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Context Women having abortions are at high risk for future unintended pregnancy, and removing the prescription requirement for oral contraceptives may increase continuation and adoption of this effective method. Methods A survey fielded from May to July 2011 collected information from 651 women aged 15-46 seeking abortion services at six urban clinics from across the United States. Descriptive statistics, chi-square tests and logistic regression analyses were conducted to estimate women's interest in over-the-counter access to oral contraceptives. Results Eighty-one percent of respondents supported over-the-counter access to oral contraceptives; while 42% of women planned to use the pill after their abortion, 61% said they would likely use this method if it were available over the counter. Thirty-three percent of women who planned to use no contraceptive following their abortion said they would use an over-the-counter pill, as did 38% who planned to use condoms afterward. In multivariable analysis, several subgroups had increased odds of likely over-the-counter use: women who were older than 19 (odds ratios, 1.8 for those aged 20-29 and 1.6 for those aged 30-46), were uninsured (1.5), had ever used the pill (1.4), had had difficulty obtaining a prescription refill for hormonal contraceptives (2.7) or planned to use the pill postabortion (13.0). By contrast, compared with white respondents, women of other races or ethnicities were less likely to say they would use over-the-counter pills (0.4-0.7). Conclusions Interest in a hypothetical over-the-counter oral contraceptive was high in this sample, and this delivery model has the potential to reduce unintended pregnancy among abortion patients. [ABSTRACT FROM AUTHOR]

In this paper, we review some of the extant literature on the study of interstellar objects (ISOs). With the forthcoming Vera C. Rubin Telescope and Legacy Survey of Space and Time (LSST), we find that 0. 3 8 − 8 4 'Oumuamua-like interstellar objects are expected to be detected in the next 10 years, with 95% confidence. The feasibility of a rendezvous trajectory has been demonstrated in previous work. In this paper, we investigate the requirements for a rendezvous mission with the primary objective of producing a resolved image of an interstellar object. We outline the rendezvous distances necessary as a function of resolution elements and object size. We expand upon current population synthesis models to account for the size dependency on the detection rates for reachable interstellar objects. We assess the trade-off between object diameter and occurrence rate, and conclude that objects with the size range between a third of the size and the size of 'Oumuamua will be optimal targets for an imaging rendezvous. We also discuss expectations for surface properties and spectral features of interstellar objects, as well as the benefits of various spacecraft storage locations. [ABSTRACT FROM AUTHOR]

Abstract: Background: In states requiring physicians to dispense mifepristone, the small number of providers offering the method limits its uptake. In 2008, Planned Parenthood of the Heartland in Iowa began providing medical abortion via telemedicine at clinics without an on-site physician. The purpose of this study was to evaluate patients'' and providers'' experiences with telemedicine provision of medical abortion. Methods: Between October 2009 and February 2010, in-depth interviews were conducted at Planned Parenthood clinics with 25 women receiving medical abortion services (20 telemedicine patients and 5 in-person patients) and 15 clinic staff. Data were analyzed qualitatively for themes related to acceptability of the telemedicine service delivery model. Findings: Patients and providers cited numerous advantages of telemedicine, including decreased travel for patients and physicians and greater availability of locations and appointment times compared with in-person provision. Overall, patients were positive or indifferent about having the conversation with the doctor take place via telemedicine, with most reporting it felt private/secure and in some cases even more comfortable than an in-person visit. However, other women preferred being in the same room with the physician, highlighting the importance of informing women about their options so they can choose their preferred service modality. Conclusions: The findings from this study indicate that telemedicine can be used to provide medical abortion in a manner that is highly acceptable to patients and providers with minimal impact on the clinic. Practice Implications: This information demonstrates the feasibility of telemedicine to extend the reach of physicians and improve abortion access in rural settings. [Copyright &y& Elsevier]

Emergency airway management, particularly outside of the operating room, is associated with a high incidence of life-threatening adverse events. Based on the recommendations of the 4th National Audit Project, we aimed to develop hospital-wide systems changes to improve the safety of emergency airway management. We describe a framework for governance in the form of a hospital airway special interest group. We describe the development and implementation of the following systems changes: 1. A local intubation algorithm modified from the Difficult Airway Society's plan A-B-C-D approach, including clear pathways for airway escalation, and emphasizing the concepts of resuscitation prior to intubation, planning for failure, and avoidance of fixation error. 2. Simplified and standardized airway equipment located in identical airway carts in all critical care areas. 3. A preintubation checklist and equipment template to standardize preparation for airway management. 4. Availability of continuous waveform endtidal capnography in all critical care areas for confirmation of correct endotracheal tube placement. 5. Multidisciplinary team training to address the technical and nontechnical aspects of nonoperating room intubation. In addition, we describe methodology for ongoing monitoring of performance through a quality assurance framework. In conclusion, changes in the process of emergency airway management at a hospital level are feasible through collaboration. Their impact on patient-based outcomes requires further study. [ABSTRACT FROM AUTHOR]

Suicide in young children is rare; the incidence increases towards the end of adolescence. Skin disorders confer a high prevalence of psychiatric and psychological comorbidities. However, published research on suicidal behaviour in adolescents and children with skin disorders is sparse. The aim of this study was to identify the prevalence of suicidal behaviour in children and adolescents under 18 years of age with chronic skin disorders and associated contributing risk factors. MEDLINE, PsycINFO, EMBASE, CINAHL and Cochrane databases were searched from inception to October 2020 for suicide or suicide attempts in patients under 18 years old with chronic skin disorders. The study protocol was logged on PROSPERO (CRD42020083528). Returned texts were reviewed independently by 2 authors. Bias was assessed according to Joanna Briggs Institute criteria. Five studies met the inclusion criteria; 4 cross-sectional surveys and 1 retrospective matched-cohort study. A total of 31,641 patients with acne, atopic dermatitis, body dysmorphic disorder or psoriasis were identified. Prevalence of suicidal ideation was 0.45% (psoriasis) to 67% (body dysmorphic disorder). The prevalence of suicidal attempts ranged from 0.08% (psoriasis) to 21.9% (acne). Patients with acne or atopic dermatitis had significantly increased odds ratio for suicidal attempts. Meta-analysis could not be performed owing to the heterogeneity and sparsity of data. Suicidal risk in skin disorders amongst adolescents and children under the age of 18 years old is broad and complex. The suicidal risk remained after adjusting for depression, suggestive of an alternative mechanism. [ABSTRACT FROM AUTHOR]

We present photometric and spectroscopic observations of a peculiar variable (designated DASCH J075731.1+201735 or J0757) discovered from our DASCH project using the digitized Harvard College Observatory archival photographic plates. It brightened by about 1.5 mag in B within a year starting in 1942, and then slowly faded back to its pre-outburst brightness from 1943 to 1950s. The mean brightness level was stable before and after the outburst, and ellipsoidal variations with a period of P = 119.18 ± 0.07 days are seen, suggesting that the star is tidally distorted. Radial-velocity measurements indicate that the orbit is nearly circular (e = 0.02 ± 0.01) with a spectroscopic period that is the same as the photometric period. The binary consists of a 1.1 ± 0.3 M☼ M0III star, and a 0.6 ± 0.2 M☼ companion, very likely a white dwarf (WD). Unlike other symbiotic binaries, there is no sign of emission lines or a stellar wind in the spectra. With an outburst timescale of ∼10 years and estimated B-band peak luminosity MB ∼ 0.7, J0757 is different from any other known classic or symbiotic novae. The most probable explanation of the outburst is hydrogen shell burning on the WD, although an accretion-powered flare cannot be ruled out. [ABSTRACT FROM AUTHOR]

