bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and effectiveness of pirfenidone combined with carboplatin‐based chemotherapy in patients with idiopathic pulmonary fibrosis and non‐small cell lung cancer: A retrospective cohort study
Authors: Yamamoto Yuji , Yano Yukihiro , Kuge Tomoki , Okabe Fukuko , Ishijima Mikako , Uenami Takeshi , Kanazu Masaki , Akazawa Yuki , Yamaguchi Toshihiko , Mori Masahide
Published: September 2020

Background

Pirfenidone is an antifibrotic agent that is potentially effective for the treatment of idiopathic pulmonary fibrosis (IPF). However, no study has reported on its prophylactic value against chemotherapy‐associated acute IPF exacerbations when combined with chemotherapy for non‐small cell lung cancer (NSCLC). The present study assessed the safety and effectiveness of pirfenidone combined with carboplatin‐based chemotherapy or immune checkpoint inhibitors (ICIs) in patients with IPF and NSCLC.

Methods

A total of 14 patients with IPF and NSCLC who received treatment from 2013 to 2019 were included. Patients were treated with pirfenidone combined with carboplatin and nanoparticle albumin‐bound paclitaxel or S‐1 as first‐line chemotherapy. After confirming disease progression, patients received cytotoxic agents or ICIs, including nivolumab and pembrolizumab. Pirfenidone was continued regardless of chemotherapy changes. Overall survival (OS) and progression‐free survival (PFS) for lung cancer and IPF were calculated. Moreover, the cumulative incidence of acute exacerbation of IPF (AE‐IPF) within one year was evaluated.

Results

Median PFS for lung cancer was 110 days (95% confidence interval [CI]: 57–199 days), while the median OS was 362 days (95% CI: 220–526 days). Moreover, PFS for IPF was 447 days (95% CI: 286–indeterminate days), and the cumulative incidence of AE‐IPF within one year was 18%. Notably, none of the patients developed AE‐IPF associated with first‐line chemotherapy. Among the included patients, four received ICIs, none of whom developed ICI‐associated AE‐IPF.

Conclusions

The present study found that pirfenidone combined with carboplatin‐based regimens or ICIs might be safe first‐line chemotherapy for patients with IPF and NSCLC.

Key points

Significant findings of the study

No patients with IPF and NSCLC who received pirfenidone in combination with first‐line carboplatin‐based chemotherapy or late‐line ICIs developed acute IPF exacerbations.

What this study adds

Pirfenidone might have a prophylactic effect against chemotherapy‐associated AE‐IPF.
Challenging Global Group Audits: The Perspective of US Group Audit Leads*
Authors: Downey Denise Hanes , Westermann Kimberly D.
Published: September 2020

Regulators are concerned about the quality of group audits because of poor inspection results, recent enforcement actions against component auditors, and the significance of these audits to the global economy. Yet research in this area is nascent. In response, we survey and interview US‐based global group audit leads to better understand the group audit process and their perceptions of challenges that arise on such engagements. Our findings indicate that group auditors organize their audits consistent with the client's structure, which drives component auditor selection, scoping, and fees. Group auditors routinely find fault with component auditors, perceiving that work performed and/or documentation provided is not sufficient, not appropriate and/or not communicated timely, to comply with US standards and reporting deadlines. In some cases, they perceive that the component auditor is unable and/or unwilling to comply and in others, that the component auditor misunderstands group instructions due to language proficiency or differing interpretation of the standards. Notably this perspective is ethnocentric, as group auditors almost exclusively attribute issues to component auditors. While ethnocentric tendencies appear myopic, they provide insight into unrecognized or overlooked aspects of the global firm model of cooperative arrangements. This study highlights the significance of the global firm's network structure to global group audits. Thus, we encourage intercommunity research, among (quantitative and qualitative) scholars and standard setters, to consider group audits in the broader context of firm networks.
Weighted gene co‐expression network analysis reveals potential candidate genes affecting drip loss in pork
Authors: Zhao X. , Wang C. , Wang Y. , Zhou L. , Hu H. , Bai L. , Wang J.
Published: September 2020

Drip loss is an essential evaluation indicator for pork quality. It is closely related to other meat quality indicators, including water‐holding capacity, water loss rate and pH value at 45 min (pH1) and 24 h post‐mortem (pH2), and is influenced by environmental and genetic factors and their interactions. We previously conducted differentially expressed gene analysis to identify candidate genes affecting drip loss using eight individuals with extremely high‐ and low‐drip loss selected from 28 purebred Duroc pigs. Using 28 identical samples, in the present study, we performed weighted gene co‐expression network analysis with drip loss and drip loss‐related traits, including water‐holding capacity, water loss rate, pH1 and pH2. A total of 25 modules were identified, and five of them correlated with at least two drip loss or drip loss‐related traits. After functional enrichment analysis of genes in the five modules, three modules were found to be critical, as their genes were significantly involved in amino acid metabolism, immune response and apoptosis, which have potential relationships with drip loss. Furthermore, we identified five candidate genes affecting drip loss in one critical module, AASS, BCKDHB, ALDH6A1, MUT and MCCC1, as they overlapped with differentially expressed genes detected in our previous study, exhibited protein–protein interactions and had potential biological functions in affecting drip loss according to the literature. The outcomes of the present study enhance our understanding of the molecular mechanisms underlying drip loss and will aid in improving the pork quality.
Mammographic interpretation in Vietnam: Tailored educational strategies are needed to increase clinicians’ expertise
Authors: Caspar Felix , Copps Emily , Diplas Adrienne , Hackney Logan , Jackson Kyle , Kearins Imogen , Lynch Marcus , McPherson Dominique , Pisconeri Bellah , Purkiss Zara , Thomas Lucy , Colley Brooke , Tapia Kriscia , Ho Karen , (Yun) Trieu Phuong Dung , Brennan Patrick , Puslednik Louise
Published: September 2020

Aim

Breast cancer incidence is rapidly increasing throughout South East Asia, highlighting the need for high‐quality early diagnosis and treatment. This study aims to investigate the efficacy of mammography detection in Hanoi and Ho Chi Minh City (HCMC), Vietnam, using data from Australian radiologists as a benchmark; factors that influence performance will be highlighted.

