bluuebunny/crossref_metadata_2025 huggingface dataset:
Rinne Test Results: How Badly Can We Be Mistaken?
Authors: Wrobel Maciej J. , Bogacz Bogdan F.
Published: March 2021

Objective

To establish the extent to which sound amplitudes delivered by a vibrating tuning fork change around its long axis and to evaluate whether such differences in amplitude might change the results of the Rinne test.

Study Design

Experimental measurements.

Setting

Laboratory setting.

Methods

Setup I: a vibrating tuning fork was handheld and manually rotated around its long axis next to a sound recording device (the simulated ear) in order to record sound amplitude data at a full range of angles relative to the device; files were split into segments in which sound amplitude changed: A (from a maximum to a minimum) and B (from a minimum to a maximum). Setup II: a vibrating tuning fork was machine‐rotated, and the angle of rotation, along with the sound amplitude, was automatically recorded through a single full rotation.

Results

The angles of 0° and 180° (which equate to the established best practice in Rinne testing) were associated with the highest sound amplitudes. All other angles decreased sound amplitude. The greatest decrease in amplitude was recorded at 51° and 130°. This difference ranged from 9.8 to 34.7 dB, depending on the initial amplitude.

Conclusion

The outcome of a Rinne test can be affected if attention is not paid to the precise angle at which the tuning fork is held relative to the ear. The potential of this effect will be greater when high background noise or patient hearing loss requires that the tuning fork be vigorously excited to obtain high sound amplitudes.
Carbonate and cation substitutions in hydroxylapatite in breast cancer micro-calcifications
Authors: Zhang Yan , Wang Changqiu , Li Yan , Lu Anhuai , Meng Fanlu , Ding Hongrui , Mei Fang , Liu Jianying , Li Kang , Yang Chongqing , Du Jingyun , Li Yanzhang
Published: March 2021

Calcification within breast cancer is a diagnostically significant radiological feature that generally consists of hydroxylapatite. Samples from 30 cases of breast carcinoma with calcification were investigated using optical microscopy, energy-dispersive X-ray analysis, transmission-electron microscopy, Fourier-transform infrared spectroscopy, Raman spectroscopy, synchrotron radiation X-ray diffraction and X-ray fluorescence. Under optical microscopy, the calcifications were found to consist of either irregular aggregates with widths > 200 μm or spherical aggregates similar to psammoma bodies with an average diameter of 30 μm. Transmission-electron microscopy showed that short columnar or dumbbell-shaped crystals with widths of 10–15 nm and lengths of 20–50 nm were the most common morphology; spherical aggregates (~1 μm in diameter) with amorphous coatings of fibrous nanocrystals were also observed. Results indicated that hydroxylapatite was the dominant mineral phase in the calcifications, and both CO32– and cation substitutions (Na, Mg, Zn, Fe, Sr, Cu and Mn) were present in the hydroxylapatite structure. Fourier-transform infrared spectra show peaks at 872 and 880 cm–1 indicating that CO32– substituted both the OH– (A type) and PO43– (B type) sites of hydroxylapatite, making it an A and B mixed type. The ratio of B- to A-type substitution was estimated in the range of 1.1–18.7 from the ratio of peak intensities (I872/I880), accompanied with CO32– contents from 1.1% to 14.5%. Trace arsenic, detected in situ by synchrotron radiation X-ray fluorescence was found to be distributed uniformly in the calcifications in the form of AsO43– substituting for PO43–. It is therefore proposed that identifying these trace elements in breast cancer calcifications may be promising for future clinical diagnostics.
Phagocyte extracellular traps in children with neutrophilic airway inflammation
Authors: King Paul T. , Dousha Lovisa , Clarke Nadeene , Schaefer Jennifer , Carzino Rosemary , Sharma Roleen , Wan Ken L. , Anantharajah Aveena , O'Sullivan Kim , Lu Zhong X. , Holdsworth Stephen R. , Ranganathan Sarath , Bardin Philip G. , Armstrong David S.
Published: March 2021

Childhood lung infection is often associated with prominent neutrophilic airway inflammation and excess production of proteases such as neutrophil elastase (NE). The mechanisms responsible for this inflammation are not well understood. One potentially relevant pathway is the production of extracellular traps by neutrophils (NETs) and macrophages (METs). The aim of this study was to measure NET and MET expression in children and the effect of deoxyribonculease (DNase) 1 and α1-antitrypsin (AAT) on this process.

We studied 76 children (median age of 4.0 years) with cystic fibrosis or chronic cough who underwent investigational bronchoscopy. NETs, METs and neutrophil elastase activity in bronchoalveolar lavage (BAL) samples were measured using confocal microscopy and functional assays. The effects of DNase 1 and AAT on NET/MET expression and neutrophil elastase activity were examinedin vitro.

Both subject groups had airway neutrophilia with prominent BAL production of NETs with neutrophil elastase co-expression; the mean %±standard error of the mean of neutrophils expressing NETs in the cystic fibrosis group was 23.3±2.8% and in the non-cystic fibrosis group was 28.4±3.9%. NET expression was higher in subjects who had detectable neutrophil elastase activity (p≤0.0074). The percentage of macrophages expressing METs in the cystic fibrosis group was 10.7±1.2% and in the non-cystic fibrosis group was 13.2±1.9%. DNase 1 decreased NET/MET expression (p<0.0001), but increased neutrophil elastase activity (p≤0.0137). The combination of AAT and DNase 1 reduced neutrophil elastase activity (p≤0.0049).

