Simulating PDT of port-wine stains in the in vivo chicken wattle model using Hemoporfin and radiation at 532 nm: Comparison of a LED and a laser source.

Port-wine stain (PWS) birthmarks are congenital capillary malformations occurring in 0.3 %∼0.5 % of newborns. Hemoporfin-mediated vascular-acting photodynamic therapy (Hemoporfin PDT) is an emerging option for treating PWS. This in vivo study aimed to compare laser and light-emitting diodes (LED) as light source for Hemoporfin PDT. Chicken wattles were used as the animal model. Color and histopathological changes were evaluated after combining Hemoporfin with KTP laser or LED light source of 532 nm at the same doses. Both PDT approaches could induce significant vascular injury and color bleaching. Although the use of the laser resulted in a greater vascular clearance, the LED showed more uniform distribution both in the beam profiles and tissue reaction and exhibited better safety. This in vivo study suggests that the LED is a favorable choice for larger PWS lesion.

The impact of manufacturing servitization on consumption-based carbon rebound effect: A global value chain research perspective.

This study investigates the causal effect of manufacturing servitization on the consumption-based carbon rebound effect, employing the empirical approach based on the value-added trade and SBM-DEA model. The results show that improving the servitization level will lead to a significant decrease in the consumption-based carbon rebound effect of the global manufacturing industry. Moreover, the main paths through which the manufacturing servitization inhibits the consumption-based carbon rebound effect are the human capital and government management. We also find that the impact of manufacturing servitization is more substantial in advanced manufacturing and developed economies, which is smaller in manufacturing sectors with higher global value chain positions and lower export penetration levels. These findings suggest that improving the level of manufacturing servitization helps alleviate the consumption-based carbon rebound effect and is conducive to achieving the target of global carbon emission reduction.

Characters, comparisons and explications of China's domestic environmental cost of agricultural exports from the perspective of global value chain.

In the context of global value chain, this paper uses world input-output table (2016) and CO2 emission data to analyze domestic environmental cost of agricultural exports based on backward linkage MRIO model. The results show that average domestic value-added and domestic embodied emissions of China's agricultural export are respectively ranked 7th and 4th in the world during the sample period, which indicates that China's agriculture does not perform well in environmental cost; On the bright side, China's domestic environmental cost displays a downward trend over time. In terms of contributing factors, CO2 emission coefficient is conducive to the reduction of domestic environmental cost, meanwhile the value-added coefficient, intermediate input structure, and agricultural export structure promote the increase of domestic environmental cost. Further, the cross-country decomposition results found that the emission coefficient and the intermediate input structure are the main reasons that lead China's domestic environmental cost to be higher than those of the main agricultural export countries. The value-added factor and the export structure have narrowed the gap of domestic environmental cost between China and other major agricultural economies. The research findings are still robust when scenario analysis is introduced. This study suggests that optimizing the structure of energy consumption and promoting cleaner production are most important ways to promote the sustainable development of China's agricultural exports.

The role of crop insurance in reducing pesticide use: Evidence from rice farmers in China.

Pesticides play a significant role in increasing agricultural yields. However, the overuse of chemical pesticides on crops is a major challenge faced by China, which damages human health, threatens food security, and increases production costs. This paper provides empirical evidence on the relationship between crop insurance and pesticide use. Based on micro-survey data collected from 3410 households, we estimate a control function (CF) approach and find that farmers who purchase crop insurance use 33.30% lower pesticides than those who do not. A series of robustness tests confirm these findings. The results of the moderating effect analysis suggest that rice cultivation training, experience, schooling years, and agricultural laborers can negatively moderate the effect of crop insurance on pesticide use. Furthermore, we also find that the treatment effect of crop insurance is stronger for farmers who are most inclined to purchase crop insurance.

Estimating effects of cooperative membership on farmers' safe production behaviors: evidence from the rice sector in China.

The current agricultural system in China highly depends on chemical fertilizers and pesticides. Consequently, agricultural production activities cause various environmental issues. Carrying out safe production provides vital support for sustainable development of agriculture, which may improve this situation. The past decades have witnessed the fast development of rural cooperatives organization in China. Given the fact that rural cooperative organization plays a crucial role in agricultural production, however, there is little empirical evidence on the relationship between cooperative membership and safe production of smallholders in China. This study aims to investigate whether the participation in farmer cooperatives contributes to safe production in agriculture in China. Using survey data covering 623 rice-producing farm households in Sichuan province in China, this study employs the endogenous switching regression model to examine the effects of the participation in farmer cooperatives on safe production in rice agriculture. The results show that cooperative membership has significantly positive effects on safe production in rice agriculture. In particular, the average treatment effects demonstrate that without the participation in cooperatives, the members' adoption of the green control techniques would reduce by 74.491%, the application of artificial weeding would reduce by 38.768%, and organic fertilizer input would reduce by 23.448%. Furthermore, the marginal treatment effect is employed to evaluate the heterogeneous effects of the participation in farmer cooperatives on safe production in rice agriculture. Heterogeneous effect analyses suggest that farmers who are more likely to participate in farmer cooperatives are easier to adopt green control technology, while farmers who are less likely to participate in farmer cooperatives are easier to adopt artificial weeding and increase organic fertilizer input. To improve safe production in rice agriculture, the Chinese government is expected to encourage rice farmers to participate in rural cooperative organizations, and to stimulate rice farmers to take collective action to address environment issues arising from agricultural production.

