1
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Chu DK, Schneider L, Asiniwasis RN, Boguniewicz M, De Benedetto A, Ellison K, Frazier WT, Greenhawt M, Huynh J, Kim E, LeBovidge J, Lind ML, Lio P, Martin SA, O'Brien M, Ong PY, Silverberg JI, Spergel JM, Wang J, Wheeler KE, Guyatt GH, Capozza K, Begolka WS, Chu AWL, Zhao IX, Chen L, Oykhman P, Bakaa L, Golden D, Shaker M, Bernstein JA, Greenhawt M, Horner CC, Lieberman J, Stukus D, Rank MA, Wang J, Ellis A, Abrams E, Ledford D, Chu DK. Atopic dermatitis (eczema) guidelines: 2023 American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters GRADE- and Institute of Medicine-based recommendations. Ann Allergy Asthma Immunol 2024; 132:274-312. [PMID: 38108679 DOI: 10.1016/j.anai.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Guidance addressing atopic dermatitis (AD) management, last issued in 2012 by the American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force, requires updating as a result of new treatments and improved guideline and evidence synthesis methodology. OBJECTIVE To produce evidence-based guidelines that support patients, clinicians, and other decision-makers in the optimal treatment of AD. METHODS A multidisciplinary guideline panel consisting of patients and caregivers, AD experts (dermatology and allergy/immunology), primary care practitioners (family medicine, pediatrics, internal medicine), and allied health professionals (psychology, pharmacy, nursing) convened, prioritized equity, diversity, and inclusiveness, and implemented management strategies to minimize influence of conflicts of interest. The Evidence in Allergy Group supported guideline development by performing systematic evidence reviews, facilitating guideline processes, and holding focus groups with patient and family partners. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach informed rating the certainty of evidence and strength of recommendations. Evidence-to-decision frameworks, subjected to public comment, translated evidence to recommendations using trustworthy guideline principles. RESULTS The panel agreed on 25 recommendations to gain and maintain control of AD for patients with mild, moderate, and severe AD. The eAppendix provides practical information and implementation considerations in 1-2 page patient-friendly handouts. CONCLUSION These evidence-based recommendations address optimal use of (1) topical treatments (barrier moisturization devices, corticosteroids, calcineurin inhibitors, PDE4 inhibitors [crisaborole], topical JAK inhibitors, occlusive [wet wrap] therapy, adjunctive antimicrobials, application frequency, maintenance therapy), (2) dilute bleach baths, (3) dietary avoidance/elimination, (4) allergen immunotherapy, and (5) systemic treatments (biologics/monoclonal antibodies, small molecule immunosuppressants [cyclosporine, methotrexate, azathioprine, mycophenolate, JAK inhibitors], and systemic corticosteroids) and UV phototherapy (light therapy).
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Affiliation(s)
- Derek K Chu
- Departments of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University and The Research Institute of St. Joe's Hamilton, Hamilton, Canada.
| | - Lynda Schneider
- Division of Immunology, Boston Children's Hospital, Boston, Massachusetts.
| | | | - Mark Boguniewicz
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Division of Pediatric Allergy and Clinical Immunology, National Jewish Health, Denver, Colorado
| | - Anna De Benedetto
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York
| | | | - Winfred T Frazier
- Department of Family Medicine, UPMC St. Margaret, Pittsburgh, Pennsylvania
| | - Matthew Greenhawt
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Section of Allergy and Immunology, Children's Hospital Colorado, Aurora, Colorado
| | - Joey Huynh
- Sepulveda VA Medical Center, North Hills, California
| | | | - Jennifer LeBovidge
- Division of Immunology, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Mary Laura Lind
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona
| | - Peter Lio
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Stephen A Martin
- University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Monica O'Brien
- Tufts University School of Medicine, Boston, Massachusetts
| | - Peck Y Ong
- Division of Clinical Immunology and Allergy, Children's Hospital Los Angeles, Los Angeles, California; Department of Pediatrics, USC Keck School of Medicine, Los Angeles, California
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Jonathan M Spergel
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Julie Wang
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Kathryn E Wheeler
- Department of Pediatrics, University of Florida, Gainesville, Florida
| | - Gordon H Guyatt
- Departments of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University and The Research Institute of St. Joe's Hamilton, Hamilton, Canada
| | - Korey Capozza
- Global Parents for Eczema Research, Santa Barbara, California
| | | | - Alexandro W L Chu
- Departments of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University and The Research Institute of St. Joe's Hamilton, Hamilton, Canada
| | - Irene X Zhao
- Departments of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University and The Research Institute of St. Joe's Hamilton, Hamilton, Canada
| | - Lina Chen
- Departments of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University and The Research Institute of St. Joe's Hamilton, Hamilton, Canada
| | - Paul Oykhman
- Departments of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University and The Research Institute of St. Joe's Hamilton, Hamilton, Canada
| | - Layla Bakaa
- Departments of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University and The Research Institute of St. Joe's Hamilton, Hamilton, Canada
| | - David Golden
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marcus Shaker
- Dartmouth Geisel School of Medicine and Dartmouth Hitchcock Medical Center, Section of Allergy, Lebanon, New Hampshire
| | | | - Matthew Greenhawt
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Section of Allergy and Immunology, Children's Hospital Colorado, Aurora, Colorado
| | - Caroline C Horner
- Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Jay Lieberman
- University of Tennessee Health Science Center and LeBonheur Children's Hospital, Memphis, Tennessee
| | - David Stukus
- Nationwide Children's Hospital and Ohio State University College of Medicine, Columbus, Ohio
| | - Matthew A Rank
- Mayo Clinic in Arizona and Phoenix Children's Hospital, Scottsdale and Phoenix, Arizona
| | - Julie Wang
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Anne Ellis
- Division of Allergy and Immunology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Elissa Abrams
- Section of Allergy and Clinical Immunology, Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Dennis Ledford
- Morsani College of Medicine, University of South Florida and James A. Haley Veterans' Affairs Hospital, Tampa, Florida
| | - Derek K Chu
- Departments of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University and The Research Institute of St. Joe's Hamilton, Hamilton, Canada
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2
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Olney KC, de Ávila C, Todd KT, Tallant LE, Barnett JH, Gibson KA, Hota P, Pandiane AS, Durgun PC, Serhan M, Wang R, Lind ML, Forzani E, Gades NM, Thomas LF, Fryer JD. Commonly disrupted pathways in brain and kidney in a pig model of systemic endotoxemia. J Neuroinflammation 2024; 21:9. [PMID: 38178237 PMCID: PMC10765757 DOI: 10.1186/s12974-023-03002-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024] Open
Abstract
Sepsis is a life-threatening state that arises due to a hyperactive inflammatory response stimulated by infection and rarely other insults (e.g., non-infections tissue injury). Although changes in several proinflammatory cytokines and signals are documented in humans and small animal models, far less is known about responses within affected tissues of large animal models. We sought to understand the changes that occur during the initial stages of inflammation by administering intravenous lipopolysaccharide (LPS) to Yorkshire pigs and assessing transcriptomic alterations in the brain, kidney, and whole blood. Robust transcriptional alterations were found in the brain, with upregulated responses enriched in inflammatory pathways and downregulated responses enriched in tight junction and blood vessel functions. Comparison of the inflammatory response in the pig brain to a similar mouse model demonstrated some overlapping changes but also numerous differences, including oppositely dysregulated genes between species. Substantial changes also occurred in the kidneys following LPS with several enriched upregulated pathways (cytokines, lipids, unfolded protein response, etc.) and downregulated gene sets (tube morphogenesis, glomerulus development, GTPase signal transduction, etc.). We also found significant dysregulation of genes in whole blood that fell into several gene ontology categories (cytokines, cell cycle, neutrophil degranulation, etc.). We observed a strong correlation between the brain and kidney responses, with significantly shared upregulated pathways (cytokine signaling, cell death, VEGFA pathways) and downregulated pathways (vasculature and RAC1 GTPases). In summary, we have identified a core set of shared genes and pathways in a pig model of systemic inflammation.
