bluuebunny/crossref_metadata_2025 huggingface dataset:
What’s New for Clinical Whole-body MRI (WB-MRI) in the 21st Century
Authors: Tunariu Nina , Blackledge Matthew , Messiou Christina , Petralia Giuseppe , Padhani Anwar , Curcean Sebastian , Curcean Andra , Koh Dow-Mu
Published: August 2020

Whole-body MRI (WB-MRI) has evolved since its first introduction in the 1970s as an imaging technique to detect and survey disease across multiple sites and organ systems in the body. The development of diffusion-weighted MRI (DWI) has added a new dimension to the implementation of WB-MRI on modern scanners, offering excellent lesion-to-background contrast, while achieving acceptable spatial resolution to detect focal lesions 5 to 10 mm in size. MRI hardware and software advances have reduced acquisition times, with studies taking 40–50 min to complete.

The rising awareness of medical radiation exposure coupled with the advantages of MRI has resulted in increased utilization of WB-MRI in oncology, paediatrics, rheumatological and musculoskeletal conditions and more recently in population screening. There is recognition that WB-MRI can be used to track disease evolution and monitor response heterogeneity in patients with cancer. There are also opportunities to combine WB-MRI with molecular imaging on PET-MRI systems to harness the strengths of hybrid imaging. The advent of artificial intelligence and machine learning will shorten image acquisition times and image analyses, making the technique more competitive against other imaging technologies.
Stereotactic body radiotherapy for adrenal oligometastasis in lung cancer patients
Authors: Arcidiacono Fabio , Aristei Cynthia , Marchionni Alessandro , Italiani Marco , Fulcheri Cristian Paolo Luca , Saldi Simonetta , Casale Michelina , Ingrosso Gianluca , Anselmo Paola , Maranzano Ernesto
Published: August 2020

Objective:

To report our experience on stereotactic body radiotherapy (SBRT) in adrenal metastases from lung cancer.

Methods:

37 oligometastatic lung cancer patients with 38 adrenal metastases submitted to SBRT were retrospectively analyzed. SBRT was delivered by volumetric modulated arc therapy (VMAT) or helical tomotherapy (HT). Primary study end point was local recurrence-free survival (LR-FS) and secondary end points were distant-progression free survival (d-PFS) and overall survival (OS).

Results:

Median age was 67 years and primary tumor was non-small-cell lung cancer in 27 (73%) and small-cell lung cancer in 10 (27%) patients. Adrenal metastases were in the left side in 66% cases. Median prescribed dose was 30 Gy in 5 fractions for a median biologically equivalent dose (α/β ratio 10  Gy, BED10) of 48 Gy. Most patients (62%) were submitted to SBRT alone, while the others (38%) received chemo-, immune- or target- therapies. Median follow-up was 10.5 months, median OS 16 months and median d-PFS 3 months. 27 (70%) patients obtained a local control with a median LR-FS of 32 months. LR-FS was significantly related to BED10 with a better LC with BED10 ≥72 Gy, 1- and 2 year LR-FS rates were 54.1±11.6% and 45±12.7% vs 100 and 100% for BED ≤59.5 Gy and BED ≥72 Gy, respectively (p = 0.05). There was no severe toxicity.

Conclusion:

SBRT was effective and safe in lung cancer adrenal metastases. A dose–response relationship was found between BED10 >72 Gy and better local control. No significant toxicity was registered thanks to the respect of dose constraints and suspension of chemo- and target-therapies.

Advances in knowledge:

SBRT with a BED10 >72 Gy is an effective treatment for adrenal oligometastatic lung cancer patients.
Challenges for managing the cumulative effective dose for patients
Authors: Vano Eliseo
Published: August 2020

Notwithstanding that 100 mSv is not a threshold for radiation effects, cumulative effective dose (CED) for patients of ≥100 mSv derived from recurrent imaging procedures with ionising radiation has been recently the topic of several publications. The International Commission on Radiological Protection has alerted on the problems to use effective dose for risk estimation in individual patients but has accepted to use this quantity for comparison the relative radiation risks between different imaging modalities. A new International Commission on Radiological Protection document on the use of effective dose (including medicine), is in preparation. Recently published data on the number of patients with CED ≥100 mSv ranged from 0.6 to 3.4% in CT and around 4% in interventional radiology. The challenges to manage the existing situation are summarised. The main aspects identified are: 1) New technology with dose reduction techniques. 2) Refinements in the application of the justification and optimisation for these groups of patients. 3) Patient dose management systems with alerts on the cumulative high doses. 4) Education on the proper use of cumulative effective dose for referrers and practitioners including information for patients. 5) Future research programmes in radiation biology and epidemiology may profit the patient dose data from the groups with high cumulative dose values.
Utilising previous radiographs: the principle of dose optimisation
Authors: Akbarian Tefaghi Farnaz , Adams Ashok , Makdissi Jimmy
Published: August 2020

Objective:

In dentistry, imaging is the most frequently used diagnostic tool. As a result, a steady increase in the use of imaging modalities are leading to an increase in healthcare cost and in patients’ radiation exposure.

Results:

67-year-old patient attended for a surgical removal of lower left third molar. A sectioned panoramic radiograph showed an incidental finding of a well-defined, unilocular radiolucency apical to the lower left second and third molars. This was partially superimposed over the outline of the ID canal. A Stafne’s bone cavity was considered as the most likely diagnosis. Further imaging was considered due to location not being fully below the ID canal as usually described in the literature. Reviewing previous imaging on PACS revealed the patient has had a CT angiogram of the head and neck 5 years prior. This showed a lingual bone defect of the surface of the mandible in the region of interest. The extension of the submandibular gland into the defect confirmed the likely nature of Stafne’s bone cavity.

