Continuous measurement of optical surfaces using a line-scan interferometer with sinusoidal path length modulation

We present a fast approach to the continuous measurement of rotational symmetric optical surfaces. This approach is based on a line scanning interferometer with sinusoidal modulation of the optical path length. The specimen is positioned with respect to the sensor and both are moved during measurement by use of a five axes system comprising a high precision rotational table. The calibration of both the line sensor as well as the scanning and positioning system is discussed. As proof of principle of the measurement and stitching concept results of a scan of a rotational symmetric sinusoidal structure and a spherical lens with a moderate slope are shown.

Photoperiodic effects on diapause-associated gene expression trajectories in European Leptinotarsa decemlineata populations

Behavioural and physiological changes during diapause, an important strategy of insects for surviving harsh seasonal conditions, have been intensively studied. The genetic and molecular mechanisms underpinning diapause development are less well known. We took a candidate gene approach to study prediapause gene expression patterns in the Colorado potato beetle (Leptinotarsa decemlineata), an invasive insect that has rapidly spread northwards to high seasonality environments. Newly eclosed beetles originating from southern (Italy) and northern (Russia) Europe were reared under short- [12 h light (L):12 h dark (D)] and long-day (18L:6D) photoperiods for 10 days. This time period includes the sensitive period for the photoperiodic induction and initiation of diapause. Gene expression trajectories of 12 diapause-related genes (regulatory, metabolic and stress-resistance) were analysed from 0-, 5- and 10-day-old beetles. Gene expression differences increased with age, deviating significantly between populations and photoperiods in 10-day-old beetles. The gene expression profiles, particularly those related to energy metabolism and stress-resistance, indicate that beetles originating from Russia also prepare for diapause under the long-day photoperiod and show qualitative differences in the diapausing phenotype. Our study shows that population-dependent differences seen in behavioural and physiological traits connected with diapause in L. decemlineata are also evident in the expression trajectories of diapause-related genes.

Course and treatment of chronic hepatitis E virus infection in lung transplant recipients

OBJECTIVE

Persistent hepatitis E virus (HEV) infections have been described in various transplant cohorts. However, the frequency and the course of HEV infection in lung transplant recipients (Lu-Tr) are not well defined.

METHODS

We retrospectively analyzed serum from 95 Lu-Tr for HEV RNA and anti-HEV immunoglobulin-G (IgG) (with the MP assay). Anti-HEV seroprevalence was compared to that of 537 healthy individuals. Prospective HEV screening was subsequently initiated in Lu-Tr.

RESULTS

Elevated liver enzymes were observed in 44/95 (46.3%) patients. Anti-HEV IgG was present in 5/95 patients (5.3%), revealing a slightly higher prevalence compared to controls (2%, 11/537; P = 0.07). Chronic HEV infection with detectable viral replication was confirmed by polymerase chain reaction in 3 (3.2%) patients, all of whom demonstrated clinical and biochemical features of active liver disease (maximum alanine aminotransferase [ALTmax ] 89, 215, and 270 IU/L, respectively). One patient had died from multi-organ failure in combination with liver cirrhosis before HEV diagnosis. Two additional patients with chronic hepatitis E were identified during prospective screening (ALTmax 359 and 318 IU/L). All patients still alive commenced ribavirin therapy for 5 months, with dose adjustment (400-600 mg/day) according to renal function and hemoglobin level. Sustained resolution of HEV infection occurred in 2 patients. One patient is still under treatment, and the fourth died from graft failure considered unrelated to ribavirin therapy.

CONCLUSION

Chronic hepatitis E should be considered in the differential diagnosis of elevated liver enzymes, which are commonly seen in Lu-Tr. We observed 1 case of end-stage liver cirrhosis and death in an HEV-infected subject, who was not treated with ribavirin. Given this potentially devastating consequence, ribavirin therapy of persistent HEV infection appears to be acceptably safe and effective in Lu-Tr. However, larger prospective studies are warranted.