Methods

A total of 53, 35 and 52 clinicians from Australia, HCMC and Hanoi, respectively, examined and diagnosed a test set of 60 mammograms, 20 of which contained cancers. Each clinician completed an accompanying questionnaire establishing demographic and experiential characteristics. The performance metrics of specificity, sensitivity, area under the receiver operating characteristic curve (AUC), location sensitivity and Jackknife free‐response ROC (JAFROC) figure of merit were used to evaluate clinicians performance. Mann‐Whitney and Kruskal‐Wallis statistical methods were employed to establish significance.

Results

Vietnamese radiologists demonstrated significantly lower sensitivity, AUC, lesion sensitivity and JAFROC scores compared to Australian radiologists. There was no difference in performance between clinicians from Hanoi and HCMC. However, certain performance features (older and more experienced clinicians compared with their younger, less experienced counterparts, readers who read more compared with fewer mammograms per week, clinicians with greater radiological experience and clinicians that completed a fellowship) demonstrated significantly better performances.

Conclusions

The significant difference in diagnostic efficacy of mammograms between Vietnam and Australia identifies the need for improvements in breast radiology training, management and practice. Cost‐effective solutions are available that can improve the reading efficacy of clinicians, and consequently health outcomes for Vietnamese women.
Distinguishing Central African rodents and shrews using their hair morphology
Authors: Guibinga Mickala Amour , Ntie Stephan , Nicolas Violaine
Published: September 2020

Species identification methods are needed for small mammals. Herein, we present a simple and efficient identification key based on the hair morphology of Central African rodents (Rodentia) and shrews (Soricomorpha). A total of 1,320 museum hair samples from 51 species were analysed with an optical light microscope. One‐third (31.37%) of these samples could be identified to the species level using four morphological characters (medulla, cuticle, size and colour). The remaining species formed nine groups of two to 10 species each which could not be discriminated because of overlapping characteristics between different taxa. In addition, shrew, dormice and squirrel hair samples were clearly distinguishable from the other samples because they were either shorter (0.68 ± 0.19 cm) or longer (1.86 ± 0.3 and 1.85 ± 0.63 cm), respectively. In addition, 19 (43.18%) field‐collected samples of unknown origin were successfully identified to the level of species or group of species. Thus, to increase the efficiency of this identification key, the inclusion of more morphological characteristics (i.e. hair diameter and shape, cuticle index, cortex types) and DNA barcoding should be considered. Finally, the proposed identification key could be used as a simple and efficient tool for species inventories and ecological studies of targeted taxa in Central Africa.
Does Transparency Inhibit Political Compromise?
Authors: Harden Jeffrey J. , Kirkland Justin H.
Published: September 2020

Governments around the world face an apparent tension when considering whether to allow public access to the governing process. In principle, transparent institutions promote accountability and good governance. However, politicians and scholars contend that such reforms also constrain politicians' capacity to negotiate and compromise, producing inefficiency and gridlock. This argument—that transparency inhibits compromise—is widely accepted, but rarely empirically tested. We develop a theoretical framework around the claim and evaluate it in the context of American state legislatures. We leverage temporal variation in state “sunshine law” adoptions and legislative exemptions to identify the effects of transparency on several observable indicators of compromise: legislative productivity, polarization, partisanship, policy change, and budget delay. Our analyses generally do not support the argument; we mostly report precisely estimated negligible effects. Thus, transparency may not be the hindrance to policy making that conventional wisdom suggests. Effective governance appears possible in state legislatures even under public scrutiny.
Workforce supply of pharmacists in Queensland communities from James Cook University Pharmacy Graduates
Authors: Drovandi Aaron , Woolley Torres
Published: September 2020

Objective

This study investigates whether the regional pharmacy school at James Cook University in North Queensland is providing graduates geared to address the pharmaceutical needs of the state's regional, rural and remote communities.

Design

A cross‐sectional study of practice locations of James Cook University pharmacy graduates in 2019 compared to those from other Australian pharmacy schools.

Participants

Pharmacists from the James Cook University pharmacy program and those from other Australian pharmacy schools working in Queensland.

Main outcome measures

Comparison of the proportion of James Cook University pharmacy graduates practising in the seven Modified Monash Model rurality classifications in Queensland to graduates from other pharmacy schools. Comparison of Index of Relative Social Advantage and Disadvantage for local government areas in these practice locations. Association between Modified Monash Model for hometown and Australian practice locations for domestic James Cook University pharmacy graduates.

Results

Of 973 James Cook University pharmacy graduates, 640 (65.8%) practised within Queensland in 2019. Compared to other Australian pharmacy graduates practising in Queensland at this time, James Cook University graduates had significantly higher odds of practising in local government areas with greater social disadvantage (lower Index of Relative Social Advantage and Disadvantage indices [<975]) and in rural and remote locations. Of 822 domestic James Cook University graduates, 84.5% were from a regional, rural or remote area, and compared to their hometown Modified Monash Model classification, two‐thirds of these graduates practised in settings with the same or more rural Modified Monash Model classification.

