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In situ investigations of cracks propagating at up to 2.5 km s-1 along an (001) plane of a silicon single crystal are reported, using X-ray diffraction megahertz imaging with intense and time-structured synchrotron radiation. The studied system is based on the Smart Cut process, where a buried layer in a material (typically Si) is weakened by microcracks and then used to drive a macroscopic crack (10-1 m) in a plane parallel to the surface with minimal deviation (10-9 m). A direct confirmation that the shape of the crack front is not affected by the distribution of the microcracks is provided. Instantaneous crack velocities over the centimetre-wide field of view were measured and showed an effect of local heating by the X-ray beam. The post-crack movements of the separated wafer parts could also be observed and explained using pneumatics and elasticity. A comprehensive view of controlled fracture propagation in a crystalline material is provided, paving the way for the in situ measurement of ultra-fast strain field propagation. [ABSTRACT FROM AUTHOR]

Recent works on three-planet mean motion resonances (MMRs) have highlighted their importance for understanding the details of the dynamics of planet formation and evolution. While the dynamics of two-planet MMRs are well understood and approximately described by a one-degree-of-freedom Hamiltonian, little is known of the exact dynamics of three-body resonances besides the cases of zeroth-order MMRs or when one of the bodies is a test particle. In this work, I propose the first general integrable model for first-order three-planet mean motion resonances. I show that one can generalize the strategy proposed in the two-planet case to obtain a one-degree-of-freedom Hamiltonian. The dynamics of these resonances are governed by the second fundamental model of resonance. The model is valid for any mass ratio between the planets and for every first-order resonance. I show the agreement of the analytical model with numerical simulations. As examples of application, I show how this model could improve our understanding of the capture into MMRs as well as their role in the stability of planetary systems. [ABSTRACT FROM AUTHOR]

The article discusses a rare genetic condition called acrogeria, which is characterized by the resorption of bones in the distal phalanges. It is caused by a mutation in the LMNA gene and shares similarities with other laminopathies. The article describes a case of acrogeria in a 35-year-old woman from South Korea and highlights the clinical features and diagnostic methods used. Acrogeria is distinguished by its unique distribution of progeroid traits and the absence of widespread osteoporosis. The article emphasizes the importance of considering cardiovascular complications in patients with acrogeria. [Extracted from the article]

This paper presents design methods for a flexible-route transit system, in which vehicles travel within predetermined areas to provide door-to-door service. The main advantage of this system is that passengers no longer have to access transit stations in order to gain service. This system is suitable for low and heterogeneous passenger demand distribution as it features a hybrid system layout that includes both a hub-and-spoke network in the peripheral region and a grid network in the central region, along with heterogeneous local routes that address local demand variations. Continuum approximation (C.A.) is used to reduce the computation burden by formulating the design problem with respect to a few decision variables. We compare the performance of the proposed transit system with (i) the typical fixed-route system, (ii) the homogeneous flexible-route grid system, and (iii) the flexible-route grid system with local routes, in hypothetical settings. It is found through our numerical examples that the integration of the three proposed features (i.e. flexible transit, local tubes, and hybrid structure), as compared to counterparts with only two or fewer features, yields lower combined agency and user costs under the assumed low heterogeneous demand distribution. We then apply the design framework to a more realistic case for the City of Changzhi, China. An implementable design for Changzhi is developed, and its performance verified with simulations, demonstrating accuracy and applicability of the proposed continuum approximation model. • Flexible-route transit system for low and spatially heterogeneous demand. • Continuum approximation model to design hybrid network structure and local routes. • Schematic design translated into implementable design that conform with street networks. • Significant agency and user cost reduction as compared to traditional transit networks. • Simulations validate performance predictions for a real-world case study. [ABSTRACT FROM AUTHOR]

• Designing a spatially heterogeneous bus route network with time-dependent service headways. • Representing both the transit and the car network in efficient and realistic settings. • Incorporating elastic demand scenarios with mode choice into the transit design problem. This paper proposes an integrated methodological framework to design a spatially heterogeneous bus route network and time-dependent service headways to serve travel demand that varies over time and space. Travelers choose to use either the transit mode or the driving mode (as well as travel paths in the corresponding modal network) that minimizes their equilibrium travel cost. In addition, transit routes involve dedicated bus lanes that occupy part of the city streets and affect the capacity reserved for private cars. Hence, roadway congestion depends on the transit route design, and its dynamic evolution is described by regional macroscopic fundamental diagrams. The proposed modeling framework consists of two parts: a bus network optimization module based on continuum approximation that produces optimal headways and local route spacing, and a dynamic aggregated network model that determines route choice, mode split, and user equilibrium conditions. An iterative solution algorithm is developed to solve the integrated model. Numerical experiments are used to demonstrate the applicability of the proposed modeling framework, and to conduct a careful analysis on the influence of the demand pattern on the transit network design, roadway congestion, and the overall system performance. [ABSTRACT FROM AUTHOR]