[Rhabdomyolysis and creatine kinase elevation]

Creatine kinase (CK) plays an important role in cellular energy metabolism in various tissues and skeletal muscle is recognized as being the largest reservoir of this enzyme. Elevated CK levels can be induced by various harmless or severe conditions implying multiple differential diagnoses for the physician. Trauma, inflammation, drug-induced toxicity, genetic disorders as well as metabolic, endocrine or rheumatic diseases might lead to cell degeneration and leakage of CK and other cellular components. Massive destruction of muscular tissue leads to rhabdomyolysis, defined as CK elevation combined with organ damage, which requires immediate diagnostic and therapeutic intervention.

Long-term (6 and 12 months) follow-up of two prospective, randomized, controlled phase III trials of photodynamic therapy with BF-200 ALA and methyl aminolaevulinate for the treatment of actinic keratosis

Background

Two phase III trials of photodynamic therapy (PDT) with BF-200 ALA, a recently approved nanoemulsion formulation of 5-aminolaevulinic acid (ALA) demonstrated high clearance rates in mild-to-moderate actinic keratosis (AK). The comparison to a registered methyl aminolaevulinate (MAL) cream demonstrated significantly superior total patient clearance rates.

Objectives

To evaluate long-term efficacy and safety of PDT for AK 6 and 12 months after the last PDT with BF-200 ALA, MAL or placebo.

Methods

The follow-up phase (FUP) was performed with patients of two phase III studies. Both studies compared BF-200 ALA with placebo, one of the studies additionally with MAL. Overall recurrence rates and various subgroups (light source, lesion severity, lesion location, complete responders after first PDT) were assessed 6 and 12 months after the last PDT.

Results

Recurrence rates were similar for BF-200 ALA and MAL, with a tendency to lower recurrence rates for BF-200 ALA. The proportion of patients who were fully cleared during PDT and remained completely clear for at least 12 months after PDT were 47% for BF-200 ALA (both studies) and 36% for MAL treatment. The subgroup that was illuminated with narrow wavelength LED lamps reached 69% and 53% for BF-200 ALA (both studies, respectively) and 41% for MAL. No safety concerns were reported.

Conclusions

The FUP data confirmed the high efficacy and safety of PDT with BF-200 ALA. The slightly lower recurrence rates after BF-200 ALA treatment compared with MAL treatment enhanced the better treatment outcome due to the significantly superior efficacy.

[Phlebology in German departments of dermatology. An analysis on behalf of the German Society of Phlebology]

BACKGROUND

Phlebologic diseases have become extremely common and have major socio-economic impact. However, the percentage of dermatologists working in phlebology appears to be decreasing according to the data of the German Society of Phlebology (DGP).

METHODS

To investigate the reasons for this development, we--on behalf of the DGP--sent a questionnaire to 120 German Departments of Dermatology in autumn 2012.

RESULTS

In 76 returned questionnaires, the number of physicians with additional fellowship training in phlebology averaged 1.5; the average number of those who fulfill the criteria for training fellows in phlebology was 0.9. In 71.1 % of the departments there was a phlebologist. A special phlebologic outpatient clinic existed in 73.7 % of the departments. Sonography with Doppler (89.5 %) and duplex (86.8 %) was used as the most frequent diagnostic tool. For therapy, compression (94.7 %), sclerotherapy (liquid 78.9 %, foam 63.2 %, catheter 18.4 %), endoluminal thermic procedures (radio wave 28.9 %, laser 17.1 %) and surgery (especially crossectomy and stripping 67.1 %, phlebectomy of tributaries 75 %) were used. The average number of treatments was very heterogenous in the different departments.

CONCLUSIONS

Phlebology definitely plays an important role in dermatology. Most departments fulfill the formal criteria for the license to conduct advanced training in phlebology. A wide spectrum of phlebological diagnostic and therapeutic procedures is available.

[Rosacea: Clinical features and classification]

Rosacea is a frequent chronic dermatological disorder mainly affecting the face. Since it affects the appearance, it can be very distressing for the patient leading to psychosocial disturbances. Rosacea occurs in adults, peaking between 40 and 50 years of age. The course of rosacea is quite variable and the disease may stop at any stage. Generally, three main stages are differentiated: erythemato-teleangiectatic rosacea (rosacea stage I), papulopustular rosacea (rosacea stage II), hyperglandular-hypertrophic rosacea (rosacea stage III). Besides these main manifestations numerous special forms exist, which often lead to difficulties in the differential diagnoses and require specific therapeutic strategies. These include rosacea conglobata, rosacea fulminans, granulomatous rosacea, persisting edema, (Morbihan disease), gram negative rosacea, ocular rosacea, and steroid rosacea. Recently increasing numbers of patients have been observed, whose rosacea was were induced by inhibitors of epidermal growth factors (cetuximab, geftinib) used as chemotherapy in patients with different malignancies. These side effects have been described as acneiform eruptions but at least some of the described patients have a rosacea-like appearance; therefore, this form can be classified as a subset of drug induced rosacea.

