bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary Valve Papillary Fibroelastoma. A Case Report
Authors: Kovačević Miljenko , Šimić Ognjen , Matana Ante , Lučin Ksenija , Štifter Sanja
Published: July 2019

We present a case of pulmonary valve fibroelastoma diagnosed by echocardiogram which was confirmed by surgical resection in a patient in whom elective coronary artery bypass surgery was performed. The patient had no clinical or constitutional symptoms suggesting the presence of an intracardiac tumor. Routine preoperative transthoracic echocardiography revealed a pulmonary valve tumor. Histopathological analysis resulted in a diagnosis of papillary fibroelastoma. Papillary fibroelastomas are rare and benign cardiac tumors. They usually arise from the cardiac valves. In the literature we found only a few cases, so it seems there is a need for further description of additional cases of pulmonary valve fibroelastoma.
Coronary Artery Stenosis following Mediastinal Radiation Therapy. Case Report and Review of the Literature
Authors: Calabrese Pietro , Oliva Stefano , Gaglione Antonio
Published: July 2019

A case of coronary artery stenosis following mediastinal radiation therapy in a young woman and a review of the literature offer indications on the criteria to follow in the diagnosis of coronary artery disease secondary to mediastinal radiation therapy.
Management of Patients with Gastrointestinal Stromal Tumors: Experience from an Italian Hospital
Authors: Cavaliere Davide , Griseri Guido , Venturino Ezio , Schirru Angelo , Cosce Umberto , Caristo Ilario , Caliendo Luigi , Pastorino Alessandra , Cavaliere Paolo
Published: July 2019

Gastrointestinal stromal tumors are malignancies originating from stromal/mesenchymal tissues, most commonly in the stomach and small intestine, although they can be located everywhere in the gastrointestinal tract. Diagnosis is based on histological and immunohistochemical examination, and these rare tumors are characterized by c-kit (CD117) staining. Complete removal of the tumor is often curative in localized gastrointestinal stromal tumors and is always recommended. Clinically, their behavior is difficult to predict, and mitotic count and tumor size seem to be the most effective prognostic factors. We performed a retrospective analysis of clinical presentation and course, surgical management and pathological features of patients with gastrointestinal stromal tumors treated in our institution from 1995 to 2003. Twenty-two patients were enrolled in the study, and all of them underwent surgery. There were two perioperative deaths, and global morbidity was about 13%. Nineteen patients were followed (mean, 31 months): 4 patients had disease progression/recurrence and died, and one patient experienced a local recurrence and was reoperated with a curative intent; 14 patients were disease free. Our experience shows that histological and immunohistochemical examinations are fundamental for a definitive diagnosis and to assess the risk of aggressive behavior. Moreover, our results confirm that in stromal tumors complete surgical resection remains the mainstay of treatment in localized gastrointestinal stromal tumors, although the recurrence rate is relatively high. It is conceivable that treatment and prognosis of metastatic and non-resectable gastrointestinal stromal tumors, as well as the adjuvant treatment of high-risk, radically excised gastrointestinal stromal tumors will be strongly impacted by the c-kit target therapy.
Raltitrexed and Radiotherapy as Adjuvant Treatment for Stage II-III Rectal Cancer: A Feasibility Study
Authors: Lupattelli Marco , Maranzano Ernesto , Bellavita Rita , Natalini Giovanni , Corgna Enrichetta , Rossetti Riccardo , Trippa Fabio , Mascioni Francesca , Sidoni Angelo , Anselmo Paola , Buzzi Franco , Brugia Mauro , Latini Paolo
Published: July 2019

Aims and Background

Adjuvant 5-FU chemotherapy plus radiotherapy represents the standard treatment for radically resected rectal cancer at high risk of relapse according to the NIH Consensus Conference. The therapeutic gain was obtained with a high rate of severe treatment-related toxicity and a sub-optimal patient compliance with this regimen. Raltitrexed is a specific thymidylate synthase inhibitor with a convenient administration schedule, acceptable toxicity and radiosensitizing properties, as the published phase I trials in combination with radiotherapy have shown. The aim of this prospective multicenter phase II study was to evaluate the feasibility, gastrointestinal and hematological acute toxicity of raltitrexed in combination with radiotherapy in rectal cancer patients.

Methods

From September 2000 to June 2004, 50 patients with radically resected stage II-III rectal adenocarcinoma were treated. All patients were evaluable for compliance and acute toxicity. Within 45-60 days of surgery, each patient underwent concomitant adjuvant radiochemotherapy. Radiotherapy was administered to the pelvis (plus perineum after abdominoperineal resection) with photon beam energy exceeding 5 MV, 3-4 fields, 45 Gy/25 fractions/5 weeks plus a boost delivered to the site of resected disease with 3-4 fields, 9 Gy/5 fractions/1 week to a total dose of 54 Gy. The boost dose was administered after complete exclusion of the small bowel from the treatment volumes; if this was not possible a total dose of 50.4 Gy was given. Raltitrexed was administered intravenously at a dose of 3 mg/m2 as a bolus injection on days 1 and 22 of radiotherapy one hour before treatment, for a total of two cycles. Each patient underwent weekly clinical evaluation and laboratory tests. Toxicity was assessed by the WHO scale.

Results

Forty-five (90%) patients completed the established treatment. Acute severe toxicity included grade III proctitis in 4/50 (8%), grade III-IV diarrhea in 4/50 (8%), grade III perineal dermatitis in 4/50 (8%) and grade III leukopenia in 2/50 (4%) patients; five patients (10%) experienced a transient grade III increase in their liver biochemistry values.