Comparison of pulsed dye laser (PDL) and photodynamic therapy (PDT) for treatment of facial port-wine stain (PWS) birthmarks in pediatric patients.

BACKGROUND: Vascular-acting photodynamic therapy (PDT) might be an alternative approach for treating port wine stain (PWS) birthmarks, but the usefulness of PDT for pediatric patients has not been fully investigated. STUDY DESIGN: Medical records of pediatric patients (3-10 years old) with red and purple facial PWS were analyzed. Clinical outcomes after one session of PDL (585 nm, 4.8-6.5 J/cm(2)) and PDT (Hemoporfin - 3.5mg/kg, copper vapour laser - 120 J/cm(2)) were compared. RESULTS: The rate of excellent response in PDT group was significantly higher than that in PDL group (25.0% vs 10.9%). For red lesions there was no significant difference in overall response between PDL and PDT group, but for purple lesions the overall response rate of PDT group was significantly higher than that of PDL group (93.0% vs 75.6%). Lesions located at the forehead, cheek and jaw regions showed better responses to PDT. Incidences of pigmentation and scar formation in PDT group were significantly lower than PDL group (8.3% vs 21.1%). CONCLUSION: This study suggests that PDT is safe and effective for treating facial PWS of childhood patients.

Adverse effects associated with photodynamic therapy (PDT) of port-wine stain (PWS) birthmarks.

BACKGROUND: Several Chinese studies suggest that Hemoporfin-mediated photodynamic therapy (PDT) is an alternative treatment for port-wine stain (PWS) birthmarks. OBJECTIVE: To evaluate treatment responses and adverse effects associated with Hemoporfin PDT for the treatment of PWS and their management. METHOD: The medical records of 700 patients who underwent PDT treatment in our center were retrospectively examined. Treatment-related reactions and adverse effects were reviewed. RESULT: Different types of PWS lesions and different individuals showed different immediate responses (e.g. swelling, color change, pain). To certain extents these reactions were a useful indicator of the treatment endpoint. Edema and scabbing were the most common post-treatment responses. Short-term (e.g. blister, eczematous dermatitis, cutaneous photosensitivity) and long-term (e.g. pigmentation change, scar formation) adverse effects were generally caused by the phototoxicity associated with the combination of photosensitizer and light exposure. CONCLUSION: Although PDT is a safe treatment alternative for PWS birthmarks, treatment parameters must be selected for each individual patient and cutaneous changes must be monitored during light irradiation to minimize the risk of adverse effects. Over estimation of required light dosage or failure to recognize cutaneous changes associated with adverse effects can increase the risk of a poor outcome.

In vivo photoacoustic imaging of model of port wine stains.

Port wine stains are categorized as a benign capillary vascular malformation, which is hard to cure. In this paper, a photoacoustic microscopy system, which integrated a two-dimensional scanning galvanometer, an objective lens and a focused ultrasound transducer, was designed for noninvasive imaging of blood vessels of port wine stains model in vivo. Cock comb was chosen as the port wine stains model in the experiment. The blood vessels in x-y plane and x-z plane were imaged clearly. Experimental results demonstrate that photoacoustic microscopy can image the blood vessels of port wine stains model in vivo with high contrast and high resolution. It has the potential for clinical applications in detecting the blood vessels in port wine stains skin.

Photodynamic therapy of port-wine stains: long-term efficacy and complication in Chinese patients.

