bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunolocalization and Quantitation of Transforming Growth Factor Alpha in Hydatidiform Mole
Authors: Molykutty John , Schultz Gregory , Rajalekshmy T. Nellika , Enose Swapna , Nair M. Krishnan , Balaram Prabha
Published: April 2018

Complete hydatidiform mole (CHM), a condition related to abnormal gestation, occurs predominantly in the young reproductive age group and has a high prevalence rate in the Trivandrum region, occurring in 1.2% of deliveries. Transforming growth factor alpha (TGF-α) is an important growth regulatory molecule, the location and function of which at the human fetomaternal interface in CHM remains to be determined. The present study examined the presence of TGF-α in the normal and complete molar placenta and decidua throughout gestation. A total of 149 complete molar placental tissue samples and 96 normal placental tissue samples were evaluated for TGF-α expression by immunohistochemistry and 50 each of CHM and normal placental tissue for TGF-α concentration by radioimmunoassay. The peptide was localized immunocytochemically with a monoclonal anti-TGF-α antibody on paraffin-embedded tissue using the avidin-biotin complex peroxidase technique with aminoethyl carbazole as the chromogen. In molar placenta, villous trophoblast cells (syncytiotrophoblasts and cytotrophoblasts) showed intense cytoplasmic staining at all gestational ages compared to normal placenta of the same gestational age. The tissue concentration of TGF-α was highly overexpressed in the molar placenta (10-1000 fold) compared to that in the normal placenta. The results indicate that TGF-α is present in trophoblasts throughout human gestation and may provide additional growth advantage to maintenance of the hyperproliterative condition in trophoblastic tumors.
Benign Granular Cell Tumor of the Breast: A Misleading Disease
Authors: Ventura Luca , Guadagni Stefano , Ventura Terenzio , Di Silvestre Katia , Coletti Gino , Leocata Pietro
Published: April 2018

Granular cell tumor (GCT) is a relatively rare neoplasm, and almost always benign in its prognostic behavior. Location of this tumor in the breast presents serious problems for differential diagnosis, both from a clinical point of view and at gross pathological examination, because of its resemblance to carcinoma. Fine needle aspiration biopsy and intraoperative frozen section examination may not be of any further help. The histogenesis of these lesions has been widely debated in the past, but no universally accepted conclusion has been reached. Most GCTs appear to be derived from Schwann cells, but many different neoplastic and non-neoplastic lesions show granular cell changes. Therefore, GCT should not be considered as a single entity but as the result of a cytoplasmic change due to still unknown metabolic alterations that may occur in various cell types. No firm conclusions can be drawn regarding the suspected hormonal influence on the development of breast GCT.

The authors describe three typical cases of breast GCT that occurred in patients of different ages, and discuss the most important questions concerning this lesion.
Integrated Treatment with Doxifluridine and Radiotherapy in Recurrent or Primary Unresectable Rectal Cancer. A Feasibility Study
Authors: Di Bartolomeo Maria , Bajetta Emilio , Buzzoni Roberto , Bozzetti Federico , Artale Salvatore , Valvo Francesca
Published: April 2018

Aims and Background

When combined with radiotherapy, fluoropyrimidines have been shown to have synergistic effects on various tumor types. Doxifluridine (5-dFUR) is a 5-fluorouracil (5-FU) prodrug that is transformed into 5-FU in neoplastic tissue, which suggests that it may improve the activity of radiotherapy. The aims of this study were to evaluate the feasibility and efficacy of the combination of radiotherapy and oral 5-dFUR plus I-leucovorin in terms of pathologically complete remissions in locally advanced rectal cancer.

Methods

Eleven patients with locally recurrent (n = 7) or primary unresectable rectal cancer (n = 4) were treated with three cycles of oral I-leucovorin 25 mg/dose followed by 5-dFUR 750 mg/m2 twice daily for four days every 12, in combination with pelvic radiation at a standard dose of 45 Gy over five weeks. The tumor burden was assessed by means of CT and endoscopic ultrasound at baseline and at least four weeks after the end of the treatment and before surgery.

Results

Four patients achieved an objective response, 6 disease stabilization and 1 had progressive disease. After a median time of five weeks from the end of treatment 8 patients underwent radical resection and a pathologically complete remission was documented in 2. Seven of these patients are still alive and disease free after a median follow-up of 18 months. The major side effects were grade 3 diarrhea in one case, and grade 1-2 nausea and vomiting in three cases. No significant hematological toxicity was observed.

Conclusions

This combination of radiation and 5-dFUR plus I-leucovorin led to an interesting rate of resectability, with pathological downstaging being documented in two cases. These preliminary results show an encouraging local control of an otherwise unresectable disease. Combined preoperative therapy with oral fluoropyrimidine plus I-leucovorin together with radiation may be an attractive approach in patients with operable rectal cancer.
Increasing dose of Continuous Infusion Ifosfamide and Fixed dose of Bolus Epirubicin in Soft Tissue Sarcomas. A Study of the Italian Group on Rare Tumors
Authors: Frustaci Sergio , Buonadonna Angela , Romanini Antonella , Cornandone Alessandro , Palma Maurizio Dalla , Gamucci Teresa , Verusio Claudio , Lionetto Rita , Dani Carla , Casali Paolo , Santoro Armando
Published: April 2018

Purpose

To evaluate the maximum tolerated doses (MTD) of ifosfamide when given as a continuous infusion and in combination with fixed doses of bolus 4′-epidoxorubicin in advanced previously untreated adult soft tissue sarcoma patients.