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Affiliation(s)
- Kimberly C Olney
- Department of Neuroscience, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, USA
| | - Camila de Ávila
- Department of Neuroscience, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, USA
| | - Kennedi T Todd
- Department of Neuroscience, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, USA
| | - Lauren E Tallant
- Department of Neuroscience, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, USA
- Mayo Clinic Graduate School of Biomedical Sciences, Scottsdale, AZ, USA
| | - J Hudson Barnett
- Department of Neuroscience, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, USA
- Mayo Clinic Graduate School of Biomedical Sciences, Scottsdale, AZ, USA
- MD/PhD Training Program, Mayo Clinic, Scottsdale, AZ, USA
| | - Katelin A Gibson
- Department of Neuroscience, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, USA
| | - Piyush Hota
- Division of Nephrology & Hypertension, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, USA
| | | | - Pinar Cay Durgun
- School of Engineering of Matter, Transport & Energy, Arizona State University, Tempe, AZ, USA
| | - Michael Serhan
- School of Engineering of Matter, Transport & Energy, Arizona State University, Tempe, AZ, USA
| | - Ran Wang
- School of Engineering of Matter, Transport & Energy, Arizona State University, Tempe, AZ, USA
| | - Mary Laura Lind
- School of Engineering of Matter, Transport & Energy, Arizona State University, Tempe, AZ, USA
| | - Erica Forzani
- School of Engineering of Matter, Transport & Energy, Arizona State University, Tempe, AZ, USA
| | - Naomi M Gades
- Department of Comparative Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Leslie F Thomas
- Division of Nephrology & Hypertension, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, USA.
| | - John D Fryer
- Department of Neuroscience, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ, USA.
- Mayo Clinic Graduate School of Biomedical Sciences, Scottsdale, AZ, USA.
- MD/PhD Training Program, Mayo Clinic, Scottsdale, AZ, USA.
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3
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Chu AWL, Wong MM, Rayner DG, Guyatt GH, Díaz Martinez JP, Ceccacci R, Zhao IX, McMullen E, Srivastava A, Wang J, Wen A, Wang FC, Brignardello-Petersen R, Izcovich A, Oykhman P, Wheeler KE, Wang J, Spergel JM, Singh JA, Silverberg JI, Ong PY, O'Brien M, Martin SA, Lio PA, Lind ML, LeBovidge J, Kim E, Huynh J, Greenhawt M, Gardner DD, Frazier WT, Ellison K, Chen L, Capozza K, De Benedetto A, Boguniewicz M, Smith Begolka W, Asiniwasis RN, Schneider LC, Chu DK. Systemic treatments for atopic dermatitis (eczema): Systematic review and network meta-analysis of randomized trials. J Allergy Clin Immunol 2023; 152:1470-1492. [PMID: 37678577 DOI: 10.1016/j.jaci.2023.08.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/06/2023] [Accepted: 08/15/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is an inflammatory skin condition with multiple systemic treatments and uncertainty regarding their comparative impact on AD outcomes. OBJECTIVE We sought to systematically synthesize the benefits and harms of AD systemic treatments. METHODS For the 2023 American Academy of Allergy, Asthma & Immunology and American College of Allergy, Asthma, and Immunology Joint Task Force on Practice Parameters AD guidelines, we searched MEDLINE, EMBASE, CENTRAL, Web of Science, and GREAT databases from inception to November 29, 2022, for randomized trials addressing systemic treatments and phototherapy for AD. Paired reviewers independently screened records, extracted data, and assessed risk of bias. Random-effects network meta-analyses addressed AD severity, itch, sleep, AD-related quality of life, flares, and harms. The Grading of Recommendations Assessment, Development and Evaluation approach informed certainty of evidence ratings. This review is registered in the Open Science Framework (https://osf.io/e5sna). RESULTS The 149 included trials (28,686 patients with moderate-to-severe AD) evaluated 75 interventions. With high-certainty evidence, high-dose upadacitinib was among the most effective for 5 of 6 patient-important outcomes; high-dose abrocitinib and low-dose upadacitinib were among the most effective for 2 outcomes. These Janus kinase inhibitors were among the most harmful in increasing adverse events. With high-certainty evidence, dupilumab, lebrikizumab, and tralokinumab were of intermediate effectiveness and among the safest, modestly increasing conjunctivitis. Low-dose baricitinib was among the least effective. Efficacy and safety of azathioprine, oral corticosteroids, cyclosporine, methotrexate, mycophenolate, phototherapy, and many novel agents are less certain. CONCLUSIONS Among individuals with moderate-to-severe AD, high-certainty evidence demonstrates that high-dose upadacitinib is among the most effective in addressing multiple patient-important outcomes, but also is among the most harmful. High-dose abrocitinib and low-dose upadacitinib are effective, but also among the most harmful. Dupilumab, lebrikizumab, and tralokinumab are of intermediate effectiveness and have favorable safety.
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Key Words
- Atopic dermatitis (eczema)
- Janus kinase (JAK) inhibitors (upadacitinib, abrocitinib, baricitinib), patient-important outcomes and adverse events or adverse reactions, disease severity, itch, sleep, itch and sleep disturbance quality of life
- network meta-analysis (comparative effectiveness, multiple treatment comparison)
- systemic treatments and phototherapy (light therapy, immunosuppressants, immunomodulators, DMARDs, cyclosporine, methotrexate, azathioprine, mycophenolate, cortiosteroids, narrow-band UVB), biologics (dupilumab, lebrikizumab, tralokinumab, nemolizumab)
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Affiliation(s)
- Alexandro W L Chu
- Department of Medicine, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University, Hamilton, Canada
| | - Melanie M Wong
- Department of Medicine, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University, Hamilton, Canada
| | - Daniel G Rayner
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Gordon H Guyatt
- Department of Medicine, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Juan Pablo Díaz Martinez
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Renata Ceccacci
- Department of Medicine, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University, Hamilton, Canada
| | - Irene X Zhao
- Department of Medicine, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University, Hamilton, Canada
| | - Eric McMullen
- Department of Medicine, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University, Hamilton, Canada
| | - Archita Srivastava
- Evidence in Allergy Group, McMaster University, Hamilton, Canada; Department of Internal Medicine, Western University, London, Canada
| | - Jason Wang
- Department of Medicine, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University, Hamilton, Canada
| | - Aaron Wen
- Department of Medicine, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University, Hamilton, Canada
| | - Fang Chi Wang
- Evidence in Allergy Group, McMaster University, Hamilton, Canada; Schulich School of Medicine & Dentistry, Western University, London, Canada
| | | | - Ariel Izcovich
- Servicio de Clínica Médica, Hospital Aleman, Buenos Aires, Argentina
| | - Paul Oykhman
- Department of Medicine, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University, Hamilton, Canada
| | | | - Julie Wang
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jonathan M Spergel
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pa
| | - Jasvinder A Singh
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Peck Y Ong
- Division of Clinical Immunology and Allergy, Children's Hospital Los Angeles, Los Angeles, Calif; Department of Pediatrics, Keck School of Medicine of USC, Los Angeles, Calif
| | | | | | - Peter A Lio
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Mary Laura Lind
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Ariz
| | - Jennifer LeBovidge
- Division of Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | | | - Joey Huynh
- Sepulveda VA Medical Center, North Hills, Calif
| | - Matthew Greenhawt
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo; Section of Allergy and Immunology, Children's Hospital Colorado, Aurora, Colo
| | | | | | | | - Lina Chen
- Evidence in Allergy Group, McMaster University, Hamilton, Canada; Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Korey Capozza
- Global Parents for Eczema Research, Santa Barbara, Calif
| | - Anna De Benedetto
- Department of Dermatology, University of Rochester Medical Center, Rochester, NY
| | - Mark Boguniewicz
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo; Division of Pediatric Allergy and Clinical Immunology, National Jewish Health, Denver, Colo
| | | | - Rachel N Asiniwasis
- Department of Dermatology, University of Saskatchewan, Regina, Saskatchewan, Canada
| | | | - Derek K Chu
- Department of Medicine, McMaster University, Hamilton, Canada; Evidence in Allergy Group, McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada; The Research Institute of St. Joe's Hamilton, Hamilton, Canada.
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4
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Thomas E, Lee JS, Shokrollahzadeh Behbahani H, Nazari A, Li Y, Yang Y, Green MD, Lind ML. Zwitterionic Copolymers for Anti-Scaling Applications in Simulated Spaceflight Wastewater Scenarios. ACS Omega 2023; 8:18462-18471. [PMID: 37273630 PMCID: PMC10233662 DOI: 10.1021/acsomega.2c08150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/26/2023] [Indexed: 06/06/2023]
Abstract
Water reclamation in spaceflight applications, such as those encountered on the International Space Station (ISS), requires complex engineering solutions to ensure maximum water recovery. Current vapor compression distillation (VCD) technologies are effective but produce highly concentrated brines and often cause scaling within a separation system. This work evaluates initial steps toward integrating pervaporation, a membrane separation process, as a brine management strategy for ISS wastewaters. Pervaporation performs separations driven by a chemical potential difference across the membrane created by either a sweep gas or a vacuum pull. Pervaporation membranes, as with most membrane processes, can be subject to scaling. Therefore, this work studies the anti-scaling properties of zwitterions (polymeric molecules with covalently tethered positive and negative ions) coated onto sulfonated pentablock terpolymer block polymer (Nexar) pervaporation membrane surfaces. We report a method for applying zwitterions to the surface of pervaporation membranes and the effect on performance parameters such as flux and scaling resistance. Membranes with zwitterions had up to 53% reduction in permeance but reduced scaling. The highest amount of scaling occurred in the samples exposed to calcium chloride, and uncoated membranes had weight percent increases as high as 1617 ± 241%, whereas zwitterion-coated membranes experienced only about 317 ± 87% weight increase in the presence of the same scalant.
