bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation between stage of small-cell lung cancer and inflammatory factors
Authors: Kim Taeyun , Choi Hyunji , Oak Chul-Ho , Jang Tae-Won , Jung Mann-Hong , Kim Jehun
Published: August 2019

Background

Several biochemical markers are associated with the stage of small-cell lung cancer. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are useful inflammatory markers and related to poor survival. This study aimed to evaluate the correlation between the disease extent of small-cell lung cancer and neutrophil-to-lymphocyte ratio or platelet-to-lymphocyte ratio.

Methods

The study was performed retrospectively in a single South Korean medical center from 2010 to 2016. Of 217 patients pathologically diagnosed with small-cell lung cancer, 157 were included in the analysis. The correlation between disease extent and neutrophil-to-lymphocyte ratio or platelet-to-lymphocyte ratio was measured by Student’s t test and analysis of variance.

Results

Neutrophil-to-lymphocyte ratio (limited disease: 2.38 ± 1.53, extensive disease: 3.25 ± 2.20, p = 0.004) and platelet-to-lymphocyte ratio (limited disease: 122.21 ± 63.13, extensive disease: 153.09 ± 98.57, p = 0.026) were highly associated with disease extent. Neutrophil-to-lymphocyte ratio was associated with advanced TNM stage (stage I: 3.53 ± 3.44, stage II: 2.66 ± 0.95, stage III: 2.34 ± 1.49, stage IV: 3.26 ± 2.22, p = 0.049), and platelet-to-lymphocyte ratio was proportional to the TNM stage but there was no statistical significance (stage I: 111.77 ± 30.76, stage II: 110.71 ± 34.04, stage III: 123.42 ± 64.48, stage IV: 154.68, p = 0.105).

Conclusions

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were increased in advanced stages of small-cell lung cancer, especially when stage was classified into extensive and limited disease. It is necessary to analyze the effect on survival outcome.
Investigation of the isosteric heat of adsorption for supercritical methane on shale under high pressure
Authors: Zhou Shangwen , Wang Hongyan , Zhang Pengyu , Guo Wei
Published: August 2019

The isosteric heat of adsorption (IHA) is one of the key thermodynamic variables for evaluating the interaction between shale and methane, which is rarely studied especially under high pressure. In this work, we conducted methane adsorption experiments at pressures up to 30 MPa and different temperatures on shale samples collected from Longmaxi formation in Sichuan Basin, China. Based on the definition of IHA and Langmuir adsorption model, we proposed a new method to analyze the IHA of methane on shale under four conditions. The calculated results show that the commonly used Clausius–Clapeyron equation overestimates the true isosteric heat of shale, especially under high pressure. IHA under four conditions yield a fixed order as qst,i-va >  qst,r-va >  qst,i+va >  qst,r+va, indicating both the real gas behavior and the adsorbed-phase volume have a negative influence on it, and the effect of adsorbed-phase volume is dominant. Moreover, IHA at zero coverage ([Formula: see text]) in Henry region determined by linear fitting can be regarded as a maximum value in the above four cases, which is independent of pressure and temperature. Therefore, [Formula: see text] can be used as a unique descriptor to evaluate the adsorption affinity of the shale. This work modified the method to obtain the true IHA of supercritical methane on shale more accurately, which lays the foundation for future investigations of the thermodynamics and heat transfer characteristics of the interaction between high pressure methane and shale.
Examining the Effects of Social Stories™ on Challenging Behavior and Prosocial Skills in Young Children: A Systematic Review and Meta-Analysis
Authors: Wahman Charis L. , Pustejovsky James E. , Ostrosky Michaelene M. , Santos Rosa Milagros
Published: August 2019

Social stories are a commonly used intervention practice in early childhood special education. Recent systematic reviews have documented the evidence base for social stories, but findings are mixed. We examined the efficacy of social stories for young children (i.e., 3–5 years) with challenging behavior across 12 single-case studies, which included 30 participants. The What Works Clearinghouse standards for single-case research design were used to evaluate the rigor of studies that included social stories as a primary intervention. For studies meeting standards, we synthesized findings on the efficacy of social stories using meta-analysis techniques and a parametric effect size measure, the log response ratio. Trends in participants’ response to treatment were also explored. Results indicate variability in rigor and efficacy for the use of social stories as an isolated intervention and in combination with other intervention approaches. Additional studies that investigate the efficacy of social stories as a primary intervention are warranted.
Polycentric urban development and economic productivity in China: A multiscalar analysis
Authors: Wang Mingshu , Derudder Ben , Liu Xingjian
Published: August 2019

‘Urban polycentricity’ has become both a conceptual framework capturing emerging empirical realities and a spatial planning vision adopted in cities across Europe, USA, and, recently, also China. Despite the blossoming academic literature on polycentricity, only limited attempts have been made to explore whether and how polycentric urban development at different spatial scales affects the urban economy. In this paper, we empirically analyse whether and how urban polycentricity at different spatial scales in China is associated with urban economic performance. To this end, we extend the Cobb–Douglas production function and include measures of both inter-urban and intra-urban polycentricity to explain differences in labour productivity. The analysis links intra-urban monocentricity and inter-urban polycentricity with higher levels of labour productivity. In addition, the analysis points to an agglomeration spillover effect, as well as a potential weak positive interaction effect between intra- and inter-urban polycentricity. The paper concludes with policy implications for China’s spatial development.
Patient Preference and Physical Demand for Hands-Free Single Crutch vs Standard Axillary Crutches in Foot and Ankle Patients
Authors: Martin Kevin D. , Unangst Alicia M. , Huh Jeannie , Chisholm Jamie
Published: August 2019

