Guidelines for treatment of atopic eczema (atopic dermatitis) part I

The existing evidence for treatment of atopic eczema (atopic dermatitis, AE) is evaluated using the national standard Appraisal of Guidelines Research and Evaluation. The consensus process consisted of a nominal group process and a DELPHI procedure. Management of AE must consider the individual symptomatic variability of the disease. Basic therapy is focused on hydrating topical treatment, and avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment based on topical glucocorticosteroids and topical calcineurin inhibitors (TCI) is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the TCI tacrolimus and pimecrolimus are preferred in certain locations. Systemic immune-suppressive treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Adjuvant therapy includes UV irradiation preferably with UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Stress-induced exacerbations may make psychosomatic counselling recommendable. 'Eczema school' educational programs have been proven to be helpful. Pruritus is targeted with the majority of the recommended therapies, but some patients need additional antipruritic therapies.

Atomization Energies of LnX Molecules (Ln = Sm, Eu, and Yb; X = Cl, Br, and I)

The gas phase equilibria Ba + LnX = BaX + Ln (Ln = Sm, Eu, Yb; X = Cl, Br, I) were investigated by Knudsen effusion mass spectrometry using a low energy of ionizing electrons to avoid fragmentation processes. The BaX molecules were used as references with well-established bond energies. The atomization enthalpies ΔatH0° of the LnX molecules were determined to be 427 ± 9 (SmCl), 409 ± 9 (EuCl), 366 ± 9 (YbCl), 360 ± 10 (SmBr), 356 ± 13 (EuBr), 316 ± 9 (YbBr), 317 ± 10 (SmI), 293 ± 10 (EuI), and 283 ± 10 (YbI) kJ·mol−1.

Morphological ripening of fluid inclusions and coupled zone-refining in quartz crystals revealed by cathodoluminescence imaging: Implications for CL-petrography, fluid inclusion analysis and trace-element geothermometry

Cathodoluminescence (CL) studies have previously shown that some secondary fluid inclusions in luminescent quartz are surrounded by dark, non-luminescent patches, resulting from fracture-sealing by late, trace-element-poor quartz. This finding has led to the tacit generalization that all dark CL patches indicate influx of low temperature, late-stage fluids. In this study we have examined natural and synthetic hydrothermal quartz crystals using CL imaging supplemented by in-situ elemental analysis. The results lead us to propose that all natural, liquid-water-bearing inclusions in quartz, whether trapped on former crystal growth surfaces (i.e., of primary origin) or in healed fractures (i.e., of pseudosecondary or secondary origin), are surrounded by three-dimensional, non-luminescent patches. Cross-cutting relations show that the patches form after entrapment of the fluid inclusions and therefore they are not diagnostic of the timing of fluid entrapment. Instead, the dark patches reveal the mechanism by which fluid inclusions spontaneously approach morphological equilibrium and purify their host quartz over geological time. Fluid inclusions that contain solvent water perpetually dissolve and reprecipitate their walls, gradually adopting low-energy euhedral and equant shapes. Defects in the host quartz constitute solubility gradients that drive physical migration of the inclusions over distances of tens of μm (commonly) up to several mm (rarely). Inclusions thus sequester from their walls any trace elements (e.g., Li, Al, Na, Ti) present in excess of equilibrium concentrations, thereby chemically purifying their host crystals in a process analogous to industrial zone refining. Non-luminescent patches of quartz are left in their wake. Fluid inclusions that contain no liquid water as solvent (e.g., inclusions of low-density H2O vapor or other non-aqueous volatiles) do not undergo this process and therefore do not migrate, do not modify their shapes with time, and are not associated with dark-CL zone-refined patches. This new understanding has implications for the interpretation of solids within fluid inclusions (e.g., Ti- and Al-minerals) and for the elemental analysis of hydrothermal and metamorphic quartz and its fluid inclusions by microbeam methods such as LA-ICPMS and SIMS. As Ti is a common trace element in quartz, its sequestration by fluid inclusions and its depletion in zone-refined patches impacts on applications of the Ti-in-quartz geothermometer.

