bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Endoscopic Ultrasound in the Diagnosis of Cystic Lesions of the Pancreas
Authors: Lévy Philippe , Rebours Vinciane
Published: June 2018

A precise diagnosis of the nature of pancreatic cystic neoplasm (PCN) is crucial since it determines the patients in need of rapid surgical resection as well as those who can be followed up, and, accordingly, the frequency and modalities of surveillance. Endoscopic ultrasound (EUS) and especially fine needle aspiration (FNA) are invasive methods, with specific adverse events occurring in 2.7-5%. Thus, they should only be used as a third-line tool in the absence of characteristic radiographic features on computed tomography (CT) scan and magnetic resonance imaging (MRI). The most difficult aspects of differential diagnosis are: intraductal papillary mucinous neoplasm (IPMN) versus chronic pancreatitis; unifocal IPMN versus serous cystic neoplasm (SCN); macrocystic SCN versus mucinous cystic neoplasm (MCN); cystic neuroendocrine tumors versus MCN; solid serous cystadenoma versus neuroendocrine tumors versus small solid pseudopapillary tumors; pseudocyst versus MCN; low-grade, high-grade, or invasive IPMN. When classical radiological and EUS features are not conclusive, EUS-FNA may be helpful by analyzing cytological, chemical, and/or molecular data. The addition of EUS-FNA to CT scan and MRI increased the overall accuracy for diagnosing PCN by 36 and 54%, respectively. Analysis of molecular markers in pancreatic cyst fluid might increase the limited accuracy of EUS-FNA by using cytology and chemical and/or tumor marker analysis alone. Current evidence suggests that contrast-enhanced EUS (CH-EUS) is highly accurate for distinguishing non-neoplastic cysts from neoplastic cysts. CH-EUS might also be useful for distinguishing mural epithelial nodules from mucinous clots. Needle-based confocal laser endomicroscopy (nCLE) images a target tissue at a subcellular level of resolution, providing real-time in-vivo optical biopsy. nCLE is feasible during EUS-FNA and allows in-vivo diagnosis of PCN with high accuracy. In conclusion, EUS is a third-line tool in the diagnosis of PCN. Clinical context as well as careful evaluation of CT scan and magnetic resonance cholangiopancreatography images by specialized radiologists are crucial in the diagnosis process. Nowadays it is inconceivable to skip these steps.
Refractory Hypertension Is not Attributable to Intravascular Fluid Retention as Determined by Intracardiac Volumes
Authors: Velasco Alejandro , Siddiqui Mohammed , Kreps Eric , Kolakalapudi Pavani , Dudenbostel Tanja , Arora Garima , Judd Eric K. , Prabhu Sumanth D. , Lloyd Steven G. , Oparil Suzanne , Calhoun David A.
Published: June 2018

Refractory hypertension (RfHTN) is an extreme phenotype of antihypertensive treatment failure defined as lack of blood pressure control with ≥5 medications, including a long-acting thiazide and a mineralocorticoid receptor antagonist. RfHTN is a subgroup of resistant hypertension (RHTN), which is defined as blood pressure >135/85 mm Hg with ≥3 antihypertensive medications, including a diuretic. RHTN is generally attributed to persistent intravascular fluid retention. It is unknown whether alternative mechanisms are operative in RfHTN. Our objective was to determine whether RfHTN is characterized by persistent fluid retention, indexed by greater intracardiac volumes determined by cardiac magnetic resonance when compared with controlled RHTN patients. Consecutive patients evaluated in our institution with RfHTN and controlled RHTN were prospectively enrolled. Exclusion criteria included advanced chronic kidney disease and masked or white coat hypertension. All enrolled patients underwent biochemical testing and cardiac magnetic resonance. The RfHTN group (n=24) was younger (mean age, 51.7±8.9 versus 60.6±11.5 years;
P
=0.003) and had a greater proportion of women (75.0% versus 43%;
P
=0.02) compared with the controlled RHTN group (n=30). RfHTN patients had a greater left ventricular mass index (88.3±35.0 versus 54.6±12.5 g/m
2
;
P
<0.001), posterior wall thickness (10.1±3.1 versus 7.7±1.5 mm;
P
=0.001), and septal wall thickness (14.5±3.8 versus 10.0±2.2 mm;
P
<0.001). There was no difference in B-type natriuretic peptide levels and left atrial or ventricular volumes. Diastolic dysfunction was noted in RfHTN. Our findings demonstrate greater left ventricular hypertrophy without chamber enlargement in RfHTN, suggesting that antihypertensive treatment failure is not attributable to intravascular volume retention.
Accelerated intermittent theta burst stimulation in major depression induces decreases in modularity: A connectome analysis
Authors: Caeyenberghs Karen , Duprat Romain , Leemans Alexander , Hosseini Hadi , Wilson Peter H. , Klooster Debby , Baeken Chris
Published: June 2018