Background:

Weightbearing restrictions following foot and ankle surgery require the use of appropriate assistive devices for nonweightbearing ambulation during the recovery period. Selecting an appropriate assistive device that safely optimizes mobility and participation in daily activities is important to patient compliance and satisfaction. The purpose of this study was to compare physiologic demand, perceived exertion, and patient preference between a hands-free single crutch (HFSC) and standard axillary crutches (SACs) in foot and ankle patients.

Methods:

Using 44 preoperative orthopedic foot and ankle patients who had a mean age of 32 (19-51) years, a prospective, randomized, crossover study was performed. The sample consisted of 35 males and 9 females. The mean body mass index (BMI) was 26 (19-36), the mean height was 1.7 m, and the mean weight was 82 kg. Patient data and preactivity heart rate were recorded for all patients, who were then randomized to either an HFSC or SACs. Each patient was randomly assigned to the device they would utilize first using a random number generator. They then crossed over to the other device after vitals returned to within 10% of their baseline heart rate. Every subject completed a 6-minute walk test (6MWT) using both assistive devices in a crossover manner. Immediately following each 6MWT, postactivity heart rate, self-selected walking velocity (SSWV), perceived exertion using the OMNI Rating of Perceived Exertion (OMNI-RPE), and perceived dyspnea using the Modified Borg Dyspnea Scale were obtained. After completing both 6MWTs, patients were asked which assistive device they preferred the most.

Results:

The HFSC was preferred by 86% of patients. Significantly lower dyspnea scores (2.8 vs 5.3; P < .001), fatigue scores (2.4 vs 5.5; P < .001), preactivity and postactivity change in heart rate (28 vs 46 bpm; P < .001), and mean postactivity heart rate (107 vs 122 bpm; P < .001) were found using the HFSC compared with the SACs. The SAC group trended toward a higher SSWV (0.8 vs 0.77 m/s; P = .08). Those with a BMI greater than 25 also preferred iWALK over SACs ( P < .05). Neither group had any falls. Sixty-eight percent of patients complained of axillary/hand pain with the SACs, while 7% complained of proximal leg strap discomfort with the HFSC.

Conclusion:

The results of the current study in our relatively healthy cohort found that foot and ankle patients who were nonweightbearing preferred the HFSC over SACs. They experienced less physiologic demand as well as discomfort and perceived less exertion when using the HFSC compared with SACs.

Level of Evidence:

Level II, prospective comparative study.
Analysis of the Effect of Tibial Stem Length on Coronal Plane Deformity of the Tibial Component in Total Ankle Arthroplasty
Authors: Berlet Gregory C. , Langan Travis M. , Jamieson Marissa D. , Ferrucci Allen M.
Published: August 2019

Background:

Coronal plane deformity is common in patients who undergo total ankle arthroplasty. The correction of this deformity is paramount to the long-term survival of the implant. Coronal plane correction is achieved with soft tissue balancing and, in some part, is maintained through articular geometry constraint. The purpose of this study was to assess the influence of tibial component stem length on the coronal plane stability.

Methods:

A consecutive case series of stemmed implants that met inclusion criteria were reviewed to determine the correction and maintenance of the correction of coronal plane deformity with special emphasis on the effect of modular tibial stem lengths of 2 and >2 segments. Twenty patients received a tibial component with 2 stem segments, and 23 patients received a tibial component with >2 stem segments. At an average patient age of 62.1 years at implantation, there was no significant difference between the 2 cohorts with respect to preoperative deformity or demographics.

Results:

Our case series had a mean coronal deformity of 5.7 degrees, with valgus being more common than varus. At a mean final radiographic follow-up of 266.3 days after the first postoperative weightbearing radiography, coronal deformity increased by 0.4 degrees ( P = .031). From the first postoperative measurement to the last postoperative measurement, there was no difference in mean coronal plane ankle deformity change between patients who received 2 stem segments and patients who received >2 stem segments ( t = −1.14, df = 41, P = .259).

Conclusion:

Coronal plane deformity had a tendency to recur, albeit at a much smaller angle than preoperatively. This recurrence of deformity did not occur because of tibial component movement. Tibial stem lengths of >2 segments did not influence the maintenance of correction of coronal plane deformity or the stability of the tibial component in the coronal plane.

Level of Evidence:

Level III, retrospective comparative series.
Factors associated with difficult intravenous access in the pediatric emergency department
Authors: Lee Se Uk , Jung Jae Yun , Ham Eun Mi , Wang Sang Won , Park Joong Wan , Hwang Soyun , Kim Do Kyun , Kwak Young Ho
Published: August 2019

Background:

Successful intravenous catheter placement plays a vital role in the pediatric emergency department. We assessed pediatric emergency department–related factors associated with difficult intravenous catheter placement.