Conclusions

Our data related to acute toxicity and patient compliance proved the feasibility of this adjuvant radiochemotherapy treatment. A longer follow-up is necessary to evaluate the effectiveness of this new regimen in terms of disease-free and overall survival.
Bag-1 Expression in Hyperplastic and Neoplastic Prostate Tissue: Is There Any Relationship with BCL-Related Proteins and Androgen Receptor Status?
Authors: Bozdoğan Önder , Atasoy Pınar , Bozdoğan Nazan , Erekul Selim , Batislam Ertan , Yilmaz Erdal , Başar M. Murad
Published: July 2019

Aims and Background

To evaluate the function and distribution of BAG-1 protein in hyperplastic and neoplastic prostate tissue and establish the relationship between this protein and BCL-related proteins (BCL-2 and BAX), androgen receptor (AR) expression and chromogranin A.

Methods

Twenty-eight prostatic adenocarcinomas and 16 prostate hyperplasias were included in this retrospective study. BAG-1, BCL-2, BAX, androgen receptor and chromogranin A immunostaining was performed by means of standard avidin-biotin peroxidase methods. The M30 antibody was used to identify preapoptotic and apoptotic cells. The immunohistochemical histological score (HSCORE) semi-quantative system was used to evaluate immunohistochemical staining.

Results

Statistical analysis showed a significant difference in HSCOREs of BAX, M30 and AR between the carcinoma and hyperplasia groups. Carcinomas expressed higher HSCOREs of these markers than hyperplasias. There were significant differences in nuclear and cytoplasmic BAG-1 positivity between high and low-grade carcinomas. BAG-1 expression was higher in low-grade carcinomas. In the carcinoma group there was a positive correlation (Pearson) between BCL-2 and cytoplasmic/nuclear BAG-1. In the hyperplasia group there was a negative correlation between BAX and BCL-2, and between AR and M30. We also detected a positive correlation between AR and nuclear/cytoplasmic BAG-1 and between nuclear and cytoplasmic BAG-1 in hyperplasias. BAG-1 showed the same specific basal cell localization as BCL-2 in hyperplastic and normal glands.

Conclusions

The BAG-1 protein showed a distinct distribution pattern in hyperplastic and neoplastic prostate. BAG-1 in association with BCL-2 inhibits apoptosis and may prolong the life of neoplastic cells and give them a chance to gain new oncogenic features in early carcinogenesis.
Treatment of Glioblastoma Multiforme in Elderly Patients. Clinico-therapeutic Remarks in 22 Patients Older than 80 Years
Authors: Piccirilli Manolo , Bistazzoni Simona , Gagliardi Franco Maria , Landi Alessandro , Santoro Antonio , Giangaspero Felice , Salvati Maurizio
Published: July 2019

We report our remarks on 22 patients, 80 years of age and older, who were treated for glioblastoma multiforme. The 16 patients who underwent a multimodality treatment (surgery + radiotherapy + chemotherapy) had an average survival of 16.7 months versus the 5.8 months of the 8 patients treated with biopsy followed by radiotherapy and/or chemotherapy (log-rank test, P <0.001). Moreover, we point out the importance of MGMT hypermethylation as a significant prognostic factor: the 9 patients with nonmethylated MGMT had a mean survival of 7.7 months vs 17.9 months of the 13 patients with the MGMT promoter methylated (log-rank test, P = 0.0006). Several studies have pointed out age as an important negative factor for the outcome of elderly patients affected by glioblastoma multiforme. Elderly patients with a diagnosis of glioblastoma multiforme are thus generally excluded from clinical trials of treatment for the neoplasm, because it is a common opinion that the prognosis for such patients is particularly poor. On the contrary, according to our clinical and surgical experience, we firmly believe that patients older than 80 years with a histologically proven diagnosis of glioblastoma multiforme and in good health conditions (Karnofsky performance status >60) should be treated in the same way as younger patients.
Post-traumatic Glioma: Report of two Cases
Authors: Anselmi Elisa , Vallisa Daniele , Bertè Raffaella , Vanzo Carlo , Cavanna Luigi
Published: July 2019

We report two cases of brain glioma that developed in the scar of an old brain trauma. The first is that of a 40-year-old man who presented with severe headaches; CT and MRI showed a large mass in the right parietal region. The tumor was unresectable and surgical biopsy showed a glioblastoma multiforme. The patient had suffered a cranial trauma in a road accident 20 years previously with an intrathecal hematoma in the right parietal region. The second case concerns a 60-year-old man who, 15 years after severe head injury in a road accident, developed a glioblastoma multiforme which was localized in the scar of the brain contusion. These cases fulfill the established criteria for a traumatic origin of brain tumors and add further support to the relationship between cranial trauma and the onset of glioma. As stated by other authors, an association between head trauma and brain tumor risk cannot be ruled out and should be studied further.
An Unusual Association of Cerebral Meningioma, Parathyroid Adenoma and Thyroid Papillary Carcinoma
Authors: Caliumi Chiara , Cotesta Dario , Petramala Luigi , Iorio Monica , Salvati Maurizio , Filetti Sebastiano , De Toma Giorgio , D'Erasmo Emilio , Letizia Claudio
Published: July 2019

