bluuebunny/crossref_metadata_2025 huggingface dataset:
DEVELOPMENT OF A SUBMINIATURE PARAMETRIC TRANSDUCER FOR HEARING REHABILITATION
Authors: SEOK JIN WAN , NA SUNG DAE , SEONG KI WOONG , LEE JYUNG HYUN , KIM MYOUNG NAM
Published: October 2019

Hearing loss is becoming increasingly common due to the aging of society and the development of multimedia devices. Hearing loss is classified by hearing level, and patients require early diagnosis and rehabilitation. To overcome hearing loss, hearing aids are used, but conventional hearing aids have disadvantages that reduce the efficiency of speech transmission. In this paper, we proposed a subminiature ultrasonic transducer with a miniaturized parametric speaker. The transducer generates sound waves with high directionality. These sound waves are focused on the umbo located the center of the tympanic membrane and connected to ossicles of the middle ear. To generate sound waves, various parameters are considered, such as target distance, radiation area, and primary frequency. We tested the directionality of the proposed transducer using extracted parameters at audible frequencies. As a result, we confirmed high directionality and audible sound generated by the proposed transducer. The method can be expected to be applied to high-efficiency hearing rehabilitation devices and various multimedia devices.
BIOKINETIC MODEL OF Tc-99m MIBI FOR EIGHT PATIENTS UNDERGONE MYOCARDIAL PERFUSION EXAMINATION via GAMMA CAMERA AND MATLAB PROGRAM: AN IN-VIVO STUDY
Authors: YEN YU-CHEN , TIEN HUI-YUN , GUO ZHENG-HONG , WANG TZU-HWEI , TSAI SHIH-CHUAN , PAN LUNG-FA , PAN LUNG-KWANG
Published: October 2019

Biokinetic model of Tc-99m MIBI for eight patients undergone myocardial perfusion examination was studied using gamma camera and MATLAB program. A six-compartment model was adopted to interpret the metabolic mechanism of each patient. Within the model framework, the respective set of simultaneous differential equations was solved by a self-developed program run in MATLAB. The experimental results exhibited a good fit with the theoretical predictions via the model. The average biological half-lives of body fluid, heart, thyroid, liver, GI Tract and remainder were assessed as [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text][Formula: see text]h, respectively. A dimensionless AT index of disagreement between the experimental data and MATLAB optimal solution was proposed of validating the applied acquisition system and analytical method feasibility. An AT of zero implies a perfect agreement between the theoretical and empirical results, while averages of the derived AT were fluctuated from 3 [Formula: see text] 2 to [Formula: see text] for five compartments. The proposed refined equation estimated the internal dose from gamma-ray as [Formula: see text][Formula: see text]mSv for eight patients according to a fast screening method, which defined human body as a spherical ball to simplify the calculation in reality. The proposed MATLAB-based fitting of in-vivo data with the theoretical results was instrumental for assessing the radiation dose received by the Tc-99m MIBI scan participants.
Surface Plasmon Resonance Imaging ( SPRi ): An Inexpensive Tool to Study the Water Transport in Thin Film PFSA Ionomers
Authors: Ahangar Shahab Bayani , Bellur Kishan , Medici Ezequiel , Tajiri Kazuya , Allen Jeffrey S. , Choi Chang Kyoung
Published: October 2019

The kinetics of water transport in confined thin film Perfluorinated sulfonic-acid (PFSA) ionomers is of vital importance in various applications such as a proton-exchange membrane or catalyst layers in polymer-electrolyte fuel cells. Advanced imaging techniques such as Neutron reflectivity, grazing-incidence x-ray scattering, and atomic force microscopy have been used for studying interfacial water transport in thin-film ionomers. The instruments mentioned are considered high-end, expensive, super-resolution microscopes. The need for an expensive microscopic apparatus restricts many laboratories in developing countries from conducting experiments in the field of interfacial sciences such as visualization and in-situ measurement of water transport in thin-film PFSA ionomers due to financial constraints, limited infrastructure, and lack of high-end technical support. Following the notion of portable and low-cost technologies, which is a vision of many researchers, we introduced the application of surface plasmon resonance imaging (SPRi) in the visualization of diffusion transport phenomena of water in thin-film ionomers. In this work, the smartphone-based Surface plasmon resonance imaging with 3D printed optical components that cost less than $350 is proposed for imaging of water transport in thin-film ionomer.
Squamous Cell Carcinoma of the Tongue with Metastasis to Myocardium: Report of a Case and Literature Review
Authors: Shafiq Ali , Samad Fatima , Roberts Eric , Levin Jonathan , Nawaz Ubaid , Tajik A. Jamil
Published: October 2019

This is a case of a 43-year-old man who in 2014 was diagnosed with oral squamous cell carcinoma involving the tongue. He underwent extensive surgery that involved right tongue cancer resection and reconstruction with a free flap graft from his right forearm. He then was started on chemotherapy and radiation. Surveillance computed tomography in December 2016 showed a cardiac lesion in the left ventricular apex, which was confirmed by further echocardiography and cardiac magnetic resonance imaging. A biopsy of the mass revealed metastatic squamous cell carcinoma. He was deemed to not be a surgical candidate and continued on palliative chemotherapy. The patient had a very poor prognosis and eventually succumbed to the disease, highlighting the importance of surveillance imaging in such cases. A high index of suspicion on the part of the physician is needed to help in the early identification of these patients.
Improvement of Clayey Soils by Combined Bamboo Strip and Flax Fiber Reinforcement
Authors: Tong Fang , Ma Qiang , Xing Wenwen
Published: October 2019