Method:

We retrospectively reviewed the electronic medical records of patients younger than 18 years who had an intravenous catheter placement attempt during their pediatric emergency department stay. Difficult intravenous access was defined as intravenous catheter placement requiring more than one attempt. The demographic-, clinical- and procedure-related factors were collected, and a logistic regression analysis was used to evaluate the factors associated with difficult intravenous access.

Result:

In total, 925 patients were enrolled, and 77 (8.32%) cases had difficult intravenous access. The median age of the patients was 3.0 (interquartile range = 1–9) years, and 496 (53.6%) patients were male. After adjustment, we found that age (odds ratio = 0.91, 95% confidence interval = (0.85–0.98), p = 0.01); a history of prematurity (odds ratio = 2.31, 95% confidence interval (1.08–4.98), p = 0.03); the intravenous catheter insertion site (foot versus hand odds ratio = 5.65, 95% confidence interval = (2.97–10.75); p < 0.001); and the experience of the provider (<6 months versus ⩾12 months odds ratio = 4.59, 95% confidence interval = (1.92–11.01), p = 0.01) were associated with difficult intravenous access. However, the acuity of disease, crowdedness at the pediatric emergency department, sex, vein visibility, vein palpability, intravenous catheter size, patients’ experience with intravenous access, and time of day were not significantly correlated with difficult intravenous access.

Conclusion:

The success rate of intravenous catheter placement at the pediatric emergency department could be improved by experienced providers. The acuity of disease and crowdedness at the pediatric emergency department were not significantly associated factors.
A Favela That Yields Fruit: Community-Based Tour Guides as Brokers in the Political Economy of Cultural Difference
Authors: Angelini Alessandro
Published: August 2019

Reversing decades of fear and neglect as no-go zones for outsiders, Rio de Janeiro’s most iconic favela communities have become tourist attractions offering a glimpse of the purported “other side” of Brazilian society as well as panoramic vistas over the Marvelous City. Since 2010, tourism has become a vehicle and justification for security, infrastructure, and capacity-building projects in Rio’s favelas. Promoted as an exemplary favela in this social uplift scheme, Santa Marta has received thousands of tourists per year. In an unprecedented step, Santa Marta guides organized themselves into a committee to collectively manage the tourism enterprise and to promote themselves as a brand of community-based tourism in contradistinction to outside commercial tour operators. Their authority and authenticity as local experts hinge on the emergent perception of the favela itself as a resource and that their labor makes that value economically productive. This article analyzes the work of these guides as cultural brokers to think through the semiotically overdetermined yet shifting status of the favela as space of cultural alterity from the perspective of those who are both targets and agents of its transformation. Exploring how community-based guides have emerged as political and economic brokers, this article suggests that their performances as local experts, as well as their modes of organizing, shape tensions and contradictions of the favela as a commodified place. It demonstrates how collectivist and competitive interests among guides embody differing perspectives on state intervention in their community. The discussions and conflicts among tour guides themselves embody the tensions over the future of communities long marginalized by state and capital yet suddenly targeted for economic investment and cultural valorization.
Inter-personal factors affecting building occupants’ thermal tolerance at cold outdoor condition during an autumn–winter period
Authors: Ghaffari Jabbari Shahla , Maleki Aida , Kaynezhad Mohammad Ali , Olesen Bjarne W.
Published: August 2019

The study was conducted to investigate thermal adaptation and the impact of individual differences on developing thermal tolerance when the outdoor temperature falls below 10°C. The applicability of the predicted mean vote (PMV) model was investigated, too. The concept of occupant’s ‘Temperament’ was evaluated as a psychological-adaptation factor. Two main hypotheses were: (a) people with different temperaments would experience different thermal sensations and (b) the classic PMV- predicted percentage dissatisfied (PPD) model is capable of predicting the neutral sensation in heated buildings under cold outdoor temperatures. There was a direct relationship between individual temperament and clothing level as well as thermal sensation. The occupants who were assessed to have cold temperament tend to wear thicker clothes and were more sensitive to variations in indoor air temperature than others. Females with a cold temperament were more than twice as likely to be affected by indoor air temperature as those with a warm temperament. The PMV-PPD model was able to predict the mean neutral temperature in the heated buildings even when the outdoor temperature fell below 10°C. However, when occupants were able to control high indoor temperature, the percentage of true prediction of actual mean votes by the adaptive thermal heat balance model was more than that by the classic PMV model.
Crystallising the official narrative: News discourses about the killings from the Philippine government’s campaign against illegal drugs
Authors: Soriano Cheryll Ruth R , David Clarissa C , Atun Jenna Mae
Published: August 2019

News media’s construction of crime and drugs can shape and change public perceptions and influence popular acceptance of policy and state responses. In this way, media, through selection of sources and framing of narratives, act as important agents of social control, either independently or indirectly by state actors. This article examines how the Philippine government’s anti-drug campaign, and the thousands of deaths resulting from them, has been depicted by the media to the public. We conducted a discourse analysis of television news stories to extract dominant frames and narratives, finding a pattern of over-privileging of State authority as a source, resulting in a monolithic message of justifying the killing of suspects. Furthermore, the ‘event-focused’ slant, which dominates the character of reports by media, inevitably solidifies the narrative that the deaths are a necessary consequence of a national public safety campaign. By relying almost exclusively on this narrative, to the exclusion of alternative frames, the media amplifies and crystallises the state’s narrative. As we critically examine how drugs, drug use and the zero-tolerance policy are positioned through discourse in news texts, the article raises important implications to the ethics and role of journalism in politics and provides explanations relating to crime-reporting norms, values and media organisation realities in the country.
A novel side-channel analysis for physical-domain security in cyber-physical systems
Authors: Wang Min , Huang Kama , Wang Yi , Wu Zhen , Du Zhibo
Published: August 2019

