bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Interleukin-2/Interleukin-2 Receptor System in Advanced Non-Small-Cell Lung Cancer
Authors: De Vita Ferdinando , Turitto Giacinto , Di Grazia Maria , Frattolillo Adele , Catalano Giuseppe
Published: April 2018

Aims and background

The purpose of the study was to investigate the IL-2/IL-2 receptor system in patients with advanced non-small-cell lung cancer (NSCLC).

Patients and methods

Sera from 40 subjects and 80 patients with stage III and IV NSCLC were assayed for soluble interleukin-2 receptor (sIL-2R) and interleukin-2 (IL-2) by the enzyme-linked immunosorbent assay. Circulating CD25+ cells were analyzed by flow cytoflorimetry. The data were related to clinical status by comparing the levels of slL-2R and IL-2 at diagnosis and during the treatment.

Results

The mean slL-2R concentrations of the NSCLC patients were significantly higher than the control population (P=0.0001); the patients with metastatic disease had significantly higher levels than those with locally advanced disease (P=0.02). No correlation was seen between circulating CD25+ cells and slL-2R levels. Disease progression was associated with an increase in slL-2R levels and a decline in IL-2; the sIL-2R/IL-2 ratio showed a gradual increase with tumor progression.

Conclusions

Our study demonstrates in a large series of patients that in advanced NSCLC there is an imbalance of the IL-2/IL-2 receptor system. Furthermore, circulating slL-2R levels and the sIL-2R/IL-2 ratio may be useful as markers of disease activity and treatment response, suggesting a potential prognostic value.
Randomized Comparison of Goserelin Acetate versus Mitomycin C plus Goserelin Acetate in Previously Untreated Prostate Cancer Patients with Bone Metastases
Authors: Fontana Dario , Bertetto Oscar , Fasolis Giuseppe , Berruti Alfredo , Tarabuzzi Roberto , Pagani Giovanni , Buniva Tiziana , Zolfanelli Roberto , Pallotti Silvio , Frezzotti Letizia , Bumma Cesare , Rossetti Salvatore Rocca , Dogliotti Luigi ,   Gruppo Onco Urologico Piemontese (GOUP). Dipartimento di Scienze Cliniche e Biologiche, Università di Torino.
Published: April 2018

In a prospective trial conducted by the Gruppo Onco Urologico Piemontese, newly diagnosed prostate cancer patients with bone metastases were randomized to receive goserelin (3.6 mg subcutaneously every 4 weeks) or goserelin plus mitomycin at 14 mg/m2 i.v. every 6 weeks. Treatment was planned to be continued until progression. The study was interrupted because of inadequate accrual rate when 63 patients had been recruited. A long-term follow-up (median, 47 months), performed to counterbalance the limited number of patients included, revealed no difference in time to progression and overall survival between the study treatments. However, 56.5% of assessable patients allocated to the chemotherapy arm presented a ≥90% reduction of prostate-specific antigen levels compared with 36.3% in the goserelin group, and previously elevated levels normalized in 73.9% versus 45.4%. Non-progressing patients received 5-7 cycles of mitomycin C with acceptable toxicity, but the cytotoxic treatment was interrupted early in all cases within the first year due to cumulative myelotoxicity. In conclusion, the results, although inconclusive, fail to support a clear advantage in terms of cost/benefit of chemotherapy plus hormone therapy over hormone treatment alone in advanced prostate cancer with bone involvement.
Primary Plasmacytoma of the Testis. A Case Report
Authors: Ingletto Daniela , Compagnucci Mario , Grillo Lucia Rosalba , Montuoro Aldo
Published: April 2018

The authors describe a case of multiple myeloma that developed several extraskeletal localizations. They evaluated the relation between the onset of the testicular tumor and the following myeloma characteristics: tumor burden, clinical phase, response to therapy and prognostic significance.

The patient presented a rapid and dramatic clinical evolution of the disease with extensive spread also to the soft tissues of the abdominal wall. Chemotherapy did not achieve any effect and the patient died due to progression of the myeloma.
Bone Tissue in Adrenal Myelolipoma: A Case Report
Authors: Rossi Armando , Incensati Roberto
Published: April 2018

This paper describes a case of adrenal myelolipoma with an unusual characteristic: the presence of bone spicules. The lesion was associated with an accessory adrenal gland containing foci of myeloadiposis. The authors believe that myelolipoma and myeloadiposis are closely associated and are in fact the expression of a single process that is both focal (myeloadiposis) and diffuse (myelolipoma). The process consists of the differentiation of choristomatous primitive mesenchymal cells into hematopoietic tissue, adipose tissue and, in rare cases, bone tissue.
Review of Current Protocols for Protontherapy in USA
Authors: Krengli Marco , Liebsch Norbert J. , Hug Eugen B. , Orecchia Roberto
Published: April 2018