Port-wine stain (PWS) are congenital vascular malformations characterized by ectatic capillaries in the papillary layer of the dermis. They usually appear at birth and tend to become darker and thicker with age. Many clinicians consider the gold standard to treat PWS is pulsed dye laser (PDL) with wavelengths of 585 nm or 595 nm. But PDL is not suitable for patients with Fitzpatrick skin type V or nodular lesions. Vascular-targeted photodynamic therapy (PDT) might be an alternative approach in the treatment of such patients. The objective of this study was to assess the long-term outcomes and complications of PDT therapy of PWS in Chinese patients retrospectively. Patients with PWS who had received PDT therapy in a 5-year period were reviewed. 642 patients and a total of 3066 treatment sessions had been performed with an average of 2.6-8.2 sessions. Over 5% of patients had complete clearing, while 70% of patients had more than 25% of clearing. More than one-quarter of patients (29.8%) experienced a clearing of more than 50%. Ten percent of patients experienced complications (1.4% blistering, 1.2% hypopigmentation, 4.3% hyperpigmentation, 2.2% scabbing, <0.7% prolonged blistering that persisted for >2 months, 0.4% eczema dermatitis, 0.6% photoallergy). Sex, age, number of treatment sessions, average energy density and type of skin were not related to complication rate using the multiple regression analysis. Chinese patients were well responsive to and satisfied with vascular-targeted PDT (Patient Satisfaction Score 7.8). Dark-skinned patients and patients with vascular papules or nodules can be treated with alternative PDT to significant therapeutic effect in Chinese patients even though they experience few complications.

Combination of photodynamic therapy and immunomodulation for skin diseases--update of clinical aspects.

In dermatology, photodynamic therapy (PDT) has become a well established treatment modality which has been shown to be effective and safe for many skin and mucosal disorders. Pre-clinical and clinical studies demonstrate that, in addition to the direct local cytotoxicity and vascular effects, PDT can induce various host immune responses. Recent clinical data also show that improved clinical outcomes can be obtained through the sequential use of PDT and immunomodulation. This article will provide an update on the current status of such a combination in dermatological applications.

Successful combination therapy for severe infantile hemangiomas: case report and literature search.

Infantile hemangiomas are common benign vascular tumors of infancy. Although the majority of uncomplicated hemangiomas involute spontaneously, rapid-growth lesions with complications need early active intervention. On the other hand, severe and complicated lesions can be difficult to treat. Recently, we successfully treated two cases of giant severe infantile facial hemangiomas using local application of bleomycin and pulsed dye laser along with systemic application of dexamethasone. Our results suggest that the multiple modalities of bleomycin, laser, and corticosteroid are a safe and effective approach for early therapeutic intervention of severe facial hemangiomas.

Photodynamic therapy in treatment of port wine stain birthmarks--recent progress.

Port wine stain (PWS) birthmarks are congenital vascular malformations characterized by ectatic capillaries in the papillary layer of the dermis. They usually appear at birth and tend to become darker and thicker with age. Cosmetic and pathological changes can cause great depression in all ages. Laser-mediated selective photothermolysis is the treatment of choice but vascular-targeted photodynamic therapy (PDT) might be an alternative approach in the treatment of PWS. PDT has shown therapeutic benefit in pink and resistant lesions. In theory, vascular-targeted PDT may be more efficient in terms of better lightening and less treatment sessions than pulsed dye laser (PDL) irradiation. Chinese clinicians have gained profound knowledge and accumulated a large body of clinical experience in PWS PDT in the past years. The pursuing of regulatory approval on PWS PDT is currently underway. In this article we will report our experience in PWS PDT, discuss current PDT protocols and introduce the novel combination therapy, such as PDT+PDL and PDT+topical angiogenic inhibitor.

Comparison of photodynamic therapy and pulsed dye laser in patients with port wine stain birthmarks: a retrospective analysis.

BACKGROUND: Photodynamic therapy (PDT) might be an alternative approach for treating port wine stains (PWS). This study attempts to compare clinical outcomes of PDT versus conventional pulsed dye laser (PDL) in Chinese patients. METHODS: Retrospective analysis of medical records of a single hospital. PDL was delivered by a 585 nm laser. PDT was carried out by a combination of hematoporphyrin monomethyl ether (HMME) and copper vapour laser (510.6 and 578.2 nm). Clinical outcomes were graded based on photographs. RESULTS: The children group (3-10 years old) included 210 patients (PDL=112 and PDT=98) with pink flat PWS located in the cheek region. The overall fair to excellent response was 95.5% in PDL group and 88.8% PDT group (P=0.901), respectively. The excellent response rate of PDT group (23.5%) was higher than that of PDL group (16.1%). The adult group (18-30 years old) included 371 patients (PDL=163 and PDT=208) with purple flat PWS located in the temple, cheek or neck region. The overall fair to excellent response in PDL and PDT group was 88.4 and 94.2% (P<0.001), respectively. The excellent response rate of PDT group (37.5%) was significantly higher than that of PDL group (3.1%). The complication rate (pigmentary or textural change) in PDT group (10.2%) was lower than that in PDL group (24.7%). CONCLUSIONS: PDT is as effective as PDL for pink flat lesions and is more effective than PDL for purple flat lesions. The true value of PDT deserves further investigation.