bluuebunny/crossref_metadata_2025 huggingface dataset:
Rosai–Dorfman disease mimicking IgG4-related diseases: a single-center experience in China
Authors: Wang Li , Li Wei , Zhang Shangzhu , Peng Linyi , Shen Min , Song Shuoning , Zhang Wei , Cao Xinxin , Feng Ruie , Zhang Wen
Published: October 2020

Background

Rosai–Dorfman disease (RDD) and IgG4-related (IgG4-RD) disease are both rare diseases, but in some cases, RDD mimics IgG4-RD clinically and pathologically. RDD mimicking IgG4-RDs (RDD mimic IgG4-RD), referring to disease initially diagnosed as IgG4-RD but finally pathologically confirmed to be RDD, is a clinically rare and confusing disease. To summarize the characteristics of this disease, we prospectively analyzed the clinical features, laboratory parameters, pathological characteristics, treatment and prognosis of patients diagnosed with RDD mimic IgG4-RD. Moreover, by analyzing characteristics of RDD mimic IgG4-RD, RDD and IgG4-RD, we further compared the similarities and differences between RDD and IgG4-RD.

Results

7 patients with RDD mimic IgG4-RD were included in this study and all of them had extranodal organ involvement, especially the central nervous system, which occurred in 5 patients (71.4%). Although serum IgG4 level was elevated in 6 cases (1360–54,100 mg/L), overall, it was still lower than that in IgG4-RD patients. Furthermore, we found a new cut-off value of serum IgG4 concentration for differentiating RDD and IgG4-RD with higher specificity. Pathological findings of RDD also showed features resembling IgG4-RD: IgG4-positive plasma cell enrichments were observed in all RDD mimic IgG4-RD patients, and the proportion of IgG4/IgG in tissues was 10–40% in 4 patients and more than 40% in 2 patients. However, none of the RDD mimic IgG4-RD patients or RDD patients displayed obliterative phlebitis or storiform fibrosis. Most of the RDD mimic IgG4-RD patients were treated with glucocorticoids combined with immunosuppressants, and a good prognosis was obtained following treatment.

Conclusions

RDD has clinical manifestations that mimic IgG4-RD. However, detailed differences in laboratory parameters and pathological characteristics are present between these two diseases. Our study underlines the necessity to rule out RDD while diagnosing IgG4-RD using pathological findings as the identification criteria and provides advice for both differentiating these two diseases and clinical treatment of RDD mimic IgG4-RD.
Long noncoding RNA Linc00337 functions as an E2F1 co-activator and promotes cell proliferation in pancreatic ductal adenocarcinoma
Authors: Wang Huakai , Yu Shiyong , Peng Huan , Shu Yijun , Zhang Wenjie , Zhu Qi , Wu Yingxia , Xu Yijun , Yan Jiqi , Xiang Honggang
Published: October 2020

Background

Long noncoding RNA (lncRNA) Linc00337 has been implicated in lung, gastric, colorectal and esophageal squamous cell carcinoma progression via various mechanisms; however, its clinicopathological significance and role in pancreatic ductal adenocarcinoma (PDAC) progression remains largely unknown.

Methods

Multiple approaches such as bioinformatic analysis, Transfection, quantitative real-time-PCR, Western blotting, animal studies, RNA-immunoprecipitation (RIP), RNA-pulldown and RNA-Fluorescence in situ hybridization (RNA-FISH) and were utilized to explore the role of Linc00337 in PDAC.

Results

Here we identified Linc00337 is an oncogenic lncRNA during PDAC progression. We found that the expression of Linc00337 is elevated in PDAC tissues and the higher Linc00337 predicts dismal prognosis. Functionally, Linc00337 promotes PDAC cell proliferation and cell cycle transition both in vitro and in vivo. Mechanistically, Linc00337 binds to E2F1 and functions as an E2F1 coactivator to trigger the targets expression during PDAC progression.

Conclusion

Our results demonstrate a reciprocal regulation mechanism between Linc00337 and E2F1 in PDAC progression and report the clinical value of Linc00337 for PDAC prognosis and treatment.
Mortality and quality of care in Nordic physician-staffed emergency medical services
Authors: Haugland Helge , Olkinuora Anna , Rognås Leif , Ohlén David , Krüger Andreas
Published: October 2020

Background

Quality indicators (QI) for physician staffed emergency medical services (P-EMS) are necessary to improve service quality. Mortality can be considered the ultimate outcome QI. The process quality of care in P-EMS can be described by 15 response-specific QIs developed for these services. The most critical patients in P-EMS are presumably found among patients who die within 30 days after the P-EMS response. Securing high quality care for these patients should be a prioritized task in P-EMS quality improvement. Thus, the first aim of this study was to describe the 30-days survival in Nordic P-EMS as an expression of the outcome quality of care. The second aim was to describe the process quality of care as assessed by the 15 QIs, for patients who die within 30 days after the P-EMS response.

Methods

In this prospective observational study, P-EMSs in Finland, Sweden, Denmark, and Norway registered 30-days survival and scored the 15 QIs for their patients. The QI performance for patients who died within 30 days after the P-EMS response was assessed using established benchmarks for the applied QIs. Further, mean QI performance for the 30-days survivors and the 30-days non-survivors were compared using Chi-Square test for categorical variables and Mann-Whitney U test for continuous variables.