We observed prominent extracellular trap formation in symptomatic children with and without cystic fibrosis. This innate inflammatory response was down-regulated by a combination of currently available therapeutics.
One Novel Hydraulic Actuating System for the Lower-Body Exoskeleton
Authors: Sun Maowen , Ouyang Xiaoping , Mattila Jouni , Yang Huayong , Hou Gang
Published: March 2021

The hydraulic exoskeleton is one research hotspot in the field of robotics, which can take heavy load due to the high power density of the hydraulic system. However, the  traditional hydraulic system is normally centralized, inefficient, and bulky during application, which limits its development in the exoskeleton. For improving the robot’s performance, its hydraulic actuating system should be optimized further. In this paper a novel hydraulic actuating system (HAS) based on electric-hydrostatic actuator  is proposed, which is applied to hip and knee joints. Each HAS integrates  an electric servo motor, a high-speed micro pump, a specific tank, and other components into a module. The specific parameters are obtained through relevant simulation according to human motion data and load requirements. The dynamic models of the HAS are built, and validated by the system identification. Experiments of trajectory tracking and human-exoskeleton interaction are carried out, which demonstrate the proposed HAS has the ability to be applied to the exoskeleton. Compared with the previous prototype, the total weight of the HAS in the robot is reduced by about 40%, and the power density is increased by almost 1.6 times.
Socioeconomic inequalities in life expectancy and disability-free life expectancy among Chilean older adults: evidence from a longitudinal study
Authors: Moreno Ximena , Lera Lydia , Moreno Francisco , Albala Cecilia
Published: March 2021

Background

Chile has one of the longest life expectancies of Latin America. The country is characterised by an important macroeconomic growth and persisting socioeconomic inequalities. This study analyses socioeconomic differences in life expectancy (LE) and disability-free life expectancy (DFLE) among Chilean older people.

Methods

The sample of the Social Protection Survey, a longitudinal study, was analysed. Five waves, from 2004 to 2016, were considered. The indicator was disability, defined as having difficulties to perform at least one basic activity of daily living. Type of health insurance was used to determine socioeconomic position (SEP). Total LE and DFLE were estimated with multistate life table models.

Results

At age 60, men in the higher SEP could expect to live 3.7 years longer (22.2; 95% CI 19.6–24.8) compared to men of the same age in the medium SEP (18.4; 95% CI 17.4–19.4), and 4.9 years longer than men of the same age in the lower SEP (17.3; 95% CI 16.4–18.2). They also had a DFLE (19.4; 95% CI 17.1–21.7) 4 (15.4; 95% CI 14.6–16.1) and 5.2 (14.2; 95% CI 13.4–14.9) years longer, compared to the same groups. Women aged 60 years in the higher SEP had a LE (27.2; 95% CI 23.7–30.8) 4.6 (22.7; 95% CI 21.9–23.5) and 5.6 (21.6; 20.6–22.6) years longer, compared to women in the medium and the lower SEP. The difference in DFLE, for the same age and groups was 4.9 and 6.1 years, respectively (high: 21.4; 95% CI 19.5–23.3; medium: 16.5; 95% CI 15.8–17.1; low: 15.3; 95% CI 14.6–16.0). Socioeconomic differences in LE and DFLE were observed among both sexes until advanced age.

Discussion

Socioeconomic inequalities in LE and DFLE were found among Chilean older men and women. Older people in the highest SEP live longer and healthier lives.

Conclusion

A reform to the Chilean health system should be considered, in order to guarantee timely access to care and benefits for older people who are not in the wealthiest group.
The role of intellectual property rights on access to medicines in the WHO African region: 25 years after the TRIPS agreement
Authors: Motari Marion , Nikiema Jean-Baptiste , Kasilo Ossy M. J. , Kniazkov Stanislav , Loua Andre , Sougou Aissatou , Tumusiime Prosper
Published: March 2021

Background

It is now 25 years since the adoption of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the same concerns raised during its negotiations such as high prices of medicines, market exclusivity and delayed market entry for generics remain relevant as highlighted recently by the Ebola and COVID-19 pandemics. The World Health Organization’s (WHO) mandate to work on the interface between intellectual property, innovation and access to medicine has been continually reinforced and extended to include providing support to countries on the implementation of TRIPS flexibilities in collaboration with stakeholders. This study analyses the role of intellectual property on access to medicines in the African Region.

Methods

We analyze patent data from the African Regional Intellectual Property Organization (ARIPO) and Organisation Africaine de la Propriété Intellectuelle (OAPI) to provide a situational analysis of patenting activity and trends. We also review legislation to assess how TRIPS flexibilities are implemented in countries.

Results

Patenting was low for African countries. Only South Africa and Cameroon appeared in the list of top ten originator countries for ARIPO and OAPI respectively. Main diseases covered by African patents were HIV/AIDS, cardiovascular diseases, cancers and tumors. Majority countries have legislation allowing for compulsory licensing and parallel importation of medicines, while the least legislated flexibilities were explicit exemption of pharmaceutical products from patentable subject matter, new or second use of patented pharmaceutical products, imposition of limits to patent term extension and test data protection. Thirty-nine countries have applied TRIPS flexibilities, with the most common being compulsory licensing and least developed country transition provisions.