The basis for interest in proton beams by clinical radiation oncologists lies in reduction in treatment volume. The yields from employing a smaller treatment volume are the increase of tumor control probability and the reduction of normal tissues complication probability. The clinical use of proton therapy began in 1954 at Uppsala University in Sweden and in 1961 at Harvard Cyclotron Laboratory in Boston, USA. So far, the total number of worldwide patients treated by protons is about 20,000. In this paper attention will be given to the treatment of patients at the Massachusetts General Hospital-Massachusetts Eye and Ear Infirmary-Harvard Cyclotron Laboratory, and at the Loma Linda University Medical Center. In particular, a review of the literature about the techniques and the results of treatment of skull base and cervical spine chordoma and low-grade chondrosarcoma, skull base meningioma, pituitary tumors, paranasal sinus carcinoma, glioblastoma multiforme, artero-venous malformations, uveal melanoma, macular degeneration, retinoblastoma, thoracic spine-sacrum tumors, and prostate carcinoma is presented. In order to verify and improve the clinical results, the conduct of prospective trials on an inter-institutional basis is essential. To facilitate the conduct of such studies the US National Cancer Institute and the American College of Radiology have established the Proton Therapy Oncology Group (PROG). Several phase III and some phase I-II trials are active at the Massachusetts General Hospital, Harvard Cyclotron Laboratory, and at the Loma Linda University Medical Center.
Neoadjuvant Chemotherapy to Radiation and Concurrent Chemoradiation for Locally Advanced Squamous Cell Carcinoma of the Cervix: A Review of the Recent Literature
Authors: Colombo Alessandro , Landoni Fabio , Maneo Andrea , Zanetta Gerardo , Nava Simonetta , Tancini Gabriele
Published: April 2018

Radiotherapy is the standard treatment for locally advanced cervical cancer; nevertheless it fails to control disease progression within the irradiation fields in more than 40% of cases, particularly in patients with bulky tumor. Distant metastases are not infrequent in more advanced cases. Chemotherapy has been integrated with radiotherapy to improve local control and treat distant subclinical metastases. Schedules of combined treatment more frequently represented by neoadjuvant chemotherapy followed by radiation (NACT) and by concomitant chemotherapy and radiation (CT-RT). A review of the recent literature is presented. The role of NACT is controversial: high response rates are reported but doubtful advantages in terms of survival or local control have been shown. In randomized trials, hydroxyurea concomitant to radiation improves local control and survival, particularly in stage IIIB and IVA. Several randomized trials of concurrent chemoradiation with 5FU, cisplatin and mitomycin C are underway, but few have been published: no significative differences are reported in term of local control or survival. Acute toxicity is higher than in radiation alone, but usually manageable. For the analysis of late morbidity a longer follow-up is required. Large randomized trials of adequate radiotherapy versus concomitant chemoradiation are necessary to refine our understanding of the benefits of this integrated treatment.
Haemostatic Changes; Plasma Levels of Alpha2-Antiplasmin-Plasmin Complex and Thrombin-Antithrombin III Complex in Female Breast Cancer
Authors: Özyılkan Özgür , Baltalı Eşmen , Özdemir Oktay , Tekuzman Gülten , Kirazlı Şerafettin , Fırat Dinçer
Published: April 2018

Aims and background

Disorders of hemostasis in patients with malignancies are based on several mechanisms, such as ability of the tumor to alter the coagulation system by producing blood clotting factors or decreasing their inhibitors by increasing fibrinolysis, and by inducing an alteration of blood vessels in relation to the state of local invasion. We investigated the fibrinolytic system marker alpha2-antiplasmin-plasmin complex (APP) and clotting system marker thrombin-antithrombin III complex (TAT) in patients with breast cancer and compare them with CA 15-3, the most well-known breast cancer antigen.

Methods

Plasma levels of APP and TAT and serum level of CA 15-3 were determined in 57 patients with breast cancer (28 in remission and 29 with active breast cancer) and 13 healthy women.

Results

In patients with active breast cancer, plasma APP levels were significantly elevated compared to those of other groups (P<0.05). In addition, we observed a poor but positive correlation between plasma levels of APP and those of CA 15-3 (r=0.24; P=0.038). Plasma TAT levels, which reflect the activation of thrombin, were also significantly elevated in patients with active breast cancer (P<0.01), and there was a significant correlation between CA 15-3 and TAT (r=0.24; P=0.041).

Conclusions

We demonstrated that increased APP and TAT levels might reflect enhanced activation of coagulation and the fibrinolytic system in patients with active breast cancer.
A Pilot Clinical Trial of Postoperative Intensive Weekly Chemotherapy Using Cisplatin, Epi-Doxorubicin, 5-Fluorouracil, 6S-Leucovorin, Glutathione and Filgrastim in Patients with Resected Gastric Cancer
Authors: Graziano Francesco , Cardarelli Nadia , Marcellini Massimo , Menichetti Ettore Tito , Catalano Giuseppina , Cascinu Stefano
Published: April 2018

Aims and background

The study was performed to assess the feasibility and activity of an intensive chemotherapeutic regimen as adjuvant treatment for patients with resected gastric cancer at high risk of recurrence (PT2N1-2; pT3-4Nany M0).

Patients and methods

Starting 21 to 28 days after potentially curative surgery for primary gastric cancer, 25 patients received 8 weekly cycles of cisplatin 40 mg/m2, 5-fluorouracil 500 mg/m2, epidoxorubicin 35 mg/m2, 6S-stereoisomer of leucovorin at a dose of 250 mg/m2, and glutathione at a dose of 1.5 g/m2. From the day after to the day before each cycle of chemotherapy, filgrastim was administered by subcutaneous injection at a dose of 5 μg/kg.

Results

After a median follow-up of 33 months, 80% of the patients were alive and disease-free. Five patients had relapsed: three in the liver, one in the peritoneum and one in the lymph nodes. Toxicity was mild: five patients experienced WHO grade III toxicity (three leukopenia, two thrombocytopenia); no toxic deaths occurred.