A combined bamboo strips and flax fiber reinforcement method to reinforce clay is proposed in this paper, and in order to study the mechanical properties of bamboo strips and flax fiber‐reinforced clay (BFRC), a series of tensile tests were carried out to obtain the relationship between the average tensile force and deformation of flax fiber and bamboo strip; after that, triaxial shear tests were carried out under the conditions of different confining pressures. In addition, the reinforcement mechanism of the bamboo strips and flax fiber‐reinforced clay (BFRC) is analyzed. The test results show that the cohesion and internal friction angle of the bamboo strips and flax fiber‐reinforced clay (BFRC) are improved compared with the pure clay. In the case of flax fiber‐reinforced clay, the cohesion of reinforced clay is increased by 18.34% and the friction angle is only increased by 0.39%. In the case of bamboo strips and flax fiber‐reinforced clay, the cohesion of reinforced clay is increased by 26.36% and the friction angle is only increased by 10.24%. The addition of bamboo strips improves the shear strength of the reinforced clay and effectively improves the deformation resistance of the flax fiber‐reinforced clay (FRC). And it increases the internal friction angle and cohesion of the clay, although the increase in the strength is mainly reflected in the influence on the cohesion.
The Utility of Immunohistochemistry in Differentiating Metastatic Primary Squamous Cell Carcinoma of the Thyroid from a Primary Lung Squamous Cell Carcinoma
Authors: Kao Nern Hoong , Tan Chien Sheng , Koh Adrian Jit Hin
Published: October 2019

Primary squamous cell carcinoma of the thyroid gland (PSCCTh) and anaplastic thyroid carcinoma with extensive squamous differentiation are rare entities which pose a diagnostic challenge in determining the primary site when presented as metastases. The difficulty in confirming a thyroid primary is further compounded by the aggressive nature of these tumours which frequently present at advanced stages. We present a case in which the patient presented with a thyroid mass and a lung mass simultaneously. The risk of misinterpreting the site of primary tumour as lung is greatly increased because squamous cell carcinoma of lung is much more common than its thyroid counterpart. This case highlights the effectiveness of PAX-8 stain in determining the primary site of tumour when squamous cell carcinoma is found in both lung and thyroid gland.
ДОСЛІДЖЕННЯ АНТИМІКРОБНОЇ АКТИВНОСТІ КОНСЕРВАНТІВ З МЕТОЮ РОЗРОБКИ СКЛАДУ КОМБІНОВАНОГО ГЕЛЮ ДЛЯ МІСЦЕВОГО ЛІКУВАННЯ ОПІКІВ
Authors: Pavliuk B. V. , Lukashiv O. Ya. , Pokryshko O. V. , Chubka M. B. , Hroshovyi T. A.
Published: October 2019

Мета роботи. Дослідження активності антимікробних консервантів у зразках гелів з водним витягом з ксенодерми та лідокаїну гідрохлоридом для місцевого лікування опіків.

Матеріали і методи. При дослідженні використовували методику оцінки ефективності антимікробних консервантів відповідно до вимог ДФУ. Як тест-культури використовували наступні мікроорганізми: Staphylococcus аureus АТСС 25923, Escherichia сoli 055К59 №3912/41, Pseudomonas aeruginosa АТСС 2853 (F51), Candida albicans АТСС 885-653, Aspergіllus brasіlіensіs АТСС 16404.

Результати й обговорення: У результаті проведених досліджень встановлена ефективність досліджуваних антимікробних консервантів (ніпагін/ніпазол, cosgard, спирт фенілетиловий, бензалконію хлорид) різних концентрацій у модельних зразках гелів з водним витягом з ксенодерми та лідокаїном гідрохлоридом. Досліджувані зразки гелів відповідають вимогам ДФУ (друге вид., том 1, п. 5.1.3) за показником “Ефективність антимікробних консервантів” для лікарських засобів для зовнішнього застосування.

Висновок. У результаті проведених досліджень найбільш прийнятним консервантом обрано спирт фенілетиловий у концентрації 0,4 %, що зумовлено його високою антимікробною активністю у даній фармацевтичній композиції, фізіологічною безпечністю, економічністю, а також можливістю його використання у ролі ароматизатора.
ВИМОГИ ДО ЯКОСТІ СУПОЗИТОРІЇВ ЯК ЛІКАРСЬКОЇ ФОРМИ У ВІДПОВІДНОСТІ ДО СВІТОВИХ ФАРМАКОПЕЙ
Authors: Aleinyk S. L. , Polova Z. M.
Published: October 2019

Мета роботи. Порівняльний аналіз даних світових фармакопей щодо показників та їх норм, а також методик і методів, що визначають якість супозиторіїв як лікарської форми (ЛФ).

Матеріали і методи. Використано методи інформаційного пошуку, аналізу літературних джерел, порівняння, узагальнення.

Результати й обговорення. Визначення супозиторіїв як ЛФ у Державній Фармакопеї України, Державних Фармакопеях Республік Білорусь та Казахстан, Європейській та Британській фармакопеях наведено у загальних фармакопейних статтях (ЗФС) «Лікарські засоби для ректального застосування» та «Лікарські засоби для вагінального застосування» (як песарії). Фармакопеї США, Японії та Російської Федерації містять характеристику супозиторіїв у ЗФС на ЛФ. У ході аналізу було встановлено, що для супозиторіїв та песаріїв визначаються такі основні показники якості: опис, ідентифікація, однорідність маси, розпадання, розчинення, температура плавлення (для ліпофільних основ), вміст домішок, кількісне визначення, мікробіологічна чистота.