Conclusions

This study indicates that regional pharmacy schools have potential to attract and retain graduates in regional, rural and remote areas, including disadvantaged and/or rural towns.
Outcomes of patients suffering unwitnessed hypothermic cardiac arrest rewarmed with extracorporeal life support: A systematic review
Authors: Podsiadło Paweł , Darocha Tomasz , Svendsen Øyvind S. , Kosiński Sylweriusz , Silfvast Tom , Blancher Marc , Sawamoto Keigo , Pasquier Mathieu
Published: September 2020

Prolonged cardiac arrest (CA) may lead to neurologic deficit in survivors. Good outcome is especially rare when CA was unwitnessed. However, accidental hypothermia is a very specific cause of CA. Our goal was to describe the outcomes of patients who suffered from unwitnessed hypothermic cardiac arrest (UHCA) supported with Extracorporeal Life Support (ECLS). We included consecutive patients’ cohorts identified by systematic literature review concerning patients suffering from UHCA and rewarmed with ECLS. Patients were divided into four subgroups regarding the mechanism of cooling, namely: air exposure; immersion; submersion; and avalanche. A statistical analysis was performed in order to identify the clinical parameters associated with good outcome (survival and absence of neurologic impairment). A total of 221 patients were included into the study. The overall survival rate was 27%. Most of the survivors (83%), had no neurologic deficit. Asystole was the presenting CA rhythm in 48% survivors, of which 79% survived with good neurologic outcome. Variables associated with survival included the following: female gender (P < .001); low core temperature (P = .005); non‐asphyxia‐related mechanism of cooling (P < .001); pulseless electrical activity as an initial rhythm (P < .001); high blood pH (P < .001); low lactate levels (P = .003); low serum potassium concentration (P < .001); and short resuscitation duration (P = .004). Severely hypothermic patients with unwitnessed CA may survive with good neurologic outcome, including those presenting as asystole. The initial blood pH, potassium, and lactate concentration may help predict outcome in hypothermic CA.
Long‐term success after trabeculotomy in primary congenital glaucoma – a study with up to 35 years follow‐up
Authors: Kessel Line , Pedersen Karen Bjerg , Siersma Volkert , Kappelgaard Per , Bach‐Holm Daniella
Published: September 2020

Purpose

To evaluate the surgical success after trabeculotomy for primary congenital glaucoma (PCG) in Denmark in the last 40 years.

Methods

Retrospective review of medical files on children who all underwent trabeculotomy as the first surgical intervention between January 1rst, 1977 and December 31, 2016. Information on diagnosis and surgical procedures were extracted. Primary outcome was surgical success was defined as intraocular pressure (IOP) < 21 mmHg without medications one year after surgery. Secondary outcome was the number of reoperations needed.

Results

Out of 118 children with PCG, 96 children (144 eyes) had an ab externo trabeculotomy as primary IOP lowering procedure opening Schlemm’s channel 4 clock hours into the anterior chamber. Complete surgical success at one year was achieved in 73% (106 of 144 eyes). On the long term, IOP could be controlled by one surgical procedure in 2/3 of children, eight eyes required >5 surgical procedures to control IOP. In 12.1% of children the second glaucoma procedure was performed >5 years after the initial trabeculotomy. There was a tendency towards greater risk of needing a second procedure in patients < 3 months of age at primary trabeculotomy (hazard ratio, HR, 2.01, 95% CI 0.96–4.22) and in boys (HR 2.02, 95% CI 0.97–4.18) and a lower risk of requiring a third surgery if the second surgery was trabeculectomy with MMC.

Conclusion

Dedicated follow‐up of patients with PCG is essential as the disease may continue to progress even after years of quiescence and some children need multiple surgeries to control IOP. Additional glaucoma procedures are required in 1/3 of children and boys and younger patients seem to be at greater risk.
Impact of PCV‐13 vaccine on invasive pneumococcal disease in hospitalised children: A multi‐institutional analysis
Authors: Dreyzin Alexandra , McCormick Meghan , Zullo James , Shah Samir S. , Kalpatthi Ramasubramanian
Published: September 2020

Aim

We aimed to describe changes in invasive pneumococcal disease (IPD) hospitalisations after introduction of the pneumococcal conjugate vaccine (PCV13).

Methods

This was a retrospective analysis of the Pediatric Health Information System (PHIS) database, including children with IPD pre‐PCV13 (2004‐2009) and post‐PCV13 (2012‐2017). Healthy children and those with chronic conditions were analysed separately. The primary outcome was IPD incidence. Secondary outcomes included length of stay, intensive care unit (ICU) admission, mechanical ventilation and mortality.

Results

9160 hospitalisations for IPD were included. The IPD rate per 100 000 discharges was 180 pre‐PVC13 and 150 post‐PCV13 [17% decrease (P = 0.085)]. The observed IPD rate in 2017 was 45.5% lower than the rate predicted by the pre‐PCV13 trend (95% CI: 44%‐46%). While a significant decrease in IPD (32%, P = 0.026) was observed among healthy children, there was no change in those with chronic conditions (9%, P = 0.24). In the post‐PCV13 period, more IPD patients had chronic conditions, ICU admissions and longer ICU stays.