Conclusion

Intensive weekly chemotherapy is a feasible postoperative treatment option for patients with resected gastric cancer at high risk of relapse. These data, together with recent results in advanced disease, make this approach of interest for the development of new programs of adjuvant therapy in this setting.
Adrenocortical Oncocytoma: Case Report and Review of the Literature
Authors: Macchi Carlo , Rebuffat Piera , Blandamura Stella , Piazza Mario , Macchi Veronica , Fiore Davide , Nussdorfer Gastone G.
Published: April 2018

Only 9 oncocytic neoplasms of true adrenal origin have been described to date. It therefore seemed of interest to study the histochemical and ultrastructural features of a non-functioning monolateral adrenocortical oncocytoma which was incidentally detected by ultrasonography and magnetic resonance imaging in a 28-year-old woman. The tumor was round, well encapsulated and weighed 73 g. It consisted of islets of eosinophilic cells, and did not display any sign of necrosis. The proliferation rate (as evaluated by mitotic index and percentage of MIB-1 Ki67 positive cells) was low, and atypic mitoses were absent; some rare cells with nuclear atypias were observed and the capsule was focally invaded by oncocytes. Immunocytochemistry did not show expression of vimentin or cytokeratin. The oncocytes had an abundant cytoplasm packed with mitochondria containing plate-like cristae. Smooth endoplasmic reticulum was virtually absent, while rough endoplasmic reticulum cisternae and free ribosomes were abundant. Although the classic histological approach clearly indicates the benign nature of the tumor, the immunocytochemical and ultrastructural features of oncocytes may suggest their potential for malignant behavior.
LA TRASFUSIONE DI SANGUE NELLA CHIRURGIA ONCOLOGICA: RUOLO DELLA ERITROPOIETINA RICOMBINANTE UMANA (rHuEPO)
Authors: Mercuriali Francesco , Inghilleri Giovanni
Published: April 2018

Anemia is common in cancer patients. The pathophysiology is multifactorial, however the most common cause is the anemia of chronic diseases (ACD). In 20-50% of cancer patients, anemia restricts physical activity and quality of life and requires transfusion support. The percentage of patients necessitating transfusion dramatically increases when patients require surgery.

The traditional belief that blood transfusion is an effective and safe therapy has been challenged by a heightened awareness of the infectious and immunologic risks associated with allogeneic blood administration. In cancer patients transfusion-induced immunomodulation may have the potential to significantly increase postoperative infections and cancer recurrence so that it seems reasonable to minimize allogeneic blood exposure.

Several strategies have been adopted to reduce allogeneic transfusion in surgical patients, however to properly select the appropriate blood conservation strategies the blood transfusion requirements for each patient should be defined.

Allogeneic blood transfusion in surgery can be reduced by the introduction of autologous blood (AB) programmes and by the use of rHuEPO, alone or in association with AB techniques. AB donation is currently a standard of care for elective surgical patients but its efficacy is limited by anemia that prevents the donation of the optimal number of AB units. rHuEPO has been shown to significantly increase the volume of AB that anemic patients can predeposit or, used perisurgically, to expand the circulating RBCs mass before surgery. Moreover clinical trials employed rHuEPO in anemic cancer patients with various solid tumors both on and off chemotherapy reporting a significantly increase in Hct in more than 50% of the treated patients. Recently different studies have shown the efficacy of rHuEPO in increasing the volume of AB also in patients with ACD and cancer, thus proving to be a useful addition to existing strategies of blood conservation to minimize exposure to allogeneic blood in surgical cancer patients.
LE TERAPIE DI SUBPPORTO IN ONCOLOGIA
Authors: Olmi Patrizia , Fallai Carlo , Ausili-Cefaro Giampiero , Marmiroli Luca
Published: April 2018

It is extremely important to deliver treatments, both in medical oncology and in radiation oncology, in compliance with the due dose intensity, in order to achieve the best results in terms of clinical response and local control and, often, also in terms of survival. Supportive care is one of the tools for the achievement of this goal, permitting the delivery of aggressive therapies and the improvement of Quality of Life.

It is the aim of the Tsonc study to evaluate what the main therapeutic trend is, on the ground of a survey performed in 105 medical oncology, radiation oncology, and haematology centres. For this assessment the WHO/INH and RTOG common toxicity criteria were adopted, even knowing that these score systems had been developed for reporting acute/subacute toxicity and not to choose the therapeutic approach. However, these scales give us the possibility to refer to highly validated systems and provide participants with a common language.

Thirty-two items of toxicity were listed, and each item included 2 to 4 degrees of severity so to report supportive care accordingly. The present paper reports the criteria of choice of the scales and symptoms and the schedule of the queries.
Different Expressivity of two Adjacent Mutations of the APC Gene
Authors: Presciuttini Silvano , Gismondi Viviana , Scarcello Edoardo , Sala Paola , D'Elia Francesco , Rossetti Carlo , Caroti-Ghelli Cristina , Molina Francesco , Groden Joanna , Mosca Franco , Bertario Lucio , Varesco Liliana
Published: April 2018

Aims and background

The phenotypic expression of different APC mutations in familial adenomatous polyposis (FAP) is variable: two to three variants of the disease have been defined based on the severity of colonic manifestations. Age of onset and number of polypectomies per person-year of postsurgical follow-up were compared in two FAP families with very close mutation sites in the APC gene, in order to ascertain mutation-specific variation of expressivity.