Kimura disease (KD) is a rare, chronic angiolymphoproliferative inflammatory disease appearing to be mostly restricted to the skin and soft tissue. Cutaneous involvement of KD includes head and/or neck nodules showing suggestive histological features, frequently associated with an atopic dermatitis-like or prurigo-like presentation. KD is challenging to treat, with high rate of recurrence using current therapeutic strategies. Evidence for involvement of a T-helper type 2 (Th2) immune response in KD pathogenesis has been found in previous studies. Consequently, this study aimed to determine the efficacy and safety of dupilumab, a human monoclonal antibody that inhibits signalling of key Th2 cytokines, interleukin (IL)-4 and IL-13, within a single-centre cohort of patients with cutaneous KD. Two adults with a diagnosis of refractory (failure of at least one treatment line) cutaneous-restricted KD based on clinical, biological, histological, molecular and imaging findings received dupilumab for KD, and showed dramatic response with a good safety profile. [ABSTRACT FROM AUTHOR]

Introduction: Software to predict the impact of aging on physical appearance is increasingly popular. But it does not consider the complex interplay of factors that contribute to skin aging. Objectives: To predict the +15‐year progression of clinical signs of skin aging by developing Causal Bayesian Belief Networks (CBBNs) using expert knowledge from dermatologists. Material and methods: Structures and conditional probability distributions were elicited worldwide from dermatologists with experience of at least 15 years in aesthetics. CBBN models were built for all phototypes and for ages ranging from 18 to 65 years, focusing on wrinkles, pigmentary heterogeneity and facial ptosis. Models were also evaluated by a group of independent dermatologists ensuring the quality of prediction of the cumulative effects of extrinsic and intrinsic skin aging factors, especially the distribution of scores for clinical signs 15 years after the initial assessment. Results: For easiness, only models on African skins are presented in this paper. The forehead wrinkle evolution model has been detailed. Specific atlas and extrinsic factors of facial aging were used for this skin type. But the prediction method has been validated for all phototypes, and for all clinical signs of facial aging. Conclusion: This method proposes a skin aging model that predicts the aging process for each clinical sign, considering endogenous and exogenous factors. It simulates aging curves according to lifestyle. It can be used as a preventive tool and could be coupled with a generative AI algorithm to visualize aging and, potentially, other skin conditions, using appropriate images. [ABSTRACT FROM AUTHOR]

Introduction: Leprosy reactions (LRs) are inflammatory responses observed in 30%-50% of people with leprosy. First-line treatment is glucocorticoids (GCs), often administered at high doses with prolonged courses, resulting in high morbi-mortality. Methotrexate (MTX) is an immunomodulating agent used to treat inflammatory diseases and has an excellent safety profile and worldwide availability. In this study, we describe the efficacy, GCs-sparing effect and safety of MTX in LRs. Methods: We conducted a retrospective multicentric study in France consisting of leprosy patients receiving MTX for a reversal reaction (RR) and/or erythema nodosum leprosum (ENL) since 2016. The primary endpoint was the rate of good response (GR) defined as the complete disappearance of inflammatory cutaneous or neurological symptoms without recurrence during MTX treatment. The secondary endpoint was the GCs-sparing effect, safety and clinical relapse after MTX discontinuation. Results: Our study included 13 patients with LRs (8 men, 5 women): 6 had ENL and 7 had RR. All patients had had at least one previous course of GCs and 2 previous treatment lines before starting MTX. Overall, 8/13 (61.5%) patients had GR, allowing for GCs-sparing and even GCs withdrawal in 6/11 (54.5%). No severe adverse effects were observed. Relapse after MTX discontinuation was substantial (42%): the median relapse time was 5.5 months (range 3–14) after stopping treatment. Conclusion: MTX seems to be an effective alternative treatment in LRs, allowing for GCs-sparing with a good safety profile. Furthermore, early introduction during LRs may lead to a better therapeutic response. However, its efficacy seems to suggest prolonged therapy to prevent recurrence. Author summary: Leprosy reactions (LRs) are acute inflammatory episodes that complicate 30% to 50% of Mycobacterium leprae infections. Type 1 is known as reversal reaction (RR), and type 2 is known as erythema nodosum leprosum (ENL). The two types have relatively distinct pathogenesis and clinical features; furthermore, they can advance to become severe and progress to irreversible nerve damage and deformities. Beyond leprosy infection, LR can bring about neurological burden, poor quality of life, and risk of further descent into poverty for often young patients. Despite effective standardized treatment of leprosy infection with multidrug therapy (MDT) since 1981, treating LRs prove to be challenging. First-line treatment of LR is based on prolonged systemic glucocorticoids (GCs) therapy. The current challenge in leprosy is now to develop and evaluate new therapeutic alternatives to reduce not only the sequelae and morbidity of LR but also the lasting side effects of GCs. Thalidomide is an effective alternative in moderate to severe ENL, but its use is limited given its numerous adverse effects. Methotrexate (MTX) is an immunomodulating agent used to treat inflammatory diseases and has an excellent safety profile and worldwide availability. Here, we describe the efficacy, GCs-sparing effect, and safety of MTX in LR. [ABSTRACT FROM AUTHOR]

