bluuebunny/crossref_metadata_2025 huggingface dataset:
The Inhibition of Cell Growth Through the EGFR/ERK/MMP-2 Pathway Induced by Ampelopsin in the Human Malignant Melanoma A375 Cell Line
Authors: Yang Fan , Yang Yin-hui , Zeng Wei-hui
Published: March 2020

Malignant melanoma is one of the most aggressive skin cancers, having a very high mortality rate. However, its effective treatment is not clear. Ampelopsin, a plant flavonoid, has been reported to inhibit cell growth and/or induce apoptosis in various types of tumor. In this study, it was shown that ampelopsin significantly inhibits melanoma A375 cell line proliferation in a concentration-dependent/time-dependent manner. The flow cytometric data clearly demonstrated that ampelopsin causes cell cycle arrest in the G2/M phase. Moreover, it also confirmed that growth inhibition mediated by treatment with ampelopsin is related to the decreased expression of Cdc2, Cdc25c, cyclin B1, and activation of caspase-3 and Bax, purportedly by epidermal growth factor receptor (EGFR), extracellular regulated protein kinases, and matrix metalloproteinase-2 (MMP-2) downregulation. As a result of this work, these findings suggest that ampelopsin inhibits human malignant melanoma A375 cell line proliferation by suppressing the EGFR/ERK/MMP-2 pathway.
Intact Periorbita Can Prevent Post-Traumatic Enophthalmos Following a Large Orbital Blow-Out Fracture
Authors: Susarla Srinivas , Hopper Richard A. , Mercan Ezgi
Published: March 2020

Treatment of orbital floor fractures is predicated on the restoration of orbital volume to prevent enophthalmos or hypoglobus. Globe position is the result of a complex interplay between the bony orbital anatomy and the soft tissue envelope. Studies on orbital fractures have frequently suggested criteria for repair on the basis of bony defect size or volume change. In this report, we describe a case of a large orbital floor defect (4.8 cm2) with intact periorbita and no herniation of soft tissue contents in a young male following facial trauma. The patient was followed for 1-year clinically and did not develop enophthalmos. This case demonstrates that bony injury alone is not sufficient to produce enophthalmos, and that the interplay between the soft tissue and bony anatomy is a critical determinant of globe position following orbital trauma.
Examining the role of hexagonal boron nitride nanoparticles as an additive in the lubricating oil and studying its application
Authors: Ramteke Sangharatna , Chelladurai H
Published: March 2020

Lubricating oil plays an important role in minimizing the friction and wear of many mechanical systems. The additives present in the conventional lubricant are inadequate to reduce the friction and wear of today’s mechanical systems. However, the use of these additives has a significant effect on the environment due to their fast chemical degradation. In recent years, nanoparticle-based lubricant has attracted great attention due to their friction reduction behavior. Therefore, it is of great importance to examine the role of nanoparticle addition in the conventional lubricant and its influence on the tribological characteristics of the mechanical systems. Hence, this research work focused on the formulation of hexagonal boron nitride nanoparticle-based nanofluids and its effect on the tribological characteristics of cylinder liner and piston rings of a realistic diesel engine. The different concentrations of hBN nanoparticle-based nanofluids were formulated and characterized using the ultraviolet–visible spectroscopy and the thermal gravimetric analysis. The results of the experimental analysis showed that hBN nanoparticles as an additive in the lubricating oil exhibited better anti-wear and friction reduction behavior than the conventional base oil 20W40.
Recurrence of Ameloblastic Fibro-Odontoma in a Child: A Case Report
Authors: Guerra Raphael Capelli , Carvalho Pedro Henrique de Azambuja , Thieringer Florian Markus , Pereira Rodrigo Santos , Hochuli-Vieira Eduardo
Published: March 2020

Introduction:

A young boy presented with mandibular swelling at the Department of Oral and Maxillofacial Surgery in Hospital Leforte, São Paulo, Brazil. Radiography showed a mixed bone lesion. Computed tomography (CT) findings were compatible with ameloblastic fibro-odontoma (AFO).

Case Report:

An excisional biopsy was performed under general anesthesia. At the 6-year follow-up, local inflammation and mild exudates were found. Local recurrence of the lesion was observed on CT. Therefore, excision and curettage were performed. No signs of recurrence have been detected to date. Ameloblastic fibro-odontoma is a rare benign neoplasm most commonly occurring in the first decade of life, with minimal probability of malignancy.

Conclusion:

Clinical, radiological, and histopathological findings aid in the diagnosis, and long-term follow-up is necessary as recurrence can develop even after 6 postoperative years.
Gilteritinib: potent targeting of FLT3 mutations in AML
Authors: Levis Mark , Perl Alexander E.
Published: March 2020

Since the discovery of FMS-like tyrosine kinase-3 (FLT3)–activating mutations as genetic drivers in acute myeloid leukemia (AML), investigators have tried to develop tyrosine kinase inhibitors that could effectively target FLT3 and alter the disease trajectory. Giltertinib (formerly known as ASP2215) is a novel compound that entered the field late, but moved through the developmental process with remarkable speed. In many ways, this drug’s rapid development was facilitated by the large body of knowledge gained over the years from efforts to develop other FLT3 inhibitors. Single-agent gilteritinib, a potent and selective oral FLT3 inhibitor, improved the survival of patients with relapsed or refractory FLT3-mutated AML compared with standard chemotherapy. This continues to validate the approach of targeting FLT3 itself and establishes a new backbone for testing combination regimens. This review will frame the preclinical and clinical development of gilteritinib in the context of the lessons learned from its predecessors.
Voluntary disclosures and peer-to-peer lending decisions: Evidence from the repeated game
Authors: Li Yan , Li Cungang , Gao Yijun
Published: March 2020