Families and APC mutations

Family A (5 patients) carried a newly characterized mutation, a four bp deletion at codon 843. Family B (5 patients) carried a previously identified mutation at codon 835.

Results

Mean age of onset was 49.7 years in family A and 30.5 years in family B; number of polypectomies per person-year of follow-up was 1.05 for family A and 10.1 for family B (P <0.001).

Conclusions

There is significant variation of expressivity (allelic heterogeneity) in FAP between two mutations separated by only eight codons, located at the 5’ extremity of APC gene exon 15.
Pharmacokinetics of Oral Doxifluridine in Patients with Colorectal Cancer
Authors: Zampino Maria Giulia , Colleoni Marco , Bajetta Emilio , Stampino Corrado Gallo , Guenzi Alberto , de Braud Filippo
Published: April 2018

Aims and background

Doxifluridine is a new fluoropyrimidine that has excellent absorption by the gastrointestinal tract when given orally. The aim of the study was to determine the disposition of doxifluridine and fluorouracil when the former is given orally for 5 days and to assess whether their pharmacokinetics are influenced by demographic or biologic parameters.

Methods and study design

Twenty colorectal cancer patients received levo-leucovorin, 25 mg orally on days 1–5, followed 2 hrs later by doxifluridine, 1200 mg/m2; the cycle was repeated every 10 days. Doxifluridine and fluorouracil levels were measured by reverse-phase high-performance liquid chromatography during the first cycle of therapy. The lowest dose given over the first 24 hrs was 1750 mg and the highest was 2500 mg.

Results

The distribution of doxifluridine parameters remained the same between days 1 and 5, with an AUC that ranged between 72.2 and 74.5 mmol h/l and a C max that remained in a narrow band of 67.1 to 68.3 mmol/l. In contrast, the variability of fluorouracil parameters increased from day 1 to day 5, with an AUC of respectively 5.46 and 7.52 mmol h/l and a C max that increased from 5.81 on day 1 to 7.34 mmol/l on day 5. A significant correlation between the AUC of doxifluridine and fluorouracil was found on day 1 and on day 5 (P <0.001). None of the demographic or biologic parameters considered was significantly related to pharmacokinetic parameters. Fluorouracil levels remained low in comparison with levels measured after classical fluorouracil therapy, although detectable for a longer time.

Conclusions

A large interpatient pharmacokinetic variability was observed without any significant correlation with the clinical parameters studied.
Chemo-Immunotherapy of Advanced Aids-Related Kaposi'S Sarcoma
Authors: Aversa Savina Maria Luciana , Cattelan Anna Maria , Salvagno Luigi , Meneghetti Francesco , Francavilla Ermenegildo , Sattin Andrea , Sasset Lolita , Cadrobbi Paolo
Published: April 2018

Aims and background

Kaposi's sarcoma (KS) is the most common neoplastic complication of HIV infection and AIDS. Multiple cytotoxic chemotherapy regimens have been used with various response rates. We have evaluated the efficacy and toxicity of low-dose chemotherapy in patients with poor-prognosis AIDS-related KS and the role of interferon alpha (IFN-α) in complete responders.

Methods

Twenty-five previously untreated patients with advanced KS received bleomycin (BL) 10 mg/m2 and vinblastine (VB) 6 mg/m2 on days 1 and 15 every two weeks. After six cycles, patients in complete remission received IFN-alpha (3 million U s.c. 3 times/week) combined with antiretroviral therapy. All patients were evaluated for toxicity using the World Health Organization (WHO) toxicity schedule. Both Eastern Cooperative Oncology Group (ECOG) and AIDS Clinical Trials Group (ACTG) response criteria were used to evaluate response and survival.

Results

The overall response rate was 84% (95% confidence interval, 51–117%) with six complete remissions (24%) and 15 partial remissions (60%) by ECOG criteria, and 92% (95% confidence interval: 58–128%) with 17 partial remissions (68%) by ACTG criteria. The median duration of response on IFN-alpha treatment was 4.5 months (range, 2–10). The overall median survival duration for all 25 patients was 9 months (range, 2–39). Grade 3–4 anemia was observed in five patients and grade 3–4 neutropenia in two patients. No other clinically significant (> grade 3) toxicities were observed.

Conclusions

Combination of BL and VB is effective and well tolerated, even if new therapeutic options are developing. This disease remains a challenging problem, so larger studies using the combination of chemotherapy and/or IFN-alpha with antiretroviral treatment are warranted.
Surgical Resection of a Cerebral Metastasis from Cervical Cancer: Case Report and Review of the Literature
Authors: Cormio Gennaro , Colamaria Antonio , Loverro Giuseppe , Pierangeli Enrico , Di Vagno Giovanni , De Tommasi Antonio , Selvaggi Luigi
Published: April 2018

Aims and background

Central nervous system metastasis from cervical carcinoma is uncommon.

Case report

We report the case of a 51-year-old woman who developed a solitary cerebral metastasis 29 months after radical hysterectomy with pelvic lymphadenectomy for a stage IB, grade III cervical cancer. The patient suddenly complained of headache, confusion and dizziness; she was submitted to emergency surgical resection of a 2×3 cm metastasis in the right frontal lobe. The postoperative course was uneventful and she completely recovered from her neurological deficit. Following surgery the patient underwent careful restaging. Massive bilateral involvement of the pelvic wall was diagnosed, and the patient received three courses of cisplatin-based chemotherapy. She developed liver and lung metastases and died 10 months later of progressive disseminated disease, without, however, any sign of recurrent or persistent cerebral involvement.