Simple Summary: Gliomas remain the most common primary brain tumor in adults. Although they are classified based on the IDH mutation status very little is known considering this alteration in the elderly glioma population. Because IDH-mutated gliomas are associated with better prognosis in the young population, it is essential to characterize its role in elderly and more frail patients to help physicians' therapeutic decisions. In this study, we demonstrated that elderly IDH-mutated gliomas had very similar characteristics to those found in the younger population but were significantly different from elderly IDH wild-type gliomas. However, patient management in this population appeared to be suboptimal, with less frequent gross total resection and irradiation. We showed that an optimal therapeutic combination of radio-chemotherapy could be safe and feasible for these elderly patients to aid in their management. Finally, we identified specific geriatric prognostic factors such as mobility, neuropsychological disorders, body mass index, and autonomy that can help physicians make future therapeutic decisions for this specific elderly population with a better prognosis. Background: Describe the characteristics, patterns of care, and predictive geriatric factors of elderly patients with IDHm high-grade glioma (HGG) included in the French POLA network. Material and Methods: The characteristics of elderly (≥70 years) patients IDHm HGG were compared to those of younger patients IDHm HGG (<70 years) and of elderly patients IDHwt HGG. Geriatric features were collected. Results: Out of 1433 HGG patients included, 119 (8.3%) were ≥70 years. Among them, 39 presented with IDHm HGG. The main characteristics of elderly IDHm HGG were different from those of elderly IDHwt HGG but similar to those of younger IDHm HGG. In contrast, their therapeutic management was different from those of younger IDHm HGG with less frequent gross total resection and radiotherapy. The median progression-free survival (PFS) and overall survival (OS) were longer for elderly patients IDHm HGG (29.3 months and 62.1 months) than elderly patients IDHwt HGG (8.3 months and 13.3 months) but shorter than those of younger patients IDHm HGG (69.1 months and not reached). Geriatric factors associated with PFS and OS were mobility, neuropsychological disorders, body mass index, and autonomy. Geriatric factors associated with PFS and OS were mobility, neuropsychological disorders, and body mass index, and autonomy. Conclusion: the outcome of IDHm HGG in elderly patients is better than that of IDHwt HGG. Geriatric assessment may be particularly important to optimally manage these patients. [ABSTRACT FROM AUTHOR]

Background: Livedoid vasculopathy (LV) is a chronic dermatosis associated with micro-thrombosis of the vessels of the dermis, leading to ischemic lesions and painful skin ulcerations of the lower limbs. This thrombosing occlusive vasculopathy, clearly distinct from 'classical vasculitis' (not related to alteration of vessel walls), may lead to peripheral neuropathy. Objective: To clarify the main clinical, electrophysiological and pathological characteristics of peripheral neuropathy linked to LV. Method: We presented a series of personal cases of peripheral neuropathy due to LV. We also conducted a review of the literature (since the first description of LV in 1974) using multiple combinations of keywords from 'PubMed', 'Google Scholar' and 'ScienceDirect' databases according to the 'Preferred Reporting Items for Systematic reviews and Meta-Analyses' guidelines. Results: We identified 16 patients (6 personal cases and 10 cases from the medical literature). Our personal cases were five females and one male, with a median age (at the onset of cutaneous signs of LV) of 38 (range 25–62). Several types of skin lesions of the lower limbs were observed. Median age at the onset of peripheral neuropathy symptoms was 48 years (range 29–66), with a main clinical and electrophysiological pattern of mononeuropathy multiplex. Discussion: We observed a typical pattern of peripheral neuropathy, mostly mononeuropathy multiplex, whose pathophysiology might be related to occlusions of the small vessels of the nerves, as seen in the dermis. Moreover, LV may also be associated with other types of peripheral neuropathies (sometimes of autoimmune etiology) not directly related to the skin lesions. Conclusion: The 'ischemic form' of peripheral neuropathy linked to LV is mainly responsible for sensory disturbances (with multifocal distribution), sometimes for motor disturbances. This type of peripheral neuropathy has to be distinguished from 'classical vasculitic neuropathies' which are usually treated with antithrombotic therapies. [ABSTRACT FROM AUTHOR]