Conclusions

Opportunities exist for WHO to work with ARIPO and OAPI to support countries in reviewing their legislation to be more responsive to public health needs.
Operatively treated ankle fractures in Switzerland, 2002–2012: epidemiology and associations between baseline characteristics and fracture types
Authors: Vieira Cardoso Diogo , Dubois-Ferrière Victor , Gamulin Axel , Baréa Christophe , Rodriguez Pablo , Hannouche Didier , Lübbeke Anne
Published: March 2021

Background

Ankle fractures are common, and their incidence has been increasing. Previous epidemiological studies have been conducted in the US, Scandinavia, and Scotland. Our objectives were to provide a current epidemiological overview of operatively treated ankle fractures and to evaluate the influence of age, sex, lifestyle factors, and comorbidities on fracture types.

Methods

We performed a population-based epidemiological study of all ankle fractures treated operatively in a 10- year period from 2002 to 2012.

Results

Two thousand forty-five ankle fractures were operated upon. Men and women differed significantly in age (median 41 vs. 57 years old), obesity (16% vs. 23%), diabetes (5% vs. 10%), smoking (45% vs. 24%), and accident type (daily activities 48% vs. 79%, transportation 24% vs. 9%, sports 21% vs. 8%) respectively. Overall, there were 2% Weber A, 77% Weber B, and 21% Weber C fractures; 54% were uni-, 25% bi-, and 21% trimalleolar; 7.5% of all fractures were open. Weber C fractures were much more frequent among men and with higher BMI (lowest vs. highest category: 14% vs. 32%), but slightly less frequent with older age and among current smokers. Trimalleolar fractures were twice as frequent in women and increased with age.

Conclusion

Men and women differed substantially in age, lifestyle factors, comorbidities, accident type, and type of ankle fracture. Male sex and higher BMI were more frequently associated with Weber C fractures, whereas female sex and older age were associated with trimalleolar fracture. The risk for severe fracture increased linearly with the degree of obesity.
Identification of a De Novoc.1000delA ANK1 mutation associated to hereditary spherocytosis in a neonate with Coombs-negative hemolytic jaundice-case reports and review of the literature
Authors: Xie Lichun , Xing Zhihao , Li Changgang , Liu Si-xi , Wen Fei-qiu
Published: March 2021

Background

To strengthen the understanding of Hereditary Spherocytosis (HS) and determine the disease-causing mutation present with neonatal jaundice. HS is a hemolytic condition resulting from various erythrocyte membrane defects. Many different mutations result in HS, including mutations in ANK1.

Case presentation

A term neonate presented at ten hours with severe jaundice requiring exchange transfusion. At two months he was hospitalized due to repeated pallor and anemia requiring blood transfusions. Using next-generation sequencing, we discovered the responsible mutation in the proband but not in his parents; a heterozygous nucleotide variation of c.1000delA (p.1334Sfs*6) in ANK1. Thus hereditary spherocytosis was diagnosed.

Conclusions

Genetic detection is an important means of discovering the cause of hemolytic anemia in neonates and infants where routine diagnostic tests are unrevealing. We found a novel de novo mutation, c.1000delA (p.1334Sfs*6) in ANK1 that might account for other cases of HS in the Chinese population.
The clinical significance of preoperative plasma fibrinogen levels and platelet counts in resectable colon cancer
Authors: Papila Kundaktepe Berrin , Papila Cigdem
Published: March 2021

Background and aim

Several aspects of the correlation between colon cancer and hemostatic markers are still unknown to many researchers in the field. In this study, we evaluated the association, if any, of preoperative platelet (PLT) counts and plasma fibrinogen levels with postoperative lymph node involvement and venous invasion in colon cancer patients.

Methods

This study retrospectively included eighty patients with colon cancer (mean age 58.09 years; 37% female 63% male).

Results

Patients with negative lymph nodes and venous invasion showed a significantly lower PLT count and higher fibrinogen level than their counterparts, i.e., patients with positive lymph nodes (p<0.001, all of them) and venous invasion (p<0.001, all of them). The results also showed a positive association of PLT counts and fibrinogen levels with lymphatic invasion (r=0.670, p<0.001 and r=0.639, p<0.001, respectively) and a positive association of PLT counts and fibrinogen levels with venous invasion (r=0.3988, p<0.001 and r=0.5268, p<0.001, respectively). According to the results of the ROC curve analysis, when the PLT count cutoff was 290/mm3, the sensitivity and specificity were 82% and 86.67%, respectively (AUC = 0.8840, p<0.0001, 95% CI 0.8084–0.9596). When the fibrinogen level cutoff was 310.0 mg/dL, the sensitivity and specificity were 72% and 96.67%, respectively (AUC 0.8790, p <0.0001, 95% CI 0.8067–0.9513).

Conclusion

The preoperative PLT count and plasma fibrinogen level may be considered key markers to monitor postoperative lymph node involvement and venous invasion in colon cancer patients.
Diagnosis prediction of tumours of unknown origin using ImmunoGenius, a machine learning-based expert system for immunohistochemistry profile interpretation
Authors: Chong Yosep , Thakur Nishant , Lee Ji Young , Hwang Gyoyeon , Choi Myungjin , Kim Yejin , Yu Hwanjo , Cho Mee Yon
Published: March 2021

Background

Immunohistochemistry (IHC) remains the gold standard for the diagnosis of pathological diseases. This technique has been supporting pathologists in making precise decisions regarding differential diagnosis and subtyping, and in creating personalized treatment plans. However, the interpretation of IHC results presents challenges in complicated cases. Furthermore, rapidly increasing amounts of IHC data are making it even harder for pathologists to reach to definitive conclusions.

