bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as prognostic markers in oral cavity cancers
Authors: Malik Akshat , Mishra Aseem , Mair Manish , Chakrabarti Swagnik , Garg Apurva , Singhvi Hitesh , Chopda Prashant , Qayyumi Burhanuddin , Sawarkar Nupoor , Mathur Yash , Shetty Rathan , Nair Sudhir , Nair Deepa , Chaturvedi Pankaj
Published: April 2019

Background: Various studies have associated inflammation with carcinogenesis. But still, the role of inflammatory markers in oral cancer has not been evaluated extensively. Most of the existing studies have been done on patients of varied sites, and their sample size is also scarce. In this study, we have evaluated the impact of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) on various clinicopathological factors and survival. Methodology: This was a retrospective analysis of prospectively collected data of 400 patients with oral squamous cell cancer. The pretreatment neutrophil and lymphocyte and platelet counts were recorded, and NLR and PLR were calculated for all patients. The NLR and PLR tertiles were correlated with the incidence of various clinicopathological factors and overall survival. Results: The median follow-up of the cohort was 36 months. The mean survival of the cohort was 41.7 months. PLR was associated with higher incidence of adverse clinicopathological factors. There was a trend of decreased overall survival with increasing NLR tertile. It was found to be significant only for the group which received adjuvant chemoradiotherapy (P 0.01). Patients with higher PLR values have been found to have a lower overall survival (P 0.006). Conclusion: NLR and PLR can be used to predict survival and outcomes in patients oral cavity cancer. PLR is a good predictor for adverse clinicopathological factors and survival. NLR can predict survival only in the subset of patients who have received chemotherapy.
Medical oncology in India: Workload, infrastructure, and delivery of care
Authors: Sengar Manju , Fundytus Adam , Hopman Wilma M. , Malhotra Hemant , Gupta Sudeep , Pramesh C S , Hammad Nazik , Sullivan Richard , Vanderpuye Verna , Seruga Bostjan , Lopes Gilberto , Brundage Michael D. , Booth Christopher M.
Published: April 2019

Background: The growing burden of cancer within India has implications across the health system including operational delivery of cancer care and planning for human health resources. Here, we report the Indian results of a global survey of medical oncology (MO) workload in comparison to medical oncologists (MOs) in other low-middle- income countries (LMICs). Methods: An online survey was distributed through a snowball method through national oncology societies to chemotherapy-prescribing physicians in 22 LMICs. The survey was distributed to Indian MOs by the Indian Society of Medical and Pediatric Oncology and the National Cancer Grid of India. The workload was measured as the annual number of new cancer patient consults seen per oncologist. Results: One hundred and forty-seven oncologists from LMICs completed the survey; 82 from India and 65 from other LMICs. About 59% (48/82) of Indian MOs reported working exclusively in the private health system compared to 23% (15/65) of MOs in other LMICs (P < 0.001). The median number of annual consults per MO was 475 in India compared with 350 in other LMICs. The proportion of MOs seeing >1000 new consults/year was 24% (20/82) in India and 20% (13/65) in other LMICs (P = 0.530). The median number of patients seen in a full-day clinic was 35 in India and 25 in other LMCs (P = 0.003); 26% of Indian MO reported seeing >50 patients per day. Compared to other LMICs, Indian MOs worked more days/week (median 6 vs. 5, P < 0.001) and hours/week (median 51–60 vs. 41–50, P = 0.004) and had less annual leave for vacation (3 weeks vs. 4, P = 0.017). Conclusion: Indian MOs have higher clinical volumes and workload than MOs in other LMICs and substantially higher workload than MOs in high-income countries. Indian health policymakers should consider alternative models of care and increasing MO workforce supply to address the growing burden of cancer.
177Lu-DOTATATE and 177Lu-prostate-specific membrane antigen therapy in a patient with advanced metastatic radioiodine-refractory differentiated thyroid cancer after failure of tyrosine kinase inhibitors treatment
Authors: Assadi Majid , Ahmadzadehfar Hojjat
Published: April 2019

Patients with radioiodine-refractory differentiated thyroid cancer (RrDTC) have only a limited or no benefit from radioiodine therapy. For these patients, tyrosine kinase inhibitors have demonstrated encouraging results in advanced RrDTC. Nevertheless, these therapies are related with substantial side effects and a high cost. Somatostatin receptor-based therapies have shown promising findings in advanced RrDTC. Recently, prostate-specific membrane antigen (PSMA) expression was seen in advanced RrDTC in imaging studies. This study presents a case of RrDTC who was treated with 177Lu-DOTATATE and 177Lu-PSMA, presumably as a first report in this regard.
Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging in prediction of response to neoadjuvant chemotherapy in pediatric osteosarcoma
Authors: Younis Jehan Ahmed , Al Antably Ismael Mohammed , Zamzam Manal , Salem Hala Taha , Zaki Eman Mohammed , Hassanian Omneya Ahmed
Published: April 2019