Results

We recorded 2808 responses in the study period. 30-days survival varied significantly between the four participating countries; from 89.0 to 76.1%. When assessing the quality of care for patients who die within 30 days after the P-EMS response, five out of 15 QIs met the established benchmarks. For nine out of 15 QIs, there was significant difference in mean scores between the 30 days survivors and non-survivors.

Conclusion

In this study we have described 30-days survival as an outcome QI for P-EMS, and found significant differences between four Nordic countries. For patients who died within 30 days, the majority of the 15 QIs developed for P-EMS did not meet the benchmarks, indicating room for quality improvement. Finally, we found significant differences in QI performance between 30-days survivors and 30-days non-survivors which also might represent quality improvement opportunities.
Effect of probiotics on nasal and intestinal microbiota in people with high exposure to particulate matter ≤ 2.5 μm (PM2.5): a randomized, double-blind, placebo-controlled clinical study
Authors: Wu Yongcan , Pei Caixia , Wang Xiaomin , Wang Mingjie , Huang Demei , Wang Fei , Xiao Wei , Wang Zhenxing
Published: October 2020

Background

Extended exposure to high concentrations of PM2.5 changes the human microbiota profile, which in turn may increase morbidity and mortality due to respiratory system damage. A balanced microecosystem is crucial to human health, and certain health-related problems may be addressed by effective microecosystem regulation. Recent studies have confirmed that probiotics may reduce the incidence of respiratory diseases. However, few studies have investigated probiotic treatment outcomes in subjects exposed to high concentrations of PM2.5.

Methods

This study is designed as a prospective, randomized, participants- and assessor-blinded, placebo-controlled trial. One hundred and twenty eligible volunteers recruited from October 2019 to July 2020 in downtown Chengdu, China, will be treated with either probiotics or placebo over 4 consecutive weeks. The primary outcome will be 16SrRNA sequencing assay data from nasal and intestinal secretions. Secondary outcomes will be pulmonary function, score on a gastrointestinal symptom rating scale, COOP/WONCA charts, and the Short-Form Health Survey 36 for quality of life. Results will be analyzed to assess differences in clinical efficacy between groups. Six-month follow-up examinations will evaluate the long-term value of probiotics on cardiovascular and respiratory disease end-point events.

Discussion

We will explore the characteristics of nasal and intestinal microbiota in a population with high exposure to PM2.5. Probiotics and placebo interventions will be tested for efficacy in microbial balance regulation, effects on lung and physical functions, and quality of life improvement. This study is expected to provide reliable evidence to support the widespread promotion of probiotics in clinical practice for the protection of individuals with high exposure to PM2.5.

Trial registration

Chinese Clinical Trial Registry ChiCTR1900025469. Registered on 27 August 2019.
Group intervention for siblings and parents of children with chronic disorders (SIBS-RCT): study protocol for a randomized controlled trial
Authors: Fjermestad Krister W. , Silverman Wendy K. , Vatne Torun M.
Published: October 2020

Background

Siblings and parents of children with neurodevelopmental disorders are at risk of mental health problems and poorer family communication. Some group interventions for siblings exist, but few have clearly described parent components and none are considered evidence-based.

Methods

We are conducting a randomized controlled trial comparing a five-session manual-based group intervention for siblings (aged 8 to 16 years) and parents of children with neurodevelopmental disorders to a 12-week waitlist, called SIBS-RCT. The intervention comprises three separate sibling and parent group sessions and two joint sessions in which each sibling talks to their parent alone. The intervention aims at improving parent-child communication and covers themes such as siblings’ understanding of the neurodevelopmental disorder, siblings’ emotions, and perceived family challenges. Participants are recruited through municipal and specialist health centers across Norway. The primary outcome is sibling mental health. Quality of life and family communication are secondary outcomes. Participants are block-randomized to the intervention or 12-week waitlist in groups of six. Measures are collected electronically at pre- and post-intervention/waitlist, as well as 3, 6, and 12 months post-intervention. The main effect to be examined is the difference between the intervention and waitlist at 12 weeks post. All outcomes will also be examined using growth curve analyses. We plan to include 288 siblings and their parents by the end of 2022.

Discussion

SIBS-RCT represents a major contribution to the research and practice field towards establishing an evidence-based intervention for siblings. In the event that intervention and waitlist are no different, the impact of SIBS-RCT is still substantial in that we will aim to identify participant subgroups that show positive response and effective components of the SIBS manual by examining group leader adherence as an outcome predictor. This will allow us to continue to re-engineer the SIBS manual iteratively to improve outcomes, and avoid the promotion of a less-than-optimal intervention.

Trial registration

ClinicalTrials.gov NCT04056884. Registered in August 2019
Increased MLKL mRNA level in the PBMCs is correlated with autoantibody production, renal involvement, and SLE disease activity
Authors: Zhang Mingjiao , Jie Hongyu , Wu Yong , Han Xinai , Li Xing , He Yi , Shi Xingliang , Luo Yuwei , Sun Ying , Yang Jinlong , Yang Jing , Quan Shulv , Lao Xiaobin , Tan Liping , Sun Erwei
Published: October 2020

Background

Necroptosis is a form of regulated necrosis that is involved in various autoimmune diseases. Mixed lineage kinase domain-like pseudokinase (MLKL) has been identified as a key executor of necroptosis; however, the significance of MLKL in peripheral blood mononuclear cells (PBMCs) of systemic lupus erythematosus (SLE) has not been investigated. In this study, we aimed to determine the mRNA level of MLKL in PBMCs and examine its relationship with clinical features and serological parameters in SLE.