Methods

We developed ImmunoGenius, a machine-learning-based expert system for the pathologist, to support the diagnosis of tumors of unknown origin. Based on Bayesian theorem, the most probable diagnoses can be drawn by calculating the probabilities of the IHC results in each disease. We prepared IHC profile data of 584 antibodies in 2009 neoplasms based on the relevant textbooks. We developed the reactive native mobile application for iOS and Android platform that can provide 10 most possible differential diagnoses based on the IHC input.

Results

We trained the software using 562 real case data, validated it with 382 case data, tested it with 164 case data and compared the precision hit rate. Precision hit rate was 78.5, 78.0 and 89.0% in training, validation and test dataset respectively. Which showed no significant difference. The main reason for discordant precision was lack of disease-specific IHC markers and overlapping IHC profiles observed in similar diseases.

Conclusion

The results of this study showed a potential that the machine-learning algorithm based expert system can support the pathologic diagnosis by providing second opinion on IHC interpretation based on IHC database. Incorporation with contextual data including the clinical and histological findings might be required to elaborate the system in the future.
Patella resurfacing during total knee arthroplasty is cost-effective and has lower re-operation rates compared to non-resurfacing
Authors: Parsons Thomas , Al-Jabri Talal , Clement Nick D. , Maffulli Nicola , Kader Deiary F.
Published: March 2021

Background

The decision to resurface the patella as part of total knee arthroplasty may be influenced by the surgeon’s preference, education, training, tradition and geographic location. Advocates for non-resurfacing or selectively resurfacing may claim no difference in patient reported outcomes, and that resurfacing is associated with increased risks such as extensor mechanism injury or malalignment, problems with the design of the patella component and technical issues intraoperatively.

Aims

To critically examine factors that should be considered in addition to patient reported outcomes in the decision process of resurfacing or non-resurfacing of the patella in total knee arthroplasty.

Method

A comprehensive literature search was conducted to identify factors that may influence decision making in addition to knee specific patient reported outcome measures such as surgical risks, patient quality of life, procedure cost, re-operation rate, implant design, surgeons learning curve and the fate of remaining cartilage in native patellae.

Results

Patient-reported outcomes are equivocal for resurfacing and non-resurfacing. Critical analysis of the available literature suggests that the complications of resurfacing the patella are historic, which is now lower with improved implant design and surgical technique. Routine resurfacing was cost-effective in the long term (potential saving £104 per case) and has lower rates of revision (absolute risk reduction 4%). Finally, surgical judgment in selective resurfacing was prone to errors.

Conclusion

Patella resurfacing and non-resurfacing had similar patient-reported outcomes. However, patella resurfacing was cost-effective and was associated with a lower rate of re-operation compared to non-resurfacing.
Differential diagnoses of COVID-19 pneumonia: the current challenge for the radiologist—a pictorial essay
Authors: Guarnera Alessia , Podda Pierfrancesco , Santini Elena , Paolantonio Pasquale , Laghi Andrea
Published: March 2021

Background

COVID-19 pneumonia represents the most severe pandemic of the twenty-first century and has crucial clinical, social and economical implications. The scientific community has focused attention and resources on clinical and radiological features of COVID-19 pneumonia. Few papers analysing the vast spectrum of differential diagnoses have been published.

Main body

Complexity of differential diagnosis lays in the evidence of similar radiological findings as ground-glass opacities, crazy paving pattern and consolidations in COVID-19 pneumonia and a multitude of other lung diseases. Differential diagnosis is and will be extremely important during and after the pandemic peak, when there are fewer COVID-19 pneumonia cases. The aim of our pictorial essay is to schematically present COVID-19 pneumonia most frequent differential diagnoses to help the radiologist face the current COVID-19 pneumonia challenge.

Conclusions

Clinical data, laboratory tests and imaging are pillars of a trident, which allows to reach a correct diagnosis in order to grant an excellent allocation of human and economical resources. The radiologist has a pivotal role in the early diagnosis of COVID-19 pneumonia because he may raise suspicion of the pathology and help to avoid COVID-19 virus spread.
Attitudes and awareness of regional Pacific Island students towards e-learning
Authors: Johnson Joel B. , Reddy Pritika , Chand Ronil , Naiker Mani
Published: March 2021

The rise of online modes of content delivery, termed e-learning, has increased student convenience and provided geographically remote students with more options for tertiary education. However, its efficacy relies upon student access to suitable technology and the internet, and the quality of the online course material. With the COVID-19 outbreak, education providers worldwide were forced to turn to e-learning to retain their student base and allow them to continue learning through the pandemic. However, in geographically remote, developing nations, many students may not have access to suitable technology or internet connections. Hence it is important to understand the potential of e-learning to maintain equitable access to education in such situations. This study found the majority (88%) of commencing students at the University of the South Pacific owned at least one ICT device and had access to the internet. Similarly, most students had adequate to strong ICT skills and a positive attitude toward e-learning. These attitudes among the student cohort, in conjunction with the previous experience of The University of the South Pacific in distance education, are likely to have contributed to its relatively successful transition from face-to-face to online learning as a result of the COVID-19 pandemic.
Artificial intelligence-aided CT segmentation for body composition analysis: a validation study
Authors: Borrelli Pablo , Kaboteh Reza , Enqvist Olof , Ulén Johannes , Trägårdh Elin , Kjölhede Henrik , Edenbrandt Lars
Published: March 2021

Background

Body composition is associated with survival outcome in oncological patients, but it is not routinely calculated. Manual segmentation of subcutaneous adipose tissue (SAT) and muscle is time-consuming and therefore limited to a single CT slice. Our goal was to develop an artificial-intelligence (AI)-based method for automated quantification of three-dimensional SAT and muscle volumes from CT images.