This study investigates the effect of voluntary disclosures on lending decisions in the repeated game. Using a unique dataset from a peer-to-peer lending platform, “ppdai” (paipaidai), we document that voluntary disclosures in the repeated game play a stronger role in promoting funding success than those in the one-shot game. We argue that voluntary disclosures improve the bidding activity in the repeated game through which they increase funding success. In addition, the greater impact of voluntary disclosures on funding success in the repeated game only holds for loans without a personal guarantee attribution. Our extended results suggest that the subjective voluntary disclosures in the repeated game have greater information content only when borrowers have a successful borrowing experience. We also point out that voluntary disclosures in the repeated game are associated with a lower probability of default. Our results are robust to the Heckman two-step estimation that addresses the self-selection effect and a specification designed to rule out the alternative explanation from reputation in the repeated game. Our study provides new insights into the real effects of costless, voluntary and unverifiable disclosures on lending decisions.
Effects of Hypericum scabrum extract on dentate gyrus synaptic plasticity in high fat diet-fed rats
Authors: Omidi Ghazaleh , Rezvani-Kamran Arezoo , Ganji Ahmad , Komaki Somayeh , Etaee Farshid , Asadbegi Masoumeh , Komaki Alireza
Published: March 2020

High-fat diet (HFD) can induce deficits in neural function, oxidative stress, and decrease hippocampal neurogenesis. Hypericum (H.) scabrum extract (Ext) contains compounds that could treat neurological disorders. This study aimed to examine the neuroprotective impacts of the H. scabrum Ext on hippocampal synaptic plasticity in rats that were fed HFD. Fifty-four male Wistar rats (220 ± 10 g) were randomly arranged in six groups: (1) HFD group; (2) HFD + Ext300 group; (3) HFD + Ext100 group; (4) Control group; (5) Ext 300 mg/kg group; (6) Ext 100 mg/kg group. These protocols were administrated for 3 months. After this stage, a stimulating electrode was implanted in the perforant pathway (PP), and a bipolar recording electrode was embedded into the dentate gyrus (DG). Long-term potentiation (LTP) was provoked by high-frequency stimulation (HFS) of the PP. Field excitatory postsynaptic potentials (EPSP) and population spikes (PS) were recorded at 5, 30, and 60 min after HFS. The HFD group exhibited a large and significant decrease in their PS amplitude and EPSP slope as compared to the control and extract groups. In reverse, H. scabrum administration in the HFD + Ext rats reversed the effect of HFD on the PS amplitude and EPSP slope. The results of the study support that H. scabrum Ext can inhibit diminished synaptic plasticity caused by the HFD. These effects are probably due to the extreme antioxidant impacts of the Ext and its capability to scavenge free radicals.
Experimental rat model for acute tubular injury induced by high water hardness and high water fluoride: efficacy of primary preventive intervention by distilled water administration
Authors: Perera Thanusha , Ranasinghe Shirani , Alles Neil , Waduge Roshitha
Published: March 2020

Background

High water hardness associated with high water fluoride and the geographical distribution of Chronic Kidney Disease of unknown etiology (CKDu) in Sri Lanka are well correlated. We undertook this study to observe the effects of high water hardness with high fluoride on kidney and liver in rats and efficacy of distilled water in reducing the effects.

Methods

Test water sample with high water hardness and high fluoride was collected from Mihinthale region and normal water samples were collected from Kandy region. Twenty-four rats were randomly divided into 8 groups and water samples were introduced as follows as daily water supply. Four groups received normal water for 60 (N1) and 90 (N2) days and test water for 60 (T1) and 90 (T2) days. Other four groups received normal (N3) and test (T3) water for 60 days and followed by distilled water for additional 60 days and normal (N4) and test (T4) water for 90 days followed by distilled water for another 90 days. The rats were sacrificed following treatment. Serum samples were subjected to biochemical tests; serum creatinine, urea, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and elemental analysis. Histopathological examinations were carried out using kidney and liver samples.

Results

Test water treated groups were associated with acute tubular injury with loss of brush border and test water followed with distilled water treated groups maintained a better morphology with minimal loss of brush border. Serum creatinine levels in T1 and T2 groups and urea level in T2 group were significantly (p < 0.05) increased compared to control groups. After administration of distilled water, both parameters were significantly reduced in T4 group (p < 0.05) compared to T2. Serum AST activity was increased in T4 group (p < 0.05) compared to control group with no histopathological changes in liver tissues. The serum sodium levels were found to be much higher compared to the other electrolytes in test groups.