Accelerated intermittent theta burst stimulation (aiTBS) is a noninvasive neurostimulation technique that shows promise for improving clinical outcome in patients suffering from treatment-resistant depression (TRD). Although it has been suggested that aiTBS may evoke beneficial neuroplasticity effects in neuronal circuits, the effects of aiTBS on brain networks have not been investigated until now. Fifty TRD patients were enrolled in a randomized double-blind sham-controlled crossover trial involving aiTBS, applied to the left dorsolateral prefrontal cortex. Diffusion-weighted MRI data were acquired at each of three time points (T1 at baseline; T2 after the first week of real/sham aiTBS stimulation; and T3 after the second week of treatment). Graph analysis was performed on the structural connectivity to examine treatment-related changes in the organization of brain networks. Changes in depression severity were assessed using the Hamilton Depression Rating Scale (HDRS). Baseline data were compared with 60 healthy controls. We observed a significant reduction in depression symptoms over time ( p < 0.001). At T1, both TRD patients and controls exhibited a small-world topology in their white matter networks. More importantly, the TRD patients demonstrated a significantly shorter normalized path length ( p AUC = 0.01), and decreased assortativity ( p AUC = 0.035) of the structural networks, compared with the healthy control group. Within the TRD group, graph analysis revealed a less modular network configuration between T1 and T2 in the TRD group who received real aiTBS stimulation in the first week ( p < 0.013). Finally, there were no significant correlations between changes on HDRS scores and reduced modularity. Application of aiTBS in TRD is characterized by reduced modularity, already evident 4 days after treatment. These findings support the potential clinical application of such noninvasive brain stimulation in TRD.
Pope Francis and Catholic Social Teaching on Ecology
Authors: Guitián Gregorio
Published: June 2018

In his visit to the United States, Pope Francis stressed the Christian message on ecology, which includes a calling to an “ecological conversion”. However, a recent paper on the influence of Christian religiosity on managerial decisions concerning the environment argues that Christian faith discourages managers’ environmental-friendly decisions. Francis message on ecology is part of the Catholic Social Teaching (CST), which contains valuable contributions, but it is still to be known. We present a synthetic view of CST on ecology and its implications for businesses, shareholders and consumers, which can also interest non-Christians concerned with the natural environment. Ultimately, we want to explain why Christians involved in economic activity should be concerned with the natural environment. We offer a moral qualification of acts regarding the natural environment, and conclude with some observations for Christian churches and business schools.
Hate Groups and Muslim Population Changes in the Fifty States: Does the Presence of Muslims Encourage Hate Group Formation?
Authors: Hummel Daniel
Published: June 2018

The size of the Muslim population in the United States is growing, while the number of hate groups also continues to increase across the states. Based on the social dominance theory and group threat theory, there may be a link between these two dynamics as social dominators become concerned about their group status, i.e. white Christian males. This potential relationship is explored in this article. Although there were significant positive correlations between the number of hate groups and the size of the Muslim population, a panelled negative binomial regression with a number of relevant control variables found that there was not a significant relationship between these variables at the 0.05 probability level. The article further explores these findings and future research in this area.
An elephant in the room?
Authors: Hackett Diana
Published: June 2018

Despite its recognised role in education, lifelong learning and active citizenship, the term information literacy (IL) is rarely used in the context of public libraries. At a time when public libraries are operating in an environment of financial austerity and are under increasing pressure to demonstrate the value of their role in UK society, this paper presents the findings of a small-scale research project examining the narratives surrounding public libraries and IL. Through a qualitative text analysis, a picture is built up of the roles of public libraries as presented by government, professional organisations and charitable organisations. This analysis shows that IL is not a concept explicitly associated with public libraries; that the government’s focus is on public libraries’ role in delivering digital inclusion while at the same time depicting a largely passive role for libraries and diminished role for professional library staff; and that while current library advocacy supports this digital role, it does not effectively address the deeper need for transferrable information skills. Based on this analysis, this paper recommends greater collaboration between academic research, higher education, and the public library sector, with a view to fostering a better understanding of IL and its potential to create a wider, more educationally-focussed role for public libraries and their staff.
How power relations affect the distribution of authority
Authors: Webster Lee , Gunter Helen
Published: June 2018

In this article we report on the distribution of authority over information practices observed in a postgraduate taught course at a large research university located in the UK. The course was designed using principles from information literacy (IL) pedagogy and represents the operationalisation of Radical Information Literacy (RIL) theory. By analysing course documentation, assessed online discussion board posts and through interviews with teaching staff and students we examine how and why the distribution of authority is a complex matter; not least that the liberatory intentions of the Programme Director actually contain repressive dimensions in practice. We identify that students are subjected to techniques of disciplinary power, including surveillance and normalisation, and that they resist these by communicating outside of official discussion board spaces. Such resistance is not necessarily problematic, as it enables learning. Notably, students demonstrate development of IL practices through, for example, shaping their information landscapes, digital stewardship and critical reflection.
A 22-Year Climatology of Cool Season Hourly Precipitation Thresholds Conducive to Shallow Landslides in California
Authors: Oakley N. S. , Lancaster J. T. , Hatchett B. J. , Stock J. , Ralph F. M. , Roj S. , Lukashov S.
Published: June 2018