Methods

Ethical approvals from Gothenburg and Lund Universities were obtained. Convolutional neural networks were trained to segment SAT and muscle using manual segmentations on CT images from a training group of 50 patients. The method was applied to a separate test group of 74 cancer patients, who had two CT studies each with a median interval between the studies of 3 days. Manual segmentations in a single CT slice were used for comparison. The accuracy was measured as overlap between the automated and manual segmentations.

Results

The accuracy of the AI method was 0.96 for SAT and 0.94 for muscle. The average differences in volumes were significantly lower than the corresponding differences in areas in a single CT slice: 1.8% versus 5.0% (p < 0.001) for SAT and 1.9% versus 3.9% (p < 0.001) for muscle. The 95% confidence intervals for predicted volumes in an individual subject from the corresponding single CT slice areas were in the order of ± 20%.

Conclusions

The AI-based tool for quantification of SAT and muscle volumes showed high accuracy and reproducibility and provided a body composition analysis that is more relevant than manual analysis of a single CT slice.
Right inferior phrenic artery injury as a complication of needle aspiration: a case report
Authors: El Adel Mohamed , Hassan Sayed , Nady Mohamed A. , Ghoneim Ahmed , Seif Hany
Published: March 2021

Background

To the best of the author’s knowledge, inferior phrenic artery injury was not documented in the literature as a complication of chest tube insertion or needle aspiration, and our case was the first to be mentioned in literature.

Traumatic injury to the inferior phrenic artery is extremely rare. It was reported to be injured by blunt trauma such as motorcar accident and may be associated with another organ injury.

Case presentation

The present case represents an unexpected event of inferior phrenic artery injury due to iatrogenic chest aspiration. Despite the safe maneuver we have approached in our center using a blunt dissection technique rather than the trocar technique, an unexpected complication occurred. The right inferior phrenic artery was injured with subsequent intra-abdominal bleeding and shock. It was treated successfully by endovascular embolization of the bleeding artery.

Conclusions

This complication might add a further morbidity and mortality and raising the responsibility of the surgeon to one of the most common daily surgeon’s practices.
Continuous usage intention to e-transaction cards in wholesale markets of agriproducts: empirical evidence from China
Authors: Sui Xuechao , Geng Xianhui
Published: March 2021

Generalizing the e-transaction services in wholesale markets of agriproducts is seen as a way for the government in China to enhance its information services capabilities. These services could also facilitate the transactions of traders. We find that traders are reluctant to use e-transaction cards although they have physical access. This paper identifies factors influencing traders’ continuous usage intention to e-transaction cards in wholesale markets of agriproducts in China. Data were collected from 204 respondents through a self-administered survey completed by traders and analyzed by structural equation modeling (SEM). The results explore that perceived ease of use (PEOU), perceived usefulness (PU) and perceived privacy security (PPS) directly and positively affect traders’ continuous usage intention. It is also demonstrated that both PEOU and perceived transaction security indirectly and positively affect continuous usage intention through PU. This research provides practical guidelines for decision makers to increase traders’ intention to e-transaction cards.
Phase II Study of the WEE1 Inhibitor Adavosertib in Recurrent Uterine Serous Carcinoma
Authors: Liu Joyce F. , Xiong Niya , Campos Susana M. , Wright Alexi A. , Krasner Carolyn , Schumer Susan , Horowitz Neil , Veneris Jennifer , Tayob Nabihah , Morrissey Stephanie , West Gabriela , Quinn Roxanne , Matulonis Ursula A. , Konstantinopoulos Panagiotis A.
Published: March 2021

PURPOSE

Uterine serous carcinoma (USC) is a distinct histologic subtype of endometrial cancer, with molecular characteristics suggesting frequent cell-cycle dysregulation paired with a high level of oncogene-driven replication stress. Adavosertib is a potent and selective oral inhibitor of the WEE1 kinase, a key regulator of the G2/M and S phase cell-cycle checkpoints. Because cells with impaired cell-cycle regulation and high replication stress may be vulnerable to WEE1 inhibition, we conducted this study to assess the activity of adavosertib monotherapy in women with recurrent USC.

PATIENTS AND METHODS

This was a single-arm two-stage phase II study with coprimary end points of objective response rate (ORR) and rate of progression-free survival at 6 months (PFS6). Women with recurrent USC were treated with adavosertib monotherapy at a starting dose of 300 mg orally once daily days 1 through 5 and 8 through 12 of a 21-day cycle until disease progression.

RESULTS

In 34 evaluable patients, 10 total responses (one confirmed complete response, eight confirmed partial responses, and one unconfirmed partial response) were observed with adavosertib monotherapy, for an ORR of 29.4% (95% CI, 15.1 to 47.5). Sixteen patients were progression-free at 6 months, for a PFS6 rate of 47.1% (95% CI, 29.8 to 64.9). Median PFS was 6.1 months, and median duration of response was 9.0 months. Frequent treatment-related adverse events (AEs) included diarrhea (76.5%), fatigue (64.7%), nausea (61.8%), and hematologic AEs. No clear correlation of clinical activity with specific molecular alterations was observed in an exploratory biomarker analysis.