Conclusion:

This case highlights the essential role of reviewing (if in the same practice) or requesting (from a different practice) previous images. The international Commission for Radiological Protection regularly publishes data relating to the principles of dose reduction; Justification, Optimisation and Limitation. All examinations have to be justified to ensure the benefit to the patient outweigh the risk and radiation should be kept as low as reasonably achievable.
Parental risk perceptions of child exposure to thirdhand smoke and related factors
Authors: Intarut Nirun
Published: August 2020

Background: Thirdhand smoke (THS) exposure is linked to lung cancer, asthma, and chronic diseases, especially in children. The parental risk perception of THS exposure in children has rarely been reported. The objective of this study was to test the association between sociodemographic factors and parental risk perceptions of child exposure to thirdhand smoke (PRPCETS) in residential homes with a child or children aged from one to five years old.

Methods: This study used secondary data from the Smoke Free Home intervention trial. 336 participants were included and analyzed. PRPCETS was assessed by self-administered questionnaire. Multiple logistic regression was used to test the factors related to parental risk perception to the harm of thirdhand smoke.

Results: The overall prevalence of disagreement that THS might be harmful to children was 22.02% (95% CI: 17.59%, 26.45%). Factors associated with PRPCETS were being over 50-years-old (OR: 2.15; 95%CI: 1.05, 4.41); attending school for more than six years (OR: 2.08; 95%CI: 1.07, 4.08); being unemployed (OR: 6.98; 95% CI, 1.41, 34.71); and the number of smokers in the home ≥2 persons (OR: 2.48; 95%CI: 1.41, 4.36).

Conclusions: Our findings show the factors related to PRPCETS as follows; aged over 50, duration of school attendance less than six years, no job status, and having ≥2 smokers in the home. Further studies should investigate parental knowledge of and attitude towards thirdhand smoke exposure.
Exploring factors that influence the practice of Open Science by early career health researchers: a mixed methods study
Authors: Zečević Ksenija , Houghton Catherine , Noone Chris , Lee Hopin , Matvienko-Sikar Karen , Toomey Elaine
Published: August 2020

Background: There is a growing global movement towards open science and ensuring that health research is more transparent. It is vital that the researchers are adequately prepared for this research environment from early in their careers. However, the barriers and enablers to practicing open science for early career researchers (ECRs) have been explored to a limited extent. This study aimed to explore the views, experiences and factors influencing open science practices amongst ECRs working in health research.

Methods: Semi-structured individual interviews were conducted with a convenience sample of ECRs working in health research. Participants also completed surveys regarding the factors influencing open science practices. Thematic analysis was used to analyse the qualitative data and descriptive statistical analyses were used to analyse survey data.

Results: 14 ECRs participated. Two main themes were identified from interview data; Valuing Open Science and Creating a Culture for Open Science. Within ‘Valuing Open Science’, participants spoke about the conceptualisation of open science to be open across the entire research cycle, and important for producing better and more impactful research for patients and the public. Within ‘Creating a Culture of Open Science’ participants spoke about a number of factors influencing their practice of open science. These included cultural and academic pressures, the positives and negatives of increased accountability and transparency, and the need for more training and supporting resources to facilitate open science practices.

Conclusion: ECRs see the importance of open science for beneficially impacting patient and public health but many feel that they are not fully supported to practice open science. Resources and supports including education and training are needed, as are better incentives for open science activities. Crucially, tangible engagement from institutions, funders and researchers is needed to facilitate the development of an open science culture.
Service Design for a Holistic Customer Experience: A Process Framework
Authors: Bellos Ioannis , Kavadias Stylianos
Published: August 2020

Modern service design practices conceptualize services as multistep processes. At each step, customers derive an uncertain value, which depends on a functional benefit and a subjective experience. The latter may depend on experiences realized at previous steps. Service designs determine the provider effort at each step given that customers prefer less-variable experiences, and enable a holistic perspective of the overall experience. We quantify two factors that shape service designs: the type of steps ((i) routine steps, where effort increases the functional benefit and decreases the experience variability, and (ii) nonroutine steps, where effort increases the functional benefit at the expense of higher variability) and a holistic coupling factor (at each step, the design is determined not only by experience realizations at predecessor steps but also by how it can shape subsequent experiences). The optimal efforts depend on the combination of these two factors, giving rise to actionable design rules. For a positive coupling factor, step type homogeneity leads to “spread the effort” designs (complementary efforts), whereas a negative coupling factor suggests focusing the effort on a few key steps at the expense of the rest of the service (substitutable efforts). Step type heterogeneity reverses these recommendations. Moreover, when the customer experience unfolds according to a nonstationary process with serial correlation, the effort at each step is determined by an impact zone defined by the steps surrounding the focal service step. Stronger correlation always induces higher effort, whereas weaker correlation may induce less effort in services with heterogeneous step types.