Clinical Use of Quantitative Computed Tomography–Based Advanced Techniques in the Management of Osteoporosis in Adults: the 2015 ISCD Official Positions—Part III

The International Society for Clinical Densitometry (ISCD) has developed new official positions for the clinical use of computed tomography (CT) scans acquired without a calibration phantom, for example, CT scans obtained for other diagnosis such as colonography. This also addresses techniques suggested for opportunistic screening of osteoporosis. The ISCD task force for quantitative CT reviewed the evidence for clinical applications of these new techniques and presented a report with recommendations at the 2015 ISCD Position Development Conference. Here we discuss the agreed upon ISCD official positions with supporting medical evidence, rationale, controversy, and suggestions for further study. Advanced techniques summarized as statistical parameter mapping methods were also reviewed. Their future use is promising but the clinical application is premature. The clinical use of QCT of the hip is addressed in part I and of finite element analysis of the hip and spine in part II.

Molecular interactions and signal transfer between sensory rhodopsin-I and its cognate transducer

SRI is unique among known photoreceptors in that it produces opposite signals depending on the color of light stimuli. Absorption of orange light (587 nm) triggers an attractant response by the cell, whereas absorption of orange light followed by near-UV light (373 run) triggers a repellent response. Using behavioral mutants that exhibit aberrant color-sensing ability, we tested a two-conformation equilibrium model, using FRET and EPR spectroscopy. The essence of the model applied to SRI-HtrI is that the complex exists in a metastable two-conformer equilibrium which is shifted in one direction by orange light absorption (producing an attractant signal) and in the opposite direction by a second UV-violet photon (producing a repellent signal). First, by FRET we found that the E-F cytoplasmic loop of SRI moves toward the RAMP domain of the HtrI transducer during the formation of the orange-light activated signaling state of the complex. This is the first localization of a change in the physical relationship between the receptor and transducer subunits of the complex and provides a structural property of the two proposed conformers that we can monitor. Second, EPR spectra of a spin label probe at this cytoplasmic position showed shifts in the dark in the mutants toward shorter or longer EF loop-RAMP distances, explaining their behavior in terms of their mutations causing pre-stimulus shifts into one or the other conformer. ^ Next, we applied a novel electrophysiological method for monitoring the directionality of proton movement during photoactivation of SRI, to investigate the process of proton transfer in the photoactive site from the chromophore to proton acceptors on both the wildtype and aberrant color-response mutants. We observed an unexpected and critical difference in the two signaling conformations of the SRI-HtrI complex. The finding is that the vectoriality (i.e. movement away or toward the cytoplasm) of the light-induced proton transfer from the chromophore to the protein is opposite in formation of the two conformations. Retinylidene proton transfer is a common critical process in rhodopsins and these results are the first to show differences in vectoriality in a rhodopsin receptor, and to demonstrate functional importance of the direction of proton transfer. ^

Investigation of I -compounds (newly discovered indigenous DNA modifications) by different approaches

I-compounds are newly discovered covalent DNA modifications detected by the $\sp{32}$P-postlabeling assay. They are age-dependent, tissue-specific and sex-different. The origin(s), chemistry and function(s) of I-compounds are unknown. The total level of I-compounds in 8-10 month old rat liver is 1 adduct in 10$\sp7$ nucleotides, which is not neglectable. It is proposed that I-compounds may play a role in spontaneous tumorigenesis and aging.^ In the present project, I-compounds were investigated by several different approaches. (1) Dietary modulation of I-compounds. (2) Comparison of I-compounds with persistent carcinogen DNA adducts and 5-methylcytosine. (3) Strain differences of I-compounds in relation to organ site spontaneous tumorigenesis. (4) Effects of nongenotoxic hepatocarcinogenes on I-compounds.^ It was demonstrated that the formation of I-compounds is diet-related. Rats fed natural ingredient diet exhibited more complex I-spot patterns and much higher levels than rats fed purified diet. Variation of major nutrients (carbohydrate, protein and fat) in the diet, produced quantitative differences in I-compounds of rat liver and kidney DNAs. Physiological level of vitamin E in the diet reduced intensity of one I-spot compared with vitamin E deficient diet. However, extremely high level of vitamin E in the diet gave extra spot and enhanced the intensities of some I-spots.^ In regenerating rat liver, I-compounds levels were reduced, as carcinogen DNA adducts, but not 5-methylcytosine, i.e. a normal DNA modification.^ Animals with higher incidences of spontaneous tumor or degenerative diseases tended to have a lower level of I-compounds.^ Choline devoid diet induced a drastic reduction of I-compound level in rat liver compared with choline supplemented diet. I-compound levels were reduced after multi-doses of carbon tetrachloride (CCl$\sb4$) exposure in rats and single dose exposure in mice. An inverse relationship was observed between I-compound level and DNA replication rate. CCl$\sb4$-related DNA adduct was detected in mice liver and intensities of some I-spots were enhanced 24 h after a single dose exposure.^ The mechanisms and explanations of these observations will be discussed. I-compounds are potentially useful indicators in carcinogenesis studies. ^