Conclusion

Hard water with high fluoride content resulted in acute tubular injury with a significant increase in serum levels of creatinine, urea and AST activity. These alterations were minimized by administering distilled water.
The epidemiology and management of stroke in French Guiana
Authors: Rochemont Dévi Rita , Mimeau Emmanuelle , Misslin-Tritsch Caroline , Papaix-Puech Martine , Delmas Emmanuel , Bejot Yannick , DeToffol Bertrand , Fournel Isabelle , Nacher Mathieu
Published: March 2020

Background

French Guiana has the highest incidence of ischemic and hemorrhagic stroke of all French territories. However, there is no further information on the epidemiology and management of stroke in French Guiana. Our goal was to describe the characteristics of patients in French Guiana in order to generate hypotheses regarding the determinants explaining the magnitude of this public health problem.

Methods

We used the data of the French multicentre INDIA prospective cohort study which included consecutive patients aged > 18 years with a first-ever stroke from June 2011 to October 2014. For the present study, only patients with ischemic or hemorrhagic stroke admitted in one of the 3 participating hospitals were analyzed.

Results

Among the 298 patients (mean age 62.2 ± 14.5 years, 63.7% man) included in French Guiana, 52% were born abroad. Most strokes were ischemic strokes (79%), 14% of which were thrombolyzed. Hypertension (70.2%), history of smoking (22%) and diabetes (25%) were the most common risk factors and 28.4% of patients had known but untreated hypertension. Overall 89 (38%) patients with ischemic stroke were admitted less than 4.5 h after the first symptoms. In-hospital mortality was greater for intracerebral hemorrhage (18.7%) than for ischemic stroke (4.2%). Overall, 84.5% had health insurance coverage and among these, 41.9% had CMU, the universal health insurance for the poor.

Conclusions

The present study is the first epidemiologic description of stroke in French Guiana. The comparisons of these results show that stroke patients in French Guiana are epidemiologically atypical because they are younger, and more likely to be males than patients in mainland France. Stroke risk factors and delay between stroke and hospital admission were comparable with what is observed in France, suggesting that efforts should focus on primary care and social inequalities of health to alleviate the main determinants of stroke in French Guiana.
‘If you can’t make it, you’re not tough enough to do medicine’: a qualitative study of Sydney-based medical students’ experiences of bullying and harassment in clinical settings
Authors: Colenbrander Laura , Causer Louise , Haire Bridget
Published: March 2020

Background

Media exposés and academic literature reveal high rates of bullying and harassment of medical students, most commonly by consultant physicians and/or surgeons. Recent reports reveal the medical profession to be characterised by hierarchy, with verbal abuse a ‘rite of passage’, as well as sexist and racist behaviours.

Methods

Semi-structured in-depth interviews were conducted with ten current or recently graduated medical students from Sydney-based medical schools. Interviews were audio-recorded, transcribed verbatim, and thematically analysed.

Results

Hierarchy, and a culture of self-sacrifice, resilience and deference, were identified as problematic elements of the medical profession. In the minds of participants, these factors created barriers to reporting mistreatment, as participants felt reporting led to being labelled a ‘troublemaker’, affecting career progression. Additionally, participants stated that avenues of recourse were unclear and did not guarantee confidentiality or desired outcomes.

Conclusions

Mistreatment is continuing in clinical teaching and has negative consequences on medical students’ mental health and learning. Structural change is needed to combat institutionalised mistreatment to ensure the wellbeing of future doctors and high quality patient care.
Adolescent polycystic ovary syndrome according to the international evidence-based guideline
Authors: Peña Alexia S. , Witchel Selma F. , Hoeger Kathleen M. , Oberfield Sharon E. , Vogiatzi Maria G. , Misso Marie , Garad Rhonda , Dabadghao Preeti , Teede Helena
Published: March 2020

Background

Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging because features of normal pubertal development overlap with adult diagnostic criteria. The international evidence-based PCOS Guideline aimed to promote accurate and timely diagnosis, to optimise consistent care, and to improve health outcomes for adolescents and women with PCOS.

Methods

International healthcare professionals, evidence synthesis teams and consumers informed the priorities, reviewed published data and synthesised the recommendations for the Guideline. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was applied to appraise the evidence quality and the feasibility, acceptability, cost, implementation and strength of the recommendations.

Results

This paper focuses on the specific adolescent PCOS Guideline recommendations. Specific criteria to improve diagnostic accuracy and avoid over diagnosis include: (1) irregular menstrual cycles defined according to years post-menarche; > 90 days for any one cycle (> 1 year post-menarche), cycles< 21 or > 45 days (> 1 to < 3 years post-menarche); cycles < 21 or > 35 days (> 3 years post-menarche) and primary amenorrhea by age 15 or > 3 years post-thelarche. Irregular menstrual cycles (< 1 year post-menarche) represent normal pubertal transition. (2) Hyperandrogenism defined as hirsutism, severe acne and/or biochemical hyperandrogenaemia confirmed using validated high-quality assays. (3) Pelvic ultrasound not recommended for diagnosis of PCOS within 8 years post menarche. (4) Anti-Müllerian hormone levels not recommended for PCOS diagnosis; and (5) exclusion of other disorders that mimic PCOS. For adolescents who have features of PCOS but do not meet diagnostic criteria an ‘at risk’ label can be considered with appropriate symptomatic treatment and regular re-evaluations. Menstrual cycle re-evaluation can occur over 3 years post menarche and where only menstrual irregularity or hyperandrogenism are present initially, evaluation with ultrasound can occur after 8 years post menarche. Screening for anxiety and depression is required and assessment of eating disorders warrants consideration. Available data endorse the benefits of healthy lifestyle interventions to prevent excess weight gain and should be recommended. For symptom management, the combined oral contraceptive pill and/or metformin may be beneficial.