Conclusion

Neurosurgical resection should be considered in cervical cancer patients with solitary brain metastasis in the absence of systemic disease.
Cd30-Positive Cutaneous Anaplastic Large Cell Lymphoma with Ichthyosis Acquisita
Authors: Zamolo Gordana , Gruber Francesco , Bosner Alan , Čabrijan Leo , Petković Marija , Jonjić Nives
Published: April 2018

Anaplastic large cell lymphoma (ALCL) is a high-grade non-Hodgkin's lymphoma recognized by the expression of the CD30 marker and by its morphology. We report an unusual case of ALCL in a 42-year-old woman. For ten years the patient only had pruritic erythematous skin lesions, then a plaque with nodules and ulcers on the right thigh and leg developed, followed by ichthyosis acquisita. The development of ALCL in women and the association of ichthyosis acquisita with this type of lymphoma are uncommon.
SÉCuRE: A clinical tool for comprehensively assessing home safety of people with mental illness
Authors: Désormeaux-Moreau Marjorie , Aubin Ginette , Larivière Nadine
Published: April 2018

Introduction

People with severe mental illness benefit from a growing number of measures aimed at supporting independent housing. The purpose of the study was to develop a comprehensive home safety assessment tool.

Method

The tool's elaboration was done in three phases. The planning phase was intended to circumscribe the phenomenon, providing input for the development phase, which consisted of creating and enhancing the tool's prototypes. The evaluation phase then featured the tool's translation validity (relevance, exhaustiveness, clarity, and apparent clinical utility), with four successive rounds of expert consultation ( n = 20). Changes were made to the tool according to the experts' suggestions.

Findings

The proposed tool, SÉCuRE, adopts a structured professional judgment approach that is designed to be used collaboratively and interprofessionally, with a specific role for occupational therapists. It aims to systematize the assessment of contributive factors (risk and protective), all stakeholders' expectations and needs and the identification of potential ethical issues. The findings supported the translation validity and acceptance of the tool by clinicians.

Conclusion

SÉCuRE was developed to assist with clinical judgment regarding home safety interventions. It is hoped that its use may ultimately foster home safety in the context of recovery.
Subclinical hypothyroidism is associated with migraine: A case-control study
Authors: Rubino Elisa , Rainero Innocenzo , Garino Francesca , Vicentini Costanza , Govone Flora , Vacca Alessandro , Gai Annalisa , Gentile Salvatore , Govone Guido , Ragazzoni Federico , Pinessi Lorenzo , Giordana Maria Teresa , Limone Paolo
Published: April 2018

Background

Recent studies suggested a potential association between both overt and subclinical hypothyroidism and migraine. Aims of this study were to estimate the comorbidity of migraine in patients with subclinical hypothyroidism and to evaluate associated clinical characteristics.

Methods

Using a case-control strategy, 151 consecutive subclinical hypothyroidism patients (mean age 48.36 ± 15.86 years) and 150 controls (mean age 50.86 ± 9.19 years) were recruited. In all subjects, migraine characteristics were collected through a direct interview. Clinical and biochemical parameters (thyroid-stimulating hormone, free triiodothyronine, free thyroxine, and anti-thyroid antibodies) were compared between subclinical hypothyroidism patients in comorbidity with migraine and subclinical hypothyroidism patients without migraine.

Results

The prevalence of lifetime migraine was significantly higher in subclinical hypothyroidism patients in comparison with controls (46% vs. 13%, p < 0.001; OR 5.80; 95% CI = 3.35–10.34). Both migraine without and with aura were significantly higher in subclinical hypothyroidism patients than controls ( p < 0.001 and p = 0.010, respectively). Thyroid hormones and concentrations of antibodies did not differ between subclinical hypothyroidism patients with and without migraine. Interestingly, a comorbidity for autoimmune diseases was observed in subclinical hypothyroidism patients with migraine in respect to those without migraine ( p = 0.005).

Conclusions

Our data suggest that migraine is more frequent in patients with subclinical hypothyroidism in respect to controls. Further studies are needed in order to confirm this association.
Development of a Structural Capacity Prediction Model Based on Traffic Speed Deflectometer Measurements
Authors: Uddin Ahmed Zihan Zia , Elseifi Mostafa A. , Gaspard Kevin , Zhang Zhongjie
Published: April 2018

The importance of incorporating pavement structural conditions in the selection of maintenance and rehabilitation strategies along with functional indices has been recognized by state agencies. To measure in-service pavement structural capacity, surface deflection under a defined load has been typically used. The traffic speed deflectometer (TSD) has emerged as a continuous deflection-measuring device as it operates at traffic speed and reduces lane closure and user delays. The present study developed a nonlinear regression model to predict pavement structural number (SN) based on surface deflections measured by the TSD along with the total pavement layer thickness and traffic volume. The proposed model was successfully developed and validated with SN calculated based on TSD and falling weight deflectometer deflection data obtained from two testing programs in Louisiana and Idaho. The model was further validated with respect to its prediction of in-service structural capacity loss and deficiency. Based on statistical measures and the model’s ability in identifying structurally deficient sections, results showed satisfactory accuracy of the model and supports its use for network-level decision-making processes in the pavement management system.
Strategic identity
Authors: Alejo Albert E.
Published: April 2018