The case of a 50-year-old woman with cerebral meningioma and concomitant parathyroid adenoma and papillary thyroid carcinoma is presented. She complained of neurological symptoms characterized by right hemiparesis and dysarthria. Cerebral CT and MRI scans revealed a left voluminous frontal parasagittal lesion with the characteristics of a meningioma. Routine laboratory analysis revealed altered values of calcium-phosphorus metabolism. Intravenous infusion of saline solution at 0.9% of NaCI resulted in a reduction of serum ionized calcium. A left craniotomy was performed and a fibroblastic meningioma of 5 cm in diameter was removed. Even though the patient's clinical condition was good, a calcium-phosphorus metabolism test confirmed high plasma levels of ionized calcium and parathyroid hormone. Thyroid and parathyroid ultrasonography revealed multinodular goiter and a parathyroid lesion confirmed by 99mTc-TCO4/99mTc-MIBI scintigraphy. A left superior parathyroidectomy and total thyroidectomy were performed. Histological examination revealed a parathyroid adenoma and a small papillary carcinoma of 0.4 cm in the right thyroid lobe. As far as we know, this patient is the third case of meningioma associated with parathyroid adenoma and papillary thyroid carcinoma described in the literature.
Abdominal Metastases from Lung Cancer Resulting in Small Bowel Perforation: Report of Three Cases
Authors: Savanis George , Simatos George , Lekka loanna , Ammari Shawki , Tsikkinis Christophoros , Mylonas Anastasios , Kafasis Eythymios , Nissiotis Athanasios
Published: July 2019

Metastatic lung cancer to the small bowel is a rare occurrence. Acute complications such as perforation, hemorrhage and obstruction are even rarer. We present 3 cases of small bowel perforation from metastatic lung cancer. All 3 patients underwent emergency laparotomy. In 2 of them there was no obvious macroscopic appearance of metastatic disease either at the site of perforation or in any other area of the abdomen, whereas in the third patient there were hepatic metastases. The postoperative period was uneventful in all three cases. The longest survival was four months. Our cases bring the number of cases reported in the international literature to a total of 43.
Report on a Case of Breast Sarcoma Metastatic to the Axillary Lymph Nodes
Authors: Brito Jack Antonio Diaz , Gatti Giovanna , Vento Anna Rita , Galimberti Viviana , Intra Mattia , Sahium De Almeida Rafaela Cecilio , Pruneri Giancarlo , Luini Alberto
Published: July 2019

Breast sarcoma is a rare entity that accounts for less than 1% of all breast malignancies; it may spread by direct invasion and/or through the blood. Axillary lymph node involvement is extremely rare and usually associated with advanced-stage disease. In the surgical treatment of this neoplasm, complete axillary lymphadenectomy is important for the local clearance of the clinically involved lymph nodes. We report a case of a 65-year-old woman affected by follicular dendritic cell sarcoma of the left breast. Six months after breast surgery she developed an axillary metastasis from the same disease.
Phase II Study of Induction Chemotherapy with Gemcitabine plus 5-Fluorouracil Followed by Gemcitabine-Based Concurrent Chemoradiotherapy for Unresectable Locally Advanced Pancreatic Cancer
Authors: Kurt Ender , Kurt Meral , Kanat Ozkan , Cetintas Sibel Kahraman , Aygun Sevilcan , Palazoglu Tulay , Ozkan Lutfi , Evrensel Turkkan , Kaya Ekrem , Manavoglu Osman
Published: July 2019

Aims and background

To evaluate the efficacy and tolerability of a new treatment approach including induction chemotherapy (CT) and concurrent chemoradiotherapy (CRT) in unresectable, locally advanced pancreatic cancer (LAPC).

Patients and methods

Twenty-four patients with LAPC were enrolled in the study. They first received induction CT consisting of 5-fluorouracil (5FU) (500 mg/m2) and gemcitabine (1000 mg/m2), which were given weekly for 3 weeks of every 4. Patients showing a response or disease stabilization after 2 cycles of induction CT received CRT consisting of external beam radiotherapy (50.4-54 Gy in fractions of 1.8 Gy/day) and gemcitabine (350 mg/m2, weekly for 6 weeks). Patients without disease progression received 2 additional cycles of CT consisting of 5FU plus gemcitabine with the same doses and schedule as given in the induction CT.

Results

After the end of the study, 2 (8%) and 5 (21%) patients showed complete and partial responses, respectively. Five patients (21%) had disease stabilization. The grade 3 and 4 toxicities associated with CT were neutropenia (21%) and thrombocytopenia (4%). The grade 3 and 4 toxicities occurring in patients who received CRT were neutropenia (24%), thrombocytopenia (24%), diarrhea (18%), and nausea (12%). The median progression-free survival for all patients was 6 months (95% CI, 3.6-8.4), and the median overall survival was 11 months (95% CI, 8.16-13.84).

Conclusions

The CRT approach of this study is moderately active and has an acceptable toxicity profile. However, the incor-poration of combination CT into CRT at the present schedule could not produce any additional benefit over CRT alone. Newer agents with more systemic activity are clearly warranted.
Analysis of Metastatic Ovarian Tumors from Extragenital Primary Sites
Authors: Turan Taner , Aykan Burcu , Koc Sevgi , Boran Nurettin , Tulunay Gokhan , Karacay Ozlem , Erdogan Zuhal , Kose Faruk
Published: July 2019

Aims and background

The aim of this study was to evaluate patients with metastatic ovarian tumors from extragenital primary sites.