The validation of the Checklist of Controlling Behaviors (CCB): assessing coercive control in abusive relationships

The current study addresses the validation of the Checklist of Controlling Behaviors (CCB), an 84-item domestic violence assessment instrument that can be used to address multiple levels of violence and coercive control in violent relationships. Derived from clinical observation and current theories, the CCB makes use of intimate partner violence survivor reports to identify the intensity and frequency of relationship violence. The instrument is divided into 10 subscales including (1) physical abuse, (2) sexual abuse, (3) male privilege, (4) isolation, (5) minimizing and denying, (6) blaming, (7) intimidation, (8) threats, (9) emotional abuse, and (10) economic abuse. To assess validity and reliability of the CCB, 2,135 female volunteers taking refuge at a domestic violence shelter were administered the instrument. Results of principal component analysis of the individual subscales revealed 10 factors having goodness-of-fit values above the desired normative level of .90.

Lateral resolution and transfer characteristics of vertical scanning white-light interferometers

White-light interferometers are widely used for high-accuracy topography measurement in industrial and scientific applications. A common way to characterize a white-light interferometer is to assume small surface amplitudes resulting in linear transfer characteristics described by the instrument transfer function (ITF). However, the well-known batwing effect gives rise to systematic errors, causing extra nonlinearity to the ITF. In this paper a model to simulate an interference pattern in the image plane as it is obtained by a vertical scanning white-light interferometer is introduced in order to overcome the limitation of small surface amplitudes. Repeating the simulation procedure for different height positions of the object results in an image stack that can be analyzed by the same algorithms as real measurement data. The simulation results agree with experimental observations: the batwing effect occurs in certain situations and the correct amplitude of a rectangular grating structure can be obtained as long as the structure is optically resolved. Both simulation, as well as experimental results, provide transfer characteristics of broader bandwidth than predicted by theoretical approaches based on linear system behavior.

Transfer characteristics of rectangular phase gratings in interference microscopy

In this Letter, the transfer characteristics of rectangular periodic phase objects are studied. It turns out that there are significant differences compared to amplitude objects. The imaging of an amplitude object can be understood as a linear process, whereas phase objects behave nonlinearly. It is shown that under certain conditions the correct shape of a rectangular phase grating can be obtained by an interference microscope as long as the first order diffraction component passes the optical imaging system. This result is in a good agreement with experimental observations and computer simulation results.

Photodynamic therapy with BF-200 ALA for the treatment of actinic keratosis: results of a multicentre, randomized, observer-blind phase III study in comparison with a registered methyl-5-aminolaevulinate cream and placebo

BACKGROUND

Photodynamic therapy (PDT) with 5-aminolaevulinic acid (ALA) or its methylester [methyl-5-aminolaevulinate (MAL) or 5-amino-4-oxopentanoate] was recently ranked as first-line therapy for the treatment of actinic keratosis (AK) and is an accepted therapeutic option for the treatment of neoplastic skin diseases. BF-200 ALA (Biofrontera Bioscience GmbH, Leverkusen, Germany) is a gel formulation of ALA with nanoemulsion for the treatment of AK which overcomes previous problems of ALA instability and improves skin penetration.

OBJECTIVES

To evaluate the efficacy and safety of PDT of AKs with BF-200 ALA in comparison with a registered MAL cream and with placebo.

METHODS

The study was performed as a randomized, multicentre, observer-blind, placebo-controlled, interindividual trial with BF-200 ALA, a registered MAL cream and placebo in a ratio of 3:3:1. Six hundred patients, each with four to eight mild to moderate AK lesions on the face and/or the bald scalp, were enrolled in 26 study centres in Germany, Austria and Switzerland. Patients received one PDT. If residual lesions remained at 3months after treatment, PDT was repeated.