Geochemistry of tetrapyrrole, tetraterpenoid, and perylene pigments in sediments from the Gulf of California

Results and discussion cover pigment analyses of 36 sediment samples recovered by Deep Sea Drilling Project Leg 64, and six samples from the Leg 64 site-survey cruise in the Guaymas Basin (Scripps Institution of Oceanography, Leg 3). Pigments investigated were tetrapyrroles, tetraterpenoids, and the PAH compound perylene. Traces of mixed nickel and copper ETIO-porphyrins were ubiquitous in all sediment samples, except for the very surface (i.e., <2 m sub-bottom), and their presence is taken as an indication of minor influxes of previously oxidized allochthonous (terrestrial) organic matter. Phorbides and chlorins isolated from Site 479 sediment samples (i.e., the oxygen-minimum locale, northeast of the Guaymas Basin) well represent the reductive diagenesis ("Treibs Scheme"; see Baker and Palmer, 1978; Treibs, 1936) of chlorophyll derivatives. Three forms of pheophytin-a, plus a variety of phorbides, were found to give rise to freebase porphyrins, nickel phylloerythrin, and nickel porphyrins, with increasing depth of burial (increasing temperature). Sediments from Sites 481, 10G, and 18G yielded chlorophyll derivatives characteristic of early oxidative alterations. Included among these pigments are allomerized pheophytin-a, purpurin-18, and chlorin-p6. The high thermal gradient imposed upon the late Quaternary sediments of Site 477 greatly accelerated chlorophyll diagenesis in the adjacent overlying sediments, that is, the production of large quantities of free-base desoxophylloerythroetioporphyrin (DPEP) occurred in a section (477-7-5) presently only 49.8 meters sub-bottom. Present depth and age of these sediments are such that only chlorins and phorbides would be expected. Carotenoid (i.e., tetraterpenoids) concentrations were found to decrease rapidly with increasing sub-bottom depth. Less deeply buried sediments (e.g., 0-30 m) yielded mixtures of carotenes and oxygen-substituted carotenoids. Oxygencontaining (oxy-, oxo-, epoxy-) carotenoids were found to be lost preferentially with increased depth of burial. Early carotenoid diagenesis is suggested as involving interacting reductions and dehydrations whereby dehydro-, didehydro-, and retro-carotenes are generated. Destruction of carotenoids as pigments may involve oxidative cleavage of the isoprenoid chain through epoxy intermediates, akin to changes in the senescent cells of plants. Perylene was found to be a common component of the extractable organic matter from all sediments investigated. The generation of alkyl perylenes was found to parallel increases in the existing thermal regime at all sites. Igneous sills and sill complexes within the sediment profile of Site 481 altered (i.e., scrambled) the otherwise straightforward thermally induced alkylation of perylene. The degree of perylene alkylation is proposed as an indicator of geothermal stress for non-contemporaneous marine sediments.

Description and chemical composition of ferromanganese deposits from Oneida Lake, New York

Saucer-shaped iron-manganese crusts occur adjacent to gravel shoal areas in Oneida lake in central New York. The crusts usually have a crude concentric banding owing to an alternation of orange, iron-rich layers and black, iron-poor layers. Materials from both types of layers are x-ray amorphous. The Oneida lake crusts, like most other freshwater manganese nodules, contain about the same Mn concentration as marine manganese nodules, but are usually higher in Fe and lower in trace metals than their marine equivalents. Although Fe and Mn may be precipitating directly from the lake water, it is more likely that the oxidate crusts are the result of precipitation of Fe and Mn when reduced sediment pore water comes in contact with well oxygenated bottom waters. Organisms, particularly bacteria, may play a role in the formation of the crusts, but to date no evidence of this has been found.

La forma del agua. Temas e invariantes en el jardín y el paisaje. Análisis de casos (Holanda-España, 1548-1648)

