The effect of mold sensitization and humidity upon allergic asthma

Introduction: Humidity is commonly associated with increased airway hyperresponsiveness in asthma. Objective: To examine mold sensitization in patients with allergic asthma or allergic rhinitis and self‐reports of humidity as exacerbating factors of clinical symptoms. Methods: A retrospective, cross‐sectional study at a University hospital outpatient allergy and asthma clinic was performed. A total of 106 patients with either allergic asthma or allergic rhinitis completed standard prick‐puncture skin testing with 17 allergens and controls and completed standardized forms addressing trigger factors for clinical symptoms. Results: Allergic asthmatics sensitized to Cladosporium were more likely to have a more severe asthma severity class (odds ratio = 4.26, confidence interval = 1.30–16.93). Sensitization to Alternaria, Cladosporium, Helminthosporium, Aspergillus and Dermatophagoides pteronyssinus in asthma was associated with higher likelihood for previous hospitalization, while sensitization to Cladosporium, Helminthosporium, Aspergillus, Dermatophagoides pteronyssinus and cockroach in asthma was associated with higher likelihood of having reduced pulmonary function based on forced expiratory volume in 1 s. Furthermore, allergic asthmatics more commonly reported humidity as an exacerbating factor of symptoms than did patients only with allergic rhinitis (68.42% vs 42.86%, respectively; P < 0.05). Conclusion: Mold sensitization is highly associated with more severe asthma, while humidity is more of an exacerbating factor in patients with allergic asthma as compared with allergic rhinitis alone. Further delineation between mold sensitization and humidity is needed to determine whether these are independent factors in asthma. Please cite this paper as: Hayes D Jr, Jhaveri MA, Mannino DM, Strawbridge H and Temprano J. The effect of mold sensitization and humidity upon allergic asthma. Clin Respir J 2013; 7: 135–144.     

The effect of excess selenium on the opto-electronic properties of Cu2ZnSnSe4 prepared from Cu–Sn alloy precursors

For the fabrication of a kesterite-type CZTSe absorber material, stacked elemental-alloy layers (SEAL) precursor consisting of Cu–Sn alloy and elemental Zn layers offer the possibility of enhanced process control due to their advantages such as improvement of material homogeneity and suppression of the commonly observed Sn loss. In this study, the impact of selenium amounts during the annealing of a SEAL-type precursor with the configuration of Zn/Cu–Sn/Zn was demonstrated. The obtained results demonstrate how the selenium amount can indirectly be used to influence the absorber composition in the described annealing process and its direct impact on the opto-electronic properties of solar cells. This occurs due to the placement of elemental Sn in the vicinity of the sample during annealing that acts as a further source of SnSe₂ vapor during the high-temperature stage of the process depending on the degree of selenium excess. The results show that higher selenium amount increases the band gap of kesterite; this is directly accompanied by a shift of the defect activation energies. Optimization of this effect can lead to widening of the space-charge width up to 400 nm, which improves the charge carrier collection. The described optimization strategy leads to device efficiencies above 11%.

This study show the influence of selenium amount during annealing of kesterite on the elemental composition of absorber and on the opto-electronic properties of solar cells. Enhanced carrier collection leads to device efficiencies approaching 12%.     

The Role of Cryosurgery of the Prostate for Nonsurgical Candidates

Introduction:

Technological advancements have reduced the morbidity associated with cryosurgery, leading to an increased interest in this modality for the treatment of organ-confined prostate cancer. In this study, we critically examine the current role of cryoablation of the prostate to better understand how to counsel patients regarding this treatment option.

Methods:

A database was compiled over a 3-year period (2008–2011) of 30 patients who underwent cryoablation for organ-confined prostate cancer. Indications for cryosurgery included primary treatment, focal treatment (institutional review board–approved prospective study), and salvage cryotherapy for radiation failure. The primary outcomes were biochemical response via prostate-specific antigen (PSA) measurement and morbidity associated with cryoablation. Cryotherapy failure was defined as an increasing postcryotherapy PSA level ≥ 2 ng/mL above the post-treatment nadir, a positive prostate biopsy, or radiographic evidence of metastatic disease.

Results:

Of the 30 patients who underwent cryoablation from 2008 to 2011, 26 patients had complete follow-up data for analysis. Of these patients, 17 (65.38%) had total gland cryotherapy, 5 (19.23%) had salvage cryotherapy for radiation failure, and 4 (15.38%) had focal cryotherapy. The mean patient age was 68 years (54–89); median preoperative PSA was 5.5 ng/mL (1.7–15.9); median prostate volume was 35 mL (15–54); mean Gleason score was 7; and the median PSA at study conclusion was 0.7 (0.02–3.4) ng/mL. Of the 17 patients who had total prostate cryotherapy, 11 (64.7%) had significant factors precluding primary treatment by a surgical and/or radiation approach, including neurological disorders (2), morbid obesity (1), rectal cancer treated with radiation (1), kidney/pancreas transplant (2), ileoanal pouch secondary to inflammatory bowel disease (IBD) (1), renal failure (1), and age (3).There were no intra- or postoperative complications. After a median follow-up of 18 months (1–40), none of the patients with multiple comorbidities had biochemical failures. Two patients from the salvage group experienced treatment failure requiring androgen deprivation therapy.