California’s winter storms produce intense rainfall capable of triggering shallow landslides, threatening lives and infrastructure. This study explores where hourly rainfall in the state meets or exceeds published values thought to trigger landslides after crossing a seasonal antecedent precipitation threshold. We answer the following questions: 1) Where in California are overthreshold events most common? 2) How are events distributed within the cool season (October–May) and interannually? 3) Are these events related to atmospheric rivers? To do this, we compile and quality control hourly precipitation data over a 22-yr period for 147 Remote Automated Weather Stations (RAWS). Stations in the Transverse and Coast Ranges and portions of the northwestern Sierra Nevada have the greatest number of rainfall events exceeding thresholds. Atmospheric rivers coincide with 60%–90% of these events. Overthreshold events tend to occur in the climatological wettest month of the year, and they commonly occur multiple times within a storm. These statewide maps depict where to expect intense rainfalls that have historically triggered shallow landslides. They predict that some areas of California are less susceptible to storm-driven landslides solely because high-intensity rainfall is unlikely.
Fault detection and diagnosis of a 12-cylinder trainset diesel engine based on vibration signature analysis and neural network
Authors: Zabihi-Hesari Alireza , Ansari-Rad Saeed , Shirazi Farzad A , Ayati Moosa
Published: June 2018

This paper presents a condition monitoring and combustion fault detection technique for a 12-cylinder 588 kW trainset diesel engine based on vibration signature analysis using fast Fourier transform, discrete wavelet transform, and artificial neural network. Most of the conventional fault diagnosis techniques in diesel engines are mainly based on analyzing the difference of vibration signals amplitude in the time domain or frequency spectrum. Unfortunately, for complex engines, the time- or frequency-domain approaches do not provide appropriate features solely. In the present study, vibration signals are captured from both intake manifold and cylinder heads of the engine and were analyzed in time-, frequency-, and time–frequency domains. In addition, experimental data of a 12-cylinder 588 kW diesel engine (of a trainset) are captured and the proposed method is verified via these data. Results show that power spectra of vibration signals in the low-frequency range reliably distinguish between normal and faulty conditions. However, they cannot identify the fault location. Hence, a feature extraction method based on discrete wavelet transform and energy spectrum is proposed. The extracted features from discrete wavelet transform are used as inputs in a neural network for classification purposes according to the location of sensors and faults. The experimental results verified that vibration signals acquired from intake manifold have more potential in fault detection. In addition, the capacity of discrete wavelet transform and artificial neural network in detection and diagnosis of faulty cylinders subjected to the abnormal fuel injection was revealed in a complex diesel engine. Beside condition monitoring of the engine, a two-step fault detection method is proposed, which is more reliable than other one-step methods for complex engines. The average condition monitoring performance is from 93.89% up to 99.17%, based on fault location and sensor placement, and the minimum classification performance is 98.34%.
Equivalence study involving rail vehicle collision test conditions
Authors: Yao Shuguang , Yan Kaibo , Lu Sisi , Xu Ping
Published: June 2018

In the context of rail vehicle collision tests, which incur high costs and consume substantial time and energy, the equivalence between a single vehicle crashing into a rigid wall and two identical vehicles colliding with each other was studied. Taking the car body as a rigid body, a three-dimensional multi-body dynamic model was built to simulate a single-vehicle impact and a collision between two identical vehicles; the results showed that the condition of a single vehicle crashing into a rigid wall at a speed of [Formula: see text] can be used to replace the condition of one vehicle moving at a speed of v and crashing into an identical vehicle that is stationary. However, the actual collision is a strong nonlinear process, and it is necessary to conduct the equivalent test of the condition of collision. Based on the similarity theory, the scaled equivalent vehicle model is established. Through a series of scaled model tests, the following conclusion is drawn: if one vehicle moving at a speed of vcrashes into another identical vehicle that is stationary, one can equivalently use a single vehicle with a speed of [Formula: see text] (units: m/s) that crashes into a rigid wall. This study provides practical support for the equivalence of vehicle collision test conditions and holds great value for engineering applications.
A case of rectus sheath haematoma related to severe coughing in a patient with acute exacerbation of chronic obstructive pulmonary disease
Authors: Wong Ching Hin Kevin , Tsang Ho Kai Patrick , Wong Oi Fung , Ma Hing Man , Lit Chau Hung Albert
Published: June 2018

Introduction:

Rectus sheath haematoma is a rare condition which is often misdiagnosed. Apart from abdominal trauma and anticoagulation, severe coughing is an uncommon precipitating cause of this rare condition.

Case presentation:

An elderly gentleman with history of ischaemic heart disease on aspirin developed rectus sheath haematoma due to severe coughing during an episode of acute exacerbation of chronic obstructive pulmonary disease. He developed severe abdominal pain and was noted to have epigastric bruising extending to bilateral loins. Ultrasound abdomen and computed tomography of the abdomen with contrast revealed haematoma over bilateral upper rectus abdominis muscles, which subsided with conservative management.

Discussion and conclusion:

Rectus sheath haematoma can be related to severe coughing. In patients, especially those with predisposing factors, presenting with abdominal pain and palpable painful abdominal mass, clinicians should raise the suspicion of this uncommon cause so that timely and appropriate management can be provided.
Toxicological Assessment of Venlafaxine: Acute and Subchronic Toxicity Study in Rats
Authors: Paulis Melad G. , Hafez Essam M. , El-Tahawy Nashwa F. , Aly Mohmed K. M.
Published: June 2018