Security of cyber-physical systems against cyber attacks is an important yet challenging problem. Cyber-physical systems are prone to information leakage from the physical domain. The analog emissions, such as magnetic and power, can turn into side channel revealing valuable data, even the crypto key of the system. Template attack is a popular type of side-channel analysis using machine learning technology. Malicious attackers can use template attack to profile the analog emission, then recover the secret key of the system. But conventional template attack requires that the adversary has access to an identical experiment device that he can program to his choice. This study proposes a novel side-channel analysis for physical-domain security in cyber-physical systems. Our contributions are the following three points: (1) Major peak region method for finding points of interests correctly is proposed. (2) A method for establishing templates on the basis of those points of interest still without requiring knowledge of the key is proposed. Several techniques are proposed to improve the quality of the templates as well. (3) A method for choosing attacking traces is proposed to significantly improve the attacking efficiency. Our experiments on three devices show that the proposed method is significantly more effective than conventional template attack. By doing so, we will highlight the importance of performing similar analysis during design time to secure the cyber-physical system.
Clinical and economic burden of heparin-induced thrombocytopenia in hospitalized patients undergoing percutaneous peripheral arterial interventions
Authors: Subahi Ahmed , Osman Mohammed , Adegbala Oluwole , Abubakar Hossam , Kheiri Babikir , Yassin Ahmed S , Khalid Mowyad , Akintoye Emmanuel , Eljack Ammar , Osman Khansa , Alkhouli Mohamad
Published: August 2019

Background

Percutaneous peripheral arterial intervention (PPAI) patients are at a high risk of developing heparin-induced thrombocytopenia due to the need for repeated and prolonged heparin exposure. We sought to investigate the incidence, outcomes, and economic impact of heparin-induced thrombocytopenia post-PPAI utilizing the National Inpatient Sample.

Methods

All patients who underwent PPAI (age ≥18 years) from 2007 to 2014 were identified by using ICD-9-CM codes. Patients were then classified into two groups based on the presence or absence of heparin-induced thrombocytopenia during hospitalization. In-hospital outcomes were compared between the two groups after propensity-score matching to account for differences in baseline characteristics.

Results

Heparin-induced thrombocytopenia was reported in 527 patients (0.23%). After adjusting for patient-level and hospital-level characteristics, in-hospital mortality differences were not significantly different between patients with heparin-induced thrombocytopenia vs. those without heparin-induced thrombocytopenia (odds ratio (OR) 1.02, 95% confidence interval (CI) 0.67 to 1.57, p = 0.951). However, PPAI patients with heparin-induced thrombocytopenia were more likely to develop ischemic stroke (OR 3.84, 95%CI 1.26 to 11.75, p = 0.018), deep venous thrombosis/pulmonary embolism (OR 1.32, 95%CI 0.79 to 1.79, p = 0.078), and acute kidney injury requiring dialysis (OR 4.04, 95%CI 1.72 to 9.50, p = 0.001). Furthermore, post-PPAI patients who developed heparin-induced thrombocytopenia had longer hospitalizations (13.8 vs. 9.8 days, p < 0.0001), higher cost of stay ($62,022 vs. $44,904, p < 0.0001), and higher rates of non-routine home discharges (50.15% vs. 42.19%, p = 0.013).

Conclusion

Among patients who underwent PPAI, heparin-induced thrombocytopenia was associated with a higher risk of venous thrombosis/pulmonary embolism, ischemic stroke, acute kidney injury requiring dialysis, prolonged hospital stay, and increased cost.
Reliability assessment of system under a generalized cumulative shock model
Authors: Gong Min , Eryilmaz Serkan , Xie Min
Published: August 2019

Reliability assessment of system suffering from random shocks is attracting a great deal of attention in recent years. Excluding internal factors such as aging and wear-out, external shocks which lead to sudden changes in the system operation environment are also important causes of system failure. Therefore, efficiently modeling the reliability of such system is an important applied problem. A variety of shock models are developed to model the inter-arrival time between shocks and magnitude of shocks. In a cumulative shock model, the system fails when the cumulative magnitude of damage caused by shocks exceed a threshold. Nevertheless, in the existing literatures, only the magnitude is taken into consideration, while the source of shocks is usually neglected. Using the same distribution to model the magnitude of shocks from different sources is too critical in real practice. To this end, considering a system subject to random shocks from various sources with different probabilities, we develop a generalized cumulative shock model in this article. We use phase-type distribution to model the variables, which is highly versatile to be used for modeling quantitative features of random phenomenon. We will discuss the reliability characteristics of such system in some detail and give some clear expressions under the one-dimensional case. Numerical example for illustration is also provided along with a summary.
Understanding the slum–health conundrum in sub-Saharan Africa: a proposal for a rights-based approach to health promotion in slums
Authors: Alaazi Dominic A. , Aganah Gamel A. M.
Published: August 2019