Methods

Real-time transcription-polymerase chain reaction (RT-PCR) analysis was used to determine the expression of MLKL mRNA in PBMCs from 59 patients with SLE, 25 patients with rheumatoid arthritis (RA), and 30 age- and sex-matched healthy controls (HC). Spearman’s correlation test was performed to assess the correlation of MLKL mRNA with clinical variables. The receiver operating characteristic (ROC) curve was created to evaluate the diagnostic value.

Results

Our results showed MLKL mRNA in PBMCs was upregulated in SLE patients compared to that in RA and HC individuals. SLE patients positive for antinuclear antibodies had significantly higher MLKL mRNA than antibody-negative patients. In SLE patients, MLKL mRNA was found to be upregulated in patients with lupus nephritis (LN) as compared with patients without LN, and also higher in active patients than in stable patients. MLKL mRNA level was significantly and positively correlated with c-reaction protein (CRP) (r = 0.3577, p = 0.0237), erythrocyte sedimentation rate (ESR) (r = 0.4091, p = 0.0043), serum immunoglobulin G (IgG) concentration (r = 0.3546, p = 0.0289), and the numbers of positive antinuclear antibodies (ANAs) (r = 0.3945, p = 0.0432). ROC analysis showed that MLKL mRNA in PBMCs had an area under the curve of 0.9277 (95% CI 0.8779–0.9775, p < 0.001) to discriminate SLE from controls.

Conclusions

These results suggest that increased MLKL mRNA level in the PBMCs of SLE patients is correlated with renal involvement and disease activity, identifying a subgroup of patients with SLE or LN who may benefit from early diagnosis and therapies targeting MLKL.
The role of EMMPRIN/CD147 in regulating angiogenesis in patients with psoriatic arthritis
Authors: Rahat Michal A. , Safieh Mirna , Simanovich Elina , Pasand Eliran , Gazitt Tal , Haddad Amir , Elias Muna , Zisman Devy
Published: October 2020

Background

Angiogenesis plays a central role in the pathophysiology of rheumatic diseases. Patients with psoriatic arthritis (PsA) demonstrate increased vascularity over patients with rheumatoid arthritis (RA), with unknown mechanisms.

Methods

We evaluated the serum levels of several pro- and anti-angiogenic factors in 62 PsA patients with active disease, 39 PsA patients in remission, 33 active RA patients, and 33 healthy controls (HC). Additionally, we used an in vitro co-culture system of fibroblast (HT1080) and monocytic-like (MM6) cell lines, to evaluate how their interactions affect the secretion of angiogenic factors and angiogenesis promoting abilities using scratch and tube formation assays.

Results

PsA patients, regardless of disease activity, exhibited higher levels of EMMPRIN/CD147, IL-17, and TNF-α relative to RA patients or HC. Factors, such as IL-6, and the ratio between CD147 and thrombospondin-1, exhibited elevated levels in active PsA patients relative to PsA patients in remission. Secretion of CD147, VEGF, and MMP-9 was increased in vitro. CD147 neutralization with an antibody reduced these levels and the ability of endothelial cells to form tube-like structures or participate in wound healing.

Conclusions

CD147 plays a role in mediating angiogenesis in PsA, and the therapeutic possibilities of neutralizing it merit further investigation.
Provision of adaptive guard band in elastic optical networks
Authors: Monteiro Neclyeux S. , Fontinele Alexandre C. , Campelo Divanilson R. , Soares André
Published: October 2020

Elastic optical networks are a network infrastructure capable of withstanding the high demand for data traffic from high-speed networks. One of the problems that must be solved to ensure the smooth functioning of the network is called Routing, Modulation Level and Spectrum Assignment (RMLSA). This work aims to propose a new approach to this problem with an algorithm to select the guard band in an adaptive way. Two algorithms for the adaptive selection of the guard band, called Guard Band according to Use of the Network (GBUN) and Guard Band by OSNR Margin (GBOM), are presented. The GBUN algorithm performs the guard band selection based on the usage level of network. On the other hand the GBOM algorithm uses an Optical Signal to Noise Ratio (OSNR) margin for the selection of the guard band. The performances of the proposed algorithms are compared with algorithms that use fixed guard band values and the adaptive proposal AGBA. The results showed that the GBOM algorithm presented a better performance in terms of bandwidth blocking probability for the studied scenarios. In general, GBOM also presents a better energy efficiency when compared to the other algorithms.
Persistent swallowing disorders after extubation in mechanically ventilated patients in ICU: a two-center prospective study
Authors: Beduneau G. , Souday V. , Richard J. C. , Hamel J. F. , Carpentier D. , Chretien J. M. , Bouchetemble P. , Laccoureye L. , Astier A. , Tanguy V. , Mercat A. , Beloncle F. , Tamion F.
Published: October 2020

Background

Persistent swallowing disorders (SD) are non-pulmonary complications of mechanical ventilation (MV). However, there are few clinical studies on persistent SD in critically ill patients undergoing tracheal intubation for MV. The aim of the present study was to assess the incidence and characteristics of clinical manifestations associated with persistent SD.