Conclusion

Although there was no overall reduction in IPD after PCV13, we observed a significant decrease in IPD among healthy patients. Further research is needed to elucidate microbiology or other factors contributing to persistent IPD hospitalisations.
Risk attitudes within farmer cooperative organizations: Evidence from China's fresh apple industry
Authors: Jin Shaoze , Jia Xiangping , James Harvey S.
Published: September 2020

We consider whether participation in cooperative organizations known as Farm Bases correlates with a farmer's risk attitudes in China. Specifically, we seek to determine if farmers see cooperative‐like organizations as a means of reducing risk or as a way of accessing riskier opportunities. Using data from a risk experiment involving 348 apple farmers, we estimate risk attitudes and correlate those indicators with participation in Farm Bases and other controls. In the case of Chinese apple producers, we find that considerations of risk are an important feature of organizational forms that involve collective decision‐making, although the correlation between risk and cooperative organizational participation is nuanced.
Postponement of cardiovascular outcomes by statin use: A systematic review and meta‐analysis of randomized clinical trials
Authors: Hansen Morten Rix , Hróbjartsson Asbjørn , Pottegård Anton , Damkier Per , Madsen Kenneth Grønkjær , Pareek Manan , Olesen Morten , Hallas Jesper
Published: September 2020

Objective

To estimate the average outcome postponement (gain in days to an event) for cardiovascular outcomes in a meta‐analysis of randomized, controlled statin trials, including any myocardial infarction, any stroke and cardiovascular death.

Design

Systematic review of large randomized, placebo‐controlled trials of statin use, including a random‐effects meta‐analysis of all included trials.

Data sources

We searched MEDLINE (15 July 2019) and ClinicalTrials.gov (16 October 2019).

Eligibility criteria for selecting studies

Randomized, placebo‐controlled trials of statin use that included at least 1000 participants. We identified 15 cardiovascular outcomes that were reported in more than 2 trials.

Results

We included 19 trials. The summary outcome postponements for the 15 cardiovascular outcomes varied between −1 and 38 days. For four major outcomes, the summary outcome postponement in days was as follows: cardiovascular mortality, 9.27 days (95% CI: 3.6 to 14.91; I2 = 72%; 9 trials) non‐vascular and non‐cardiovascular mortality, 1.5 days (95% CI: −2.2 to 5.3; I2 = 0%; 6 trials) any myocardial infarction 18.0 days (95% CI; 12.1 to 24.1; I2 = 92%; 15 trials); and any stroke, 6.1 days (95% CI; 2.86 to 9.39; I2 = 66%; 14 trials).

Conclusion

Statin treatment provided a small, average postponement of cardiovascular outcomes during trial duration.
Hiring Frictions in a Regulated Occupation: Evidence from US Laboratories
Authors: Weaver Andrew
Published: September 2020

Determining the nature and source of hiring frictions is an important topic for policymakers, as these frictions impact both worker outcomes and economic growth. To date, there has been very little US‐based research that has combined detailed measures of employer skill requirements, market structure, organizational characteristics and hiring difficulties at the establishment level. Prior to this study, there has been almost no research that has investigated these issues in the context of a highly regulated industry such as healthcare, which employs more workers than either retail or manufacturing. Using a unique, nationally representative dataset, this study finds that organizational practices and market structure are more relevant predictors of hiring difficulties for laboratory technologists than factors, such as skill mismatch, that are often assumed to be of primary importance.
Development of cannabidiol as a treatment for severe childhood epilepsies
Authors: Williams Claire M. , Stephens Gary J.
Published: September 2020

In recent years, there has been a growing appreciation by regulatory authorities that cannabis‐based medicines can play a useful role in disease therapy. Although often conflagrated by proponents of recreational use, the legislative rescheduling of cannabis‐derived compounds, such as cannabidiol (CBD), has been associated with the steady increase in the pursuit of use of medicinal cannabis. One key driver in this interest has been the scientific demonstration of efficacy and safety of CBD in randomised, placebo‐controlled clinical trials in children and young adults with difficult‐to‐treat epilepsies, which has encouraged increasing numbers of human trials of CBD for other indications and in other populations. The introduction of CBD as the medicine Epidiolex in the United States (in 2018) and as Epidyolex in the European Union (in 2019) as the first cannabis‐derived therapeutic for the treatment of seizures was underpinned by preclinical research performed at the University of Reading. This work was awarded the British Pharmacological Society Sir James Black Award for Contributions to Drug Discovery 2019 and is discussed in the following review article.
Clinical approaches to minimize iatrogenic weight gain in children and adolescents
Authors: Sweeney Brooke , Kelly Aaron S. , San Giovanni Christine B. , Kelsey Megan M. , Skelton Joseph A.
Published: September 2020

Clinical providers may underestimate the role of management of diseases that can occur with obesity, termed co‐morbid conditions, distinct from disease that arise as a result of obesity, co‐morbidities. Many of these conditions are associated with iatrogenic weight gain, and can interfere with weight loss outcomes in children and adolescents with obesity. Management of co‐morbid conditions, and thoughtful selection of medications associated with weight neutrality or weight loss may increase the effectiveness of obesity treatment strategies. The aim of this commentary is to summarize the literature and discuss considerations for obesity treatment in the context of the more complicated patient, which often requires strategic management of co‐morbid conditions and minimizing iatrogenic weight gain.
Internet of Things assisted radio frequency identification based mine safety management platform
Authors: Xie Xionghui , Lin Rongping , Yu Bo , Wen Wenfu , Gu Fahui , Sivaparthipan C.B. , Vadivel Thanjai
Published: September 2020