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Affiliation(s)
- Elisabeth
R. Thomas
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
- NSF
Nanosystems Engineering Research Center Nanotechnology-Enabled Water
Treatment, Rice University, 6100 Main Street, Houston, Texas 77005, United States
| | - Jae Sang Lee
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | | | - Ani Nazari
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Yusi Li
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
- NSF
Nanosystems Engineering Research Center Nanotechnology-Enabled Water
Treatment, Rice University, 6100 Main Street, Houston, Texas 77005, United States
| | - Yi Yang
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Matthew D. Green
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Mary Laura Lind
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
- NSF
Nanosystems Engineering Research Center Nanotechnology-Enabled Water
Treatment, Rice University, 6100 Main Street, Houston, Texas 77005, United States
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5
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Mo M, Fu B, Hota P, Cay-Durgun P, Wang R, Cheng EH, Wiktor P, Tsow F, Thomas L, Lind ML, Forzani E. Threshold-Responsive Colorimetric Sensing System for the Continuous Monitoring of Gases. Sensors (Basel) 2023; 23:3496. [PMID: 37050555 PMCID: PMC10098906 DOI: 10.3390/s23073496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/20/2023] [Accepted: 03/23/2023] [Indexed: 06/19/2023]
Abstract
Colorimetric sensors are widely used because of their inherent advantages including accuracy, rapid response, ease-of-use, and low costs; however, they usually lack reusability, which precludes the continuous use of a single sensor. We have developed a threshold-responsive colorimetric system that enables repeated analyte measurements by a single colorimetric sensor. The threshold responsive algorithm automatically adjusts the sensor exposure time to the analyte and measurement frequency according to the sensor response. The system registers the colorimetric sensor signal change rate, prevents the colorimetric sensor from reaching saturation, and allows the sensor to fully regenerate before the next measurement is started. The system also addresses issues common to colorimetric sensors, including the response time and range of detection. We demonstrate the benefits and feasibility of this novel system, using colorimetric sensors for ammonia and carbon dioxide gases for continuous monitoring of up to (at least) 60 detection cycles without signs of analytical performance degradation of the sensors.
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Affiliation(s)
- Manni Mo
- Health Futures Center, Arizona State University, Phoenix, AZ 85054, USA
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
- Division of Nephrology, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Bo Fu
- Health Futures Center, Arizona State University, Phoenix, AZ 85054, USA
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
- Division of Nephrology, Mayo Clinic, Scottsdale, AZ 85259, USA
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ 85287, USA
| | - Piyush Hota
- Health Futures Center, Arizona State University, Phoenix, AZ 85054, USA
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
- Division of Nephrology, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Pinar Cay-Durgun
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
| | - Ran Wang
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
| | - Edward H. Cheng
- Health Futures Center, Arizona State University, Phoenix, AZ 85054, USA
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
| | - Peter Wiktor
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
| | - Francis Tsow
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
| | - Leslie Thomas
- Health Futures Center, Arizona State University, Phoenix, AZ 85054, USA
- Division of Nephrology, Mayo Clinic, Scottsdale, AZ 85259, USA
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ 85287, USA
| | - Mary Laura Lind
- Health Futures Center, Arizona State University, Phoenix, AZ 85054, USA
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
- Division of Nephrology, Mayo Clinic, Scottsdale, AZ 85259, USA
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ 85287, USA
| | - Erica Forzani
- Health Futures Center, Arizona State University, Phoenix, AZ 85054, USA
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
- Division of Nephrology, Mayo Clinic, Scottsdale, AZ 85259, USA
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ 85287, USA
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6
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Perry LA, Chew NGP, Grzebyk K, Cay-Durgun P, Lind ML, Sitaula P, Soukri M, Coronell O. Correlating the Role of Nanofillers with Active Layer Properties and Performance of Thin-Film Nanocomposite Membranes. Desalination 2023; 550:116370. [PMID: 37274380 PMCID: PMC10237506 DOI: 10.1016/j.desal.2023.116370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Thin-film nanocomposite (TFN) membranes are emerging water-purification membranes that could provide enhanced water permeance with similar solute removal over traditional thin-film composite (TFC) membranes. However, the effects of nanofiller incorporation on active layer physico-chemical properties have not been comprehensively studied. Accordingly, we aimed to understand the correlation between nanofillers, active layer physico-chemical properties, and membrane performance by investigating whether observed performance differences between TFN and control TFC membranes correlated with observed differences in physico-chemical properties. The effects of nanofiller loading, surface area, and size on membrane performance, along with active layer physico-chemical properties, were characterized in TFN membranes incorporated with Linde Type A (LTA) zeolite and zeolitic imidazole framework-8 (ZIF-8). Results show that nanofiller incorporation up to ~0.15 wt% resulted in higher water permeance and unchanged salt rejection, above which salt rejection decreased 0.9-25.6% and 26.1-48.3% for LTA-TFN and ZIF-8-TFN membranes, respectively. Observed changes in active layer physico-chemical properties were generally unsubstantial and did not explain observed changes in TFN membrane performance. Therefore, increased water permeance in TFN membranes could be due to preferential water transport through porous structures of nanofillers or along polymer-nanofiller interfaces. These findings offer new insights into the development of high-performance TFN membranes for water/ion separations.
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Affiliation(s)
- Lamar A. Perry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7431, USA
- Curriculum in Applied Sciences and Engineering, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7431, USA
| | - Nick Guan Pin Chew
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7431, USA
| | - Kasia Grzebyk
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7431, USA
| | - Pinar Cay-Durgun
- School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ 85287, USA
| | - Mary Laura Lind
- School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ 85287, USA
| | - Paban Sitaula
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, Durham, NC 27709-2194, USA
| | - Mustapha Soukri
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, Durham, NC 27709-2194, USA
| | - Orlando Coronell
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7431, USA
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7
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Maleki-Yazdi KA, Heen AF, Zhao IX, Guyatt GH, Suzumura EA, Makhdami N, Chen L, Winders T, Wheeler KE, Wang J, Spergel J, Silverberg JI, Ong PY, O'Brien M, Martin SA, Lio PA, Lind ML, LeBovidge J, Kim E, Huynh J, Greenhawt M, Frazier WT, Ellison K, Capozza K, De Benedetto A, Boguniewicz M, Begolka WS, Asiniwasis RN, Schneider LC, Chu DK. Values and Preferences of Patients and Caregivers Regarding Treatment of Atopic Dermatitis (Eczema): A Systematic Review. JAMA Dermatol 2023; 159:320-330. [PMID: 36696136 DOI: 10.1001/jamadermatol.2022.6045] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Importance Patient values and preferences can inform atopic dermatitis (AD) care. Systematic summaries of evidence addressing patient values and preferences have not previously been available. Objective To inform American Academy of Allergy, Asthma & Immunology (AAAAI)/American College of Allergy, Asthma and Immunology (ACAAI) Joint Task Force on Practice Parameters AD guideline development, patient and caregiver values and preferences in the management of AD were systematically synthesized. Evidence Review Paired reviewers independently screened MEDLINE, Embase, PsycINFO, and CINAHL databases from inception until March 20, 2022, for studies of patients with AD or their caregivers, eliciting values and preferences about treatment, rated risk of bias, and extracted data. Thematic and inductive content analysis to qualitatively synthesize the findings was used. Patients, caregivers, and clinical experts provided triangulation. The GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative Research) informed rating of the quality of evidence. Findings A total of 7780 studies were identified, of which 62 proved eligible (n = 19 442; median age across studies [range], 15 years [3-44]; 59% female participants). High certainty evidence showed that patients and caregivers preferred to start with nonmedical treatments and to step up therapy with increasing AD severity. Moderate certainty evidence showed that adverse effects from treatment were a substantial concern. Low certainty evidence showed that patients and caregivers preferred odorless treatments that are not visible and have a minimal effect on daily life. Patients valued treatments capable of relieving itching and burning skin and preferred to apply topical corticosteroids sparingly. Patients valued a strong patient-clinician relationship. Some studies presented varied perspectives and 18 were at high risk for industry sponsorship bias. Conclusions and Relevance In the first systematic review to address patient values and preferences in management of AD to our knowledge, 6 key themes that may inform optimal clinical care, practice guidelines, and future research have been identified.