Methods

Treatment consisted of epidoxorubicin, 60 mg/m2 days one and two, and ifosfamide, 1.5 g/m2 every 12 hrs as a 72-hr infusion, at the first level. Further levels of ifosfamide were defined as increments of 12 hrs of the same infusion program. G-CSF 300 μg/die was administered from days +7 to +14. Dose-limiting toxicity (DLT) was defined as: G4 leukopenia or thrombocytopenia of ≥5 days; any G3 neuro or nephrotoxicity; G4 toxicity of any kind. Patients had to complete at least 2 consecutive cycles, and MTD was defined as the level in which 20% of patients developed a DLT; 10-15 patients were entered in each level.

Results

First level: overall, 13 patients entered, 3 were not assessable for MTD, and only one developed a DLT. Second level: 18 patients entered, 3 were not assessable for MTD. Hematologic DLT was observed in 3/15 assessable patients. Therefore, the MTD was found at the ifosfamide level of 10.5 g/m2 given in 84 hrs. Eight patients of 29 assessable for response achieved an objective response: 1 complete and 7 partial. The overall response rate was 28% (95% CI: 13-47%).

Conclusions

If we accept 4-day G4 leukopenia as a reliable cutoff for safety, ifosfamide intensification cannot be substantially exploited over already available schedules with the combination of ifosfamide and anthracyclines.
Management of Malignant Mucinous Adenomas
Authors: Spinelli Pasquale , Schicchi Angelo Aldo , Rigante Antonella , Calarco Giuseppe
Published: April 2018

Background

Malignant polyps are defined as adenoma with cancerous tissue penetrating into or through the muscolaris mucosae in the submucosa, and endoscopic removal is the most common treatment for such polyps. In the presence of malignant mucinous adenoma, defined as a malignant adenoma in which a significant amount of mucus is present in the stroma, the therapeutic approach is controversial and authors have performed surgical resection in all cases. The purpose of the study was to demonstrate that malignant mucinous adenoma is not a condition suggesting by itself a bowel resection.

Methods

Ten patients with malignant mucinous adenoma were enrolled in the study: endoscopic treatment alone was performed in 4 cases, and polypectomy was followed by surgical resection in 6 cases.

Results

At a median follow-up of 74.2 months no distant metastases had occurred in any of the patients treated with endoscopic polypectomy alone; during the follow-up, 1 patient had a local recurrence and surgical resection was performed. Only one case of residual disease was found at histology among the patients in which endoscopic polypectomy was followed by surgical resection. No complications occurred after endoscopic treatment in any case.

Conclusions

In the absence of unfavorable histologic parameters, malignant mucinous adenomas should be managed with the same criteria of other malignant adenomas, and endoscopic polypectomy is considered as a safe and effective treatment when radicality criteria are fulfilled.
Fludarabine Phosphate as an Active and Well Tolerated Salvage Therapy in an Elderly Heavily Pretreated Hodgkin's Disease Patient: A Case Report
Authors: Bordonaro Roberto , Ferraù Francesco , Giuffrida Dario , Cali Stefania , Priolo Domenico , Colina Paolo , Ursino Maria , Failla Giuseppe
Published: April 2018

Up to two thirds of all patients affected by advanced Hodgkin's disease will be cured by chemotherapy alone or by combined chemoradiation modalities. High-dose chemotherapy with autologous stem cell rescue may be potentially curative for patients progressing under frontline chemotherapy or developing early relapse of disease. In spite of this, an unacceptably high percentage of these highrisk patients will relapse after salvage treatments and die of their disease. Fludarabine phosphate is an adenosine nucleoside analog highly active in chronic lymphocytic leukemia and low-grade non-Hodgkin's lymphomas. There are only few data in the literature concerning its use in the management of Hodgkin's disease. We report the case of an elderly, heavily pretreated Hodgkin's disease patient in progression under third-line chemotherapy who experienced good palliation of her B symptoms and a major clinical response of her refractory bone lesions with the administration of fludarabine as monotherapy. The treatment was well tolerated, without grade 4 hematological toxicity or opportunistic infections. The duration of clinical remission and systemic symptom palliation was 9 and 11 months, respectively. Further evaluation of fludarabine phosphate as salvage therapy in relapsed/refractory elderly Hodgkin's disease patients is needed.
Correcting the Completeness BIAS of Observed Prevalence
Authors: Corazziari Isabella , Mariotto Angela , Capocaccia Riccardo
Published: April 2018

Aims and Background

The cancer prevalence in given areas can be estimated on the basis of data supplied by cancer registries. As the obtained estimate of prevalence depends on the length of the cancer registry's observation period, it is generally lower than the total prevalence in the considered area. In the present work we propose a method to calculate a correction factor of this bias in order to obtain an approximation to the total prevalence.

Methods & Study Design

The method is based on the relationship between relative survival and incidence by age for a specific cancer site.

