bluuebunny/crossref_metadata_2025 huggingface dataset:
A Structure-Aware Adversarial Framework with the Keypoint Biorientation Field for Multiperson Pose Estimation
Authors: Meng Xianjia , Yang Yong , Li Kang , Ying Zuobin
Published: February 2022

Human pose estimation is aimed at locating the anatomical parts or keypoints of the human body and is regarded as a core component in obtaining detailed human understanding in images or videos. However, the occlusion and overlap upon human bodies and complex backgrounds often result in implausible pose predictions. To address the problem, we propose a structure-aware adversarial framework, which combines cues of local joint interconnectivity and priors about the holistic structure of human bodies, achieving high-quality results for multiperson human pose estimation. Effective learning of such cues and priors is typically a challenge. The presented framework uses a nonparametric representation, which is referred to as the Keypoint Biorientation Field (KBOF), to learn orientation cues of joint interinteractivity in the image, just as human vision can explore geometric constraints of joint interconnectivity. Additionally, a module using multiscale feature representation with inflated convolution for joint heatmap detection and Keypoint Biorientation Field detection is applied in our framework to fully explore the local features of joint points and the bidirectional connectivity between them at the microscopic level. Finally, we employ improving generative adversarial networks which use KBOF and multiscale feature extraction that implicitly leverages the cues and priors about the structure of human bodies for global structural inference. The adversarial network enables our framework to combine information about the connections between local body joints at the microscopic level and the structural priors of the human body at the global level, thus enhancing the performance of our framework. The effectiveness and robustness of the network are evaluated on the task of human pose prediction in two widely used benchmark datasets, i.e., MPII and COCO datasets. Our approach outperforms the state-of-the-art methods, especially in the case of complex scenes. Our method achieves an improvement of 2.6% and 1.7% compared to the latest method on the MPII test set and COCO validation set, respectively.
Treatment of Liver Cancer: Role of the Traditional Mongolian Medicine
Authors: Bao Xiaomei , Chen Lu , Liu Yiman , Sheng Hua , Wang Kailong , Luo Yanming , Qin Tongling , Liu Ying , Qiu Yuling
Published: February 2022

Liver cancer is an extraordinarily heterogeneous malignancy with relatively high mortality and increasing incidence rate among the so far identified cancers. Improvements in liver cancer therapy have been made in the past decades, but therapeutics against liver cancer are still limited. Traditional Mongolian Medicine, formed and developed by the Mongolian people to maintain health in the medical practice of fighting against diseases, has been recognized as one of the key components of the world healthcare system. Traditional Mongolian Medicine has been used to treat various malignancies, including liver cancer, for a long time in Asia and its advantages have become more and more apparent. Herein, this review made a comprehensive summary of Traditional Mongolian Medicine, including the ideas in the liver cancer treatment, sources of medicines or prescriptions, traditional applications, modern pharmacological research, chemical structure and mechanisms of several monomer compounds isolated from Traditional Mongolian Medicine, with a view to finding promising drugs against liver cancer and expanding the clinical application of Traditional Mongolian Medicine in liver cancer therapy.
The Effect of Vitamin D3 on the Alignment of Mandibular Anterior Teeth: A Randomized Controlled Clinical Trial
Authors: Al-Attar Ali , Abid Mushriq
Published: February 2022

Objectives. To investigate the effect of vitamin D3 level on the alignment of mandibular anterior teeth in adults and explore the associated root resorption and pain perception. Trial Design. Multicentre, double blinded randomized clinical trial. Subjects and Methods. Adult patients aged 18–30 years, with moderate mandibular incisor crowding [Little’s Irregularity index (LII) 3–6 mm], needing nonextraction treatment with fixed orthodontic appliance, were randomly allocated into two groups with 1 : 1 allocation ratio. In the 1st group (normal vitamin D3 level group [ND3G]), vitamin D level was measured and corrected to normal before starting orthodontic treatment, while in the 2nd group [control group (CG)] the vitamin D level was kept unknown until completion of the alignment phase. Outcome measures included mandibular incisor crowding using LII, orthodontically induced root resorption (OIRR), and pain perception. Independent sample t-test was used to compare the duration of treatment, the effectiveness of alignment, and OIRR between groups, while differences in pain perception were analysed by Mann–Whitney U-test (P<0.05). Results. Out of 87 patients recruited from four centres, 33 patients were randomly allocated into two groups (17 patients to ND3G and 16 patients to CG). Time elapsed for the complete alignment of the mandibular incisor crowding was one month shorter in ND3G (23.532% faster), and the improvement percentage was significantly higher in all periods when compared to the CG. The amount of OIRR was not significantly different between groups; however, pain during the first three days of alignment was significantly less in ND3G. Conclusions. Having optimal vitamin D3 level reduced the alignment time and pain associated with orthodontic treatment, but it had no role in reducing OIRR. Registration. The trial was registered with ClinicalTrials.gov on 12th April 2021 (registration number: NCT04837781).
Dual Intra-Articular Fracture of the Body and Hook of Hamate: A Delayed Presentation
Authors: Phoenix Eimear , Mahon John , Kenyon Robert M. , Pajda Rafal
Published: February 2022