Conclusions

Extensive international engagement accompanied by rigorous processes honed both diagnostic criteria and treatment recommendations for PCOS during adolescence.
Circulating PAMM, a novel antioxidant and anti-inflammatory protein, is elevated in acute SCI
Authors: Morse Leslie R. , Nguyen Nguyen , Xu Yan , Jha Prakash , Battaglino Ricardo A.
Published: March 2020

Background

Peroxiredoxin activated in M-CSF stimulated monocytes (PAMM) is a novel protein produced by adipocytes with putative redox regulatory and anti-inflammatory properties. Because acute spinal cord injury (SCI) is associated with oxidative stress and neuroinflammation and because PAMM can be detected in systemic circulation, we hypothesized that acute neuro-trauma might induce changes in circulating PAMM expression. Specifically, we hypothesized that PAMM levels might vary based on the presence or absence of acute, traumatic SCI. We therefore investigated circulating PAMM levels in adults with and without acute traumatic SCI.

Methods

We studied 105 men and women (54 with SCI and 51 without SCI). Participants with SCI were admitted for acute rehabilitation within 1 month after injury. Serum samples were obtained during hospitalization and stored at − 80 °C until batch analysis. Total PAMM was quantified by ELISA assay (MyBiosource, Cat. No: MBS9327247) with a detection limit of 0.25 ng/ml. Separate multivariate models including age, BMI, and injury severity were assessed to determine significant clinical predictors of change in PAMM levels.

Results

When adjusting for BMI, age, and gender, mean change in PAMM levels were greatest in participants with motor complete SCI compared to able-bodied (1.65 ng/ml versus 0.94 ng/ml, p = 0.003). This model explained 26% of the variation in change in circulating PAMM levels.

Conclusions

Our results suggest that PAMM may be a novel biomarker of neurological injury or of native anti-inflammatory responses to neurological injury. More work is needed to establish the role of PAMM and other adipocyte-derived factors in the acute response to neurotrauma.
Role of dietary fatty acids in microglial polarization in Alzheimer’s disease
Authors: Desale Smita Eknath , Chinnathambi Subashchandrabose
Published: March 2020

Microglial polarization is an utmost important phenomenon in Alzheimer’s disease that influences the brain environment. Polarization depends upon the types of responses that cells undergo, and it is characterized by receptors present on the cell surface and the secreted cytokines to the most. The expression of receptors on the surface is majorly influenced by internal and external factors such as dietary lipids. Types of fatty acids consumed through diet influence the brain environment and glial cell phenotype and types of receptors on microglia. Reports suggest that dietary habits influence microglial polarization and the switching of microglial phenotype is very important in neurodegenerative diseases. Omega-3 fatty acids have more influence on the brain, and they are found to regulate the inflammatory stage of microglia by fine-tuning the number of receptors expressed on microglia cells. In Alzheimer’s disease, one of the pathological proteins involved is Tau protein, and microtubule-associated protein upon abnormal phosphorylation detaches from the microtubule and forms insoluble aggregates. Aggregated proteins have a tendency to propagate within the neurons and also become one of the causes of neuroinflammation. We hypothesize that tuning microglia towards anti-inflammatory phenotype would reduce the propagation of Tau in Alzheimer’s disease.
Psychological functioning in children suspected for mitochondrial disease: the need for care
Authors: van de Loo Kim F. E. , Custers José A. E. , Koene Saskia , Klein Inge-Lot , Janssen Mirian C. H. , Smeitink Jan A. M. , Verhaak Christianne M.
Published: March 2020

Background

Mitochondrial diseases (MD) are generally serious and progressive, inherited metabolic diseases. There is a high comorbidity of anxiety and depression and limitations in daily functioning. The complexity and duration of the diagnostic process and lack of knowledge about prognosis leads to uncertainty. In this study, we investigated the psychological well-being of children who are suspected for MD and their parents.

Methods

In total 122 children suspected for MD and their parents, received questionnaires as part of standard clinical investigation.

Results

Parent proxy report revealed a lower quality of life (QoL) compared to norms and even more physical problems compared to chronically ill patients. They also reported more behavioral problems in general and more internalizing problems compared to the norms. Most frequent reported somatic complaints were tiredness and pain. Parents did not report enhanced levels of stress regarding parenting and experienced sufficient social support. At the end of the diagnostic process, 5.7% of the children received the genetically confirmed diagnosis of MD, 26% showed non-conclusive abnormalities in the muscle biopsy, 54% did not receive any diagnosis, and the remaining received other diagnoses. Strikingly, children without a diagnosis showed equally QoL and behavioral problems as children with a diagnosis, and even more internalizing problems.