Results and Conclusions

We provide values of the correction factor, the completeness index R, relative to the most important cancer sites, for specific ages and periods of observation of the cancer registries in Italy. In addition, we provide indications for extended use of the index when substantial variations from the basic pattern of relative survival are observed in practical situations. Furthermore, we give helpful suggestions to obtain approximate values of the correction factor to be used for ages and periods of observation that are intermediate between the ones presented in this paper.
Cancer Prevalence in Italian Regions with Local Cancer Registries
Authors: Mariotto Angela , Dally Leonard G. , Micheli Andrea , Canario Francesca , Verdecchia Arduino
Published: April 2018

Objective

To provide estimates and projections of cancer incidence and prevalence for those Italian regions whose population is partially covered by a cancer registry (CR) and to determine to what extent local CRs can be considered representative of the region, thus improving the potential of the information provided by CRs.

Methods

A statistical method, MIAMOD (mortality-incidence analysis model), was used to estimate regional cancer incidence and prevalence from regional cancer mortality data and patient survival data recorded by the cancer registries. Estimates of the cancer incidence and prevalence in the various regions have thus been obtained for a number of major cancer sites. A first and important step in validating the regional estimates has been the comparison of the MIAMOD estimates in the areas covered by the cancer registries with empirical incidence and prevalence observed by CRs, in order to assess the consistency in data, methods and assumptions. Empirical prevalence has been calculated by counting patients with a diagnosis of cancer who were alive on the reference date by PREVAL method. A correction factor has been applied to include patients diagnosed before the period of activity of the registry.

Results

General consistency was found between empirical and estimated (by MIAMOD) incidence and prevalence in the registry areas, which is indicative of the quality and the completeness of all data involved as well as the appropriateness of model choices. The prevalence of all cancers combined for Italian regions with CRs was estimated and projected to the year 2000 as ranging between 1,240 per 100,000 in Sicilia and 2,781 in Emilia-Romagna for men, while for women these figures were 1,765 in Sicilia and 4,019 in Liguria. Comparison of cancer prevalence in CR areas with regional estimates shows quite good consistency for Piemonte, Liguria and Lombardia, which means that the local CRs (of Torino, Genova and Varese, respectively) are representative of their respective regions. Prevalence in Emilia-Romagna appears to be rather well represented by only one, the Parma CR, of the three local CRs. The southern Italian registries of Latina and Ragusa recorded a lower cancer prevalence than was actually estimated in their respective regions.

Discussion

Cancer registries with a longer period of activity showed better agreement between empirical and estimated figures due to the more precise information provided, particularly regarding survival and incidence trends. In conclusion, this work shows the potential of the cancer registries not only to represent their population with respect to cancer morbidity but also as an invaluable tool to extrapolate this information to the larger areas they represent.
The Role of Cancer Registration for Programming Health Services
Authors: Buiatti Eva , Barchielli Alessandro
Published: April 2018

The Italian National Health Plan 1998-2000 indicates quantitative and qualitative goals in the fight against cancer. This approach stresses the need of reliable and updated descriptive data to evaluate, at a population level, the burden of neoplastic disease, the results of primary and secondary preventive actions, and the efforts towards a more equal distribution of diagnostic and therapeutic services.

The aims of this paper is to evaluate the use of descriptive data to quantify the burden of neoplastic disease, using the data provided by the network of Italian cancer registries (the most reliable source of information on neoplastic disease in Italy). Crude rates are the most adequate for describing the “burden” of cancer patients who are expected in a certain period and will need specific diagnostic or therapeutic activities. Incidence, prevalence and mortality rates provide information on different phenomena (i.e., patients requiring diagnostic and therapeutic activities related with the first definition and treatment of the disease; patients requiring periodic follow-up or treatment of disease relapse; need palliative care). The use of these measures combined is highly informative in relation with the different objectives of health planners (i.e., patients requiring diagnostic and therapeutic activities related with the first definition and treatment of the disease; patients requiring periodic follow-up or treatment of disease relapse; need palliative care).
Risk of Basal and Squamous Cell Carcinomas of the Skin in Sion, Switzerland: A Case-control Study
Authors: Rosso Stefano , Joris François , Zanetti Roberto
Published: April 2018

Aims and Background

Non-melanocytic skin cancers are the most common cancers in white populations. Studies on populations of Anglo-Saxon and Mediterranean origins highlighted different patterns of risk of basal-cell carcinoma and squamous-cell carcinoma in relation to sunlight exposure, skin characteristics and phenotype susceptibility. In Sion, and in Switzerland as a whole, the high incidence suggests the possible presence of additional risk factors or of a different pattern of exposure to solar radiation as well as different composition of pigmentary traits and skin sensitivity to sun.

Methods and Study Design

We conducted a case-control study of 146 cases (73% of eligible cases) and 144 controls (81% of eligible subjects) to further evaluate the relationship between nonmelanocytic skin cancer and risk factors in the Sion population. Interviews were conducted by trained interviewers with a standardized questionnaire.

Results

Pigmentary characteristics such as blonde and red hair as well as tendency to sunburn without tanning and number of sunburns showed a statistically significant and independent risk increase in basal-cell carcinoma. Sun exposure during recreational activities (outdoor sports) showed a risk increase in basal-cell carcinoma with borderline statistical significance. Analysis of squamous-cell carcinoma risk was limited by the small number of cases, but it was positively associated with lifetime exposure to sun during outdoor work and with skin characteristics.