Methods

The medical records of 75 patients were reviewed retrospectively for age at diagnosis, presenting symptoms, preoperative tumor marker levels, preoperative diagnostic workup, operative technique, intraoperative evaluation, frozen-section and pathology results, laterality of metastasis, and primary tumor site. The specific impact of metastasis from colorectal and gastric primary sites on laterality, gross features and dimensions of ovarian mass, volume of ascites and tumor marker levels was investigated.

Results

Primary sites were stomach (37.3%), colorectal region (28%), lymphoma (12%), breast (6.7%), biliary system (2.7%), appendix (1.3%) and small intestine (1.3%). It was not possible to identify the primary tumor site in 8 (10.7%) patients. Bilateral metastasis was found in 86.4% patients; 42.7% of the metastatic ovarian tumors were Krukenberg tumors; 50.7% of the ovarian masses were solid. Frozen section was confirmed by postoperative pathological results in 98% of the patients. The mean preoperative serum levels of tumor markers were 298.7 U/mL, 178 U/mL and 113.3 U/mL for CA 125, CA 19-9 and CA 15-3, respectively. CA 125 levels were above 35 U/mL in 81.3% of the patients. The presence of ascites was more frequent in ovarian tumors originating from colorectal and gastric primaries.

Conclusions

Surgery is essential for the diagnosis of the primary tumor and necessary for relief of symptoms. The identification of the primary site is required to plan adequate treatment.
Target Coverage in Head and Neck Cancer Treated with Intensity-Modulated Radiotherapy: A Comparison between Conventional and Conformal Techniques
Authors: Palazzi Mauro , Orlandi Ester , Pignoli Emanuele , Lualdi Manuela , Zonca Giancarlo , Sangalli Claudia , Stucchi Claudio , Olmi Patrizia
Published: July 2019

Aims and background

We designed a comparative planning study aimed at quantifying the advantages of intensity-modu-lated radiotherapy (IMRT) over the conventional 3-field technique (3FT) and a 5-field conformal technique (5FCT) for head and neck (HN) cancer.

Methods

We selected 9 patients treated at our institution with curative radiotherapy for a HN cancer. For all cases 4 plans were generated: 2 plans using the “standard” techniques (3FT and 5FCT), a third plan using IMRT, and a fourth “mixed” plan using IMRT followed by a conventional boost.

Results

Our study confirmed literature data on the ability of IMRT to significantly decrease the dose received by organs at risk, compared with previous techniques. Target coverage was systematically better with 5FCT and IMRT than with 3FT. However, the increase in coverage of both PTV2 and PTV1 was only about 3-5% and this was achieved at the price of a similar increase in maximum dose (D1%). Volumetric parameters (V100%, V95%) were much more sensitive in detecting the improvement with IMRT.

Conclusions

The improvement of target coverage attained by IMRT, as compared with conventional and conformal techniques, might be overestimated by data currently available in the medical literature. If treatment with conventional techniques is planned using all tools provided by currently available fully 3-D planning systems, excellent target coverage can be obtained.
MRI in the Early Detection of Breast Cancer in Women with High Genetic Risk
Authors: Trecate Giovanna , Vergnaghi Daniele , Manoukian Siranuosh , Bergonzi Silvana , Scaperrotta Gianfranco , Marchesini Monica , Ferranti Claudio , Peissel Bernard , Spatti Gianbattista , Bohm Silvia , Conti Alberto , Costa Claudia , Sporeni Manila , Podo Franca , Musumeci Renato
Published: July 2019

Aims and background

Women with BRCA1 or BRCA2 germline mutations have an elevated risk of developing breast and/or ovarian cancer. Because of the early onset of the disease, screening of this group of women should start at an earlier age than in the general population. The association of breast magnetic resonance imaging (BMRI) and ultrasonography (US) with mammography (MX) and clinical breast examination (CBE) in the regular surveillance of these individuals has been proposed and seems to improve the early detection of breast cancer.

Methods

Within a multicenter study started by the Istituto Superiore di Sanita (Rome), at the Istituto Nazionale Tumori of Milan (INT) we enrolled 116 women at high genetic risk for breast cancer; they were either BRCA1 or BRCA2 mutation carriers or had a strong family history of breast cancer. They underwent CBE, MX, US and BMRI once a year.

Results

Between June 2000 and April 2005, at INT 12 cancers were detected among the 116 screened individuals (10%). In this subgroup, 1 patient refused BMRI and in 2 cases US was not performed. With BMRI we found 11 cancers and 6 of them were detectable only by this technique. In these 6 cases, the size of the disease was less than 1 cm and MX was false negative due to irregularly nodular parenchyma in 4 cases and scar tissue or prosthesis in the other 2. US was not performed in 2 cases and was false negative in 4 cases. Three false positive results were found with BMRI: 1 case was considered suspect but related to hormonal influences; 1 case with the same pattern was sent for second-look US, which gave a negative result and BMRI review after 6 months showed normalization of the parenchyma; in the third case histology revealed the presence of adenosis. No false positive results were registered for MX.