Antidepressants are the most commonly prescribed drugs for psychiatric treatment, and venlafaxine (VEN) is one of the most popular options. Venlafaxine is a nontricyclic dual-acting serotonin–norepinephrine reuptake inhibitor. Although an increased incidence of acute toxicity and addiction has been reported, controlled studies examining its toxic effects on different organs are still lacking. This study investigated the possible toxic effects of VEN on the liver, kidney, and gastric tissues. Three groups of rats were administered saline, a single LD50 dose (350 mg/kg), or 100 mg/kg VEN daily, followed by increases in the dose of 50 mg/kg every 10 days for 30 days (about 10 times the therapeutic doses). The following parameters of liver and kidney injury were then assayed: alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, prothrombin time, partial thromboplastin time, blood urea nitrogen, and serum creatinine. A histopathological examination was then conducted. Both acute and subchronic administration of VEN produced multiple clinical manifestations in the experimental animals, including seizures, coma, and even death. Moreover, the liver and renal function tests indicated injury in these tissues. Furthermore, the histopathological examination showed signs of organ toxicity after both acute and chronic VEN exposure. This study has shown that VEN has harmful effects on the liver, kidney, and stomach in either a single high dose (LD50) or repeated exposure to 10 times the therapeutic doses. As a result, strategies to increase awareness of these effects among physicians and the public are needed because this drug may be addictive.
Concordance Among Methods for Empiric Renal Drug Dosing: Meropenem as a Role Model for Clinical Superiority of Cockroft–Gault or Modification of Diet in Renal Disease
Authors: Al Jasmi Sabaa M , Khan Amer H , Saadah Loai M , Sulaiman Syed Azhar Syed , Al Khalidi Doaa Kamal
Published: June 2018

Objective:

The objectives of this study are, first, to measure concordance between 5 different renal function estimates (methods) in terms of recommended drug doses, and, subsequently, to establish the potential for significant clinical differences between Cockroft–Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations in dosing a specific medication, namely, meropenem.

Design and setting:

This study used a Monte Carlo simulation, and this is a computer–based study with no actual patient data.

Patients:

A total of 1200 and 8701 simulated cases to study the concordance for the 5 methods and the potential clinical significance of discordance between CG and MDRD, respectively, were chosen for the study.

Methods:

Simulated factors were age, sex, height, weight, serum creatinine, ethnicity, and albumin. We estimated the renal function using 5 formulas (ie, 10 combinations) including CG, MDRD, and Chronic Kidney Disease Epidemiology Collaboration (CKD–EPI). Next, the team evaluated concordance for each combination in dosing 22 drugs. Finally, our researchers reviewed and simulated data from the literature to show how CG versus MDRD use can result in clinically significant differences for meropenem.

Results:

Pairwise combinations yielded statistically significant differences ( P < .0001) except for CG and MDRD ( P < .5147). In addition, the highest concordance was for MDRD and CKD–EPI. Average discordance is in the range of 25% to 30% with the lowest being between CG and albumin–based estimates. Both CG and MDRD were largely discordant which can reach up to 40% with a drug like meropenem and may be associated with significant adverse outcomes.

Conclusions:

Both CG and MDRD in our simulation are statistically comparable. Clinically, nonetheless, they are significantly inconsistent in terms of recommended drug dosing. We encourage practical comparisons of outcomes for individual or groups of medications (eg, meropenem and antibiotics) empirically dosed in renal patients on the basis of equations used in distinct populations.
Technical issues and clinical outcomes of endovascular repair of isolated iliac artery aneurysms: A single-center experience
Authors: Gao Peixian , Dong Dianning , Yang Le , Yuan Hai , Wang Mo , Zhang Jingyong , Zhong Zhenyue , Zhang Shiyi , Jin Xing , Wu Xuejun
Published: June 2018

Purpose

Isolated iliac artery aneurysms are the relatively uncommon condition. This study aims to evaluate the technical issues and clinical outcomes of endovascular repair in a cohort of isolated iliac artery aneurysms treated.

Methods

We retrospectively reviewed 22 consecutive patients with isolated iliac artery aneurysms between December 2006 and September 2016. Iliac artery aneurysms were treated in one of the three ways: (1) standard bifurcated aortic stent graft placement with limb extension; (2) coverage of iliac artery aneurysms with covered stent grafts; and (3) embolization of the arterial branches distal to the aneurysms with coils or vascular plugs.

Results

Twenty-two patients (20 men) with a mean age 64.7 years underwent endovascular repair during the study period. The median diameter of the isolated iliac artery aneurysms was 5.9 ± 1.7 cm (2.9–9.0 cm). Technical success was 95.5%. Conversion to open surgery was performed in one patient with bilateral internal iliac artery aneurysms. Four patients underwent placement of a bifurcated stent graft. A covered stent graft was deployed in 16 patients, with embolization of internal iliac artery in 14 patients. Simple coil embolization of isolated internal iliac artery aneurysm was performed in one patient. There was one sudden cardiac death on day 4 after the procedure due to heart failure. During the follow-up period (range: 1–50 months, mean 19.8 months), five patients died of causes not related to isolated iliac artery aneurysms, and transient buttock claudication was observed in one patient.