Conclusions

Results confirmed previous suggestions of a different mechanism leading to malignant transformation of target cells from the basal and squamous epidermal layers, mediated by different phenotypes, and conditioning the ability to develop an effectively protective tan.
A Computerized Database for Head and Neck Cancer Registry
Authors: Benazzo Marco , Lanza Laura , Mullace Mauro , Tinelli Carmine , Castelnuovo Paolo , Mira Eugenio
Published: April 2018

Aims

Over the last years, the management of patients with head and neck cancer has become extremely complex, and the knowledge and information needed to care for a patient can no longer be trusted to the memory or manual systems. Recent advances in data processing technology offer the potential for creating ideal instruments to organize, store and analyze such information.

Methods

We developed a computerized database management system (H&N-CDMS) which fulfils the following requisites: easy to use even by operators not expert in informatics; minimum possibility of insertion of ambiguous data; use for clinical and research purposes; can be interconnected in a network of similar database operating in other centers; can be expanded to image processing.

Conclusions

The configuration of the system is described and its main characteristics are discussed: data entry and coding facilities, data accuracy and standardization, security and anonymity, data retrieval and analysis. H&H-CDMS is a user-friendly tool for head and neck cancer data management in clinical and research environments.
The Concentrations of Five Tumor Markers in Both Bal Fractions in Lung Cancer Patients in Relation to Cigarette Smoking
Authors: Prados M Concepción , Álvarez-Sala Rodolfo , De Terreros Caro F. Javier Gómez , Gómez Luis , De Terreros F. Javier Gómez , Villamor José
Published: April 2018

Background

Lung cancer is the leading cause of death from cancer. Tobacco is related to the development of this type of tumor due to genetic alterations and to the secretion of certain biological markers. Bronchogenic carcinomas secrete a series of biological substances known as tumor markers. Some of these markers, such as carcinoembryonic antigen, neuron-specific enolase, tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and CYFRA 21.1, possess clear clinical value when analyzed in bronchoalveolar lavage (BAL) of patients with lung malignancies, particularly when they are analyzed in the two BAL fractions, bronchial (BF) and alveolar (AF), being more increased in the BF. For this reason, we intend to demonstrate that smokers with cancer secrete more biological substances in the BF and that the concentrations of these markers are higher in the BAL of smokers than in that of non-smokers.

Methods

The five aforementioned tumor markers were studied in the two BAL fractions of 52 lung cancer patients (46 smokers and 6 non-smokers). We performed BAL using 150 ml of 0.9% saline solution divided in three aliquots of 50 ml. The fluid obtained from the first 50 ml was the BF. The liquid from the other two aliquots was the AF. The five tumor marker concentrations were calculated in accord with the indications of the laboratory.

Results

The TPA and TPS levels in the BAL of lung cancer patients were more increased in the BF than in the AF, even when the patients were divided into smokers and non-smokers. When we compared smokers with non-smokers, the smokers had higher levels of TPS in the BF and of TPA in the AF.

Conclusions

Thus, we believe that the cellular alterations produced by tobacco are responsible for the secretion of these tumor markers.
Mitoxantrone, 5-Fluorouracil and Low-dose Leucovorin in Doxorubicin-resistant Advanced Breast Cancer Patients: A Phase II Study
Authors: Šušnjar Snežana , Vasović Suzana , Nešković-Konstantinović Zora , Stamatović Ljiljana , Lukić Vesna , Čolaković Slobodanka , Mitrović Labuda , Jelić Svetislav , Radulović Siniša
Published: April 2018

Aim

Twenty-two anthracycline-resistant advanced breast cancer patients were entered from June 1995 till November 1997 in a phase II study to assess the activity and tolerability of second-line chemotherapy consisting of mitoxantrone, 5-fluorouracil and low-dose leucovorin.

Study Design

Patients were eligible if they failed to respond to doxorubicin-containing chemotherapy, given as first-line chemotherapy for metastatic disease. Treatment consisted of mitoxantrone, 12 mg/m2 iv infusion on day 1, and leucovorin, 50 mg iv 1 hr before 5-fluorouracil, 350 mg/m2 iv infusion on days 1-3, every three weeks.

Results

Nineteen patients were eligible for response, 2 refused further therapy after 2 cycles, and 1 was excluded because grade 3 myelotoxicity developed during the first cycle. Partial remission of 15 months duration occurred in 1 patient, in 7/19 women disease remained stable with a median duration of 11 months (range, 5-24), and 11/19 patients experienced progressive disease. Median time to disease progression was 2 months (range, 0-17), and median survival was 8 months (range, 0-24). Toxicity was generally mild and acceptable. One patient was excluded because of grade 3 granulocytopenia and thrombocytopenia, and one due to cardiotoxicity assessed by the drop of left ventricular ejection fraction to more than 20% below the initial value.

Conclusions

In spite of the very low objective response rate, almost one-fourth of our anthracycline-resistant patients achieved a disease stabilization of 27 weeks duration during mitoxantrone-based second-line chemotherapy. Hence, mitoxantrone in combination with 5-fluorouracil, especially continuous infusion, should be further investigated in this setting, particularly if new and expensive drugs, considered the most active, are not readily available.
Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer: A Preliminary Report
Authors: Baltali Esmen , Günel Nazan , Onat Demir Ali , Atahan Ibdisan Lale , Akçali Zafer , Büyükünal Evin , Firat Dincer ,   Turkish Oncology Study Group, Turkey
Published: April 2018

Aims and Background

A pilot study of neoadjuvant chemotherapy with cyclophosphamide-epirubicin-5-fluorouracil (FEC) was performed on 85 patients with locally advanced breast cancer.