The aim of our study was to evaluate the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) in prediction of response to neoadjuvant chemotherapy (NAC) in pediatric osteosarcoma (OS) patients compared to percentage of tumor necrosis after surgical excision of the tumor. Forty-six pediatric OS patients treated with neoadjuvant chemotherapy and surgery were underwent PET/CT and MRI before, after 3 cycles, and after the completion of neoadjuvant chemotherapy. Imaging parameters include maximum standardized uptake value (SUVmax1, 2, and 3), tumor liver ratio (TLR 1, 2, and 3), and MRI tumor volume (MRTV 1, 2, and 3) at initial assessment before starting NAC, after finishing three cycles and after finishing 6 cycles before tumor excision, respectively. Cutoff values of the PET/CT and MRI parameters were determined using receiver operating characteristic (ROC) curve analysis and percentage of tumor necrosis of postsurgical specimen. Fourteen patients were good responders (30.4%), with more than 90% tumor necrosis, while 31 patients were poor responders (67.4%). The results of one patient were missed. We noticed that higher sensitivity for detecting poor responders was detected by SUVmax3/1, TLR3/1, and MRTV2/1 ratio cutoff values, while higher specificity was detected by TRL2 and SUVmax3 cutoff values. ROC curve analysis of MRTV2/1 and MRTV3/1 ratio was fair in predicting poor responders. PET/CT parameters are capable of predicting histological response to NAC in OS patients with overall sensitivity and specificity higher than MRI parameters.
Malignant peripheral nerve sheath tumor of thigh with sphenoid and brain metastases: Extremely rare occurrence with dismal prognosis despite significant response to palliative chemoradiotherapy
Authors: Purkayastha Abhishek , Singh Sankalp , Kapoor Amul , Bhatia Jasvinder Kaur , Bisht Niharika , Husain Azhar
Published: April 2019

Malignant peripheral nerve sheath tumor (MPNST) is a neurogenic tumor arising from peripheral nerves or nerve sheaths. MPNSTs are highly aggressive sarcomas mainly associated with neurofibromatosis type-1 (NF-1) with high rates of local recurrence and distant metastasis carrying a dismal prognosis. Lung is the most common metastatic site. Bone metastasis although documented in the literature is still very rare, while dissemination to brain without the involvement of lungs and that too in a non-NF-1 case is extremely unusual. A 48-year-old female was diagnosed with a case of non-NF-1 MPNST left thigh with bone metastases including sphenoid. Despite showing complete resolution of skeletal and primary lesions postpalliative chemoradiotherapy, she developed brain metastases and succumbed to her disease. This case is discussed to highlight an unusual scenario we encountered, the clinical course of the disease with its management, and overall poor prognosis. To the best of our knowledge, this may be the earliest case of MPNST with sphenoid metastases detected by 18-fluorodeoxyglucose positron-emission computed tomography scan and a sporadic case of brain metastases reported in the world literature.
Investigating patients with normocalcemic hyperparathyroidism: When is a parathyroid scintigraphy indicated?
Authors: Mazokopakis Elias E. , Skarakis Spyridon-Nikitas I.
Published: April 2019

In clinical practice, physicians often encounter patients with persistent elevated serum parathyroid hormone levels and normal serum calcium levels, a state known as normocalcemic hyperparathyroidism (NHPT). The investigation of NHPT cases can lead to unnecessary use of parathyroid scintigraphy (PS) and consequently unnecessary health-care costs. In this clinical review, the most common causes of NHPT and the possible indications for PS performance in such cases are mainly presented and discussed.
Performance characteristic evaluation of a bismuth germanate-based high-sensitivity 5-ring discovery image quality positron emission tomography/computed tomography system as per National Electrical Manufacturers Association NU 2-2012
Authors: Jha Ashish , Mithun Sneha , Puranik Ameya , Purandare Nilendu , Shah Sneha , Agrawal Archi , Rangarajan Venkatesh
Published: April 2019

National Electrical Manufacturers Association (NEMA) provides guidelines to assess the performance of Positron Emission Tomography (PET). A PET/CT scanner, Discovery IQ, GE Medical systems, Milwaukee, USA was installed in our department which has high a sensitivity PET component. We have performed the NEMA NU-2 2012 quality control tests to evaluate this system on site before clinical use. Performance measurements of the PET scanner were made using the NEMA NU2-2012 procedures for spatial resolution, scatter fraction, sensitivity, count rate loss and random coincidence estimation, Noise Equivalent Count Rate (NECR) and image quality. As per NU2 2012, spatial resolution was measured at 1 cm, 10 cm and 20 cm vertically from the centre and at each of these points resolution was measured at tangential, radial and axial directions. Sensitivity was measured at centre and 10 cm off center vertically from the center. The system sensitivity is reported as an average of the two measured values. Scatter fraction and NECR measurements, Image quality test was also performed. The tangential, radial and axial FWHM were 4.99 mm, 4.20 mm and 4.79 mm at 1 cm off centre, 5.49 mm, 4.69 mm and 4.81 mm at 10 cm off centre and 7.99 mm, 5.07 mm and 4.95 mm at 20 cm off centre respectively. The absolute sensitivity of this scanner was found to be 20.1 cps/kBq. The scatter fraction calculated from the decay method was 37.94% and NECR was 125 kcps. The peak NECR was achieved at activity concentration of 8.7 KBq/ml and the count loss below the peak NECR was found to be 0.68%. Image quality test for, contrast recovery, background variability and lung error residual mean met all specifications. Overall PET performance of Discovery IQ whole-body scanner was satisfactory and the scanner met all the performance specifications required by NEMA 2012.
Quality control and GMP synthesis of 68Ga-prostate-specific membrane antigen-11 for detection of low- and high-grade prostate cancer
Authors: Assadi Majid , Dadgar Habibollah
Published: April 2019