We present a multi-object optical spectroscopy follow-up study of X-ray sources in a field along the Galactic plane (l = 327.°42, b = 2.°26) which is part of the Chandra Multi-wavelength Plane survey (ChaMPlane). We obtained spectra for 46 stars, including 15 likely counterparts to X-ray sources, and sources showing an Hα color excess. This has led to the identification of a new cataclysmic variable (CV), CXOPS J154305.5-522709, also named ChaMPlane Bright Source 7 (CBS 7), and we identified eight X-ray sources in the field as active late-type stars. CBS 7 was previously studied in X-rays and showed a hard spectrum and two periods: 1.22 ± 0.08 hr and 2.43 ± 0.26 hr. We present here clear evidence that the source is a CV through the detection of H, He I, and He II emission lines in its optical spectrum. The hard X-ray spectrum and the presence of the He II λ4686 in emission with a large equivalent width suggest a magnetic CV. The near-infrared counterpart is significantly variable, and we found a period consistent with the longest X-ray period at 2.39 ± 0.05 hr but not the shortest X-ray period. If this period is the orbital period, this would place the system in the CV period gap. The possible orbital period suggests a dM4 ± 1 companion star. The distance is then estimated to be ∼1 kpc. The system could be a relatively hard and X-ray luminous polar or an intermediate polar, possibly nearly synchronous. [ABSTRACT FROM AUTHOR]

Whey protein (WP) as a dietary supplement for athletes and gym-users is characterized by a content of high-quality amino acids. The benefits of their consumption are well-known and mainly related to the improvements of strength and body composition. Nevertheless, there is a scarce information about the risk associated to their elemental composition. The aim was to evaluate the total content and bioavailability of twenty-five elements in twenty whey protein powder samples, using Inductively Coupled Plasma Mass Spectrometry, and to evaluate the possible risk associated to the excessive daily intake of such products. Results showed that Na, K, Ca and Mg were the most predominant elements. After Hierarchical Cluster Analysis three different groups of whey protein supplements were observed. ANOVA analysis indicates that the concentration of the Na, K and Mg above mentioned elements is the key for the observed classification. The average elemental bioavailable fraction in the stomach is 45 % whereas in the intestine is 64 %. Most of the elements tested (nineteen) show gastric bioavailability higher than 60 %, being Al the lowest (37 %) and Co the highest one (76 %). According to our results, previously published data and recommendations of producers, WP samples can be considered save from the elemental composition point of view. • Na, K, Ca and Mg were the most predominant elements. • Elemental bioavailable fraction in the stomach are 45 % and gastric part 64 %. • Nineteen elements show gastric bioavailability values higher than 60 %. • Companies of sports supplementation products should provide reliable information. • Consumption of supplements should be prescribed and supervised by a professional. [ABSTRACT FROM AUTHOR]

Background and Objectives: (1) To identify patient reported outcome measures (PROMs) which have been used to screen and assess mental health symptoms in studies of youth with skin disease. (2) To critically appraise their evidence base in this population. Methods: A systematic literature search was conducted within PubMed and PsycINFO combining search terms for pediatric populations, dermatology, screening and assessment tools, and psychological and psychiatric conditions, to identify PROMs which screened or assessed for mental health symptoms in youth with skin disease. PROMs which had undergone validation within this population were assessed for quality and evidence base using the COSMIN risk of bias tool. Results: One hundred eleven PROMs which assess mental health symptoms in studies of youth with skin disease were identified. These included generic mental health scales which are extensively validated in different populations. Only one PROM, the "Skin Picking Scale—Revised" has undergone specific validation in youth with skin disease. This showed poor quality of evidence for content validity and therefore cannot be recommended. Conclusion: There is an urgent need to identify mental health problems early and treat proactively to improve outcomes in youth with skin disease. This review highlights the current lack of consensus around the best way to assess our patients. It is likely that existing generic mental health methods and PROMS will be appropriate for our needs. More work is required to examine the utility, feasibility, and acceptability of existing generic, validated mental health screening tools in youth with skin disease. [ABSTRACT FROM AUTHOR]

The lighting installations demand the biggest part of the energy consumed in road tunnels. This demand is much higher during daytime, when the visual adaptation of the drivers coming from bright environments, requests very intense illumination levels, especially in the first part of the tunnel, the so called threshold zone. The lighting necessities in road tunnels depend on three main critical parameters: maximum speed allowed in the tunnel, tunnel orientation and the characteristics of the portal gate surroundings. In this work, actions on this last parameter have been evaluated: four different species of climbing plants have been tested as candidates to forest the surroundings of portal gates in an environment of Mediterranean climate. The lighting demands in the threshold zone arising from the choice of each species have been quantified by luminance measurement. As a result, the common ivy ( Hedera helix ) is proposed as the best candidate to fully forest the surroundings of portal gates optimizing the binomial energy consumption-landscape integration in a Mediterranean climate. [ABSTRACT FROM AUTHOR]

In the past few years, microwave induced plasma optical emission spectrometry (MIP-OES) has generated great interest as an alternative technique to inductively coupled plasma-based techniques due to its lower operational cost. Since MIP-OES suffers from severe matrix effects due to easily ionizable elements (EIEs) (Na, Ca, etc.), it is unclear whether this technique could be employed for elemental bioavailability studies in soils and sediments since the main extractant solutions employed in such works may contain high levels of these elements. Thus, the aim of this work was to evaluate the feasibility of MIP-OES as a detector for such applications. To this end, the influence of different extractant solutions (0.25 mol L−1 MgCl 2 , 0.25 mol L−1 CaCl 2 , 0.10 mol L−1 acetic acid, 0.05 mol L−1 Na 2 EDTA, 0.25 mol L−1 NaNO 3 , 0.25 mol L−1 NaOAc/HOAc and 0.10 mol L−1 NH 2 OH·HCl) on the analyte emission of several elements (As, Cd, Co, Cr, Cu, Fe, Mg, Mn, Mo, Ni, Pb, Rh, Se, Sr and Zn) was investigated. Results were compared to those obtained using a reference solution made of 5% w w−1 HNO 3 solution. For saline extractant solutions, both the optimum nebulizer gas flow rate (Q g) and analyte emission were modified with regard to the reference solution. In general, the optimum Q g was reduced by between 0.1 and 0.2 L min−1 for both ionic and atomic lines. Under optimum Q g conditions, analyte emission was supressed by saline solutions except for atomic lines with an upper electronic state below 4 eV, which were enhanced. The magnitude of matrix effects was strongly dependent on EIE ionization energy. The lower the ionization energy, the greater the matrix effects were registered. No measurable matrix effects were registered on both Q g and analyte emission within experimental uncertainties for NH 2 OH·HCl and acetic acid extractant solutions. Experimental data suggest that matrix effects were related to changes in plasma characteristics and the analyte excitation/ionization mechanism. To mitigate matrix effects and improve long-term MIP-OES performance, internal standardization using either Rh (343.489 nm and 369.236 nm) or OH molecular emission band (308.958 nm) was required. This calibration methodology was successfully applied to the study of the elemental bioavailability in soil samples from a vineyard affected by copper-based fungicides and sediment samples from an area affected by mining waste. [Display omitted] • MIP-OES is suitable as a detector for elemental bioavailability studies. • Saline extraction solutions affect to Q g and the analyte emission signal. • Matrix effects depend on wavelength characteristics and the extractant solution. • Internal standard mitigates matrix effects and improve long-term MIP-OES performance. [ABSTRACT FROM AUTHOR]