Висновки. Проведений аналіз вказує на деякі відмінності даних світових фармакопей щодо контролю якості супозиторіїв та песаріїв. Це свідчить про необхідність гармонізації вимог фармакопей для уніфікації методик та методів аналізу супозиторіїв та песаріїв як широко застосовуваних ЛФ.
BANKA KÂRLILIĞINA ETKİ EDEN MİKRO DEĞİŞKENLER: TÜRK BANKACILIK SEKTÖRÜ ÜZERİNE BİR ARAŞTIRMA
Authors: ÇELİK Serkan , KAYA Ferudun
Published: October 2019

Çalışmanın
amacı; 2009-2017 yılları arasında Türkiye’de faaliyet gösteren mevduat
bankalarının kârlılığının mikro düzeydeki belirleyicilerinin tespit
edilmesidir. Varlık karlılığı değişkeninin bankaların karlılık ölçütü olması
için bağımlı değişken olarak kullanıldığı çalışmada, klasik panel veri analiz
yöntemi kullanılarak elde edilen bulgulara göre; banka yaşı değişkeni ile karlılık arasında tüm bankalar düzeyinde bir
ilişki tespit edilemezken, banka ölçeği değişkeni; tüm bankalar düzeyinde
negatif bir ilişki içerisindedir. Sermaye
yeterlilik oranı sektörü olumlu etkilerken, kredilendirme düzeyi tüm sektör
düzeyinde pozitif ve anlamlı bir ilişki olduğunu göstermektedir. Personel
giderlerini tüm sektör düzeyinde karlılık üzerinde negatif ve anlamlı ilişkisi
mevcut olduğu da tespit edilmiştir.
Hiding Between Basho and Chōra
Authors: Schroeder Brian
Published: October 2019

This essay considers the relation between two fundamentally different notions of place—the Greek concept of χώρα and the Japanese concept of basho 場所—in an effort to address the question of a possible “other beginning” to philosophy by rethinking the relation between nature and the elemental. Taking up a cross-cultural comparative approach, ancient through contemporary Eastern and Western sources are considered. Central to this endeavor is reflection on the concept of the between through an engagement between, on the one hand, Plato, Martin Heidegger, Jacques Derrida, Edward Casey, and John Sallis, and on the other, Eihei Dōgen, Nishida Kitarō, and Watsuji Tetsurō.
Should We Extend Voluntary Euthanasia to Non-medical Cases? Solidarity and the Social Context of Elderly Suffering
Authors: Schmidt Andreas T.
Published: October 2019

Several Dutch politicians have recently argued that medical voluntary euthanasia laws should be extended to include healthy elderly citizens who suffer from non-medical ‘existential suffering’ (‘life fatigue’ or ‘completed life’). In response, some seek to show that cases of medical euthanasia are morally permissible in ways that completed life euthanasia cases are not. I provide a different, societal perspective. I argue against assessing the permissibility of individual euthanasia cases in separation of their societal context and history. An appropriate justification of euthanasia needs to be embedded in a wider solidaristic response to the causes of suffering. By classifying some suffering as ‘medical’ and some as ‘non-medical’, most societies currently respond to medical conditions in importantly different ways than they do to non-medical suffering. In medical cases, countries like the Netherlands have a health care, health research and public health system to systematically assign responsibilities to address causes of medical suffering. We lack such a system for non-medical suffering among elderly citizens, which makes completed life euthanasia importantly different from euthanasia in medical cases. Because of this moral ‘responsibility gap’, focusing on the permissibility of completed life euthanasia in separation of wider societal duties to attend to possible causes is societally inappropriate. To spell out this objection in more philosophical terms, I introduce the concept of acts that are morally permissible but contextually problematic.
Tradierende Drucker
Authors: Reich Philip
Published: October 2019

The late medieval chess books developed a specific iconographic programm. In the transfer to the incunabula by some printers of southwest Germany (Zainer, Knoblochtzer, Schönsperger), a ‘material tradition’ and a specific behaviour towards traditions is obvious. Moreover, the picture of the deviant eighth pawn is combined with the Low-German parody text Der Boiffen Orden and fool’s literature.
Tyranny in Greece in the Fifth and Fourth Centuries BC
Authors: Rhodes P.J.
Published: October 2019

In a world in which it was easy to contrast slavery as being ruled by others with freedom as the power to rule others, it might have been said that subjection to a tyrant was bad but being a tyrant was good if one could get away with it. But in the fourth century Plato and Aristotle created a contrast between kings as good rulers and tyrants as bad rulers, which has been standard ever since. However, recent studies have tried to move away from the polarisation of good kings and bad tyrants, and look more generally at the nature of monarchic rule in Greece. This article explores the topic of tyrants and the use of the notion of tyranny in classical Greece, at the end of the sixth century and in the fifth and fourth.
International Legal Norms in the System of the Ukrainian Constitution
Authors: Tymchenko Leonid
Published: October 2019

