bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnetic Stability of Massive Star-forming Clumps in RCW 106
Authors: Tamaoki Shohei , Sugitani Koji , Nguyen-Luong Quang , Nakamura Fumitaka , Kusune Takayoshi , Nagayama Takahiro , Watanabe Makoto , Nishiyama Shogo , Tamura Motohide
Published: April 2019

The RCW 106 molecular cloud complex is an active massive star-forming region where a ministarburst is taking place. We examined its magnetic structure by near-IR polarimetric observations with the imaging polarimeter SIRPOL on the IRSF 1.4 m telescope. The global magnetic field is nearly parallel to the direction of the Galactic plane and the cloud elongation. We derived the magnetic field strength of ∼100–1600 μG for 71 clumps with the Davis–Chandrasekhar–Fermi method. We also evaluated the magnetic stability of these clumps and found that massive star-forming clumps tend to be magnetically unstable and gravitationally unstable. Therefore, we propose a new criterion to search for massive star-forming clumps. These details suggest that the process enhancing the clump density without an increase of the magnetic flux is essential for the formation of massive stars and the necessity for accreting mass along the magnetic field lines.
Cloud Atlas: Rotational Spectral Modulations and Potential Sulfide Clouds in the Planetary-mass, Late T-type Companion Ross 458C
Authors: Manjavacas Elena , Apai Dániel , Lew Ben W. P. , Zhou Yifan , Schneider Glenn , Burgasser Adam J. , Karalidi Theodora , Miles-Páez Paulo A. , Lowrance Patrick J. , Cowan Nicolas , Bedin Luigi R. , Marley Mark S. , Metchev Stan , Radigan Jacqueline
Published: April 2019

Measurements of photometric variability at different wavelengths provide insights into the vertical cloud structure of brown dwarfs and planetary-mass objects. In seven Hubble Space Telescope consecutive orbits, spanning ∼10 hr of observing time, we obtained time-resolved spectroscopy of the planetary-mass T8 dwarf Ross 458 C using the near-infrared Wide Field Camera 3. We found spectrophotometric variability with a peak-to-peak signal of 2.62 ± 0.02% (in the 1.10–1.60 μm white light curve). Using three different methods, we estimated a rotational period of 6.75 ± 1.58 hr for the white light curve, and similar periods for narrow J- and H-band light curves. Sine wave fits to the narrow J- and H-band light curves suggest a tentative phase shift between the light curves with wavelength when we allow different periods between both light curves. If confirmed, this phase shift may be similar to the phase shift detected earlier for the T6.5 spectral type 2MASS J22282889–310262. We find that, in contrast with 2M2228, the variability of Ross 458C shows evidence for a color trend within the narrow J-band, but gray variations in the narrow H-band. The spectral time-resolved variability of Ross 458C might be potentially due to heterogeneous sulfide clouds in the atmosphere of the object. Our discovery extends the study of spectral modulations of condensate clouds to the coolest T-dwarf, planetary-mass companions.
Carnegie Supernova Project-II: Using Near-infrared Spectroscopy to Determine the Location of the Outer 56Ni in Type Ia Supernovae∗
Authors: Ashall C. , Hsiao E. Y. , Hoeflich P. , Stritzinger M. , Phillips M. M. , Morrell N. , Davis S. , Baron E. , Piro A. L. , Burns C. , Contreras C. , Galbany L. , Holmbo S. , Kirshner R. P. , Krisciunas K. , Marion G. H. , Sand D. J. , Shahbandeh M. , Suntzeff N. B. , Taddia F.
Published: April 2019

We present the H-band wavelength region of 37 postmaximum light near-infrared spectra of three normal, nine transitional, and four subluminous type Ia supernovae (SNe Ia), extending from +5 days to +20 days relative to the epoch of B-band maximum. We introduce a new observable, the blue-edge velocity, v
edge, of the prominent Fe/Co/Ni-peak H-band emission feature, which is quantitatively measured. The v
edge parameter is found to decrease over subtype ranging from around −14,000 km s−1 for normal SNe Ia, to −10,000 km s−1 for transitional SNe Ia, down to −5000 km s−1 for the subluminous SNe Ia. Furthermore, inspection of the +10 ± 3 days spectra indicates that v
edge is correlated with the color-stretch parameter, s

BV
, and hence with peak luminosity. These results follow the previous findings that brighter SNe Ia tend to have 56Ni located at higher velocities as compared to subluminous objects. As v
edge is a model-independent parameter, we propose it can be used in combination with traditional observational diagnostics to provide a new avenue to robustly distinguish between leading SNe Ia explosion models.
Les enseignants de la formation professionnelle : leur travail, leur réalité
Authors: Holgado Otilia
Published: April 2019

Cet article rend compte d’une recherche qui explore le travail quotidien de huit enseignants de la formation professionnelle secondaire au Québec, dans six métiers : arpentage, cuisine, entretien paysager, secrétariat, transport par camion et conduite des engins de chantier. Menée selon une démarche d’analyse du travail à partir d’entretiens libres, la recherche se propose d’accéder aux représentations des enseignants participants afin de rendre compte de la manière dont ceux-ci se représentent leur propre métier, les tâches qui le composent, les responsabilités qui leur incombent, ainsi que les conditions de travail, les difficultés qu’ils rencontrent et les moyens qu’ils déploient pour y faire face au quotidien. Les résultats obtenus montrent le partage entre les tâches prescrites et celles qui sont prises en charge volontairement par les enseignants, dans le but de favoriser l’apprentissage des élèves et d’assurer le bon fonctionnement de leur centre de formation. Nous constatons que cela amène une surcharge de travail dont la réalisation se prolonge sur le temps personnel, conduisant à une délimitation floue entre vie professionnelle et vie privée.
Au service de l’Europe
Authors: Georgakakis Didier
Published: April 2019