Conclusions

Our study documents the safety and effectiveness of endovascular repair of isolated iliac artery aneurysms with low morbidity and mortality.
Inflammation, von Willebrand factor, and ADAMTS13
Authors: Chen Junmei , Chung Dominic W.
Published: June 2018

Increasing evidence indicates that inflammation can cause thrombosis by a von Willebrand factor (VWF)-mediated mechanism that includes endothelial activation, secretion of VWF, assembly of hyperadhesive VWF strings and fibers, cleavage by ADAMTS13, and adhesion and deposition of VWF-platelet thrombi in the vasculature. This mechanism appears to contribute to thrombosis not only in small vessels, but also in large vessels. Inflammation and VWF contribute to atherogenesis and may contribute to arterial and venous thrombosis as well as stroke. Elucidation of the mechanism will hopefully identify new targets and suggest new approaches for prevention and intervention.
Oncogenic N-Ras and Tet2 haploinsufficiency collaborate to dysregulate hematopoietic stem and progenitor cells
Authors: Jin Xi , Qin Tingting , Zhao Meiling , Bailey Nathanael , Liu Lu , Yang Kevin , Ng Victor , Higashimoto Tomoyasu , Coolon Rosemary , Ney Gina , Figueroa Maria E. , Li Qing
Published: June 2018

Key Points

N-RasG12D and haploinsufficient Tet2 collaborate to induce lethal and highly penetrant CMML in mice with shortened overall survival. N-RasG12D and haploinsufficient Tet2 together promote balanced proliferation and enhanced competitiveness and self-renewal in HSPCs.
Adherence to treatment with artemether–lumefantrine or amodiaquine–artesunate for uncomplicated malaria in children in Sierra Leone: a randomized trial
Authors: Banek Kristin , Webb Emily L. , Smith Samuel Juana , Chandramohan Daniel , Staedke Sarah G.
Published: June 2018

Background

Prompt, effective treatment of confirmed malaria cases with artemisinin-based combination therapy (ACT) is a cornerstone of malaria control. Maximizing adherence to ACT medicines is key to ensuring treatment effectiveness.

Methods

This open-label, randomized trial evaluated caregiver adherence to co-formulated artemether–lumefantrine (AL) and fixed-dose amodiaquine–artesunate (AQAS) in Sierra Leone. Children aged 6–59 months diagnosed with malaria were recruited from two public clinics, randomized to receive AL or AQAS, and visited at home the day after completing treatment. Analyses were stratified by site, due to differences in participant characteristics and outcomes.

Results

Of the 784 randomized children, 680 (85.6%) were included in the final per-protocol analysis (340 AL, 340 AQAS). Definite adherence (self-reported adherence plus empty package) was higher for AL than AQAS at both sites (Site 1: 79.4% AL vs 63.4% AQAS, odds ratio [OR] 2.16, compared to probable adherence plus probable or definite non-adherence, 95% confidence interval [CI] 1.34–3.49; p = 0.001; Site 2: 52.1% AL vs 37.5% AQAS, OR 1.53, 95% CI 1.00–2.33, p = 0.049). However, self-reported adherence (ignoring drug package inspection) was higher for both regimens at both sites and there was no strong evidence of variation by treatment (Site 1: 96.6% AL vs 95.9% AQAS, OR 1.19, 95% CI 0.39–3.63, p = 0.753; Site 2: 91.5% AL vs 96.4% AQAS, OR 0.40, 95% CI 0.15–1.07, p = 0.067). In Site 2, correct treatment (correct dose + timing + duration) was lower for AL than AQAS (75.8% vs 88.1%, OR 0.42, 95% CI 0.23–0.76, p = 0.004). In both sites, more caregivers in the AQAS arm reported adverse events (Site 1: 3.4% AL vs 15.7% AQAS, p < 0.001; Site 2: 15.2% AL vs 24.4% AQAS, p = 0.039).

Conclusions

Self-reported adherence was high for both AL and AQAS, but varied by site. These results suggest that each regimen has potential disadvantages that might affect adherence; AL was less likely to be taken correctly at one site, but was better tolerated than AQAS at both sites. Measuring adherence to anti-malarials remains challenging, but important. Future research should focus on comparative studies of new drug regimens, and improving the methodology of measuring adherence.

Trial registration: Clinicaltrials.gov, NCT01967472. Retrospectively registered 18 October 2013,https://clinicaltrials.gov/ct2/show/NCT01967472
Attenuated FOLFIRINOX in the salvage treatment of gemcitabine‐refractory advanced pancreatic cancer: a phase II study
Authors: Kim Jung Hoon , Lee Sang‐Cheol , Oh Sung Yong , Song Seo‐Young , Lee Namsu , Nam Eun Mi , Lee Soonil , Hwang In Gyu , Lee Hyo Rak , Lee Kyu Taek , Bae Sang‐Byung , Kim Han Jo , Jang Joung Soon , Lim Do Hyoung , Lee Hyun Woo , Kang Seok Yun , Kang Jung Hun
Published: June 2018

Background

Combination therapy with oxaliplatin, irinotecan, fluorouracil, and leucovorin (FOLFIRINOX) chemotherapy drastically improves survival of advanced pancreatic cancer patients. However, the efficacy of FOLFIRINOX as a second‐line treatment after gemcitabine failure has not been tested prospectively. We investigated the feasibility and safety of attenuated FOLFIRINOX in patients with gemcitabine‐refractory advanced pancreatic cancer.