This article introduces the concept of ‘strategic identity’ as a bridge between the indigenous peoples’ struggle for self-determination and their search for solidarity in the context of globalization, with a focus on the Lumads, or indigenous peoples in southern Philippines. The paper begins with an encounter with a global actor affecting a local community. We realize the impact of powerful, well-networked forces that challenge even the operation of the state. Without trivializing the threats associated with this model of globalization, we also insist that a realistic and hopeful approach may emerge if we acknowledge the many ‘selves’ in the indigenous peoples’ self-determination. At the heart of this proposal is a matrix that unpacks the complex ways that local, national, sectoral, and global actors can engage in conflict or solidarity with these strategic identity assertions. Solidarity work, then, becomes diversified and strategized in response to the evolving multiple indigenous identities that modernity paradoxically both endangers and engenders.
Living with the problem of national parks
Authors: Perez Padmapani L. ,   with BUKLURAN-The Philippine ICCA Consortium
Published: April 2018

‘You mean to say we’re not the only people in the world with the problem of a national park?’ This question was raised during a focus group discussion held with an indigenous community whose ancestral domain overlaps entirely with a national park in the Philippine Cordillera. The question encapsulates an experience shared across the Philippines, particularly in spaces where both the Indigenous Peoples’ Rights Act and the National Integrated Protected Areas System are implemented. This paper examines recent developments in indigenous leaders’ participation in, and critique of, the implementation of these two laws and the development of environmental policies. It follows an emerging, multi-sectoral movement calling for the recognition of Indigenous Communities Conserved Areas and Territories (ICCAs), which has led to the crafting of a draft law. The ICCA bill is envisioned as a law that will resolve indigenous peoples’ problems with national parks, while meeting biodiversity conservation targets. The authors direct attention to how indigenous leaders campaigning for the ICCA bill are asserting their right to delineate space and make decisions in the contexts of policy-making and implementation. It is argued here that their articulations are registers of indigenous critique. Taking these critiques seriously has the potential to drive conservation policy-making past the stewardship stalemate, where conservation goals are pursued at the cost of indigenous peoples’ right to self-determination and indigenous peoples are expected to perform harmony with nature.
Re-visioning obscure spaces
Authors: Canuday Jose Jowel
Published: April 2018

In popular imagery, the littorals of Sulu and Zamboanga conjure visions of pirates, terrorists, and bandits marauding its rough seas, open shores, and rugged mountains. These bleak accounts render the region nothing but a violent and peripheral southern Philippine backdoor inconspicuous to the sophisticated constituencies of the world’s metropolitan centres. Obscured from these imageries are the lasting cosmopolitan traits of openness, flexibility, and reception of local folk to trans-local cultural streams that marked Sulu and Zamboanga as a globalised space across the ages and oceans. The distinctive features of these cosmopolitan sensibilities are strikingly discernible in inter-generationally shared narratives, artefacts, and performances that were continually renewed from the days when Sulu and Zamboanga served as a borderless trading and cultural enclave nestled at the crossroads of the Pacific and the Indian Oceans. These enduring cosmopolitan sensibilities are embodied in the blending, among others, of the time-honoured dance of pangalay and the pop-musical dance genre celebrated on actual, analogue, and digitally-mediated spaces of the contemporary world. Furthermore, these embodied sensibilities are evident in song compositions that proclaim the humanistic themes of hope, peace, and prosperity to their place and the world in ways that exemplify the local people’s broader sense of connections beyond the narrow association of family, community, ethnicity, religion, and identity. This mixed bag of age-old and recent imaginaries and cultural traffic evoke a sociality that link the social spaces of the troubled but once and current globalised region to continuing acts of transcendence in history, memory, and visions of the future. In these marginalized places, we can see an unyielding tradition of cultural re-adaptation and creativity made up of myriad everyday acts that are down-to-earth, pragmatic, interstitial, and practical cosmopolitanism.
Home ground advantage: artwork as auto-biographical stories of multiple indigenous selves in colonised spaces and histories
Authors: Rhall Steven
Published: April 2018

This essay details the manifestation of the artwork Home Ground, including its subsequent iterations, to explore how an artwork might function as both an expression and extension of narratives associated with its author, Steven Rhall. This exploration begins with a consideration of the ways in which various contextual frameworks inform ‘subjective decisions’, for example, coloniality, and process-led making. I identify as a Taungurung man (First Nations Australian) but I live in a colonised society, experiencing cultures tied to each positionality in the contradictory, complex overlapping contexts of everyday life. The essay takes interest in how these frameworks also shift as the iterative work unfolds in new temporal and geographical locations, ultimately emphasising the interrelationship between author, narrative, and wider contextual frameworks. The essay then moves to consider how the narratives spurred in the art-making process continue to evolve in the author’s absence and in relationship to subsequent audiences. The essay posits itself as a metanarrative in that it acts as an extension of the artwork it is discussing. As such, the essay employs the same photographic images that form the material nexus of Home Ground (as originally exhibited), thereby further extending the narratives contained in them via the medium of this written text itself.
High-Frequency Percussive Ventilation Rescue Therapy in Morbidly Obese Patients Failing Conventional Mechanical Ventilation
Authors: Korzhuk Anatoliy , Afzal Ashwad , Wong Ivan , Khusid Felix , Worku Berhane , Gulkarov Iosif
Published: April 2018

Background:

Morbidly obese patients with respiratory failure who do not improve on conventional mechanical ventilation (CMV) often undergo rescue therapy with extracorporeal membrane oxygenation (ECMO). We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue modality.