The production of any mine depends heavily on the secure relation between human and mining equipment. Protecting and optimizing the use of these tools and workers from potential accidents by real‐time monitoring and control will greatly improve mine safety and productivity. As an emerging technology, the Internet of Things (IoT) and radio frequency identification (RFID) provides a new strategy for underground production of mine security and safety. The main technologies of the Internet of Things are introduced in line with the required of mine safety production. The innovation used in this process is RFID technology, sensor technology for the conceiving of things, intelligent technology for thinking about things, and inherent security technology. In this article, the adaptive heuristic mathematical model based on IoT and RFID real‐time monitoring systems has been proposed for the production of mine safety and analysis. This system allows for real‐time tracking, detecting suspicious incidents, and verification of the position of a miner within the harsh underground mining environment. The major involvement of this research is the cost‐efficient framework to efficiently promote the protection of underground coalmines. This system helps solve serviceability, accessibility, flexibility, and interoperability problems in coal mines.
Orale Propranolol‐ und Neodym:YAG‐Farbstofflaser‐Kombinationstherapie infantiler Hämangiome: eine retrospektive Analyse von 30 Kindern mit 48 Hämangiomen
Authors: Hartmann Franziska , Lockmann Anike , Himpel Okko , Kühnle Ingrid , Hensen Janina , Schön Michael P. , Thoms Kai‐Martin
Published: September 2020

Hintergrund und Ziele

Infantile Hämangiome können sowohl durch systemische Propranolol‐ als auch durch Neodym:YAG‐Farbstofflaser‐Kombinationstherapie erfolgreich behandelt werden. In dieser retrospektiven Studie wurden Wirksamkeit und Sicherheit der sequenziellen und parallelen Therapie komplizierter Hämangiome, die mit beiden Verfahren behandelt wurden, evaluiert.

Patienten und Methoden

30 Kinder mit 48 komplizierten Hämangiomen wurden mit Propranolol‐ und Neodym: YAG‐Farbstofflaser‐Kombinationstherapie behandelt. Im Fotovergleich wurde die prozentuale Remissionsrate durch drei Untersucher anhand einer vierstufigen Skala bewertet (I: 0–25 %, II: 26–50 %, III: 51–75 % und IV: 76–100 %).

Ergebnisse

Elf Kinder erhielten parallel Propranolol‐ und Lasertherapie (A), zwölf Kinder wurden nach Propranolol lasertherapiert (B) und sieben Kinder erhielten nach Lasertherapie Propranolol (C). Ein Kind konnte aufgrund einer Auswanderung ins Ausland nicht abschließend ausgewertet werden. Eine starke Verbesserung (IV) wurde bei 23/29 (79,3 %) aller behandelten Kinder festgestellt (A: 90,9 %, B 75 %, C 66,7 %). Die mittlere Dauer der Propranolol‐Therapie bei allen Kindern betrug 8,6 Monate (A: 8,9 Monate, B: 8,2 Monate, C: 8,9 Monate). Im Mittel erfolgten 2,33 Laserbehandlungen pro Hämangiom (A: 1,95, B: 3,2, C: 1,91). Schwerwiegende Nebenwirkungen durch die Propranolol‐ und Lasertherapie wurden nicht beobachtet.

Schlussfolgerungen

Propranolol‐ und Neodym: YAG‐Farbstofflaser‐Kombinationstherapie können sequenziell oder parallel sicher und effektiv eingesetzt werden und sich sinnvoll ergänzen.
Dermatoskopische Merkmale pigmentierter intraepidermaler Karzinome an Kopf und Hals
Authors: Inskip Michael , Cameron Alan , Akay Bengu Nisa , Gorji Mahdieh , Clark Simon P. , Rosendahl Nikita , Coetzer‐Botha Martelle , Kittler Harald , Rosendahl Cliff
Published: September 2020

Hintergrund und Ziel

Pigmentierte intraepidermale Karzinome sind dermatoskopisch durch Punkte und strukturlose Bereiche sowie durch linear angeordnete Punkte und Knäuelgefäße gekennzeichnet. Es gibt keine Studien zu den dermatoskopischen Merkmalen pigmentierter intraepidermaler Karzinome an Kopf und Hals. Unser Ziel ist die Beschreibung des klinischen und dermatoskopischen Erscheinungsbildes dieser Entität.

Patienten und Methodik

Wir analysierten retrospektiv 79 Fälle pigmentierter intraepidermaler Karzinome an Kopf und Hals.

Ergebnisse

Dermatoskopisch waren pigmentierte intraepidermale Karzinome an Kopf und Hals durch mehrere Farben (98,7 %, n = 78), pigmentierte Kreise (48,1 %, n = 38), weiße Kreise (17,7 %, n = 14), abgewinkelte Linien (41,8 %, n = 33) und strukturlose Bereiche (86,1 %, n = 68) gekennzeichnet. Linear angeordnete Punkte traten in 13,9 % (n = 11) der Fälle auf, Knäuelgefäße in 7,6 % (n = 6) der Fälle; der dominierende Gefäßtyp waren prominente geschlängelte Gefäße (29,2 %, n = 23), die dicker und/oder rötlicher in der Farbgebung als die umliegenden Gefäße waren und meistens in der winkligen Anordnung des dermalen Plexus (24,1 %, n = 19) lagen.