This paper was accepted by Serguei Netessine, operations management.
Quality by design of yogurt product using taguchi multi responses method
Authors: Parkhan Ali , Purnomo Muhammad Ridwan Andi
Published: August 2020

Quality of yogurt could be determined based on its flavor and texture which could be tested using an organoleptic test. The quality objective of the yogurt flavor and texture is larger the better. As one of the intermediate products that could be processed to become various other products, the demand for yogurt is continuously increasing in Indonesia. Along with the increase in demand, the demand for quality of yogurt has also increased. In this study, experiments have been conducted to improve the quality of a yogurt product. The experiments were designed based on the Taguchi method with Multi Responses Signal to Noise (MRSN) that involves 7 factors consists of 6 controllable factors and 1 uncontrollable factor. Every factor has 2 levels of an experiment. The 6 controllable factors are heating temperature, heating duration, number of yogurt seeds, incubation temperature, incubation duration, number of sugars, while the uncontrollable factor is the weather condition. Result of the experiments showed when weight for flavor and texture is 0.437 and 0.563 respectively, the levels of the optimum factors are 950C for milk heating temperature, 20 minutes for the duration of milk heating process, 75 ml of yogurt seeds, 450C of the temperature of incubation, 6 hours of incubation duration and 12.5 grams of sugar weight. Based on the organoleptic test that conducted by a group of experienced testers, the new optimum factors combination could improve the yogurt’s quality in term of flavor and quality up to 16.24% and 11.37% respectively. It could be concluded that the proposed method could improve the quality of yogurt-based on preferences from the experienced testers that have been expressed by the weight of every quality response.
Currency movement forecasting using time series analysis and long short-term memory
Authors: Putri Kristina Sanjaya , Halim Siana
Published: August 2020

Foreign exchange is one type of investment, which its goal is to minimize losses that could occur. Forecasting is a technique to minimize losses when investing. The purpose of this study is to make foreign exchange predictions using a time series analysis called Auto-Regressive Integrated Moving Average (ARIMA) and Long Short-term memory methods. This study uses the daily EUR / USD exchange rates from 2014 to March 2020. The data are used as the model to predict the value of the foreign exchange market in April 2020. The model obtained will be used for predictions in April 2020, where the RMSE values obtained from time series analysis (ARIMA) with a window size of 100 days and LSTM sequentially as follows 0.00527 and 0.00509. LSTM produces lower RMSE values than ARIMA. LSTM has better prediction results; this is because the LSTM has the ability to learn so that it can utilize a large amount of data while ARIMA cannot use it. ARIMA does not have the ability to learn even though given a large amount of data it gives poor forecasting results. The ARIMA prediction is the same as the values of the previous day.
Direct versus indirect transfer for traumatic brain injury to James Cook University Hospital: a retrospective study
Authors: Vats A , Roy D , Prasad MK
Published: August 2020

Introduction

Patients with traumatic brain injury are referred to the neurosurgical unit at James Cook University Hospital, Middlesbrough, either from local accident and emergency departments (direct transfer from the scene) or from other hospitals (indirect transfer). This study looked at the outcome in both groups.

Material and methods

This was a retrospective observational study using trauma audit research network data for patients treated for traumatic brain injury at the neurosurgery department at the neurosurgical unit at James Cook University Hospital.

Results

A total of 356 patients with traumatic brain injury were admitted under the care of neurosurgeons; 143 (40%) of these patients had a neurosurgical procedure. Of the patients undergoing a neurological procedure, 111 patients were transferred directly while 32 were indirect transfers; 213 patients were managed conservatively. Of those managed conservatively, 165 were transferred directly while 48 were indirect transfers. We compared the length of hospital stay and Glasgow Outcome Scale score for the patients based on whether they were conservatively managed or required surgery in the direct and indirect transfer groups. The difference in the length of stay in the surgical and conservative groups following direct and indirect transfer was insignificant (p = 0.07). The time to the operation in direct and indirect transfer was also not statistically significant (p = 0.06).

Conclusion

Patients are as safe, if not safer, by reaching the nearest trauma unit with facilities for resuscitation and imaging.
Colonoscopy and flexible sigmoidoscopy for follow-up of patients with left-sided diverticulitis
Authors: Abdulazeez Z , Kukreja N , Qureshi N , Lascelles S
Published: August 2020

Introduction

The prevalence of diverticular disease has been increasing in the western world over the last few decades, causing a growing burden on health care systems. This study compared the uses of flexible sigmoidoscopy with colonoscopy as a follow-up investigation for patients diagnosed with acute left-sided diverticulitis and to evaluate the need for using either procedure.

Materials and methods

A retrospective study of 327 patients diagnosed with acute diverticulitis was carried out. Of this total, 240 patients with left-sided diverticulitis diagnosed via computed tomography were included. These patients were categorised into two equal groups: the first 120 patients underwent colonoscopy and the second 120 patients underwent flexible sigmoidoscopy.

Results

All colonoscopes and flexible sigmoidoscopes confirmed the computed tomography diagnosis of sigmoid diverticular disease with no major new findings. All colonoscopes and flexible sigmoidoscopes were reported as having no complications, with nine colonoscopes reported as being difficult compared with only three flexible sigmoidoscopes. All biopsies were reported as no malignancy. Full bowel preparation was required in all colonoscopes, compared with no preparation required for flexible sigmoidoscopes.