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Affiliation(s)
| | - Anja Fog Heen
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Irene X Zhao
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Gordon H Guyatt
- Department of Medicine, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada
| | - Erica A Suzumura
- Department of Preventive Medicine, Faculdade de Medicina Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Nima Makhdami
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Lina Chen
- Faculty of Medicine, University of Ottawa, Ontario, Canada
| | | | | | - Julie Wang
- Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Jonathan Spergel
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, Department of Pediatrics-Perelman School of Medicine at University of Pennsylvania, Philadelphia
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Peck Y Ong
- Children's Hospital Los Angeles, University of Southern California, Los Angeles
| | - Monica O'Brien
- Tufts University School of Medicine, Boston, Massachusetts
| | | | - Peter A Lio
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Mary Laura Lind
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe
| | - Jennifer LeBovidge
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Joey Huynh
- Orthopedic Neurological Rehabilitation, Northridge, California
| | | | - Winfred T Frazier
- Department of Family Medicine, UPMC St Margaret, Pittsburgh, Pennsylvania
| | | | | | - Anna De Benedetto
- Department of Dermatology; University of Rochester Medical Center, Rochester, New York
| | - Mark Boguniewicz
- University of Colorado School of Medicine, Aurora.,National Jewish Health, Denver, Colorado
| | | | | | - Lynda C Schneider
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Derek K Chu
- Department of Medicine, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada.,The Research Institute of St Joe's Hamilton, Hamilton, Canada
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8
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Chu AWL, Devasenapathy N, Wong M, Srivastava A, Ceccacci R, Lin C, MacDonald M, Wen A, Steen J, Levine M, Pyne L, Wang J, Spergel JM, Silverberg JI, Ong PY, O’Brien M, Martin SA, Lio PA, Lind ML, LeBovidge J, Kim E, Huynh J, Greenhawt M, Frazier WT, Chen L, De Benedetto A, Boguniewicz M, Asiniwasis RN, Schneider L, Chu DK. 321 Cancer risk with topical pimecrolimus and tacrolimus for atopic dermatitis: systematic review and Bayesian meta-analysis. Br J Dermatol 2023. [DOI: 10.1093/bjd/ljac140.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Abstract
Atopic dermatitis affects millions worldwide and is effectively managed by topical treatments, including topical calcineurin inhibitors, pimecrolimus and tacrolimus. In 2005 and 2011, the FDA released reviews associating topical calcineurin inhibitors with a theoretical cancer risk, albeit an uncertain association. We systematically reviewed the risk of cancer in patients with atopic dermatitis exposed to topical calcineurin inhibitors. We systematically identified randomized controlled trials, comparative, and non-comparative non-randomized studies from database inception to 6 June 2022, from MEDLINE, EMBASE, GREAT, LILACS, ICTRP, FDA, EMA, company registers and relevant citations. We included studies in any language addressing the risk of cancer in patients with atopic dermatitis exposed to topical calcineurin inhibitors for greater than 3 weeks. We excluded split-body studies. We conducted a Bayesian meta-analysis and used the GRADE approach to determine the certainty of the evidence. A multidisciplinary panel including patients, advocacy groups and care providers, set an a priori threshold of 1 in 1000 risk difference as a clinically important effect. We analysed 121 studies (52 randomized controlled trials and 69 non-randomized studies) including 3.4 million patents followed for a mean of 11 months (range: 0.7–120). The absolute risk of any cancer with topical calcineurin inhibitor exposure was neither different from controls (absolute risk 4.70 per 1000 with topical calcineurin inhibitor exposure vs. 4.56 per 1000 without; odds ratio 1.03 [95% credible interval 0.94–1.11], moderate-certainty evidence) nor the general US population (4.6 per 1000). Findings were similar in infants, children, and adults, and were robust to trial sequential, subgroup and sensitivity analyses. Among infants, children and adults with atopic dermatitis, moderate-certainty evidence shows that topical calcineurin inhibitors do not increase the risk of cancer. These findings support the safe use of topical calcineurin inhibitors in the management of patients with atopic dermatitis. Our findings provide actional information to inform updated clinical practice guidelines, product labels and continuing education for care providers, to clarify the safe usage of topical calcineurin inhibitors.
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Affiliation(s)
| | | | | | | | | | | | | | - Aaron Wen
- McMaster University , Hamilton, ON , Canada
| | | | | | | | - Julie Wang
- Icahn School of Medicine at Mount Sinai , New York City, NY , USA
| | | | - Jonathan I Silverberg
- The George Washington University School of Medicine and Health Sciences , Washington, DC , USA
| | - Peck Y Ong
- USC Keck School of Medicine , Los Angeles, CA , USA
| | | | | | | | | | | | - Elaine Kim
- University of Toronto , Toronto, ON , Canada
| | - Joey Huynh
- Orthopedic Neurological Rehabilitation , Northridge, CA , USA
| | | | | | - Lina Chen
- University of Ottawa , Ottawa, ON , Canada
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9
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Yepes-Nuñez JJ, Guyatt GH, Gómez-Escobar LG, Pérez-Herrera LC, Chu AWL, Ceccaci R, Acosta-Madiedo AS, Wen A, Moreno-López S, MacDonald M, Barrios M, Chu X, Islam N, Gao Y, Wong MM, Couban R, Garcia E, Chapman E, Oykhman P, Chen L, Winders T, Asiniwasis RN, Boguniewicz M, De Benedetto A, Ellison K, Frazier WT, Greenhawt M, Huynh J, Kim E, LeBovidge J, Lind ML, Lio P, Martin SA, O'Brien M, Ong PY, Silverberg JI, Spergel J, Wang J, Wheeler KE, Schneider L, Chu DK. Allergen immunotherapy for atopic dermatitis: Systematic review and meta-analysis of benefits and harms. J Allergy Clin Immunol 2023; 151:147-158. [PMID: 36191689 DOI: 10.1016/j.jaci.2022.09.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/22/2022] [Accepted: 09/01/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Atopic dermatitis (AD, eczema) is driven by a combination of skin barrier defects, immune dysregulation, and extrinsic stimuli such as allergens, irritants, and microbes. The role of environmental allergens (aeroallergens) in triggering AD remains unclear. OBJECTIVE We systematically synthesized evidence regarding the benefits and harms of allergen immunotherapy (AIT) for AD. METHODS As part of the 2022 American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters AD Guideline update, we searched the MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, Global Resource for Eczema Trials, and Web of Science databases from inception to December 2021 for randomized controlled trials comparing subcutaneous immunotherapy (SCIT), sublingual immunotherapy (SLIT), and/or no AIT (placebo or standard care) for guideline panel-defined patient-important outcomes: AD severity, itch, AD-related quality of life (QoL), flares, and adverse events. Raters independently screened, extracted data, and assessed risk of bias in duplicate. We synthesized intervention effects using frequentist and Bayesian random-effects models. The GRADE approach determined the quality of evidence. RESULTS Twenty-three randomized controlled trials including 1957 adult and pediatric patients sensitized primarily to house dust mite showed that add-on SCIT and SLIT have similar relative and absolute effects and likely result in important improvements in AD severity, defined as a 50% reduction in SCORing Atopic Dermatitis (risk ratio [95% confidence interval] 1.53 [1.31-1.78]; 26% vs 40%, absolute difference 14%) and QoL, defined as an improvement in Dermatology Life Quality Index by 4 points or more (risk ratio [95% confidence interval] 1.44 [1.03-2.01]; 39% vs 56%, absolute difference 17%; both outcomes moderate certainty). Both routes of AIT increased adverse events (risk ratio [95% confidence interval] 1.61 [1.44-1.79]; 66% with SCIT vs 41% with placebo; 13% with SLIT vs 8% with placebo; high certainty). AIT's effect on sleep disturbance and eczema flares was very uncertain. Subgroup and sensitivity analyses were consistent with the main findings. CONCLUSIONS SCIT and SLIT to aeroallergens, particularly house dust mite, can similarly and importantly improve AD severity and QoL. SCIT increases adverse effects more than SLIT. These findings support a multidisciplinary and shared decision-making approach to optimally managing AD.