Summary: Background: Bullous pemphigoid (BP) is an autoimmune blistering disorder that mainly affects older people. Although the disease is associated with considerable morbidity and mortality, the burden of disease worldwide is unclear. Objectives: The study aim is to pool the global incidence of BP and determine whether this varies according to geographic area, age group, setting and study quality. Methods: Ovid MEDLINE, Ovid Embase and grey literature were systematically searched on 7 April 2020. Two reviewers independently screened, extracted data and appraised each study's quality using the Joanna Briggs Institute critical appraisal tool. Two domains, indicative of selection and survey bias, were used to identify high‐quality studies. The cumulative incidence was standardized to 1 year and pooled in a random‐effects meta‐analysis. Subgroup and sensitivity analyses were conducted. Results: Twenty‐seven studies were identified, of which 23 provided cumulative incidence and four provided incidence rates. The cumulative incidence of BP was 8·2 [95% confidence interval (CI) 4·8–13.7] per million people whereas the incidence rate was 34·2 (95% CI 19·2–60·7) per million person‐years. Of the continents that contributed more than one study, the cumulative incidence was 10·3 (95% CI 5·8–18·2) and 5·6 (95% CI 3·5–9·0) per million people in Europe and Asia, respectively. The incidence was highest in studies including adults only (n = 2), in population‐based studies (n = 9) and in more recent years. The cumulative incidence was higher (13·3 per million people, 95% CI 6·0–29·5) when restricting the analysis to higher‐quality studies (n = 11). High heterogeneity (I2 > 82%) was observed across all pooled estimates. Conclusions: The incidence of BP varies globally, is generally low but appears to be increasing over time. The burden of disease is likely to be underestimated. Whatis already known about this topic?Bullous pemphigoid (BP) is a disease of older people.BP is associated with considerable mortality and comorbidity. Whatdoes this study add?The incidence of BP varies globally, is highest in North America and Europe, and appears to be increasing over time.The burden of disease is likely to be underestimated due to the considerable selection bias and incomplete capture of cases.Great attention needs to be paid to the design of future studies to ensure complete capture of cases within the population at risk. Linked Comment: V. Aoki and D. Miyamoto. Br J Dermatol 2022; 186:386–387. [ABSTRACT FROM AUTHOR]

We have assembled a tiled array (220 cm^2) of fine pixel (0.6 mm) imaging CZT detectors for a balloon borne wide-field hard X-ray telescope, ProtoEXIST2. ProtoEXIST2 is a prototype experiment for a next generation hard X-ray imager MIRAX-HXI on board Lattes, a spacecraft from the Agencia Espacial Brasilieira. MIRAX will survey the 5 to 200 keV sky of Galactic bulge, adjoining southern Galactic plane and the extragalactic sky with 6^\prime angular resolution. This survey will open a vast discovery space in timing studies of accretion neutron stars and black holes. The ProtoEXIST2 CZT detector plane consists of 64 of 5 mm thick 2 cm \times 2 cm CZT crystals tiled with a minimal gap. MIRAX will consist of 4 such detector planes, each of which will be imaged with its own coded-aperture mask. We present the packaging architecture and assembly procedure of the ProtoEXIST2 detector. On 2012, Oct 10, we conducted a successful high altitude balloon experiment of the ProtoEXIST1 and 2 telescopes, which demonstrates their technology readiness for space application. During the flight both telescopes performed as well as on the ground. We report the results of ground calibration and the initial results for the detector performance in the balloon flight. [ABSTRACT FROM PUBLISHER]

The article discusses the implications of switching to over-the-counter oral contraceptives for a progestin-only pill for maternity insurance and access to the drugs in the U.S. He is critical of the variety of the coverage and access to the over-the counter medications that are provided by government-sponsored programs. Also investigated is the possible impact of the health care reform Affordable Care Act (ACA) on access to the contraceptive methods.

The REgolith X-ray Imaging Spectrometer (REXIS) instrument on board NASA's OSIRIS-REx mission to the asteroid Bennu is a Class-D student collaboration experiment designed to detect fluoresced X-rays from the asteroid's surface to measure elemental abundances. In July and November 2019 REXIS collected ∼615 hours of integrated exposure time of Bennu's sun-illuminated surface from terminator orbits. As reported in Hoak et al. (Results from the REgolith X-ray Imaging Spectrometer (REXIS) at Bennu, 2021) the REXIS data do not contain a clear signal of X-ray fluorescence from the asteroid, in part due to the low incident solar X-ray flux during periods of observation. To support the evaluation of the upper limits on the detectable X-ray signal that may provide insights for the properties of Bennu's regolith, we present an overview of the REXIS instrument, its operation, and details of its in-flight calibration on astrophysical X-ray sources. This calibration includes the serendipitous detection of the transient X-ray binary MAXI J0637-430 during Bennu observations, demonstrating the operational success of REXIS at the asteroid. We convey some lessons learned for future X-ray spectroscopy imaging investigations of asteroid surfaces. [ABSTRACT FROM AUTHOR]

Objective: To assess whether evidence-based information on progestin-only pills (POPs) and over-the-counter (OTC) oral contraceptives (OCs) increases support among clinicians for bringing a POP or combined oral contraceptive (COC) OTC and to identify concerns clinicians may have about OTC access to OCs. Materials and Methods: In 2018 a survey of 778 clinicians assessed support for bringing a POP and COC OTC before and after receiving evidence-based information, which was pretested through in-depth interviews. Clinicians were randomized into two groups, stratified by clinician type. One group received information about OTC access to OCs generally, and the second group received OTC information plus information about POPs. Levels of support between arms were compared using robust Poisson models. Results: Before receiving information, 31% of clinicians supported moving a POP OTC. After receiving information, 39% of clinicians who only received OTC information supported moving a POP OTC compared to 61% who received OTC and POP information (relative risk = 1.53, 95% confidence interval: 1.34 to 1.75). Support for bringing a COC OTC increased marginally for those who received OTC and POP information, while support among those who received only OTC information increased by 12 percentage points (to 50%). Among clinicians opposed to moving a POP OTC after receiving information, top concerns included safety (26%), effectiveness (19%), potential for incorrect use (19%), and loss of preventive screenings (15%). Conclusion: Evidence-based information, particularly around POPs, has the potential to change clinician attitudes and address misconceptions about POPs and OTC access. [ABSTRACT FROM AUTHOR]

Background: Many research studies have been published on atopic eczema and these are often summarised in systematic reviews (SRs). Identifying SRs can be time-consuming for health professionals, and researchers. In order to facilitate the identification of important research, we have compiled an on-line resource that includes all relevant eczema reviews published since 2000. Methods: SRs were searched for in MEDLINE (Ovid), EMBASE (Ovid), PubMed, the Cochrane Database of Systematic Reviews, DARE and NHS Evidence. Selected SRs were assessed against the pre-defined eligibility criteria and relevant articles were grouped by treatment category for the included interventions. All identified systematic reviews are included in the Global Resource of EczemA Trials (GREAT) database (www.greatdatabase.org.uk) and key clinical messages are summarised here. Results: A total of 128 SRs reviews were identified, including three clinical guidelines. Of these, 46 (36%) were found in the Cochrane Library. No single database contained all of the SRs found. The number of SRs published per year has increased substantially over the last thirteen years, and reviews were published in a variety of clinical journals. Of the 128 SRs, 1 (1%) was on mechanism, 37 (29%) were on epidemiology, 40 (31%) were on eczema prevention, 29 (23%) were on topical treatments, 31 (24%) were on systemic treatments, and 24 (19%) were on other treatments. All SRs included searches of MEDLINE in their search methods. One hundred six SRs (83%) searched more than one electronic database. There were no language restrictions reported in the search methods of 52 of the SRs (41%). Conclusions: This mapping of atopic eczema reviews is a valuable resource. It will help healthcare practitioners, guideline writers, information specialists, and researchers to quickly identify relevant up-to-date evidence in the field for improving patient care. [ABSTRACT FROM AUTHOR]