Methods

A multicenter phase II prospective open‐label, single‐arm study was conducted at 14 hospitals. Patients with histologically proven invasive ductal pancreatic adenocarcinoma, a measurable or evaluable lesion, Eastern Cooperative Oncology Group performance status 0 or 1, adequate organ function, and aged 19 years or older were eligible. Attenuated FOLFIRINOX consisted of oxaliplatin 65 mg/m2, irinotecan 135 mg/m2, and leucovorin 400 mg/m2 injected intravenously on day 1 and 5‐fluorouracil 2000 mg/m2 continuously infused intravenously over 46 h on days 1–2, repeated every 2 weeks. The primary endpoint was progression‐free survival from the initiation of FOLFIRINOX. Secondary endpoints were the objective response rate, disease control rate, overall survival, safety, and tolerability. We estimated overall survival and progression‐free survival using the Kaplan–Meier methods.

Results

We enrolled 39 patients from 14 institutions. The objective response rate was 10.3%, while the disease control rate was 64.1%. The 6‐month and 1‐year overall survival rates were 59.0% and 15.4%, respectively. Median progression‐free survival and overall survival were 3.8 months (95% confidence interval [CI] 1.5–6.0 months) and 8.5 months (95% CI 5.6–11.4 months), respectively. Grade 3 or 4 adverse events were neutropenia (41.0%), nausea (10.3%), anorexia (10.3%), anemia (7.7%), mucositis (7.7%), pneumonia/pleural effusion (5.1%), and fatigue (5.1%). One treatment‐related death attributable to septic shock occurred.

Conclusion

Attenuated FOLFIRINOX may be promising as a second‐line therapy for gemcitabine‐refractory pancreatic cancer.
SAD-A Promotes Glucose-Stimulated Insulin Secretion Through Phosphorylation and Inhibition of GDIα in Male Islet β Cells
Authors: Nie Jia , Sun Chao , Chang Zhijie , Musi Nicolas , Shi Yuguang
Published: June 2018

Rho GDP-dissociation inhibitor (GDIα) inhibits glucose-stimulated insulin secretion (GSIS) in part by locking Rho GTPases in an inactive GDP-bound form. The onset of GSIS causes phosphorylation of GDIα at Ser174, a critical inhibitory site for GDIα, leading to the release of Rho GTPases and their subsequent activation. However, the kinase regulator(s) that catalyzes the phosphorylation of GDIα in islet β cells remains elusive. We propose that SAD-A, a member of AMP-activated protein kinase–related kinases that promotes GSIS as an effector kinase for incretin signaling, interacts with and inhibits GDIα through phosphorylation of Ser174 during the onset GSIS from islet β cells. Coimmunoprecipitation and phosphorylation analyses were carried out to identify the physical interaction and phosphorylation site of GDIα by SAD-A in the context of GSIS from INS-1 β cells and primary islets. We identified GDIα directly binds to SAD-A kinase domain and phosphorylated by SAD-A on Ser174, leading to dissociation of Rho GTPases from GDIα complexes. Accordingly, overexpression of SAD-A significantly stimulated GDIα phosphorylation at Ser174 in response to GSIS, which is dramatically potentiated by glucagonlike peptide-1, an incretin hormone. Conversely, SAD-A deficiency, which is mediated by short hairpin RNA transfection in INS-1 cells, significantly attenuated endogenous GDIα phosphorylation at Ser174. Consequently, coexpression of SAD-A completely prevented the inhibitory effect of GDIα on insulin secretion in islets. In summary, glucose and incretin stimulate insulin secretion through the phosphorylation of GDIα at Ser174 by SAD-A, which leads to the activation of Rho GTPases, culminating in insulin exocytosis.
Spectral Affordances of the Catalogue
Authors: Jaussen Paul
Published: June 2018

Critical assessments of the literary catalogue often stress its desire for order, highlighting the device’s encyclopedic tendencies of inclusion, exclusion, totality, and transparency. This article offers an alternative approach, arguing that the catalogue of persons can function as a document of loss, whose formal structure produces spectral, ghostly, and even traumatic effects. Analyzing catalogues from Homer’s Iliad, Charles Dickens’s American Notes for General Circulation, and Roberto Bolaño’s 2666, this essay demonstrates that the formal capacity for spectrality is an underappreciated affordance of the catalogue, through which it confronts actual historical violence. A comparative reading of Homer, Dickens, and Bolaño demonstrates that the catalogue, far from establishing mastery and transparency, is a literary device shot through with virtual effects, emergent echoes, and palpable absences. These affordances challenge the catalogue’s claims for totality while also making it a powerful mechanism for measuring history as loss.
Sox30 initiates transcription of haploid genes during late meiosis and spermiogenesis in mouse testes
Authors: Bai Shun , Fu Kaiqiang , Yin Huiqi , Cui Yiqiang , Yue Qiuling , Li Wenbo , Cheng Le , Tan Huanhuan , Liu Xiaofei , Guo Yueshuai , Zhang Yingwen , Xie Jie , He Wenxiu , Wang Yuanyuan , Feng Hua , Xin Changpeng , Zhang Jinwen , Lin Mingyan , Shen Bin , Sun Zheng , Guo Xuejiang , Zheng Ke , Ye Lan
Published: June 2018

