Human polyomaviruses (HPyVs) are small, nonenveloped, double‐stranded DNA viruses that express tumour antigen proteins. Fourteen species of polyomaviruses have been discovered in humans, and since the 2008 discovery of the first cutaneous polyomavirus – Merkel cell polyomavirus (MCPyV) – six more species have been detected in the skin: trichodysplasia spinulosa‐associated polyomavirus (TSPyV), HPyV6, HPyV7, HPyV9, HPyV10 and HPyV13. Of these cutaneous species, only MCPyV, TSPyV, HPyV6 and HPyV7 have been definitively associated with diseases of the skin, most commonly in immunocompromised individuals. MCPyV is a predominant aetiology in Merkel cell carcinomas. TSPyV is one of the aetiological factors of trichodysplasia spinulosa. HPyV6 and HPyV7 have been recently linked to pruritic skin eruptions. The roles of HPyV9, HPyV10 and HPyV13 in pathogenesis, if any, are still unknown, but their molecular features have provided some insight into their functional biology. In this review, we summarize the known molecular mechanisms, clinical presentation and targeted therapies of each of the eight cutaneous HPyVs. We hope that heightened awareness and clinical recognition of HPyVs will lead to increased reports of HPyV‐associated diseases and, consequently, a more robust understanding of how to diagnose and treat these conditions.
The increasing use of online resources in emergency medicine (EM) education has driven demand for higher quality resources. Learning experience design (LED) is the study of how electronic user interfaces impact learner outcomes. We sought to summarize the evidence for LED principles to inform creation of EM educational resources.We performed scripted searches of MeSH terms, PubMed keywords, and hand tracings. Inclusion criteria were controlled studies using light-emitting diode or liquid crystal display monitors with Latin-based languages. Cathode ray tube (CRT) monitors were excluded because of the user experience confounders.Thirty-two articles met inclusion criteria. Overall, 14-point size significantly improved legibility compared to smaller font sizes. Similarly, Verdana and Arial typefaces significantly improved legibility compared to Times New Roman typeface. Verdana also significantly decreased subjective mental workload and visibility difficulty ratings and required the least eye movement of any typefaces tested. Positive polarity (dark text on light background) significantly improved reading outcomes across many measurements over negative polarity. There was higher character identification accuracy with higher luminance. Text effects (e.g., italics), interword and interletter spacing, and page presentation are among variables with mixed or minimal evidence.Learning experience design principles significantly impacted reading and learning outcomes in laboratory settings. No studies evaluated classroom outcomes. Recommendations for electronic learning environments are 14-point font with Verdana or Arial typeface with positive polarity (dark letters on light background). We recommend increasing screen brightness slightly. EM educators may significantly improve the speed and accuracy of learning written material by espousing evidence-based LED principles.