Conclusions

There is no evidence to support the routine use of endoscopic evaluation after an episode of left-sided diverticulitis diagnosed on computed tomography if no worrying radiological findings have been reported. This study supports similar findings from other studies and therefore we disagree with The Royal College of Surgeons of England (Association of Coloproctology of Great Britain and Ireland recommendations) commissioning guide, which advocates routine surveillance of the colon.
End-to-end Res-Unet based reconstruction algorithm for photoacoustic imaging
Authors: Feng Jinchao , Deng Jianguang , Li Zhe , Sun Zhonghua , Dou Huijing , Jia Kebin
Published: August 2020

Recently, deep neural networks have attracted great attention in photoacoustic imaging (PAI). In PAI, reconstructing the initial pressure distribution from acquired photoacoustic (PA) signals is a typically inverse problem. In this paper, an end-to-end Unet with residual blocks (Res-Unet) is designed and trained to solve the inverse problem in PAI. The performance of the proposed algorithm is explored and analyzed by comparing a recent model-resolution-based regularization algorithm (MRR) with numerical and physical phantom experiments. The improvement obtained in the reconstructed images was more than 95% in pearson correlation and 39% in peak signal-to-noise ratio in comparison to the MRR. The Res-Unet also achieved superior performance over the state-of-the-art Unet++ architecture by more than 18% in PSNR in simulation experiments.
Optical spin polarization in ruby enhances slow light by high-contrast transient spectral hole-burning
Authors: Riesen Hans , Rebane Aleksander K. , Hutchison Wayne , Ganschow Steffen
Published: August 2020

The spin-lattice relaxation time in the

4

A

2

ground state of

C
r

3
+

in ruby can be on the order of magnitude of seconds at liquid helium temperatures in low magnetic fields

B

|

|

c

. This allows for highly efficient optical pumping of the spin levels in this system. Such pumping can then in turn be employed to drastically increase the optical density of the inhomogeneously broadened

R

1

(
±

3

/

2

)

or

R

1

(
±

1

/

2

)

lines and also to narrow the spectral hole width because Cr–Cr electron-spin flips (cross relaxation) are suppressed in the ground state, leading to longer dephasing times

T
2
∗

. Both effects can be employed to further reduce the group velocity of light pulses propagating through a transient spectral hole.
Coupling silicon vacancy centers in a thin diamond membrane to a silica optical microresonator
Authors: Pauls Abigail , Lekavicius Ignas , Wang Hailin
Published: August 2020

We report the development of a composite cavity QED system, in which silicon vacancy centers in a diamond membrane as thin as 100 nm couple to optical whispering gallery modes (WGMs) of a silica microsphere with a diameter of order 50 µm. The membrane induces a linewidth broadening of 3 MHz for equatorial and off-resonant WGMs, while the overall linewidth of the composite system remains below 40 MHz. Photoluminescence experiments in the cavity QED setting demonstrate the efficient coupling of optical emissions from silicon vacancy centers into the WGMs. Additional analysis indicates that the composite system can be used to achieve the good cavity limit in cavity QED, enabling an experimental platform for applications such as state transfer between spins and photons.
Low-cost planar waveguide-based optofluidic sensor for real-time refractive index sensing
Authors: Barshilia Devesh , Chau Lai-Kwan , Chang Guo-En
Published: August 2020

We report on the design, fabrication, and characterization of mass-producible, sensitive, intensity-detection-based planar waveguide sensors for rapid refractive index (RI) sensing; the sensors comprise suspended glass planar waveguides on glass substrates, and are integrated with microfluidic channels. They are facilely and cost-effectively constructed via vacuum-less processes. They yield a high throughput, enabling mass production. The sensors respond to solutions with different RIs via variations in the transmitted optical power due to coupling loss in the sensing region, facilitating real-time and simple RI detection. Experiments yield a good resolution of 5.65 × 10−4 RIU. This work has major implications for several RI-sensing-based applications.
Deep neural network for multi-depth hologram generation and its training strategy
Authors: Lee Juhyun , Jeong Jinsoo , Cho Jaebum , Yoo Dongheon , Lee Byounghyo , Lee Byoungho
Published: August 2020

We present a deep neural network for generating a multi-depth hologram and its training strategy. The proposed network takes multiple images of different depths as inputs and calculates the complex hologram as an output, which reconstructs each input image at the corresponding depth. We design a structure of the proposed network and develop the dataset compositing method to train the network effectively. The dataset consists of multiple input intensity profiles and their propagated holograms. Rather than simply training random speckle images and their propagated holograms, we generate the training dataset by adjusting the density of the random dots or combining basic shapes to the dataset such as a circle. The proposed dataset composition method improves the quality of reconstructed images by the holograms generated by the network, called deep learning holograms (DLHs). To verify the proposed method, we numerically and optically reconstruct the DLHs. The results confirmed that the DLHs can reconstruct clear images at multiple depths similar to conventional multi-depth computer-generated holograms. To evaluate the performance of the DLH quantitatively, we compute the peak signal-to-noise ratio of the reconstructed images and analyze the reconstructed intensity patterns with various methods.
Efficacy and Safety of Endoscopic Full-Thickness Resection in the Colorectum: Results From the German Colonic FTRD Registry
Authors: Meier Benjamin , Stritzke Bettina , Kuellmer Armin , Zervoulakos Philipp , Huebner Georg Hermann , Repp Michael , Walter Benjamin , Meining Alexander , Gutberlet Klaus , Wiedbrauck Thomas , Glitsch Anne , Lorenz Albrecht , Caca Karel , Schmidt Arthur
Published: August 2020

INTRODUCTION:

Endoscopic full-thickness resection (EFTR) is a powerful option for resection of colorectal lesions not amenable to conventional endoscopic resection. The full-thickness resection device (FTRD) allows clip-assisted EFTR with a single-step technique. We report on results of a large nationwide FTRD registry.