Tout est dit, et pense-t-on a été dit, sur les « eurocrates », leurs privilèges, leur idéologie (néo-libérale pour les uns, au contraire régulatrice et étatiste pour d’autres, technocratique pour tous) et les diktats multiples qu’ils imposeraient. Rares sont pourtant les analyses qui dépassent ces anathèmes et traite de la diversité sociologique des fonctionnaires européens, de la complexité de leur position et des fondations de leur pouvoir individuel et collectif. À y regarder de plus près, ce groupe vit pourtant une transformation assez majeure. Originellement pensé comme un corps assez unique de permanents de l’Europe proche d’une fonction publique d’État et destiné à neutraliser les nombreux conflits d’intérêts politiques, économiques et sociaux qui vont de pair avec une « Union toujours plus étroite », cette infrastructure humaine de l’intégration européenne a subi de profondes transformations qui l’ont progressivement bien plus rapprochée du modèle des manageurs internationaux indifféremment publics et privés que de son modèle d’origine. Ce mouvement, né dans un contexte chargé de réformes administratives et institutionnelles, d’élargissements, puis de crise économique et monétaire, représente un déplacement important ; il est plus encore à l’origine d’une véritable crise sociologique qui fragilise ce collectif et comprend de nombreuses conséquences sur le processus européen et sa direction. 

 

Fruit d’un ensemble d’enquêtes sociologiques de terrain sur les fonctionnaires européens et le mystère de leur formation en tant que groupe, ce livre tranche avec la somme d’anathèmes et leur pendant de justifications que déchaine ordinairement la seule évocation des « eurocrates ». En en éclairant des aspects largement méconnus, il s’interroge sur les transformations de leur pouvoir et, au-delà, du projet européen lui-même.  La question du sens et de la direction à venir de l’Europe est indissociable d’une réflexion sur sa fonction publique dans tous les sens du terme.
Flip-Game Engineering and Technology Methodology
Authors: Gómez de Merodio Milagros Huerta , Dodero Juan Manuel , Núñez Nestor Mora , Núñez José Mª Portela
Published: April 2019

Flip-GET has been developed with the objective of optimizing engineering practicals. The innovative element of this methodology is the use of serious games, as a complement to the flipped classroom method, in the teaching-learning process of engineering studies. This methodology uses serious games to take advantage of the capacity of motivation that video games have for the current generation of students, who have been involved with digital content, software, and electronic devices. This methodology has been evaluated using the method of case studies and by an experimental evaluation carried out in different stages, each of which has been developed during an academic course. In the experimental evaluation of the methodology, the control group carried out the practicals dividing the students into subgroups, without using the Flip-GET methodology, while the experimental group performed them with the methodology.
Gastric lymphoma and gastric tuberculosis: A diagnostic dilemma
Authors: Jain Atul , Yadav Pradhuman , Dey Subhajeet , Karim Tanweer
Published: April 2019

Gastric outlet obstruction may be caused by a heterogeneous group of diseases that include both benign and malignant conditions. Primary gastric lymphoma (3%–5% of all gastrointestinal malignancies) and primary gastric tuberculosis (TB) (0.4%–2%) are very rare and resemble each other in clinical presentation with diagnostic dilemma between them. Do the two entities exist concomitantly or precede each other is still a topic of debate in the literature. Here, we present a case of primary gastric TB and gastric lymphoma in the same patient.
Octamer 4 expression and lymph node metastasis in ductal carcinoma of breast: Are they associated?
Authors: Vanik Sangita A , Yadav Shakti Kumar , Jahan Aarzoo , Pruthi Sonam Kumar , Sarin Namrata , Chopra Ratna , Singh Sompal
Published: April 2019

Purpose: Octamer 4 (Oct-4) is a transcription factor which is required for the self-renewal and pluripotency of embryonic stem cells and germ cells. In this study, we tried to examine the association of expression of Oct-4 with lymph node metastasis in ductal carcinoma of the breast. Methods: The study was conducted on a total of 45 cases of invasive ductal carcinoma of breast, no special type. Oct-4 expression was studied on paraffin-embedded sections by immunohistochemistry. Results: Oct-4 expression was seen in 22.2% of cases. No statistically significant association was found between the expression of Oct-4 and histological type, tumor size, histological grade, and lymph node metastasis. Of Oct-4 positive tumor, 80% of cases showed lymph node metastasis, as compared to 62.85% without Oct-4 expression. However, the association was statistically insignificant. Conclusion: Oct-4 expression can be a promising biomarker of carcinogenesis, metastatic potential, and prognosis of carcinoma breast. However, the study with larger sample size is needed to establish the clinicopathological potential of this biomarker.
Trends in gallbladder cancer incidence in the high- and low-risk regions of India
Authors: Phadke Prachi Ravindra , Mhatre Sharayu Sitaram , Budukh Atul Madhukar , Dikshit Rajesh Prabhakar
Published: April 2019