Prostate-specific membrane antigen (PSMA) labeled with 68Ga routinely used with higher sensibility and specificity than other radiotracers for detection of low and high grades of prostate cancer using positron emission tomography (PET)-computed tomography. 68Ge/68Ga generators are generally used with automated modules for the syntheses of 68Ga radiopharmaceuticals. The aim of the current study is to describe the procedures for labeling PSMA with radiotracers and their standard QC tests. The automated synthesis method for 68Ga-PSMA-11 was taken and set of a quality control based on chromatographic and spectrometric methods used to determine radiochemical and radionuclide purity of the radiolabeled compound. Meanwhile, high-performance liquid chromatography and rainbow trail Lutheran camp are the best choices after stability tests for assessment of radiochemical purity at the optimized conditions. The clinical utility of the synthesized radiopharmaceuticals was ascertained by performing PET scans in human patients.
Rural South African Community Perceptions of Antibiotic Access and Use: Qualitative Evidence from a Health and Demographic Surveillance System Site
Authors: Anstey Watkins Jocelyn , Wagner Fezile , Xavier Gómez-Olivé Francesc , Wertheim Heiman , Sankoh Osman , Kinsman John
Published: April 2019

Knowledge and practices of rural South African populations with regard to antibiotic access and use (ABACUS) remain understudied. By using the case of four villages in the north east of the country, our aim was to investigate popular notions and social practices related to antibiotics to inform patient-level social interventions for appropriate antibiotic use. To achieve this, we investigated where community members (village residents) were accessing and sourcing medication, and what they understood antibiotics and antibiotic resistance (ABR) to be. Embedded within the multicountry ABACUS project, this qualitative study uses interviews and focus group discussions. A sample of 60 community members was recruited from the Agincourt Health and Demographic Surveillance System, situated in Mpumalanga Province, from April to August, 2017. We used the five abilities of seek, reach, pay, perceive, and engage in access to healthcare as proposed by Levesque’s “Access to Healthcare” framework. Respondents reported accessing antibiotics prescribed from legal sources: by nurses at the government primary healthcare clinics or by private doctors dispensed by private pharmacists. No account of the illegal purchasing of antibiotics was described. There was a mix of people who finished their prescription according to the instructions and those who did not. Some people kept antibiotics for future episodes of infection. The concept of “ABR” was understood by some community members when translated into related Xitsonga words because of knowledge tuberculosis and HIV/AIDS treatment regimens. Our findings indicate that regulation around the sale of antibiotics is enforced. Safer use of antibiotics and why resistance is necessary to understand need to be instilled. Therefore, context-specific educational campaigns, drawing on people’s understandings of antibiotics and informed by the experiences of other diseases, may be an important and deployable means of promoting the safe use of antibiotics.
A Prospective Study on the Impact and Out-of-Pocket Costs of Dengue Illness in International Travelers
Authors: Tozan Yesim , Headley Tyler Y. , Sewe Maquines Odhiambo , Schwartz Eli , Shemesh Tamar , Cramer Jakob P. , Eberhardt Kirsten A. , Ramharter Michael , Harrison Nicole , Leder Karin , Angheben Andrea , Hatz Christoph , Neumayr Andreas , Chen Lin Hwei , De Pijper Cornelis A. , Grobusch Martin P. , Wilder-Smith Annelies
Published: April 2019

Although the costs of dengue illness to patients and households have been extensively studied in endemic populations, international travelers have not been the focus of costing studies. As globalization and human travel activities intensify, travelers are increasingly at risk for emerging and reemerging infectious diseases, such as dengue. This exploratory study aims to investigate the impact and out-of-pocket costs of dengue illness among travelers. We conducted a prospective study in adult travelers with laboratory-confirmed dengue and recruited patients at travel medicine clinics in eight different countries from December 2013 to December 2015. Using a structured questionnaire, we collected information on patients and their health-care utilization and out-of-pocket expenditures, as well as income and other financial losses they incurred because of dengue illness. A total of 90 patients participated in the study, most of whom traveled for tourism (74%) and visited countries in Asia (82%). Although 22% reported hospitalization and 32% receiving ambulatory care while traveling, these percentages were higher at 39% and 71%, respectively, after returning home. The out-of-pocket direct and indirect costs of dengue illness were US$421 (SD 744) and US$571 (SD 1,913) per episode, respectively, averaging to a total out-of-pocket cost of US$992 (SD 2,052) per episode. The study findings suggest that international travelers incur important direct and indirect costs because of dengue-related illness. This study is the first to date to investigate the impact and out-of-pocket costs of travel-related dengue illness from the patient’s perspective and paves the way for future economic burden studies in this population.
Enhanced Mycobacterial Antigen–Induced Pro-Inflammatory Cytokine Production in Lymph Node Tuberculosis
Authors: Kathamuthu Gokul Raj , Moideen Kadar , Sridhar Rathinam , Baskaran Dhanaraj , Babu Subash
Published: April 2019