Sub-Saharan Africa is the world’s least urbanized region but is ironically also the region with the largest proportion of urban slum dwellers. However, there exists limited understanding of the impact of slums on health in the region. To address this knowledge gap, we conducted a systematic search in PubMed, Google, and Google Scholar to identify and review studies examining the slum–health relationship in sub-Saharan African cities. Subsequently, we performed thematic analysis of 40 studies to identify themes that explain the health impact of slums in the region. The majority of studies characterize slums as health-damaging settings, where poverty and unfavorable environmental conditions pose threats to public health and safety. Only a handful of studies suggest a beneficial relationship between slums and health, in such areas as affordable housing provision, employment generation, and community cohesion. We argue that the literature’s overwhelming emphasis on the environmental risks of slums feeds into a neoliberal urban agenda that seeks to clear slums at the expense of their beneficial contributions to health. Accordingly, we advocate a shift in policy discourse, from static characterization of slums as health risks to a health-promotion agenda that emphasizes the housing and service rights of slum populations.
Glycemic Variability and Hypoglycemic Excursions With Continuous Glucose Monitoring Compared to Intermittently Scanned Continuous Glucose Monitoring in Adults With Highest Risk Type 1 Diabetes
Authors: Avari Parizad , Moscardo Vanessa , Jugnee Narvada , Oliver Nick , Reddy Monika
Published: August 2019

Background:

The I-HART CGM study has shown that real-time continuous glucose monitoring (rtCGM) has greater beneficial impact on hypoglycemia than intermittently scanned continuous glucose monitoring (iscCGM) in adults with type 1 diabetes at high risk (Gold score ≥4 or recent severe hypoglycemia using insulin injections). In this subanalysis, we present the impact of rtCGM and iscCGM on glycemic variability (GV).

Methods:

Forty participants were recruited to this parallel group study. Following two weeks of blinded rtCGM (DexcomG4), participants were randomized to rtCGM (Dexcom G5; n = 20) or iscCGM (Freestyle Libre; n = 20) for eight weeks. An open-extension phase enabled participants on rtCGM to continue for a further eight weeks and those on iscCGM to switch to rtCGM over this period. Glycemic variability measures at baseline, 8- and 16-week endpoints were compared between groups.

Results:

At the eight-week endpoint, between-group differences demonstrated significant reduction in several GV measures with rtCGM compared to iscCGM (GRADE%hypoglycemia, index of glycemic control [IGC], and average daily risk range [ADRR]; P < .05). Intermittently scanned continuous glucose monitoring reduced mean average glucose and glycemic variability percentage and GRADE%hyperglycemia compared with rtCGM ( P < .05). At 16 weeks, the iscCGM group switching to rtCGM showed significant improvement in GRADE%hypoglycemia, personal glycemic status, IGC, and ADRR.

Conclusion:

Our data suggest most, but not all, GV measures improve with rtCGM compared with iscCGM, particularly those measures associated with the risk of hypoglycemia. Selecting appropriate glucose monitoring technology to address GV in this high-risk cohort is important to minimize the risk of glucose extremes and severe hypoglycemia.

Clinical trial registration:

ClinicalTrials.gov NCT03028220
Effect of Graft-Host Interference Fit on Graft Integration after Osteochondral Allograft Transplantation: A Comparative MRI Analysis of Two Instrumentation Sets
Authors: Ackermann Jakob , Duerr Robert A. , Barbieri Mestriner Alexandre , Shah Nehal , Gomoll Andreas H.
Published: August 2019

Objective

Precise graft-host interference fit is a potentially import factor for the successful incorporation of osteochondral allograft (OCA) transplants for the treatment of symptomatic focal cartilage defects. It was hypothesized that selection of OCA plug instrumentation set has a significant effect on graft integration and morphology after OCA transplantation

Methods

Thirty-one patients who underwent OCA transplantation between July 2013 and July 2016 were identified for this comparative magnetic resonance imaging (MRI) analysis. Patients were stratified into two groups based on the treatment with the Arthrex Allograft OATS Instrument Set or the JRF Ortho Osteochondral Allograft Plug Instrumentation. MRI was obtained at 12 months postoperatively. All grafts were assessed for integration using the Osteochondral Allograft MRI Scoring System (OCAMRISS), host marrow edema size, graft-host interface distance, graft cartilage integrity, cyst size, graft contour and presence of effusion.

Results

At a mean follow-up of 11.39 ± 1.98 months, 95.5% of all grafts showed osseous integration into the recipient bone with 68.2% presenting without cystic changes of the graft or host-graft junction. No differences were seen in any OCAMRISS subscale besides cartilage signal, which demonstrated minimal differences ( P = 0.046).