RESULTS

PDT with BF-200 ALA was superior to placebo PDT with respect to patient complete clearance rate (78·2% vs. 17·1%; P<0·0001) and lesion complete clearance rate (90·4% vs. 37·1%) at 3months after the last PDT. Moreover, superiority was demonstrated over the MAL cream regarding the primary endpoint patient complete clearance (78·2% vs. 64·2%; P<0·05). Significant differences in the patient and lesion complete clearance rates and severity of treatment-related adverse events were observed for the narrow- and broad-spectrum light sources.

CONCLUSIONS

BF-200 ALA is a very effective, well-tolerated new formulation for AK treatment with PDT and is superior to a registered MAL medication. Efficacies and adverse events vary greatly with the different light sources used.

All about PSY DREAM. Psychiatric Drug Registration, Evaluation & All-inclusive Monitoring

Aims — In this article the author – board-member of the European Network of (ex-) Users and Survivors of Psychiatry (ENUSP) -explains, what is needed to guarantee a minimal level of involvement of users and survivors of psychiatry into issues relating to psychiatric drugs. Methods – He reflects demands of their organisations, and compares these demands with the current involvement level. Considering the concrete circumstances in psychiatry, he reflects the risks and dangers of the administered drugs -especially the widely used neuroleptics –for example enhanced breast cancer risk in women, suicidal effects, receptor changes, tardive dyskinesia and other toxic reactions. Results – Considering the unique situation of psychiatric patients to receive treatment in general without informed consent and in a violent way or through bullying and threat, he argues for to provide their involvement in all aspects of psychiatric drug issues -especially registration and monitoring, for example by their involvement in creating and running a suicide register. And he argues for involvement in ethics committees, licensing processes and providing guidelines and decision making about effectiveness and reimbursement of costs. Conclusions – As first steps towards these aims he proposes independent and user-controlled research, independent and user-controlled education and independent and user-controlled information about the effects of psychiatric drugs.

Declaration of Interest: the Author did not receive any grants and financial support for the study; any forms of financing (included pharmaceutical company support and any honoraria for consultancies or interventions in the last two years); any other involvements that might be considered a conflict of interest in connection with the submitted article.

Using strength-based approaches to explore pretreatment change in men who abuse their partners

Group work with men who batter has traditionally consisted predominantly of psychoeducational programs that ignore concepts such as self-determination, goal setting, and positive engagement with men. More recently, this paradigm has begun to shift to include cognitive approaches and the utilization of strength-based strategies. The present sample included 42 men who were part of an ongoing batterer intervention program. Information for this study included assessment of each man's strengths, their goals, and their perceptions of the changes they felt they had already made prior to attending group treatment. Through a grounded theory analysis, a model was developed that highlights the pretherapeutic change processes that men experience due to their being arrested, charged with a misdemeanour domestic charge, and subsequently convicted of domestic violence. Particularly highlighted are changes in the ways that men view and navigate three distinct areas of their lives: their external world (including work and education); their internal world (perception of self, values, and skills); and their interpersonal relationships with their partner and children.

Transitions of gene expression induced by short-term blue light

Blue light modulates many processes in plants and plant cells. It influences global and long-term responses, such as seedling development and phototropism, and induces short-term adaptations like stomatal opening and chloroplast movement. Three genes were identified as important for the latter process, namely PHOT1, PHOT2 and CHUP1. The former two phototropin blue light receptors act in perception of the blue light signal. The protein CHUP1 is localised to the outer envelope membrane of chloroplasts and is involved in chloroplast movement. To explore whether short-term reactions required for chloroplast movement are under transcriptional control, we analysed the transcriptome in wild-type Arabidopsis thaliana, phot1, phot2 and chup1 with different blue light treatments for 5 or 30 min. Blue light-induced changes in transcription depended on illumination time and intensity. Illumination with 100 μmol·m(-2) · s(-1) blue light induced down-regulation of several genes and might point to cascades that could be important for sensing low levels of blue light. Analysis of the transcriptome of the mutants in response to the different light regimes suggests that the transcriptional response to blue light in the wild-type can be attributed to phot1 rather than phot2, suggesting that blue light-induced alteration of expression is a function of phot1. In contrast, the blue light response at the transcriptional level of chup1 plants was unique, and confirmed the higher light sensitivity of this mutant.