El espacio geográfico, entendido como territorio que da soporte a la vida y a la civilización, ha estado siempre fuertemente supeditado a la presencia de agua. Desde la Prehistoria el hombre otorgó al agua, junto a otros elementos que aseguraban o protegían su vida, un valor superior, por encima de lo humano. Paralelamente y de manera natural, el jardín, en sus inicios en estrecha relación con la agricultura y con el paisaje, fue el ámbito idóneo para la creación de nuevas formas acuáticas artificiales. Este proceso dio lugar a un extenso repertorio de formas compositivas que parece que tuvo en el Renacimiento un punto de inflexión, en el que se observa como la mayoría de recursos y configuraciones básicas del agua estaban ya plenamente establecidas. Esta evolución y sus resultados ha sido el objeto de la primera parte de la tesis: su objetivo ha sido analizar cómo el agua configura, cualifica o puede llegar a construir el jardín y el territorio en el que se inserta, así como establecer las posibles relaciones entre estos dos ámbitos de estudio. Aunque la historia es su fundamento, el planteamiento aquí ha sido más bien conceptual; estudiando los componentes acuáticos desde un punto de vista fundamentalmente compositivo. Esta indagación previa ha sido indispensable para llegar a entender en profundidad los modos en los que el agua se muestra en el jardín y en el paisaje renacentista y manierista, momentos en que se insertan los dos casos de estudio que constituyen la segunda parte de la tesis. Sin caer en un determinismo geográfico extremo, puede admitirse que el jardín, como manifestación cultural intrínsecamente ligada al entorno, depende fuertemente del territorio en el que se asienta; hecho particularmente evidente en aquellas regiones en las que su especial geografía ha sido un claro factor condicionante de su historia. Por ello, Holanda y España han sido las dos localizaciones elegidas para profundizar en este estudio; no tanto por su estrecha relación política y cultural, sino por su profundo y sugerente contraste de medio físico y climático. La Península Ibérica, geográficamente el término del mundo conocido en Occidente hasta el final de la Edad Media, y por esta circunstancia convertida en destino, en territorio de permanencia y fusión, estará además supeditada en la mayoría de su territorio a la falta de agua, siendo a la vez heredera directa del universo y la tradición del jardín meridional originario de Oriente. En el extremo opuesto, Holanda, espacio de transición entre el mar y la tierra firme “real”, es un territorio permeado de humedad y surcado con generosidad por grandes ríos. El país, con una relación ambivalente con el agua, unas veces como amenaza y otras como fuente de nuevas oportunidades, será por el contrario especialmente favorable para el desarrollo de un modelo de jardín septentrional. Un jardín del norte, que no obstante, no surgirá de despejar los bosques, como en el arquetipo nórdico, sino que crecerá sobre planicies antes saturadas de agua o directamente anegadas. El marco temporal de los dos casos concretos ha considerado como fecha inicial 1548, momento en el que Felipe II, aún príncipe, realizó su primer viaje a los Países Bajos, y entró en contacto con el modelo holandés. La extensa producción posterior de jardines de Felipe II, siempre con el agua como protagonista, tuvo como destacado referente la adaptación al suelo y la geografía hispánicos de dicho modelo. Como fecha final se fija 1648, justo un siglo después, fecha coincidente con la firma de la Paz de Westfalia, tratado que supone la total reorganización política del territorio europeo y la pérdida de la hegemonía española en Europa. En Holanda sólo dos años después nacerá Guillermo III de Orange, estatúder de las Provincias Unidas, también futuro rey de Inglaterra, Escocia e Irlanda. Para entonces en Holanda ya se había asistido al desarrollo de un arte propio de jardín, íntimamente ligado al agua, sorprendentemente no demasiado bien conocido y que será uno de los temas de esta investigación. Finalmente, se propone una lectura conjunta de toda esta serie de intervenciones que tienen como argumento el agua, en la que se integra la información procedente de distintos campos de estudio, cada una con su metodología particular. El resultado es una tesis en la que el jardín y el territorio son tratados desde un nuevo y enriquecedor punto de vista. ABSTRACT Geographical space, understood as the territory that provides support to human life and civilization, has always been strongly subjected to the presence of water. From Prehistory man gave to water, along with other elements that ensured or protected life, a higher value than the merely human. At the same time and in a natural way, the garden, in its beginnings with a close relationship with agriculture and landscape, soon developed as the appropriate ground for the creation of new artificial aquatic forms, in a process that seems to have a turning point in the Renaissance, when most of the basic waterworks and resources were already fully established. This development and its outcomes are the subjects of the first part of the thesis: its scope has been to analyse how water configures, qualifies and might even help to construct the garden or landscape attached to it; and to establish the possible links between these two fields of study. Although history based, the point of view here is mainly conceptual, studying the water components understood as composite elements. This exploratory research has been essential to deeply understand the water patterns shown in the Renaissance and Mannerist garden and landscape, periods in which the two case studies are inserted. Without falling in extreme determinism, it can be accepted however, that garden, as a cultural expression linked to environment, is strongly dependant on territorial setting; something particularly evident in those areas where specific geography has been a clear history conditioning factor. This is the reason that leads to choose the Netherlands and Spain to deepen this study, no so much for their interesting cultural and politics relations as for the suggestive and profound contrast of their physical environment and climate. The Iberian Peninsula, geographically the limit of the known world in Occident until the end of the Medium Age, and by this circumstance understood as endpoint, more a destination than a crossroad, a territory of permanence and fusion, but also subjected to water shortage; is thus associated with the universe and tradition of the meridional garden imported from Orient. In the opposite, the Netherlands, a transitional space between the sea and the “real” firm land, is a territory permeated by water and crossed by big rivers. Always with an ambivalent relationship with water, sometimes seen as a threat and sometimes as a source of new opportunities, it was in the other hand the adequate land for the development of a special model of Northern garden. A garden that will not arise, however, from the clearing of woods as in the Nordic archetype, but that will grow on plains originally saturated of water or directly waterlogged. The timeframe of the two cases has 1548 as the initial year, moment in which Philip II, yet prince, made his first trip to the Low Lands and imbibed the Dutch garden model. The later and bountiful garden works of the king, always with the water as the main focus, adapted the imported model to the Spanish ground and geography. The final date is fixed in 1648, just a century after, in coincidence with the Westfalia Peace; a treaty that implied the total political reorganization of the European territory and the end of the Spanish hegemony in the continent. In Holland, only two years later, William III of Orange, Stadtholder of the United Provinces and also future king of England, Scotland and Ireland, was born. But by then the Netherlands had developed an own garden art, closely linked to water. This type garden, surprisingly not very well known, and its relationship with water, will be other of the addressing questions of this work. Finally, the investigation merges the different interventions that have water as an argument, integrating all the fields considered with their particular methodological approaches. The final result is a thesis in which garden and territory are treated from a new and enriching perspective.