Methods:

In a retrospective analysis from 2009 to 2016, 12 morbidly obese patients underwent HFPV after failing to wean from CMV. Data were collected regarding demographics, cause of respiratory failure, ventilation settings, and hospital course outcomes. Our end point data were pre- and post-HFPV partial pressure of arterial oxygen and PaO2 to fraction of inspired oxygen (PF) ratios measured at initiation, 2, and 24 hours.

Results:

Twelve morbidly obese patients required HFPV for respiratory failure. Causes of respiratory failure overlapped and included cardiogenic pulmonary edema (n = 8), pneumonia (n = 5), septic shock (n = 5), and asthma (n = 1). After HFPV initiation, mean fraction of inspired oxygen FiO2 was tapered from 98% to 82% and 66% at 2 and 24 hours, respectively. Mean PaO2 increased from 60.9 mm Hg before HFPV to 175.1 mm Hg ( P < .05) at initiation of HFPV, then sustained at 129.5 mm Hg ( P < .05) and 88.1 mm Hg ( P < .005) at 2 and 24 hours, respectively. Mean PF ratio improved from 66.1 before HFPV to 180.3 ( P < .05), 181.0 ( P < .05) and 148.9 ( P < .0005) at initiation, 2, and 24 hours, respectively. The improvement in mean PaO2 and PF ratios was durable at 24 hours whether or not the patient was returned to CMV (n = 10) or remained on HFPV (n = 2). Survival to discharge was 66.7%.

Conclusion:

In our cohort of morbidly obese patients, HFPV was successfully utilized as a rescue therapy precluding the need for ECMO. Despite our small sample size, HFPV should be considered as a rescue therapy in morbidly obese patients failing CMV prior to the initiation of ECMO. Our retrospective analysis supports consideration for HFPV as another form of rescue therapy for obese patients with refractory hypoxemia and respiratory failure who are not improving with CMV.
Ionic liquid effect for efficiency improvement in poly(methyl acrylate)/poly(vinyl acetate)-based dye-sensitized solar cells
Authors: Winie Tan , Azmar Amisha , Rozana MD
Published: April 2018

Polymer electrolytes based on the blends of poly(methyl acrylate) (PMA) and poly(vinyl acetate) (PVAc) were prepared using tetrapropylammonium iodide (TPAI) salt and 1-butyl-3-methylimidazolium iodide (BMII) ionic liquid. Single transition between the glass transition temperatures of the constituents indicates the miscibility of PMA and PVAc over the entire composition range. The presence of TPAI and BMII does not affect the miscibility of PMA and PVAc. The complexation in the PMA/PVAc-TPAI-BMII is supported by the differential scanning calorimetry and Fourier transform infrared spectroscopic studies. Conductivity increases by two order of magnitudes with the incorporation of 5 wt% of BMII. Conductivity increment is due to the extra charge carriers provided by BMII. Electrolyte films were sandwiched between titanium dioxide photoanode and platinum counter electrode for dye-sensitized solar cells (DSSCs) assembly. The addition of BMII increases the efficiency of DSSC from 2.79% to 4.62%.
Finite element analysis of the effect of high tibial osteotomy correction angle on articular cartilage loading
Authors: Trad Zahra , Barkaoui Abdelwahed , Chafra Moez , Tavares João Manuel RS
Published: April 2018

Osteoarthritis is a globally common disease that imposes a considerable ongoing health and economic burden on the socioeconomic system. As more and more biomechanical factors have been explored, malalignment of the lower limb has been found to influence the load distribution across the articular surface of the knee joint substantially. In this work, a three-dimensional finite element analysis was carried out to investigate the effect of varying the high tibial osteotomy correction angle on the stress distribution in both compartments of the human knee joint. Thereafter, determine the optimal correction angle to achieve a balanced loading between these two compartments. The developed finite element model was validated against experimental and numerical results. The findings of this work suggest that by changing the correction angle from 0° to 10° valgus, high tibial osteotomy shifted the mechanical load from the affected medial compartment to the lateral compartment with intact cartilage. The Von Mises and the shear stresses decreased in the medial compartment and increased in the lateral compartment. Moreover, a balanced stress distribution between the two compartments as well as the desired alignment were achieved under a valgus hypercorrection of 4.5° that significantly unloads the medial compartment, loads the lateral compartment and arrests the progression of osteoarthritis. After comparing the achieved results against the ones of previous studies that explored the effects of the high tibial osteotomy correction angle on either clinical outcomes or biomechanical outcomes, one can conclude that the findings of this study agree well with the related clinical data and recommendations found in the literature.
Exergy analysis of ethylbenzene dehydrogenation to styrene monomer
Authors: Taghizadeh Damanabi Ahmad , Bahadori Fatemeh
Published: April 2018