Transcription factors of the Sox protein family contain a DNA-binding HMG box and are key regulators of progenitor cell fate. Here, we report that expression of Sox30 is restricted to meiotic spermatocytes and postmeiotic haploids. Sox30 mutant males are sterile due to spermiogenic arrest at the early round spermatid stage. Specifically, in the absence of Sox30, proacrosomic vesicles fail to form a single acrosomal organelle, and spermatids arrest at step 2-3. Although most Sox30 mutant spermatocytes progress through meiosis, accumulation of diplotene spermatocytes indicates a delayed or impaired transition from meiotic to postmeiotic stages. Transcriptome analysis of isolated stage-specific spermatogenic cells reveals that Sox30 controls a core postmeiotic gene expression program that initiates as early as in late meiotic cells. ChIP-seq analysis shows that Sox30 binds to specific DNA sequences in mouse testes, and its genomic occupancy correlates positively with expression of many postmeiotic genes including Tnp1, Hils1, Ccdc54 and Tsks. These results define Sox30 as a crucial transcription factor that controls the transition from a late meiotic to a postmeiotic gene expression program and subsequent round spermatid development.
A study of the deltaic coast morphometry of river Pinios in relation to its hydro- & sediment dynamics
Authors: Foutrakis P. , Poulos S. , Maroukian H. , Livaditis G.
Published: June 2018

This paper refers to the study of the morphodynamic processes, on a seasonal basis, in the river delta of Pinios (Greece) with the application of the discharge effectiveness index (Ef) -which associates the water discharge (D) with the wave power (PJ- and the estimation of the potential longshore sediment transport (Ql). The delta is characterised according to the classification proposed by Galloway (1975) and revised by Briggs et al (1997), as wave/fluvial dominated type of delta, having a cuspate shape like the deltas of San Francisco and Rhone. Wave processes are dominant during summer-autumn period (low values ofEf) and river processes are important in winter and spring (high values ofEf). The total potential longshore sediment transport is northwards and more intensive in the region to the south of its current mouth.
Comparative geomorphological observations in two groups of alluvial fans of Sperchios and Eurotas regions, Greece
Authors: Kontou A. , Gaki-Papanastasiou K. , Maroukian H.
Published: June 2018

In the present study two groups of alluvial fans from two different regions in Greece were comparetively studied, the first in the region of Sperchios river and the second in the region ofEurotas river. Distinct morphometric characteristics of the drainage basins of the tributaries Ts er lias, Xerias, Gorgopotamos, Kerasias, Retsas and Kakaris, as well as their fans were measured and compared. Furthermore ,the longitudinal stream profiles were mapped, pebble measurements were made and contour crenulations of the fans were studied. In gravelometry, it was found that the mean size M of the pebbles decreases from the apex to the apron of the fan. The crenulation analysis showed that the fans of the streams ofEurotas region have undergone greater erosion than those of Sperchios region. Remarkable differences exist between the fans of the two regions. These results lead to the conclusion that recent tectonism, the prevailing lithology and climate are responsible for the formation and evolution of the fans and also influence their shape, area and all the other morphometric characteristics
Study of natural mechanisms for the supply of transported materials to the Ag. Varvara coast (Lesvos island)
Authors: Lykoudi E. , Antoniou M.
Published: June 2018

The shaping of a coast is the result of the interaction of ground and marine factors. To study the formation mechanism of the coast, it is necessary to study both the characteristics of the source from which the transported materials originate, that is the rivers discharging in it, and the characteristics of the receiver of these materials, that is the coastal zone. The results of such a study contribute to the application of a administrative action plan to this system, based on the principles of the integrated administration and the viable evolution. In this work the dynamics that shapes the coast ofAg. Varvara are examined. To this purpose, both the natural supply mechanism of the Ag. Varvara 's coastal zone with materials from the Voulgaris river and the settlement mechanism of these materials are under investigation. The most significant factors influencing the characteristics of the Voulgaris river - which is the main materials supplier of the coast – and shaping the evolution of the Ag. Varvara 's coatal zone, are the catchment area as well as the interactions taking place in it, the type and the quantity of the transported material, (geological factor), the tectonic movements influencing the shaping of the area, and finally the climatic conditions. The geomorphologic-morphotectonic analysis points to the fact that, while there is substantial supply of material to the river bed, only a small percentage of that is being transported to the coast. This is attributing to the diminished transportation capability of the river. Other factors contributing to this are the longer than expected length of the river bed, its small slopes, an the low rainfall level in the area
The foreshore zone determination according to the Greek legislation, using geologic and océanographie data
Authors: Pehlivanoglou K. G. , Martsoukou M.
Published: June 2018

The available scientific field data of the marine and the coastal enviroment, (the wind and the wave field data, the shallow area bathymetry, the coastal area geomorphology and topography, etc.), joint to deep and shallow wave prediction numerical modelling (by means of the wind and bathymetry measurements), calculation of the near shore wave height and maximum wave run up, were used to support the mapping of the innermost limit of the foreshore zone, according to the Greek legislation which defines that "the foreshore is the zone of land wetted by the highest however unexceptional sea wave run up " and the Supreme Administrative Court standard case law. These methods applied for two areas, which completely differ for the wind and the wave field, the géomorphologie and topographic characteristics of the coastal area, proposing different procedures for the determination of the innermost limit of the foreshore zone. The proposed limits of the foreshore zones for both areas, resulted from the study, are compared to the limits proposed by the authorised Administrative Commissions, which were published in the Official Gazette and also were applied by the local authorities for the coastal area management
Landslide hazard analysis - a case study in Kerasia village (prefecture of Karditsa)
Authors: Matziaris V. , Ferentinou M. , Angelopoulou O. , Karanasiou S. , Sakellariou M.
Published: June 2018