Methods

We prospectively evaluated in patients requiring more than 7 days of invasive MV the incidence and characteristics of clinical manifestations related to persistent SD. For this purpose, quality of swallowing was assessed within 24 h after extubation by an experienced physical therapist not directly involved in patient management. Swallowing assessment consisted in a specific standardized test combining a swallowing test and a full clinical evaluation of the cranial nerves involved in swallowing. In patients with SD on the first test, a second test was done within 48 h in order to discriminate between transient and persistent SD.

Results

Among the 482 patients mechanically ventilated more than 7 days, 138 were enrolled in this study. The first test performed 24 h after extubation revealed SD in 35 patients (25%). According to the second test performed 48 h later, SD were considered transient in 21 (15%) and persistent in 14 (10%) cases. Patients with persistent SD were older (66 ± 16 vs 58 ± 15 years), had lower bodyweight at admission (76 ± 15 vs 87 ± 23 kg) and received less often neuromuscular blocking agents (36% vs 66%) compared to patients without or with only transient SD. Patients with persistent SD had longer duration of Intensive Care Unit (ICU) stay after first extubation and longer delay to oral feeding than patients without or with only transient SD, respectively, 11 ± 9 vs 7 ± 6 days and 23 ± 33 vs 5 ± 7 days.

Conclusions

Based on a specific standardized clinical test, 25% of patients mechanically ventilated more than 7 days exhibited clinical manifestations of SD. However, SD were considered as persistent after extubation in only 10% of them. Persistent SD were associated with longer duration of ICU stay after extubation and longer time of enteral feeding.

Trial registration: The study is registered with Clinical Trials (NCT01360580).
Existence-uniqueness of positive solutions to nonlinear impulsive fractional differential systems and optimal control
Authors: Song Shu , Zhang Lingling , Zhou Bibo , Zhang Nan
Published: October 2020

In this thesis, we investigate a kind of impulsive fractional order differential systems involving control terms. By using a class ofφ-concave-convex mixed monotone operator fixed point theorem, we obtain a theorem on the existence and uniqueness of positive solutions for the impulsive fractional differential equation, and the optimal control problem of positive solutions is also studied. As applications, an example is offered to illustrate our main results.
Correction to: Functional dissociation of hippocampal subregions corresponding to memory types and stages
Authors: Seok Ji-Woo , Cheong Chaejoon
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Extra-pair paternity and antiparasitic defence
Authors: Møller Anders Pape , Søraker Jørgen Skavdal , Soler Juan José
Published: October 2020

Background

Extra-pair paternity (EPP) in birds provides benefits in terms of more offspring, and characteristics for maintenance of this behaviour have been the subject of investigation. Microorganisms are known to be transmitted during mating, especially when mating with multiple partners, and factors reducing this cost of multiple mating are expected. Further, plumage brightness and colour intensity have been shown to be important traits to benefits from multiple mating as predicted by sexual selection. The aim of this study was to investigate the relationship between the rate of extra-pair paternity and the relative size of the uropygial gland at the interspecific level, as the uropygial gland is an exocrine gland hypothesized to produce antiparasitic substances and further identified to affect plumage brightness. Because of the expected benefits of large uropygial gland in scenarios of sexual selection, we predicted a positive correlation with EPP.

Methods

We collected information from the literature of uropygial gland size and frequency of extra-pair paternity of 60 avian species of different families and explored the predicted positive correlation between them. We did so with means of comparative analyses that considered phylogenetic relationship as random factor and included body mass as covariate. We used Markov chain Monte Carlo generalized linear mixed models that were weighted by number of nests used to estimate extra-pair paternity.

Results

We detected a positive relationship between level of extra-pair paternity and uropygial gland size at an interspecific level. This finding is consistent with the prediction.

Conclusions

We discuss the importance of this result in scenarios of sexual selection and argue that the detected relationship may have arisen by utilizing antiparasitic secretions through secondary sexual characters indicating parasite resistance.
Non-adherence to inhaled medications among adult asthmatic patients in Ethiopia: a systematic review and meta-analysis
Authors: Aberhe Woldu , Hailay Abrha , Zereabruk Kidane , Mebrahtom Guesh , Haile Teklehaimanot
Published: October 2020

Background

Medication non-adherence is one of a common problem in asthma management and it is the main factor for uncontrolled asthma. It can result in poor asthma control, which leads to decreased quality of life, increase hospital admission, increased health care utilization, lost productivity, and mortality. To date, there have been no studies and protocols that estimated the pooled national prevalence of non-adherence to inhaled anti-asthmatic medications in Ethiopia. Therefore, the primary purpose of this systematic review and meta-analysis is to determine the pooled national prevalence of non-adherence to inhaled medications among asthmatic patients in Ethiopia.

Methods

Different database searching engines including PubMed, Scopus, Google Scholar, Africa journal online, World Health Organization afro library, and Cochrane review were systematically searched by using keywords such as “prevalence, non-adherence to inhaled medications, inhaled corticosteroids, and asthmatic patients” and their combinations. Six published observational studies that report the prevalence of non-adherence to inhaled medications were finally selected. The Preferred Reporting Items for Systematic Review and Meta-Analysis guideline was followed. Heterogeneity across the included studies was evaluated by the inconsistency index (I2). The random-effect model was fitted to estimate the pooled prevalence of non-adherence to inhale anti-asthmatic medications. All statistical analysis was done using R version 3.5.3 and R Studio version 1.2.5033 software for windows.

