseline characteristics of patients in the risankizumab trials. Adjustment variables were selected based on expert consensus (n = 5) and adherence to established MAIC guidelines. Recalculated bimekizumab Wk52 outcomes for American College of Rheumatology (ACR) 20/50/70 response criteria and minimal disease activity (MDA) index (non-responder imputation) were compared with risankizumab outcomes via non-placebo-adjusted comparisons. Results: In patients who were bDMARD naïve, bimekizumab had a significantly greater likelihood of response than risankizumab at Wk52 for ACR50 (odds ratio [95% confidence interval]: 1.52 [1.11, 2.09]) and ACR70 (1.80 [1.29, 2.51]). In patients who were TNFi-IR, bimekizumab had a significantly greater likelihood of response than risankizumab at Wk52 for ACR20 (1.78 [1.08, 2.96]), ACR50 (3.05 [1.74, 5.32]), ACR70 (3.69 [1.82, 7.46]), and MDA (2.43 [1.37, 4.32]). Conclusions: Using MAIC, bimekizumab demonstrated a greater likelihood of efficacy in most ACR and MDA outcomes than risankizumab in patients with PsA who were bDMARD naïve and TNFi-IR at Wk52. Trial Registration NCT03895203, NCT03896581, NCT03675308, NCT03671148
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