Background: Gallbladder cancer (GBC), a common cancer surrounding the Gangetic belt of India, accounts for 80%–90% of biliary tract cancers. GBC incidence shows striking geographical variation in India. Materials and Methods: We used the data from the National Cancer Registry Programme for the year 2001–2014 to study the time trends of GBC in the high- and low-risk geographical regions of India. Annual percentage change (APC) in age-adjusted incidence rates was computed by log-linear regression model. Results: Among females, a statistically significant increase in trend was observed in Cachar (APC: 7.0, P = 0.02), Delhi (APC: 4.0, P = 0.04), and Kamrup (APC: 4.3, P = 0.02) marked under high-risk region and in Bengaluru (APC: 5.7, P = 0.04) and Pune (APC: 3.4, P = 0.04) marked under low-risk region. Among males, increasing but statistically nonsignificant trends were observed in Cachar, Dibrugarh, Kamrup, Nagpur, and Sikkim, whereas decreasing trends were observed in Bengaluru, Barshi, Bhopal, and Kolkata. Aurangabad showed a statistically significant decrease in trend (APC: −14.5, P < 0.001) among males. Conclusion: The time trend and pattern of GBC have striking differences within the country as well as in state. Further large-scale region-wise studies are needed to find the risk factors of GBC.
Strongyloides stercoralis hyperinfection complicated by secondary infections in a case of transformed diffuse large B-cell lymphoma
Authors: Vira Hemant J , D'Souza Hollis , Bhat Vivek G , Bonda Avinash
Published: April 2019

We report Strongyloides stercoralis hyperinfection complicated by secondary infections in a case of transformed diffuse large B-cell lymphoma. The hyperinfection was followed by a sequela of candidemia and infection of the peritoneal fluid that was associated with the leakage of gut flora from the bowel damaged by the migration of larvae. This phenomenon has seldom been reported in a case of hematolymphoid cancer such as transformed diffuse large B-cell lymphoma. The complications arising due to S. stercoralis hyperinfection are associated with a high fatality rate in immunocompromised patients, and this should be taken into account in the diagnosis and management of this condition.
Role of pretreatment fluorodeoxyglucose positron emission tomography quantitative parameters in prognostication of head-and-neck squamous cell carcinoma
Authors: Subramaniam Narayana , Balasubramanian Deepak , Sundaram P Shanmuga , Murthy Samskruthi , Thankappan Krishnakumar , Iyer Subramania
Published: April 2019

In spite of the good organ preservation strategies available for locally advanced head-and-neck squamous cell carcinoma (HNSCC), failure rates have been reported to be as high as 35%–50%. There has been an increasing interest in predicting response to treatment, to aid early intervention and better outcomes. Fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) is a standard modality for posttreatment evaluation; however, it is still underutilized as a pretreatment investigative modality. Several articles have described quantitative parameters in pretreatment FDG-PET to prognosticate patients and determine the likelihood of response to treatment; however, they are still not used commonly. This article was a review of the literature available on pretreatment FDG-PET quantitative parameters and their value in predicting failure. A thorough review of literature from MEDLINE and EMBASE was performed on pretreatment quantitative parameters in HNSCC. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were reliable parameters to predict response to organ preservation therapy, disease-free survival, and overall survival. Maximum SUV (SUVmax) was an inconsistent parameter. MTV and TLG may help predict poor response to organ preservation to initiate early surgical salvage or modify therapeutic decisions to optimize clinical outcomes. Routine use may provide additional information over SUVmax alone.
Human leukocyte antigen-matched unrelated donor search experience for hematological disorder patients requiring transplant: scenario for Indian patients
Authors: Mishra Vikash Chandra , Dorwal Pranav , Solanki Hina , Kohli Tarun , Tiwari Aseem Kumar , Raina Vimarsh , Sharma Girish
Published: April 2019

Introduction: Human leukocyte antigen (HLA)-matched unrelated donor (MUD) is the source of MUD transplantation (MUDT) for about 70% of patients who do not have matched related donor. To facilitate MUD search globally, there are 75 stem cell registries with more than 28 million donors registered (as of January 2017). Out of these donors, India has an insignificant representation of approximately 0.23 million. Further, Indians express high genetic variations, making it difficult to find MUD for an Indian patient. Aims and Objectives: The aim of this study is to analyze the MUD search for hematological disorder patients requiring transplant. An attempt was made to observe the MUD scenario for Indian patients requiring MUDT from accessible stem cell registries. Methods: A total of 558 patients approached Genebandhu registry and Chimera Transplant Research Foundation for MUD search over a period of 4 years requiring MUDT were included in this study. High resolution of HLA-A, -B, -C, -DRB1, and -DQB1 was used to perform MUD search through proprietary software called Prometheus and Bone Marrow Donors Worldwide (BMDW) search tool. Results: Out of 558 patients, MUD was located only for 135 (24.19%) patients. Out of these 135 patients, 91 (16.30%) patients found an MUD in global database and only 44 (7.88%) patients within India. Conclusion: This study demonstrates that building a large Indian database will not only help in increasing the chances of finding an MUD for maximum number of patients within India but also provide cost-effective treatment, in a society where cost is a vital factor.
Drug review: Carfilzomib
Authors: Ganesan Prasanth
Published: April 2019

Carfilzomib is a second generation proteasome inhibitor approved for use in relapsed/ refractory multiple myeloma. The mechanism of action, usage, toxicity and key trials involving this agent are briefly reviewed here.
Clinical profile and outcomes of Non-Hodgkin's lymphoma in children: A report from a tertiary care hospital from India
Authors: Meena Jagdish Prasad , Gupta Aditya Kumar , Parihar Mansingh , Seth Rachna
Published: April 2019