Results

The pooled national prevalence of non-adherence to inhaled medications among asthmatic patients was 29.95% (95% CI, 19.1, 40.8%). The result of this meta-analysis using the random-effects model revealed that there is high heterogeneity across the included studies. The result of subgroup analysis indicates that one out of three in the Oromia region and one out of five in the Amhara region asthmatic patients was non-adherent to their inhaled anti-asthmatic medications.

Conclusion

the prevalence of non-adherence to inhaled anti-asthmatic medications was high. Thus, our finding suggests that one out of four asthmatic patients were non-adherent to inhaled medications. The ministry of health, health policymakers, clinicians, and other health care providers should pay attention to strengthening the adherence levels to inhaled anti-asthmatic medications, and country-based interventions should be developed to reduce the burden of non-adherence to inhaled anti-asthmatic medications.
Does synbiotic supplementation affect the quality of life in children with cystic fibrosis? A pilot randomized controlled clinical trial
Authors: Bilan Nemat , Marefat Effat , Nikniaz Leila , Abbasalizad Farhangi Mahdieh , Nikniaz Zeinab
Published: October 2020

Background

There is no clinical trial that assesses the effect synbiotic supplementation on HRQOL in CF children. Considering the importance of HRQOL as an essential primary outcome and determinant of therapeutic benefit in chronic diseases like cystic fibrosis, the present clinical trial aimed to determine the efficacy of synbiotic supplementation on HRQOL in children with CF.

Methods

In the present double-blind randomized clinical trial, 40 CF children were randomly allocated to the two groups. The intervention group was supplemented with synbiotics supplements and the patients in the placebo group received maltodextrin for 6 months. Demographic data and information about antibiotic use were recorded using the questionnaire. The health-related quality of life was assessed using the Persian version of quality of life inventory questionnaires. Paired t-test and ANCOVA were used for statistical analysis.

Results

Totally, 36 participants completed the trial. The mean score of HRQOL was 76.34 ± 17.33. There were no significant differences between synbiotic and placebo groups regarding baseline demographic and quality of life characteristics. Compared with baseline values, the mean total score and subscores of quality of life did not change significantly after synbiotic and placebo supplementation (p > 0.05). Moreover, the results of ANCOVA showed that there were no significant differences between the two groups regarding the post-trial value of HRQOL total score and subscores.

Conclusion

According to results, six-month supplementation with synbiotic did not have a significant effect on the HRQOL in children with CF. However, further studies with larger sample sizes and using more disease-specific questionnaires are needed for a more precise conclusion.

The protocol of the study was registered at Iranian registry clinical trials (Registration code: IRCT2017011732004N1; Registration date: 2017-02-14).
Save the hearing, an ear surgery training project program to combat deafness in developing countries
Authors: El-Begermy Mohamed A. , Deghady Hany A. , El-Seidy Nasr , Ezzat Abdelrahman , El-Begermy Marwa M. , AlAqel Abdul Wasa , Mosleh Mohmed Saleh , Nafie Yasser ,   Many Others
Published: October 2020

Background

Hearing loss is one of the most common health problems affecting people in the developing countries so our aim of the “Save The Hearing Project” was to combat deafness by training local doctors for ear surgery in order to treat their local patients with low cost as possible. The project was done as ear surgery campaigns in peripheral areas in Egypt, Yemen, and other countries, to train young ENT specialists and to treat patients there. Our plan was put according to the frequency of different causes of deafness as shown by previous surveys. We used the previous local and evidence-based researches to make our protocols of management of different diseases. These protocols were further evaluated during our work.

The project has five stages. The first stage included management of sudden sensory neural hearing loss (SSNHL), otitis media with effusion (OME), and local anesthesia for the ear surgery—cartilage tympanoplasty and ossiculoplasty. The second stage included mastoidectomy cholesteatoma surgery and otoendoscopy. The third stage included more advanced surgery as stapedectomy and tympanosclerosis. The fourth stage included combating SNHL mainly through audiology and rehabilitation program, beside referral for cochlear implants to specialized centers. The fifth stage was only a plan for doing stem cell research in management of hearing loss.

Results

Our teams did about 42 campaigns only and the data of 31 were recorded. There were 259 attendants, 70 had hands on training, and 35 were well trained and became trainers. We did 270 tympanoplasties, 52 mastoidectomies, and cholesteatoma surgery beside 16 operations of stage III.