This article studies influence of international legal norms on the Ukrainian Constitution. Special attention is given to the provisions of Article 9 of the Constitution which regulates the implementation of international treaties in the legal system of Ukraine. The creation and main directions of activity of the Constitutional Assembly are analyzed. The author arrived at the conclusion that the main drawback of the current Constitution is the declarative nature of some constitutional provisions.
New Jesuit Sources on the Iconography of the Good Shepherd Rockery from Portuguese India: the Garden of Shepherds of Miguel de Almeida (1658)
Authors: Gusella Francesco
Published: October 2019

The Good Shepherd Rockery is the only original iconography developed in the ivory carving tradition of Portuguese India. Despite the large production of these statuettes, the scarcity of written sources and the untracked diffusion of such artworks did not allow the clear understanding of the original purposes of this iconography. The present essay wishes to establish a comparison between the artworks’ iconography and the prologue of the Onvalleancho Mallo (Garden of Shepherds) by the Jesuit Miguel de Almeida (1607–83), published in Goa in 1658. This doctrinal work presents a detailed interpretation of pastoral images which perfectly overlaps with the artworks’ iconography. Almeida’s work represents the best documentation for the interpretation of the iconography as it was circulating in the missionary discourse of Portuguese India. It suggests that the statuettes symbolized the eschatological role of the missionary clergy and the Catholic Church though the didactic use of pastoral allegories.
How an Irish-American Priest Became Puerto Rican of the Year: Joseph P. Fitzpatrick, S.J., and the Puerto Ricans
Authors: Burgaleta Claudio M.
Published: October 2019

One of the first and largest migrations of Latin Americans to the United States occurred from Puerto Rico to New York City in the 1950s. At its height in 1953, the Great Puerto Rican Migration saw some seventy-five thousand Puerto Ricans settled in the great metropolis, and by 1960 there were over half a million New Yorkers of Puerto Rican ancestry in the city. The exodus transformed the capital of the world and taxed its social fabric and institutions. Joseph P. Fitzpatrick, S.J. (1913–95), a Harvard-trained sociologist teaching at Fordham University in the Bronx, played a key role in helping both New York City, its people and social institutions, respond with compassion and creativity to this upheaval. This article chronicles Fitzpatrick’s involvement with the Puerto Ricans for over three decades as priest, public intellectual, and advocate on behalf of the newcomers, and social researcher.
Characterizing potential repelling volatiles for “push-pull” strategy against stem borer: a case study in Chilo auricilius
Authors: Yi Xin , Shi Song , Wang Peidan , Chen Yaoyao , Lu Qiqi , Wang Tianyi , Zhou Xiaofan , Zhong Guohua
Published: October 2019

Background

Massive techniques have been evaluated for developing different pest control methods to minimize fertilizer and pesticide inputs. As “push-pull” strategy utilizes generally non-toxic chemicals to manipulate behaviors of insects, such strategy is considered to be environmentally friendly. “Push-pull” strategy has been extraordinarily effective in controlling stem borers, and the identification of new “pushing” or “pull” components against stem borers could be significantly helpful.

Results

In this study, the results of field trapping assay and behavioral assay showed the larvae of C.auricilius, one kind of stem borers, could be deterred by rice plant under tilling stage, its main host crop. The profiles of volatiles were compared between rice plants under two different developmental stages, and α-pinene was identified as a key differential component. The repelling activity of α-pinene against C.auricilius was confirmed by Y-tube olfactometer. For illuminating the olfactory recognition mechanism, transcriptome analysis was carried out, and 13 chemosensory proteins (CSPs) were identified in larvae and 19 CSPs were identified in adult of C.auriciliu, which was reported for the first time in this insect. Among these identified CSPs, 4 CSPs were significantly regulated by α-pinene treatment, and CSP8 showed good binding affinity with α-pinene in vitro.

Conclusions

Overall, C.auricilius could be repelled by rice plant at tilling stage, and our results highlighted α-pinene as a key component in inducing repelling activity at this specific stage and confirmed the roles of some candidate chemosensory elements in this chemo-sensing process. The results in this study could provide valuable information for chemosensory mechanism of C.auricilius and for identification of “push” agent against rice stem borers.
Genetic and environmental variation impact the cuticular hydrocarbon metabolome on the stigmatic surfaces of maize
Authors: Dennison Tesia , Qin Wenmin , Loneman Derek M. , Condon Samson G. F. , Lauter Nick , Nikolau Basil J. , Yandeau-Nelson Marna D.
Published: October 2019

Background

Simple non-isoprenoid hydrocarbons accumulate in discrete regions of the biosphere, including within bacteria and algae as a carbon and/or energy store, and the cuticles of plants and insects, where they may protect against environmental stresses. The extracellular cuticular surfaces of the stigmatic silks of maize are rich in linear hydrocarbons and therefore provide a convenient system to study the biological origins and functions of these unique metabolites.

Results

To test the hypotheses that genetics and environment influence the accumulation of surface hydrocarbons on silks and to examine the breadth of metabolome compositions across diverse germplasm, cuticular hydrocarbons were analyzed on husk-encased silks and silks that emerged from the husk leaves from 32 genetically diverse maize inbred lines, most of which are commonly utilized in genetics experiments. Total hydrocarbon accumulation varied ~ 10-fold among inbred lines, and up to 5-fold between emerged and husk-encased silks. Alkenes accounted for 5-60% of the total hydrocarbon metabolome, and the majority of alkenes were monoenes with a double bond at either the 7th or 9th carbon atom of the alkyl chain. Total hydrocarbon accumulation was impacted to similar degrees by genotype and husk encasement status, whereas genotype predominantly impacted alkene composition. Only minor differences in the metabolome were observed on silks that were emerged into the external environment for 3- versus 6-days. The environmental influence on the metabolome was further investigated by growing inbred lines in 2 years, one of which was warmer and wetter. Inbred lines grown in the drier year accumulated up to 2-fold more hydrocarbons and up to a 22% higher relative abundance of alkenes. In summary, the surface hydrocarbon metabolome of silks is primarily governed by genotype and husk encasement status, with smaller impacts of environment and genotype-by-environment interactions.