Background: Non-Hodgkin's lymphoma (NHL) is an aggressive malignancy. Its outcome has improved over the past decades. Although it accounts for 8%–10% of all childhood cancers, very less information about its clinical presentation and outcomes is available from India. Our objective was to study the clinical presentation and outcomes in children (<15 years) with NHL at our center. Methodology: We retrospectively analyzed 26 children diagnosed with NHL at our center from August 2008 to June 2014 and followed them up to May 2017. Results: The median age at the time of diagnosis was 7.7 years (2.5–13 years). Abdominal distension and an abdominal lump were the most common presenting features occurring in 75%, followed by fever (73.8%) and weight loss (46.2%). Most patients had advanced-stage (Stage III/IV, 92.3%) disease at presentation. The primary presentation was extranodal in 57.7%, nodal in 26.9%, and combined in 15.4%. Burkitt's lymphoma (BL) was the most common subtype (46.2%), followed by T-lymphoblastic lymphoma, diffuse large B-cell lymphoma, and anaplastic large-cell lymphoma. Three patients did not take treatment. The median follow-up of patients was 48 months (36–99 months). Nineteen patients achieved remission and four had progressive disease. Significantly better event-free survival (EFS) was found with younger age and lower stage of presentation. The EFS did not significantly differ with sex, group of disease, lactate dehydrogenase levels, and presenting features. Conclusions: Our cohort of patients with NHL showed characteristics similar to those reported from other developing countries. NHL occurred at a younger age, with a higher incidence of BL. The outcome for patients aged >10 years was poor. The outcome of NHL was comparable to that of other centers in the world.
Radioiodine (131I) therapy in a child with autism spectrum disorder: A complex and demanding task
Authors: Bibbo Giovanni , Kirkwood Ian , Sigalas Victoria , Benger Tracy
Published: April 2019

In January 2017, an 11.5-year-old male child with autism was referred for radioiodine (RAI) therapy post total thyroidectomy for papillary thyroid carcinoma. The treatment required swallowing a RAI capsule and remaining isolated (48–72 h). Initially, obstacles to a successful treatment seemed insurmountable as he had complex needs and behavioral issues due to his autism, mild intellectual disability, and family environment. His mother was adamant that he would not be able to swallow the capsule and comply with the required isolation period. A multidisciplinary team was formed to explore options for successful treatment. Each option considered had its own risks and challenges. Behavioral therapy was considered to be the only possible option. It was pursued with regular, frequent contact between the child, his parents, and members of the team for counseling and behavioral modification, familiarization of the child with the staff, procedures, trial visits, and admission. The patient was successfully treated in October 2017.
A rare case of minimally invasive follicular thyroid cancer with intraluminal superior vena cava and right atrium metastases
Authors: Khoo Alex Cheen Hoe , Chen Soo Ling
Published: April 2019

Follicular thyroid cancers are known to spread hematogenously to the bones and lungs and rarely presenting with massive angioinvasion. We report a case of a middle-aged female who had undergone total thyroidectomy for minimally invasive follicular thyroid cancer with angioinvasion in 2014. She was noted to have a large tumor thrombus extending from the superior vena cava to the right atrium on whole body scan post-Iodine-131 (131I) remnant ablation therapy. We discuss the various imaging modalities, treatment options, and difficulties in managing such massive angioinvasion in patients with well-differentiated thyroid cancers.
The effect of retinoic acid in the ability of cold solid thyroid nodule to take up radioactive iodine: A preliminary study
Authors: Lim Andreas , Budiawan Hendra , Darmawan Budi , Hidayat Basuki , Sukandar Hadyana , Sundawa Kartamihardja Achmad Hussein
Published: April 2019

One of the treatment options for benign thyroid nodules is radioactive iodine (RAI). However, this treatment is more effective for hot/warm solid thyroid nodules. Cold thyroid solid nodules are characterized by the lack of iodine uptake compared to normal thyroid tissue. Oral retinoic acid (RA) is a synthetic derivative of Vitamin A. The effect of RA on the uptake of RAI is still controversial. The aim of this study was to evaluate the effect of RA in the ability of a cold solid thyroid nodule to take up RAI. Individuals with a cold solid thyroid nodule based on ultrasonography and thyroid scintigraphy were included. Participants with liver dysfunction, smokers, and pregnant patients were excluded from the study. Each participant underwent thyroid uptake scintigraphy twice (pre- and post-RA consumption) using 35–37 MBq NaI-131. Participants consumed RA at a dose of 1 mg/kg body weight (BW) followed with 1.5 mg/kg BW. This study was approved by Dr. Hasan Sadikin General Hospital Ethic Committee. A total of 12 cold thyroid solid nodules were evaluated. The mean percentage of the nodule uptake value pre- and post-intervention was 1.11% and 0.62%, respectively (P = 0.004), while normal thyroid tissue uptake values pre- and post-intervention were 27.57% and 13.40%, respectively (P = 0.002). The percentage alteration of nodules and normal thyroid tissue uptake value were 42.4% and 51.5% lower, respectively (P = 0.354). This study showed that RA reduces the ability of cold solid thyroid nodule, as well as normal thyroid tissue, to take up RAI.
Vas deferens infiltration by prostate cancer on prostate-specific membrane antigen-targeted 18F-DCFPyL positron emission tomography/computed tomography: A unique visual pattern
Authors: Yin Yafu , Paller Channing J. , Pomper Martin G. , Pienta Kenneth J. , Gorin Michael A. , Rowe Steven P.
Published: April 2019