METHODS:

The “German colonic FTRD registry” was created to further assess efficacy and safety of the FTRD System after approval in Europe. Data were analyzed retrospectively.

RESULTS:

Sixty-five centers contributed 1,178 colorectal FTRD procedures. Indications for EFTR were difficult adenomas (67.1%), early carcinomas (18.4%), subepithelial tumors (6.8%), and diagnostic EFTR (1.3%). Mean lesion size was 15 × 15 mm and most lesions were pretreated endoscopically (54.1%). Technical success was 88.2% and R0 resection was achieved in 80.0%. R0 resection was significantly higher for subepithelial tumor compared with that for other lesions. No difference in R0 resection was found for smaller vs larger lesions or for colonic vs rectal procedures. Adverse events occurred in 12.1% (3.1% major events and 2.0% required surgical treatment). Endoscopic follow-up was available in 58.0% and showed residual/recurrent lesions in 13.5%, which could be managed endoscopically in most cases (77.2%).

DISCUSSION:

To date, this is the largest study of colorectal EFTR using the FTRD System. The study demonstrated favorable efficacy and safety for “difficult-to-resect” colorectal lesions and confirms results of previous studies in a large “real-world” setting. Further studies are needed to compare EFTR with other advanced resection techniques and evaluate long-term outcome.
Colonoscopy Outcomes in Average-Risk Screening Equivalent Young Adults: Data From the New Hampshire Colonoscopy Registry
Authors: Butterly Lynn F. , Siegel Rebecca L. , Fedewa Stacey , Robinson Christina M. , Jemal Ahmedin , Anderson Joseph C.
Published: August 2020

INTRODUCTION:

Data are needed to further inform the American Cancer Society recommendation to begin colorectal cancer (CRC) screening at age 45. We used the New Hampshire Colonoscopy Registry to compare the prevalence of advanced neoplasia (AN) in an “average-risk screening equivalent” group aged 45–49 years with patients aged 50–54 years and older receiving screening colonoscopy.

METHODS:

Colonoscopies in adults older than 50 years of age usually have diagnostic indications of varying clinical significance. We combined patients older than 50 years with diagnostic indications (abdominal pain and constipation) expected to yield AN prevalence similar to screening low AN risk and those with a screening indication to form an “average-risk screening equivalent” group. We excluded high-risk indications (e.g., bleeding and anemia), surveillance examinations, and patients with a first-degree family history of CRC, incomplete examinations, and poor bowel preparation. We calculated prevalence/adjusted risks for AN (≥1 cm, villous, high-grade dysplasia, and CRC) and clinically significant serrated polyps (large [≥1 cm] hyperplastic polyps, sessile serrated polyp, traditional serrated adenomas, and proximal hyperplastic polyp ≥ 5 mm).

RESULTS:

In our sample (n = 40,812), AN prevalence was as follows: <40 years (1.1%), 40–44 years (3.0%), 45–49 years (3.7%), 50–54 years (3.6%), 55–59 years (5.1%), and 60+ years (6.7%) (P < 0.0001 across all groups). The prevalence of both AN and clinically significant serrated polyp was similar in the 45–49 and 50–54 years' age groups. Furthermore, the prevalence of AN increased significantly in the 40–44 group as compared to that in the <40 years group. Adjusted analyses confirmed these results. The diagnostic indications considered to have low risk were not predictive of AN.

DISCUSSION:

New Hampshire Colonoscopy Registry data, demonstrating an increase in AN risk starting at age 40 and a similar prevalence for individuals aged 45–49 and those ages 50–54, provide clinically useful evidence for optimization of prevention and the age to start screening. However, this is a complex issue involving additional considerations that will need to be addressed.
Endoscopic Surveillance of Duodenal Polyposis After Total Gastrectomy in Familial Adenomatous Polyposis
Authors: Shah Ravi S. , Mehta Neal , Mankaney Gautam , Walsh Matthew R. , Burke Carol A. , Bhatt Amit
Published: August 2020

The lifetime incidence of duodenal polyposis in familial adenomatous polyposis (FAP) approaches 100%, and duodenal cancer is the most common malignancy once colectomy is performed. The incidence of gastric cancer is increasing in patients with FAP, and when gastric polyps with high-grade dysplasia or cancer are present, a total gastrectomy with Roux-en-Y esophagojejunostomy is indicated. The altered anatomy after surgery and presence of adhesions from a previous colectomy make endoscopic surveillance of the duodenum with standard equipment difficult. This case report highlights an approach to duodenal polyposis surveillance in FAP after total gastrectomy with Roux-en-Y esophagojejunostomy.
PROPUESTA PARA EL USO PERTINENTE DEL IDIOMA ESPAÑOL EN MEDICINA
Authors: D'Ottavio Alberto Enrique , D'Ottavio María Eugenia
Published: August 2020