Lymph node tuberculosis (LNTB) is characterized by the enhanced baseline and antigen-specific production of type 1/17 cytokines and reduced baseline and antigen-specific production of interleukin (IL)-1β and IL-18 at the site of infection when compared with peripheral blood. However, the cytokine profile in the lymph nodes (LNs) of Mycobacterium tuberculosis culture–positive LNTB (LNTB+) and negative LNTB (LNTB−) has not been examined. To address this, we have examined the baseline and mycobacterial antigen–stimulated cytokine levels of type 1 (interferon gamma [IFNγ], tumor necrosis factor alpha [TNFα], IL-2), type 2 (IL-4, IL-5, and IL-13), type 17 (IL-17A, IL-17F, and IL-22), pro-inflammatory (IL-1α, IL-1β, IL-18, and granulocyte macrophage colony-stimulating factor [GM-CSF]), and regulatory cytokines (IL-10, transforming growth factor beta [TGF-β]) cytokines in the LN culture supernatants of LNTB+ and LNTB− individuals. We have observed significantly enhanced baseline levels of IL-13 and IL-10 and significantly reduced baseline levels of IL-4 and GM-CSF in LNTB+ individuals compared with LNTB− individuals. By contrast, we have observed significantly enhanced levels of type 1 (IFNγ, TNFα, and IL-2), type 17 (IL-17F and IL-22), and pro-inflammatory (IL-1α and GM-CSF) cytokines and significantly reduced levels of TGFβ in response to purified protein derivative, early secreted antigen-6, and culture filtrate protein-10 antigens in LNTB+ compared with LNTB− individuals. On phorbol 12-myristate 13-acetate/ionomycin stimulation, no significant difference was observed for any of the cytokines examined. Thus, our study revealed several interesting differences in the cytokine profiles of mycobacterial antigen–stimulated LN cultures in LNTB+ and LNTB− individuals. Therefore, we suggest the presence of mycobacteria plays a significant role in driving the cytokine response at the site of infection in LNTB.
Safety and Differential Antibody and T-Cell Responses to the Plasmodium falciparum Sporozoite Malaria Vaccine, PfSPZ Vaccine, by Age in Tanzanian Adults, Adolescents, Children, and Infants
Authors: Jongo Said A. , Church L. W. Preston , Mtoro Ali T. , Chakravarty Sumana , Ruben Adam J. , Swanson Phillip A. , Kassim Kamaka R. , Mpina Maximillian , Tumbo Anneth-Mwasi , Milando Florence A. , Qassim Munira , Juma Omar A. , Bakari Bakari M. , Simon Beatus , James Eric R. , Abebe Yonas , KC Natasha , Saverino Elizabeth , Gondwe Linda , Studer Fabian , Fink Martina , Cosi Glenda , El-Khorazaty Jill , Styers David , Seder Robert A. , Schindler Tobias , Billingsley Peter F. , Daubenberger Claudia , Sim B. Kim Lee , Tanner Marcel , Richie Thomas L. , Abdulla Salim , Hoffman Stephen L.
Published: April 2019

In 2016, there were more cases and deaths caused by malaria globally than in 2015. An effective vaccine would be an ideal additional tool for reducing malaria’s impact. Sanaria® PfSPZ Vaccine, composed of radiation-attenuated, aseptic, purified, cryopreserved Plasmodium falciparum (Pf) sporozoites (SPZ) has been well tolerated and safe in malaria-naïve and experienced adults in the United States and Mali and protective against controlled human malaria infection with Pf in the United States and field transmission of Pf in Mali, but had not been assessed in younger age groups. We, therefore, evaluated PfSPZ Vaccine in 93 Tanzanians aged 45 years to 6 months in a randomized, double-blind, normal saline placebo-controlled trial. There were no significant differences in adverse events between vaccinees and controls or between dosage regimens. Because all age groups received three doses of 9.0 × 105 PfSPZ of PfSPZ Vaccine, immune responses were compared at this dosage. Median antibody responses against Pf circumsporozoite protein and PfSPZ were highest in infants and lowest in adults. T-cell responses were highest in 6–10-year olds after one dose and 1–5-year olds after three doses; infants had no significant positive T-cell responses. The safety data were used to support initiation of trials in > 300 infants in Kenya and Equatorial Guinea. Because PfSPZ Vaccine–induced protection is thought to be mediated by T cells, the T-cell data suggest PfSPZ Vaccine may be more protective in children than in adults, whereas infants may not be immunologically mature enough to respond to the PfSPZ Vaccine immunization regimen assessed.
Resurgence of Pertussis Infections in Shandong, China: Space-Time Cluster and Trend Analysis
Authors: Zhang Yuzhou , Bambrick Hilary , Mengersen Kerrie , Tong Shilu , Feng Lei , Zhang Li , Liu Guifang , Xu Aiqiang , Hu Wenbiao
Published: April 2019

Although vaccination is effective in preventing infection, pertussis remains endemic worldwide, including China. To lead better targeted prevention strategies, we examined dynamics of spatial and temporal patterns of pertussis transmission in Shandong, China, from 2009 to 2017. We used space-time cluster analysis, logistic regression analysis, and regression tree model to detect the changes in spatial patterns of pertussis infections in Shandong Province, China, between periods (2009–2011, 2012–2014, and 2015–2017). The yearly pertussis incidence rates dramatically increased by 16.8 times from 2009 to 2017. Shifting patterns of peaks of pertussis infections were observed over both time (from June–July to August–September) and space (from Linyi to Jinan), with increasing RR from 4.1 (95% CI: 2.3–7.4) (2009–2011) to 6.1 (95% CI: 5.6–6.7) (2015–2017) and obvious coincidence of peak time. West Shandong had larger odds of increased infections over the study period (odds ratio: 1.52 [95% CI: 1.05–2.17]), and pertussis had larger odds of spreading to east (odds ratio: 2.32 [95% CI: 1.63–3.31]) and north (odds ratio: 1.69 [95% CI: 1.06–2.99]) over time. Regression tree model indicated that the mean difference in yearly average pertussis incidence between 2009–2011 and 2015–2017 increased by more than 4-fold when the longitudes of counties are < 118.0°E. The geographic expansion of pertussis infection may increase the risk of epidemic peaks, coinciding with increased infections in the future. The findings might offer evidence for targeting preventive measures to the areas most in need to minimize the impact of the disease.
A Direct from Blood/Plasma Reverse Transcription–Polymerase Chain Reaction for Dengue Virus Detection in Point-of-Care Settings
Authors: Mehta Ninad , Perrais Bastien , Martin Kimberly , Kumar Anil , Hobman Tom C. , Cabalfin-Chua Mary Noreen , Donaldo Manuel Emerson , Siose Painaga Maria Salome , Gaite James Yared , Tran Vanessa , Kain Kevin C. , Hawkes Michael T. , Yanow Stephanie K.
Published: April 2019

