Enhanced accuracy through machine learning-based simultaneous evaluation: a case study of RBS analysis of multinary materials

We address the high accuracy and precision demands for analyzing large in situ or in operando spectral data sets. A dual-input artificial neural network (ANN) algorithm enables the compositional and depth-sensitive analysis of multinary materials by simultaneously evaluating spectra collected under multiple experimental conditions. To validate the developed algorithm, a case study was conducted analyzing complex Rutherford backscattering spectrometry (RBS) spectra collected in two scattering geometries. The dual-input ANN analysis excelled in providing a systematic analysis and precise results, showcasing its robustness in handling complex data and minimizing user bias. A comprehensive comparison with human supervision analysis and conventional single-input ANN analysis revealed a reduced susceptibility of the dual-input ANN analysis to inaccurately known setup parameters, a common challenge in material characterization. The developed multi-input approach can be extended to a wide range of analytical techniques, in which the combined analysis of measurements performed under different experimental conditions is beneficial for disentangling details of the material properties.

Shared Perspectives of Patients With Advanced Cancer and Their Informal Caregivers on Essential Aspects of Health Care: A Qualitative Study

OBJECTIVE

The aim of this study is to explore the essential aspects of health care according to patients with advanced cancer and their informal caregivers by using a dyadic approach.

METHODS

Seven focus groups and 7 in-depth semi-structured interviews were conducted. Patients with advanced cancer and informal caregivers were recruited between January 2017 and June 2017 in 6 Dutch hospitals. All interviews were audiotaped, transcribed verbatim, and open coded using a thematic analysis approach. For this analysis Atlas.ti was used.

RESULTS

There was congruence between the aspects mentioned by patients and their informal caregiver. Two essential aspects of quality of care arose: "relation" and "organization of care." Regarding relation, patients and informal caregivers found it essential that health care professionals were personally engaged and provided support and compassion. Regarding organization of care, patients and informal caregivers expressed the importance of supportive care being offered multiple times during the disease trajectory, continuity of care, and well-organized logistics tailored to their needs.

CONCLUSION

This study generates awareness among health care professionals that patients with advanced cancer and their relatives have similar perspectives on essential aspects of care and may increase anticipation to meet health care preferences to optimize care.

Pulmonary complications and survival after elective infrarenal endovascular abdominal aneurysm repair in patients with documented chronic obstructive pulmonary disease

BACKGROUND

Elective abdominal aortic aneurysm (AAA) repair is advocated in patients where risk of rupture exceeds the risks of peri-procedural morbidity and mortality. Chronic obstructive pulmonary disease (COPD) is a known risk factor for AAA and increased operative morbidity in general. Since literature on the correlation between the clinical classification of COPD and morbidity following endovascular infrarenal AAA repair (EVAR) is scarce, assessment per individual remains a challenge.

OBJECTIVE

To analyse the pulmonary and all-cause morbidity and mortality in patients with documented COPD and relate this to their GOLD classification.

METHODS

Sixty-eight patients with COPD, documented by a lung function test, who underwent elective EVAR between July 2002 and July 2018 were retrospectively reviewed. The primary endpoint was the incidence of 30-day pulmonary adverse events. Procedural characteristics, length of hospital stay, pulmonary and all-cause morbidity including major adverse events (MAEs) during follow-up and five-year survival divided per GOLD classification were the secondary endpoints.

RESULTS

There was no statistically significant difference in the incidence of pulmonary adverse events between GOLD I/II and GOLD III/IV patients. There was neither procedural nor 30-day mortality in either group. Through 30 days and 1 year, there was no difference in pulmonary and all-cause morbidity between groups. Three MAEs occurred in the GOLD I/II group versus 2 MAE in the GOLD III/IV group during the first postoperative year. The five-year survival was 66.0%, 60.9% and 61.9% for patients with GOLD I, GOLD II and GOLD III, respectively. Three of four GOLD IV died within the first year after EVAR.

CONCLUSION

EVAR can be safely performed in patients with COPD, with low 30-day morbidity and mortality rates. Although severe co-morbidity should be taken into account, EVAR seems to be justified in patients with COPD with a GOLD classification I, II or III. Further research should focus on optimising the pulmonary condition in patients selected for EVAR.