New radiotracers for positron emission tomography imaging that target prostate-specific membrane antigen (PSMA) have emerged as important clinical tools for imaging prostate cancer (PCa). PSMA-targeted radiotracers have demonstrated high sensitivity and high specificity for detecting sites of PCa and are demonstrably superior to conventional imaging modalities such as computed tomography and bone scan. Vas deferens invasion is a rarely encountered poor prognostic feature of PCa. In this case report, we describe a novel pattern of radiotracer uptake in a patient with PCa imaged with PSMA-targeted 18F-DCFPyL positron emission tomography/computed tomography that is consistent with diffuse vas deferens involvement.
Assessing oral glucose and intravenous insulin loading protocol in 18F-fluorodeoxyglucose positron emission tomography cardiac viability studies
Authors: Sarikaya Ismet , Sharma Prem N. , Sarikaya Ali , Elgazzar Abdelhamid H.
Published: April 2019

Oral glucose and intravenous insulin (G/I) loading protocols are commonly used in 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) cardiac viability studies. Although the amount of insulin to be given per blood glucose range has been well described in guidelines, the amount of glucose to be given is not detailed well. In this retrospective study, we aimed to assess if certain parameters, particularly the amount of glucose and insulin given, may affect 18F-FDG uptake in the hibernating myocardium and also determine the problems with this protocol. 18F-FDG PET cardiac viability study with G/I loading protocols was performed in 49 patients. Fasting blood glucose (FBG), amount of glucose given, blood glucose level after glucose load, amount of insulin given, and blood glucose level at the time of 18F-FDG injection were recorded. Statistical analysis was performed to determine if there is any difference in the above values in PET viable and PET nonviable groups and also in subgroups assessing 18F-FDG uptake also in normal myocardium. For G/I loading, we used our local protocol in 43 patients, and other protocols in six. 18F-FDG PET showed viability in 31 patients, and it was negative for viability in 18. In 22 patients, mainly in PET viable group, there was varying degree of reduced 18F-FDG uptake in normal myocardium. There was no significant difference in FBG, amount of glucose given, blood glucose level after glucose load, amount of insulin given, and blood glucose level at the time of 18F-FDG injection in PET viable and PET nonviable groups and also in subgroups. The problems with G/I loading protocol included deciding on the amounts of glucose and insulin given, maximum amount of insulin to be given, handling diabetics, optimal time to measure blood glucose after insulin administration, and interpretation of findings in cases with diffusely reduced 18F-FDG uptake. Further improvements in current guidelines are necessary to obtain images in optimal conditions for accurate results.
Implications of fluorodeoxyglucose uptake in low-intermediate grade metastatic neuroendocrine tumors from peptide receptor radionuclide therapy outcome viewpoint: A semi-quantitative standardized uptake value-based analysis
Authors: Adnan Aadil , Sampathirao Nikita , Basu Sandip
Published: April 2019

Dual tracer positron emission tomography (PET) imaging approach (with 68Ga-DOTATATE PET-computed tomography (CT) for somatostatin receptor and 18-fluorodeoxyglucose (18FDG) PET-CT for glucose transporter receptor) plays a vital role in baseline differentiation, treatment decision-making, and prognostic assessment of neuroendocrine tumors (NETs). The aims of this study were to observe and compare the clinical behavior of low-/intermediate-grade NETs depending on their baseline FDG metabolism (calculated through pre-peptide receptor radionuclide therapy [PRRT] FDG standardized uptake value [SUV]) and to determine its prognostic importance in predicting extent of therapeutic response (post-PRRT) in terms of symptomatic, biochemical, and scan parameters along with the long-term impact on progression-free survival (PFS) and overall survival (OS). Fifty-nine patients with low (≤2%) and intermediate (3–20% Mib-1/Ki-67 index) grade metastatic NET were selected for this retrospective analysis and divided into three groups: Group 1 consisted of patients having low-grade FDG uptake at baseline, predefined as SUVmax< 5 (n = 13); Group 2 consisted of those having intermediate-grade FDG uptake at baseline, SUVmax5–10 (n = 34), and Group 3 consisted of patients having high-grade FDG uptake at baseline, defined as SUVmax>10 (n = 12). The trend of FDG avidity was studied from the baseline till the time of analysis and the overall outcomes were compared in terms of symptomatic response (Karnofsky and ECOG performance score), biochemical response, scan response (anatomical and metabolic, RECIST 1.1 and PERCIST 1.0), PFS and OS. Patients in Groups 1 and 2 showed highest proportion of symptomatic complete response, biochemical partial response, and stable disease on scan. These patients also demonstrated better PFS and OS and lowest hazard ratio compared to patients in the Group 3. An important finding was a substantial fraction of the complete metabolic responders (CMRs) across the groups, achieved CMR within first 2 cycles of PRRT (85% of Group 1, 51% of Group 2, and 47% of Group 3). In conclusion, most of the patients of low-/intermediate-grade NET having low-to-moderate baseline tumor FDG metabolism (SUVmax≤10) showed favorable symptomatic response with good biochemical and anatomical disease control and were associated with prolonged PFS and OS, compared to that of those having high-grade baseline tumor FDG metabolism (SUVmax> 10).
B – Flow assessment of femoral artery as predictor of coronary artery disease in patients evaluated for chest pain by radionuclide myocardial perfusion scintigraphy
Authors: Avramovski Petar , Avramovska Maja , Servini Zaklina , Nikleski Zorica , Veljanovska Keti , Mihajlova Snezana , Sotiroski Kosta , Sikole Aleksandar
Published: April 2019