Fractures of the hamate bone are an unusual clinical entity. Dual fractures involving both the body and the hook of the hamate are even more unique, with only two previous cases described in the literature, to our knowledge. Clinicians are often unfamiliar with the presenting signs of this unusual injury, and subsequently, diagnosis is often delayed or missed entirely. We describe the case of a 19-year-old male who sustained an intra-articular body of hamate fracture with an ipsilateral hook of hamate fracture in his dominant hand. He presented 10 days following the initial injury and was managed with open reduction and internal fixation (ORIF).
Knowledge, Attitude, and Practice toward Skin Cancer Prevention and Detection among Jordanian Medical Students: A Cross-Sectional Study
Authors: Seetan Khaled , Khamees Almu’atasim , Migdadi Afnan , Abu Shqeer Mosab , Hasan Maram Jameel , Shatnawi Leen Ahmad , Abu Bakr Tala , Zayed Nada
Published: February 2022

Introduction. Skin cancer is one of the most growing types of cancer, especially in the Mediterranean, even though it is a preventable disease. The purpose of this study is to assess medical students’ knowledge, attitude, and practice about skin cancer prevention and detection. Methods. A cross-sectional study was conducted using a validated structured questionnaire covering the areas of knowledge, attitude, and practice of the study participants. Results. The study involved 1530 students; 55.3% were females. Most of the students possessed proper knowledge about skin cancer (81%). The most prevalent skin cancer risk factors were sun exposure during the day (83.5%) and immunosuppression (71.2%). More than half of the students did not have any habits of skin examination (61.5%). 20% of the students never used sunscreen, while only 20% of them avoided sun exposure during day hours. Conclusion. The general level of the medical students’ knowledge of skin cancer and its risk factors appeared to be higher than what is found in other studies; it is reasonable as the study participants were medical students. However, the protective behavior from the sun was inadequate when compared to the level of knowledge reported. Additional education about the behavior toward sun exposure and protection against skin cancer may be needed to be implemented in the dermatology curriculum.
The Effects of Insertion Approach on the Stability of Dental Implants
Authors: Hsu Yuan-Yang , Huang Heng-Li , Fuh Lih-Jyh , Tsai Ming-Tzu , Hsu Jui-Ting
Published: February 2022

Dental implant surgery involves the insertion of a dental implant into the alveolar bone; the success of the surgery depends on the initial stability of the implant. The objective of this study was to examine the effects of dental implant insertion approaches in clinical surgery and in accordance with the standards of American Society for Testing and Materials on initial implant stability. Three insertion approaches were used for dental implant placement (Branemark Systems NobelSpeedy Groovy, Nobel Biocare AB, Gothenburg, Sweden) in two types of artificial bone—good bone (GB) and poor bone (PB). The three insertion approaches were as follows: (1) continuous rotation insertion (CRI): using a torque testing machine to continuously screw in an implant to completion and (2 and 3) intermittent rotation insertion (IRI)_90 and IRI_80: using CRI to bury an implant to 90% and 80% of its full length followed by IRI to complete the implantation, respectively. The maximum insertion torque value (ITV), periotest value (PTV), and implant stability quotient (ISQ) were measured and compared. The results indicated that bone quality and insertion approach both affected implant stability. Insertion approaches affected all three implant stability indicators differently in the GB and PB groups (

p
=
0.008

). In GB groups, the insertion approach primarily affected ITV, whereas in PB groups, it primarily affected PTV. The effect of the insertion approach was less apparent for ISQ. Overall, in both the GB and PB groups, the implant stability for IRI_80 was greater than that for IRI_90, and the implant stability for IRI_90 was greater than that for CRI. Future in vitro studies should adopt an insertion approach that complies with the clinical practice for dental implant surgery. Dentists should adjust the timing for IRI in dental implant surgery to achieve greater initial dental implant stability.
Modification of Superabsorbent Hydrogels for Industrial Wastewater Treatment
Authors: Rahman Md. Owaleur , Halim Md. Abdul , Deb Anjan , Ahmed Shafi , Rahman Md. Wasikur , Dafader N. C. , Alam S. M. Nur , Khandaker Shahjalal , Alam Md. Jahangir
Published: February 2022

A breakthrough in superabsorbent hydrogel (SAH) preparation was studied in the current issue by blending potato starch and acrylic acid for wastewater treatment. Gamma irradiation source (60Co irradiation) was used to irradiate SAH from 1 to 10 kGy dose at room temperature (~27°C). The swelling ratio, water absorption, equilibrium water content, and gel fraction properties of the hydrogel were investigated. The as-prepared hydrogel treated with KOH (THG) showed excellent absorption capacity but less mechanical stability compared to untreated hydrogel (UHG). The gel fraction of treated SAH was slightly lower in methanol, but the utmost in water at 5 kGy infers the proper grafting of SAH at this point. The prepared SAH was characterized using scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) to investigate the surface morphology and molecular interaction, respectively. Moreover, this study’s focal point is to propose an alternative method to remove chromium and methylene blue by SAH from industrial wastewater. The Cr adsorption capacity of UHG was higher than that of THG because the proton’s replacement is easier than that of K by Cr. On the other hand, THG was found to be more efficient in removing methylene blue from industrial wastewater due to the presence of an easily ionized group (–COOK) in SAH. Therefore, the hydrogel can be proposed as a potential superabsorbent to remove heavy metals and organic dyes from industrial wastewater.
Swarm Unmanned Aerial Vehicles (SUAVs): A Comprehensive Analysis of Localization, Recent Aspects, and Future Trends
Authors: Khelifi Manel , Butun Ismail
Published: February 2022