Conclusions

This study reveals that the composition of the cuticular hydrocarbon metabolome on silks is affected significantly by genetic factors, and is therefore amenable to dissection using quantitative genetic approaches. Such studies will clarify the genetic mechanisms responsible for the accumulation of these metabolites, enabling detailed functional investigations of the diverse and complex protective roles of silk surface lipids against environmental stresses.
Regional versus systemic analgesia in video-assisted thoracoscopic lobectomy: a retrospective analysis
Authors: Haager Benedikt , Schmid Daniel , Eschbach Joerg , Passlick Bernward , Loop Torsten
Published: October 2019

Background

The optimal perioperative analgesic strategy in video-assisted thoracic surgery (VATS) for anatomic lung resections remains an open issue. Regional analgesic concepts as thoracic paravertebral or epidural analgesia were used as systemic opioid application. We hypothesized that regional anesthesia would provide improved analgesia compared to systemic analgesia with parenteral opioids in VATS lobectomy and would be associated with a lower incidence of pulmonary complications.

Methods

The study was approved by the local ethics committee (AZ 99/15) and registered (germanctr.de; DRKS00007529, 10th June 2015). A retrospective analysis of anesthetic and surgical records between July 2014 und February 2016 in a single university hospital with 103 who underwent VATS lobectomy. Comparison of regional anesthesia (i.e. thoracic paravertebral blockade (group TPVB) or thoracic epidural anesthesia (group TEA)) with a systemic opioid application (i.e. patient controlled analgesia (group PCA)). The primary endpoint was the postoperative pain level measured by Visual Analog Scale (VAS) at rest and during coughing during 120 h. Secondary endpoints were postoperative pulmonary complications (i.e. atelectasis, pneumonia), hemodynamic variables and postoperative nausea and vomiting (PONV).

Results

Mean VAS values in rest or during coughing were measured below 3.5 in all groups showing effective analgesic therapy throughout the observation period. The VAS values at rest were comparable between all groups, VAS level during coughing in patients with PCA was higher but comparable except after 8–16 h postoperatively (PCA vs. TEA; p < 0.004). There were no significant differences on secondary endpoints. Intraoperative Sufentanil consumption was significantly higher for patients without regional anesthesia (p < 0.0001 vs. TPVB and vs. TEA). The morphine equivalence postoperatively applicated until POD 5 was comparable in all groups (mean ± SD in mg: 32 ± 29 (TPVB), 30 ± 27 (TEA), 36 ± 30 (PCA); p = 0.6046).

Conclusions

Analgesia with TEA, TPVB and PCA provided a comparable and effective pain relief after VATS anatomic resection without side effects. Our results indicate that PCA for VATS lobectomy may be a sufficient alternative compared to regional analgesia.

Trial registration

The study was registered (germanctr.de; DRKS00007529; 10th June, 2015).
Treatment of lead and arsenic poisoning in anuric patients – a case report and narrative review of the literature
Authors: Hsiao Chun-Yuan , Gresham Chip , Marshall Mark R.
Published: October 2019

Background

Heavy metal poisoning can cause debilitating illness if left untreated, and its management in anuric patients poses challenges. Literature with which to guide clinical practice in this area is rather scattered.

Case presentation

We present a case of symptomatic lead and arsenic poisoning from use of Ayurvedic medicine in a 28-year-old man with end-stage kidney disease on chronic hemodialysis. We describe his treatment course with chelating agents and extracorporeal blood purification, and review the relevant literature to provide general guidance.

Conclusion

Cumulative clinical experience assists in identifying preferred chelators and modalities of extracorporeal blood purification when managing such patients. However, a larger body of real-world or clinical trial evidence is necessary to inform evidence-based guidelines for the management of heavy metal poisoning in anuric patients.
Exploration of candidate serum biomarkers potentially related to the chronic pain condition in Medication–overuse headache
Authors: Pellesi Lanfranco , Bellei Elisa , Guerzoni Simona , Cainazzo Maria Michela , Baraldi Carlo , Monari Emanuela , Pini Luigi Alberto
Published: October 2019

Background

Medication Overuse Headache (MOH) is a prevalent and disabling disorder resulting from the overuse of analgesic drugs, triptans or other acute headache medications. In previous proteomic studies, several proteins have been found at high concentrations in the urine of MOH patients and in the serum of rats with neuropathic pain. The aim of this study was to compare the serum levels of lipocalin-type Prostaglandin D2 synthase (L-PGDS), Vitamin D-binding protein (VDBP), apolipoprotein E (APOE) and apolipoprotein A1 (APOA1) in MOH patients and healthy individuals, further exploring their relationship with cutaneous pain thresholds (CPTs) in the territories innervated by the trigeminal nerve.

