In addition to its well-documented value in improving the diagnosis of skin tumours, dermoscopy is continually gaining appreciation in the field of general dermatology. Dermoscopy has been shown to facilitate the clinical recognition of several inflammatory and infectious diseases, as well as their discrimination from skin tumours. Moreover, recent data indicate that it might also be profitable in assessing the outcome and adverse effects of various treatments. Application of dermoscopy should follow the standard procedure of acquiring information from patient history and clinically evaluating the number, location and morphology of the lesion(s). Four parameters should be assessed when applying dermoscopy in the realm of inflammatory and infectious diseases: (i) morphological vascular patterns; (ii) arrangement of vascular structures; (iii) colours; and (iv) follicular abnormalities, while the presence of other specific features (clues) should also be evaluated. It must be underlined that dermoscopic findings should always be interpreted within the overall clinical context of the patient, integrated with information from the history and the macroscopic examination. With new evidence continuously being gathered, the dermatoscope gradually acquires a role similar to the stethoscope of general practitioners, becoming an irreplaceable clinical tool for dermatologists. In this article, we provide a succinct summary of existing data on dermoscopy in general dermatology. Practical tips are suggested, which can assist clinicians in profitably utilizing and applying the available knowledge in their everyday practice.
The surge of research on marine litter is generating important information on its inputs, distribution and impacts, but data on the nature and origin of the litter remain scattered. Here, we harmonize worldwide litter-type inventories across seven major aquatic environments and find that a set of plastic items from take-out food and beverages largely dominates global litter, followed by those resulting from fishing activities. Compositional differences between environments point to a trend for litter to be trapped in nearshore areas so that land-sourced plastic is released to the open ocean, predominantly as small plastic fragments. The world differences in the composition of the nearshore litter sink reflected socioeconomic drivers, with a reduced relative weight of single-use items in high-income countries. Overall, this study helps inform urgently needed actions to manage the production, use and fate of the most polluting human-made items on our planet, but the challenge remains substantial.
We present here the first estimates of floating macro-litter in surface waters from the Rhone River, based on monthly visual observations during 1-year period (2016-2017). Plastic represented 77% of the identified items, confirming its predominance in riverine floating litter. Fragments (2.5-50 cm) and Single Use Plastics (i.e. bags, bottles and cover/packaging) were among the most abundant items. Frequent non-plastic floating litter were paper items such as packaging material and newspapers, and metal items (mostly cans), representing 14% and 5% of total litter, respectively. A lower-end estimate resulted in ∼223,000 plastic items (∼0.7 t of plastic) transported annually by the Rhone surface waters to the Gulf of Lion (NW Mediterranean Sea). Floating macroplastics are only a fraction of the total plastic export by the Rhone. Our study highlights the current discrepancy between field observations and theoretical estimations. Improvements are needed to harmonize data collection methodologies for field studies and model validation.
he input of solid waste from terrestrial sources to the world's oceans has become a major environmental threat, positioning marine litter and plastic pollution as priority issues in the international agenda [1][2][3][4] . If no effective measures are taken, the prospects for future growth in the production and use of plastics foresee an unsustainable increase in the amount of waste accumulated in terrestrial and aquatic ecosystems around the world 5-7 , with potential impacts on biodiversity and human health 8,9 . Jambeck et al. 10 provided a first approach to modelling mismanaged waste (MW), regarding items as waste if littered or inadequately disposed of on land. Considering the population within a 50-km distance buffer from the coast and assuming a range of conversion rates to marine debris of between 15 and 40% MW, the authors estimated a global annual input of 4.8-12.7 million tonnes (Mt) of plastic to the marine environment. This range of conversion rates of MW to marine debris (15-40%) was based on municipal water quality data gathered in the San Francisco Bay (California) watersheds. Field measurements of plastic input to the oceans are, however, essential for evaluating MW land-ocean transfer rates 6,11,12 , still leaving considerable room for improvement.Rivers act as conduits to the ocean, funnelling the waste dumped into the drainage basins and, as such, they contribute to better understanding the input of litter to the ocean from terrestrial sources. Lebreton et al. 11 and Schmidt et al. 12 estimated the export
A high percentage of the litter entering the marine environment is assumed to come from land-based sources, but freshwater litter inputs have not been quantified. The lack of data and knowledge on fluxes of riverine litter to the sea, i.e., quantities and sources, hinders implementation of appropriate environmental regulations and mitigation measures. Estimations of riverine litter inputs require a consistent and harmonized approach to gather comparable data. The visual observation of floating litter on rivers has been selected as a simple and robust methodology for litter monitoring. A collaborative network of 36 institutions has been set-up for large spatial coverage. Currently 58 rivers are being observed regularly. A tablet computer application has been developed for the monitoring of floating macro litter (>2.5 cm) to harmonize the visual observations. The application allows recording of the observed items, their size and geo-position data during monitoring sessions. A common agreed list of litter items and size ranges is used, providing a common harmonized approach for data collection and reporting.
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