Within the last decade, Swarm Unmanned Aerial Vehicles (SUAVs) are booming and growing at a surprisingly rapid pace. From military combat, environmental surveillance, and air transport to the blossoming public entertainment sector, there is a wide range of UAV applications. For these above use cases, the accurate location of the target of interest can be requested/queried, which is very important for their mission accomplishment. In the case of GPS-armed SUAVs, this is an easy task. However, the GPS signal can be obscured, affected by environmental conditions, or suppressive jamming. Therefore, location information needs to be improved/assisted by some other localization techniques, which constitutes the main scope of this article. Besides, with the advancements in localization, guidance, and communication technologies; future SUAVs will be operating autonomously by distributing tasks and coordinating the operation of many UAVs. Thus, UAV to UAV communication is presented as it constitutes the SUAV’s autonomous coordination ability. In addition, future research directions and open challenges that need to be addressed, including autonomous SUAVs, are also discussed.
Association of Atraumatic Splenic Rupture and Acute Pancreatitis: Case Report with Literature Review
Authors: Ljubicic Lidija , Sesa Vibor , Cukovic-Cavka Silvija , Romic Ivan , Petrovic Igor
Published: February 2022

Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This article presents a case of a 35-year-old patient presenting with acute pancreatitis who subsequently developed a splenic vein thrombosis and splenic rupture requiring a laparotomy and splenectomy. This rare but life-threatening complication requires prompt recognition and management in patients with pancreatitis who develop sudden hemodynamic instability.
Dependable and Provable Secure Two-Factor Mutual Authentication Scheme Using ECC for IoT-Based Telecare Medical Information System
Authors: Radhakrishnan Niranchana , Muniyandi Amutha Prabakar
Published: February 2022

With the recent tremendous growth in technology, the Internet of Things (IoT) Telecare Medicine Information System (TMIS) is the most widely used medical information system with prominent achievements. Authentication schemes, which use Smart cards, offer the best solution for TMIS applications that in turn provide efficiency and security. Furthermore, authentication schemes that combine passwords and smart cards are considered to be an effective solution for the two-factor authentication scheme. Such schemes contribute to high security along with the public-key cryptosystem. In this research work, a two-factor authentication technique that is both efficient and secure, which makes use of Elliptic Curve Cryptography (ECC) with smart cards, has been proposed. Here, we have used the fundamental assumptions of strong and collision free cryptographic Hash function and Elliptic Curve arithmetic. The proposed authentication technique protects user privacy by allowing registered users to change their passwords without revealing their identity to the server. The proposed authentication scheme has been subjected to formal and informal security investigations. In terms of efficiency and performance, the proposed two-factor authentication technique was compared with the existing relevant two-factor authentication schemes based on ECC. This scheme satisfies the two-factor authentication scheme’s basic security standards.
Combined Perioperative Lapatinib and Trastuzumab in Early HER2-Positive Breast Cancer Identifies Early Responders: Randomized UK EPHOS-B Trial Long-Term Results
Authors: Bundred Nigel , Porta Nuria , Brunt Adrian Murray , Cramer Angela , Hanby Andrew , Shaaban Abeer M. , Rakha Emad A. , Armstrong Anne , Cutress Ramsey I. , Dodwell David , Emson Marie A. , Evans Abigail , Hartup Sue M. , Horgan Kieran , Miller Sarah E. , McIntosh Stuart A. , Morden James P. , Naik Jay , Narayanan Sankaran , Ooi Jane , Skene Anthony I. , Cameron David A. , Bliss Judith M.
Published: February 2022

Purpose:

EPHOS-B aimed to determine whether perioperative anti-HER2 therapy inhibited proliferation and/or increased apoptosis in HER2-positive breast cancer.

Patients and Methods:

This randomized phase II, two-part, multicenter trial included newly diagnosed women with HER2-positive invasive breast cancer due to undergo surgery. Patients were randomized to: part 1 (1:2:2), no treatment (control), trastuzumab or lapatinib; part 2 (1:1:2) control, trastuzumab, or lapatinib and trastuzumab combination. Treatment was given for 11 days presurgery. Coprimary endpoints were change in Ki67 and apoptosis between baseline and surgery tumor samples (biologic response: ≥30% change). Central pathology review scored residual cancer burden (RCB). Relapse-free survival (RFS) explored long-term effects.

Results:

Between November 2010 and September 2015, 257 patients were randomized (part 1: control 22, trastuzumab 57, lapatinib 51; part 2: control 29, trastuzumab 32, combination 66). Ki67 response was evaluable for 223 patients: in part 1 Ki67 response occurred in 29/44 (66%) lapatinib versus 18/49 (37%) trastuzumab (P = 0.007) and 1/22 (5%) control (P < 0.0001); in part 2 in 36/49 (74%) combination versus 14/31 (45%) trastuzumab (P = 0.02) and 2/28 (7%) control (P < 0.0001). No significant increase in apoptosis after 11 days was seen in treatment groups. Six patients achieved complete pathologic response (pCR, RCB0) and 13 RCB1, all but two in the combination group. After 6 years median follow-up, 28 (11%) had recurrence and 19 (7%) died. No recurrences or deaths were observed among patients who achieved a pCR. Ki67% falls ≥50% associated with fewer recurrences (P = 0.002).