In the evaluation of patients with suspected coronary artery disease (CAD), the presence of the superficial femoral artery (SFA) plaque is more informative than a carotid plaque and at least as informative as coronary plaque in the identification of coronary death individuals. In 60 patients with chest pain with a normal electrocardiogram, B-flow ultrasound estimation of SFA plaque and radionuclide myocardial perfusion scintigraphy (MPS) estimation for CAD was performed. We found significant positive correlations between age and SFA plaque score (PS) (P = 0.0084), myocardial ischemia in rest and SFA PS (P < 0.0001), and between transient ischemic dilation (TID) and SFA PS (P = 0.0069), too. The TID correlates only with myocardial ischemia in rest (P = 0.0022) and SFA PS (P = 0.0069). The results we got by the receiver operating characteristics (ROC) curve analysis with TID/without TID were the area under curve (0.704, P = 0.0038). The multiple regression analysis showed standardized coefficient β coefficients for SFA PS and TID (3.4577 and 1.9903, P < 0.001 and P = 0.0021), respectively. By proven correlative relationship of SFA atherosclerotic plaques and CAD, we can use B-flow as a screening method for triage of patients with chest pain before being sent to the assessment of coronary circulation with radionuclide MPS.
Detection efficiency of 18F-flourodeoxyglucose positron emission tomography/computed tomography for primary tumors in patients with carcinoma of unknown primary
Authors: Fatima Nosheen , Zaman Maseeh Uz , Zaman Areeba , Zaman Unaiza , Zaman Sidra , Tahseen Rabia
Published: April 2019

Carcinoma of unknown primary (CUP) is defined as biopsy proven tumor metastases that remains unidentified after a thorough diagnostic evaluation. The purpose of this study was to find the detection efficiency of 18F-flourodeoxyglucose positron emission tomography/computed tomography (18FDG PET/CT) in patients with CUP. This prospective study was conducted at PET/CT Section of Department of Radiology, Aga Khan University Hospital Karachi, Pakistan from August 2017 to January 2018. Patients with a history of CUP referred for 18FDG PET/CT scan for detection of primary sites during the study were recruited. 18FDG PET/CT scan was acquired using standardized protocol, and patients with suspected primary sites underwent biopsies. Scan findings and biopsy results were analyzed to find the detection rate, sensitivity, area under curve (AUC), and positive predictive value (PPV). As no biopsy was performed in negative scan, true negative, and specificity could not be calculated. During the study, 46 consecutive patients with CUP were included. Mean age of cohort was 58 ± 17 years (63% male and 37% female) having a mean body mass index of 24.70 ± 4.97 kg/m2. Thirty-four patients (34/46) found to have a hypermetabolic focus suggestive of the primary tumor with known metastatic sites and subjected to biopsy which turned out to be positive in 26/34 patients (true positive). The primary tumor was detected in gastrointestinal and hepatobiliary in 8 (17%), head and neck in 6 (13%), genitourinary 4 (09%), lung 3 (06%), and miscellaneous sites in 5 (11%) patients. Detection rate, sensitivity and PPV of 18FDG PET/CT were 57%, 68%, and 76%, respectively. Remaining 12/46 patients with negative 18FDG PET/CT for primary focus did not have biopsy. Receiver operating character curve revealed fair diagnostic strength of 18FDG PET/CT for detecting unknown primary (AUC 0.667; P = 0.054; standard error = 0.083; confidence interval: 0.504–0.830). We conclude that 18FDG PET/CT is an effective tool for detecting primary tumor in patients with CUP and its upfront use could preclude the use of many futile diagnostic procedures. Furthermore, higher resolution scanners and acquiring delayed images in patients with negative study could reduce false-negative results in patients with CUP.
Design and Implementation of a Wireless Sensor Network for Agricultural Applications
Authors: John Jobish , S. Kasbekar Gaurav , K. Sharma Dinesh , Ramulu V. , Shojaei Baghini Maryam
Published: April 2019

We present the design and implementation of a shortest path tree based, energy eﬃcient data collection wireless sensor network to sense various parameters in an agricultural farm using in-house developed low cost sensors. Nodes follow a synchronized, periodic sleep-wake up schedule to maximize the lifetime of the network. The implemented network consists of 24 sensor nodes in a 3 acre maize farm and its performance is captured by 7 snooper nodes for diﬀerent data collection intervals: 10 minutes,1 hour and 3 hours. The almost static nature of wireless links in the farm motivated us to use the same tree for a long data collection period (3 days). The imbalance in energy consumption across nodes is observed to be very small and the network architecture uses easy-to-implement protocols to perform diﬀerent network activities including handling of node failures. We present the results and analysis of extensive tests conducted on our implementation, which provide signiﬁcant insights.
Neonatal Sepsis Epidemiology in a Rural Province in Southeastern Cambodia, 2015–2017
Authors: Labuda Sarah M. , Te Vantha , Var Chivorn , Iv Ek Navapol , Seang Sosorphea , Bazzano Alessandra N. , Oberhelman Richard A.
Published: April 2019

Neonatal sepsis is the second most prevalent cause of neonatal deaths in low- and middle-income countries, and many countries lack epidemiologic data on the local causes of neonatal sepsis. During April 2015–November 2016, we prospectively collected 128 blood cultures from neonates admitted with clinical sepsis to the provincial hospital in Takeo, Cambodia, to describe the local epidemiology. Two percent (n = 3) of positive blood cultures identified were Gram-negative bacilli (GNB) and were presumed pathogens, whereas 10% (n = 13) of positive blood cultures identified were likely contaminants, consistent with findings in other published studies. No group B Streptococcus was identified in any positive cultures. The presence of GNB as the primary pathogens could help influence local treatment guidelines.
Daily Variations in the Expression of Genes Related to Insecticide Resistance in the Chagas Disease Vector Triatoma infestans (Hemiptera: Reduviidae)
Authors: Varela Gonzalo M. , Stroppa María M. , García Beatriz A.
Published: April 2019