Conclusions

The aim of secondary prevention is the detection of cancer at its earliest stage. BMRI screening in women with BRCA1 or BRCA2 mutations or at high familiar risk appears to be highly sensitive and may detect mammographically occult disease. The accuracy of MR imaging is higher than that of conventional imaging but the technique is flawed by a lower specificity. In order to avoid unnecessary biopsies we believe that the combination of BMRI and conventional imaging can be very useful in screening women with a high genetic risk of breast cancer, especially with second-look evaluation by means of US when BMRI yields the only positive diagnostic result. Second-look US has been demonstrated to be of critical importance both in recognizing false positive BMRI results and in guiding biopsies, when necessary.
Pretreatment Tumor Lysis Syndrome Associated with Bulky Retroperitoneal Tumors. Recognition is the Mainstay of Therapy
Authors: Theodorou Dimitrios , Lagoudianakis Emmanuel , Pattas Michael , Drimousis Panagiotis , Tsekouras Dimitrios K , Genetzakis Michael , Katergiannakis Vagelogiannis , Manouras Andreas
Published: July 2019

Acute pretreatment tumor lysis syndrome is a rare complication of cancer. Early recognition and aggressive management are mandatory for prevention of the adverse sequelae of the syndrome. Here we present 2 cases of pretreatment tumor lysis syndrome, concluding that this clinical entity should be in the differential diagnosis of acute renal failure associated with malignancy, as early recognition is in fact the mainstay of treatment.
Skeletal Muscle Metastases from Renal Cell Carcinoma: A Case Report
Authors: Manzelli Antonio , Rossi Piero , De Majo Adriano , Coscarella Giorgio , Gacek Iwona , Gaspari Achille Lucio
Published: July 2019

In this paper, we describe a case of a 73-year old female with late skeletal muscle metastases from a clear-type renal cell carcinoma 8 years after total nephrectomy. The metastases were located in the right femoral quadriceps, in the sartorius muscle and adductor magnus muscle. A full clinical work-up was performed with blood examinations, radiological and pathological assessment. A complete surgical resection with a wide margin was performed for all lesions, and the final pathological report deposed for metastatic renal carcinoma clear-type cells. In this case report, we discuss the crucial rule of accurate radiological and pathological assessment and aggressive surgical management.
Prevalence of Gambling Disorder Among Prisoners: A Systematic Review
Authors: Banks James , Waters Jaime , Andersson Catrin , Olive Victoria
Published: July 2019

This article presents the first systematic review of studies on the prevalence of gambling disorder among prisoners across international jurisdictions. Only original studies that were published in English and employed reliable and valid screening tools are included in this analysis. The review finds that rates of problem or pathological gambling in prison populations are highly variable, ranging from 5.9% to 73% of male and female inmates surveyed. Nevertheless, recorded rates of problem and pathological gambling among inmates are consistently and significantly higher than rates of problem and pathological gambling recorded among the general population. The review indicates that the institution of problem gambling treatment programmes in carceral settings is necessary, to aid community re-entry and reduce the likelihood of re-offending. Moreover, it is suggested that the screening of inmates should become standard practice across penal institutions and other criminal justice organisations, with a view to better addressing the needs of offenders.
Hydrothermal process development for the treatment of crocidolite asbestos waste
Authors: Nzogo Metoule CT , Delaby S , Ferrasse JH , Boutin O
Published: July 2019

The asbestos-containing waste management is a public health topic for countries which have used this mineral. Treatment of chrysotile (white asbestos), a phyllosilicate from serpentine, crocidolite (blue asbestos, first results on this kind of asbestos), one of the five asbestos varieties of amphibole family and asbestos-containing waste conversion process is proposed by using hydrothermal treatment in supercritical water. All samples were treated in an Inconel Batch Reactor. The treatment durations range is from 1 to 6 hours, temperatures range is from 400°C to 750°C, mass concentration range is from 0.02 to 170 mg. mL−1 and pressures are higher than 23 MPa. Ultrapure water is used for sample preparation. This ultrapure water is used to monitor mineral leaching on the aqueous phase and to avoid particle cross-contamination. Transmission electron microscopy analyses were carried out to check the presence or not of asbestos phase. According to these analyses, the best conditions of conversion were 1 hour and 0.02 mg. mL−1 for chrysotile, 3 hours and 0.02 mg. mL−1 for crocidolite and 1 hour and 20 mg. mL−1 for asbestos-containing waste, at T = 750°C. Supercritical water conditions were maintained during the whole treatment. The X-ray diffraction showed that the main phases present after treatments were riebeckite and magnetite (crocidolite), forsterite and enstatite (chrysotile), and calcite, spurrite and gehlenite (asbestos-containing waste). Finally, a scanning electron microscopy analysis was performed to monitor morphological fibre change. The elongated structure, partially fragmented, was found in all samples.
Childhood Adversity, Socioeconomic Instability, Oxytocin-Receptor-Gene Methylation, and Romantic-Relationship Support Among Young African American Men
Authors: Kogan Steven M. , Bae Dayoung , Cho Junhan , Smith Alicia K. , Nishitani Shota
Published: July 2019

Men’s emerging adult romantic relationships forecast downstream relationship behavior, including commitment and quality. Accumulating evidence implicates methylation of the oxytocin-receptor-gene ( OXTR) system in regulating relationship behavior. We tested hypotheses regarding the links between (a) childhood adversity and (b) socioeconomic instability in emerging adulthood on supportive romantic relationships via their associations with OXTR methylation. Hypotheses were tested using path analysis with data from 309 participants in the African American Men’s Project. Consistent with our hypotheses, results showed that OXTR methylation proximally predicted changes in relationship support during a 1.5-year period. Childhood adversity was not directly associated with OXTR methylation but, rather, with contemporaneous socioeconomic instability, which in turn predicted elevated OXTR methylation. Findings suggest that early adversity is indirectly associated with OXTR methylation by links with downstream socioeconomic instability. Findings must be considered provisional, however, because preregistered replications are needed to establish more firmly the relations among these variables.
Utilization of Value-based Management in the Strategic Management of German Automotive Industry
Authors: Raj Razaq , Beck Valentin , Soliman Alaa
Published: July 2019