Conclusions

This study highlights the psychological concerns of children with a suspicion of MD. It is important to realize that as well as children with a confirmed diagnosis, children without a diagnosis are vulnerable since explanation for their complaints is still lacking.
Therapeutic Potential of the Gut Microbiota in the Management of Sepsis
Authors: Bassetti Matteo , Bandera Alessandra , Gori Andrea
Published: March 2020

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2020. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2020. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.
A Clinician’s Guide to Management of Intra-abdominal Hypertension and Abdominal Compartment Syndrome in Critically Ill Patients
Authors: De Laet Inneke E. , Malbrain Manu L. N. G. , De Waele Jan J.
Published: March 2020

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2020. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2020. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.
Respiratory Muscle Rehabilitation in Patients with Prolonged Mechanical Ventilation: A Targeted Approach
Authors: Bissett Bernie , Gosselink Rik , van Haren Frank M. P.
Published: March 2020

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2020. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2020. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.
Burnout and Joy in the Profession of Critical Care Medicine
Authors: Kerlin Meeta Prasad , McPeake Joanne , Mikkelsen Mark E.
Published: March 2020

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2020. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2020. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.
Analysis of the lung microbiota in dogs with Bordetella bronchiseptica infection and correlation with culture and quantitative polymerase chain reaction
Authors: Fastrès Aline , Canonne Morgane A. , Taminiau Bernard , Billen Frederic , Garigliany Mutien-Marie , Daube Georges , Clercx Cécile
Published: March 2020

Infection with Bordetella bronchiseptica (Bb), a pathogen involved in canine infectious respiratory disease complex, can be confirmed using culture or qPCR. Studies about the canine lung microbiota (LM) are recent, sparse, and only one paper has been published in canine lung infection. In this study, we aimed to compare the LM between Bb infected and healthy dogs, and to correlate sequencing with culture and qPCR results. Twenty Bb infected dogs diagnosed either by qPCR and/or culture and 4 healthy dogs were included. qPCR for Mycoplasma cynos (Mc) were also available in 18 diseased and all healthy dogs. Sequencing results, obtained from bronchoalveolar lavage fluid after DNA extraction, PCR targeting the V1–V3 region of the 16S rDNA and sequencing, showed the presence of Bb in all diseased dogs, about half being co-infected with Mc. In diseased compared with healthy dogs, the β-diversity changed (P = 0.0024); bacterial richness and α-diversity were lower (P = 0.012 and 0.0061), and bacterial load higher (P = 0.004). Bb qPCR classes and culture results correlated with the abundance of Bb (r = 0.71, P < 0.001 and r = 0.70, P = 0.0022). Mc qPCR classes also correlated with the abundance of Mc (r = 0.73, P < 0.001). Bb infection induced lung dysbiosis, characterized by high bacterial load, low richness and diversity and increased abundance of Bb, compared with healthy dogs. Sequencing results highly correlate with qPCR and culture results showing that sequencing can be reliable to identify microorganisms involved in lung infectious diseases.
Some inequalities related to strong convergence of Riesz logarithmic means
Authors: Lukkassen D. , Persson L. E. , Tephnadze G. , Tutberidze G.
Published: March 2020

In this paper we derive a new strong convergence theorem of Riesz logarithmic means of the one-dimensional Vilenkin–Fourier (Walsh–Fourier) series. The corresponding inequality is pointed out and it is also proved that the inequality is in a sense sharp, at least for the case with Walsh–Fourier series.
A new error estimate on uniform norm of a parabolic variational inequality with nonlinear source terms via the subsolution concepts
Authors: Boulaaras Salah , Bencheikh Le Hocine Mohamed El Amine , Haiour Mohamed
Published: March 2020

This paper deals with the numerical analysis of parabolic variational inequalities with nonlinear source terms, where the existence and uniqueness of the solution is provided by using Banach’s fixed point theorem. In addition, an optimally $L^{\infty}$L∞-asymptotic behavior is proved using Euler time scheme combined with the finite element spatial approximation. The approach is based on Bensoussan–Lions algorithm for evolutionary free boundary problems using the concepts of subsolutions.
Spatio-temporal co-occurrence of hotspots of tuberculosis, poverty and air pollution in Lima, Peru
Authors: Carrasco-Escobar Gabriel , Schwalb Alvaro , Tello-Lizarraga Kelly , Vega-Guerovich Percy , Ugarte-Gil Cesar
Published: March 2020

Growing evidence suggests pollution and other environmental factors have a role in the development of tuberculosis (TB), however, such studies have never been conducted in Peru. Considering the association between air pollution and specific geographic areas, our objective was to determine the spatial distribution and clustering of TB incident cases in Lima and their co-occurrence with clusters of fine particulate matter (PM2.5) and poverty. We found co-occurrences of clusters of elevated concentrations of air pollutants such as PM2.5, high poverty indexes, and high TB incidence in Lima. These findings suggest an interplay of socio-economic and environmental in driving TB incidence.
Surgical management and prognostic factors of spinal metastatic tumors
Authors: Elmesallamy Wael A. A. , Taha Mahmoud M.
Published: March 2020

Objective

This study aims to evaluate different prognostic factors after surgical management of metastatic spinal tumors regarding clinical condition, preoperative investigations, histopathological results, and surgical data.

Methods

Seventy patients diagnosed as metastatic spinal tumors with neurological deficits and/or unstable spine operated for spinal decompression with or without instrumental fixation according to Spinal Instability Neoplastic Score (SINS) at our institute during the period from May 2014 to October 2018 with follow-up at least 9 months.

