Actinic cheilitis: a systematic review of treatment options.

Actinic cheilitis is a premalignant condition that can progress to squamous cell carcinoma with a higher propensity for metastasis than cutaneous squamous cell carcinoma. Optimal treatment for actinic cheilitis has not been established, and evidence-based estimates of clinical cure in the dermatology literature are limited. Here, we review and synthesize outcome data published for patients with actinic cheilitis after treatment with various modalities. A systematic review was conducted in MEDLINE, Embase and the Cochrane library for English, French and German-language studies and references of included articles from inception to 20 January 2020. Studies were included if they reported on at least six patients with biopsy-proven actinic cheilitis. After quality appraisal, results of studies with the strongest methodology criteria were synthesized. 18 studies of 411 patients (published 1985 to 2016) were included. The majority of the studies were case series. Carbon dioxide laser ablation and vermilionectomy were associated with the most favourable outcomes with fewest recurrences. Chemical peel and photodynamic therapy were associated with higher recurrence. Adverse effects generally resolved in the weeks following treatment and cosmetic outcomes were favourable overall. In conclusion, there is a lack of high-quality comparative studies evaluating different treatment options for actinic cheilitis. The included publications used various outcome measures; however, the majority reported on the recently defined core outcome sets. These results suggest that both carbon dioxide laser ablation and vermilionectomy are effective treatments for actinic cheilitis. Prospective head-to-head studies are needed to compare these treatment modalities and to assess patient preferences.

Dual threshold neural closed loop deep brain stimulation in Parkinson disease patients.

BACKGROUND: Closed loop deep brain stimulation (clDBS) in Parkinson's disease (PD) using subthalamic (STN) neural feedback has been shown to be efficacious only in the acute post-operative setting, using externalized leads and stimulators. OBJECTIVE: To determine feasibility of neural (N)clDBS using the clinical implanted neurostimulator (Activa™ PC + S, FDA IDE approved) and a novel beta dual threshold algorithm in tremor and bradykinesia dominant PD patients on chronic DBS. METHODS: 13 PD subjects (20 STNs), on open loop (ol)DBS for 22 ±â€¯7.8 months, consented to NclDBS driven by beta (13-30 Hz) power using a dual threshold algorithm, based on patient specific therapeutic voltage windows. Tremor was assessed continuously, and bradykinesia was evaluated after 20 min of NclDBS using a repetitive wrist flexion-extension task (rWFE). Total electrical energy delivered (TEED) on NclDBS was compared to olDBS using the same active electrode. RESULTS: NclDBS was tolerated for 21.67 [21.10-26.15] minutes; no subject stopped early. Resting beta band power was measurable and similar between tremor and bradykinesia dominant patients. NclDBS improved bradykinesia and tremor while delivering only 56.86% of the TEED of olDBS; rWFE velocity (p = 0.003) and frequency (p < 0.001) increased; tremor was below 0.15 rad/sec for 95.4% of the trial and averaged 0.26 rad/sec when present. CONCLUSION: This is the first study to demonstrate that STN NclDBS is feasible, efficacious and more efficient than olDBS in tremor and bradykinesia dominant PD patients, on long-term DBS, using an implanted clinical neurostimulator and driven by beta power with a novel dual threshold algorithm, based on customized therapeutic voltage windows.

Chemical-vapor deposited ultra-fast diamond detectors for temporal measurements of ion bunches.

This article reports on the development of thin diamond detectors and their characterization for their application in temporal profile measurements of subnanosecond ion bunches. Two types of diamonds were used: a 20 µm thin polycrystalline chemical vapor deposited (CVD) diamond and a membrane with a thickness of (5 ± 1) µm etched out of a single crystal (sc) CVD diamond. The combination of a small detector electrode and an impedance matched signal outlet leads to excellent time response properties with a signal pulse resolution (FWHM) of τ = (113 ± 11) ps. Such a fast diamond detector is a perfect device for the time of flight measurements of MeV ions with bunch durations in the subnanosecond regime. The scCVD diamond membrane detector was successfully implemented within the framework of the laser ion generation handling and transport project, in which ion beams are accelerated via a laser-driven source and shaped with conventional accelerator technology. The detector was used to measure subnanosecond proton bunches with an intensity of 108 protons per bunch.

Aerial ultra-low-volume application of naled: impact on nontarget imperiled butterfly larvae (Cyclargus thomasi bethunebakeri) and efficacy against adult mosquitoes (Aedes taeniorhynchus).

We assessed the exposure and acute toxicity of naled, applied aerially as an ultra-low-volume spray for mosquito control, on late instar larvae of the Miami blue (Cyclargus thomasi bethunebakeri) (Comstock and Huntington 1943) (Lepidoptera: Lycaenidae), an imperiled South Florida butterfly. We concurrently evaluated the control efficacy against caged adult female salt-marsh mosquitoes (Aedes taeniorhynchus) (Wiedemann 1821) (Diptera: Culicidae). This 3-yr study was conducted in north Key Largo (Monroe County, FL) beginning in 2006. The field trials incorporated 15 sampling stations: nine in the target spray zone, three in the spray drift zone at varying distances from the target zone, and three in the control zone not subjected to naled spray drift. A total of six field spray trials were completed, three at an altitude of 30.5 m (100 feet), and three at 45.7 m (150 feet). For all trials, the ultra-low-volume application of Trumpet EC insecticide (78% naled) at a rate of 54.8 ml/ha (0.75 fl. oz/acre) was effective in killing caged adult mosquitoes in the target zone. Butterfly larvae survival was significantly reduced in the spray zone compared with drift and control zones. Analysis of insecticide residue data revealed that the mortality of the late instar butterfly larvae was a result of exposure to excess residues of naled. Additional research is needed to determine mitigation strategies that can limit exposure of sensitive butterflies to naled while maintaining mosquito control efficacy.

Host plant selection, larval survival, and reproductive phenology in Megathymus yuccae (Lepidoptera: Hesperiidae).

Our primary objective in this study was to determine the plant level and environmental factors that affect oviposition choice and subsequent offspring survival in Megathymus yuccae (Boisduval and Leconte) on its host plant, Yucca filamentosa L. A preliminary survey suggested that the frequency of pupal eclosion tent presence increased only with host plant height. In an expanded survey conducted during the adult flight period the following spring, we found that plant height increased the probability of oviposition, whereas the density of herbaceous stems and fire damage decreased the probability of egg presence. Similarly, the number of eggs on occupied plants increased with plant height and decreased with fire damage. When we surveyed the plants from the spring 2008 sampling the following winter to determine presence of late-instar larvae or pupae, we found that the probability that at least one larva survived on previously occupied plants decreased with the density of herbaceous stems. These results collectively suggest that larger, unburned Y. filamentosa individuals and those in relatively open areas are more attractive as host plants for oviposition and that larval performance is generally, but not exclusively, consistent with female preference in this system.