Abstract: The public transport system of Santiago de Cali (Colombia) experienced several deficiencies in the last decade. Although it was used by about 70% of the population and included 30 private operators of collective transport, who offered services for 233 routes utilising a variety of different vehicles, regulation was limited and often did not cover routes, stops, and frequencies. In 2009, the “Masivo Integrado de Occidente” (MIO), a Bus Rapid Transit (BRT) system came into operation, as a cost-effective transport alternative for urban mobility. This article examines the relationship between social exclusion and transport in Santiago de Cali and demonstrates that there is still room for improvement in aspects of spatial coverage and for a greater focus on the factors which explain the social need for transport which are not usually considered within planning. To this end, the theoretical framework for accessibility, social exclusion and provision of public transport is set out and the subject area of study is described. Later in the article an index of social transport needs is drawn up and another index, demonstrating the provision of public transport is presented in such a way as to highlight the difference between the two, expressing the spatial gap between need and supply. The results indicate that the BRT system can improve its services by implementing specific measures which take into account the socio-economic factors that largely explain the social transport needs of Santiago de Cali. [Copyright &y& Elsevier]

We have discovered 10 periodic X-ray sources from the l Ms Chandra ACIS observation of the Limiting Window (LW), a low-extinction region (Av ~ 3.9) at 1°.4 south of the Galactic center. The observed periods (~1.3-3.4 hr) and the X-ray luminosities (1031.8-32.9 erg s-1 at 8 kpc) of the 10 periodic sources, combined with the lack of bright optical counterparts and thus high X-ray-to-optical flux ratios, suggest that they are likely accreting binaries, in particular, magnetic cataclysmic variables (MCVs). All of them exhibit a relatively hard X-ray spectrum (Γ < 2 for a power-law model), and relatively high extinction observed in the X-ray spectra of at least five sources indicates some intrinsic absorption in the system, which is also a typical sign of MCVs, On close inspection, the period distribution of these sources resembles those of polars, whereas the relatively hard spectra suggest that they could be intermediate polars (IPs). These puzzling properties can be explained by unusual polars with buried magnetic fields or a rare sub-class of MCVs, nearly synchronous MCVs. These unusual MCVs may provide important clues in the evolutionary path of MCVs from IPs to polars. The completeness simulation indicates that ≥40% of the hard X-ray sources in the LW are periodic. Therefore, this discovery provides a first direct evidence of a large MCV population in the bulge and further supports the current view that MCVs constitute the majority of low-luminosity hard X-ray sources (~ 1030-33 erg s-1) in the bulge. [ABSTRACT FROM AUTHOR]

Summary Background Knowledge of the prevalence and incidence of skin conditions is a prerequisite for designing clinical services and providing appropriate training for primary health care professionals. In the U.K. the general practitioner and practice nurse are the first point of medical contact for persons with skin conditions. Objectives We aimed to obtain contemporary data in age-, gender- and diagnosis-specific detail on persons presenting to primary care with skin problems. Comparisons were made with similar data for other major disease groups and with similar data from other recent years. Methods We used surveillance data collected in the Weekly Returns Service (WRS) of the Royal College of General Practitioners during 2006 and trend data for subsequent years. The WRS sentinel practices monitor all consultations by clinical diagnosis in a representative population of 950 000 in England and Wales. Results For conditions included in chapter XII of the International Classification of Diseases Ninth Revision (ICD9), 15% of the population consulted; a further 9% presented with skin problems classified elsewhere in the ICD9, making a total of 24%. There was no evidence of increasing or decreasing trend since 2006. Skin infections were the commonest diagnostic group, while 20% of children < 12 months were diagnosed with atopic eczema. Considered collectively, the incidence of new episodes of skin disorders (including diagnoses outside chapter XII) exceeded incidences for all other major disease groupings. Conclusions Compared with other major disease groups, skin conditions are the most frequent reason for consultation in general practice. This result emphasizes the need for appropriate education and training for all medical students and particularly for continuing education in dermatology for all primary health care professionals. [ABSTRACT FROM AUTHOR]

Abstract: We successfully carried out the first high-altitude balloon flight of a wide-field hard X-ray coded-aperture telescope ProtoEXIST1, which was launched from the Columbia Scientific Balloon Facility at Ft. Sumner, New Mexico on October 9, 2009. ProtoEXIST1 is the first implementation of an advanced CdZnTe (CZT) imaging detector in our ongoing program to establish the technology required for next generation wide-field hard X-ray telescopes such as the High Energy Telescope (HET) in the Energetic X-ray Imaging Survey Telescope (EXIST). The CZT detector plane in ProtoEXIST1 consists of an 8×8 array of closely tiled 2cm×2cm×0.5cm thick pixellated CZT crystals, each with 8×8 pixels, mounted on a set of readout electronics boards and covering a 256cm2 active area with 2.5mm pixels. A tungsten mask, mounted at 90cm above the detector provides shadowgrams of X-ray sources in the 30–600keV band for imaging, allowing a fully coded field of view of 9°×9° (and 19°×19° for 50% coding fraction) with an angular resolution of . In order to reduce the background radiation, the detector is surrounded by semi-graded (Pb/Sn/Cu) passive shields on the four sides all the way to the mask. On the back side, a 26cm×26cm×2cm CsI(Na) active shield provides signals to tag charged particle induced events as well as background photons from below. The flight duration was only about 7.5h due to strong winds (60 knots) at float altitude (38–39km). Throughout the flight, the CZT detector performed excellently. The telescope observed Cyg X-1, a bright black hole binary system, for at the end of the flight. Despite a few problems with the pointing and aspect systems that caused the telescope to track about 6.4° off the target, the analysis of the Cyg X-1 data revealed an X-ray source at in the 30–100keV energy band at the expected location from the optical images taken by the onboard daytime star camera. The success of this first flight is very encouraging for the future development of the advanced CZT imaging detectors (ProtoEXIST2, with 0.6mm pixels), which will take advantage of the modularization architecture employed in ProtoEXIST1. [Copyright &y& Elsevier]

This review summarizes the clinical importance of 18 systematic reviews and guidelines on psoriasis published or indexed between November 2008 and October 2009. The topics covered include guidance on the use of topical, systemic and biological therapies for the treatment of psoriasis; comorbidities associated with psoriasis; and complementary therapies for psoriasis. A similar and more detailed review to this appeared in the 2009 Annual Evidence Update on Psoriasis from NHS Evidence – Skin Disorders in November 2009. [ABSTRACT FROM AUTHOR]

Abstract: The Raf-1 protein kinase is a major activator of the ERK MAPK pathway, which links signaling by a variety of cell surface receptors to the regulation of cell proliferation, survival, differentiation and migration. Signaling by Raf-1 is regulated by a complex and poorly understood interplay between phosphorylation events and protein–protein interactions. One important mode of Raf-1 regulation involves the phosphorylation-dependent binding of 14-3-3 proteins. Here, we have examined the mechanism whereby the C-terminal 14-3-3 binding site of Raf-1, S621, controls the activation of MEK-ERK signaling. We show that phosphorylation of S621 turns over rapidly and is enriched in the activated pool of endogenous Raf-1. The phosphorylation on this site can be mediated by Raf-1 itself but also by other kinase(s). Mutations that prevent the binding of 14-3-3 proteins to S621 render Raf-1 inactive by specifically disrupting its capacity to bind to ATP, and not by gross conformational alteration as indicated by intact MEK binding. Phosphorylation of S621 correlates with the inhibition of Raf-1 catalytic activity in vitro, but 14-3-3 proteins can completely reverse this inhibition. Our findings suggest that 14-3-3 proteins function as critical cofactors in Raf-1 activation, which induce and maintain the protein in a state that is competent for both ATP binding and MEK phosphorylation. [Copyright &y& Elsevier]