Conclusion

Training an ear surgeon is a tedious and long process, but it is at the end very fruitful and useful for the community. Most causes of HL are preventable. We think that our project plan to combat HL is very suitable to be applied in developing countries in Africa and the Middle East.
Integrated geophysical imaging of rare earth element-bearing iron oxide-apatite deposits in the Eastern Adirondack Highlands, New York
Authors: Shah Anjana K. , Taylor Ryan D. , Walsh Gregory J. , Phillips Jeffrey D.
Published: October 2020

The eastern Adirondack Highlands of northern New York host dozens of iron oxide-apatite (IOA) deposits containing magnetite and rare earth element (REE)-bearing apatite. We use new aeromagnetic, aeroradiometric, ground gravity, and sample petrophysical and geochemical data to image and understand these deposits and their geologic framework. Aeromagnetic total field data reflect highly magnetic leucogranite host rock and major structures that likely served as fluid conduits for the hydrothermal system. Band-pass filtering of the aeromagnetic data reveals locations of individual deposits that were verified in the field or from historical records. A 3D inversion for magnetic susceptibility images these deposits at depth, allowing the inference of plunge directions and relative size. Radiometric data highlight variations in the surface geology and several large tailings piles that contain REE-bearing apatite. Within the host rock, eTh (equivalent Th), K, and the eTh/K ratio are variable with high eTh/K near several of the IOA deposits. Areas with elevated K or low eTh/K representing potassic alteration appear to be rare; instead, elevated eTh/K ratios likely reflect widespread sodic alteration that overprinted potassic alteration. Bouguer gravity anomalies show limited correspondence to the surface geology, radiometric data, or magnetic data, but they do exhibit approximately 10 km wide highs in areas where deposits are observed. Some 2D forward models of the gravity and magnetic data show that deeper dense material beneath the leucogranite is quantitatively feasible. If these dense rocks represent intrusions that were emplaced or still cooling at the time of mineralization, they may have served as a heat source that helped to drive the hydrothermal system. Combining data sets, we find that deposits occur toward the distal ends of major structures within the host leucogranite and mostly above gravity highs. The geophysical modeling thus suggests that IOA deposits formed in structural, thermal, and chemical traps near the distal ends of the hydrothermal system.
Robust damped rank-reduction method for simultaneous denoising and reconstruction of 5D seismic data
Authors: Innocent Oboué Yapo Abolé Serge , Chen Wei , Wang Hang , Chen Yangkang
Published: October 2020

We have developed a new method for simultaneous denoising and reconstruction of 5D seismic data corrupted by random noise and missing traces. Several algorithms have been developed for seismic data restoration based on rank-reduction (RR) methods. More recently, a damping operator has been introduced into the conventional truncated singular-value decomposition (TSVD) formula to further remove residual noise, the presence of which disturbs the quality of the seismic results. Despite the success of the damped RR (DRR) method when the observed data have an extremely low signal-to-noise ratio (S/N), random noise is still a limiting factor for obtaining a perfect quality of the result. Therefore, how to accurately solve the simultaneous denoising and reconstruction problem with high fidelity is still challenging. We assume that introducing only the damping operator into the TSVD formula is not enough to remove the random noise and restore the useful signal well. By combining the soft thresholding (ST) operator and the moving-average (MA) filter, we have developed a new operator, which we call the STMA operator. Then, by introducing the STMA operator into the DRR framework, we have developed a new algorithm known as the robust DRR method, which aims at mixing the advantages of the STMA operator and the damping operator. The STMA operator is applied to the Hankel matrix after damped TSVD to better remove residual noise. Examples of our approach on synthetic and field 5D seismic data demonstrate the better performance in terms of the visual examination and numerical test compared with the DRR approach. Our method aims at producing an effective low-rank filter and, thus, can perfectly enhance the S/N of the simultaneously denoised and reconstructed results with higher accuracy.
Surface wave tomography using 3D active-source seismic data
Authors: Barone Ilaria , Kästle Emanuel , Strobbia Claudio , Cassiani Giorgio
Published: October 2020

Surface wave tomography (SWT) is a powerful and well-established technique to retrieve 3D shear-wave (S-wave) velocity models at the regional scale from earthquakes and seismic noise measurements. We have applied SWT to 3D active-source data, in which higher modes and heterogeneous spatial sampling make phase extraction challenging. First, synthetic traveltimes calculated on a dense, regular-spaced station array are used to test the performance of three different tomography algorithms (linearized inversion, Markov chain Monte Carlo [MCMC], and eikonal tomography). The tests suggest that the lowest misfit to the input model is achieved with the MCMC algorithm, at the cost of a much longer computational time. Then, real phases were extracted from a 3D exploration data set at different frequencies. This operation included an automated procedure to isolate the fundamental mode from higher order modes, phase unwrapping in two dimensions, and the estimation of the zero-offset phase. These phases are used to compute traveltimes between each source-receiver couple, which are input into the previously tested tomography algorithms. The resulting phase-velocity maps show good correspondence, highlighting the same geologic structures for all three methods. Finally, individual dispersion curves obtained by the superposition of phase-velocity maps at different frequencies are depth inverted to retrieve a 3D S-wave velocity model.
Detection of karst cavity beneath cast-in-place pile using the instantaneous phase difference of two receiver recordings
Authors: Liu Liu , Shi Zhenming , Tsoflias Georgios P. , Peng Ming , Liu Chengcheng , Tao Fengjuan , Liu Chunsheng
Published: October 2020