Methods

Sixty-nine MOH patients and 42 age- and sex-matched healthy volunteers were enrolled in the study. Von Frey-like filaments were applied to the skin territories innervated by the trigeminal nerve, to determine the CPTs. L-PGDS, VDBP, APOE and APOA1 were quantified in the serum by Enzyme-linked Immunosorbent Assay (ELISA). Clinical and laboratory data were collected. Comparisons between MOH patients and healthy individuals were performed using independent t test or χ2test. To correlate serum proteins with CPTs, Pearson correlation coefficient or Spearman’s rank correlation coefficient were used.

Results

CPTs were lower among MOH patients. L-PGDS, VDBP and APOE had significantly different serum concentrations between groups (p < 0.01), but no correlation was found with CPTs. APOA1 serum concentrations did not differ between patients and healthy individuals.

Conclusions

L-PGDS, VDBP and APOE had abnormal serum levels in MOH patients, confirming their alteration in some conditions of chronic headache and neuropathic pain. However, they had no relationship with CPTs. The in-depth study of serum proteins represents a promising approach for a better understanding of MOH, as well as the detection of candidate biomarkers for chronic headache or the risks associated with overuse medications.
Global differences in the prevalence of the CpG island methylator phenotype of colorectal cancer
Authors: Advani Shailesh Mahesh , Advani Pragati Shailesh , Brown Derek W. , DeSantis Stacia M. , Korphaisarn Krittiya , VonVille Helena M. , Bressler Jan , Lopez David S. , Davis Jennifer S. , Daniel Carrie R. , Sarshekeh Amir Mehrvarz , Braithwaite Dejana , Swartz Michael D. , Kopetz Scott
Published: October 2019

Background

CpG Island Methylator Phenotype (CIMP) is an epigenetic phenotype in CRC characterized by hypermethylation of CpG islands in promoter regions of tumor suppressor genes, leading to their transcriptional silencing and loss of function. While the prevalence of CRC differs across geographical regions, no studies have compared prevalence of CIMP-High phenotype across regions. The purpose of this project was to compare the prevalence of CIMP across geographical regions after adjusting for variations in methodologies to measure CIMP in a meta-analysis.

Methods

We searched PubMed, Medline, and Embase for articles focusing on CIMP published from 2000 to 2018. Two reviewers independently identified 111 articles to be included in final meta-analysis. We classified methods used to quantify CIMP into 4 categories: a) Classical (MINT marker) Panel group b) Weisenberg-Ogino (W-O) group c) Human Methylation Arrays group and d) Miscellaneous group. We compared the prevalence of CIMP across geographical regions after correcting for methodological variations using meta-regression techniques.

Results

The pooled prevalence of CIMP-High across all studies was 22% (95% confidence interval:21–24%; I2 = 94.75%). Pooled prevalence of CIMP-H across Asia, Australia, Europe, North America and South America was 22, 21, 21, 27 and 25%, respectively. Meta-regression analysis identified no significant differences in the prevalence of CIMP-H across geographical regions after correction for methodological variations. In exploratory analysis, we observed variations in CIMP-H prevalence across countries.

Conclusion

Although no differences were found for CIMP-H prevalence across countries, further studies are needed to compare the influence of demographic, lifestyle and environmental factors in relation to the prevalence of CIMP across geographical regions.
Synchronous colonic adenoma and intestinal marginal zone B-cell lymphoma associated with Crohn’s disease: a case report and literature review
Authors: Bennani Amal , Kharrasse Ghizlane , Achraf Miry , Wafa Khanoussi , Zahi Ismaili , Imane Kamaoui , Mohamed Bouziane
Published: October 2019

Background

Lymphoma and dysplasia are rare complications of long-standing Crohn’s disease. We report an exceptional case of a synchronous intestinal marginal zone B-cell lymphoma (MALT lymphoma) and colonic adenoma in a Crohn’s disease patient.

Case presentation

A 50-year-old male patient presented with right lower quadrant for the last 9 months. He also had associated weight loss and diarrhea alternating with constipation. Ileo-colonoscopy revealed a pseudopolypoid appearance of the colonic and ileal mucosa with many discontinuous ulcerations with a 3 cm sessile polypoid mass at 17 cm from the anal verge. Histological examination of the polypoid lesion revealed an adenoma with high grade dysplasia, while the biopsies of colonic mucosa showed histologic features of Crohn’s disease. Abdominal computed tomography scan (CT scan) and magnetic resonance imaging (MRI) showed circumferential wall thickening of the colon and ileum, enlarged mesenteric lymph nodes and a sessile polypoid mass of the rectosigmoid junction. The patient was scheduled for an ileocoletectomy with resection of the upper rectum and ileorectostomy.

The histological examination of the resected segment showed histologic features of Crohn’s disease, a recto-sigmoid polyp with high grade.

dysplasia and extensive small lymphocytic infiltrate in both colonic and ileal wall which is strongly stained by CD20 and BCL2. The diagnosis of MALT lymphoma with adenoma on a background of Crohn’s disease was made.

The patient successfully completed 8 cycles of Rituximab+ chlorambucil chemotherapy.

Nowadays the patient is asymptomatic without evidence of lymphoproliferative recurrence 10 months after surgery.

Conclusion

We report the first case in the literature of Malt lymphoma with colonic adenoma associated with Crohn’s disease, and discuss his unique macroscopic and histological features in a patient.