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Affiliation(s)
| | - Gordon H Guyatt
- Department of Medicine, McMaster University, and Evidence in Allergy Group, Hamilton; Department of Health Research Methods, Evidence and Impact, Hamilton
| | | | | | - Alexandro W L Chu
- Department of Medicine, McMaster University, and Evidence in Allergy Group, Hamilton
| | - Renata Ceccaci
- Department of Medicine, McMaster University, and Evidence in Allergy Group, Hamilton
| | | | - Aaron Wen
- Department of Medicine, McMaster University, and Evidence in Allergy Group, Hamilton
| | | | - Margaret MacDonald
- Department of Medicine, McMaster University, and Evidence in Allergy Group, Hamilton
| | | | - Xiajing Chu
- Department of Health Research Methods, Evidence and Impact, Hamilton; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou
| | - Nazmul Islam
- Department of Health Research Methods, Evidence and Impact, Hamilton; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha
| | - Ya Gao
- Department of Health Research Methods, Evidence and Impact, Hamilton; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou
| | - Melanie M Wong
- Department of Medicine, McMaster University, and Evidence in Allergy Group, Hamilton
| | - Rachel Couban
- Department of Health Research Methods, Evidence and Impact, Hamilton
| | | | | | - Paul Oykhman
- Department of Medicine, McMaster University, and Evidence in Allergy Group, Hamilton
| | - Lina Chen
- Department of Medicine, McMaster University, and Evidence in Allergy Group, Hamilton; University of Ottawa, Ottawa
| | | | | | - Mark Boguniewicz
- National Jewish Health, Denver; University of Colorado School of Medicine, Aurora
| | - Anna De Benedetto
- Department of Dermatology, University of Rochester Medical Center, Rochester
| | | | | | | | - Joey Huynh
- Orthopedic Neurological Rehabilitation, Northridge
| | | | | | - Mary Laura Lind
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe
| | - Peter Lio
- Northwestern University Feinberg School of Medicine, Chicago
| | | | | | - Peck Y Ong
- Children's Hospital Los Angeles, University of Southern California, Los Angeles
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington
| | - Jonathan Spergel
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine at University of of Pennsylvania, Philadelphia
| | - Julie Wang
- Icahn School of Medicine at Mount Sinai, New York
| | | | | | - Derek K Chu
- Department of Medicine, McMaster University, and Evidence in Allergy Group, Hamilton; Department of Health Research Methods, Evidence and Impact, Hamilton; Research Institute of St Joe's Hamilton, Hamilton.
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10
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Bakaa L, Pernica JM, Couban RJ, Tackett KJ, Burkhart CN, Leins L, Smart J, Garcia-Romero MT, Elizalde-Jiménez IG, Herd M, Asiniwasis RN, Boguniewicz M, De Benedetto A, Chen L, Ellison K, Frazier W, Greenhawt M, Huynh J, LeBovidge J, Lind ML, Lio P, O'Brien M, Ong PY, Silverberg JI, Spergel JM, Wang J, Begolka WS, Schneider L, Chu DK. Bleach baths for atopic dermatitis: A systematic review and meta-analysis including unpublished data, Bayesian interpretation, and GRADE. Ann Allergy Asthma Immunol 2022; 128:660-668.e9. [PMID: 35367346 DOI: 10.1016/j.anai.2022.03.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Bleach bathing is frequently recommended to treat atopic dermatitis (AD), but its efficacy and safety are uncertain. OBJECTIVE To systematically synthesize randomized controlled trials (RCTs) addressing bleach baths for AD. METHODS We searched MEDLINE, EMBASE, CENTRAL, and GREAT from inception to December 29, 2021, for RCTs assigning patients with AD to bleach vs no bleach baths. Paired reviewers independently and in duplicate screened records, extracted data, and assessed risk of bias (Cochrane version 2) and GRADE quality of evidence. We obtained unpublished data, harmonized individual patient data and did Frequentist and Bayesian random-effects meta-analyses. RESULTS There were 10 RCTs that enrolled 307 participants (median of mean age 7.2 years, Eczema Area Severity Index baseline mean of means 27.57 [median SD, 10.74]) for a median of 6 weeks (range, 4-10). We confirmed that other trials registered globally were terminated. Bleach baths probably improve AD severity (22% vs 32% improved Eczema Area Severity Index by 50% [ratio of means 0.78, 95% credible interval 0.59-0.99]; moderate certainty) and may slightly reduce skin Staphylococcal aureus colonization (risk ratio, 0.89 [95% confidence interval, 0.73-1.09]; low certainty). Adverse events, mostly dry skin and irritation, along with itch, patient-reported disease severity, sleep quality, quality of life, and risk of AD flares were not clearly different between groups and of low to very low certainty. CONCLUSION In patients with moderate-to-severe AD, bleach baths probably improve clinician-reported severity by a relative 22%. One in 10 will likely improve severity by 50%. Changes in other patient-important outcomes are uncertain. These findings support optimal eczema care and the need for additional large clinical trials. TRIAL REGISTRATION PROSPERO Identifier: CRD42021238486.
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Affiliation(s)
- Layla Bakaa
- Evidence in Allergy Group, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jeffrey M Pernica
- Department of Pediatrics, Division of Infectious Diseases, McMaster University, Hamilton, Ontario, Canada
| | - Rachel J Couban
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Kelly Jo Tackett
- Department of Dermatology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Craig N Burkhart
- Department of Dermatology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Liz Leins
- Royal Children's Hospital, Allergy & Immunology, Victoria, Australia
| | - Joanne Smart
- Royal Children's Hospital, Allergy & Immunology, Victoria, Australia
| | | | - Itzel Guadalupe Elizalde-Jiménez
- Department of Dermatology, National Institute of Pediatrics, Mexico City, Mexico; Ministry of Health, General Directorate of Quality and Education of Health, Mexico City, Mexico
| | - Michael Herd
- Paediatric Department, Waitakere Hospital, Waitemata District Health Board, Auckland, New Zealand; Current location: Paediatric Department, Whakatane Hospital Bay of Plenty District Health Board, Whakatane, New Zealand
| | | | | | | | - Lina Chen
- University of Ottawa, Ottawa, Ontario, Canada
| | | | - Winfred Frazier
- Department of Family Medicine, UPMC St. Margaret, Pittsburgh, Pennsylvania
| | - Matthew Greenhawt
- Section of Allergy and Immunology, Children's Hospital Colorado, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Joey Huynh
- Orthopedic Neurological Rehabilitation, Northridge, California
| | - Jennifer LeBovidge
- Division of Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - Mary Laura Lind
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona
| | - Peter Lio
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Monica O'Brien
- Tufts University School of Medicine, Boston, Massachusetts. Medical Student, Class of 2025
| | - Peck Y Ong
- Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Jonathan M Spergel
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Julie Wang
- Icahn School of Medicine at Mount Sinai, New York City, New York
| | | | - Lynda Schneider
- Division of Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - Derek K Chu
- Evidence in Allergy Group, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; The Research Institute of St. Joe's Hamilton, Hamilton, Ontario, Canada.
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11
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Thomas ER, Jain A, Mann SC, Yang Y, Green MD, Walker WS, Perreault F, Lind ML, Verduzco R. Freestanding self-assembled sulfonated pentablock terpolymer membranes for high flux pervaporation desalination. J Memb Sci 2020. [DOI: 10.1016/j.memsci.2020.118460] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Yin H, Cay-Durgun P, Lai T, Zhu G, Engebretson K, Setiadji R, Green MD, Lind ML. Effect of ZIF-71 ligand-exchange surface modification on biofuel recovery through pervaporation. POLYMER 2020. [DOI: 10.1016/j.polymer.2020.122379] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Liu NY, Cay-Durgun P, Lai T, Sprowls M, Thomas L, Lind ML, Forzani E. A Handheld, Colorimetric Optoelectronic Dynamics Analyzer for Measuring Total Ammonia of Biological Samples. IEEE J Transl Eng Health Med 2018; 6:2800610. [PMID: 30112251 PMCID: PMC6092083 DOI: 10.1109/jtehm.2018.2840678] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/11/2018] [Accepted: 05/20/2018] [Indexed: 12/30/2022]
Abstract
This paper introduces a wireless, solid-state, portable, and automated device capable of measuring the total ammonia [ammonia (NH3) and ammonium (NH4+)] levels of fluids, including biological samples. This device reliably measures the total ammonia of biological samples (e.g., urine) faster than the current ammonia quantification techniques. Medical professionals typically estimate NH4+ levels using error-prone indirect measurement techniques (i.e., urine anion gap), which are time-consuming and are seldom suitable for periodic measurements. Several instantaneous measurements of total ammonia levels in a patient urine could be utilized as an early warning for both acid-base and/or potassium disturbances. Given the device’s operation mechanism, it is able to quantify the total ammonia concentration within a biological sample in only 5 s and can simultaneously transmit data to other devices via Bluetooth. The analytical operation demonstrated high sensitivity, high specificity, fast reversibility, rapid response time, and has enabled the accurate determination of total ammonia concentration in urine samples produced by subjects who had consumed diets of variable protein compositions.