CONCLUSION

Adavosertib monotherapy demonstrated encouraging and durable evidence of activity in women with USC, and further investigation of this agent in this cancer and biomarkers of activity are indicated.
Transient Leukopenia After Radioactive Iodine Treatment in Patients With Graves’ Disease: A Retrospective Cohort Study
Authors: Yamashita Kaoru , Morimoto Satoshi , Kimura Shihori , Seki Yasufumi , Bokuda Kanako , Watanabe Daisuke , Yazaki Tomoyo , Abe Koichiro , Ichihara Atsuhiro
Published: March 2021

Context

Radioactive 131I (RAI) for the treatment of differentiated thyroid cancer is known to induce bone marrow suppression, which occurs approximately 1 month after treatment. However, it is unknown whether RAI therapy for Graves’ disease causes bone marrow suppression.

Objective

This study aimed to evaluate the short- and long-term effects of RAI therapy on bone marrow function in patients with Graves’ disease.

Methods

In this retrospective cohort study, we included patients with Graves’ disease who received RAI therapy only once between 2003 and 2019 at Tokyo Women’s Medical University. Blood cell counts at baseline were compared with counts at 1, 2, 4, 12, 24, 48, 144, and 240 weeks after RAI therapy. Moreover, changes in white blood cell (WBC) count and leukopenia at 1 week after RAI treatment were compared by baseline patient characteristics.

Results

We enrolled 48 patients. Leukopenia was observed in 6 patients at 1 week after RAI treatment, and the overall WBC count significantly decreased (P < 0.001) 1 week after the therapy; however, the values were not significantly lower after 2 weeks. Neither red blood cell nor platelet count were significantly altered. Moreover, independent of other factors, the neutrophil count at the baseline was significantly negatively associated with changes in WBC count or the occurrence of leukopenia 1 week after the RAI treatment.

Conclusion

These data showed that RAI treatment induced transient reduction in the WBC count 1 week after treatment, although WBC levels were subsequently restored.
Cardiovascular Events in Patients with Thyroid Storm
Authors: Waqar Zainulabedin , Avula Sindhu , Shah Jay , Ali Syed Sohail
Published: March 2021

Context

Thyroid storm can present as a multitude of symptoms, the most significant being cardiovascular (CV). It is associated with various manifestations such as cardiac arrhythmia, heart failure, and ischemia. However, the frequencies of events and characteristics associated with patients that experience these events are not known.

Methods

Study cohort was derived from the National Inpatient Sample database from January 2012 to September 2015. Total hospitalizations of thyroid storm were identified using appropriate ICD-9 diagnostic codes. The analysis was performed using SAS.

Objective

To better understand the frequency and characteristics CV occurrences associated with thyroid storm, through a retrospective analysis of thyroid storm hospital admissions.

Design

The study cohort was derived from the National Inpatient Sample database from January 2012 to September 2015.

Setting

Total hospitalizations of thyroid storm were identified using International Classification of Diseases (ICD)-9 diagnostic codes. The analysis was performed using Statistical Analysis System (SAS).

Results

A total of 6380 adult hospitalizations were included in the final analysis, which includes 3895 hospitalizations with CV events (CEs). Most frequently associated CEs were arrhythmia (N = 3770) followed by acute heart failure (N = 555) and ischemic events (N = 150). Inpatient mortality was significantly higher in patients with CEs compared with those without CEs (3.5% vs 0.2%, P < 0.005). The median length of stay was also higher in patients with CEs compared with those without CEs (4 days vs 3 days, P < 0.0005). Atrial fibrillation was the most common arrhythmia type, followed by nonspecified tachycardia.

Conclusions

In patients who were hospitalized due to thyroid storm and associated CEs significantly increased in-hospital mortality, length of stay, and cost. Patients with obesity, alcohol abuse, chronic liver disease, and COPD were more likely to have CEs. Patients with CV complications were at higher risk for mortality. In-hospital mortality increased with ischemic events and acute heart failure. Further evaluation is needed to further classify the type of arrhythmias and associated mortality.
Monitoring the Release of Silver from a Supramolecular Fullerene C60-AgNO3 Nanomaterial
Authors: Hill Jonathan P , Shrestha Rekha Goswami , Song Jingwen , Ji Qingmin , Ariga Katsuhiko , Shrestha Lok Kumar
Published: March 2021

Release of silver from the supramolecular fullerene-silver(I) nitrate complex C60(AgNO3)5 was investigated. Silver(I) nitrate release from the complex on treatment with solvent was monitored using the small molecule organo-supergelator 1-phenyl-3-(quinolin-5-yl)urea, which interacts selectively with AgNO3 yielding a stable gel whose extent (i.e. volume fraction of solvent gelated) and persistence indicate that Ag+ cations are continuously released from the complex when immersed in 2-propanol over extended periods of time. The effect of AgNO3 release on the morphology of the C60(AgNO3)5 complex crystals was evaluated using scanning electron microscopy showing that AgNO3 is concurrently deposited as silver nanoparticles at the crystal-solution interface onto an insoluble C60 crystalline framework. Silver release was also monitored potentiometrically revealing emergence of Ag nanoparticles. Initial intense release of Ag+ (in the form of AgNO3) is followed by reductive fixing of silver in nanoparticulate form for longer term bactericidal activity. The latter was established by observing viability of bacterial colonies in aqueous medium where their growth was essentially arrested when C60(AgNO3)5 crystals were present in the medium in contrast to the case for pristine C60 where colony growth proceeded unhindered. Cell proliferation studies using HeLa cell line revealed that C60(AgNO3)5 crystals also exhibit antiproliferative properties in aqueous media.
Alcoholic pontine myelinolysis: beware the stroke mimic
Authors: Kusel Kieran , Azzam Omar , Youssef Adam , Prentice David
Published: March 2021