Conclusion

OCAs show excellent osseous integration at the graft-host junction at 12 months postoperatively. The comparative MRI analysis of two instrumentation sets yielded no significant differences in terms of graft integration, bone marrow edema, or cystic formation. Hence, this study cannot recommend one instrumentation set over the other. Consequently, the individual preference should guide the surgeon’s selection of instrumentation for OCA transplantation.
Outcome of concomitant treatment with thiopurines and allopurinol in patients with inflammatory bowel disease: A nationwide Danish cohort study
Authors: Thomsen Sandra Bohn , Allin Kristine Højgaard , Burisch Johan , Jensen Camilla Bjørn , Hansen Susanne , Gluud Lise Lotte , Theede Klaus , Kiszka‐Kanowitz Marianne , Nielsen Anette Mertz , Jess Tine
Published: August 2019

Background

Thiopurine and allopurinol in combination are associated with clinical remission in inflammatory bowel diseases but their influence on subsequent outcomes is unclear. We compared outcomes during exposure to both thiopurines and allopurinol versus thiopurines alone.

Methods

We established a nationwide cohort of patients with inflammatory bowel diseases exposed to thiopurines ± allopurinol during 1999–2014, using registry data. Patients were followed until hospitalization, surgery, anti‐TNFα, or death (as a primary composite outcome). We used Poisson regression analyses to calculate incidence rate ratios overall and stratified by calendar period (assuming the combined exposure was unintended before 2009).

Results

A total of 10,367 patients with inflammatory bowel diseases (Crohn’s disease, n  = 5484; ulcerative colitis, n  = 4883) received thiopurines. Of these, 217 (2.1%) also received allopurinol. During 24,714 person years of follow‐up, we observed 40 outcomes among thiopurine‐allopurinol‐exposed patients, and 4745 outcomes among those who were thiopurine exposed; incidence rate ratio, 1.26 (95% confidence interval, 0.92–1.73). The incidence rate ratios decreased over time: 4.88 (95% confidence interval 2.53–9.45) for 1999–2003, 2.19 (95% confidence interval, 1.17–4.09) for 2004–2008 and 0.80 (95% confidence interval, 0.52–1.23) for 2009–2014.

Conclusion

Our nationwide inflammatory bowel disease cohort study shows that concomitant thiopurine‐allopurinol is as safe to use as thiopurines alone, with a tendency towards a positive effect on clinical outcomes in recent calendar periods when combined use was intended.
“Donald Trump Is My President!”: The Internet Research Agency Propaganda Machine
Authors: Bastos Marco , Farkas Johan
Published: August 2019

This article presents a typological study of the Twitter accounts operated by the Internet Research Agency (IRA), a company specialized in online influence operations based in St. Petersburg, Russia. Drawing on concepts from 20th-century propaganda theory, we modeled the IRA operations along propaganda classes and campaign targets. The study relies on two historical databases and data from the Internet Archive’s Wayback Machine to retrieve 826 user profiles and 6,377 tweets posted by the agency between 2012 and 2017. We manually coded the source as identifiable, obfuscated, or impersonated and classified the campaign target of IRA operations using an inductive typology based on profile descriptions, images, location, language, and tweeted content. The qualitative variables were analyzed as relative frequencies to test the extent to which the IRA’s black, gray, and white propaganda are deployed with clearly defined targets for short-, medium-, and long-term propaganda strategies. The results show that source classification from propaganda theory remains a valid framework to understand IRA’s propaganda machine and that the agency operates a composite of different user accounts tailored to perform specific tasks, including openly pro-Russian profiles, local American and German news sources, pro-Trump conservatives, and Black Lives Matter activists.
Clinical research about the improved PVP method in treatment of acute osteoporotic vertebral compression fractures
Authors: Zhang Yao , Song JiPeng , Hou Yu , Zhang GenAi , Ding LiXiang
Published: August 2019

Objective:

The traditional percutaneous vertebroplasty (PVP) could induce massive radiation and side injuries to the tissues around the fractured centrum. This study was designed to reduce the radiation and damage and improve the treatment efficiency of PVP.

Methods:

Forty four patients who diagnosed to be acute osteoporotic single vertebral compression fractures were collected and randomly divided into traditional group and improved group, and these two groups were separately treated by the traditional and improved PVP which assisted by the preoperative digital design. The treatment outcome between these two groups was compared and analyzed by Students’ t test and χ 2 test.

Results:

Compared with the traditional PVP, the improved PVP could significantly reduce the X-ray fluoroscopy times for determining puncture point (14.41 ± 4.00 vs. 6.82 ± 2.15, p < 0.001) and puncture route (22.73 ± 3.89 vs. 13.36 ± 3.39, p < 0.001), the X-ray fluoroscopy times during the operation (76.59 ± 12.4 vs. 34.82 ± 6.74, p < 0.001), operation duration (28.64 ± 7.43 min vs. 15.23 ± 4.4 min, p < 0.001), and total radiological dose (588.85 ± 53.86 cGycm2 vs. 276.5 ± 58.17 cGycm2, p < 0.001). The improved PVP could also significantly decrease the visual analog score at intra-operation (7.68 ± 0.78 vs. 4.50 ± 0.67, p < 0.001) and 1 day after the operation (2.45 ± 0.51 vs. 2.16 ± 0.36, p < 0.05). Besides, the improved PVP could not significantly affect the Oswestry disability index after operation ( p > 0.05).

Conclusion:

The improved PVP operation could significantly reduce the total radiological dose and X-ray fluoroscopy times, protect the patients and medical staff, and reduce the pain caused by the operation.