Infection with dengue virus (DENV) is widespread across tropical regions and can result in severe disease. Early diagnosis is important both for patient management and to differentiate infections that present with similar symptoms, such as malaria, chikungunya, and Zika. Rapid diagnostic tests that are used presently for point-of-care detection of DENV antigens lack the sensitivity of molecular diagnostics that detect viral RNA. However, no molecular diagnostic test for DENV is available for use in field settings. In this study, we developed and validated a reverse transcription–polymerase chain reaction (RT-PCR) for the detection of DENV adapted for use in field settings. Reverse transcription–polymerase chain reaction was performed directly from plasma samples without RNA extraction. The assay detected all four serotypes of DENV spiked into blood or plasma. Our RT-PCR does not cross-react with pathogens that cause symptoms that overlap with dengue infection. The test performed equally well in a conventional laboratory qPCR instrument and a small, low-cost portable instrument that can be used in a field setting. The lower limit of detection for the assay was 1 × 104 genome copy equivalents/mL in blood. Finally, we validated our test using 126 archived patient samples. The sensitivity of our RT-PCR was 76.7% (95% CI: 65.8–87.9%) on the conventional instrument, and 78.3% (95% CI: 65.8–87.9%) on the field instrument, when compared with the RealStar Dengue RT-PCR Kit 2.0. The molecular test described here is user-friendly, low-cost, and can be used in regions with limited laboratory capabilities.
Tax burden borne by electricity and mining companies in Peru during 2010-2015 period
Authors: Molina Llopis Rafael , Díaz Becerra Oscar Alfredo , Cortez Diaz Saba , Alfaro Esparza Andrés
Published: April 2019

O objetivo principal da pesquisa é quantificar a pressão fiscal suportada pelas empresas elétricas e de mineração que operam no Peru, no período 2010-2015, de tal forma que a existência de diferenças entre os dois setores econômicos analisados possa ser avaliada. Para este propósito, é apresentada uma descrição do setor elétrico e de mineração, bem como a evolução e influência que exercem sobre o crescimento econômico do Peru. Como elemento importante da investigação, foi realizada uma análise do arcabouço jurídico tributário que regula as atividades das empresas dos dois setores analisados, em especial, no tocante ao Imposto de Renda. O referencial teórico incorpora as principais referências vinculadas à Taxa Tributária Efetiva (SIT), que é o indicador utilizado na pesquisa. A análise estatística dos dados revela que, em média, os benefícios das empresas de mineração têm uma carga tributária maior do que os das empresas do setor elétrico durante todo o período em estudo.
Atrial fibrillation risk factors in patients with ischemic stroke
Authors: Wańkowicz Paweł , Nowacki Przemysław , Gołąb-Janowska Monika
Published: April 2019

Introduction

Atrial fibrillation (AF) is the most common heart arrhythmia. The condition is known to increase the risk of ischemic stroke (IS). Classical risk factors for the development of AF include advanced age, hypertension, diabetes mellitus, coronary heart disease and lipid metabolism disorders. Importantly, these are also recognized risk factors for ischemic stroke. Therefore, the purpose of this study was to investigate AF risk factors in patients with IS.

Material and methods

This is single-centre retrospective study which included 696 patients with acute ischemic stroke and nonvalvular atrial fibrillation and 1678 patients with acute ischemic stroke without atrial fibrillation.

Results

In this study we found – based on a univariable and multivariable logistic regression model – that compared to the patients with IS without AF, the group of patients which suffered from IS with nonvalvular atrial fibrillation (NVAF) had a higher proportion of patients who smoked cigarettes (OR = 15.742, p < 0.01; OR = 41.1, p < 0.01), had hypertension (OR = 5.161, p < 0.01; OR = 5.666, p < 0.01), history of previous stroke (OR = 3.951, p < 0.01; OR = 4.792, p < 0.01), dyslipidemia (OR = 2.312, p < 0.01; OR = 1.592, p < 0.01), coronary heart disease (OR = 2.306, p < 0.01; OR = 1.988, p < 0.01), a greater proportion of female patients (OR = 1.717, p < 0.01; OR = 2.095, p < 0.01), higher incidence of diabetes mellitus (OR = 1.341, p < 0.01; OR = 1.261, p = 0.106) and more patients in old age (OR = 1.084, p < 0.01; OR = 1.101, p < 0.01).

Conclusions

Our study demonstrates a need for thorough and systematic monitoring of post-ischemic stroke patients in whom AF has not been detected and who display other important risk factors. Regardless of the stroke, these factors may be responsible for development of AF.
Differentiation between non-hypervascular pancreatic neuroendocrine tumour and pancreatic ductal adenocarcinoma on dynamic computed tomography and non-enhanced magnetic resonance imaging
Authors: Ohki Kazuyoshi , Igarashi Takao , Ashida Hirokazu , Shiraishi Megumi , Nozawa Yosuke , Ojiri Hiroya
Published: April 2019

Purpose

To determine the differentiating features between non-hypervascular pancreatic neuroendocrine tumour (PNET) and pancreatic ductal adenocarcinoma (PDAC) on dynamic computed tomography (CT) and non-enhanced magnetic resonance imaging (MRI).