Methods and Study Design

Patients received four cycles of neoadjuvant chemotherapy followed by surgery, radiotherapy and a treatment with cyclophosphamide-methotrexate-5-fluorouracil for three cycles.

Results

Major clinical response was obtained in 76 (89%) patients. Complete response was documented in 14 (17%) patients at pathologic examination of surgical specimen. Grade 1-2 nausea and vomiting was the most common (77%) side effect. Grade 2-3 alopecia was 66%. Grade 2-3 neutropenia occurred in 16% of patients. None of the patients developed febrile neutropenia. Sinus tachycardia was observed only in one patient. Three patients had a more than 10% decrease in the left ventricular ejection fraction without any clinical signs. Nine patients had progressive or stable disease and 4 did not undergo surgery or receive radiation therapy; thus 13 were excluded from survival analysis. After a median follow-up of 31 months (range, 15-41), disease-free survival and overall survival were 20 (range, 13-32) and 23 months (range, 17-32).

Conclusions

The FEC combination is safe and effective for a neoadjuvant setting in locally advanced breast cancer. A longer follow-up is necessary for the end point results.
Primary Esophageal Lymphoepithelioma
Authors: Parra Pablo , Aguilar José , López-Garrido Juan , Meléndez Blas , Merino Esther , Martinez Pablo , Gordillo Emilio , Roldán Juan Pastor
Published: April 2018

Lymphoepitheliomas are extremely rare outside the nasopharynx. Extranasopharyngeal lymphoepitheliomas may be located in the stomach or digestive tract, and only one single case of esophageal location has been found in our review. In many cases the tumor is related to Epstein-Barr virus infection. We report a case of undifferentiated carcinoma of the distal third of the esophagus in a 79-year-old man. Pathological examination of the esophagus revealed an undifferentiated carcinoma with lymphoid stroma (lymphoepithelioma). In situ hybridization of the neoplastic cells was negative for Epstein-Barr virus. To our knowledge, the present case is the first documented esophageal lymphoepithelioma in Western countries.
Primary Malignant Melanoma Arising in the Parotid Gland: Case Report and Literature Review
Authors: Bussi Mario , Cardarelli Laura , Riontino Elena , Valente Guido
Published: April 2018

Melanoma of the head and neck is an extremely rare disease, characterized by difficult and late diagnosis and poor prognosis; moreover, the definition of primary melanomas of the salivary glands remains controversial. In this paper we describe an unusual case of primary melanoma arising in the parotid gland.

A 60-year-old woman presented to us for the persistence of a parotid neoplasm diagnosed as carcinoma by fine-needle aspiration and treated with radiation therapy. Wide destructive surgery was performed and immunohistochemical analysis of the surgical specimen led to a diagnosis of melanoma. Complete screening excluded other primary tumor sites. After five years of follow-up the patient is alive and free of disease. Here we report the diagnostic procedures leading to the diagnosis along with a critical analysis of the literature, emphasizing the difficulties in the diagnosis and classification of melanoma as a primary tumor in the parotid gland and the need for destructive surgery.
Newcastle Disease Virus Infection in Quail
Authors: Susta Leonardo , Segovia Diego , Olivier Timothy L. , Dimitrov Kiril M. , Shittu Ismaila , Marcano Valerie , Miller Patti J.
Published: April 2018

Newcastle disease (ND), caused by virulent strains of Newcastle disease virus (NDV), is a devastating disease of poultry worldwide. The pathogenesis of ND in quail is poorly documented. To characterize the ability of virulent NDV strains to replicate and cause disease in quail, groups of 14 two-week-old Japanese quail ( Coturnix japonica) were experimentally inoculated with 108 EID50 (embryo infectious dose 50%) units of 1 of 4 virulent NDV strains: 2 isolated from quail ( N2, N23) and 2 from chickens ( Israel, Pakistan). At day 2 postinfection, noninfected quail (contact group) were added to each infection group to assess the efficacy of virus transmission. Tested NDV strains showed moderate pathogenicity, with highest mortality being 28% for the N2 strain and below 10% for the others. Two N2-inoculated birds showed neurological signs, such as head tremor and ataxia. Microscopic lesions were present in N2-, Israel-, and Pakistan-inoculated birds and consisted of nonsuppurative encephalitis. Contact birds showed no clinical signs or lesions. In both inoculated and contact birds, virus replication was moderate to minimal, respectively, as observed by immunohistochemistry in tissues and virus isolation from oropharyngeal and cloacal swabs. Strains originally isolated from quail resulted in higher numbers of birds shedding in the inoculation group; however, transmission appeared slightly more efficient with chicken-derived isolates. This study shows that virulent NDV strains have limited replicative potential and mild to moderate disease-inducing ability in Japanese quail.
Design and fabrication of very-low-cost engineering experiments via 3-D printing and vacuum forming
Authors: Meng Fanhe , Van Wie Bernard J. , Thiessen David B. , Richards Robert F.
Published: April 2018