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Affiliation(s)
- Nai-Yuan Liu
- School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeAZ85287USA.,Center for Bioelectronics and BiosensorsThe Biodesign Institute, Arizona State UniversityTempeAZ85287USA
| | - Pinar Cay-Durgun
- School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeAZ85287USA
| | - Tianmiao Lai
- School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeAZ85287USA.,Center for Bioelectronics and BiosensorsThe Biodesign Institute, Arizona State UniversityTempeAZ85287USA
| | - Mark Sprowls
- School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeAZ85287USA.,Center for Bioelectronics and BiosensorsThe Biodesign Institute, Arizona State UniversityTempeAZ85287USA
| | - Leslie Thomas
- School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeAZ85287USA.,Mayo Clinic in Arizona Division of NephrologyScottsdaleAZ85259USA
| | - Mary Laura Lind
- School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeAZ85287USA.,Center for Bioelectronics and BiosensorsThe Biodesign Institute, Arizona State UniversityTempeAZ85287USA.,Mayo Clinic in Arizona Division of NephrologyScottsdaleAZ85259USA
| | - Erica Forzani
- School for Engineering of Matter, Transport, and EnergyArizona State UniversityTempeAZ85287USA.,Center for Bioelectronics and BiosensorsThe Biodesign Institute, Arizona State UniversityTempeAZ85287USA.,Mayo Clinic in Arizona Division of NephrologyScottsdaleAZ85259USA
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15
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Huang Y, Cay-Durgun P, Lai T, Yu P, Lind ML. Phenol Removal from Water by Polyamide and AgCl Mineralized Thin-Film Composite Forward Osmosis Membranes. Ind Eng Chem Res 2018. [DOI: 10.1021/acs.iecr.8b00205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yangbo Huang
- College of Chemistry and Molecular Sciences, Wuhan University, Wuhan, Hubei 430072, People’s Republic of China
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Pinar Cay-Durgun
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
- Nanosystems Engineering Research Center for Nanotechnology-Enabled Water Treatment, Arizona State University, Tempe, Arizona 85287, United States
| | - Tianmiao Lai
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Ping Yu
- College of Chemistry and Molecular Sciences, Wuhan University, Wuhan, Hubei 430072, People’s Republic of China
| | - Mary Laura Lind
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
- Nanosystems Engineering Research Center for Nanotechnology-Enabled Water Treatment, Arizona State University, Tempe, Arizona 85287, United States
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16
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Abstract
A new method has been developed for one-step synthesis of cysteine-capped Ag nanoparticles. The particles have been characterized by several techniques, including ultraviolet–visible spectroscopy, infrared spectroscopy, X-ray diffraction, scanning electron microscopy, and transmission electron microscopy. The interaction of these nanoparticles has been seen with two pesticides, namely, chlorpyrifos and malathion, which are major water pollutants.
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Affiliation(s)
- Aditi Singhal
- School of Engineering and Applied Science, Ahmedabad University, Ahmedabad, Gujarat, India
| | - Mary Laura Lind
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA
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Yin H, Khosravi A, O’Connor L, Tagaban AQ, Wilson L, Houck B, Liu Q, Lind ML. Effect of ZIF-71 Particle Size on Free-Standing ZIF-71/PDMS Composite Membrane Performances for Ethanol and 1-Butanol Removal from Water through Pervaporation. Ind Eng Chem Res 2017. [DOI: 10.1021/acs.iecr.7b01833] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Huidan Yin
- School
for Engineering of Matter, Transport and Energy, Arizona State University, P.O. Box 876106, Tempe, Arizona 85287, United States
| | - Afsaneh Khosravi
- School
for Engineering of Matter, Transport and Energy, Arizona State University, P.O. Box 876106, Tempe, Arizona 85287, United States
| | - Liana O’Connor
- School
for Engineering of Matter, Transport and Energy, Arizona State University, P.O. Box 876106, Tempe, Arizona 85287, United States
- Bioscience High School, 512 East
Pierce St., Phoenix, Arizona 85004, United States
| | - Alexa Q. Tagaban
- School
for Engineering of Matter, Transport and Energy, Arizona State University, P.O. Box 876106, Tempe, Arizona 85287, United States
- Bioscience High School, 512 East
Pierce St., Phoenix, Arizona 85004, United States
| | - Lindsay Wilson
- School
for Engineering of Matter, Transport and Energy, Arizona State University, P.O. Box 876106, Tempe, Arizona 85287, United States
- Bioscience High School, 512 East
Pierce St., Phoenix, Arizona 85004, United States
| | - Brandon Houck
- School
for Engineering of Matter, Transport and Energy, Arizona State University, P.O. Box 876106, Tempe, Arizona 85287, United States
| | - Qianlang Liu
- School
for Engineering of Matter, Transport and Energy, Arizona State University, P.O. Box 876106, Tempe, Arizona 85287, United States
| | - Mary Laura Lind
- School
for Engineering of Matter, Transport and Energy, Arizona State University, P.O. Box 876106, Tempe, Arizona 85287, United States
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Yin H, Lau CY, Rozowski M, Howard C, Xu Y, Lai T, Dose ME, Lively RP, Lind ML. Free-standing ZIF-71/PDMS nanocomposite membranes for the recovery of ethanol and 1-butanol from water through pervaporation. J Memb Sci 2017. [DOI: 10.1016/j.memsci.2017.02.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jin H, Rivers F, Yin H, Lai T, Cay-Durgun P, Khosravi A, Lind ML, Yu P. Synthesis of AgCl Mineralized Thin Film Composite Polyamide Membranes To Enhance Performance and Antifouling Properties in Forward Osmosis. Ind Eng Chem Res 2017. [DOI: 10.1021/acs.iecr.6b04287] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Haiyang Jin
- College
of Chemistry and Molecular Sciences, Wuhan University, Wuhan, Hubei 430072, People’s Republic of China
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Frederick Rivers
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Huidan Yin
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Tianmiao Lai
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Pinar Cay-Durgun
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
- Nanosystems
Engineering Research Center for Nanotechnology-Enabled Water Treatment, Arizona State University, Tempe, Arizona 85287, United States
| | - Afsaneh Khosravi
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
| | - Mary Laura Lind
- School
for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, Arizona 85287, United States
- Nanosystems
Engineering Research Center for Nanotechnology-Enabled Water Treatment, Arizona State University, Tempe, Arizona 85287, United States
| | - Ping Yu
- College
of Chemistry and Molecular Sciences, Wuhan University, Wuhan, Hubei 430072, People’s Republic of China
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Abstract
Here we present the formation of thin layers of barrier polymers onto mesoporous and macroporous substrates via dip coating of latex solutions. We investigated four commercially available latex solutions: polytetrafluoroethylene (PTFE), perfluoroalkoxy fluorothermoplastic (PFA), polyvinylidene chloride (PVDC), and polyolefin-based latex (Hypod). We examined the latex film formation on porous polymeric and ceramic substrates with a broad range of pore sizes from 10 to 200 nm. Our results show that both characteristics of the latex solution [glass transition temperature (Tg), particle size, and crystallinity] and the characteristics of the porous substrate (pore size and hydrophobicity) impact the film formation. We confirmed the defect-free, barrier nature of our latex thin films through scanning electron microscopy (SEM), atomic force microscopy (AFM), and hydraulically driven water permeation tests. Additionally, we found that latex concentration (not dipping time) is the most important parameter determining ultimate latex film thickness. We obtained defect-free films from PVDC and Hypod, which are "soft" polymers (Tg < room temperature), on mesoporous substrates under the conditions of slow evaporation rate of the solvent from these latex solutions. PTFE and PFA, which are "hard" polymers (Tg > room temperature), did not form continuous films on porous substrates.
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Affiliation(s)
- Afsaneh Khosravi
- School for Engineering of Matter, Transport and Energy, Arizona State University , Tempe, Arizona 85287, United States
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Yadav A, Lind ML, Ma X, Lin YS. Nanocomposite Silicalite-1/Polydimethylsiloxane Membranes for Pervaporation of Ethanol from Dilute Aqueous Solutions. Ind Eng Chem Res 2013. [DOI: 10.1021/ie303240f] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Amit Yadav
- School for Engineering of Matter, Transport and Energy, P.O. Box 876106, Tempe, Arizona 85287, United
States
| | - Mary Laura Lind
- School for Engineering of Matter, Transport and Energy, P.O. Box 876106, Tempe, Arizona 85287, United
States
| | - Xiaoli Ma
- School for Engineering of Matter, Transport and Energy, P.O. Box 876106, Tempe, Arizona 85287, United
States
| | - Y. S. Lin
- School for Engineering of Matter, Transport and Energy, P.O. Box 876106, Tempe, Arizona 85287, United
States
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Lind ML, Eumine Suk D, Nguyen TV, Hoek EMV. Tailoring the structure of thin film nanocomposite membranes to achieve seawater RO membrane performance. Environ Sci Technol 2010; 44:8230-8235. [PMID: 20942398 DOI: 10.1021/es101569p] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Herein we report on the formation and characterization of pure polyamide thin film composite (TFC) and zeolite-polyamide thin film nanocomposite (TFN) reverse osmosis (RO) membranes. Four different physical-chemical post-treatment combinations were applied after the interfacial polymerization reaction to change the molecular structure of polyamide and zeolite-polyamide thin films. Both TFC and TFN hand-cast membranes were more permeable, hydrophilic, and rough than a commercial seawater RO membrane. Salt rejection by TFN membranes was consistently below that of hand-cast TFC membranes; however, two TFN membranes exhibited 32 g/L NaCl rejections above 99.4%, which was better than the commercial membrane under the test conditions employed. The nearly defect-free TFN films that produced such high rejections were achieved only with wet curing, regardless of other post-treatments. Polyamide films formed in the presence of zeolite nanoparticles were less cross-linked than similarly cast pure polyamide films. At the very low nanoparticle loadings evaluated, differences between pure polyamide and zeolite-polyamide membrane water and salt permeability correlated weakly with extent of cross-linking of the polyamide film, which suggests that defects and molecular-sieving largely govern transport through zeolite-polyamide thin film nanocomposite membranes.