Conclusions:

Early response after short duration anti-HER2 dual therapy identifies cancers dependent on the HER2 pathway providing a strategy for exploring risk-adapted individualized treatment de-escalation.
Nintedanib plus Docetaxel after Immune Checkpoint Inhibitor Failure in Patients with Advanced Non-Small-Cell Lung Cancer: A Case Series
Authors: Hochmair Maximilian Johannes , Kolb Rainer , Wurm Robert , Zach Herwig , Bittner Nora
Published: February 2022

Advances in the treatment of non-small-cell lung cancers (NSCLCs) lacking an actionable driver mutation have included the approval of immunotherapies, such as monotherapy or in combination with chemotherapy. However, limited evidence exists to guide clinical decision-making after progression with immunotherapy. The vascular endothelial growth factor (VEGF) signaling pathway promotes tumor angiogenesis and the development of an immunosuppressive tumor microenvironment (TME). Anti-VEGF treatment is postulated to favor an immunosupportive TME through an “angio-immunogenic switch.” Nintedanib, an anti-VEGF receptor treatment, is approved in the EU and other countries, in combination with docetaxel for the treatment of locally advanced, metastatic, or locally recurrent adenocarcinoma NSCLC after failure of first-line chemotherapy. We present a case series from 5 patients treated with nintedanib plus docetaxel, after chemotherapy and immunotherapy, during routine clinical practice in Austria and Hungary. Four patients were treated with nintedanib plus docetaxel as a second- or third-line treatment after chemotherapy and immunotherapy, and a fifth patient received immunotherapy before and after nintedanib plus docetaxel. Although these patients would typically have a poor prognosis, each achieved a partial response with nintedanib plus docetaxel, with response duration from 8 months to over 30 months. Adverse events were manageable. The fifth patient case shows that nintedanib does not preclude later-line immunotherapy or chemotherapy, supporting the angio-immunogenic switch hypothesis. Overall, the case studies indicate that nintedanib plus docetaxel is an effective and well tolerated treatment, after sequential or combined chemo-immunotherapy for advanced NSCLC, and is compatible with a rechallenge with immunotherapy.
A Case of Fifteen Simultaneous Rectal Neuroendocrine Tumors and Endocrine Cell Micronests Resected by Both Endoscopic Treatments and Surgery
Authors: Hashimoto Hikaru , Yoshida Naohisa , Inoue Ken , Kobayashi Reo , Tomita Yuri , Sugino Satoshi , Dohi Osamu , Hirose Ryohei , Inada Yutaka , Murakami Takaaki , Morinaga Yukiko , Kishimoto Mitsuo , Itoh Yoshito
Published: February 2022

Case Report:A 65-year-old man without any symptoms received colonoscopy for cancer screening and underwent cold snare polypectomy (CSP) for a 3-mm rectal lesion at a local clinic. A histopathological examination revealed neuroendocrine tumor (NET) G1 with a positive margin. The patient was referred to our hospital for further treatment. Then, the post-CSP scar was removed by endoscopic submucosal dissection (ESD), with a sufficient endoscopically normal margin. Histopathology showed 4 NETs and endocrine cell micronests (ECMs) distant from the post-CSP scar, with a positive lateral margin. We considered that the possibility of other NETs was high. Additional surgery was performed. After a histopathological examination, 11 NETs and ECMs were found in the whole rectum, without lymph node metastasis. The patient had no recurrence at 24 months after surgery. In the past 10 years, we have experienced 4 cases (including the present case) of multiple rectal NETs among 56 cases of rectal NETs of ≤10 mm (7.1%). None of our 4 cases showed any recurrence (follow-up period: 12–32 months).Conclusions:We herein report a case involving a patient with 15 rectal NETs and ECMs. We reviewed our experience with multiple rectal NETs, and the rate of multiple rectal NETs was 7.1%. Endoscopists should consider that multiple lesions may be present in cases of rectal NET and be aware that some cannot be detected endoscopically.
Transient Small-Bowel Intussusception Unmasking Adult Celiac Disease
Authors: AlAhmad Maryam , Almessabi Abdulqader
Published: February 2022