A new approach to fabricate flexible and inexpensive experiments for undergraduate students to gain hands-on experience with engineering concepts has been developed. The approach is driven by design for manufacture and leverages new manufacturing tools such as computer-aided design, 3-D printers, and vacuum forming machines to produce an array of simple and easy-to-use experimental hardware. The design and fabrication process is illustrated by documenting the evolution of four generations of experimental hardware. Experimental hardware has been developed around two areas in fluid mechanics: a Venturi nozzle experiment, illustrating use of the Bernoulli equation and a Pipe Flow experiment focusing on conservation of mass and energy. The Pipe Flow experiment was implemented in a junior-level fluid mechanics class and student learning was assessed. Students who participated in the Pipe Flow experiment demonstrated significantly higher scores on questions relating to head loss in a pipe than students who attended a lecture. In contrast, student scores on questions relating to fluid velocity were no better after participating in the experiment than those for students who saw the lecture. These divergent learning outcomes appear to be a result of the effectiveness of the educational interventions to stimulate a complete experiential learning cycle involving the targeted engineering concept, a crucial aspect of the design of the experimental hardware.
Hemodiafiltration (HD-HF): One Year Follow-Up of Nine Hours Weekly
Authors: Bigazzi R. , Gentini G.P. , Mazzoni A. , Setti G.P. , Cocciolo G. , Ghiara F. , Silvis C. , Baldari G.
Published: April 2018

Data are presented concerning our experience with hemodiafiltration (HD-HF) in uremic patients. Ten patients previously submitted to regular dialysis treatment, cuprophane membrane (RDT), for the last year twelve hours weekly, were treated for one year, nine hours weekly, HD-HF. Five of ten had suffered discomfort by RDT and five spontaneously chose HD-HF owing to its shorter treatment period. The follow-up of the two treatment schedules did not show any significant difference in absolute and percentage values of small molecules. Hematocrit, body weight and blood arterial pressure were not different following both treatment. Patients submitted to HD-HF complained of no discomfort including patients suffering of dialytic discomfort under RDT. HD-HF has proved as useful and more confortable than RDT in long-term treatment of patients with chronic renal failure.
Toxicity in Uremia 1. Correlation between PTH Levels and Depressed Cell Proliferation
Authors: Esposito R. , Manzo M. , Hohenegger M. , Pluvio M. , Lanzetti N. , Perna N. , Romano-Carratelli C. , Giordano C.
Published: April 2018

Cell proliferation is significantly depressed in uremia; to assess the influence of PTH on it, normal lymphocytes were cultured in presence of uremic patients’ serum with low or high plasma PTH levels (Group A; PTH < 2.5 ng/ml; Group B: PTH > 12 ng/ml), and serum of normal subjects (Group C).

Cell proliferation was lowered by serum from both groups (p A vs C < 0.004; p B vs C < 0.001). However, the depressing effect was more evident when group B serum was employed (p A vs B< 0.002).
Surface Modification of Copolyether-Urethane Catheters with Poly(Ethylene Oxide)
Authors: Brinkman E. , Poot A. , Beugeling T. , Van Der Does L. , Bantjes A.
Published: April 2018

Pellethane 2363 80A catheters were modified with poly(ethylene oxide) in order to improve their blood compatibility. Contact angle measurements showed that Pellethane 2363 80A surfaces had increased wettability after this modification. The results of in vitro blood compatibility tests showed that surface modification with poly(ethylene oxide) resulted in a five-fold reduction of platelet deposition. Activation of coagulation was not affected.
Cord Blood Banking for Stem Cell Transplant
Authors: Bertolini F. , Lazzari L. , Corsini C. , Lauri E. , Gorini F. , Sirchia G.
Published: April 2018

Umbilical cord blood has been recently used as a source of hematopoietic progenitor cells for transplantation of pediatric patients. This study was performed to evaluate the feasibility of a cord blood bank for unrelated transplant. When the umbilical cord was clamped within 20 seconds after delivery, it was possible to collect 86±25 ml of cord recipients with more than 2000 CFU-GM/kg; 53% of cord blood samples were found to contain enough CFU-GM for engraftment in 50-70 kg adult patients.
Social Determinants of Health and Preclinical Glycemic Control in Newly Diagnosed First-Episode Psychosis Patients
Authors: Veru-Lesmes Franz , Rho Aldanie , King Suzanne , Joober Ridha , Pruessner Marita , Malla Ashok , Iyer Srividya N.
Published: April 2018

Background:

The abnormally high incidence of disorders of glucose metabolism (DGM) in psychotic-spectrum disorders (PSD) has often been attributed to the side effects of antipsychotics and unhealthy lifestyles. The influence of social determinants of health has been largely ignored, despite ample evidence linking social adversity with both PSD and DGM. The aim of this study is to examine the influence of well-established social determinants of health on preclinical levels of glycated hemoglobin (HbA1c) in a sample of first-episode psychosis (FEP) patients.

Methods:

In a sample of newly admitted FEP patients, univariate analyses were used to select the main predictors of HbA1c levels from the following social determinants of health: childhood trauma, immigrant background, visible minority status, and indices of social and material deprivation. The predictors identified in the univariate analyses were tested in multivariate linear regression models including age, sex, BMI, depression, and physical anergia (proxy of sedentary behaviour) as covariates.