Schlussfolgerungen

Pigmentierte intraepidermale Karzinome an Kopf und Hals unterscheiden sich von bisher publizierten Beschreibungen pigmentierter intraepidermaler Karzinome. Dieser Unterschied ist statistisch signifikant mit geringerer Inzidenz von Knäuelgefäßen und höherer Inzidenz pigmentierter Kreise. Es gibt offensichtliche Ähnlichkeiten zu pigmentierten aktinischen Keratosen in dieser Lokalisation.
Optische Kohärenztomographie für die schnelle Bildgebung, Beurteilung und Überwachung entzündlicher Autoimmunerkrankungen der Haut am Krankenbett?
Authors: Ha Linh , Hundt Jennifer E.
Published: September 2020

Die optische Kohärenztomographie (OCT) ist ein nichtinvasives, hochauflösendes Bildgebungsverfahren, das in der Dermatologie zunehmend an Bedeutung gewinnt. Das Prinzip der OCT ist mit dem der Sonographie vergleichbar, bei dem statt Ultraschallwellen allerdings Infrarotlaserstrahlung verwendet wird. Klinisch eignet sich die OCT nachweislich zur Unterscheidung verschiedener nichtmelanozytärer Hautkrebsarten in einem frühen Erkrankungsstadium. Bei der optischen Kohärenztomographie werden zwei‐ oder dreidimensionale Bilder mit einer Eindringtiefe von bis zu 2 mm, einem Sichtfeld von 6 mm x 6 mm und einer Erfassungszeit von wenigen Sekunden erstellt. Das Auflösungsvermögen der OCT ist mehr als drei‐ bis hundertmal höher als bei der Sonographie. Es ist von besonderem Interesse, dass die OCT zusätzliche Informationen über das Gefäßsystem liefert und dadurch die Beurteilung und Überwachung entzündlicher Hauterkrankungen ermöglicht. Bei der Diagnose blasenbildender Autoimmunerkrankungen kann mittels OCT die exakte Blasenebene lokalisiert werden. Man nimmt an, dass ein Nachweis subklinischer Läsionen auf ein Rezidiv der Erkrankung hindeuten könnte. Dies könnte zukünftig die frühzeitige Intervention und Therapie erleichtern. Darüber hinaus könnte die Entwicklung von Hochgeschwindigkeits‐OCTs schnelle Scans und eine Bildgebung großer Bereiche des Körpers am Krankenbett ermöglichen.
CIVIL ASSET FORFEITURE, CRIME, AND POLICE INCENTIVES: EVIDENCE FROM THE COMPREHENSIVE CRIME CONTROL ACT OF 1984
Authors: Kantor Shawn , Kitchens Carl T. , Pawlowski Steven
Published: September 2020

The 1984 federal Comprehensive Crime Control Act (CCCA) included a provision that permitted local law enforcement agencies to acquire up to 80% of the proceeds derived from civil asset forfeitures obtained in joint operations with federal authorities. We investigate how this rule governing forfeited assets influenced crime and police incentives by taking advantage of pre‐existing differences in state‐level civil asset forfeiture law and the timing of the CCCA. We find that after the CCCA was enacted crime fell about 17% in places where the federal law allowed police to retain more of their seized assets than state law previously allowed. (JEL K42, K15, H76)
Changes in Nkx2.1, Sox2, Bmp4, and Bmp16 expression underlying the lung‐to‐gas bladder evolutionary transition in ray‐finned fishes
Authors: Funk Emily C. , Breen Catriona , Sanketi Bhargav D. , Kurpios Natasza , McCune Amy
Published: September 2020

The key to understanding the evolutionary origin and modification of phenotypic traits is revealing the responsible underlying developmental genetic mechanisms. An important organismal trait of ray‐finned fishes is the gas bladder, an air‐filled organ that, in most fishes, functions for buoyancy control, and is homologous to the lungs of lobe‐finned fishes. The critical morphological difference between lungs and gas bladders, which otherwise share many characteristics, is the general direction of budding during development. Lungs bud ventrally and the gas bladder buds dorsally from the anterior foregut. We investigated the genetic underpinnings of this ventral‐to‐dorsal shift in budding direction by studying the expression patterns of known lung genes (Nkx2.1, Sox2, and Bmp4) during the development of lungs or gas bladder in three fishes: bichir, bowfin, and zebrafish. Nkx2.1 and Sox2 show reciprocal dorsoventral expression patterns during tetrapod lung development and are important regulators of lung budding; their expression during bichir lung development is conserved. Surprisingly, we find during gas bladder development, Nkx2.1 and Sox2 expression are inconsistent with the hypothesis that they regulate the direction of gas bladder budding. Bmp4 is expressed ventrally during lung development in bichir, akin to the pattern during mouse lung development. During gas bladder development, Bmp4 is not expressed. However, Bmp16, a paralogue of Bmp4, is expressed dorsally in the developing gas bladder of bowfin. Bmp16 is present in the known genomes of Actinopteri (ray‐finned fishes excluding bichir) but absent from mammalian genomes. We hypothesize that Bmp16 was recruited to regulate gas bladder development in the Actinopteri in place of Bmp4.
Sibilant consonants classification comparison with multi‐ and single‐class neural networks
Authors: Anjos Ivo , Cavalheiro Marques Nuno , Grilo Margarida , Guimarães Isabel , Magalhães João , Cavaco Sofia
Published: September 2020

Many children with speech sound disorders cannot pronounce the sibilant consonants correctly. We have developed a serious game, which is controlled by the children's voices in real time, with the purpose of helping children on practicing the production of European Portuguese (EP) sibilant consonants. For this, the game uses a sibilant consonant classifier. Since the game does not require any type of adult supervision, children can practice producing these sounds more often, which may lead to faster improvements of their speech. Recently, the use of deep neural networks has given considerable improvements in the classification of a variety of use cases, from image classification to speech and language processing. Here, we propose to use deep convolutional neural networks to classify sibilant phonemes of EP in our serious game for speech and language therapy. We compared the performance of several different artificial neural networks that used Mel frequency cepstral coefficients or log Mel filterbanks. Our best deep learning model achieves classification scores of 95.48% using a 2D convolutional model with log Mel filterbanks as input features. Such results are then further improved for specific classes with simple binary classifiers.
NetHALOC: A learned global image descriptor for loop closing in underwater visual SLAM
Authors: Bonin‐Font Francisco , Burguera Burguera Antoni
Published: September 2020