Celiac disease (CD) is a chronic immune-mediated small-intestinal disorder. The tissue transglutaminase (TTG) antibodies test is the initial step in the diagnosis of CD. Intussusception is a process where one segment of the bowel invaginates into the lumen of an adjacent segment. Despite that, the association between adult intussusception and CD has been descried previously, and it is still not widely recognized. We report a case of adult intussusception as the first manifestation of CD. A 28-year-old nonalcoholic and nonsmoker, previously healthy man, presented to the emergency department with a 1-week history of progressive diffuse abdominal pain associated with abdominal distension, nausea, vomiting, diarrhea, and 7 kg weight loss. The physical exam was remarkable for thin body habitus with no lymphadenopathy. Laboratory testing was significant for hypochromic microcytic anemia, AST 214 IU/L, ALT 217 IU/L, alkaline phosphatase 183 IU/L, and INR 2.9. An abdominal radiograph showed distended gas-filled small- and large-bowel loops. An abdominal computed tomography scan with contrast was done and demonstrated a telescoping of the small bowel in at least 3 areas with a target sign appearance with no signs of obstruction that suggested small-bowel intussusception. Following this imaging result, the patient was admitted under general surgery and kept nothing by mouth. The surgical team approached the gastroenterology team for push enteroscopy with biopsy which the patient refused. Further investigation included TTG antibodies; IgA and IgG were significantly elevated, 4,965.5 CU and 431.9 CU, respectively (reference: <19.9 CU). The diagnosis of CD leading to adult intussusception was made. The patient was advised to start a gluten-free diet. During the hospital stay, the patient had complete resolution of his symptoms and was discharged home. In summary, this case highlights the potential link between adult intussusception and CD. Adult intussusception is a rare condition that its underlying etiology should be meticulously investigated to expedite treatment and prevent unnecessary surgical intervention.
Grey Matter Volume Reductions of the Left Hippocampus and Amygdala in PTSD: A Coordinate-Based Meta-Analysis of Magnetic Resonance Imaging Studies
Authors: Del Casale Antonio , Ferracuti Stefano , Barbetti Andrea Steven , Bargagna Paride , Zega Paolo , Iannuccelli Alessia , Caggese Federico , Zoppi Teodolinda , De Luca Gabriele Pasquale , Parmigiani Giovanna , Berardelli Isabella , Pompili Maurizio
Published: February 2022

Introduction: In recent years, research on posttraumatic stress disorder (PTSD) focused on the description of different biological correlates of illness. Morphological changes of different brain regions were involved in PTSD neurophysiopathology, being related to trauma or considered a resilience biomarker. In this meta-analysis, we aimed to investigate the grey matter changes reported in magnetic resonance imaging (MRI) studies on patients who have developed PTSD compared to exposed subjects who did not show a clinical PTSD onset. Methods: We meta-analysed eight peer-reviewed MRI studies conducted on trauma-exposed patients and reported results corrected for false positives. We then conducted global and intergroup comparisons from neuroimaging data of two cohorts of included subjects. The included studies were conducted on 250 subjects, including 122 patients with PTSD and 128 non-PTSD subjects exposed to trauma. Results: Applying a family-wise error correction, PTSD subjects compared to trauma-exposed non-PTSD individuals showed a significant volume reduction of a large left-sided grey matter cluster extended from the parahippocampal gyrus to the uncus, including the amygdala. Conclusions: These volumetric reductions are a major structural correlate of PTSD and can be related to the expression of symptoms. Future studies might consider these and other neural PTSD correlates, which may lead to the development of clinical applications for affected patients.
Radiotherapy as a Treatment Option for Local Disease Control in Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type
Authors: Zehnder Mara , Amarov Boyko , Abrunhosa-Branquinho André N. , Maiwald-Urosevic Mirjana , Mühleisen Beda , Saulite Ieva , Anzengruber Florian , Imhof Laurence , Navarini Alexander A. , Cozzio Antonio , Dummer Reinhard , Dimitriou Florentia , Guenova Emmanuella
Published: February 2022

Background: Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT) is an aggressive lymphoma variant. Anthracycline-based chemotherapy with rituximab is recommended as first-line treatment. Radiotherapy (RT) has been considered as a therapeutic option for local disease control in patients with solitary or localized lesions. Methods: We report the results of a retrospective analysis of PCDLBC, LT patients treated either with RT alone or with physician’s decision as first-line treatment, aiming to assess disease progression and/or first recurrence in these treatment groups. Results: We retrospectively analyzed 20 patients treated either with RT alone (n = 8) or with investigator’s choice treatment (n = 12), which included chemotherapy alone or combined with local therapy (RT and wide local excision). Complete response (CR) was achieved in 8 patients from the first group and 9 patients from the second group, with 1 treatment failure. Six patients treated with RT alone progressed with a median time to progression (TTP) of 12.5 months. In the second group, 5 patients progressed with a median TTP of 5.2 months. RT showed good local disease control in both groups without any skin relapses during the follow-up period. Conclusion: RT as first-line monotherapy followed by watchful waiting did not significantly improve the overall risk of disease progression but resulted in good local disease control. After progression, RT could still easily be combined with systemic treatment. The strength of this analysis needs to be evaluated in a larger patient cohort.
Komplementäre und alternative Therapien: Wie wirkt eine ketogene metabolische Therapie bei Patienten mit fortgeschrittenem Mammakarzinom?
Authors: Voiss Petra
Published: February 2022