Results:

Univariate analyses identified visible minority status and childhood physical abuse as predictors of HbA1c. After controlling for covariates, minority status significantly predicted higher levels of glycated hemoglobin (β = 0.23; P = 0.01), and physical abuse had a marginally significant effect (β = 0.23; P = 0.06). Other predictors were not significantly associated.

Conclusion:

FEP patients from a visible minority or who were victims of childhood physical abuse have higher levels of HbA1c at admission compared with other patients. This might suggest an increase in risk for the development of future DGM. If confirmed, preventive strategies could be tailored for these groups.
Caregivers’ Perspectives of Quality of Life of People With Young- and Late-Onset Alzheimer Disease
Authors: Kimura Nathália R. S. , Baptista Maria Alice T. , Santos Raquel L. , Portugal Maria da Gloria , Johannenssen Aud , Barca Maria L. , Engedal Knut , Laks Jerson , Simões José Pedro , Rodrigues Valeska Marinho , Dourado Marcia C. N.
Published: April 2018

Background:

Quality of life (QoL) is a growing area of interest in dementia research. This study aims to investigate the caregivers’ perspective about the QoL of people with young-onset Alzheimer disease (YOAD) and late-onset Alzheimer disease (LOAD). We also aim to investigate factors that might be associated to caregivers’ perspective in YOAD and LOAD.

Methods:

We included 110 people with Alzheimer disease (PwAD; 53 YOAD) and their primary caregivers. The PwAD completed assessments about their QoL and cognition. The caregivers provided information about the PwAD (demographics, QoL, ability to perform activities of daily living, mood, and dementia severity) and had burden of care assessed.

Results:

We did not find a difference in caregivers’ perspectives of PwAD QoL according to the age at onset. However, the linear regression analysis indicated that caregivers’ burden ( P < .01) and PwAD depressive symptoms ( P < .05) were significantly related to the caregivers’ perspective of YOAD QoL. Caregivers’ burden ( P < .01), years of education ( P < .05), and self-reported QoL ( P < .01) were significantly related to the caregivers’ perspective of LOAD QoL.

Conclusions:

The factors that drive the perceptions of caregivers of PwAD QoL may vary according to the age at onset. The study provides basic information on caregivers’ perspectives of PwAD QoL to create more effective interventions according to the age at onset.
Network analysis of a coolant flow performance for the combined impingement and film cooled first-stage of high pressure gas turbine nozzle guide vane
Authors: Reddy Kukutla Pol , Prasad BVSSS
Published: April 2018

The present paper describes a system-level thermo-fluid network analysis for the secondary air system analysis of a typically film-cooled nozzle guide vane with multiple actions of jet impingement. The one-dimensional simulation was done with the help of the commercially available Flownex 2015 software. The system-level thermo-fluid network results were validated with both the computational fluid dynamics results and experimentally available literature. The entire nozzle guide vane geometry was first mapped to a thermo-fluid network model and the pressure conditions at different nodes. The discharge and heat transfer coefficients obtained from the Ansys FLUENT were specified as inputs to the thermo-fluid network model. The results show that the one-dimensional simulation of the coolant mass flow rates and jet Nusselt number values are in good agreement with the three-dimensional computational fluid dynamics results.
A novel reduced order modeling of interval system using soft computing optimization approach
Authors: Vijaya Anand N , Siva Kumar M , Srinivasa Rao R
Published: April 2018

This research article presents a novel algorithm for the model order reduction of higher order linear time interval systems using soft computing optimization approach. In the proposed method, a new recursive formula for alpha parameters is developed for determining reduced order interval model without formulating alpha and beta tables. The denominator and numerator polynomials of reduced order interval model are determined based on minimization of a multi-objective function comprising integral squared error and impulse response energy error using particle swarm optimization technique. The proposed algorithm has several advantageous features such as reduced computational complexity and stability preservation property. The efficacy of the proposed algorithm is illustrated through typical numerical examples available in the literature, and the results are successfully compared with the other familiar methods.
Turning Ethics into Institutions: The Techno-politics of Human Research Regulation in Taiwan
Authors: Kuo Wen-Hua
Published: April 2018

This article provides a critical assessment of the development of Taiwan’s ethical framework for regulating medical and biopharmaceutical innovations. Advancing science, technology and society scholarship that treats ethics as subject to modification, adjustment and negotiation rather than as an abstract set of principles, this article examines the dominant role of East Asian states in the development of the life sciences. It also looks at the logic these states utilise to legitimise their therapeutic standards and to support the biopharmaceutical infrastructure in order to increase their economic competitiveness. In particular, this article traces the establishment of legal regulations in different social settings where innovations in clinical practice and medicine are introduced. It argues that, instead of a comprehensive, coherent ethical framework based on the adoption of international conventions, Taiwan’s 2011 Human Subjects Research Act is a techno-political assemblage, an inconsistent legal product involving not only policy makers but also physicians, the pharmaceutical industry and the state. This article also takes a critical stance towards institutional review boards (IRBs), which resolve jurisprudential conflicts within this legal framework of human research. It argues that, rather than being passive organisations that protect research from unethical fraud, IRBs in Taiwan have been institutions in which negotiations among investigators, research sponsors and the government are conducted in the name of health governance.
Health and Disease in the Tropical Zone: Nineteenth-century British and Dutch Accounts of European Mortality in the Tropics
Authors: Pols Hans
Published: April 2018