This review summarizes the clinical importance of six systematic reviews on psoriasis published between January 2007 and October 2008. A meta-analysis demonstrated that several traditional nonbiological systemic therapies have equal or superior efficacy to some biological therapies used in the treatment of psoriasis. Two further meta-analyses comparing biological therapies for psoriasis (excluding adalimumab) have established a hierarchy of efficacy for short-term treatment (10–16 weeks): infliximab > etanercept 50 mg twice weekly > etanercept 25 mg twice weekly > efalizumab > alefacept. Excluding adalimumab, rates of adverse events are significantly higher for biological therapies than for placebo, except for etanercept at both 25 and 50 mg twice weekly. Further, head to head trials of biological therapies for psoriasis and longer-term safety data on their use are required. Psoriasis can be induced by and/or exacerbated during antitumour necrosis factor (TNF) therapy. It is recommended to initially switch anti-TNF agent in this situation and only discontinue therapy if psoriasis is extensive and/or intolerable, allowing the primary disease to remain under control. Most screening and monitoring tests carried out during treatment of psoriasis with biological therapies are neither supported nor refuted by current evidence and the clinician must assess each case individually. Studies designed specifically to assess appropriate use of these tests are required. Further research is needed to evaluate the effectiveness of existing psychological interventions in psoriasis. The effectiveness of support groups has not been adequately proven, although there are limited data supporting the use of cognitive behavioural therapy. [ABSTRACT FROM AUTHOR]

Abstract: We have constructed a moderately large area (), fine pixel (2.5mm pixel, 5mm thick) CZT imaging detector which constitutes the first section of a detector module () developed for a balloon-borne wide-field hard X-ray telescope, ProtoEXIST1. ProtoEXIST1 is a prototype for the High Energy Telescope (HET) in the Energetic X-ray imaging Survey Telescope (EXIST), a next generation space-borne multi-wavelength telescope. We have constructed a large (nearly gapless) detector plane through a modularization scheme by tiling of a large number of CZT crystals. Our innovative packaging method is ideal for many applications such as coded-aperture imaging, where a large, continuous detector plane is desirable for the optimal performance. Currently we have been able to achieve an energy resolution of 3.2keV (FWHM) at 59.6keV on average, which is exceptional considering the moderate pixel size and the number of detectors in simultaneous operation. We expect to complete two modules () within the next few months as more CZT becomes available. We plan to test the performance of these detectors in a near space environment in a series of high altitude balloon flights, the first of which is scheduled for Fall 2009. These detector modules are the first in a series of progressively more sophisticated detector units and packaging schemes planned for ProtoEXIST2 & 3, which will demonstrate the technology required for the advanced CZT imaging detectors (0.6mm pixel, area) required in EXIST/HET. [Copyright &y& Elsevier]

The Raf–MEK–ERK pathway couples growth factor, mitogenic and extracellular matrix signals to cell fate decisions such as growth, proliferation, migration, differentiation and survival. Raf-1 is a direct effector of the Ras GTPase and is the initiating kinase in this signalling cascade. Although Raf-1 activation is well studied, little is known about how Raf-1 is inactivated. Here, we used a proteomic approach to identify molecules that may inactivate Raf-1 signalling. Protein phosphatase 5 (PP5) was identified as an inactivator that associates with Raf-1 on growth factor stimulation and selectively dephosphorylates an essential activating site, Ser 338. The PP5-mediated dephosphorylation of Ser 338 inhibited Raf-1 activity and downstream signalling to MEK, an effect that was prevented by phosphomimetic substitution of Ser 338, or by ablation of PP5 catalytic function. Furthermore, depletion of endogenous PP5 increased cellular phospho-Ser 338 levels. Our results suggest that PP5 is a physiological regulator of Raf-1 signalling pathways. [ABSTRACT FROM AUTHOR]

Atopic eczema (herein referred to as 'eczema') is a skin disease characterized by remitting and relapsing symptoms. The Harmonising Outcome Measures for Eczema (HOME) initiative was developed to establish a core outcome set (COS) for eczema to be measured for all future eczema trials. The core outcome set for atopic eczema clinical trials includes the domain for patient‐reported eczema control, but a review of the validation of available eczema control instruments was lacking. We aimed to review the literature and systematically assess the measurement properties of validated patient‐reported outcome instruments that capture eczema control. PubMed and Ovid EMBASE were searched up to 24 January 2020 for any study that reported on PROM instrument development or validation. The COnsensus‐based Standards for the selection of health Measurement Instruments (COSMIN) criteria were used to assess the quality of eligible studies. We screened 12 036 titles and abstracts and 58 full texts. A total of 12 papers were included, reporting on seven PROMS. These were assessed with respect to development, reliability, construct validity and responsiveness. Two instruments, Recap of Atopic Eczema (RECAP) and the Atopic Dermatitis Control Tool (ADCT), have been developed and validated to a sufficient standard to support their recommendation as patient‐reported outcome instruments for measuring control of atopic eczema as part of the HOME Core Outcome Set. [ABSTRACT FROM AUTHOR]

Summary: Background: Clinical practice guidelines (CPGs) play a critical role in standardizing and improving treatment outcomes based on the available evidence. It is unclear how many CPGs are available globally to assist clinicians in the management of patients with skin disease. Objectives: To search for and identify CPGs for dermatological conditions with the highest burden globally. Methods: We adapted a list of 12 dermatological conditions with the highest burden from the Global Burden of Disease (GBD) study 2019. A systematic literature search was done to identify CPGs published between October 2014 to October 2019. The scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) framework. Results: A total of 226 CPGs were included. Melanoma had the greatest representation in the CPGs, followed by dermatitis and psoriasis. Skin cancers had a relatively high CPG representation but with lower GBD disease burden ranking. There was an uneven distribution by geographical region, with resource‐poor settings being under‐represented. The skin disease categories of the CPGs correlated weakly with the GBD disability‐adjusted life‐years metrics. Eighty‐nine CPGs did not have funding disclosures and 34 CPGs were behind a paywall. Conclusions: The global production of dermatology CPGs showed wide variation in geographical representation, article accessibility and reporting of funding. The number of skin disease CPGs were not commensurate with its disease burden. Future work will critically appraise the methodology and quality of dermatology CPGs and lead to the production of an accessible online resource summarizing these findings. What is already known about this topic? Skin‐related diseases are leading causes of disability and disease burden globally.Clinical practice guidelines (CPGs) are important to ensure appropriate standards of care for skin conditions.The number, distribution, accessibility and quality of dermatological CPGs available globally is unknown. What does this study add? This is the first scoping review to describe the distribution of CPGs for common dermatological conditions of highest burden available internationally.Inflammatory skin conditions and skin cancers represent a higher proportion of the number of CPGs produced, largely driven by high‐income countries.Further studies to evaluate the quality of CPGs in dermatology, and the development of CPGs in skin diseases predominantly affecting resource‐poor countries, are needed. Linked Comment: T.E. Sivesind and R.P. Dellavalle. Br J Dermatol 2021; 185:690–691. Plain language summary available online [ABSTRACT FROM AUTHOR]