El empleo correcto del idioma español es de prioritaria relevancia para estudiantes y graduados en Medicina. En tal marco, este trabajo: (a) propone una factible secuencia reparadora en etapas de los “desaseos de la lengua”, (b) intenta proveer, a su través, herramientas valiosas para que los profesionales interactúen con personas de diferente nivel cultural sin deteriorar la comunicación, y (c)  efectúa complementarias reflexiones sobre su eventual implementación. La primera etapa persigue evitar: barbarismos, anglicismos y solecismos (queísmos y dequeísmos, empleo inadecuado de los adverbios donde y cuando, incorrecta asociación de tiempos del modo subjuntivo con el tiempo condicional del modo indicativo, equivocado empleo de los verbos haber y hallar, disonante uso de muletillas y expletivos, despeño en redundancias y frecuente confusión entre siglas, sigloides y acrónimos). La segunda etapa se centra en conocer el  verdadero significado de palabras desconocidas, y aún de aquéllas, supuestamente conocidas, así como en sus respectivas etimologías, y la última etapa incursiona en sinónimos, antónimos, parónimos, homónimos y epónimos.
MEJORAMIENTO DE LAS PRÁCTICAS DOCENTES A PARTIR DE PROYECTOS DE INNOVACIÓN
Authors: Manuale Marcela Alicia
Published: August 2020

Se presenta un avance del estudio en relación a los proyectos de innovación, como parte de mi tesis doctoral que se ocupa de “Los procesos de innovación y las buenas prácticas de enseñanza.”, donde se abordan tópicos sobre los procesos de enseñanza en el ámbito universitario y su vinculación con las innovaciones educativas, la investigación sobre las prácticas y el mejoramiento del aprendizaje de los alumnos. Se estudian los Proyectos de Innovación Curricular (PIC) de la Facultad de Bioquímica y Ciencias Biológicas, de la Universidad Nacional del Litoral-Argentina, desarrollados durante el ciclo lectivo 2017, desde una perspectiva compleja y crítica. Del análisis del marco teórico y de los datos obtenidos se realizarán algunas reflexiones. Aunque es preliminar, puede afirmarse que los procesos de diseño, implementación y evaluación de las innovaciones pedagógicas constituyen ámbitos favorecedores de la mejora de las prácticas educativas, de la formación y el desarrollo profesional de los docentes universitarios.
“Finished Knowing – Then –”
Authors: Schnabel Margaret Vivian
Published: August 2020

This essay explores the ways in which Emily Dickinson’s poems about death challenge romantic Puritan and Victorian conceptions of death, undermining the idea of death as a meaningful, knowable phenomenon. I argue that in placing pressure on Puritan logic—indeed, on the idea that logic might be applied to death at all—Dickinson’s poems ultimately rupture syntactically and semantically, rendering futile the search for certainty in death. This destruction of certainty, as I argue, allows Dickinson’s death poems to explore a variety of philosophical and spiritual perspectives on death and dying, taking on a renewed “life” of their own. Finally, I examine Dickinson’s poems within the context of the Civil War Era and New England Puritanism to reveal the extent to which these poetic explorations of death offer a crucial rebuttal to discourses and systems of belief eager to bring false certainty to the unknowable.
Acute and Long-Term Comparison of Fixed vs. Self-Selected Rest Interval Between Sets on Upper-Body Strength
Authors: Simão Roberto , Polito Marcos , Freitas de Salles Belmiro , Marinho Daniel Almeida , Garrido Nuno D. , Junior Evaldo Rui Tavares Santos , Willardson Jeffrey M.
Published: August 2020

Simão, R, Polito, M, de Salles, BF, Marinho, DA, Garrido, ND, Santos Junior, ERT, and Willardson, JM. Acute and long-term comparison of fixed vs. self-selected rest interval between sets on upper-body strength. J Strength Cond Res 36(2): 540–544, 2022—The effects of different rest interval durations between sets has been widely studied, but only recently, the self-selected rest interval (SSRI) has been a matter of interest. However, previous studies comparing fixed and SSRI have investigated only acute responses. The purpose of this study was to analyze the acute and long-term effects of a fixed rest interval (FRI) vs. an SSRI between sets on upper-body performance and strength gains. Thirty-three trained men were randomly divided into 2 groups: FRI (75 seconds between sets), and SSRI. Both groups performed 3 sets with 75% of 1-repetition maximum until repetition failure in the chest press (CP), lat pull-down (LPD), shoulder press (SP), and seated row (SR) 3 times a week for 8 weeks. The results demonstrated that the SSRI allowed for significantly greater repetition performance vs. the FRI in the CP (26.1 ± 2.0 vs. 21.5 ± 1.8), LPD (30.1 ± 2.3 vs. 24.9 ± 1.9), SP (24.0 ± 2.8 vs. 17.4 ± 1.5), and SR (26.3 ± 1.6 vs. 22.0 ± 1.6). In addition, the following strength gains were observed: SSRI (CP: 6.8%, LPD: 8.0%, SP: 6.7%, SR: 7.8%) and FRI (CP: 7.4%, LPD: 6.7%, SP: 6.1%, SR: 7.0%) without significant differences between the groups. In conclusion, within an 8-week period, both protocols seem to be effective for strength gains, despite the higher training volume accomplished by the SSRI group. However, the FRI was 37% more time efficient.
Reliability and Validity of a 6-Minute Yo-Yo Intermittent Endurance Test Level 2 in Subelite Part Time Male Soccer Players
Authors: Gibson Neil , Easton Chris , Williams Michael , McCunn Robert , Gibson Neil V.
Published: August 2020