Direct evidence for a predominantly exolytic processive mechanism for depolymerization of heparin-like glycosaminoglycans by heparinase I

Heparinase I from Flavobacterium heparinum has important uses for elucidating the complex sequence heterogeneity of heparin-like glycosaminoglycans (HLGAGs). Understanding the biological function of HLGAGs has been impaired by the limited methods for analysis of pure or mixed oligosaccharide fragments. Here, we use methodologies involving MS and capillary electrophoresis to investigate the sequence of events during heparinase I depolymerization of HLGAGs. In an initial step, heparinase I preferentially cleaves exolytically at the nonreducing terminal linkage of the HLGAG chain, although it also cleaves internal linkages at a detectable rate. In a second step, heparinase I has a strong preference for cleaving the same substrate molecule processively, i.e., to cleave the next site toward the reducing end of the HLGAG chain. Computer simulation showed that the experimental results presented here from analysis of oligosaccharide degradation were consistent with literature data for degradation of polymeric HLGAG by heparinase I. This study presents direct evidence for a predominantly exolytic and processive mechanism of depolymerization of HLGAG by heparinase I.

“Switch I” mutant forms of the bacterial enhancer-binding protein NtrC that perturb the response to DNA

NtrC (nitrogen regulatory protein C) is a bacterial enhancer-binding protein of 469 residues that activates transcription by σ54-holoenzyme. A region of its transcriptional activation (central) domain that is highly conserved among homologous activators of σ54-holoenzyme—residues 206–220—is essential for interaction with this RNA polymerase: it is required for contact with the polymerase and/or for coupling the energy from ATP hydrolysis to a change in the conformation of the polymerase that allows it to form transcriptionally productive open complexes. Several mutant NtrC proteins with amino acid substitutions in this region, including NtrCA216V and NtrCG219K, have normal ATPase activity but fail in transcriptional activation. We now report that other mutant forms carrying amino acid substitutions at these same positions, NtrCA216C and NtrCG219C, are capable of activating transcription when they are not bound to a DNA template (non-DNA-binding derivatives with an altered helix–turn–helix DNA-binding motif at the C terminus of the protein) but are unable to do so when they are bound to a DNA template, whether or not it carries a specific enhancer. Enhancer DNA remains a positive allosteric effector of ATP hydrolysis, as it is for wild-type NtrC but, surprisingly, appears to have become a negative allosteric effector for some aspect of interaction with σ54-holoenzyme. The conserved region in which these amino acid substitutions occur (206–220) is equivalent to the Switch I region of a large group of purine nucleotide-binding proteins. Interesting analogies can be drawn between the Switch I region of NtrC and that of p21ras.