Acclimatisation theories varied depending on the political and social contexts in which they were used. Historians of medicine have argued that the pessimism of physicians practising in British India about the acclimatisation of white settlers in the tropics increased around the turn of the eighteenth century. Both British and Dutch physicians had long commented on the proverbial unhealthfulness of Batavia, but rather than relating this to the tropical climate, they emphasised the unwholesome behaviour of Dutch inhabitants. When Dutch physicians debated the possibility of white settlement in the tropical East Indies in the 1840s, many emphasised the importance of virtuous predisposition and intelligent behaviour in adjusting to the colony’s climate, suggesting optimistically that environmental problems might be resisted.
Collagen analysis by second-harmonic generation microscopy predicts outcome of luminal breast cancer
Authors: Natal Rodrigo A , Vassallo José , Paiva Geisilene R , Pelegati Vitor B , Barbosa Guilherme O , Mendonça Guilherme R , Bondarik Caroline , Derchain Sophie F , Carvalho Hernandes F , Lima Carmen S , Cesar Carlos L , Sarian Luís Otávio
Published: April 2018

Second-harmonic generation microscopy represents an important tool to evaluate extracellular matrix collagen structure, which undergoes changes during cancer progression. Thus, it is potentially relevant to assess breast cancer development. We propose the use of second-harmonic generation images of tumor stroma selected on hematoxylin and eosin–stained slides to evaluate the prognostic value of collagen fibers analyses in peri and intratumoral areas in patients diagnosed with invasive ductal breast carcinoma. Quantitative analyses of collagen parameters were performed using ImageJ software. These parameters presented significantly higher values in peri than in intratumoral areas. Higher intratumoral collagen uniformity was associated with high pathological stages and with the presence of axillary lymph node metastasis. In patients with immunohistochemistry-based luminal subtype, higher intratumoral collagen uniformity and quantity were independently associated with poorer relapse-free and overall survival, respectively. A multivariate response recursive partitioning model determined 12.857 and 11.894 as the best cut-offs for intratumoral collagen quantity and uniformity, respectively. These values have shown high sensitivity and specificity to differentiate distinct outcomes. Values of intratumoral collagen quantity and uniformity exceeding the cut-offs were strongly associated with poorer relapse-free and overall survival. Our findings support a promising prognostic value of quantitative evaluation of intratumoral collagen by second-harmonic generation imaging mainly in the luminal subtype breast cancer.
More Than Place-Based: Viewing Geography on a Continuum and the Implications for Social Work Practice
Authors: Carbone Jason T. , McMillin Stephen Edward
Published: April 2018

Communities play an important role within the field of social work as the context within which specific social work activities occur. To date, much of the social work literature divides communities into the mutually exclusive, dichotomous categories of geographic and functional communities. The authors propose a new method for defining community that views geography on a continuum and suggests that membership within a community is moderated by place. The concept of place-moderated communities is applied to specific examples, and the application to social work practice is discussed within the context of community membership, community engagement, community rights, and community development efforts.
Age at Time of Craniosynostosis Repair Predicts Increased Complication Rate
Authors: Bruce William J. , Chang Victor , Joyce Cara J. , Cobb Adrienne N. , Maduekwe Uma I. , Patel Parit A.
Published: April 2018

Objective:

This study uses administrative data to assess the optimal timing for surgical repair of craniosynostosis and to identify factors associated with risk of perioperative complications.

Design:

Statistical analysis of the Healthcare Cost and Utilization Project Kids’ Inpatient Database (2006, 2009, 2012).

Setting:

KID-participating hospitals in 44 states. Patients: Children 0 to 3 years of age with ICD-9 codes for surgical correction of craniosynostosis (756 and 0124, 0125, 0201, 0203, 0204, or 0206).

Main Outcome Measure:

Age-based cohorts were assessed for perioperative complications. We performed a multivariable analysis to determine characteristics associated with increased risk of complications.

Results:

21 million admissions were screened and 8417 visits met criteria for inclusion. Seventy-five percent of procedures occurred before age 1. Complications occurred in 8.6% of patients: 6.6% of patients at age 0 to 6 months, 10.3% of patients aged 7 to 12 months, and 13.9% of patients 12 to 36 months. Patients with acrocephalosyndactyly or associated congenital anomalies experienced complications in 22.9% of cases (OR = 3.07, 95% CI = 2.33, 4.03).

Conclusion:

Craniosynostosis repair is safe; however, the risk of complications increases with age at intervention. Presence of a syndromic congenital deformity at any age carries the greatest increased risk of perioperative complications. This suggests that optimal timing of intervention is within the first year of life, especially in those cases with additional factors increasing perioperative risk. These data support the importance of counseling patients of the increased risk associated with delaying craniosynostosis repair.
The Median Mandibular Symphysis Tessier 30 Cleft:
Authors: Mahajan Siddharth , Patel Pravin K. , Duan Yao , Warshawsky Neil
Published: April 2018

Atypical craniofacial clefts of the upper facial region have been well documented; however, the mandibular clefts remain rare and reported as isolated case reports. We report a case of a median mandibular cleft within the context of a Tessier 0-14 axis that we have followed over a 5-year period without surgical/orthodontic intervention. The mandibular symphysis cleft remained open without evidence of the fusion, in contrast to ossification of the metopic dysraphism. Within this context, we present a review of the median mandibular cleft cases from 1819 to 2015.