Without immunosuppressive therapy.
Cost-effectiveness of a mindfulness-based mental health promotion program: economic evaluation of a nonrandomized controlled trial with propensity score matching
Authors: Müller Gerhard , Pfinder Manuela , Schmahl Christian , Bohus Martin , Lyssenko Lisa
Published: October 2019

Background

Mental health promotion programs have been shown to reduce the burden associated with mental distress and prevent the onset of mental disorders, but evidence of cost-effectiveness is scarce.

Objective

To evaluate the cost-effectiveness of a mindfulness-based mental health prevention program provided by health coaches in a multi-site field setting in Germany.

Methods

The single-study based economic evaluation was conducted as part of a nonrandomized controlled trial, comparing the effects of a group-based prevention program to usual care based on propensity score matching. Participants (N = 1166) were recruited via a large statutory health insurance fund. Health outcome was assessed with the Hospital Anxiety and Depression Scale (HADS). Cost outcomes were actually incurred costs compiled from the health insurance’ records. Incremental cost-effectiveness ratios (ICER) were analyzed from a societal and a health care perspective for a 12-month time horizon with sampling uncertainty being handled using nonparametric bootstrapping. A cost-effectiveness acceptability curve was graphed to determine the probability of cost-effectiveness at different willingness-to-pay ceiling ratios.

Results

From a societal perspective, prevention was cost-effective compared to usual-care by providing larger effects of 1.97 units on the HADS (95% CI [1.14, 2.81], p < 0.001) at lower mean incremental total costs of €-57 (95% CI [− 634, 480], p = 0.84), yielding an ICER of €-29 (savings) per unit improvement. From a health care perspective, the incremental health benefits were achieved at additional direct costs of €181 for prevention participants (95% CI [40, 318], p = 0.01) with an ICER of €91 per unit improvement on the HADS. Willingness-to-pay for the prevention program to achieve a 95% probability of being cost-effective compared to usual-care, was estimated at €225 per unit improvement on the HADS score from a societal, and €191 from a health care perspective respectively. Sensitivity analyses suggested differential cost-effect-ratios depending on the initial distress of participants.

Limitations

Due to the complexity of the field trial, it was not feasible to randomize participants and offer an active control condition. This limitation was met by applying a rigorous matching procedure.

Conclusions

Our results indicate that universal mental health promotion programs in community settings might be a cost-effective strategy to enhance well-being. Differences between the societal and health care perspective underline the call for joint funding in the dissemination of preventive services.

Trial registration

German Clinical Trials Registration ID: DRKS00006216 (2014/06/11, retrospective registration).
Prevalence of chronic obstructive pulmonary disease (COPD) and its associated factors among adults in Abeshge District, Ethiopia: a cross sectional study
Authors: Woldeamanuel Gashaw Garedew , Mingude Alemu Basazin , Geta Teshome Gensa
Published: October 2019

Background

Chronic obstructive pulmonary disease (COPD) is one of the major public health problems worldwide. Despite an increasing burden of COPD in the world, it is often a neglected disease in low income countries and COPD prevalence studies are rare in Sub-Saharan Africa. The objective of this study was to determine the prevalence of COPD and its associated factors among adults in Ethiopia.

Methods

A community based cross sectional study was conducted from February 5 to May 20, 2019 in Abeshge district, Southern Ethiopia. A total of 734 adults aged at least 30 years were selected using multistage cluster sampling technique and included in the study. All participants were interviewed about socio-demographic characteristics, respiratory symptoms, smoking status and clinical characteristics. Moreover, all participants underwent spirometry. We defined COPD as a post-bronchodilator FEV1/FVC of less than 70%. Data were entered into Epi-data manager 4.4 and analyzed using SPSS version 23. Descriptive statistics and binary logistic regression analysis were used and p-value < 0.05 was considered as significant.

Results

Of the 779 adults invited to participate, 734 adults (421 men and 313 women) were participated in this study. The mean (SD) age of the participants was 39.15 (± 9.36) years, within the age range of 30–75 years. The prevalence of COPD was 17.8% (95% confidence interval [CI], 15.1–20.6). Factors significantly associated with COPD were age above 50 years (adjusted odds ratio [AOR] = 1.91, 95% CI [1.10, 3.30]), being smoker (AOR = 4.54, 95% CI [2.69, 7.66]), Exposed to biomass smoke (AOR = 2.05, 95% CI [1.06, 3.95]) and poor ventilated kitchen (AOR = 4.12, 95% CI [2.67, 6.34]).

Conclusion

It is evident from this study that the prevalence of COPD in Ethiopia is high. Factors such as old age, cigarette smoking, exposure to biomass smoke and poor kitchen ventilation plays a role in the development of COPD.
Supernumerary kidneys: a clinical and radiological analysis of nine cases
Authors: Rehder Peter , Rehwald Rafael , Böhm Julia M. , Grams Astrid E. , Loizides Alexander , Pedrini Marco , Stühmeier Jannik , Glodny Bernhard
Published: October 2019

Background

A supernumerary kidney (SK) is an additional kidney with its own capsule and blood supply that is not fused with the ipsilateral kidney (IK). Because individual case reports indicate a high morbidity rate, the aim of this retrospective study was a detailed analysis of this rare anatomical variant.

Methods

Our systematic imaging-based search for SKs, conducted in the period from 2000 and to 2017, yielded 9 cases in total (5 men, 4 women; mean age: 51.8 ± 22.8 years).