Karst cavities beneath bored cast in situ piles are hazardous to the stability of infrastructure projects. Therefore, it is important to detect karst cavities during the construction of piles. Downward-looking sonar deployed at the bottom of a pile hole can be used to detect cavities; however, interference of multiple reflected surface waves from the walls of the pile hole masks the weak cavity reflections. We have developed a sonar method that exploits the instantaneous phase difference between signals recorded at two receivers to detect karst cavities beneath piles. The receiver separation is set to half the dominant wavelength of surface waves propagating along the pile hole. We define the instantaneous phase difference intensity (IPDI) as an index that measures the similarity of instantaneous phase between the signals at the two receivers. Higher IPDI values signify that the two signals have a similar instantaneous phase at that time, which implies the arrival of a reflection from a cavity. Reflected surface-wave arrivals exhibit low IPDI by design of the receiver geometry. Thus, the first break of reflected P-waves from the roof and floor of a cavity can be identified. We evaluate the effectiveness of the IPDI-based analysis method using numerical tests simulating the varying depth, azimuth, and size of karst cavities. A prototype using the IPDI analysis demonstrates the application of the new pile hole sonar method at two field investigations. Advance drilling, borehole optical image logs, and crosshole tomography verify the IPDI detection results. We conclude that the two-receiver sonar instrumentation along with the IPDI analysis are effective for detecting cavities beneath piles.
Microseismic denoising assessment by polarization histograms
Authors: Brunini German I. , Sabbione Juan I. , Gómez Julián L. , Velis Danilo R.
Published: October 2020

We have performed a comparison of microseismic data denoising methods based on their effect on the polarization attributes of 3C microseismic signals. The compared denoising methods include the classic band-pass filtering, and three recently proposed denoising techniques: restricted-domain hyperbolic Radon transform denoising, singular value decomposition (SVD)-based reduced-rank filtering, and empirical mode decomposition denoising. In order to draw the comparison, we denoised 3C synthetic data contaminated with noise extracted from field data records; calculated their rectilinearity, azimuth, and dip polarization attributes; and arranged them into histograms. The comparison has been drawn by measuring the distances between the polarization histograms of the clean and denoised data, assuming that one method outperforms another if the aforementioned distance is smaller. This strategy allows us to quantify the improvement in the calculated polarization attributes due to the different denoising processes. In addition, we also calculated the quality factor (QF) of the denoised signals, which adds value and robustness to the comparison. Our results indicated that the method based on SVD preserves the original polarization attributes better than the other techniques tested in this work. Moreover, it also retrieved the denoised signal with the highest QF. Finally, we tested the methods with field data and assessed their performance qualitatively on the basis of the insight gained from numerical tests with synthetic data.
Relational and affective neuroscience: a quiet revolution in psychiatric and psychotherapeutic practice
Authors: Mizen C. Susan , Hook John
Published: October 2020

We consider some advances in relational and affective neuroscience and related disciplines that attempt to resolve some fundamental aspects of the mind–brain problem. We consider the key role of affect in generating consciousness and in meeting our essential survival needs; the neural correlates of relating; how self and other are represented in the brain and awareness of self and other is generated through interoceptive predictive processes. We describe some leading models of the generation and purpose of consciousness, linking theories of affective and cognitive consciousness. We discuss psychiatric and psychotherapeutic innovations arising from this research, new integrated biopsychosocial interventions and the obstacles to be overcome in applying these models in practice.
Adjuvant Sorafenib for Renal Cell Carcinoma at Intermediate or High Risk of Relapse: Results From the SORCE Randomized Phase III Intergroup Trial
Authors: Eisen Tim , Frangou Eleni , Oza Bhavna , Ritchie Alastair W.S. , Smith Benjamin , Kaplan Rick , Davis Ian D. , Stockler Martin R. , Albiges Laurence , Escudier Bernard , Larkin James , Bex Axel , Joniau Steven , Hancock Barry , Hermann Gregers G. , Bellmunt Joaquim , Hodgkinson Elizabeth , Stewart Grant D. , Barber Jim , Brown Janet , McMenemin Rhona , Nathan Paul , Pickering Lisa M. , Parmar Mahesh K.B. , Meade Angela
Published: October 2020

PURPOSE

SORCE is an international, randomized, double-blind, three-arm trial of sorafenib after surgical excision of primary renal cell carcinoma (RCC) found to be at intermediate or high risk of recurrence.

PATIENTS AND METHODS

We randomly assigned participants (2:3:3) to 3 years of placebo (arm A), 1 year of sorafenib followed by 2 years of placebo (arm B), or 3 years of sorafenib (arm C). The initial sorafenib dose was 400 mg twice per day orally, amended to 400 mg daily. The primary outcome analysis, which was revised as a result of external results, was investigator-reported disease-free survival (DFS) comparing 3 years of sorafenib versus placebo.

RESULTS

Between July 2007 and April 2013, we randomly assigned 1,711 participants (430, 642, and 639 participants in arms A, B, and C, respectively). Median age was 58 years, 71% of patients were men, 84% had clear cell histology, 53% were at intermediate risk of recurrence, and 47% were at high risk of recurrence. We observed no differences in DFS or overall survival in all randomly assigned patients, patients with high risk of recurrence, or patients with clear cell RCC only. Median DFS was not reached for 3 years of sorafenib or for placebo (hazard ratio, 1.01; 95% CI, 0.83 to 1.23; P = .95). We observed nonproportional hazards; the restricted mean survival time (RMST) was 6.81 years for 3 years of sorafenib and 6.82 years for placebo (RMST difference, 0.01 year; 95% CI, −0.49 to 0.48 year; P = .99). Despite offering treatment adaptations, more than half of participants stopped treatment by 12 months. Grade 3 hand-foot skin reaction was reported in 24% of participants on sorafenib.