Gibson, N, Easton, C, Williams, M, McCunn, R, Gibson, NV. Reliability and validity of a 6-minute Yo-Yo Intermittent Endurance Test Level 2 in subelite part time male soccer players. J Strength Cond Res 36(4): 1011–1018, 2022—The aim of this study was to assess the reliability and relationship to maximal intermittent running performance of the 6-minute Yo-Yo Intermittent Endurance Test Level 2 (YYIET2), among subelite part time soccer players. Twenty male soccer players (15–22 years) completed three 6-minute YYIET2 trials with heart rate (HR), PlayerLoad, and rating of perceived exertion assessed during the protocol and HR and blood lactate assessed during 5 minutes of recovery. Subjects also completed a maximal version of the YYIET2 and the maximal Yo-Yo Intermittent Recovery Test Level 1 (YYIRT1) and 2 (YYIRT2). Heart rate at 4 and 6 minutes, PlayerLoad at 4 minutes, and HR recovery at 2, 3, 4, and 5 minutes during recovery from the 6-minute YYIET2 demonstrated little variance between tests. Correlations between variables measured during and after the 6-minute YYIET2 and distance covered in maximal tests ranged from r = 0.02 to −0.72. The 6-minute YYIET2 provides practitioners with a method of reliably assessing HR responses within subelite part time soccer players, although large correlations with maximal assessments suggest it can be used as a proxy measure for maximal intermittent running performance. Given its ease of administration and low time cost, the 6-minute YYIET2 offers practitioners a useful means of tracking training status and movement efficiency in players longitudinally.
The Impact of Recovery Time on Performance in Division I Collegiate Beach Volleyball Players
Authors: Holtgeerts Rebecca N. , Gann Joshua , Jung Hyun Chul , Hey William
Published: August 2020

Holtgeerts, RN, Gann, J, Jung, HC, and Hey, W. The impact of recovery time on performance in Division I collegiate beach volleyball players. J Strength Cond Res 36(3): 667–673, 2022—The sport of beach volleyball has recently grown significantly at the collegiate level, and collegiate beach volleyball players often practice and compete 5 or 6 days per week during the competitive season. This study examined the effects of the amount of recovery time on performance in Division 1 Collegiate beach volleyball players. Ten female NCAA Division 1 beach volleyball players, aged 20.2 ± 1.23 years, participated in the study. Subjects completed 2 trials consisting of 4 sessions of volleyball play (with a 24-hour recovery trial and 48-hour recovery trial). Trials were randomized and counter balanced. Each trial measured counter-movement jump, 5-10-5 agility time, 3 beach volleyball drills, and scores of a beach volleyball match. Perceived recovery, sleep quality, and rating of perceived exertion were also recorded. The significance level set for the study was p ≤ 0.05. Counter-movement jump showed small but significant increases following the 24-hour recovery period (p ≤ 0.05). 5-10-5 agility test showed significant improvement with the 48-hour recovery period (p ≤ 0.05). Perceived Recovery scores demonstrated significant increases in both recovery periods (p ≤ 0.05). Beach volleyball drill and match performance were not affected by the change in recovery time. These results indicate that, although some physical skills are affected by recovery time, beach volleyball performance as a whole is relatively stable over several days. It is normal for NCAA athletes to play back-to-back days and with little recovery time, and these results indicate that this practice does not negatively affect sport performance.
A 3-Week, Low-Carbohydrate, High-Fat Diet Improves Multiple Serum Inflammatory Markers in Endurance-Trained Males
Authors: Waldman Hunter S. , Heatherly Alexander J. , Killen Lauren G. , Hollingsworth Angela , Koh Yunsuk , O'Neal Eric K.
Published: August 2020

Waldman, HS, Heatherly, AJ, Killen, LG, Hollingsworth, A, Koh, Y, and O'Neal, EK. A three-week, low-carbohydrate, high-fat diet improves multiple serum inflammatory markers in endurance-trained males. J Strength Cond Res 36(9): 2502–2508, 2022—This study examined the effects of a low-carbohydrate, high-fat diet (LCHF) on inflammatory marker responses in middle-aged endurance athletes. Eight male runners maintained their habitual mixed diet (HMD) in the first phase of the study before switching to a noncalorically restricted LCHF diet (∼70% of kcals from fat; carbohydrate <50 g) for 3 weeks. Subjects completed a 50-minute fixed pace treadmill running protocol in a hot environment, followed by a 5-km outdoor time trial. Fasting serum samples were collected immediately after exercise and heat stress restriction, and again 24 hours after the exercise/heat stressor. Thirty inflammation markers were assessed using the multiplex flow immunoassay technique. Seven markers (BAFF/TNFSF-13, sCD30/TNFRSF8, sCD163, Chitinase3-like1, gp130SIL-6Rβ, sTNFR-1, and sTNFR-2) reached statistical significance (p < 0.05) favoring LCHF before exercise, and sCD30/TNFRSF8 favored (p < 0.05) LCHF before (HMD = 459 ± 111; LCHF = 296 ± 100) and after (HMD = 385 ± 104; LCHF = 285 ± 104 pg·ml−1) exercise. Although the current dietary intervention was short in duration, LCHF seems to offer some protection against multiple chronic inflammation markers for physically active men between ages 30 and 50 years.
Postactivation Performance Enhancement of Concentric Bench Press Throw After Eccentric-Only Conditioning Exercise
Authors: Krzysztofik Michal , Wilk Michal , Lockie Robert G. , Golas Artur , Zajac Adam , Bogdanis Gregory C.
Published: August 2020