This article presents the experimental assessment of a hash‐based loop closure detection methodology for visual simultaneous localization and mapping (SLAM), addressed to underwater autonomous vehicles. This methodology uses a new global image descriptor called net hash‐based loop closure (NetHALOC), which is learned with a simple and fast convolutional neural network. The results using NetHALOC have been compared with the results using three different top‐quality state‐of‐the‐art global image descriptors: Net vector of locally aggregated descriptors, hash‐based loop closure and deep loop closure. The transformation from images to hashes implies a considerable reduction of data to be processed, shared, compared and transmitted in global navigation, localization or mapping tasks. Complete tests with an extensive set of real underwater imagery were done to compare the performance of the defined loop closure detection approach using the aforementioned four hashing techniques, in order to conclude which of them is the more adequate for visual SLAM applications under the sea.
Petroleum NAPL Depletion Estimates and Selection of Marker Constituents from Compositional Analysis
Authors: DeVaull George E. , Rhodes Ileana A. L. , Hinojosa Emiliano , Bruce Cristin L.
Published: September 2020

Spills and releases of hydrocarbons may result in zones of nonaqueous phase liquids (NAPL) within soils and groundwater. The NAPL will change, or “weather” over time due to a range of physical, chemical, and biological processes. Hydrocarbon constituents in environmental samples collected from NAPL‐impacted groundwater wells, sediments, or soils vary in composition over time due to weathering. The changing composition can be used to estimate mass depletion rates and trends for the bulk NAPL and for individual constituent chemicals relative to marker constituents which are less susceptible to weathering. Methods for the selection of marker constituents and for quantitatively and conservatively estimating NAPL depletion rates and trends over time are shown. Estimates are included for two sites with different NAPL mixtures present (crude oil and gasoline/diesel‐range product), for which depletion of half the initial total NAPL is estimated at 13.6 ± 2.9 years and 7.3 ± 1.8 years respectively, and with no active NAPL remediation at either site. Similar methods for oil or NAPL depletion estimates have often relied on a prior‐identified suite of presumed‐conserved marker constituents. The method presented here includes steps which identify the best set of analyzed candidate marker constituents in a NAPL mixture. This can confirm prior‐selected markers but is particularly useful for NAPL mixtures in which no prior‐identified marker constituents are present.
Clinical influence of calcium hydroxide and N‐acetylcysteine on the levels of resolvins E1 and D2 in apical periodontitis
Authors: Corazza B. J. M. , Martinho F. C. , Khoury R. D. , Toia C. C. , Orozco E. I. F. , Prado R. F. , Machado F. P. , Valera M. C.
Published: September 2020

Aim

To investigate the presence of resolvins E1 (RvE1) and D2 (RvD2) in teeth with primary endodontic infections and apical periodontitis, and to assess the influence of calcium hydroxide medication [Ca(OH)2], in association with 2% chlorhexidine gel (2% CHX gel), and N‐acetylcysteine (NAC) on the levels of RvE1 and RvD2 in periapical tissues.

Methodology

Thirty‐six single‐rooted teeth with primary endodontic infections and apical periodontitis were selected and randomly divided into three groups according to the medication: [Ca(OH)2] + saline solution (SSL) [Ca(OH)2 + SSL group] (n = 12), Ca(OH)2 + 2% chlorhexidine gel [Ca(OH)2 + 2% CHX gel group] (n = 12) and NAC [NAC group] (n = 12). Samples were collected from the periapical interstitial fluid at two different sampling times: before (S1) and after 14 days of intracanal medications (S2). Resolvins were measured using the enzyme‐linked immunosorbent assay. Data were analysed using paired t‐test, Wilcoxon test and Kruskal–Wallis test, followed by Dunn’s post hoc test; all statistical tests were performed at a significance level of 5%.

Results

RvE1 and RvD2 were detected in 100% of the samples (36/36) at S1 and S2. Ca(OH)2 medication did not increase the levels of RvE1 or RvD2 (both P > 0.05); however, NAC significantly increased the levels of RvE1 and RvD2 after 14 days of treatment (P < 0.05).

Conclusions

RvE1 and RvD2 were detected in periapical tissues from teeth with root canal infections. Moreover, calcium hydroxide medication did not increase the levels of resolvins in apical periodontitis. In contrast, the use of NAC intracanal medication significantly increased the levels of RvE1 and RvD2 after 14 days of treatment.
Review on potential non‐dairy synbiotic beverages: a preliminary approach using legumes
Authors: Chaturvedi Smriti , Chakraborty Snehasis
Published: September 2020

In the past few years, certain functional foods have gained consumer acceptance like those containing synbiotics (a blend of both prebiotics and probiotics) in different food systems. Synbiotics enhance gut functionality and confer health benefits to humans. However, due to the limitations exerted by dairy‐based matrices like lactose intolerance, milk allergies, limited shelf life and inclination towards veganism, consumer’s interest in non‐dairy foods has increased. Among the non‐dairy matrices, legumes (such as chickpeas, kidney beans, lupin) are the less explored areas with the majority focus on only soya beans. The present review gives brief information about the different research associating with various legume‐based probiotics, prebiotics and synbiotic foods narrowing down specifically to beverages. The integration of such information will allow the researchers to explore product development using new prebiotic ingredients that have not been studied in much detail and hold an exceptional potential to be employed in the synbiotic food industry.
The HemoScreen hematology point‐of‐care device is suitable for rapid evaluation of acute leukemia patients
Authors: Kristian Kur Dår , Thøgersen Danny , Kjeldsen Lars , Friis‐Hansen Lennart
Published: September 2020