We present the spectral analysis system for the second-generation energetic X-ray imaging telescope experiment (EXITE2) balloon payload. EXITE2 is an imaging hard X-ray telescope using a coded-aperture mask and a NaI/CsI phoswich detector operating in the energy range 20–600 keV. The instrument was flown on a high-altitude scientific balloon from Ft. Sumner, NM on 7–8 May, 1997. We describe the details of the EXITE2 spectral analysis system, with emphasis on those aspects peculiar to coded-aperture instruments. In particular, we have made our analysis compatible with the standard X-ray spectral fitting package xspec by generating a response matrix in the appropriate format including all the effects of a coded-aperture system. The use of xspec, which may be a first for coded-aperture data, permits great flexibility in the fitting of spectral models. The additional effects of our phoswich system, or any other detector-specific considerations, may be easily included as well. We test our spectral analysis using observations of the Crab Nebula, and find that the EXITE2 Crab spectrum is consistent with those recorded by previous instruments operating in this energy range. [Copyright &y& Elsevier]

Examines the cell regulation of the Bfa1p-Bup2p complex at spindle pole bodies (SPB). Activation of the protein kinase complex; Association of the mitotic exit network with SPB; Role of the cell cycle phosphatase Cdc14p in the protein complex.

Dear Editor, Bullous pemphigoid (BP) and pemphigus vulgaris (PV) are autoimmune blistering skin disorders that are increasing in incidence; they are associated with high mortality.1,2 As people with BP and PV often have comorbidities and require treatment that has severe side-effects, they can die of various causes.3-5 A systematic review on cause-specific mortality in BP and PV has not previously been conducted. Of the 28 studies, 14 were for BP (11 cohort studies; three RCTs), 13 for PV (11 cohort studies; two RCTs) and one study included both (cohort study). CI, confidence interval. gl Respiratory disease is the most common cause of death in patients with BP, while in PV cardiovascular disease is the most common. [Extracted from the article]

The article discusses the risk factor of skin cancer in people with the skin pigmentation disorder Vitiligo. It discusses the research studies also showing how genetic profiles of vitiligo patient can prevent nonmelanoma skin cancer (NMSC), study of case-control and cohort between people with vitiligo and without vitiligo.

Summary: There is variation in the treatment of lower limb cellulitis (LLC) with no agreement on the most effective antibiotic regimen. Many patients with cellulitis fail to respond to first‐line antibiotics. This can negatively affect patient care and result in unnecessary hospital admissions. The aim of this systematic review was to determine the clinical response and safety of antibiotic regimens for the management of LLC. A systematic review for randomized controlled trials (RCTs) was conducted using OVID MEDLINE, Ovid Embase and Cochrane Central Register of Controlled Trials in January 2019. Outcomes of interest included the clinical response to antibiotic regimens (type, dose, route, duration) and the safety of antibiotics in LLC. Trial quality was identified using the Cochrane Risk of Bias tool. Four RCTs were included. All included studies showed no significant differences between the clinical response to different antibiotic type, administration route, treatment duration or dose. LLC may be overtreated and shorter courses of oral antibiotics, possibly with lower doses, may be more suitable. There is a lack of published data on the clinical response and safety of antibiotics in LLC. Three studies were high risk for bias overall. Further high‐quality studies may help determine whether less intensive antibiotic regimens can effectively treat LLC. Click here for the corresponding questions to this CME article. [ABSTRACT FROM AUTHOR]

Summary: This review forms part of an annual update series on atopic eczema (AE), where systematic reviews (SRs) are gathered and appraised to provide a summary of key recent research findings. The focus of this article is systemic therapies used in AE, while a review on prevention and topical therapies is provided in Part 1. In total, 17 SRs on various systemic treatments used in AE were first published or indexed in 2018. There is a lack of evidence to support vitamin D supplementation, montelukast and naltrexone in AE treatment. The adverse effects of systemic corticosteroids are the main barrier to their use, and there is also a lack of data to determine the optimal delivery and duration of treatment with them. Of other immunosuppressants, ciclosporin has the most robust evidence of efficacy. Biologic therapies in AE treatment are being increasingly investigated, and to date, the greatest quantity of data and evidence of efficacy relates to dupilumab. The most commonly reported adverse effects are injection‐site reactions and conjunctivitis. Other biologics showing some evidence of efficacy include nemolizumab, lebrikizumab and tralokinumab, although further data are needed. There are currently insufficient data on oral small molecules, including Janus kinase inhibitors, in the treatment of AE. A Cochrane review on probiotics showed no significant benefit, and SRs and meta‐analyses on complementary and alternative medicines, including probiotics, in paediatric AE demonstrated significant heterogeneity, thereby limiting their interpretation. This summary of recent SRs provides up‐to‐date evidence for clinicians on systemic therapies in AE. Click here for the corresponding questions to this CME article. [ABSTRACT FROM AUTHOR]

Introduction: In the USA, the requirement that individuals obtain a prescription for hormonal contraception is a significant barrier for women who lack the time, finances, insurance coverage or means of transportation to visit a provider. The emergence of telemedicine services has removed some of these barriers by providing women with the opportunity to conveniently obtain birth control prescriptions through their computer or smartphone.Methods: In this article, we compare the prescribing processes and policies of online platforms that prescribe hormonal contraceptives to women in the USA, and use the recommendations of the 2016 US medical eligibility criteria for contraceptive use to evaluate whether online prescribers are providing evidence-based care.Results: As of February 2018, nine online platforms prescribed hormonal birth control to women across various states in the USA. These platforms varied in regard to their prescribing processes, range of methods offered, locations of operation, fees for services, and policies regarding age restrictions.Discussion: An assessment of each platform's online health questionnaire reveals that these telemedicine services are adequately screening for contraindications and safely providing birth control methods to patients, although efforts could be made to strengthen the rigour of online health questionnaires to ensure they adequately screen for all contraindications. [ABSTRACT FROM AUTHOR]

• PDX are useful for biological studies in cancer; engraftment may not be stochastic. • The overall engraftment rate of EGFR -PDX from lung adenocarcinoma is low. • Latency of EGFR-PDX generation render the models inadequate for avatar experiments. • Sample selection for EGFR -PDX experiments should target specific clinical scenarios. • Engraftment of metastases (100%) or after failure to EGFR-inhibitors (70%) is high. Patient-derived xenografts (PDX) are useful preclinical models to study cancer biology and mechanisms of drug response/resistance, particularly in molecularly targetable tumors. However, PDX engraftment may not be stochastic. We investigated clinical, histological and molecular features associated with PDX engraftment in a large cohort of EGFR -mutated lung adenocarcinoma (LUAD). Samples were collected by different methods from patients at various disease stages and phases of treatment. PDX engraftment was defined as an ability to passage tumors twice in NOD-SCID mice. Uni- and multivariate logistic regression evaluated factors associated with engraftment. Among 138 EGFR -mutated LUAD implanted into NOD-SCID mice, the overall engraftment rate was only 10% (14/138). However, engraftment was significantly higher in specimens from surgical resections or core-needle biopsies collected from metastatic sites (5/5; 100%) or from patients who had progressed on EGFR -inhibitors (7/10; 70%). Engrafted tumors usually showed poor histological differentiation, a solid morphologic pattern, and presence of either EGFR T790 M and/or TP53 mutations. Population level analyses of mutant EGFR -PDX show that these models might not fully recapitulate the inter-patient heterogeneity of EGFR -LUAD. However, mutant EGFR -PDXs may be useful to address key clinical questions, notably development of resistance to EGFR -inhibitors and disease progression to distant metastases. [ABSTRACT FROM AUTHOR]