CONCLUSION

Sorafenib should not be used as adjuvant therapy for RCC. Active surveillance remains the standard of care for patients at intermediate or high risk of recurrence after nephrectomy and is the appropriate control of our current international adjuvant RCC trial, RAMPART.
ARTSCAN III: A Randomized Phase III Study Comparing Chemoradiotherapy With Cisplatin Versus Cetuximab in Patients With Locoregionally Advanced Head and Neck Squamous Cell Cancer
Authors: Gebre-Medhin Maria , Brun Eva , Engström Per , Haugen Cange Hedda , Hammarstedt-Nordenvall Lalle , Reizenstein Johan , Nyman Jan , Abel Edvard , Friesland Signe , Sjödin Helena , Carlsson Henrik , Söderkvist Karin , Thomasson Marcus , Zackrisson Björn , Nilsson Per
Published: October 2020

PURPOSE

We performed an open-label randomized controlled phase III study comparing treatment outcome and toxicity between radiotherapy (RT) with concomitant cisplatin versus concomitant cetuximab in patients with locoregionally advanced head and neck squamous cell carcinoma (HNSCC; stage III-IV according to the Union for International Cancer Control TNM classification, 7th edition).

MATERIALS AND METHODS

Eligible patients were randomly assigned 1:1 to receive either intravenous cetuximab 400 mg/m2 1 week before start of RT followed by 250 mg/m2/wk, or weekly intravenous cisplatin 40 mg/m2, during RT. RT was conventionally fractionated. Patients with T3-T4 tumors underwent a second random assignment 1:1 between standard RT dose 68.0 Gy to the primary tumor or dose escalation to 73.1 Gy. Primary end point was overall survival (OS) evaluated using adjusted Cox regression analysis. Secondary end points were locoregional control, local control with dose-escalated RT, pattern of failure, and adverse effects.

RESULTS

Study inclusion was prematurely closed after an unplanned interim analysis when 298 patients had been randomly assigned. At 3 years, OS was 88% (95% CI, 83% to 94%) and 78% (95% CI, 71% to 85%) in the cisplatin and cetuximab groups, respectively (adjusted hazard ratio, 1.63; 95% CI, 0.93 to 2.86; P = .086). The cumulative incidence of locoregional failures at 3 years was 23% (95% CI, 16% to 31%) compared with 9% (95% CI, 4% to 14%) in the cetuximab versus the cisplatin group (Gray’s test P = .0036). The cumulative incidence of distant failures did not differ between the treatment groups. Dose escalation in T3-T4 tumors did not increase local control.

CONCLUSION

Cetuximab is inferior to cisplatin regarding locoregional control for concomitant treatment with RT in patients with locoregionally advanced HNSCC. Additional studies are needed to identify possible subgroups that still may benefit from concomitant cetuximab treatment.
Glycemic Control and Variability of Diabetes Secondary to Total Pancreatectomy Assessed by Continuous Glucose Monitoring
Authors: Juel Caroline T B , Dejgaard Thomas F , Hansen Carsten P , Storkholm Jan H , Vilsbøll Tina , Lund Asger , Knop Filip K
Published: October 2020

Context

The extent of the glycemic variability in diabetes secondary to total pancreatectomy is not fully understood.

Objective

To evaluate glycemic variability in totally pancreatectomized (PX) patients and compare it to glycemic variability in hemoglobin A1c (HbA1c)-matched patients with long-standing type 1 diabetes (T1D).

Design

A case-control study was performed.

Setting

Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.

Patients or Other Participants

Ten PX patients (mean [SD]: age 64.3 [9.8] years; body mass index (BMI) 23.4 [5.0] kg/m2; duration of diabetes 3 [2.8] years), 10 HbA1c-matched patients with T1D (63.9 [8.6] years; 24.6 [3.1] kg/m2; 22 [4] years), and 10 gender-, age-, and BMI-matched healthy controls. All patients were managed on multiple daily injections of insulin.

Intervention

Continuous glucose monitoring (CGM) (Medtronic MiniMed iPro 2) during 12 consecutive days.

Main Outcome Measures

Glycemic variability.

Results

HbA1c levels were similar in the PX group and the T1D group. The PX group had greater continuous overall net glycemic action per 60 minutes (CONGA60 min) compared with the T1D group (mean [SEM]: 9.5 [0.3] vs 8.3 [0.2] mmol/L, P < 0.003) and mean plasma glucose values were higher in the PX group (10.6 [0.9] vs 9.0 [0.9] mmol/L, P < 0.001), whereas coefficient of variation for plasma glucose and standard deviation of mean plasma glucose, respectively, were similar in the 2 groups. Time spent below range was not different between the PX and the T1D group (2.3 [0.8] vs 4.5 [0.8]%, P = 0.065), whereas time spent above range was higher in the PX group (51.4 [3.3] vs 37.6 [1.9]%, P < 0.001).

Conclusions

CGM-assessed glycemic variability showed higher CONGA60 min and time spent above range in our PX patients compared with HbA1c-matched T1D patients. This study is registered at www.ClinicalTrials.gov (NCT02944110).