Results

Lymphoma metastases were the commonest spinal metastases of 23% with significant p value = 0.001, males and ages above 50 years old were significantly affected. High vascularity and bone invasion were significant operative findings. Significant good prognostic factors for both survival and Klekampe score improvement were paretic patients, > 15 preoperative Klekampe score, early surgery, ≤ 3 vertebral affection, extradural tumor location, gross total resection, and metastatic tumors from multiple myeloma, thyroid gland, lymphoma, and prostatic gland.

Conclusion

Early surgeries aiming neural decompression and keeping spinal stability according to Spinal Instability Neoplastic Score for patients with spinal metastases are the main hope for better survival and neurological improvement.
Correction to: Hybrid image of three contents
Authors: Sripian Peeraya , Yamaguchi Yasushi
Published: March 2020

In the original publication of this article [1], the Figs. 3 and 4 are not clear enough. They are adjusted the size and showed as below:
Immunologic Characteristics of Nonmelanoma Skin Cancers: Implications for Immunotherapy
Authors: Hall Evan T. , Fernandez-Lopez Elena , Silk Ann W. , Dummer Reinhard , Bhatia Shailender
Published: March 2020

In this review, we summarize the immunology of nonmelanoma skin cancers (NMSCs) and the clinical data with immunotherapy in this heterogeneous group of cancers that include basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (CSCC), and Merkel cell carcinoma (MCC). NMSCs are exceedingly common, and their treatment consumes substantial health care resources. Annual global mortality from NMSCs is comparable to that from malignant melanoma. Although the majority of NMSCs are localized at diagnosis and are treated effectively with surgery, metastases (nodal and distant) can sometimes arise and require systemic therapy. Given the success of immunotherapy in treating cutaneous melanoma, there has been an increasing interest in studying the immunology of NMSCs. Immunocompromised patients have a substantially higher risk of developing NMSCs (particularly CSCC and MCC), suggesting a role of the immune system in the pathogenesis of these cancers. Similar to cutaneous melanoma, the pathogenesis of BCC, CSCC, and virus-negative MCC is related to DNA damage from ultraviolet radiation exposure, and these cancers have a very high tumor mutational burden, which likely results in higher levels of tumor neoantigens that may be targets for the immune system. Viral antigens in virus-positive MCC are also strongly immunogenic. Emerging data from clinical trials of immune checkpoint inhibitors in NMSCs look very promising and are rapidly changing the treatment landscape of these cancers. Specifically, pembrolizumab and avelumab are U.S. Food and Drug Administration–approved for treatment of metastatic MCC and cemiplimab for metastatic CSCC. Several ongoing trials are investigating novel immunotherapies (monotherapies as well as combination) for treatment of NMSCs.
Bringing Life to Death: The Need for Honest, Compassionate, and Effective End-of-Life Conversations
Authors: MacKenzie Amy R. , Lasota Michelle
Published: March 2020

Conversations about death and dying are a crucial part of all medical care and are particularly relevant in the field of oncology. Patients express a desire to have discussions about goals of care, and many patients have thought about their end-of-life (EOL) wishes but have not had an opportunity to openly talk with care providers about this. Deficiencies in medical training, lack of confidence, limited time, and cultural barriers all contribute to the paucity of these important discussions. Although physicians are often expected to lead these conversations, nurses and nurse practitioners also play a vital role in the identification of opportunities to address EOL goals and should be a resource for the care team in facilitating EOL conversations at all points on the care continuum. Public engagement is paramount in normalizing conversations about death and dying, and the health care system needs to partner with public health agencies and private groups to open dialogues about EOL. Providers at all levels need improved education in having these difficult but essential conversations.
Total Number of Alterations in Liquid Biopsies Is an Independent Predictor of Survival in Patients With Advanced Cancers
Authors: Vu Peter , Khagi Yulian , Riviere Paul , Goodman Aaron , Kurzrock Razelle
Published: March 2020

PURPOSE

Studies have demonstrated an association between quantity of circulating tumor DNA (ctDNA) and poorer survival. We investigated the relationship between percent ctDNA (%ctDNA), total number of ctDNA alterations, and overall survival (OS) in liquid biopsies.

MATERIALS AND METHODS

Overall, 418 patients with blood-based next-generation sequencing (54 to 73 genes) were analyzed. Eligible patients included those who had advanced/metastatic solid tumor malignancies and never received immunotherapy treatment, which may alter the survival curve in patients with high mutational burden.

RESULTS

Patients with a high (≥ 5%) %ctDNA had significantly shorter OS versus those with intermediate (≥ 0.4% to < 5%) or low (< 0.4%) values (median OS, 7.0 v 14.1 v not reached [NR] months, respectively; P < .0001). Patients with a high (≥ 5) total number of alterations had significantly shorter OS versus those with intermediate (≥ 1.46 to < 5), low (< 1.46), or no alterations (median OS, 4.6 v 11.7 v 21.3 v NR months, respectively; P < .0001). The total number of alterations correlated with %ctDNA (r = 0.85; 95% CI, 0.81 to 0.87; P < .0001). However, only an intermediate to high total number of alterations (≥ 1.46) was an independent predictor of worse OS (hazard ratio, 1.96; 95% CI, 1.30 to 2.96; P = .0014; multivariate analysis).