Background: At present there is no standard nomenclature for describing the diversity of human constitutive skin colour. Objectives: To develop a standard nomenclature to describe human constitutive skin colour. Methods: Monthly focus group discussions were carried out among a multidisciplinary group of specialists over a 7‐month period. Topics covered were (i) limitations and unmet needs of current nomenclature(s) pertaining to human cutaneous diversity, (ii) practical considerations about the function and role of any proposed nomenclature pertaining to human cutaneous diversity, (iii) review of the cellular basis and current molecular genetic understanding of variation in human skin pigmentation and (iv) in vivo methods to evaluate human skin pigmentation. In addition, a preliminary review of the published literature was undertaken to collate data on published skin reflectance measurements, notably melanin index values for well‐referenced human populations. Results: We developed a five‐point scale to describe the full spectrum of human constitutive skin colour, termed the Eumelanin Human Skin Colour Scale. The nomenclature of the scale uses eumelanin, the dominant chromophore of human skin, as a central descriptive word. The categories of the scale (nomenclature and melanin index values) are eumelanin low (EML), < 25; eumelanin intermediate low (EMIL), 25 to < 50; eumelanin intermediate (EMI), 50 to < 75; eumelanin intermediate high (EMIH), 75 to < 100; and eumelanin high (EH), ≥ 100. Conclusions: The Eumelanin Human Skin Colour Scale enables the complete range of human constitutive skin colour to be described in an objective, equitable and understandable manner. In future, this scale can be used as the basis for developing other scales that address the specific functional aspects of human skin, such as response to ultraviolet radiation. [ABSTRACT FROM AUTHOR]

Intra-arterial therapy is an effective way of performing chemotherapy or radiation therapy in patients with primary liver cancer (i.e. hepatocellular carcinoma). Although this minimally invasive approach is now an established treatment option, support tools for pre-operative planning and intra-operative assistance might be helpful. We developed an approach for semi-automatic segmentation of computed tomography angiography images of the main arterial branches (required for access path to the treatment site), automatic segmentation of the liver, arterial and venous tree, and interactive segmentation of the tumors (required for procedure-specific planning). This approach was then integrated into a liver-specific workflow within EndoSize® solution, a planning software for endovascular procedures. The main branches extraction approach was qualitatively evaluated inside the software, while the automatic segmentation methods were quantitatively assessed. Main branches extraction provides a success rate of 85% (i.e. all arteries correctly extracted) in a dataset of 172 patients. On public databases, a mean DICE of 0.91, 0.47 and 0.92 was obtained for liver, venous and arterial trees segmentation, respectively. This pipeline is suitable for directly accessing the treatment site, giving anatomic measurements, and visualizing the hepatic trees, liver, and surrounding arteries during the pre-operative planning. HCC: hepatocellular carcinoma; TACE: transarterial chemoembolization; SIRT: selective internal radiation therapy; CT: computed tomography; CTA: computed tomography angiography; AMS: superior mesenteric artery; LGA: left gastric artery; RHA: right hepatic artery; LHA: left hepatic artery; rbHA: right branch of the hepatic artery; lbHA: left branch of the hepatic artery; GDA: gastroduodenal artery; VOI: volume of interest; SD: standard deviation; MICCAI: medical image computing and computer assisted interventions; MR: magnetic resonance [ABSTRACT FROM AUTHOR]

