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An overview of the latest metabolomics studies on atopic eczema with new directions for study
(2022)
As Neuroendocrine Tumors (NET) often present as metastatic lesions, immunohistochemical assignment to a site of origin is one of the most important tasks in their pathological assessment. Since a fraction of NETs eludes the typical expression profiles of their primary localization, additional sensitive and specific markers are required to improve diagnostic certainty.
We investigated the expression of the transcription factor Pituitary Homeobox 2 (PITX2) in a large-scale cohort of 909 NET and 248 Neuroendocrine Carcinomas (NEC) according to the Immunoreactive Score (IRS) and correlated PITX2 expression groups with general tumor groups and localization of the primary.
PITX2 expression (all expression groups) was highly sensitive (98.1%) for midgut-derived NET, but not perfectly specific, as non-midgut NET (especially pulmonary/duodenal) were quite frequently weak or moderately positive. The specificity rose to 99.5% for a midgut origin of NET if only a strong PITX2 expression was considered, which was found in only 0.5% (one pancreatic/one pulmonary) of non-midgut NET. In metastases of midgut-derived NET, PITX2 was expressed in all cases (87.5% strong, 12.5% moderate), while CDX2 was negative or only weakly expressed in 31.3% of the metastases. In NEC, a fraction of cases (14%) showed a weak or moderate PITX2 expression, which was not associated with a specific tumor localization.
Our study independently validates PITX2 as a very sensitive and specific immunohistochemical marker of midgut-derived NET in a very large collective of Neuroendocrine Neoplasms. Therefore, our data argue towards implementation into diagnostic panels applied for NET as a first line midgut marker.
Spreading devices used to create powder layers in the laser powder bed fusion of metals (PBF-LB/M) were found to have a significant impact on the additive manufacturing process. However, previous research primarily focused on theoretical investigations, including recoater concepts that are not available on the market, while no comprehensive comparison of commercially available spreading devices currently exists. The aim of this study is therefore to examine the powder bed properties and part qualities that can be achieved with the three most common types of recoater: carbon fiber brushes, polymer lips, and high speed steel (HSS) blades. Identical build jobs were produced using each of the spreading devices. Their capabilities were assessed by nine evaluation criteria, including dimensional, metallurgical, and mechanical properties and criticality of particles abraded from the spreading devices. Based on these quantitative findings, a spreading device selection guide was compiled for the benefit of PBF-LB/M practitioners. All recoaters yielded processes with high stability and part properties that were on a par with or even outperformed the nominal values from the literature. However, the HSS blade was found to provide higher accuracy and stability in steady-state processes. In turn, the brush and lip are better suited for parameter development and design studies. Additionally, the lip was found to have economic benefits over the brush, while the brush was deemed an effective all-rounder.
Additive Manufacturing (AM) offers great potential for producing complex parts. However, the economical fabrication depends among others on the part height. Hence, the combination of a conventionally manufactured base body and AM offers potential to reduce part costs. This combination is called Hybrid Additive Manufacturing (HAM) and requires additional clamping mechanisms and a positioning system in the laser powder bed fusion process. Concepts for both requirements will be investigated within this paper. In order to increase flexibility and automation a concept for an automated process chain will be developed. The requirements and properties of the process chain will be discussed.
This S3 guideline was created based on the European S3 guideline, with special consideration of the medical conditions in the German-speaking region and incorporating additions from the previous German-language version. The interdisciplinary guideline commission consisted of representatives from the German Dermatological Society, the Professional Association of German Dermatologists, the Austrian Society of Dermatology and Venereology, the Swiss Society of Dermatology and Venereology, the German Society for Allergology and Clinical Immunology, the German Society for Pediatric and Adolescent Medicine, the Professional Association of Pediatricians and Adolescent Medicine, the Society for Pediatric Allergology and Environmental Medicine, the German Society for Pediatric Rehabilitation and Prevention, the German Society for Psychosomatic Medicine and Medical Psychotherapy, the German Network for Health Services Research, the German Eczema Association and the German Allergy and Asthma Association.
This first part of the guideline focuses on the definition and diagnostic aspects of atopic dermatitis (AD), addressing topical therapy as well as non-pharmacological treatment approaches such as UV therapy, psychoeducational therapy, dietary interventions for AD, allergen immunotherapy for AD, and complementary medicine. This part of the guideline also covers specific aspects of AD in children and adolescents, during pregnancy and lactation, and in the context of family planning. Additionally, it addresses occupational aspects of AD and highlights the perspective of the patients. The second part of the guideline, published separately, addresses the systemic therapy of AD.
The present S3 guideline was created based on the European English-language S3 guideline, with special consideration given to the medical conditions in the German-speaking region, and with additions from the previous German-language version, in accordance with the criteria of the AWMF. This second part of the guideline addresses the systemic therapy of atopic dermatitis (AD). It covers topics such as the indication for systemic therapy in children, adolescents, and adult patients with AD. Furthermore, it addresses all medications approved for AD, such as the biologics dupilumab and tralokinumab, the Janus kinase inhibitors abrocitinib, baricitinib, and upadacitinib, as well as conventional immunosuppressive therapies with systemic glucocorticosteroids and ciclosporin. Additionally, it discusses systemic off-label therapies. The first part of the guideline, published separately, includes the definition and diagnostic aspects of AD, describes topical therapy, non-drug therapy approaches, and addresses aspects related to special patient groups.