CONCLUSION

We demonstrate that the total number of alterations and %ctDNA have prognostic value and correlate with one another, but only the total number of alterations was independently associated with survival outcomes. Our findings suggest that the total number of alterations in plasma may be an indicator of more aggressive tumor biology and therefore poorer survival.
A “Step–Ramp–Step” Protocol to Identify the Maximal Metabolic Steady State
Authors: IANNETTA DANILO , INGLIS ERIN CALAINE , POGLIAGHI SILVIA , MURIAS JUAN M. , KEIR DANIEL A.
Published: March 2020

The oxygen uptake (V̇O2) at the respiratory compensation point (RCP) closely identifies with the maximal metabolic steady state. However, the power output (PO) at RCP cannot be determined from contemporary ramp-incremental exercise protocols.

Purpose

This study aimed to test the efficacy of a “step–ramp–step” (SRS) cycling protocol for estimating the PO at RCP and the validity of RCP as a maximal metabolic steady-state surrogate.

Methods

Ten heathy volunteers (5 women; age: 30 ± 7 yr; V̇O2max: 54 ± 6 mL·kg−1·min−1) performed in the following series: a moderate step transition to 100 W (MOD), ramp (30 W·min−1), and after 30 min of recovery, step transition to ~50% POpeak (HVY). Ventilatory and gas exchange data from the ramp were used to identify the V̇O2 at lactate threshold (LT) and RCP. The PO at LT was determined by the linear regression of the V̇O2 versus PO relationship after adjusting ramp data by the difference between the ramp PO at the steady-state V̇O2 from MOD and 100 W. Linear regression between the V̇O2–PO values associated with LT and HVY provided, by extrapolation, the PO at RCP. Participants then performed 30-min constant-power tests at the SRS-estimated RCP and 5% above this PO.

Results

All participants completed 30 min of constant-power exercise at the SRS-estimated RCP achieving steady-state V̇O2 of 3176 ± 595 mL·min−1 that was not different (P = 0.80) from the ramp-identified RCP (3095 ± 570 mL·min−1) and highly consistent within participants (bias = −26 mL·min−1, r = 0.97, coefficient of variation = 2.3% ± 2.8%). At 5% above the SRS-estimated RCP, four participants could not complete 30 min and all, but two exhibited non–steady-state responses in blood lactate and V̇O2.

Conclusions

In healthy individuals cycling at their preferred cadence, the SRS protocol and the RCP are capable of accurately predicting the PO associated with maximal metabolic steady state.
Teachers Who Make a Difference According to Teachers’ Perceptions
Authors: Çetin Abdullah , Ünsal Serkan
Published: March 2020

: This research aimed to explore the characteristics of the teachers who make a difference along with the activities they did, the actions they took and the contributions they made to society. Having a qualitative research design, this research utilized a phenomenological design. The working group of the research consisted of 12 volunteer teachers who completed their master degree at the department of Educational Sciences in Kahramanmaraş Sütçü İmam University during the 2018-2019 academic year and who had teaching experience. The research employed semi-structured interview form prepared by the researchers. Content analysis was used during data analysis. The teachers making a difference were found to differ from their colleagues with these characteristics such as taking responsibility in the solution of the social problems, producing practical solutions to problems, being open to criticism, having a unique personality. The teachers were determined to make a difference by doing social activities, solving social problems, guiding the society and bringing innovation. Besides, they demonstrated some behaviours like breaking out of the routine and not following the procedures. Various recommendations were provided in order to raise teachers who make a difference. Formal procedures should be reduced and free/democratic environment should be created during in-service training, while teachers should be specifically selected for the profession and faculty members should be role models during pre-service training. The teachers who make a difference contributed to the social integrity, development, meeting the needs of the society, bringing individuals into society and making individuals gain values.
Capitalism as an Economic System Research: Power, Technological Change, and Innovation
Authors: Levent Adem
Published: March 2020

Political economy, which developed as a study of wealth and ethics on the basis of the natural law philosophy and the British utilitarian philosophy which is a branch of natural law philosophy, has turned into economics with the marginalist revolution. The marginalist revolution has aimed at scientific “certainity” as in natural sciences, by excluding the concepts of class, institutions and history. This transformation gave the discipline a mature scientific theory appearance instead of a loose social theory form. This transformation is also consistent with the liberal character of the discipline. With that transformation, economics, on one hand, gained the most powerful scientific form among social sciences and on the other hand, it narrowed its borders. Institutional economics, one of the schools of heterodox economics, is seriously opposed to the transformation of the discipline. Both by choosing capitalism as an analysis object and by staying apart from or critical towards this capitalism institutional economics judges the liberal nature of formal economics. Institutional economics considers the economy as an institutionalized process. It accepts the market as given not natural. Economics also covers a wider area than the market. In this case, according to institutional economics, the definition of economics as science will expand and change. Economics will move away from the narrow patterns of scientific economics and reappear as political economy. In this study, it is claimed that conceiving institutional economics as political economy constitutes an opportunity to evaluate contemporary capitalism and to understand the basic tendencies of the this capitalism.
Extreme pacemaker reel syndrome in an elderly patient with cognitive impairment
Authors: Smith Bethany , Ashton Lisa
Published: March 2020