Background: Ketogenic metabolic therapy (KMT) using ketogenic diets (KD) is emerging as viable alternative or complementary strategy for managing cancer; however, few clinical trials have been reported. The present study aimed to evaluate the effects of a KD in patients with locally advanced and metastatic breast cancer receiving chemotherapy. Methods: A total of 80 patients undergoing treatment with chemotherapy were randomly assigned to KD or control group for 12 weeks. Concurrent with the admission, midway point, and at 12 weeks, fasting blood samples were collected for evaluation of insulin, IGF-1, CEA, CA15–3, ESR, CRP, IL-10, and TNF-α. Sonography for patients with locally advanced disease and CT or MRI scans for patients with metastatic disease were done on admission and at 12 weeks. At the completion of the chemotherapy, patients with locally advanced disease underwent surgery and stage was recalculated. Also patients with metastases were evaluated for response rate. Results: TNF-α decreased significantly after 12 weeks of treatment (MD: 0.64 [CI 95%: -3.7, 5] P < 0.001), while IL-10 increased (MD: 0.95 [CI 95%: -1, 3] P < 0.001) in the intervention compared to the control group. Patients in the KD group had lower adjusted serum insulin compared to the control group (MD:-1.1 [CI 95%: -3, 1] p < 0.002). KD lead to a reduction in tumor size in the KD compared to the control (27 vs 6 mm, P = 0.01). Stage decreased significantly in patients with locally advanced disease in the KD group after 12 weeks (P < 0.01). No significant differences in response rate were observed in patients with metastatic disease. Conclusions: KMT in breast cancer patients might exert beneficial effects through decreasing TNF-α and insulin and increasing IL-10. KD may result in a better response through reductions in tumor size and downstaging in patients with locally advanced disease; however, more studies are needed to elucidate the potential beneficial effects of KD in patients with metastases. Trial registration: This trial has been registered on Iranian Registry of Clinical Trials (IRCT) under the identification code: IRCT20171105037259N2. https://www.irct.ir/trial/30755.
Book Review
Authors: Walach Harald
Published: February 2022

none
Archaeological Mortar Characterization Using Laser-Induced Breakdown Spectroscopy (LIBS) Imaging Microscopy
Authors: Richiero Sarah , Sandoval Claudio , Oberlin Christine , Schmitt Anne , Lefevre Jean-Claude , Bensalah-Ledoux Amina , Prigent Daniel , Coquidé Catherine , Valois Antoine , Giletti Federico , Pelascini Frédéric , Duponchel Ludovic , Dugourd Philippe , Comby-Zerbino Clothilde , Motto-Ros Vincent
Published: February 2022

Lime mortar is a complex mixture resulting from hardening of lime, water, and aggregates. Lime mortar was used from the time of the Roman Empire until the Industrial Revolution. The recipes used differ according to the period, geographical area of preparation, craftsman, or function. This is why the study of archaeological mortars is of such great importance in building archaeology. In this study, we used laser-induced breakdown spectroscopy (LIBS) to characterize the elemental composition of three lime mortar samples with a µ-LIBS instrument, allowing elemental image compilation. These samples originate from three different geographical locations: Angers (France), Dardilly (France), and Pompeii (Italy), and were taken from buildings that had different functions: cathedral, aqueduct, and house, respectively. Thanks to image processing and the creation of masks, it was possible to extract not only the lime signature and nature of the aggregate but also its granulometry and circularity. All this information is essential for cultural heritage research. This study shows the potential of the LIBS technique in archaeometric analysis of archaeological mortars.
A systematic scoping review of dissociation in borderline personality disorder and implications for research and clinical practice: Exploring the fog
Authors: Al-Shamali Huda F , Winkler Olga , Talarico Fernanda , Greenshaw Andrew J , Forner Christine , Zhang Yanbo , Vermetten Eric , Burback Lisa
Published: February 2022

Background:

Borderline Personality Disorder (BPD) is frequently complicated by the presence of dissociative symptoms. Pathological dissociation is linked with earlier and more severe trauma exposure, emotional dysregulation and worse treatment outcomes in Posttraumatic Stress Disorder and Dissociative Disorders, with implications for BPD.

Objective:

A systematic scoping review was conducted to assess the extent of current literature regarding the impact of dissociation on BPD and to identify knowledge gaps.

Methods:

Four electronic databases (MEDLINE, APA PsycINFO, EMBASE, CINAHL Plus) were searched, and English peer-reviewed studies with adults with BPD were included, following Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension for scoping reviews (PRISMA-ScR) 2018 guidelines.

Results:

Most of the 70 included studies were observational (98%) with first authors from Germany (59%). Overall, dissociation was associated with increased BPD symptom severity, self-harm and reduced psychotherapy treatment response; findings regarding suicide risk were mixed. Dissociation was associated with working memory and cognitive deficits, decreased pain perception, altered body ownership, no substance abuse or the abuse of sedative substances, increased fantasy proneness, personality fragmentation, fearful attachment, dream anxiety, perceived stress and altered stress responses, increased cumulative body mass index, decreased water consumption, several neurological correlates and changes in gene expression.