U.S. servicewomen have high rates of unintended pregnancy, but federal policy prohibits abortion provision at military treatment facilities and military insurance coverage of abortion, except in cases of rape, incest, or a life-endangering pregnancy. Such restrictions pose challenges to abortion access for servicemembers, particularly during deployment. We aimed to explore the experiences of U.S. servicewomen when accessing abortion during overseas tours and deployment. We reviewed de-identified data from email inquiries and online consultation forms from U.S. servicewomen or military spouses seeking medication abortion from the telemedicine service Women on Web between January 2010 and December 2017. We used descriptive statistics and inductively coded textual responses to describe client characteristics, circumstances of pregnancy, reasons for abortion, and barriers to abortion care. Our sample included data for 323 individuals. Reasons for abortion related to military service included disruption of deployment, fear of military reprimand, and potential career impacts. Additionally, servicemembers faced barriers to abortion access related to overseas military deployment or tour, including a lack of legal abortion in-country, limited financial resources, language barriers, travel restrictions, and a lack of confidentiality. U.S. military servicewomen stationed in countries where safe, legal abortion is restricted or unavailable face deployment-related barriers to abortion care, which compound those barriers they may face regardless of deployment status. Removal of federal bans on the provision and coverage of abortion care and improved education about existing regulations could improve access to timely abortion care and in some cases allow servicewomen who wish to obtain abortion care to remain deployed. [ABSTRACT FROM AUTHOR]

To model the impacts of out-of-pocket cost of an over-the-counter (OTC) progestin-only pill on use and associated unintended pregnancy among U.S. women. Using data from a 2015 nationally representative survey of 2,539 U.S. women aged 15 to 44 assessing interest in using an OTC progestin-only pill, we used discrete survival analysis and a Markov model to analyze women's likelihood of using of an OTC pill at different price points and by sociodemographic characteristics. We modeled the impact of product price on the potential total number of U.S. users and on unintended pregnancies in 1 year among adult women at risk of unintended pregnancy. In a model assuming no out-of-pocket costs, more than 12.5 million adults and 1.75 million teens reported likely use of an OTC progestin-only pill if available. Among adults, this resulted in an estimated 8% decrease in unintended pregnancy in 1 year. Adult and teen women on average were willing to pay $15 and $10, respectively, resulting in 7.1 million adult and 1.3 million teen users and an estimated 5% decrease in unintended pregnancy among adults. At low and no out-of-pocket cost, a large population of women in the United States might likely use an OTC progestin-only pill. A low retail price and insurance coverage are necessary to provide equitable access to this method for low-income populations across the United States, fill current gaps in contraceptive access, and potentially decrease unintended pregnancy. [ABSTRACT FROM AUTHOR]

Summary: Background: Cellulitis can be a difficult diagnosis to make. Furthermore, 31% of patients admitted from the emergency department with suspected lower‐limb cellulitis have been misdiagnosed, with incorrect treatment potentially resulting in avoidable hospital admission and the prescription of unnecessary antibiotics. Objectives: We sought to identify diagnostic criteria or tools that have been developed for lower‐limb cellulitis. Methods: We conducted a systematic review using Ovid MEDLINE and Embase databases in May 2018, with the aim of describing diagnostic criteria and tools developed for lower‐limb cellulitis, and we assessed the quality of the studies identified using the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. We included all types of study that described diagnostic criteria or tools. Results: Eight observational studies were included. Five studies examined biochemical markers, two studies assessed imaging and one study developed a diagnostic decision model. All eight studies were considered to have a high risk for bias in at least one domain. The quantity and quality of available data was low and results could not be pooled owing to the heterogeneity of the findings. Conclusions: There is a lack of high‐quality publications describing criteria or tools for diagnosing lower‐limb cellulitis. Future studies using prospective designs, validated in both primary and secondary care settings, are needed. What's already known about this topic? Diagnosing lower‐limb cellulitis on first presentation is challenging.Approximately one in three patients admitted from the emergency department with suspected lower‐limb cellulitis do not have cellulitis and are given another diagnosis on discharge. Consequently, this results in potentially avoidable hospital admissions and the prescription of unnecessary antibiotics.There are no diagnostic criteria available for lower‐limb cellulitis in the U.K. What does this study add? This systematic review has identified a key research gap in the diagnosis of lower‐limb cellulitis.There is a current lack of robustly developed and validated diagnostic criteria or tools for use in clinical practice. Linked Comment: George. Br J Dermatol 2019; 181:1119. Plain language summary available online [ABSTRACT FROM AUTHOR]

We revisit the K  -band period–luminosity (P–L) relations of Galactic red supergiants using Gaia Data Release 2 parallaxes and up to 70 yr of photometry from AAVSO and ASAS campaigns. In addition, we examine 206 LMC red supergiants using 50 yr of photometric data from the digitized Harvard Astronomical Plate Collection. We identified periods by computing power spectra and calculated the period–luminosity relations of our samples and compared them with the literature. Newly available data tighten the P–L relations substantially. Identified periods form two groups: one with periods of 300–1000 d, corresponding to pulsations, and another with Long Secondary Periods between 1000 and 8000 d. Among the 48 Galactic objects we find shorter periods in 25 stars and long secondary periods in 23 stars. In the LMC sample we identify 85 and 94 red supergiants with shorter and long secondary periods, respectively. The P–L relation of the Galactic red supergiants is in agreement with the red supergiants in both, the Large Magellanic Cloud and the Andromeda galaxy. We find no clear continuity between the known red giant period–luminosity sequences, and the red supergiant sequences investigated here. [ABSTRACT FROM AUTHOR]

Introduction: Despite evidence that the unintended pregnancy rate is higher among U.S. servicewomen than the general population and that servicewomen may face barriers to contraceptive use, there is little research about contraceptive access and use experiences of non-deployed active duty servicewomen. This qualitative study aimed to explore the experiences of accessing contraception while in the U.S. military among active duty servicewomen who had an abortion.Materials and Methods: From January 2015 to July 2016, we conducted qualitative in-depth interviews with 21 servicewomen who had obtained an abortion within the prior two years while active duty. The interviews included questions about participants' experiences accessing and using contraception while in the military. Interviews were transcribed and analyzed thematically using inductive and deductive coding. Ethical approval was obtained from the Allendale Investigational Review Board.Results: Over half of the respondents had ever obtained contraception from the military and had positive feelings about the military's contraceptive services; however, the vast majority of participants described barriers to contraceptive access in the military. Many identified barriers that were related to the military health care system, including inadequate counseling, challenges getting a preferred contraceptive method, and the structure and functioning of the military health system, or were a result of the demands of military service. In addition to these factors that were directly related to being in the military, respondents identified barriers not directly related to service, including contraceptive adherence, product concerns, and side effects; although not directly related to their service, in some cases, these barriers were exacerbated by their career.Conclusions: Active duty servicewomen who had an abortion experienced many barriers to accessing contraception while in the military. These findings highlight the need to improve contraceptive counseling and access in the U.S. military. Results support the need to implement mandatory yearly and pre-deployment contraceptive counseling as required by the 2016 National Defense Authorization Act, offer contraceptive counseling in multiple settings, ensure military providers receive training to avoid contraceptive coercion, expand military clinic and pharmacy hours, increase the number of female military health care providers and providers able to administer all forms of contraception, and expand the contraceptive methods included under the Basic Core Formulary. Limitations to this study include that participants were self-selected and were asked to recall experiences up to several years in the past. Future studies should evaluate representative samples to understand the proportion of servicewomen with unmet contraceptive need. [ABSTRACT FROM AUTHOR]