Pyrethroid resistance has been detected in Triatoma infestans, which in part has been attributed to increased oxidative metabolism of the insecticide by cytochrome P450s. Nicotinamide adenine dinucleotide phosphate (NADPH) cytochrome P450 reductase (CPR) catalyzes electron transfer from NADPH to all known cytochrome P450s. In this study, the expression of the CPR gene at transcriptional level was determined in different tissues and two life stages. The expression patterns showed differences in the tissues and stages studied, suggesting differential metabolic requirements. On the other hand, to investigate the presence of rhythms in the expression of genes related with insecticide resistance, we explored the daily expression profile of the CPR gene and a P450 gene (CYP4EM7) in fat body from adults of T. infestans under different dark/light regimes. The results suggest that CPR gene expression is under endogenous clock regulation and show a rhythmic profile in the expression of the CYP4EM7 gene.
A influência do board interlocks na prática da divulgação voluntária em empresas brasileiras
Authors: Ribeiro Flávio , Consoni Silvia , Colauto Romualdo Douglas
Published: April 2019

O estudo investiga a influência da estrutura de formação do board interlocks na divulgação voluntária de empresas de capital aberto no Brasil. Utiliza-se a abordagem de análise de redes sociais para captar e avaliar o nível de relacionamento existente entre empresas em função dos laços formados por membros do conselho de administração. Duas hipóteses exploram as medidas de (i) centralidade de grau (degree centrality) e de (ii) centralidade de intermediação (betweenness centrality), as quais têm potencial de descrever o posicionamento dos atores em uma rede. A terceira hipótese endereça a questão da qualidade dos laços (holes). Os resultados sugerem que a estrutura de formação do board interlocks aumenta a propensão de as empresas reportarem informações de natureza voluntária em seus relatórios anuais. Interpreta-se, por isso, que o board interlocks atua como um fator que favorece a disseminação de práticas de divulgação voluntária.
Relações entre Corrupção Percebida e Transparência Orçamentária: um estudo com abordagem cross-national
Authors: Reis Anderson De Oliveira , Almeida Fernanda Maria de , Ferreira Marco Aurélio Marques
Published: April 2019

A corrupção causa efeitos permissivos como a corrosão de receitas e ineficiência na alocação de recursos. O presente estudo objetiva verificar com qual intensidade a transparência orçamentária, fatores sociais, econômicos, políticos-institucionais e acesso a tecnologias da informação podem explicar o nível percebido de corrupção em uma amostra de 82 países. Os resultados apontam que a transparência orçamentária, a qualidade da estrutura de governança, os gastos com saúde e a receita pública tem efeitos positivos sobre a redução na corrupção percebida. Já nível de despesa pública possui efeito contrário, o que demonstra que quanto maior seu valor, maior o nível de corrupção. Em síntese, pode-se concluir que, a redução do nível de corrupção depende de avanços no controle social e na construção de mecanismos de accountability que deve ser realizado por meio do aumento da transparência e melhorias na estrutura de governança na administração pública. Artigo apresentado no EnANPAD 2017
A Utilização do múltiplo EV/EBITDA na precificação de IPO’s no mercado brasileiro
Authors: Orlovas Anatoli Dias , Serra Ricardo Goulart , Carrete Liliam Sanchez
Published: April 2019

Este artigo verificou se o múltiplo EV/EBITDA de empresas comparáveis (pertencentes ao mesmo setor) são bons parâmetros para precificar os IPO’s (initial public offering). Foram 116 IPO’s no mercado brasileiro, entre 2004 e 2014. Após as exclusões (empresas financeiras, empresas com falta de informações ou informações negativas e outliers), foram analisados 36 IPO’s. Além dos múltiplos das empresas comparáveis, utilizou-se como variáveis explicativas: dummy de ano e variáveis ligadas aos drivers de valor (rentabilidade, alavancagem e tamanho). Os resultados indicam que o múltiplo de empresas comparáveis é relevante para precificar as empresas no momento do IPO, sendo que os modelos com a média e com a mediana obtiveram melhores coeficiente de ajuste (R2). Nenhum dos drivers de valor mostrou-se significativo. A dummy de ano foi significativa apenas para um modelo. Os modelos com a classificação setorial NAICS apresentaram ajustes melhores do que os modelos com a classificação da Economatica®.
Determinantes da perda do prazo de divulgação dos relatórios financeiros das companhias brasileiras de capital aberto
Authors: Souza Paulo Vitor Souza de , Silva Alexandre Gleyson Araújo da , Macedo Marcelo Alvaro Da Silva
Published: April 2019