The purpose of this research article is to analyse the value-based management commitment of automotive enterprises and to examine the factors that explain the control parameters in automotive industry. There have been a few empirical studies published in the German’s automotive sector, but most of the existing studies failed to provide evidence of utilization of value-based management in the strategic management in the automotive sector. The German automotive industry’s development is closely related to global economic developments. Previous research work has considered control parameters of enterprises, but there is little evidence on the factors that explain which control parameters are used in automotive industry. A survey based on annual reports from 2008 to 2011 is used. In total, 20 annual reports of automotive companies were analysed. The results show that automotive companies, especially original equipment manufacturers and listed suppliers, have committed to value-oriented management and have implemented value-oriented approaches. However, not all of the suppliers are communicating this in their reports. The results also show that economic value added is the leading key indicator in the automotive industry.
Role of Industry Factors in Financing the Outward Foreign Direct Investment by Indian Multinational Enterprises
Authors: Tripathi Vanita , Thukral Sonal
Published: July 2019

The article investigates the impact of industry environment of the home country (in which Indian parent firms operate) on financing their outward foreign direct investment (OFDI) for the period 2008–2009 to 2013–2014. Due to difficulty in empirically examining the flows within a multinational system there exists scant literature in this area. By employing random effects probit model we find that size and growth rate of the industry have important implications for OFDI financing by parent firm. Second, by including time effects, uniqueness of the industry to which the parent firm belongs significantly shapes the OFDI financing. Third, parent firms are found to significantly rely on their own strengths than industry environment in financing the OFDI, lending support to the ownership advantage theory of international business. Finally, parent firm is found to follow industry norms in financing their OFDI. The study has implications for supply-side factors determining capital structure of firm and internal capital available to a multinational.
Experimental and numerical studies on a novel shape-memory alloy wire–woven trusses capable of undergoing large deformation
Authors: Rao Zhixiang , Yan Xiaojun , Zhang Xiaoyong , Zhang Bin , Jiang Jun , Zhang Shuqing , Guo Chaoyong , Huang Dawei , Qi Mingjing
Published: July 2019

Currently, most wire-woven trusses are fabricated with traditional metals such as steel and aluminum, thus the deformation ability is constrained due to the low yield strain of common metals. Shape-memory alloy is a kind of smart material which can bear large recoverable strain while producing hysteresis. Due to the unique capacity of large deformation and remarkable damping property of the shape-memory alloy, a novel lattice trusses assembled by superelastic shape-memory alloy coil springs was proposed. Furthermore, the treatment processes to prepare the shape-memory alloy coil springs and the assembly method to fabricate the shape-memory alloy wire–woven trusses were also introduced. The quasi-static compression under different maximum deformation and temperatures was performed to investigate the mechanical and thermal responses of the proposed shape-memory alloy wire–woven trusses. Cyclic compression tests were also performed to study the functional fatigue of the shape-memory alloy wire–woven trusses. The proposed wire-woven trusses can undergo up to 80% deformation by compression and recover without evident residual deformation after unloading. Finite element analysis simulation of representative volume element under different deformation was presented. Analytical modeling of the stiffness of shape-memory alloy wire–woven trusses was also carried out. Both the numerical and analytical methods can predict the stiffness within a small deviation.
What Contributions, if Any, Can Non-Indigenous Researchers Offer Toward Decolonizing Health Research?
Authors: Krusz Emily , Davey Tamzyn , Wigginton Britta , Hall Nina
Published: July 2019

Four non-Indigenous academics share lessons learned through our reflective processes while working with Indigenous Australian partners on a health research project. We foregrounded reflexivity in our work to raise consciousness regarding how colonizing mindsets—that do not privilege Indigenous ways of knowing or recognize Indigenous land and sovereignty—exist within ourselves and the institutions within which we operate. We share our self-analyses and invite non-Indigenous colleagues to also consider socialized, unquestioned, and possibly unconscious assumptions about the dominance of Western paradigms, asking what contributions, if any, non-Indigenous researchers can offer toward decolonizing health research. Our processes comprise of three iterative features—prioritizing attempts to decolonize ourselves, acknowledging the necessary role of discomfort in doing so, and moving through nonbinary and toward nondualistic thinking. With a nondual lens, working to decolonize ourselves may itself be seen as one contribution non-Indigenous researchers may offer to the collective project of decolonizing health research.
Predicting chemotherapy-induced thrombocytopenia in cancer patients with solid tumors or lymphoma
Authors: Razzaghdoust Abolfazl , Mofid Bahram , Zangeneh Masoumeh
Published: July 2019

Purpose

Chemotherapy-induced thrombocytopenia is a serious complication in chemotherapy-treated patients. Identification of patients at risk for chemotherapy-induced thrombocytopenia could have clinical value in personalized management of patients and optimized administration of prophylactic thrombopoietic agents. The aim of this study was to develop a predictive model for chemotherapy-induced thrombocytopenia (platelet count < 100,000/µl) in cancer patients undergoing chemotherapy.