Conclusion:

BPD with significant dissociative symptoms may constitute a more severe and at-risk subgroup of BPD patients. However, there are significant research gaps and methodological issues in the area, including the possibility of unrecognized Dissociative Disorders in BPD study populations confounding results. Further studies are needed to better understand the impact of dissociation on BPD course and treatment, and to clarify the most appropriate assessment tools for clinical practice. In addition, interventional studies are needed to develop dissociation-specific BPD treatments to determine whether targeting dissociation in BPD can improve treatment outcomes.
“Islamic Medicine”: A true discipline for the 21st century or quackery?
Authors: Mayberry John
Published: February 2022

The purpose of this review is to consider the position of “Islamic Medicine” and whether it is a legitimate form of clinical care or quackery. The analysis is based on published work together with an identification of themes derived from testimonials on practitioners’ websites, as well as a consideration of how such therapies are considered in medical search engines. “Islamic Medicine” covers Traditional or Yunani practice, Prophetic Medicine, Hijama and Ruqya. Their origins are discussed and, subsequently, current-day practice and its relationship to allopathic medicine. Reasons for antagonism to modern medicine are considered and the absence of a rational basis for many of the views expressed. In the case of Yunani medicine, its pre-Islamic origins are identified together with the impact of anti-colonialism and the potential role of clerics in wishing to distance medical care from Galenic concepts. In the case of Hijama, the absence of effective training and regulation and its promotion as a “lost sunna” are discussed alongside claims for miraculous cures. The movement of Ruqyah away from Qur’anic recitation in support of the sick towards a popularised approach to dealing with magic and possession is considered, together with consequential adverse publicity in the media. The consequences of a failure to adopt training practices for Yunani medicine, as recommended by the WHO, are identified. Accredited detailed courses monitored by external statutory regulatory agencies, based in institutions committed to providing the best healthcare, and supporting research would allow “Islamic Medicine” to become a significant role player in contemporary clinical practice and stop present-day quackery.
Cutaneous mimickers of physical child abuse: A brief overview
Authors: Zeidan Nehal A , Bukhamseen Fatimah M , Al-Qassab Aqilah T , Alsadah Fatimah Z , Menezes Ritesh G
Published: February 2022

Child abuse is one of the medico-legal issues a physician may face during his/her clinical practice. It has devastating effects on both the child and family, especially psychological. If falsely identified as a child abuse case, it could result in detrimental consequences. Therefore, physicians must recognise and be able to rule out child abuse mimickers, which are often conditions that are mistakenly confused with true physical child abuse. Injuries like bruises and burns are common presentations and therefore it is important to consider cutaneous abuse mimics to avoid incorrect diagnosis of child abuse. This review article sheds light on the most common cutaneous conditions that can mimic physical child abuse, where patients present with patterns of various skin lesions that raise a suspicion of child abuse.
Copy competitively-tested adaptations of wild species, maybe, but not natural ecosystems tested only by persistence
Authors: Denison R Ford
Published: February 2022

Some aspects of nature are better potential models for agriculture than others. Natural ecosystems have not competed against each other the way wild plants have, so individual adaptations have been improved more consistently over time, relative to ecosystem-level patterns and processes. Wild plants have also been improved by competitive natural selection for longer than humans or most ecosystems have existed. Evolution-tested adaptations, like inducible defenses against pests, will often be worth preserving (if inherited by crops from wild ancestors) or copying. However, when there are tradeoffs between individual competitiveness and plant-community performance, as illustrated by solar tracking, reversing effects of past natural selection will often be a better option. Nitrogen-fixing cereals are unlikely to be a viable alternative to fertilizer unless we can copy adaptations that existing nitrogen-fixing plants have evolved to deal with oxygen and with conflicts of interest with symbionts.
Rare case of self-limiting haemolysis associated with Dengue fever in a Sri Lankan female – case report
Authors: Luke WANV , Lohithalingam P , Jayamanne SF
Published: February 2022

A 61-year old female with dengue haemorrhagic fever developed anaemia and rising transaminase levels on the 6th day of illness. She was found to have haemolysis with a negative direct antiglobulin test (DAT), and no red cell fragmentation. She recovered with supportive care. Haemolysis with associated Haemolytic uraemic syndrome (HUS), Disseminated intravascular coagulation (DIC) and cold Auto-immune haemolytic anaemia (AIHA) is reported previously; DAT negative haemolytic anaemia associated with dengue fever has not. This case suggests a need for further studies on other immune mechanisms that can lead to haemolysis with dengue fever.
Searching for Shangrila: Existential Authenticity, Buddhist Revival, and Ethnic Empowerment on the Sino-Tibetan Frontier
Authors: Elazar Gideon
Published: February 2022

In 2001, the county of Zhongdian in Diqing Tibetan Autonomous Prefecture, Yunnan province, was renamed Shangrila, after the monastery described in James Hilton’s 1933 novel, Lost Horizon, and in allusion to the mythical Tibetan kingdom of Shambhala. Thereafter, work began on constructing the region as an easily accessible showcase for Tibetan culture. Based on fieldwork conducted in the Shangrila Thangka Academy, this article deals with the production and commodification of Tibetan Thangka scrolls. The multiple narratives presented in this article, in parallel and sometimes contradictory ways, center around authenticity—ranging from the preservation of Tibetan culture to the propagation of Tibetan Buddhism—and function as a cultural critique of Chinese society in the reform era.
Public Service Motivation of Street- Level Bureaucrats Amidst the COVID-19 Pandemic: An Analysis of Experiences in Implementation of an at-Home Vaccination Program
Authors: Rauhaus Beth M.
Published: February 2022

