Ex Vivo Confocal Laser Scanning Microscopy in Rare Skin Diseases.

While ex vivo confocal laser scanning microscopy has previously demonstrated its utility in most common skin diseases, its use in the assessment of dermatological entities with lower incidence remains unexplored in most cases. We therefore aimed to evaluate the diagnostic efficacy of some rare skin tumors as well as a few inflammatory skin diseases, that have not yet been studied in ex vivo confocal laser scanning microscopy. A total of 50 tissue samples comprising 10 healthy controls, 10 basal cell carcinoma, 10 squamous cell carcinoma, and 20 rare skin conditions were imaged using the newest generation ex vivo confocal microscopy (Vivascope 2500 M-G4, Vivascope GmbH, Munich, Germany). Three blinded investigators were asked to identify characteristic features of rare skin disorders and distinguish them from more common skin diseases in the ex vivo confocal microscopy images. Our findings present the capability of ex vivo confocal microscopy to display distinctive morphologic patterns in common and rare skin diseases. As might be expected, we found a strong correlation between imaging experience and diagnostic accuracy. While the imaging inexperienced dermatohistopathologist reached 60% concordance, the imaging-trained dermatologist obtained 88% agreement with dermatohistopathology. The imaging-trained dermatohistopathologist achieved concordance up to 92% with gold-standard dermatohistopathology. This study highlights the potential of ex vivo confocal laser scanning microscopy as a promising adjunct to conventional dermatohistopathology for the early and precise identification of rare dermatological disorders.

First steps towards sustainability? University freshmen perceptions on nature versus environment.

The Global Earth Overshoot Day, the date when all annually available natural resources are consumed, is set for July this year. For densely populated European countries like Germany or Switzerland, that specific day is due even earlier (May). To overcome such an unsustainable lifestyle, immediate actions are required, which includes substantial educational efforts. As the model of "Sustainable Development" is complex, appropriate pedagogical actions need to support cognitive learning, critical thinking and behavioural actions. Knowledge about individual conceptions in relation to the Environment, Nature and Ecological Footprints contributes to pre-conditions to succeed. To what extent present teaching methods influenced individual conceptions during the first UN-decade regarding those terms is illustrated by 464 Swiss-German university freshmen who participated in our paper-pencil test, which is based on four open questions. The term of Environment was perceived as the sum of biocentric, ecocentric and anthropocentric views. The participants often equated the term to Nature and associated it with positive feelings or emotions. Therefore, calm, joy and aesthetic appreciation were predominantly named. Regardless of the concept, humans were perceived as the Greatest Environmental Threat. In contrast, recommendations to reduce Environmental Footprints regarding mobility & transport, waste avoidance and consumption differ. Following a binary logistic regression analysis, the involvement of the Inclusion of Self Scale (INS) was used as an explanatory variable to detect patterns of those conceptions. Relating sustainable concepts, natural resources were frequently named exceeding saving water and energy or other association dealt with second-hand issues or regional/ seasonal usages. Such ideas are shaped by experiences and scientific expertise.

How freshmen perceive Environmental Education (EE) and Education for Sustainable Development (ESD).

Concepts of 464 university freshmen towards Environmental Education (EE) and Education for Sustainable Development (ESD) were analyzed. Responses were classified into seven main categories: 'ecological aspects', 'ecological problems', 'economical aspects', 'social aspects', 'environmental attitudes', 'environmental behavior' and 'education'. Analyses of sustainability concepts show a large discrepancy between EE and ESD, whereby the latter includes an additional sub-group: 'the next generation aspect'. Labeling individual sources of EE in a retrospective assessment identified the family as the most important source of knowledge, followed by media, school and outreach. Further differences were detected between students' self-perception and their ideal conception of environmental behavior, by using the scale Inclusion of Nature in Self (INS). Only some EE statements produced higher (unfulfilled) expectations 'economic aspects', 'environmental behavior' and 'ecological problems'. In contrast fewer (unfulfilled) expectations were observed in the categories of 'education' and 'ecological aspects'.

Effects of different dosages of propylene glycol in dry cows and cows in early lactation.