Methods

A total of 14 covariates were prospectively assessed as explanatory variables in a cohort of consecutive patients with solid tumors or lymphoma. A multivariable logistic regression model was developed after univariable analysis. A bootstrapping technique was applied for internal validation.

Results

Data from 305 patients during 1732 chemotherapy cycles were considered for analysis. Forty-eight patients (15.73%) developed chemotherapy-induced thrombocytopenia during their treatment course. The multivariable model exhibited three final predictors for chemotherapy-induced thrombocytopenia, including high ferritin (odds ratio, 4.41; bootstrap P = 0.001), estimated glomerular filtration rate <60 ml/min/1.73 m2 (odds ratio, 3.08; bootstrap P = 0.005), and body mass index <23 kg/m2 (odds ratio, 2.23; bootstrap P = 0.044). The main characteristics of the model include sensitivity 75%, specificity 65.4%, positive likelihood ratio 2.16, and negative likelihood ratio 0.382. Moreover, the model was well calibrated (Hosmer–Lemeshow P = 0.713) and the area under the receiver operating characteristic curve was 0.735 (95% confidence interval, 0.654–0.816; P < 0.001).

Conclusions

We developed a predictive model for chemotherapy-induced thrombocytopenia based on readily available and easily assessable clinical and laboratory factors. This study may provide a valuable insight to guide optimized treatment of cancer patients. Further studies with larger sample size are warranted.
Effectiveness and safety of nab-paclitaxel/gemcitabine in locally advanced or metastatic pancreatic adenocarcinoma
Authors: Nebot-Villacampa María-José , Zafra-Morales Ricardo , Alfaro-Olea Ascensión , Marín-Gorricho Raquel , Casajús-Navasal Andrea , Uriarte-Pinto Moisés
Published: July 2019

Background

Treatment based on nab-paclitaxel plus gemcitabine is one of the standard treatments for locally advanced or metastatic pancreatic adenocarcinoma. Not much information is available about its use in clinical practice. Looking for prognostic markers may aid in improving treatment plans for patients.

Objective

To describe the effectiveness and safety profile of nab-paclitaxel/gemcitabine in locally advanced or metastatic pancreatic adenocarcinoma. We also tried to evaluate prognostic markers of response to treatment.

Setting

Retrospective descriptive study carried out in a tertiary hospital of Spain.

Method

Patients with locally advanced or metastatic pancreatic adenocarcinoma treated with nab-paclitaxel/gemcitabina between January 2014 and December 2017 were included in the analyses.

Main outcome measure

Effectiveness was measured in terms of overall survival, progression-free survival and response rate. To evaluate the safety profile, every adverse event from the start of the treatment and up to 10 days after its completion was registered.

Results

Fifty patients were included. Thirty-three (66%) had metastatic disease. Median overall survival was 8.8 months (95%CI: 5.1–12.5) and the median progression-free survival was 5.6 months (95%CI: 4.3–6.9). Relevance of carbohydrate antigen 19-9 baseline levels as prognostic response marker was confirmed, while neutrophil-to-lymphocyte ratio did not show conclusive results for overall survival. Safety profile was similar to that observed in clinical trials, with a single case of treatment discontinuation due to grade 3 neuropathy.

Conclusion

The studied schedule for locally advanced or metastatic pancreatic adenocarcinoma seems to be an effective therapeutic option, with an easy to manage toxicity profile, similar to other schedules used in pancreatic adenocarcinoma.
A Rapid Special Staining Technique for Identification of Normal Ureter by Frozen Section in Children With Ureteropelvic Junction Obstruction
Authors: Babu Ramesh , Vittalraj Pavithra , Sundaram Sandhya , Pothankulankara Manjusha Mullappali , Ramanan Venkat , Sai Venkata
Published: July 2019

Background

The exact etiology of ureteropelvic junction obstruction (UPJO) is unknown, and inadequate excision of the narrow segment has been proposed as a cause of failure in 5% to 7% of cases of pyeloplasty.

Aims

To study whether frozen section can be useful to detect normal ureter distal to UPJO during pyeloplasty.

Methods

Histological sections from 31 patients with UPJO were analyzed for collagen to muscle ratio (CMR) on conventional (formalin) and rapid (frozen section) Masson’s trichrome staining. Pathological findings were correlated with postoperative outcomes analyzed at 1-year follow-up and expressed as excellent, moderate, or mild improvement, static and deterioration based on ultrasound grade, differential renal function, and renogram drainage pattern.

Results

There was a very strong positive correlation ( r = .94; P = .001) between CMR by conventional and rapid frozen Masson’s trichrome staining. There was a very strong negative correlation between pyeloplasty outcomes and CMR on conventional staining ( r = −.94; P = .001) or rapid frozen Masson’s trichrome staining ( r = −.91; P = .001). Regression analysis revealed that a CMR of 1.2 or less (95% confidence interval: 1.9–0.7) was associated with a successful outcome.