Carbon nanotubes decorated with gold, platinum and rhodium clusters by injection of colloidal solutions into the post-discharge of an RF atmospheric plasma

In this paper, we present a new, simple, robust and efficient technique to decorate multi-wall carbon nanotubes (MWCNT) with metal nanoparticles. As case studies, Au, Pt and Rh nanoparticles are grafted onto MWCNTs by spraying a colloidal solution into the post-discharge of an atmospheric argon or argon/oxygen RF plasma. The method that we introduce here is different from those usually described in the literature, since the treatment is operated at atmospheric pressure, allowing the realization in only one step of the surface activation and the deposition processes. We demonstrate experimentally that the addition of oxygen gas in the plasma increases significantly the amount of grafted metal nanoparticles. Moreover, TEM pictures clearly show that the grafted nanoparticles are well controlled in size.

[Cutaneous adverse effects of lithium]

Oral administration of lithium is used as treatment in psychiatry. The drug frequently induces cutaneous side effects corresponding to acneiform or maculo-papular eruptions, psoriasis and folliculitis. Men are more frequently affected than women. These manifestations are characterized by the accumulation of neutrophils in the skin. Alopecia and classical drug reactions are also possible. Topical applications of lithium used to treat some dermatoses do not induce similar side effects, probably because dosages are much lower.

[Photodermatoses by photosensitization]

There exists a series of photodermatoses due to phototoxic or photoallergic reactions. Anamnestic and clinical clues supplemented by dermatopathological examination and photobiological tests are key features for reaching the correct diagnosis and the adequate choice of therapy.

[Physiological responses to sun exposure]

The physiological responses to ultraviolet light exposure can be immediate, early or delayed. Typical examples include actinic erythema, suntan, the telogen actinic effluvium, ephelids, lentigines, some melanocytic naevi, and actinic wrinkles.

[Skin and its daily chronobiological clock]

Some cutaneous functions of importance are governed by periodical variations according to the nycthemeral timing. Similarly to other organs, the skin is under the influence of a coherent organisation of circadian and nythemeral rhythms modulating various biological cycles which usually display a wide amplitude. The cutaneous biorhythms in humans suggest that during daylight the skin boosts diverse protective functions with regard to environmental threats. In the evening and at night, the skin increases its renewal and diverse metabolic processes. Biorhythms in the skin which are in line with the organism's needs, merit to be recognized. Chronophysiology, chronopathology and clinical chronopharmacology may help reach optimal therapeutic decisions.

[How I explore ... an orphan metastasis from melanoma]

A presumed melanoma metastasis is sometimes found without any evidence for the primary neoplasm. Such an orphan metastasis merits a complementary exploration. Searching for the primary melanoma must then be performed using non invasive and clinically oriented methods. Beside a thorough skin examination, otorhinolaryngological, ophtalmic and gynecologic searches are recommended. In addition, paraclinical investigations are conducted according to the metastatic location, the gender and the functional complaints of the patient. The prognosis of these orphan metastases is not more dramatic than when the primary lesion is identified. Therapies are similar to those proposed in the classical presentation of the disease.

[Occupational stigmata in instrumental musicians]

The frequent practice of a music instrument represents a risk for frictional or allergic contact dermatitis. The localisation and type of lesions are often typical for the musician specialty.

[Skin betrayal, above athletic performance]

Several compounds listed as illicit doping agents can express some effects on the skin. The cutaneous signs are diverse. The clue of the intake of such compounds can be supported by objective non-invasive biometrological assessments. However, such evaluations do not bring the irrefutable proof. The skin can also present unwanted reactions indicating intolerance to the doping agent. Such physiopathological manifestations are not limited to the sport competition, but can also affect some groups of the population searching for a look reminiscent of the ideal young and performing athlete.

Dermal dendritic cells in anogenital warty lesions unresponsive to an immune-response modifier

BACKGROUND

Human papilloma viruses (HPV) are responsible for a variety of proliferative epithelial lesions including anogenital condylomas. These lesions may regress during treatment with an immune-response modifier such as imiquimod. The release of specific cytokines from the monocyte-macrophage lineage induces a cascade of events abating the HPV replication.