Background

Hematological patients, receiving intensive chemotherapy (predominantly acute leukemia patients), have repeated postchemotherapy periods with severe bone marrow suppression. As a result, these patients require regular monitoring of the complete blood counts (CBC) for optimal patient care. To reduce the strain on the patient, there is a need for a point‐of‐care (POC) hematology device that provides rapid and reliable results both in general and in cytopenic samples and is suitable for outpatient clinics. We evaluated the HemoScreen device for the most used CBC parameter both overall and at the lower range.

Methods

The HemoScreen was compared with the Sysmex XN‐9000 in 206 routine venous samples and 79 capillary bedside samples focusing on white blood cells (WBC), absolute neutrophil count (ANC), red blood cells (RBC), PLT and HGB.

Results

The HemoScreen was less precise compared to the acceptance criteria set for larger and more advanced hematology instrument with a CV% 3.0‐3.7 for WBCs, 3.6‐8.4 for ANCs, 1.1‐1.5 for RBCs, 2.5‐4.4 for PLTs, and 1.7‐2.3 for HGB. Correlation coefficient for all five parameters for the entire range was r >.95 and r >.90 at lower range for venous and capillary samples. Bias limits were within the CTCAE acceptance limits.

Conclusions

The HemoScreen provides rapid and accurate test results, for evaluation of WBC, PLT, and HGB, as well as at low concentrations for guiding transfusions and postchemotherapy treatment. The device is easy to operate and can measure both venous and capillary samples. Therefore, the HemoScreen is well suited for smaller outpatient clinics and potentially home use.
Onward migration of Latin American families: negotiating citizenship and mobility in times of crisis
Authors: McCarthy Helen N. J.
Published: September 2020

Transnational families have long used migration as a strategy for upward social mobility. However, migration projects are increasingly complex and often do not involve a single move from one country to another. Drawing on qualitative interviews, this paper explores how Latin American families negotiate different stages of their migration from Latin America to Spain to the UK. The paper demonstrates how families negotiate within the opportunity structures afforded to them to achieve physical and social mobility. These opportunities are structured by different legal regimes and the way that immigration, citizenship and labour market policies are implemented. The initial migration from Latin America to Spain had enabled Latin American families to gain economic stability and EU citizenship, but at the cost of a period of family separation. However, faced with the financial crisis, some families opted for onward migration to the UK, a process that resulted in families becoming “re‐transnationalised.”
Frailty status, timely goals of care documentation and clinical outcomes in older hospitalised medical patients
Authors: Subramaniam Ashwin , Tiruvoipati Ravindranath , Green Cameron , Srikanth Velandai , Soh Lionel , Yeoh Aun Chian , Hussain Faisal , Bailey Michael , Pilcher David
Published: September 2020

Background

Hospitalised frail older patients are at risk of clinical deterioration. Early goals of care (GOC) documentation is vital to avoid futile/unwarranted interventions in the event of deterioration.

Aims

To investigate the impact of frailty on timely GOC and its association with clinical outcomes in hospitalised older patients.

Methods

This was a single‐centre retrospective study of all medical patients aged ≥80 years admitted to the acute medical unit between 1/3/2015 and 31/8/2015, with GOC derived from electronic records. Frailty was measured using the Hospital Frailty Risk Score (HFRS) derived from hospital coding data. Primary outcome compared proportions of timely GOC within 72‐h between frail (HFRS ≥ 5) and non‐frail (HFRS < 5) patients. Exploratory secondary outcomes included in‐hospital mortality, rapid response calls (RRC), prolonged length of stay (LOS) and 28‐day readmission rates.

Results

Of the 1118 admitted patients, 529 (47.3%) were frail. Timely GOC occurred in 50% (559/1118), more commonly in frail patients (283/529, 53.5%) than non‐frail patients (276/589, 46.9%), P = 0.027. Frailty was positively associated with timely GOC independent of age and gender (odds ratio = 1.28; 95% confidence interval = 1.01–163; P = 0.041). In univariable analyses, timely GOC was associated with greater in‐hospital mortality, RRC, and hospital LOS in both frail and non‐frail patients (all P < 0.05) and greater 28‐day readmissions only among frail patients (P = 0.028). Multivariable regression demonstrated that timely GOC was associated only with in‐hospital mortality in both frail and non‐frail patients, independent of age and gender.

Conclusion

Older frail hospitalised patients were more likely to have timely GOC than older non‐frail patients. Timely GOC in such patients may avoid burdensome treatments.
Global nursing leadership: alive and kicking in the midst of the COVID‐19 pandemic
Authors: Catton Howard
Published: September 2020

As the COVID‐19 pandemic continues its journey around the world, it has triggered a global nursing response, with nurses everywhere working to save the lives of their extremely sick patients. In parallel with the frontline response, the International Council of Nurses, the World Health Authority and the International Confederation of Midwives have used their biennial Triad meetings to set out what needs to be done from a global perspective to protect nurses and the people they serve. At a time of crisis, it is imperative that the world’s nursing leaders, through ICN’s National Nursing Associations, step up to give support and guidance at this historically unsettling time.