Material and methods

We enrolled 102 patients with non-hypervascular PNET (n = 15) or PDAC (n = 87), who had undergone dynamic CT and non-enhanced MRI. One radiologist evaluated all images, and the results were subjected to univariate and multivariate analyses. To investigate reproducibility, a second radiologist re-evaluated features that were significantly different between PNET and PDAC on multivariate analysis.

Results

Tumour margin (well-defined or ill-defined) and enhancement ratio of tumour (ERT) showed significant differences in univariate and multivariate analyses. Multivariate analysis revealed a predominance of well-defined tumour margins in non-hypervascular PNET, with an odds ratio of 168.86 (95% confidence interval [CI]: 10.62-2685.29; p < 0.001). Furthermore, ERT was significantly lower in non-hypervascular PNET than in PDAC, with an odds ratio of 85.80 (95% CI: 2.57-2860.95; p = 0.01). Sensitivity, specificity, and accuracy were 86.7%, 96.6%, and 95.1%, respectively, when the tumour margin was used as the criteria. The values for ERT were 66.7%, 98.9%, and 94.1%, respectively. In reproducibility tests, both tumour margin and ERT showed substantial agreement (margin of tumour, κ = 0.6356; ERT, intraclass correlation coefficients (ICC) = 0.6155).

Conclusions

Non-hypervascular PNET showed well-defined margins and lower ERT compared to PDAC, with significant differences. Our results showed that non-hypervascular PNET can be differentiated from PDAC via dynamic CT and non-enhanced MRI.
Effect of silicone gel versus Contractubex or corticosteroid phonophoresis for post-burn hypertrophic scars: a single-blind randomized controlled trial
Authors: Wahba Ereny S. , Hamada Hamada Ahmed , Khatib Ayman El
Published: April 2019

Introduction

Hypertrophic scars and keloids are physically and mentally disturbing, and can cause pain and itching. Various treatment is utilized to diminish or counteract scarring. The purpose of this study was to compare the effect of silicone gel, Contractubex gel, and corticosteroid phonophoresis for post-burn hypertrophic scars.

Methods

A prospective, single-blind, randomized, controlled study with pretest-posttest design was performed; 45 patients aged 20–45 years with hypertrophic scars, 2–4 months post thermal burn were involved. They were randomly assigned to 3 groups: group A (15 patients, 8 males and 7 females) received phonophoresis with silicone gel, group B (15 patients, 8 males and 7 females) received phonophoresis with Contractubex gel, and group C (15 patients, 9 males and 6 females) received corticosteroid phonophoresis. All treatment interventions were applied at the frequency of 3 sessions/week for 24 weeks. The participants were recruited from the Kasr El-Ani hospital outpatient clinic to be treated in the outpatient clinic, Faculty of Physical Therapy, Cairo University.

Results

Outcome measures were taken with the modified Vancouver Scar Scale (VSS) before the treatment, and 12 and 24 weeks after the intervention. The comparison among the 3 groups revealed a highly significant decrease in modified VSS total score in group A compared with group B and group C (p < 0.01), as well as in group B compared with group C (p < 0.001).

Conclusions

Silicone gel phonophoresis is a more effective method for post-burn hypertrophic scar management than Contractubex gel phonophoresis or corticosteroid phonophoresis.
The effectiveness of two individualized physical interventions on the upper limb condition after radical mastectomy
Authors: Odynets Tetiana , Briskin Yuriy , Yefremova Anzhelika , Goncharenko Ievgen
Published: April 2019

Introduction

The aim of the study was to compare the effectiveness of two individualized physical interventions on the upper limb condition after radical mastectomy.

Methods

Overall, 68 patients after breast cancer surgery participated in 12-week outpatient rehabilitation. They were randomly enrolled for water individualized physical intervention (water exercise group, n = 34) and Pilates physical intervention (Pilates group, n = 34). Upper limb force (dynamometry), size of upper limb lymphedema (circumference), and active range of motion (goniometry) on the affected side were determined before and after 36 individualized physical rehabilitation sessions.

Results

After 12-week physical rehabilitation, the average values of active range of flexion and abduction were statistically significantly higher in the water exercise group compared with the Pilates group by 8.73 degrees (p < 0.01) and 6.87 degrees (p < 0.01), respectively. The size of lymphedema in the area of forearm and hand was significantly lower in the water exercise group compared with the Pilates group by 0.46 cm (p < 0.05) and 0.44 cm (p < 0.05), respectively. There were no statistically significant differences in upper limb force between the studied groups at the end of the 12-week intervention.

Conclusions

The results have confirmed that elaborated individualized physical interventions might be considered as effective methods for range of motion improvement and decrease in breast cancer-related lymphedema in patients with post-mastectomy syndrome. The 3-month water exercises were more effective in improving mobility and muscle force of the upper limb and decreasing lymphedema than Pilates exercises.
The technique of physical rehabilitation in clubfoot
Authors: Nesterchuk Natalia , Grygus Igor , Prusik Krzysztof , Zukow Walery
Published: April 2019

Introduction

To develop the technique for physical rehabilitation of children with congenital clubfoot. To prove the positive influence of physical rehabilitation available to correct disorders in children with congenital clubfoot.

Methods

The pedagogical experiment involved 68 preschool children aged 4–5 years with congenital clubfoot, who were divided into the control 1 (n = 34) and main (n = 34) groups. At the beginning of the study, the children were treated and were classified in the ‘D’ register by the children’s orthopaedist. Peers without developmental disorders (n = 34) constituted the control group 2.

Results

The physical rehabilitation technique based on the methods of functional status diagnosis, purpose, content, and physical rehabilitation program included 3 stages of implementation. The basic technique components of physical rehabilitation experimentally verified its effect on correcting the basic disease and functional status of children with congenital clubfoot. The emphasis was placed on the active involvement of parents, establishing close and trusting relationships with them. Parents are taught to correctly apply physical rehabilitation. They have mastered the skills required for the organization of physical rehabilitation at home.