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Affiliation(s)
- Mary Laura Lind
- Department of Civil & Environmental Engineering and California NanoSystems Institute, University of California, Los Angeles, Los Angeles, California, USA
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Lind ML, Duan G, Johnson WL. Isoconfigurational elastic constants and liquid fragility of a bulk metallic glass forming alloy. Phys Rev Lett 2006; 97:015501. [PMID: 16907383 DOI: 10.1103/physrevlett.97.015501] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2006] [Indexed: 05/11/2023]
Abstract
Samples of Zr(46.25)Ti(8.25)Cu(7.5)Ni(10)Be(27.5) were isothermally annealed and quenched near the glass transition temperature and studied by the pulse-echo overlap technique. The shear modulus G of the samples shows a strong reversible dependence on annealing temperatures and, thus, on the specific configurational potential energy of the equilibrium liquid. The low-T dependence of G of the configurationally frozen glasses shows linear temperature dependence as expected by Debye-Grüneisen theory. The T dependence of G in the liquid state is directly related to the viscosity and fragility of the liquid.
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Affiliation(s)
- Mary Laura Lind
- W. M. Keck Laboratory of Engineering Materials, 138-78, California Institute of Technology, 1200 East California Boulevard, Pasadena, California 91125, USA.
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Langworth S, Anundi H, Friis L, Johanson G, Lind ML, Söderman E, Akesson BA. Acute health effects common during graffiti removal. Int Arch Occup Environ Health 2001; 74:213-8. [PMID: 11355296 DOI: 10.1007/s004200000211] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to identify possible health effects caused by different cleaning agents used in graffiti removal. METHODS In 38 graffiti removers working 8-h shifts in the Stockholm underground system, the exposure to organic solvents was assessed by active air sampling, biological monitoring, and by interviews and a questionnaire. Health effects were registered, by physical examinations, porta7ble spirometers and self-administered questionnaires. The prevalence of symptoms was compared with 49 controls working at the underground depots, and with 177 population controls. RESULTS The 8-h time-weighted average exposures (TWA) were low, below 20% of the Swedish permissible exposure limit value (PEL) for all solvents. The short-term exposures occasionally exceeded the Swedish short-term exposure limit values (STEL), especially during work in poorly ventilated spaces, e.g. in elevators. The graffiti removers reported significantly higher prevalence of tiredness and upper airway symptoms compared with the depot controls, and significantly more tiredness, headaches and symptoms affecting airways, eyes and skin than the population controls. Among the graffiti removers, some of the symptoms increased during the working day. On a group basis, the lung function registrations showed normal values. However, seven workers displayed a clear reduction of peak expiratory flow (PEF) over the working shift. CONCLUSIONS Though their average exposure to organic solvents was low, the graffiti removers reported significantly higher prevalence of unspecific symptoms such as fatigue and headache as well as irritative symptoms from the eyes and respiratory tract, compared with the controls. To prevent adverse health effects it is important to inform the workers about the health risks, and to restrict use of the most hazardous chemicals. Furthermore, it is important to develop good working practices and to encourage the use of personal protective equipment.
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Affiliation(s)
- S Langworth
- Department of Public Health Sciences, Division of Occupational Medicine, Karolinska Institute, Karolinska University Hospital, 17176 Stockholm, Sweden.
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Anundi H, Langworth S, Johanson G, Lind ML, Akesson B, Friis L, Itkes N, Söderman E, Jönsson BA, Edling C. Air and biological monitoring of solvent exposure during graffiti removal. Int Arch Occup Environ Health 2000; 73:561-9. [PMID: 11100951 DOI: 10.1007/s004200000157] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The principal aim of the study was to estimate the level of exposure to organic solvents of graffiti removers, and to identify the chemicals used in different cleaning agents. A secondary objective was to inform about the toxicity of various products and to optimise working procedures. METHODS Exposure to organic solvents was determined by active air sampling and biological monitoring among 38 graffiti removers during an 8-h work shift in the Stockholm underground system. The air samples and biological samples were analysed by gas chromatography. Exposure to organic solvents was also assessed by a questionnaire and interviews. RESULTS Solvents identified were N-methylpyrrolidone (NMP), dipropylene glycol monomethyl ether (DPGME), propylene glycol monomethyl ether (PGME), diethylene glycol monoethyl ether (DEGEE), toluene, xylene, pseudocumene, hemimellitine, mesitylene, ethylbenzene, limonene, nonane, decane, undecane, hexandecane and gamma-butyrolactone. The 8-h average exposures [time-weighted average (TWA)] were below 20% of the Swedish permissible exposure limit value (PEL) for all solvents identified. In poorly ventilated spaces, e.g. in elevators etc., the short-term exposures exceeded occasionally the Swedish short-term exposure limit values (STEL). The blood and urine concentrations of NMP and its metabolites were low. Glycol ethers and their metabolites (2-methoxypropionic acid (MPA), ethoxy acetic acid (EAA), butoxy acetic acid (BAA), and 2-(2-methoxyethoxy) acetic acid (MEAA)) were found in low concentrations in urine. There were significant correlation between the concentrations of NMP in air and levels of NMP and its metabolites in blood and urine. The use of personal protective equipment, i.e. gloves and respirators, was generally high. CONCLUSIONS Many different cleaning agents were used. The average exposure to solvents was low, but some working tasks included relatively high short-term exposure. To prevent adverse health effects, it is important to inform workers about the health risks and to restrict the use of the most toxic chemicals. Furthermore, it is important to develop good working procedures and to encourage the use of personal protection equipment.
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Affiliation(s)
- H Anundi
- Department of Occupational and Environmental Medicine, Uppsala University Hospital, Sweden.
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Koralewska-Makár A, Molander N, Madsen K, Lind ML, Stenevi U, Ehinger B. Endogenous hyaluronan in the normal and traumatized rabbit iris. Acta Ophthalmol Scand 1998; 76:391-5. [PMID: 9716322 DOI: 10.1034/j.1600-0420.1998.760401.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE Hyaluronan concentration in the iris tissue after iridectomy was studied in order to establish the influence of trauma on the production of hyaluronan in the anterior chamber of the eye and whether the iris participates in this process or not. METHOD Hyaluronan was measured with a radiometric assay at different time points after surgery and identified with specific histochemical staining. RESULTS AND CONCLUSIONS The concentration of hyaluronan in iris tissue peaked two days after surgery, reaching an average of 115.3 (S.E.M.:+/-12.2) microg/g. It then decreased slowly to almost normal values after 3 to 5 weeks. Histochemistry demonstrated the most intense hyaluronan staining in the iris stroma and in iridial processes around the iridectomy two days after the operation. Our findings indicate in situ synthesis of hyaluronan in the iris tissue.
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Langworth S, Sällsten G, Barregård L, Cynkier I, Lind ML, Söderman E. Exposure to mercury vapor and impact on health in the dental profession in Sweden. J Dent Res 1997; 76:1397-404. [PMID: 9207773 DOI: 10.1177/00220345970760071001] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Possible adverse effects of mercury exposure in dentistry have been discussed in several studies. The objective of the present study was to carry out detailed measurements of mercury exposure in the dental profession in Sweden, and to search for adverse health effects from such exposure. We examined 22 dentists and 22 dental nurses, working in teams, at six Swedish dental clinics. Measurements of air mercury, performed with personal, active air samplers, showed a median air Hg of 1.8 micrograms/m3 for the dentists, and 2.1 micrograms/m3 for the dental nurses. Spot measurements with a direct reading instrument displayed temporarily elevated air Hg, especially during the preparation and application of amalgam. The average concentration of mercury in whole blood (B-Hg) was 18 nmol/L, in plasma (P-Hg) 5.1 nmol/L, and in urine (U-Hg) 3.0 nmol/mmol creatinine. Possible effects on the central nervous system (CNS) were registered with three questionnaires: Q16, Eysenck Personality Inventory (EPI), and the Profile of Mood Scales (POMS). In the Q16, the number of symptoms was statistically significantly higher in the dentistry group compared with an age- and gender-matched control group (n = 44). The urinary excretion of albumin and urinary activity of the tubular enzyme N-acetyl-beta-glucose-aminidase (NAG) did not differ between the two groups. The results confirm that exposure to mercury in the dental profession in Sweden is low. The air Hg levels were mainly influenced by the method of amalgam preparation and inserting, and by the method of air evacuation during drilling and polishing.