Este artigo teve como objetivo verificar quais fatores determinam a perda do prazo de divulgação dos relatórios financeiros de companhias abertas no Brasil. Foram utilizadas 152 empresas no estudo, sendo 76 que perderam o prazo de divulgação dos seus relatórios financeiros em pelo menos um exercício no período de 2010 a 2016 e outras 76 que não perderam o prazo nesse mesmo período. Foram testados tamanho, tipo de auditor, endividamento e prejuízo no exercício como fatores determinantes da perda do prazo, por meio da aplicação de regressão logística, atribuindo-se 1 às empresas que perderam o prazo e 0 caso contrário, em cada ano. Os resultados apontam, em relação a probabilidade de perder o prazo de divulgação dos relatórios financeiros, que empresas auditadas por Big Four têm menor probabilidade; empresas endividadas têm maior probabilidade; e empresas com prejuízo no exercício têm maior probabilidade. A variável tamanho não teve resultado estatístico significativo.
The association of quantitative insulin sensitivity indices (HOMA-IR and QUICKI) with anthropometric and cardiometabolic indicators in adolescents
Authors: Mirzaalian Yaser , Nourian Mozhgan , Gholamalizadeh Maryam , Doaei Saeid , Hatami Mahshid , Hassanzadeh Akbar , Askari Gholamreza , Farahi Raheleh
Published: April 2019

Introduction

Homoeostasis model assessment (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI) are used to evaluate insulin resistance. The aim of this study was to investigate the association between quantitative insulin sensitivity indices and anthropometric and cardiometabolic indicators in adolescents.

Material and methods

This descriptive-analytic cross-sectional study was conducted on 80 adolescents aged 12 to 13 years in Isfahan, Iran. Anthropometric, cardiometabolic and QUICKI and HOMA-IR indicators were measured. In the results analysis, Pearson correlation coefficient and regression analysis were used.

Results

There was a significant positive correlation between most of the anthropometric indicators and the HOMA-IR index and a significant negative correlation with QUICKI (all p < 0.0001). Moreover, serum triglyceride level had a significant negative correlation with QUICKI index (R = –0.33, p = 0.002) and systolic blood pressure (R = 0.44, p < 0.0001), and triglyceride level (R = 0.66, p < 0.0001) had a significant positive correlation with HOMA index. The results of these two indices were highly correlated in most of the anthropometric and biochemical indices, except for the waist circumference to the neck circumference ratio and systolic blood pressure, which had a significant positive association with HOMA-IR, but did not show a significant association with QUICKI index.

Conclusions

A significant correlation between anthropometric and cardiometabolic indicators with insulin resistance indices (HOMA-IR and QUICKI) was found. Moreover, the results of these two indices were highly correlated in most of the anthropometric and biochemical indices, except for the waist circumference to the neck circumference ratio and systolic blood pressure.
Assessment of quality of life and anxiety in heart failure outpatients
Authors: Polikandrioti Maria , Panoutsopoulos Georgios , Tsami Athanasia , Gerogianni Georgia , Saroglou Sofia , Thomai Efthalia , Leventzonis Ioannis
Published: April 2019

Introduction

Heart failure (HF) is a chronic disease associated with increased morbidity and mortality. HF prevalence is expected to expand enormously, largely due to population ageing, rising incidence of HF risk factors and increased survival after cardiovascular events. The aim of the study was to assess levels of quality of life (QOL) and anxiety in HF outpatients and the associated factors as well as to explore the impact of anxiety on QOL.

Material and methods

One hundred HF outpatients were enrolled in the study. Data collection was performed by completion of the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the Self-rating Anxiety Scale (SAS) and a questionnaire including patients’ characteristics.

Results

Of the 100 HF outpatients, 64% were men and 66% above 70 years old. Regarding QOL, at least 50% of patients scored above 68 (median) in the total score of MLHFQ and in terms of anxiety, 50% scored above 46 (median) in the SAS. These values indicate a large impact of HF on QOL and a moderate impact of HF on anxiety. Furthermore, a statistically significant correlation was observed between QOL and anxiety in HF outpatients (rho
> 0.6, p < 0.001). An increase in anxiety score by one unit implies a statistically significant increase in QOL by 1.22 points (95% CI: 0.91–1.52, p < 0.001), after adjustment for potential confounders.

Conclusions

The present findings emphasize the importance of alleviating the emotional burden of anxiety, thus improving patients’ QOL.
T wave positivity in lead aVR is associated with mortality after transcatheter aortic valve implantation
Authors: Dönmez Yurdaer , Urgun Örsan Deniz , Halil Kurt İbrahim
Published: April 2019

Introduction

Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (SAVR) in patients with increased comorbidity. Lead aVR in surface ECG has valuable information about prediction of mortality in many cardiovascular diseases. Our aim was to determine the relationship between ischemic changes in lead aVR and mortality in TAVI patients.

Material and methods

We retrospectively examined 86 patients with TAVI. The ST segment deviation in lead aVR (STaVR) and T wave polarity (TPaVR) on surface ECG were measured. The absolute values of TPaVR and STaVR were calculated. A ratio (TP/STaVR or vice versa) was obtained from the division of the larger absolute value by the smaller one.

Results

The patients were divided into two groups as living and deceased. The living group had 68 patients, and the deceased group had 18 patients. The number of positive TPaVR patients after TAVI, TPaVR after TAVI, and TP/STaVR ratio after TAVI were significantly higher in the deceased group. The deceased group had a significantly shorter aortic annulus-LMCA distance. Presence of positive TPaVR (OR = 8.765, 95% CI: 1.088–70.618, p = 0.041), aortic annulus-LMCA distance (for each 1 mm increase, OR = 0.306, 95% CI: 0.158–0.595, p < 0.001) and TP/STaVR ratio (for each 0.1 increase, OR = 1.966, 95% CI: 1.276–3.024, p = 0.002) were determined as independent predictors for mortality.

Conclusions

Ischemic changes in lead aVR may provide valuable information about mortality after TAVI.