Twiddler's syndrome is a rare cause of pacemaker failure, where patient manipulation of the pulse generator results in lead dislodgement or retraction. Variations in manifestation have been identified including reel syndrome, where rotation occurs around the transverse axis resulting in coiling of the leads, and ratchet syndrome where arm movement results in lead displacement. Device manipulation leading to device failure has been documented in up to 1.7% of implants, particularly in patients with large pockets or mental disorders. Such complications have serious consequences, particularly in pacing-dependent patients where loss of capture may result in asystole. This article reviews the case of an 84-year-old patient presenting at 8-month pacemaker follow-up in complete heart block with no evidence of pacemaker function.
Understanding roles in health care through interprofessional educational experiences
Authors: Furr Susan , Lane Susan Hayes , Martin Dana , Brackney Dana E
Published: March 2020

Background:

Students can find interacting within a healthcare team challenging. It is important for students to understand their role and respect those of other healthcare team members. Interprofessional education (IPE) is a strategy for exploring the roles of self and others within the team.

Aim:

The purpose of this study was to evaluate nursing students' perceptions of roles and responsibilities following an IPE experience.

Methods:

Students in an undergraduate baccalaureate degree nursing programme participated in a two-day IPE event with students in the physician's assistant's (PA) programme, pharmacy programme, and physical therapy (PT) programme.

Findings:

Self-perception and the perception of others were two main themes that emerged. The results suggested that roles and responsibilities are often misunderstood.

Conclusion:

Educators must be committed to educating our future healthcare workforce on role expectations and responsibilities within an individual's own profession and that of others. This education should start in the foundation stages of each discipline's educational curricula.
Psoriasis: Management and self-care
Authors: Duncan Deborah Louise , Lyall Gillian
Published: March 2020

Psoriasis is a common skin condition that affects an estimated 3% of the population. In one third of cases, psoriasis will develop during childhood or adolescence. Juvenile psoriasis is also associated with other co-morbidities such as hyperlipidaemia, obesity, hypertension, diabetes mellitus, rheumatoid arthritis and Crohn's disease. Understanding this illness means that health-care professionals such as school nurses can help by providing schools with appropriate information about the condition, improving its management and providing education to help reduce stigma.
Child sexual abuse: A critical analysis of social workers' role in recognising and responding to it
Authors: Wade Gary
Published: March 2020

The role of social workers in safeguarding and child protection has received much critical attention in recent years, in an evolving political and social arena, where policy and practice has shifted following both public outcry of serious case reviews and subsequent policy and practice changes concerning the profession and how it services the needs of the most vulnerable in society. This article seeks to critically examine the current methodology for identifying suspected child sexual abuse signs and indicators, the evolving spectrum of abuse, including critical evaluation of current perspectives on child sexual exploitation.
Agression: Managing aggressive behaviour in students
Authors: Thornton Stephanie
Published: March 2020

I Levels of aggressive behaviour among children and young people appear to have been rising over the years. Stephanie Thornton asks what the reasons are behind this rise
PREVALÊNCIA DE PARASITOSES INTESTINAIS EM USUÁRIOS DE UM HOSPITAL UNIVERSITÁRIO, SANTA CRUZ-RN, BRASIL
Authors: Lima Ericlebson Cleyton da Silva , Oliveira Heloisa Mara Batista Fernandes , Leon Carlos Marcio Ponce , Barbosa Vanessa Santos de Arruda
Published: March 2020

Introdução: Enteroparasitas são helmintos e protozoários que atingem o trato intestinal causando infecções denominadas enteroparasitoses. Tais parasitos podem provocar diversos transtornos ao hospedeiro. O presente trabalho objetivou determinar a prevalência das enteroparasitoses em usuários do Laboratório de Análises Clínicas do Hospital Universitário Ana Bezerra em Santa Cruz-RN. Metodologia: O estudo foi do tipo retrospectivo documental, no qual usou-se o banco de dados do CompLab do período de julho/2016 a julho/2017. Foram coletados os resultados dos laudos dos exames parasitológicos de fezes e variáveis epidemiológicas como: sexo, idade e área de residência. Foi utilizado o teste qui-quadrado (?2) e foi aceito p<0,05, estatisticamente significativo. Os dados foram analisados no software SPSS. Resultados: De 3.480 laudos, 32,4% eram positivos para enteroparasitos e/ou enterocomensais. Dentre os positivos (1.129), 75,5% estavam monoparasitados e 24,5% bi/poliparasitados. As espécies mais prevalentes entre os monoparasitados foram Endolimax nana (76,2%) e Giardia lamblia (12,2%). A associação parasitária mais prevalente foi Entamoeba coli + Endolimax nana (52,8%). Dentre os positivos prevaleceu o sexo feminino (63,5%), faixa etária de 20-59 anos (44,5%) e os residentes de zona urbana (77,8%). No entanto não foi encontrada associação estatisticamente significativa entre essas variáveis. Infecções por Giardia prevaleceram em crianças (54,8%). Nos adultos (20-59 anos) prevaleceram as infecções por Entamoeba histolytica/E.dispar (44,4%) e os casos de bi/poliparasitismo (48,7%). Conclusão: Os resultados indicam necessidade de implantação de medidas profiláticas eficazes e ações educacionais principalmente nos grupos mais expostos a essas infecções.