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Affiliation(s)
- S Langworth
- Department of Occupational Medicine, Huddinge University Hospital, Sweden
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Brawn PN, Jay DW, Foster DM, Kuhl D, Speights VO, Johnson EH, Riggs M, Lind ML, Coffield KS, Weaver B. Prostatic acid phosphatase levels (enzymatic method) from completely sectioned, clinically benign, whole prostates. Prostate 1996; 28:295-9. [PMID: 8610055 DOI: 10.1002/(sici)1097-0045(199605)28:5<295::aid-pros4>3.0.co;2-b] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Clinically benign, whole untrimmed prostates were obtained from 104 patients at autopsy, completely sectioned, and examined microscopically. The histological and gross findings of the prostate were correlated with premortem prostatic acid phosphatase levels (PAP, enzymatic method, ACA, Dupont Co.) to determine how often carcinoma of the prostate (CAP) affected PAP levels and to identify other findings within the prostate associated with elevated PAP levels. Sixty (58%) prostates did not have CAP, 34 (33%) had CAP smaller than 1 ml in volume, and 10 (10%) had CAP larger than 1 ml in volume. PAP levels were elevated (greater than 1 U/L) in 8 of 60 (13%) prostates without CAP, in 2 of the 34 (6%) prostates with CAP smaller than 1 ml, and in 1 of the 10 (10%) prostates with CAP larger than 1 ml. These differences were not statistically significant. Likewise, a statistically significant correlation between PAP levels and patient age, patient race, severe inflammation, of high grade prostatic intraepithelial neoplasia (PIN) was not found. However, there was a statistically significant correlation between PAP levels and prostate weight (p < 0.0001). This study suggest that PAP cannot distinguish between patients with clinically undetected CAP and patients without CAP. Furthermore, elevated PAP levels are often not due to metastatic CAP and additional evidence should be present, even in patients with known CAP, before an elevated PAP level is considered to be conclusive evidence of metastatic CAP.
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Affiliation(s)
- P N Brawn
- Department of Pathology, Veterans Administration Medical Center, University of Michigan, Ann Arbor 48105, USA
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Brawn PN, Foster DM, Jay DW, Kuhl D, Speights VO, Johnson EH, Coffield KS, Lind ML, Karl R, Weaver B. Characteristics of prostatic infarcts and their effect on serum prostate-specific antigen and prostatic acid phosphatase. Urology 1994; 44:71-5. [PMID: 7518984 DOI: 10.1016/s0090-4295(94)80012-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To determine how prostatic infarcts affect serum prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) levels. METHODS Two hundred eighteen clinically benign, whole prostates were obtained at autopsy, completely sectioned, and examined histologically. PSA and PAP levels were determined from premortem serum. RESULTS Six of the 218 (2.8%) prostates had infarcts. The infarcts were usually multiple and usually located in the central and/or middle concentric zones of the middle third of the prostate without a preference for a particular lobe. Serum PSA by immunoradiometric assay were elevated in all 6 cases. Serum PAP by both enzymatic assay (ACA), and immunoradiometric assay were available for 5 cases and were elevated by both methods in 2 cases, approached elevated levels by both methods in 1 case, and were normal by both methods in 2 cases. The PSA and PAP levels appeared to be affected more by the age than by the size of the infarct. CONCLUSIONS Prostatic infarcts elevate PSA levels more frequently than PAP levels, and prostatic infarcts may be responsible for some unexplained elevations of serum PSA and PAP levels.
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Affiliation(s)
- P N Brawn
- Department of Pathology, Veterans Affairs Medical Center, Ann Arbor, Michigan
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Abstract
The exposure to organic solvents among 12 graffiti removers was studied. Health effects were also assessed by structured interview and a symptom questionnaire. Blood and urine samples were collected at the end of the day of air sampling. The concentrations of dichloromethane, glycol ethers, trimethylbenzenes and N-methyl-2-pyrrolidinone in the breathing zone of each worker were measured during one working day. The 8-h time-weighted average exposure to dichloromethane ranged from 18 to 1200 mg/m3. The Swedish Permissible Exposure Limit value for dichloromethane is 120 mg/m3. The air concentrations of glycol ethers, trimethylbenzenes and N-methyl-2-pyrrolidinone were low or not detectable. No exposure-related deviations in the serum concentrations of creatinine, aspartate transaminase, alanine transaminase, gamma-glutamyl transpeptidase or hyaluronan or the urine concentrations of alpha 1-microglobulin, beta 2-microglobulin or N-acetyl-beta-glucosaminidase were found. Irritative symptoms of the eyes and upper respiratory tract were more prevalent than in the general population. This study demonstrates that old knowledge about work hazards is not automatically transferred to new professions. Another aspect is that the public is also exposed as the job is performed during daytime in underground stations. At least for short periods, bystanders may be exposed to high concentrations of organic solvent vapours. People with predisposing conditions, e.g. asthmatics, may risk adverse reactions.
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Affiliation(s)
- H Anundi
- Department of Occupational Medicine, University Hospital, Uppsala, Sweden
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Abstract
BACKGROUND Black men are known to have a higher incidence and mortality from prostate carcinoma than white men and are more likely to have a more advanced stage or grade of disease diagnosed. METHODS In a Veterans Administration Medical Center where black and white men have the same eligibility for medical care, the authors reviewed the stage at presentation of 861 consecutive cases of prostate carcinoma diagnosed from 1969-1990. In addition, survival, stratified by race, stage, and grade, was determined on all men in whom prostate cancer was diagnosed from 1969-1985 (525 patients). RESULTS It was found that 26% of white and 52% of black men with prostate carcinoma presented with Stage D disease. Similar proportions of white and black men with prostate carcinoma presented with Stage D disease between 1969-73 as between 1986-90. The overall survival was poorer for black men because of their higher proportion of Stage D disease, but stratified for grade and stage, survival was similar in both races. CONCLUSIONS This study suggests that factors other than eligibility for medical care may be responsible for the higher proportion of black men with prostate carcinoma presenting with Stage D prostate carcinoma.
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Affiliation(s)
- P N Brawn
- Department of Pathology, Veterans Administration Medical Center, Ann Arbor 48105
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Göthe CJ, Cynkier I, Lind ML, Blomberg R, Svensson EB, Ytterlind A. [Exposure to noise by electronic amplified music--rock concerts carry a risk of hearing damage]. Lakartidningen 1992; 89:3579-80. [PMID: 1460969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- C J Göthe
- Yrkesmedicinska kliniken, Södersjukhuset, Stockholm
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Brawn PN, Speights VO, Kuhl D, Riggs M, Spiekerman AM, McCord RG, Coffield KS, Stewart DT, Lind ML. Prostate-specific antigen levels from completely sectioned, clinically benign, whole prostates. Cancer 1991; 68:1592-9. [PMID: 1716510 DOI: 10.1002/1097-0142(19911001)68:7<1592::aid-cncr2820680721>3.0.co;2-m] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Clinically benign whole, untrimmed prostates and pelvic lymph nodes were obtained from 105 patients at autopsy. All 105 patients had premortem serum from which prostate-specific antigen (PSA) levels were obtained. Sixty-eight did not have carcinoma of the prostate (CAP), 28 had CAP less than 1 ml and 9 had CAP larger than 1 ml. Eleven untrimmed prostates weighed 80 g or more and eight had elevated PSA levels (more than 4.0 ng/ml): five of eight without CAP, two of two with CAP less than 1 ml, and one of one with CAP larger than 1 ml. Ninety-four whole untrimmed prostates weighed less than 80 g and 20 had elevated PSA levels: ten of 60 without CAP, two of 26 with CAP less than 1 ml, and eight of eight with CAP larger than 1 ml. This study suggests that PSA levels from patients with untrimmed prostates weighing 80 g or more (equivalent to a 60-g trimmed prostate) are usually elevated regardless whether CAP is present. However, CAP less than 1 ml, in untrimmed prostates less than 80 g, usually does not elevate PSA levels whereas CAP larger than 1 ml usually does (P less than 0.0001). The likelihood that elevated PSA levels, from patients with untrimmed prostates less than 80 g, are due to CAP larger than 1 ml increases as the PSA level increases.
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Affiliation(s)
- P N Brawn
- Department of Anatomic Pathology, Veterans Administration Medical Center, Temple, Texas
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