Trial registration:

This trial was registered in China clinical trial registration center and the registration number was ChiCTR-INR-17011557.
PARP Inhibitor Olaparib Use in a BRCA1-Positive Patient With Metastatic Triple-Negative Breast Cancer, Without the Initial Use of Platinum-Based Chemotherapy, Showing Significant Rapid Near Resolution of Large Liver Metastasis While Patient Experienced Gout-Like Symptoms
Authors: Matthews Hew Trevanne , Zuberi Lara
Published: August 2019

Triple-negative breast cancer (TNBC) accounts for 20% of breast cancers diagnosed worldwide. This subtype of breast cancer tends to behave more aggressively, and unlike other breast cancer subtypes, there are no standard targeted treatments for most patients. However, up to 20% of patients with TNBC harbor a breast cancer gene (BRCA) mutation, particularly in BRCA1. For patients who carry this gene mutation, this opens the door for new management options by the use of newer agents such as polyadenosine diphosphate-ribose polymerase (PARP) inhibitors in the metastatic setting. Given that this is uncommon and that PARP inhibitors have only recently received Federal Drug Administration approval, the experience with these drugs is relatively new. In this article, we present a case of a patient treated in this setting with olaparib who developed an unanticipated side effect as a result of the high efficacy of the drug.
Numerical modelling of ECMM of micro-dimples considering the effect of 3-phase electrolyte
Authors: Prashanth K. , Patel Divyansh Singh , Jain V. K. , Ramkumar J.
Published: August 2019

Electrochemical surface texturing is a complex process consisting of two-phase fluid dynamics, unsteady state heat transfer, mass transfer, electrochemistry, etc., between moving boundaries. There are no anode shape prediction models for surface texturing because of the complications involved in the process. The models available for electrochemical micromachining (ECMM) are incomplete because most of them ignore the influence of sludge and gas bubbles produced during the electrochemical dissolution. In this article, a modified anode shape prediction model considering the evolution of heat, sludge and H2 bubbles have been proposed for ECMM of micro-dimples. Comparison of simulated and experimental anode profiles reveals a satisfactory agreement between the two. In addition, a comparison has been made between the proposed model and the models, which do not consider the effect of generation of sludge and gas bubbles on the conductivity of the electrolyte.
Targeted inhibition of CD47-SIRPα requires Fc-FcγR interactions to maximize activity in T-cell lymphomas
Authors: Jain Salvia , Van Scoyk Alexandria , Morgan Elizabeth A. , Matthews Andrew , Stevenson Kristen , Newton Gail , Powers Foster , Autio Anu , Louissaint Abner , Pontini Guillemette , Aster Jon C. , Luscinskas Francis W. , Weinstock David M.
Published: August 2019

This study reveals that successful therapeutic targeting of the CD47-SIRPα axis in peripheral T-cell lymphoma is highly dependent on the Fc-FcγR interaction and is augmented by cotreatment with the anti-CCR4–targeted monoclonal antibody mogamulizumab.
High mitochondrial mass is associated with reconstitution capacity and quiescence of hematopoietic stem cells
Authors: Takihara Yuji , Nakamura-Ishizu Ayako , Tan Darren Qiancheng , Fukuda Masahiro , Matsumura Takayoshi , Endoh Mitsuhiro , Arima Yuichiro , Chin Desmond Wai Loon , Umemoto Terumasa , Hashimoto Michihiro , Mizuno Hidenobu , Suda Toshio
Published: August 2019

Key Points

HSCs can be separated based on high or low mitochondrial mass. Higher mitochondrial mass is associated with quiescence and greater reconstitution capacity of HSCs.
Multiparametric and multiregional diffusion features help predict molecule information, grade and survival in lower-grade gliomas: a feasibility study
Authors: Lin Hai , Xu Yanwen , Chen Lei , Na Peng , Li Weiping
Published: August 2019

Objective:

This study was to investigate the relationship of diffusion features with molecule information, and then predict grade and survival in lower-grade gliomas.

Methods:

65 patients with primary lower-grade gliomas (WHO Grade II & III) who underwent conventional MRI and diffusion tensor imaging were retrospectively studied. The tumor region was automatically segmented into contrast-enhancing tumor, non-enhancing tumor, edematous and necrotic volumes. Diffusion features, including fractional anisotropy (FA), axial diffusivity, radial diffusivity and apparent diffusion coefficient (ADC), were extracted from each volume using histogram analysis. To estimate molecule biomarkers and predict clinical characteristics of grade and survival, support vector machine, generalized linear model, logistic regression and Cox regression were performed on the related features.

Results:

The diffusion features in non-enhancing tumor volume showed differences between isocitrate dehydrogenase mutant and wild-type gliomas. And the mean accuracy of support vector machine classifiers was 0.79. Ki-67 labeling index was correlated with these features, which were combined to significantly estimate Ki-67 expression level (r = 0.657, p < 0.001). These features also showed differences between Grade II and III gliomas. A combination of them for grade classification resulted in an area under the curve of 0.914 (0.857–0.971). Mean FA and fifth percentile of ADC were independently associated with overall survival, with lower FA and higher ADC showing better survival outcome.

Conclusion:

In lower-grade gliomas, multiparametric and multiregional diffusion features could help predict molecule information, histological grade and survival.