This article details public service motivation of emergency medical services (EMS) personnel within a local fire department in Texas, as they implemented an at-home vaccination program, amidst the COVID-19 pandemic. EMS personnel were surveyed and interviewed to learn more about their professional experiences. Using mixed methods, this work finds that EMS personnel in the local department exhibit high levels of public service motivation in both deciding to participate in the at-home vaccination program and throughout their experience in administering the vaccine to community members. This research offers insight local public servants’ motives during a time of crisis and while working in a new, innovative capacity.
Managing Performance for Capital Projects
Authors: Grandage Andrew J.
Published: February 2022

This study contributes to our understanding of public performance with original research on Earned Value Management (EVM), a practice used for managing cost and schedule performance for capital projects throughout execution. Recently, EVM has emerged in some states as part of their performance management strategy for major Information Technology acquisitions but research has yet to study implementation. Overall, results indicate that EVM can support proactive cost and schedule management and help achieve performance objectives but that it is not fully embedded into work routines. Findings also illustrate that successful implementation is contingent on several organizational, human capital, and policy variables.
Slow practice and tempo-management strategies in instrumental music learning: Investigating prevalence and cognitive functions
Authors: Allingham Emma , Wöllner Clemens
Published: February 2022

Practicing slowly is an intuitive and prevalent learning strategy among instrumental musicians. Nevertheless, little is known about the psychological mechanisms of slow practice, or how rehearsing slow movements may support the performance of fast-tempo playing. This study investigated the prevalence and possible functions of slow practice strategies. A total of 256 adult instrumental musicians provided self-report ratings about slow practice and tempo-management strategy use, musical background information, and the Musical Self-regulated Learning Questionnaire in an online survey. Results indicate that practicing slowly is an extremely common technique among classical (99.45%) and non-classical (89.12%) musicians of varying expertise, supporting both technical and expressive goals, with technical more frequently reported. Principal components analysis identified three types of slow practice as serving expressive, technical, or preparatory functions. Expressive Slow Practice and Technical Slow Practice were positively associated with self-regulated learning, but not expertise across both music genre groups. Preparatory Slow Practice was positively associated with self-regulated learning and expertise in classical musicians, while in non-classical musicians, it had no association with self-regulation and a negative association with expertise. These findings provide groundwork for further research exploring causal effects of slow practice and tempo-management strategies on learning and development of self-regulated learning in various music genre cultures.
A very British state capitalism: Variegation, political connections and bailouts during the COVID-19 crisis
Authors: Wood Geoffrey T , Onali Enrico , Grosman Anna , Haider Zulfiquer Ali
Published: February 2022

The COVID-19 pandemic has resulted in governments playing increasingly prominent roles as active economic agents. However, state capitalism does not necessarily serve broad developmental purposes, and rather can be directed to supporting sectional and private interests. As the literature on variegated capitalism alerts us, governments and other actors regularly devise fixes in response to a systemic crisis, but the focus, scale, and scope of the interventions vary considerably, according to the constellation of interests. Rapid progress with vaccines notwithstanding, the UK government's response to COVID-19 has been associated with much controversy, not only because of an extraordinarily high death rate, but also because of allegations of cronyism around the granting of government contracts and bailouts. We focus on the latter, investigating more closely who got bailed out. We find that badly affected sectors (e.g. hospitality, transportation) and larger employers were more likely to get bailouts. However, the latter also favored the politically influential and those who had run up debt profligately. Although, as with state capitalism, crony capitalism is most often associated with emerging markets, we conclude that the two have coalesced into a peculiarly British variety, but one that has some common features with other major liberal markets. This might suggest that the eco-systemic dominance of the latter is coming to an end, or, at the least, that this model is drifting towards one that assumes many of the features commonly associated with developing nations.
A comprehensive country-based day-ahead wind power generation forecast model by coupling numerical weather prediction data and CatBoost with feature selection methods for Turkey
Authors: Özen Cem , Deniz Ali
Published: February 2022

A country-based day-ahead wind power generation forecast (WPGF) model with a grid selection algorithm and feature selection models was proposed in this study. Atmospheric variables extracted from 300, 500, 700 hPa pressure levels, and surface level of ERA5 reanalysis data with 2.5° spatial resolution were used to train/validate the categorical boosting (CatBoost) model. A special grid selection algorithm was proposed by considering Turkey’s spatial distribution of wind power plants. The day-ahead forecasts of ECMWF’s HRES (High-resolution) were used as the test subset, therefore, paving the way for the operational use of the model. The proposed model could be considered much as a specialized machine learning based downscaling method for country-based WPGF due to using numerical weather prediction model outputs as its input. Results showed that the proposed model that uses fewer features has outperformed the other models with a normalized root mean square error of 7.6% and coefficient of determination of 0.8989.
Fornication and Illegitimacy in Reformation Geneva: Cases from the Consistory, 1542–1558
Authors: Corretti Carolyn , Desai Sukumar P.
Published: February 2022

This article examines cases of fornication and illegitimacy as they were regulated by the Genevan Consistory, a morals discipline court that John Calvin created in 1541 to eradicate sin from the community. We argue that ordinary people failed to live up to the moral standards of Calvinist reformers as they practiced illicit sex and had bastard children. The authorities did their best to correct such behavior and provide for illegitimate children.