Conclusions

It is feasible to intraoperatively identify normal ureter distal to UPJO using CMR analysis on the novel rapid frozen section technique reported.
Adapting treatment in an eating disorder program to meet the needs of patients with ARFID: Three case reports
Authors: Rienecke Renee D , Drayton Amy , Richmond Rebekah L , Mammel Kathleen A
Published: July 2019

Avoidant/restrictive food intake disorder (ARFID) was introduced in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. Three different subtypes of ARFID are described: individuals who seem disinterested in eating, those who avoid certain foods because of a sensitivity to specific characteristics of the food, and those who are concerned about an aversive experience associated with eating. There is currently no first-line treatment for ARFID. Three case studies are presented of patients with ARFID who participated in a family-based partial hospitalization program/intensive outpatient program for eating disorders. A description of the course of treatment is included, as well as ways in which the eating disorder program adapted treatment to more closely meet the unique needs of these patients. An approach with emphasis on parental involvement seems promising, although research is needed to investigate this more fully.
Rice husk incorporated foam concrete wall panels as a thermal insulating material in buildings
Authors: Aravind NR , Sathyan Dhanya , Mini K M
Published: July 2019

The major segment for energy consumption is found in industry, transport, agricultural, residential and commercial sector. The main part of the energy consumption in residential and commercial buildings is due to the use of mechanical devices to maintain a comfortable indoor environment. Thermal conductivity of building materials is one of the factors which influence the heat transfer in buildings. Thermal conductivity can be reduced by the use of materials with low density. The present paper reports the development of a sustainable thermal insulating external wall panel and its mechanical, thermal and durability properties. The wall panel was prepared using foam concrete and rice husk and replacing the cement by fly ash. Strength of panel was tested by conducting in plane bending test and compressive strength test. Thermal conductivity was tested using guarded hot plate apparatus. Durability properties were tested by conducting water absorption test, drying shrinkage and acid resistance test. The test results showed that the rice husk and fly ash content had a major influence on the thermal conductivity and durability properties of the developed wall panels.
Rethinking consumer resistance through institutional entrepreneurship
Authors: Chaney Damien , Slimane Karim Ben
Published: July 2019

This article adopts an institutional view to rethink consumer resistance. Two types of consumers who resist market domination are identified: “rebels” and “entryists.” Rebels are able to consume but do not want to and oppose all or part of the market, whereas entryists want to consume but are kept out of the market. These two categories of resistant consumers are regarded as institutional entrepreneurs because they attempt to shape established institutions. Rebels are game changers, their resistance aims at disrupting market and consumption practices while entryists are justiciaries, their resistance aims at empowering those who are left behind. Implications for marketing of this renewed vision of consumer resistance are discussed in this article.
Age-Related Effect of Antihypertensive Treatment on Cognitive Performance: Is it Better Preventing Dementia in Older Age?
Authors: Vazirinejad Reza , Mirmotalebi Maryam , Bageri Monireh , Kounis Nicholas G. , Koniari Ioanna , Lilley Jeanette M. , Gommnami Nasser
Published: July 2019

The aim of this study is to investigate the impact of optimal antihypertensive medication on cognitive function. In this 6-month clinical trial, 248 adults were randomly selected by a registry of hypertensive-treated patients (based on a National Hypertension Treatment Program), followed health centers located in Rafsanjan County, Southeast, Iran. Blood pressure was measured 3 times in each appointment pre- and posttreatment. Mini-Mental State Examination was used for cognitive performance evaluation. Paired t test and multiple regression model showed significant correlation between “the differences of systolic and diastolic blood pressure levels” and “cognitive performance in treated patients more than 40 years old.” Cognitive performance was not significantly different in patients less than 40 years old post antihypertensive treatment. Cognitive performance scores demonstrated significant increase in responders more than 40 years old post antihypertensive treatment. Antihypertensive treatment in responders with age equal or more than 40 years improves the level of cognitive performance significantly.
Bilateral Contralaterally Controlled Functional Electrical Stimulation Reveals New Insights Into the Interhemispheric Competition Model in Chronic Stroke
Authors: Cunningham David A. , Knutson Jayme S. , Sankarasubramanian Vishwanath , Potter-Baker Kelsey A. , Machado Andre G. , Plow Ela B.
Published: July 2019

Background. Upper-limb chronic stroke hemiplegia was once thought to persist because of disproportionate amounts of inhibition imposed from the contralesional on the ipsilesional hemisphere. Thus, one rehabilitation strategy involves discouraging engagement of the contralesional hemisphere by only engaging the impaired upper limb with intensive unilateral activities. However, this premise has recently been debated and has been shown to be task specific and/or apply only to a subset of the stroke population. Bilateral rehabilitation, conversely, engages both hemispheres and has been shown to benefit motor recovery. To determine what neurophysiological strategies bilateral therapies may engage, we compared the effects of a bilateral and unilateral based therapy using transcranial magnetic stimulation. Methods. We adopted a peripheral electrical stimulation paradigm where participants received 1 session of bilateral contralaterally controlled functional electrical stimulation (CCFES) and 1 session of unilateral cyclic neuromuscular electrical stimulation (cNMES) in a repeated-measures design. In all, 15 chronic stroke participants with a wide range of motor impairments (upper extremity Fugl-Meyer score: 15 [severe] to 63 [mild]) underwent single 1-hour sessions of CCFES and cNMES. We measured whether CCFES and cNMES produced different effects on interhemispheric inhibition (IHI) to the ipsilesional hemisphere, ipsilesional corticospinal output, and ipsilateral corticospinal output originating from the contralesional hemisphere. Results. CCFES reduced IHI and maintained ipsilesional output when compared with cNMES. We found no effect on ipsilateral output for either condition. Finally, the less-impaired participants demonstrated a greater increase in ipsilesional output following CCFES. Conclusions. Our results suggest that bilateral therapies are capable of alleviating inhibition on the ipsilesional hemisphere and enhancing output to the paretic limb.