Central pontine myelinolysis (CPM), often referred to as osmotic demyelination syndrome, is most commonly seen in the setting of rapid correction of hyponatraemia. Although imaging is the key to diagnosis, conventional CT and MRI findings often lag the clinical manifestations and characteristic MRI changes may be delayed by up to 14 days.

We present a case of a 45-year-old female with an extensive history of alcohol misuse and malnutrition who presented with left hemiparesis, initially suspected to be a stroke. This was following a recent hospital admission when she was managed for Wernicke’s encephalopathy and treated with electrolyte and vitamin replacement. As part of a “code stroke” protocol, CT was initially performed. The initial non-contrast CT brain and CT angiogram of the intracranial arteries were normal, but a CT brain perfusion study demonstrated increased pontine blood flow. A subsequent MRI of the brain confirmed CPM, which was congruent with her clinical course.

This case highlights the importance of osmotic demyelination as a stroke mimic. CPM should be considered in alcoholic patients with neurological impairment regardless of serum sodium. To our knowledge, this is the first published case which illustrates CT perfusion changes in CPM. MRI, however, remains essential for diagnosis.
Community-networks that facilitate engagement in health research: Ifakara Health Research Institute-Bagamoyo case study
Authors: Bategereza Leah , Olotu Ally , Kamuya Dorcas
Published: March 2021

Background: Involvement of communities in the field of health research has been at the forefront of what is considered as ethical conduct of research.  A commonly used approach is regular meetings with locally recognized community leaders to consult about research activities, i.e. community engagement. At the Ifakara Health Research Institute (IHI) in Bagamoyo, Tanzania, different approaches to engaging with the community in health research have been used, but there has not been a systematic understanding of the functioning of the community network that is engaged within health research.

Methods: To understand the community networks engaged in health research, perceptions of community stakeholders and researchers on the functionality of the community networks was performed. We conducted six focus group discussions with respondents who have participated in IHI research for the past five years and 49 in-depth interviews.

Results: Community networks involved in engagement were influenced by the type of research project and kind of participants needed. Different community networks were involved in engagement activities, namely village executive officers, community health workers, hamlet leaders, nurses, doctors and community advisory boards. Approaches used during engagement processes to inform potential participants about the work of IHI and specific studies that are undertaken were useful in passing key information, however, they did not always reach the target population due to having limited levels of interaction with potential participants. Participants and researchers suggested additional ways to engage with the community.  

Conclusion: There is a need of developing a community engagement unit that would work across projects to support engagement with the community. The unit will maintain continuous engagement with the community and conduct research to understand the relationship between communities we work in and researchers. Funding of this unit could be done through contributions from the core budget, individual’s projects or competitive grant application.
Rapid inactivation of SARS-CoV-2 by titanium dioxide surface coating
Authors: Micochova Petra , Chadha Ambika , Hesseloj Timi , Fraternali Franca , Ramsden Jeremy J. , Gupta Ravindra K.
Published: March 2021

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission occurs via airborne droplets and surface contamination. Titanium dioxide (TiO2) coating of surfaces is a promising infection control measure, though to date has not been tested against SARS-CoV-2.

Methods: Virus stability was evaluated on TiO2- and TiO2–Ag (Ti:Ag atomic ratio 1:0.04)-coated 45 x 45 mm ceramic tiles. After coating the tiles were stored for 2–4 months before use. We tested the stability of both SARS-CoV-2 Spike pseudotyped virions based on a lentiviral system, as well as fully infectious SARS-CoV-2 virus. For the former, tile surfaces were inoculated with SARS-CoV-2 spike pseudotyped HIV-1 luciferase virus. At intervals virus was recovered from surfaces and target cells infected. For live virus,  after illuminating tiles for 0–300 min virus was recovered from surfaces followed by infection of Vero E6 cells. % of infected cells was determined by flow cytometry detecting SARS-CoV-2 nucleocapsid protein 24 h post-infection.

Results: After 1 h illumination the pseudotyped viral titre was decreased by four orders of magnitude. There was no significant difference between the TiO2 and TiO2–Ag coatings. Light alone had no significant effect on viral viability. For live SARS-CoV-2, virus was already significantly inactivated on the TiO2 surfaces after 20 min illumination. After 5 h no detectable active virus remained. Significantly, SARS-CoV-2 on the untreated surface was still fully infectious at 5 h post-addition of virus. Overall, tiles coated with TiO2 120 days previously were able to inactivate SARS-CoV-2 under ambient indoor lighting with 87% reduction in titres at 1h and complete loss by 5h exposure.