In this Research Paper we hypothesised that the temporary insulin resistance seen during the transition period in dairy cows may cause significant differences in the efficacy of PG at different sampling periods and that in some cases this effect will be dose dependent. Eighty four sampling sets were generated by studying 7 multiparous Holstein cows repeatedly at 4 sampling periods of 3 d length (dry cows: days 40, 39 and 38 antepartum; close up cows: days 10, 9 and 8 antepartum; fresh cows: days 3, 4 and 5 post-partum; lactating cows: days 38, 39 and 40 post-partum). On each of these days 3 h after morning feeding propylene glycol was drenched in different dosages of 100, 300 or 500 ml once per day (cross over study). The different doses were applied in an alternating order (Latin square). Blood samples were taken before, every 30 min up to 4 h, after 6 and 12 h after PG application. Following parameters have been measured: insulin, non-esterified fatty acids (NEFA), betahydroxybutyrate (BHB), bilirubin, cholesterol, potassium, aspartate aminotransferase (AST) and glutamate dehydrogenase (GLDH). Revised Quantitative Insulin Sensitivity Check Index (RQUICKI) was calculated. It was found that glucose, insulin, NEFA, BHB, bilirubin and potassium concentrations were influenced differently by the three defined dosages of propylene glycol at four different sampling periods. Whereas RQUICKI, cholesterol, AST and GLDH did not differ between the sampling periods and treatments. The major results of the study are that the effect of PG is dose-dependent and that the effect of PG is depending on the time of application according to calving. It can be concluded that in fresh cows higher dosages are necessary to provoke similar effects in comparison to dry, close up and lactating cows. Although the study did not compare to topdressing of PG from the results it is reasonable to believe that bolus application of a specific PG volume is necessary to provoke the effect.

Genotyping of German and Austrian Taylorella equigenitalis isolates using repetitive extragenic palindromic (REP) PCR and pulsed-field gel electrophoresis (PFGE).

A total of 124 Taylorella (T.) equigenitalis and five T. asinigenitalis field isolates collected between 2002 and 2014 were available for genotyping using REP- (repetitive extragenic palindromic) PCR and PFGE (pulsed-field gel electrophoresis). The study comprised 79 T. equigenitalis field isolates originating from ten defined breeds of German horses and revealed a spectrum of five REP (rep-E1-E4, rep-E3a) and 15 PFGE (TE-A1-A9, TE-B1-B3, TE-C, TE-E1, and TE-E2) genotypes. T. equigenitalis field isolates (n=40) obtained from Austrian Lipizzaner horses were differentiated into three REP (rep-E1, rep-E3a, and rep-E4) and three PFGE genotypes (TE-A2, TE-A5, and TE-D); those isolated from four Austrian Trotters belonged to the REP/PFGE genotype rep-E2/TE-A1. Interestingly, a T. equigenitalis isolate recovered from a Holsteiner stallion living in South Africa revealed the REP/PFGE genotype rep-E1/TE-A5 which was otherwise exclusively present in the majority of Austrian Lipizzaner horses in our study. The type strain included in this study revealed the genotype REP/PFGE rep-E1/TE-F. Six strains of T. asinigenitalis including the type strain were separated into three REP (rep-A1-A3) and six PFGE genotypes (TA-A1, TA-A2, TA-A3, TA-B, TA-C, TA-D). Overall, the generated REP and PFGE genotypes showed a good correlation, whereas REP-PCR proved to be a suitable method for molecular epidemiological screening of T. equigenitalis and T. asinigenitalis isolates that should be differentiated in detail by genotyping using PFGE.

Plasma homocysteine and cardiovascular risk in heart failure with and without cardiorenal syndrome.

INTRODUCTION: Plasma homocysteine (Hcy) has been associated with an increased cardiovascular (CV) risk in patients with chronic heart failure (CHF). Thus, we investigated whether Hcy has a prognostic impact on CV events in CHF-patients with and without cardiorenal syndrome (CRS). METHODS: 161 patients with CHF were included in the present analysis. 94 patients had systolic (SD) (EF <40%) and 67 diastolic (DD) dysfunction (EF>or=40%). 60 had cardiorenal syndrome (CRS+ creatinine clearance<60 ml/min). Mean ejection fraction was 38+/-16% (n=153) and mean VO2 max 19+/-7 ml/min (n=87). RESULTS: Homocysteine is significantly increased in patients with CHF (20+/-7 micromol/l). The increase correlates not only with the severity of the disease (NYHA, EF, VO2max), but also with various metabolic (BNP, uric acid) and nephrologic parameters (creatinine, creatinine clearance). During follow-up (23+/-37 months), patients with the highest homocysteine (>or=20 micromol/l) passed away more often (p<0.035) or decompensated more frequently (p<0.004) than those with a low Hcy. In patients with CRS the rate of decompensation was significantly higher than in those without CRS (p<0.0007). CONCLUSIONS: Homocysteine is an important marker for an increased CV risk in patients with CHF. A homocysteine of >/=20 micromol/l is associated with a high risk to decompensate or to die (odds ratio 2.57). The presence of CRS is also associated with an increased CV risk (odds ratio 3.7) and predicts an adverse clinical outcome.