Krzysztofik, M, Wilk, M, Lockie, RG, Golas, A, Zajac, A, and Bogdanis, GC. Postactivation performance enhancement of concentric bench press throw after eccentric-only conditioning exercise. J Strength Cond Res 36(8): 2077–2081, 2022—This study examined changes in power output and bar velocity in the concentric-only bench press throw (CONONLY) after sets of eccentric-only bench press exercises (ECCONLY) at 2 supramaximal loads. Thirteen strength-trained men participated in this study (age = 25.7 ± 1.9 years, body mass = 94.8 ± 8 kg, 1 repetition maximum [1RM] = 147 ± 14.2 kg, and strength training experience = 6.5 ± 2.2 years). The subjects performed 2 conditioning sets of the bench press exercise of 2 repetitions each, with a 5-minute rest interval between sets, using the ECCONLY mode against 110% or 130% of concentric 1RM load. The 1 repetition of the CONONLY bench press throw with a load of 30% 1RM was performed before and 5 minutes after the conditioning activity (CA) to assess changes in peak power (PP) and peak velocity (PV). The differences between the analyzed variables before and after the CA were determined using a 2-way repeated measures analysis of variance. There was an increase of PP by 10.5 ± 6.0% (effect size [ES] = 0.34) and 9.9 ± 8.1% (ES = 0.33) for the 110 and 130% of concentric 1RM conditions, respectively, with no difference between the 2 conditions (p < 0.01 main effect time, no interaction). Similarly, PV increased by 5.9 ± 5.5% (ES = 0.40) and 6.1 ± 6.1% (ES = 0.43) for the 110 and 130% of concentric 1RM conditions, respectively, with no difference between the 2 conditions (p < 0.01 main effect time, no interaction). Activation with an ECCONLY contraction and loads exceeding 1RM are effective at improving power output and bar velocity during the CONONLY bench press throw.
Catecholamine-induced cerebral vasospasm and multifocal infarctions in pheochromocytoma
Authors: Madhok Jai , Kloosterboer Amy , Venkatasubramanian Chitra , Mihm Frederick G
Published: August 2020

We report the case of a 76-year-old male with a remote history of papillary thyroid cancer who developed severe paroxysmal headaches in the setting of episodic hypertension. Brain imaging revealed multiple lesions, initially of inconclusive etiology, but suspicious for metastatic foci. A search for the primary malignancy revealed an adrenal tumor, and biochemical testing confirmed the diagnosis of a norepinephrine-secreting pheochromocytoma. Serial imaging demonstrated multiple cerebral infarctions of varying ages, evidence of vessel narrowing and irregularities in the anterior and posterior circulations, and hypoperfusion in watershed areas. An exhaustive work-up for other etiologies of stroke including thromboembolic causes or vasculitis was unremarkable. There was resolution of symptoms, absence of new infarctions, and improvement in vessel caliber after adequate alpha-adrenergic receptor blockade for the management of pheochromocytoma. This clinicoradiologic constellation of findings suggested that the etiology of the multiple infarctions was reversible cerebral vasoconstriction syndrome (RCVS). Pheochromocytoma remains a poorly recognized cause of RCVS. Unexplained multifocal cerebral infarctions in the setting of severe hypertension should prompt the consideration of a vasoactive tumor as the driver of cerebrovascular dysfunction. A missed or delayed diagnosis has the potential for serious neurologic morbidity for an otherwise treatable condition.

Learning points:

The constellation of multifocal watershed cerebral infarctions of uncertain etiology in a patient with malignant hypertension should trigger the consideration of undiagnosed catecholamine secreting tumors, such as pheochromocytomas and paragangliomas.

Reversible cerebral vasoconstriction syndrome is a serious but reversible cerebrovascular manifestation of pheochromocytomas that may lead to strokes (ischemic and hemorrhagic), seizures, and cerebral edema.

Alpha-adrenergic receptor blockade can reverse cerebral vasoconstriction and prevent further cerebral ischemia and infarctions.

Early diagnosis of catecholamine secreting tumors has the potential for reducing neurologic morbidity and mortality in patients presenting with cerebrovascular complications.
Existence Theory and Stability Analysis of Nonlinear Neutral Pantograph Equations via Hilfer-Katugampola Fractional Derivative
Authors: S. Harikrishnan  , E.M. Elsayed  , K. Kanagarajan
Published: August 2020

The aim and objectives of this paper are devoted to study some adequate results for the existence and stability of solutions of nonlinear neutral pantograph equations with Hilfer-Katugampola fractional derivative. The arguments are based upon Schauder fixed point theorem and Banach contraction principle. Further, we also study the Ulam type stability for proposed problem.
X-Linked Myotubular Myopathy and Duchenne Muscular Dystrophy in a Preterm Infant: A Rare Combination
Authors: Varma Uma , Mukherjee Devdeep , Hughes Imelda , Sethuraman Chitra , Kamupira Susan
Published: August 2020

Disorders of central and peripheral nervous system should be considered in floppy infants with ventilator dependence. Workup for neuromuscular disorders should be undertaken in infants with hypotonia, weakness, contractures, feeding difficulties, or failed attempts at extubation. We present the case of a preterm infant with hypotonia and ventilator dependence where despite a positive result, further investigations were undertaken because of lack of clinical correlation. The infant had a rare combination of 2 neuromuscular conditions: X-linked myotubular myopathy and Duchenne muscular dystrophy. One was the reason for immediate clinical manifestation and the other influenced the prognosis and decision-making in determining reorientation of care. This case demonstrates the value of interpretation of a positive result that did not explain the clinical picture and warranted consideration of further diagnosis. This case also emphasizes the importance of discussions with family about the prognosis of 2 conditions that influenced decision making.