Conclusions

The technique was based on physical rehabilitation purpose, objectives, and adequate principles. It also discloses the specific organization and methodology of physical rehabilitation in congenital clubfoot. The guiding direction is to achieve physical rehabilitation of motor activity and functional status of children with congenital clubfoot to the level of their peers without disabilities.
Characterization of organic aerosols from a Chinese megacity during winter: predominance of fossil fuel combustion
Authors: Haque Md. Mozammel , Kawamura Kimitaka , Deshmukh Dhananjay K. , Fang Cao , Song Wenhuai , Mengying Bao , Zhang Yan-Lin
Published: April 2019

Abstract. PM2.5 aerosol samples were collected from the Chinese megacity of
Nanjing (32.21∘ N, 118.73∘ E) during winter and analyzed
for a total of 127 compounds from 12 organic compound classes. The most
abundant classes of compounds were n-alkanes (mean concentration of
205 ng m−3), followed by fatty acids (76.3 ng m−3), polycyclic
aromatic hydrocarbons (PAHs; 64.3 ng m−3),
anhydrosugars (56.3 ng m−3),
fatty alcohols (40.5 ng m−3) and phthalate esters
(15.2 ng m−3), whereas hydroxy-/polyacids (8.33 ng m−3),
aromatic acids (7.35 ng m−3), hopanes (4.19 ng m−3), primary
sugars and sugar alcohols (4.15 ng m−3), lignin and resin products
(2.94 ng m−3), and steranes (2.46 ng m−3) were less abundant.
The carbon preference index of n-alkanes (0.83–1.38) indicated that they
had a strong fossil fuel combustion origin. Diagnostic concentration ratios
of organic tracers suggested that PAHs and hopanes originated mostly from
coal burning and traffic emissions, respectively, in the Nanjing urban area.
Positive matrix factorization analysis demonstrated that fossil fuel combustion was the major pollution
source (28.7 %), followed by emissions from biomass burning (17.1 %),
soil dust (14.5 %) and plastic burning (6.83 %)
for Nanjing winter aerosols, although the contribution of secondary oxidation products
(32.9 %) was the most abundant. Most of the compounds
generally showed higher concentrations at nighttime compared with daytime;
this was due to the accumulation process associated with inversion layers and
the enhancement of emissions from heavy trucks at night. We conclude that
fossil fuel combustion largely influences the winter organic aerosols in
urban Nanjing. Based on the comparison of this study's results with previous
research, we found that pollution levels in organic aerosols have decreased
in the urban Nanjing atmosphere over the last decade.
Contribution and uncertainty of sectorial and regional emissions to regional and global PM2.5 health impacts
Authors: Crippa Monica , Janssens-Maenhout Greet , Guizzardi Diego , Van Dingenen Rita , Dentener Frank
Published: April 2019

Abstract. In this work we couple the HTAP_v2.2 global air pollutant
emission inventory with the global source receptor model TM5-FASST to
evaluate the relative contributions of the major anthropogenic emission
sources (power generation, industry, ground transport, residential,
agriculture and international shipping) to air quality and human health in
2010. We focus on particulate matter (PM) concentrations because of the
relative importance of PM2.5 emissions in populated areas and the
well-documented cumulative negative effects on human health. We estimate
that in 2010, depending on the region, annual averaged anthropogenic
PM2.5 concentrations varied between ca. 1 and 40 µg m−3,
with the highest concentrations observed in China and India, and lower
concentrations in Europe and North America. The relative contribution of
anthropogenic emission sources to PM2.5 concentrations varies between
the regions. European PM pollution is mainly influenced by the agricultural
and residential sectors, while the major contributing sectors to PM
pollution in Asia and the emerging economies are the power generation,
industrial and residential sectors. We also evaluate the emission sectors
and emission regions in which pollution reduction measures would lead to the
largest improvement on the overall air quality. We show that air quality
improvements would require regional policies, in addition to local- and urban-scale measures, due to the transboundary features of PM pollution. We
investigate emission inventory uncertainties and their propagation to
PM2.5 concentrations, in order to identify the most effective
strategies to be implemented at sector and regional level to improve
emission inventories, knowledge and air quality modelling. We show that the
uncertainty of PM concentrations depends not only on the uncertainty of
local emission inventories, but also on that of the surrounding regions.
Countries with high emission uncertainties are often impacted by the
uncertainty of pollution coming from surrounding regions, highlighting the
need for effective efforts in improving emissions not only within a region but
also from extra-regional sources. Finally, we propagate emission inventory uncertainty to PM concentrations and health impacts. We estimate 2.1 million
premature deaths per year with an uncertainty of more than 1 million premature
deaths per year due to the uncertainty associated only with the emissions.
An instrument for the rapid quantification of PM-bound ROS: the Particle Into Nitroxide Quencher (PINQ)
Authors: Brown Reece A. , Stevanovic Svetlana , Bottle Steven , Ristovski Zoran D.
Published: April 2019