Landslides are common phenomena in almost every part of the world. In Greece, there are many areas which suffer from landslides resulting mostly in damages to infrastructures and rarely in fatalities. Using GIS tools, one can perform stability analysis using infinite slope model, either in large or in medium scale, depending on the demands of the specific study. The proposed tool is the Landslide Hazard Analysis (LHA) which enables the user to run a stability analysis under circular, plane, or wedge failure in an area by taking into account the geomorphological, hydrological, geological and geotechnical conditions. In this paper, a problematic area was selected in Kerasia village in Karditsa district, in central Greece in order to determine slope stability. Back analysis using a limit equilibrium method prior to the GIS analysis was important so as to determine the shear strength parameters of the soil slopes. Implementing these data in LHA, a landslide hazard map was derived indicating high hazard areas. For these areas, further analysis could be performed so as to determine the status of stability more precisely and also to examine possible effects of rainfall, using more sophisticated models
Pétrographie characterization of rocks from the Mirabello bay region, Crete, and its application to Minoan archaeology: the provenance of stone implements from Minoan sites
Authors: Dierckx H. M. , Tsikouras B.
Published: June 2018

The Minoans of East Crete used a variety of igneous and metamorphic rocks as stone implements. These were probably procured in dry riverbeds and beaches located in a region along the Bay of Mirabello or from an onlap conglomerate, which geologically dominates that region and contains rock types of igneous, metamorphic and sedimentary origin. Several rock samples were collected for pétrographie investigation to examine and confirm the source for the igneous rocks. Detailed pétrographie description of natural samples provides the identification of the rocks employed by Minoans and confirms the source of their origin. Apparently the Minoans were able to evaluate the hardness of the stones procured according to the desirable usage and their expected fatigue, thus avoiding unnecessary timeconsuming treatment. The identification of the variable lithotypes used for these implements and the verification of their source regions reveal the time it took to procure the raw materials as well as the time period during which the rocks were employed.
Safety assessment and protection of monuments located in caves - a case study from the city of Volos, Greece
Authors: Loupasakis C. , Nikolaou N.
Published: June 2018

The holy shrine ofPanagia (Saint Maria) Goritsis is located in a cave on the outer limits of the city of Volos, on the coastline. The stability problems caused by the loosening of the rockmass and the expansion of the joints generated issues about the safety of the numerous worshippers visiting the church every day. The cave is located into the Middle Triassic - Upper Jurassic marbles of the Pelagonian zone. The fragmentation of the rockmass along the two faults intersecting the slope until the coastline, combined with the weathering action of waves led to the formation of the cave. Although the action of the waves was cut of by the construction of the narthex and the surrounding buildings, the stability problems of the cave are intensified by the dynamic loading of the roof. The ceiling of cave is located 1 to 3 metres under the national road and the railway line connecting Volos with Agia. The selection of the proper support measures was complicated. The limited space, the small depth and most of all the religious and the historical value of the cave led to the selection of light support measures combined with the imposition of restriction for the reduction of the dynamic and the static loading
The Plaka petrified forest park in western Lesvos - Greece
Authors: Zouros N. , Velitzelos E. , Valiakos I. , Labaki O.
Published: June 2018

On the island of Lesvos, large accumulations of fossilised tree trunks comprise the Lesvos Petrified Forest a protected natural monument. Within the protected area of the Lesvos Petrified Forest Geopark, several fossil sites with impressive fossilized trees have been discovered along the coast. During the last few years, the Natural History Museum of the Lesvos Petrified Forest has conducted systematic scientific research on these sites. The coastal area ofPlaka was one of the main sites of research interest in order to explore the terrestrial and marine fossil sites. Several clusters of petrified trees have been found and identified in 45 different fossil sites. Some of them were standing while others were lying. The intact root systems of the standing trees provide proof that these trees were petrified in situ. Most of the trees are angiosperms and gymnosperms. The coastal landscape and its rich ecosystem, and the fossil sites, in combination with volcanic, tectonic and geomorphological structures, are basis of the rich geotouristic potential of the new Plaka Park, which has become an area for environmental education as well as a new geotouristic attraction.
Estimation of rockfall hazard using a GIS-based three-dimensional rockfall simulation model
Authors: Charalambous S. , Sakellariou M.
Published: June 2018

Rockfall is a very common geomorphological process, yet a major hazard mainly in mountainous areas or along man-made slopes, potentially threatening lives, settlements, equipment, facilities and road infrastructure. In Greece, rockfalls are considered to be one of the most common forms of landslide as well as the most common failure mode likely to be triggered by a seismic event. Rockfall hazard assessment is requisite for both safety purposes (countermeasure design), as well as for land planning purposes. In this paper, a new three-dimensional rockfall simulation model, developed in GIS environment, is proposed as a tool for assessing rockfall hazard for a local- or even a regional-scale area. The application provides stochastic analysis, three-dimensional visualization and animation of rockfalls, by taking advantage of the capabilities offered by GIS. By means of case studies we evaluate the simulation model as a tool assisting spatial analysis and planning, which can be used in decision-making and design concerning road infrastructures, or even a large technical work, such as a dam.