Abstract Haptens (i.e. biomolecules which molecular weight is lower than 10 kDa) determination by inductively coupled plasma mass spectrometry (ICP-MS) is usually performed by means of competitive immunoassays. In these immunoassays, analyte quantification is indirectly carried out using two different tracer species (i.e. antibodies or antigen-protein conjugates). However, the benefits (and drawbacks) derived from using a given tracer species have not been systematically investigated so far. The goal of this work is to evaluate the influence of the tracer species employed in competitive immunoassays on the analytical figures of merit for aflatoxin M 1 (AFM 1) determination in milk samples. To this end, three different strategies have been developed and evaluated, namely: (i) antibody binding inhibition assay (ABIA); (ii) capture inhibition assay (CIA); and (iii) capture bridge inhibition assay (CBIA). Experimental results show that the use of the antibody as tracer species (as in the ABIA approach) affords better analytical figures of merit for AFM 1 determination than using the antigen-protein conjugate as the tracer one (as in the CIA and CBIA strategies). The limit of detection afforded by ABIA strategy (i.e. 0.1 ng kg−1) for AFM 1 determination was 1000-fold and 50-fold lower regarding the CIA and CBIA strategies, respectively. In the case of the ABIA approach, the characteristics of the metal nanoparticle label employed to detect the tracer species is critical on the analytical figures of merit. However, when the hapten-protein conjugates are used as tracer species, immunocomplex formation is severely hampered by steric effects caused by the protein moiety and, consequently, the characteristics of the metal nanoparticle label is not critical in the immunoassay performance. The different immunoassay strategies were successfully validated for AFM 1 determination in milk samples using a certified reference material of whole milk powder (ERM-BD283) according to European Conformity guidelines for analytical methods of food contaminants and mycotoxins. Compared to ELISA, the immunoassay developed for AFM 1 determination in milk samples improve limits of detection up to 10-fold. Graphical abstract Image 1 Highlights • Different competitive immunoassays for AFM1 determination by ICP-MS are developed. • Figures of merit depend on the immunoassay tracer species and the nanoparticle used. • Developed immunoassays allow monitoring AFM1 below the maximum levels set by EU. • Limits of detection for AFM1 in milk are improved 10-fold regarding ELISA. [ABSTRACT FROM AUTHOR]

Context. The 16 Myr old star 1SWASP J140747.93-394542.6 (V1400 Cen) underwent a series of complex eclipses in May 2007, interpreted as the transit of a giant Hill sphere filling debris ring system around a secondary companion, J1407b. No other eclipses have since been detected, although other measurements have constrained but not uniquely determined the orbital period of J1407b. Finding another eclipse towards J1407 will help determine the orbital period of the system, the geometry of the proposed ring system and enable planning of further observations to characterize the material within these putative rings. Aims. We carry out a search for other eclipses in photometric data of J1407 with the aim of constraining the orbital period of J1407b. Methods. We present photometry from archival photographic plates from the Harvard DASCH survey, and Bamberg and Sonneberg Observatories, in order to place additional constraints on the orbital period of J1407b by searching for other dimming and eclipse events. Using a visual inspection of all 387 plates and a period-folding algorithm we performed a search for other eclipses in these data sets. Results. We find no other deep eclipses in the data spanning from 1890 to 1990, nor in recent time-series photometry from 2012–2018. Conclusions. We rule out a large fraction of putative orbital periods for J1407b from 5 to 20 yr. These limits are still marginally consistent with a large Hill sphere filling ring system surrounding a brown dwarf companion in a bound elliptical orbit about J1407. Issues with the stability of any rings combined with the lack of detection of another eclipse, suggests that J1407b may not be bound to J1407. [ABSTRACT FROM AUTHOR]

Summary: This review forms part of a series of annual updates that summarize the evidence base for atopic eczema (AE), providing a succinct guide for clinicians and patients. It provides a summary of key findings from 26 systematic reviews that were published during 2015, and focuses on the treatment and prevention of AE. For systematic reviews on the epidemiology and methodological issues, see Part 1 of this update. Topical corticosteroid withdrawal syndrome, ‘steroid addiction’, has been evaluated in a high‐quality systematic review, which helps better define this entity and the risk factors for it. A Cochrane Review has not demonstrated any association between topical corticosteroid use in pregnancy and adverse outcomes, although very large quantities of potent/very potent topical corticosteroids may be associated with reduced birth weight. House dust mite avoidance strategies do not appear to prevent AE. Exposure to probiotics prenatally and in early infancy may help prevent AE, but there is no evidence that maternal diet or supplementation has a preventative effect. [ABSTRACT FROM AUTHOR]

Summary: This review forms part of a series of annual updates that summarize the evidence base for atopic eczema (AE), providing a succinct guide for clinicians and patients. It provides a summary of key findings from 15 systematic reviews that were published during 2015, and focuses on the epidemiology and methodology issues of AE. For systematic reviews on the prevention and treatment of AE, see Part 2 of this update. The worldwide prevalence of AE during childhood has been calculated to be 7.89% (95% CI 7.88–7.89), based on studies of 1 430 329 children from 102 countries. Children with AE are four times more likely than controls to have allergic rhinitis and asthma [relative risk (RR) = 4.24, 95% CI 3.75–4.79]. Twin studies show the heritability of AE to be about 75%. AE is more prevalent in patients with vitiligo and alopecia, and is positively associated with a high body mass index in America and Asia but not in Europe. Possible relationships between AE and exercise, maternal folate supplementation, maternal stress and autism spectrum disorder (ASD) have been assessed, but more high‐quality studies are needed for definitive conclusions. The Harmonising Outcomes Measures for Eczema (HOME) Initiative is developing a core set of outcome measures for AE trials. Suitable instruments for measuring quality of life are yet to be agreed, and use of Investigator Global Assessment in trials requires standardization. Transparent reporting of AE trials remains problematic. [ABSTRACT FROM AUTHOR]

Summary: Background: The diagnosis of psoriasis in adults and children is made clinically, for both patient management and the selection of participants in research. Diagnostic criteria provide a structure for clinical assessment, which in turn helps standardize patient recruitment into clinical trials and case definitions in observational studies. Objectives: The aim of this systematic review was to identify and critically appraise the published studies to date that had a primary research aim to develop or validate diagnostic criteria for psoriasis. Methods: A search of Ovid MEDLINE and Ovid Embase was conducted in October 2016. The primary objective was to record the sensitivity and specificity of diagnostic criteria for psoriasis. Secondary objectives included diagnostic recommendations, applicability to children and study characteristics. Diagnostic accuracy studies were critically appraised for risk of bias using the QUADAS‐2 tool. Results: Twenty‐three studies met the inclusion criteria. None detailed clinical examination‐based diagnostic criteria. The included criteria varied from genetic and molecular diagnostic models to skin imaging, histopathology, and questionnaire‐based, computer‐aided and traditional Chinese medicine criteria. High sensitivity and specificity (> 90%) were reported in many studies. However, the study authors often did not specify how the criteria would be used clinically or in research. This review identified studies with varying risk of bias, and due to each study developing separate criteria meta‐analysis was not possible. Conclusions: Clinical examination‐based diagnostic criteria are currently lacking for psoriasis. Future research could follow an international collaborative approach and employ study designs allowing high‐quality diagnostic accuracy testing. Existing and newly developed criteria require validation. [ABSTRACT FROM AUTHOR]