Conclusions:

This critical analysis of a single-surgeon experience at a large academic prostate cancer program revealed that the contemporary role of cryosurgery is, in select patients with comorbidities, preventing surgical and/or radiation therapy. Additionally, cryosurgery has a role in treating radiation failures. Further studies are necessary to investigate focal cryotherapy as an option for primary treatment, but our preliminary results are promising, without any biochemical failures in our focal therapy cohort.     

Macular thickness as determined by optical coherence tomography in relation to degree of myopia,axial length and vitreous chamber depth in Malay subjects

Purpose: This study aimed to determine the relationship between macular thickness and spherical equivalent refraction (SER), axial length (AL) and vitreous chamber depth (VCD) in Malay subjects. Methods: Sixty‐three subjects (aged 19–24 years) with a mean SER of ‐1.79 ± 2.24 D, mean axial length of 24.26 ± 1.35 mm and mean vitreous chamber depth of 17.02 ± 1.33 mm were included in this clinical cross‐sectional study. Stratus optical coherence tomography (Time Domain optical coherence tomography) was used to determine the thickness of the outer macular (perifovea) and inner macular (parafovea) at four different locations, that is, temporal, superior, nasal and inferior quadrants and also the fovea itself. Results: Positive correlations were found between the outer macular (perifovea) thickness and SER at the temporal (R = 0.47, p < 0.05), superior (R = 0.36, p < 0.05) and inferior (R = 0.31, p < 0.05) quadrants. Foveal thickness was also positively correlated with AL (R = 0.34, p < 0.05) and VCD (R = 0.32, p < 0.05). Negative correlations were found between outer macular thickness and axial length at the temporal (R = ‐0.46, p < 0.05), superior (R = ‐0.27, p < 0.05), nasal (R = ‐0.25, p < 0.05) and inferior (R = ‐0.36, p < 0.05) quadrants. Negative correlations were also found between outer macular thickness and VCD at the temporal (R = ‐0.51, p < 0.05), superior (R = ‐0.32, p < 0.05), nasal (R = ‐0.31, p < 0.05) and inferior (R = ‐0.40, p < 0.05) quadrants. Conclusions: This study shows that the degree of myopia and elongation of the globe are associated with thinning of most areas of the perifovea. A trend for foveal thickening in the high myopia group is also inferred, although this does not apply to the low and moderate myopia groups.     

SGLT2 inhibitor/GLP-1 receptor agonists as first step monotherapy—evidence and implications

International Journal of Diabetes in Developing Countries -     

Modifications of the CZTSe/Mo back-contact interface by plasma treatments

Molybdenum (Mo) is the most commonly used back-contact material for copper zinc tin selenide (CZTSe)-based thin-film solar cells. For most fabrication methods, an interfacial molybdenum diselenide (MoSe₂) layer with an uncontrolled thickness is formed, ranging from a few tens of nm up to ≈1 μm. In order to improve the control of the back-contact interface in CZTSe solar cells, the formation of a MoSe₂ layer with a homogeneous and defined thickness is necessary. In this study, we use plasma treatments on the as-grown Mo surface prior to the CZTSe absorber formation, which consists of the deposition of stacked metallic layers and the annealing in selenium (Se) atmosphere. The plasma treatments include the application of a pure argon (Ar) plasma and a mixed argon–nitrogen (Ar–N₂) plasma. We observe a clear impact of the Ar plasma treatment on the MoSe₂ thickness and interfacial morphology. With the Ar–N₂ plasma treatment, a nitrided Mo surface can be obtained. Furthermore, we combine the Ar plasma treatment with the application of titanium nitride (TiN) as back-contact barrier and discuss the obtained results in terms of MoSe₂ formation and solar cell performance, thus showing possible directions of back-contact engineering for CZTSe solar cells.

Molybdenum (Mo) is the most commonly used back-contact material for copper zinc tin selenide (CZTSe)-based thin-film solar cells. The effect of a pure Ar plasma and a mixed Ar–N₂ plasma on the back-contact interface of CZTSe solar cells is reported in this study.     

A phase III randomised trial of trans-abdominal ultrasound in improving application quality and dosimetry of intra-cavitary brachytherapy in locally advanced cervical cancer

IntroductionIntra-cavitary brachytherapy (ICB) remains an integral part of radiotherapy treatment in cervical cancer. Two-dimensional X ray point-based planning remains common and blind insertion leads to uterine perforations and higher toxicity. We conducted a randomised controlled trial of using trans-abdominal ultrasound in performing ICB to reduce perforation and organ at risk doses.Patient and methodsThe present study is a phase III open label randomised controlled trial of ultrasound guided ICB conducted on invasive cervical cancer patients. Patients were randomised by a simple computer-generated randomization chart into Arm A (No Ultrasound guidance) and Arm B (ICB with ultrasound guidance). The uterine perforation rates, tandem length change rates, bladder doses, rectal dose and procedure times were compared. Fischer exact test was used to compare the arms and p value <0.05 considered significant.ResultsA total of 160 patients were randomised. With US assistance, the uterine perforation rate was 1.25% (n = 1). In the non-US assistance arm the perforation rate was 12.5% (n = 10) (p = 0.005). Mean time to complete the entire procedure was significantly shortened from 26 min to 19 min favouring the US arm (p = 0.001). Dosimetric assessment between the two groups showed significant decrease in dose received by the various organs at risk with US assistance.ConclusionThe present study confirms significant improvement in application quality as well as dosimetry with reduction in procedure time. Trans-Abdominal US should be routinely used for ICB procedures, particularly in resource limited settings.