Background: In addition to general measures, pharmacological treatment is the basis of the management of scabies. No recent data in real‐life are available on the efficacy and safety of 10% benzyl benzoate emulsion for skin application administered as monotherapy. Method: This prospective, multicenter, French observational study comprised a registry and a prospective cohort with a follow‐up at 28 days and a telephone call at week 12. To participate in the registry, patients had to be over 1 month old, ambulatory, presenting common, nonhyperkeratotic, untreated scabies. To be included in the cohort, patients had to be included in the registry and treated with two applications of 10% benzyl benzoate emulsion 8 days apart. The primary endpoint was cure at day 28. Results: Of the 186 patients included in the registry, 116 were included in the cohort. Fourteen patients were included in the cohort without being included in the registry, which led to a total of 130 patients in the cohort. At day 28, 119/130 (91.5%; 95% CI 85.4–95.6%) were clinically cured. The cure was confirmed by dermoscopy in 44/47 patients (93%). Among the 130 patients, the cure rate was 82% at week 12. Of the 119 patients cured at day 28, the rate of cure at week 12 was 89.9%. Conclusion: In real life, two applications of 10% benzyl benzoate emulsion 8 days apart provides high cure rates in patients with common scabies. [ABSTRACT FROM AUTHOR]

The article titled "Back Cover" is based on the original article "Predicting the evolution of clinical skin aging in a multi-ethnic population: Developing causal Bayesian networks using dermatological expertise" by Hussein Jouni et al. The study focuses on predicting the progression of skin aging in a diverse population using Bayesian networks. The authors include a wide range of experts in the field of dermatology and explore the impact of various factors on skin aging. This research provides valuable insights into understanding and addressing skin aging in different ethnic groups. [Extracted from the article]

We describe 7 cases of extensive tinea corporis since 2018 in a hospital in Paris, France, after failure to cure with terbinafine. Molecular analysis indicated Trichophyton mentagrophytes internal transcribed spacer type VIII (T. indotineae). This strain, which has mutations in the squalene epoxidase gene, is spreading on the Indian subcontinent. [ABSTRACT FROM AUTHOR]

Background: Some keloids show cystic cavities that give rise to acute inflammatory flares and oozing. These suppurative keloids (SK) have rarely been systematically studied. We conducted a retrospective cohort study to evaluate SK frequency and its risk factors. We also reviewed microbiological analyses as well as the histological features of removed SKs. Methods: Between July 1, 2015, and September 30, 2016, all adult patients attending a specialized keloid clinic were asked to participate. Clinical information and microbiological results were extracted from each patient's file. Histological features were observed and interpreted. Results: In this study, we observed an SK rate of 26% for a mean keloid history of 17.2 years. Male gender, African ancestry, and a family history of keloids were significantly associated with suppuration. Microbiological examination revealed commensal skin flora 7/9 (77.8%), Staphylococcus aureus 1/9 (11.1%), and Enterococcus faecalis 1/9 (11.1%). Conclusion: Suppuration is a common complication of keloids occurring in patients with severe keloid disease and may arise from pilosebaceous occlusion and aseptic inflammation. [ABSTRACT FROM AUTHOR]

Background: Leishmaniases are regularly seen in non-endemic areas due to the increase of international travels. They include cutaneous leishmaniases (CL) and mucocutaneous (MC) caused by different Leishmania species, and visceral leishmaniases (VL) which present with non-specific symptoms.Methods: We reviewed all consecutive leishmaniasis cases seen between September 2012 and May 2020. The diagnostic strategy included microscopy after May-Grünwald-Giemsa staining, a diagnostic quantitative PCR (qPCR) assay, and species identification based on sequencing of the cytochrome b gene.Results: Eighty-nine patients had a definitive leishmaniasis diagnosis. Nine patients had VL with Leishmania infantum. Eighty patients had CL. Twelve patients acquired CL after trips in Latin America (7 Leishmania guyanensis, 2 Leishmania braziliensis, 2 Leishmania mexicana, and 1 Leishmania panamensis). Species could be identified in 63 of the 68 CLs mainly after travel in North Africa (59%) with Leishmania major (65%), Leishmania tropica/killicki (24%), and L. infantum (11%), or in West Sub-Saharan Africa (32%), all due to L. major. The median day between appearance of the lesions and diagnosis was 90 [range 60-127].Conclusions: Our diagnostic strategy allows both positive diagnoses and species identifications. Travelers in West Sub-Saharan Africa and North Africa should be better aware of the risk of contracting leishmananiasis. [ABSTRACT FROM AUTHOR]

• Multicentric reticulohistiocytosis is a rare non-Langerhans histiocytosis characterized by red papulonodular skin lesions and destructive polyarthritis. • Multicentric reticulohistiocytosis can be associated with malignancies, including lung cancers, or with autoimmune diseases. • Pulmonary involvement in multicentric reticulohistiocytosis is rare, and may include lung nodules, pleuritic, usual interstitial pneumonia or organizing pneumonia. [ABSTRACT FROM AUTHOR]