Conclusions: In the context of emerging viral variants with increased transmissibility, TiO2 coatings could be an important tool in containing SARS-CoV-2, particularly in health care facilities where nosocomial infection rates are high.
Towarzystwo Polsko-Ormiańskie we Lwowie (1920-1922)
Authors: Osiecki Jakub
Published: March 2021

Polish-Armenian Society in Lwów (1920-1922)

Using Armenian and Polish sources, the author analyses the activities ofthe Polish-Armenian Society (Towarzystwo Polsko-Ormiańskie) founded in Lwów(Poland) on June 15, 1920. This organization focused on building relations betweenPoland and Armenia. Its leaders, Jan Grzegorzewski, Garabed Keuprulian and AugustTeodorowicz established cooperation with the Armenian National Delegationin Paris, chaired by Boghos Nubar Pasha, and with its branch in Berlin. They alsoundertook the difficult mission of lobbying for the Armenian case in Warsaw. In thefirst phase of its activity, the Society planned to relocate Polish Armenians (officialsand intelligentsia) to the territories of Western Armenia; due to the deteriorating internationalsituation, the idea was abandoned. Subsequently, efforts were focused onhelping Armenian refugees from Turkey in the Caucasus; on this matter, the Societymade an appeal to the Polish Minister of Foreign Affairs, Count Konstanty Skirmunt.The suspension of the Society’s activity was related to the deterioration of Armenia’ssituation on the international arena. With the abandonment of the Armenianquestion by France and Great Britain, the exchange of letters with activists in Parisalso stopped. The author compares the Society with its counterpart in London – theBritish Armenian Committee, emphasizing the organization of Polish Armenianswas truly exceptional because it was the first one of its kind, and also because itfocused not on the problems of the local diaspora, but on the issue of Armenia’s independence.
Nauczanie języka ormiańskiego na Uniwersytecie Lwowskim w latach 1904-1939
Authors: Krzyżowski Tomasz
Published: March 2021

Teaching the Armenian language at the University of Lwówin the years 1904-1939

The first attempts to introduce an Armenian language course at the Universityof Lwów were made at the beginning of the 20th century. The authorities ofthe Faculty of Philosophy obtained the consent of the Ministry of Religious Affairsand Education in Vienna to open a course of Old and New Armenian, which wasconducted in the years 1904-1933 by Rev. Bogdan Dawidowicz. The classes wereattended by seminarians of the Armenian-Catholic archdiocese, linguists, orientalistsand others interested in Armenian issues. Typically, two hours a week were allocatedto these classes. Students learned Armenian grammar and literature, including theworks of Movses Khorenatsi and Raffi (Hakob Melik Hakobian), as well as with thespecific conditions of the development of the Armenian language in Poland. Afterthe death of Rev. Dawidowicz, Garabed Keuprulian continued the course, focusingon West Armenian. In the interwar period, lectures on Armenian language and classicalliterature were conducted by professor Andrzej Gawroński from the Institute ofOriental Studies, while professor Jerzy Kuryłowicz taught Old Armenian from thehistorical and comparative perspective. During the discussed period, the universitycommunity in Lviv and the activists of the Archdiocese Union of Armenians werealso involved in publishing aimed at popularizing knowledge and broadening thestudies in the field of the Armenian language.
Wartan Rubenowicz Grigorian (1929-2019)
Authors: Grigorian Aram
Published: March 2021

Vartan Rubenovich Grigoryan: historian, armenologist, publicist,collector of ancient Armenian manuscripts (1929-2019)

The author outlines the profile of Dr. Vartan Grigoryan, an outstandingArmenian historian, a longtime researcher at the Matenadaran Institute of AncientManuscripts in Yerevan. Against the background of a private biography, he analyzeshis scientific achievements, including those relating to the history of Polish Armenians,as well as his attitude to the national heritage of Armenia and the issue of itsindependence, and in this respect, also his commitment to Nagorno-Karabakh.
Lectura de las desigualdades en la Zona Metropolitana del Valle de México a partir de los precios inmobiliarios
Authors: Ribardière Antonine , Valette Jean-François
Published: March 2021

Este artículo presenta diferentes lecturas producto del cruce de tres fuentes de información sobre el mercado de la vivienda en la Zona Metropolitana del Valle de México: anuncios de ventas y de alquiler en línea, anuncios en periódicos y anuncios en el espacio público. Por un lado, a la altura de la metrópoli fue posible ubicar los anuncios en línea al nivel de las unidades espaciales censales y al de los diferentes “tipos de poblamiento”. Por otro, el enfoque empírico permitió una mejor comprensión de la producción y la oferta inmobiliaria habitacional. Primero, es posible mostrar la diferencia de visibilidad y legibilidad de la ciudad según el canal de información. Segundo, la variabilidad espacial de los precios anunciados refleja las tensiones que existen en el espacio habitacional a diferentes escalas y, permite una lectura de la división socio-espacial y de la segmentación del mercado de la vivienda, destacando la reproducción de desigualdades.
Semi-authentic practices for student health interpreters
Authors: Crezee Ineke
Published: March 2021

This paper will briefly describe some pedagogical tools used to provide semi-authentic practices for trainee healthcare interpreters. Such practices facilitate legitimate peripheral participation by a Community of Learners in the Community of Practice (Lave & Wenger, 1991; Wenger, 1998, 2000). Special emphasis will be placed on the importance of shared pre-professional practice, and an example of this will be described in some detail. The pedagogical tools outlined in this paper can be easily replicated by interpreter educators internationally.