In this paper, exergetic analysis for dehydrogenation of ethylbenzene over a potassium-promoted iron oxide catalyst for styrene monomer production is investigated. The purpose of the study is to decrease the work loss in the process. Due to the high energy consumption of the unit, exergy analysis was used to optimize the energy consumption of styrene production unit and associated fractionation unit. Preheater, second reactor, and benzene–toluene tower were studied to optimize energy consumption. It is observed that coupling of an Liquified Natural Gas (LNG) type of heat exchanger with preheater improves the exergetic efficiency of the preheater. Also, decreasing the pressure of benzene–toluene column from 220 kPa to 60 kPa increases the exergetic efficiency from 77.45 to 90.86, while by optimizing the oxygen injection rate to the second reactor, the exergetic efficiency increased from 25.76 to 38.07.
Disciplined freedom: The productive self and conspicuous busyness in “free” time
Authors: Shir-Wise Michelle
Published: April 2018

The current article conceptualizes free time as subjectively experienced and defined, as it explores not only how individuals spend free time, but also how they perceive and interpret it. It challenges established approaches to leisure that relate to it as a realm of freedom distinct from work or duties, suggesting that the discourse of work imbues free time with ideals, which shape, not only how we spend our free time, but also, how we perceive it and utilize it for self-management. My focus is on the relationship between time, freedom, and the self, while taking into account the input of culture. The theoretical concept that I offer here in order to analyze free time is disciplined freedom. I use this term to refer to the ways by which cultural paradigms shape conceptions and actions of free time by promoting a disciplinary gaze that encourages a form of management of time and the self that adheres to authenticity, freedom, and choice. Based on qualitative data from 43 in-depth interviews, the findings revealed the impact of conflicting discourses that competed in shaping meaning and action related to free time. The article brings into question the freedom of individuals in the face of discursive frameworks that were found to operate as powerful, taken for granted dictates in everyday life.
Micromechanics-based characterization of elastic properties of shape memory polymer nanocomposites containing SiO2 nanoparticles
Authors: Hassanzadeh-Aghdam Mohammad Kazem , Mahmoodi Mohammad Javad
Published: April 2018

In this article, a unit cell micromechanics model is developed to predict the elastic properties of shape memory polymer nanocomposites containing silica (SiO2) nanoparticles. The model incorporates an interphase zone corresponding to a perturbed region of shape memory polymer matrix around SiO2 nanoparticles. It is found that the elastic properties of shape memory polymer nanocomposites are significantly sensitive to the temperature in the presence of interphase region. As the temperature increases, the shape memory polymer nanocomposite elastic modulus decreases, while the normalized elastic modulus nonlinearly rises. The results reveal that Poisson’s ratio decreases nonlinearly with the increase of temperature. The shape memory polymer nanocomposite mechanical properties are significantly influenced by the nanoparticle diameter in the presence of interphase region. Substantial improvement in normalized elastic modulus is observed with reducing the nanoparticle diameter. Also, a nonlinear decrease in Poisson’s ratio is found as the nanoparticle diameter decreases. Furthermore, the role of nanoparticle diameter becomes more prominent due to enhancement of temperature. The results indicate that with increasing SiO2 nanoparticles’ volume fraction, the elastic modulus of shape memory polymer nanocomposite nonlinearly rises, while Poisson’s ratio decreases. Finally, it is shown that the increase of interphase thickness leads to the enhancement of normalized elastic modulus of shape memory polymer nanocomposite.
Which neurofeedback session is better for motor skill acquisition; before or after training?
Authors: Ghasemian Mohammadreza , Taheri Hamidreza , Saberi Kakhki Alireza , Ghoshuni Majid
Published: April 2018

This study aimed to compare the effect of two neurofeedback protocols with two different mechanisms on learning a motor task. Forty-two volunteers aged 18–22 years old were placed in three groups of pre-training, post-training, and control. In the pre-training group, Mu (8–12 Hz) amplitude was suppressed at C4 before the motor skill training, while the participants in the post-training group were instructed to increase theta (4–8 Hz) amplitude at Pz and immediately after motor skill training. After the training session, the subjects participated in retention tests at approximately 90 min, 24 h, and 1 week after training. The results showed that the pre-training group performed better in the first retention test ( p = 0.002). Nevertheless, this superiority was not maintained in subsequent retention tests, where no difference was observed between the groups. Mu amplitude suppression before training led to more beneficial effect on learning of a new motor skill, even though it was not so effective over time. However, it appears that the inhibition of Mu amplitude in the motor cortex and subsequent higher excitability can effect motor skill acquisition.
A Survey of School Nurses’ Perceptions of Complementary, Alternative, and Integrative Therapies
Authors: Lartey Grace , Sturgeon Lizbeth P. , Garrett-Wright Dawn , Kabir Umar Y. , Eagle Susan
Published: April 2018

Complementary, alternative, and integrative therapies (CAIs) involve the use of practices outside of mainstream, conventional medicine. Few studies have been conducted on nurses’ perception and knowledge of CAI therapies. There is limited information on the protocols school nurses must follow in their practice on CAI use. The purpose of this study is to assess school nurses’ perception and knowledge of CAI therapies. A cross-sectional, nonexperimental survey study design was used, and participants were sampled with a cross-sectional convenience method. Members of four state School Nurses Associations were invited to participate in the study. Of the 290 participants, 100% of certified school nurses and 63% of non-certified school nurses believed CAI therapies have a place in their current practice (χ2 = 1.83, df = 1, p < .05). The study found that school nurses believe CAI therapies have a role in the school setting; however, the participants were not comfortable with assessing and administering these therapies.