Advances in knowledge:

The multi parametric diffusion features in non-enhancing tumor were associated with molecule information, grade and survival in lower-grade gliomas.
A retrospective analysis of the treatment results for advanced synchronous head and neck and esophageal cancer
Authors: Fan Kang-Hsing , Chao Yin-Kai , Chang Joseph Tung-Chieh , Tsang Ng-Ming , Liao Chun-Ta , Chang Kai-Ping , Lin Chien-Yu , Wang Hong-Ming , Hsu Cheng-Lung , Huang Shiang-Fu
Published: August 2019

Objective:

The treatments for synchronous head and neck cancer (HNC) and esophageal cancer (ESC) are toxic and difficult to employ. The aim of this study was to identify the feasibility of a protracted, less toxic treatment course and prognostic factor of synchronous HNC and ESC.

Methods:

Cancer registry data from 2004 to 2012 were reviewed. The inclusion criteria were two cancer diagnoses within 30 days, and Stage III/IV HNC or Stage II–IV ESC that chemoradiation therapy was indicated. Evident metastasis, Eastern Cooperative Oncology Group performance score >2, a history of prior cancer, or palliative treatment were excluded. Survival rates and patient and treatment characteristics were analyzed.

Results:

There were 51 eligible cases. The 2 year overall survival rate was 25.1%. Univariate analysis found that anemia, larynx/hypopharynx HNC, and no esophagectomy correlated with poor overall survival. Multivariate analysis demonstrated that anemia and no esophagectomy were independent poor prognostic factors. The 2 year progression-free survival rate was 14.8%. Univariate analysis found only no esophagectomy correlated with poor progression-free survival.

Conclusion:

The outcomes are poor for patients with advanced synchronous HNC and ESC. Radiotherapy with a split or protracted course does not result in inferior treatment result and can be considered when the aim is to avoid adverse events. Esophagectomy correlated with good prognosis and should be performed for patients if possible.

Advances in knowledge:

The treatment results of synchronous HNC and ESC is poor. A protracted chemoradiation course for synchronous HNC and ESC did not result in inferior survival and should be applied to patients with a poor prognosis. Esophagectomy correlates with good outcomes and should be encouraged if the patient has a good prognosis.
Modern imaging and image-guided treatments of the prostate gland: MR and ablation for cancer and prostatic artery embolization for benign prostatic hyperplasia
Authors: Dias João Lopes , Bilhim Tiago
Published: August 2019

Multiparametric MRI (mpMRI) has proven to be an essential tool for diagnosis, post-treatment follow-up, aggressiveness assessment, and active surveillance of prostate cancer. Currently, this imaging technique is part of the daily practice in many oncological centres. This manuscript aims to review the use of mpMRI in the set of prostatic diseases, either malignant or benign: mpMRI to detect and stage prostate cancer is discussed, as well as its use for active surveillance. Image-guided ablation techniques for prostate cancer are also reviewed. The need to establish minimum acceptable technical parameters for prostate mpMRI, standardize reports, uniform terminology for describing imaging findings, and develop assessment categories that differentiate levels of suspicion for clinically significant prostate cancer led to the development of the Prostate Imaging Reporting and Data System that is reviewed. Special focus will also be given on the most up-to-date evidence of prostatic artery embolization (PAE) for symptomatic benign prostatic hyperplasia (BPH). Management of patients with BPH, technical aspects of PAE, expected outcomes and level of evidence are reviewed with the most recent literature. PAE is a challenging technique that requires dedicated anatomical knowledge and comprehensive embolization skills. PAE has been shown to be an effective minimally-invasive treatment option for symptomatic BPH patients, that can be viewed between medical therapy and surgery. PAE may be a good option for symptomatic BPH patients that do not want to be operated and can obviate the need for prostatic surgery in up to 80% of treated patients.
Assessment of relationship between extracranial and intracranial carotid calcifications—a retrospective cone beam computed tomography study
Authors: Mutalik Sunil , Tadinada Aditya
Published: August 2019

Objectives:

Cone beam CT scans in current day dental practice are highly collimated yet involve areas along the course of the extracranial carotid artery. Detecting an extracranial carotid calcification on small volume scans leaves the dentist with two questions: whether the patient is likely to have intracranial carotid calcifications and whether the patient warrants further medical attention. This study aimed to assess the presence of intracranial carotid artery calcifications (ICAC) in the presence of extracranial carotid artery calcifications (ECAC).

Methods:

450 CBCT scans were retrospectively evaluated for ECAC and ICAC. Erby et al’s classification was modified to classify calcifications as mild, moderate, and severe. The presence of ICAC when ECAC were present was evaluated in all three orthogonal planes. The risk of ICAC in the presence of ECAC was calculated as odds ratio and the association between the two was calculated using a χ2 test.

Results:

The odds ratio for bilateral ICAC in the presence of bilateral ECAC was 15.09. The odds ratio for left ICAC/right ICAC in the presence of left/ right ECAC was 0.833 and 2.564, respectively. The number and severity of calcifications increased with age. The χ2 test showed that there was a strong association (p < 0.001) between bilateral ECAC with bilateral ICAC.

Conclusions:

The results of this group of patients showed that there is an increased presence of ICAC in the presence of ECAC.