METHOD

A total of 14 persistent warty anogenital lesions were excised 4 to 7 weeks after completing a 4-month imiquimod treatment. Another series of 25 untreated condylomas and 8 bowenoid papulosis served as controls. All examined lesions had been excised in otherwise healthy individuals with a normal immune status. Lesions were examined for the presence of Langerhans cells and subpopulations of the monocyte/macrophage/dendrocyte lineage using immunohistochemical detection of L1-protein, CD68, lysozyme and Factor-XIIIa. CD45R0-positive T lymphocytes were also identified. HPV capsid antigens and genotypes were searched for using immunohistochemistry and in situ hybridization, respectively.

RESULTS

The persistent although treated anogenital lesions were identified as 10 viral condylomas, 3 bowenoid papulosis and 1 basal cell carcinoma. The inflammatory cell densities and distributions were similar in the untreated and imiquimod-resistant condylomas with the exception of Factor XIIIa-positive dendrocytes. These dermal dendritic cells were slim and rare in all imiquimod-resistant lesions. In contrast, about two-thirds of the untreated condylomas were enriched in these cells.

CONCLUSION

As dermal dendritic cells play a role in the immune surveillance, their low densities in some lesions might be a key feature responsible for low cytokine local production and failure of imiquimod treatment. The combined apparent lack of Langerhans cell activation might suggest that both intraepidermal and intradermal compartments of antigen-presenting cells are affected in imiquimod-resistant lesions.

[How I investigate...a burning mouth]

Burning mouth is a symptom typical for the oral mucosa. In contrast, pruritus is absent at this site. The situation which is the reverse on the skin can be explained by microanatomical differences in the sensorial innervation and by a different balance between neuromediators. Burning mouth sensation calls for the search of a series of diseases. However, it is most often a monosymptomatic expression of a minimal lichenoid stomatitis.

Toxic epidermal necrolysis associated with treatment for preterm labor

We report a 29-year-old pregnant woman who developed toxic epidermal necrolysis at 29 weeks of gestation after administration of ritodrine, indomethacin and betamethasone. Toxic epidermal necrolysis is an unreported side effect of this widely used combination of medications. Since toxic epidermal necrolysis is a potentially fatal disease, awareness of a possible association is warranted.

Breast cancer metastatic to the eyelids

Metastases to the eyelids are rare. They may appear as diffuse swellings, nodules or ulcerations. Most often they correspond to the dissemination of a breast adenocarcinoma. An 83 year old woman is reported with mammary adenocarcinoma metastasizing to the eyelids.

[Bites by terrestrial vertebrates]

Bites by terrestrial vertebrates, reptiles or mammals, represent a special risk in tropical regions. Envenomation is possible by a few lizards and many snakes. For mammals, tissular destructions due to the bite can be severe. Whatever is the offending animal, bites can further become infected by transmitted viruses or bacteria.

[Overview of tropical endoparasitic diseases with cutaneous manifestations]

Among the diverse endoparasitic disorders some are primary cutaneous disorders and others exhibit signs on the skin in association with predominant internal manifestations. A variety of protozoans and helminths are responsible for these disorders.

[Towards obsolete senescence. Everything wanes ... Old age no longer exists!]

Skin ageing is the global result of the influence of numerous factors. Oxidative stress through the intervention of free radicals is one of the most important biological mechanisms solicited by ageing promotors. Prevention of skin senescence relies on several approaches. The main ones are sun protection, tobacco avoidance and limitation of sustained mechanical stress to the skin. Free radical scavengers in adequate combinations might slow down the ageing process. In cosmetology, retinol fulfills its claims. Vitamins E and C, as well as selenium and some plant extracts also show some interest. In the search for increased efficacy, tretinoin is the single topical drug available. Its biologic activity boosts the epidermal growth and the collagen synthesis while inhibiting some metalloproteinases responsible for dermal degradation. Clinical proofs of its efficacy are beyond doubt.

[Bacterial resistance during anti-acne antibiotic therapy. How to limit the risk]

The treatment of moderate to severe acne often relies on antibiotherapy in order to eradicate as much as possible microorganisms such as Propionibacterium spp colonizing the sebaceous follicles. In recent years, bacterial resistances against specific antibiotics have emerged. Both the antibiotic and its administration modalities must be considered in order to control the risk. With regard to this conundrum, minocycline is a medication of choice among the diverse anti-acneic therapies.