Abstract. Reactive oxygen species (ROS) present on or generated by
particulate matter (PM) have been implicated in PM-induced health effects.
Methodologies to quantify ROS concentrations vary widely, both in detection
and collection methods. However, there is currently an increasing emphasis on
rapid collection and measurement due to observations of short half-life ROS.
To address this problem, this paper details the design and
characterization of a novel instrument for the measurement of PM-bound ROS
named the Particle Into Nitroxide Quencher (PINQ). This instrument combines
the 9,10-bis (phenylethynyl) anthracene-nitroxide (BPEAnit) ROS assay in
conjunction with a purpose-built aerosol collection device, the insoluble
aerosol collector (IAC). The IAC continuously collects PM regardless of size
or chemistry directly into a liquid sample with a collection efficiency of
> 0.97 and a cut-off size of < 20 nm. The sampling time
resolution of the PINQ is 1 min, with a limit of detection (LOD) of
0.08 nmol m−3 in equivalent BPEAnit-Me concentration per volume of
air. This high sample time resolution and sensitivity is achieved due to a
combination of the highly concentrated IAC liquid sample, minimized liquid
sample volume, and the rapid reaction and stability of the BPEAnit probe.
Estimation of emissions from biomass burning in China (2003–2017) based on MODIS fire radiative energy data
Authors: Yin Lifei , Du Pin , Zhang Minsi , Liu Mingxu , Xu Tingting , Song Yu
Published: April 2019

Abstract. Biomass burning plays a significant role in air pollution and climate change.
In this study, we used a method based on fire radiative energy (FRE) to
develop a biomass burning emission inventory for China from 2003 to 2017.
Daily fire radiative power (FRP) data derived from 1 km MODIS Thermal
Anomalies/Fire products (MOD14/MYD14) were used to calculate FRE and
combusted biomass. Available emission factors were assigned to four biomass
burning types: forest, cropland, grassland, and shrubland fires. The farming
system and crop types in different temperate zones were taken into account in
this research. Compared with traditional methods, the FRE method was found to
provide a more reasonable estimate of emissions from small fires. The
estimated average annual emission ranges, with a 90 % confidence
interval, were 91.4 (72.7–108.8) Tg CO2 yr−1, 5.0
(2.3–7.8)  Tg CO yr−1, 0.24
(0.05–0.48) Tg CH4 yr−1, 1.43
(0.53–2.35) Tg NMHC yr−1, 0.23
(0.05–0.45) Tg NOx yr−1, 0.09
(0.02–0.17) Tg NH3 yr−1, 0.03
(0.01–0.05) Tg SO2 yr−1, 0.04
(0.01–0.08) Tg BC yr−1, 0.27 (0.07–0.49) Tg OC yr−1, 0.51
(0.19–0.84) Tg PM2.5 yr−1, 0.57 (0.15–1.05) Tg
PM10 yr−1, where NMHC, BC, and OC are nonmethane hydrocarbons,
black carbon, and organic carbon, respectively. Forest fires are
determined to be the primary contributor to open fire emissions, accounting
for 45 % of the total CO2 emissions (average 40.8 Tg yr−1).
Crop residue burning ranked second place with a large portion of 39 %
(average 35.3 Tg yr−1). During the study period, emissions from forest
and grassland fires showed a significant downward trend. Crop residue
emissions continued to rise during 2003–2015 but dropped by 42 % in
2015–2016. Emissions from shrubland were negligible and little changed.
Forest and grassland fires are concentrated in northeastern China and
southern China, especially in the dry season (from October to March of the
following year). Plain areas with high crop yields, such as the North China
Plain, experienced high agricultural fire emissions in harvest seasons. Most
shrubland fires were located in Yunnan and Guangdong provinces. The
resolution of our inventory (daily, 1 km) is much higher than previous
inventories, such as GFED4s and GFASv1.0. It could be used in global and
regional air quality modeling.
Deep-seated gravitational slope deformation scaling on Mars and Earth: same fate for different initial conditions and structural evolutions
Authors: Kromuszczyńska Olga , Mège Daniel , Dębniak Krzysztof , Gurgurewicz Joanna , Makowska Magdalena , Lucas Antoine
Published: April 2019

Abstract. Some of the most spectacular instances of deep-seated
gravitational slope deformation (DSGSD) are found on Mars in the Valles
Marineris region. They provide an excellent opportunity to study DSGSD
phenomenology using a scaling approach. The topography of selected DSGSD
scarps in Valles Marineris and in the Tatra Mountains is investigated after
their likely similar postglacial origin is established. The deformed Martian
ridges are larger than the deformed terrestrial ridges by 1 to 2 orders
of magnitude with, however, a similar height-to-width ratio of ∼0.24. The measured horizontal spreading perpendicular to the ridges is
proportionally 1.8 to 2.6 times larger for the Valles Marineris ridges than
the Tatra Mountains and vertically 2.9 to 5.1 times larger, suggesting that
starting from two different initial conditions, with steeper slopes in
Valles Marineris, the final ridge geometry is now similar. Because DSGSD is
expected to now be inactive in both regions, their comparison suggests that
whatever the initial ridge morphology, DSGSD proceeds until a mature profile
is attained. Fault displacements are therefore much larger on Mars. The
large offsets imply reactivation of the DSGSD fault scarps in Valles
Marineris, whereas single seismic events would be enough to generate DSGSD
fault scarps in the Tatra Mountains. The required longer activity of the
Martian faults may be correlated with a long succession of climate cycles
generated by the unstable Martian obliquity.
IAHS: a brief history of hydrology
Authors: Rosbjerg Dan , Rodda John
Published: April 2019

Abstract. After describing the hydrological cycle and defining hydrology in the
introduction, the early historical development of hydrology is briefly
presented in the second section. Then the incorporation of hydrology within
the IUGG and the subsequent development of the association are described
chronologically. This description is organized into five sections
corresponding to five different periods, focused on the scientific and
organizational development of the association during each period. Finally, in
the conclusions, the present state of the association is discussed together
with an outlook for the future.