Results

The SKs were observed on the right in six and on the left side in three cases. In six subjects (66%) they were located caudal and in three cases (33%) cranial to the ipsilateral kidney. Calculi were found in three (33%) of the renal collecting systems. Five (56%) of the SKs had hydronephrosis grade IV and one SK had recurrent pyelonephritis (11%). Two of the ureters opened into the ipsilateral seminal vesicle (22%). Two (22%) SKs were functional but atrophic. Clinically relevant findings were made in 33% of the IKs: atrophy (n = 2), calculi (n = 1), and reflux with recurrent pyelonephritis (n = 1); another 33% had anatomical anomalies without functional impairment. The correct diagnosis of a SK is possible using CT imaging in all subjects. The prevalence of SK based on CT imaging can be estimated to be 1:26750.

Conclusions

CT is the method of choice for visualizing SKs. The correct diagnosis is crucial in preventing dispensable surgical procedures and for providing optimal patient treatment and outcome.
Development of a novel human phage display-derived anti-LAG3 scFv antibody targeting CD8+ T lymphocyte exhaustion
Authors: Ascione Alessandro , Arenaccio Claudia , Mallano Alessandra , Flego Michela , Gellini Mara , Andreotti Mauro , Fenwick Craig , Pantaleo Giuseppe , Vella Stefano , Federico Maurizio
Published: October 2019

Background

Lymphocyte-activation gene (LAG)3 is a 498 aa transmembrane type I protein acting as an immune inhibitory receptor. It is expressed on activated lymphocytes, natural killer cells and plasmacytoid dendritic cells. In activated lymphocytes, LAG3 expression is involved in negative control of cell activation/proliferation to ensure modulation and control of immune responses. In view of its deregulated expression in tumor-infiltrating lymphocytes, LAG3, together with the additional immune checkpoint inhibitors CTLA4 and PD1, is considered a major target in order to reverse the immunosuppression typically mounting in oncologic diseases. Since many patients still fail to respond to current immune checkpoints-based therapies, the identification of new effective immune inhibitors is a priority in the ongoing fight against cancer.

Results

We identified a novel human single-chain variable fragment (scFv) Ab against a conformational epitope of LAG3 by in vitro phage display technology using the recombinant antigen as a bait. This scFv (referred to as F7) was characterized in terms of binding specificity to both recombinant antigen and human LAG3-expressing cells. It was then rebuilt into an IgG format pre-optimized for clinical usage, and the resulting bivalent construct was shown to preserve its ability to bind LAG3 on human cells.

Next, we analyzed the activity of the anti-LAG3 scFvF7 using two different antigen-specific CD8+T lymphocyte clones as target cells. We proved that the reconstituted anti-LAG3 F7 Ab efficiently binds the cell membrane of both cell clones after peptide-activation. Still more significantly, we observed a striking increase in the peptide-dependent cell activation upon Ab treatment as measured in terms of IFN-γ release by both ELISA and ELISPOT assays.

Conclusions

Overall, the biotechnological strategy described herein represents a guiding development model for the search of novel useful immune checkpoint inhibitors. In addition, our functional data propose a novel candidate reagent for consideration as a cancer treatment.
Fit for fight – self-reported health in military women: a cross-sectional study
Authors: Fadum Elin Anita , Strand Leif Åge , Martinussen Monica , Breidvik Laila , Isaksen Nina , Borud Einar
Published: October 2019

Background

Substantial research has found that women assess their health as poor relative to men, but the reasons for this are not fully understood. Military women are characterised by good health and the ability to work in an archetypically male culture. Thus, studies on the gender pattern of self-reported health in military personnel could generate hypotheses for future research on the possible associations between gender and health. However, such studies are rare and limited to a few countries. The aim of this study was to examine self-reported physical and mental health in Norwegian military women.

Methods

We compared responses on self-reported health of 1068 active duty military women in Norway to those of active duty military men (n = 8100). Further, we compared the military women to civilian women working in the Norwegian Armed Forces (n = 1081). Participants were stratified into three age groups: 20–29; 30–39; and 40–60 years. We used Pearson Chi-square tests, Students t-tests and regression models to assess differences between the groups.

Results

The military women in our study reported physical illness and injuries equal to those of military men, but more military women used pain relieving and psychotropic drugs. More military women aged 20–29 and 30–39 years reported mental health issues than military men of the same age. In the age group 30–39 years, twice as many military women assessed their health as poor compared to military men. In the age group 40–60 years, more military women than men reported musculoskeletal pain. Military women used less smokeless tobacco than military men, but there were few differences in alcohol consumption and smoking. Military women appeared to be more physically healthy than civilian women, but we found few differences in mental health between these two groups.

Conclusion

Most military women reported physical symptoms equal to those of military men, but there were differences between the genders in mental health and drug use. More favourable health compared to civilian women was most evident in the youngest age group and did not apply to mental health.
Physiotherapy students’ DiSC behaviour styles can be used to predict the likelihood of success in clinical placements
Authors: Milne Nikki , Louwen Chanelle , Reidlinger Dianne , Bishop Jo , Dalton Megan , Crane Linda
Published: October 2019

Background

Behaviour can be defined as the internally coordinated responses (actions or inactions) of whole living organisms (individuals or groups) to internal and/or external stimuli, excluding responses more easily understood as developmental changes. Unlike personality traits, that are thought to be biologically consistent, behaviour, through the application of cognition and reasoning is open to change across time and circumstance, although most humans will display preferred ways of behaving. The objective of this study was to: i) identify the behaviour styles of physiotherapy students and investigate if there is a relationship (predictive or otherwise) between students’ unique behaviour patterns and their clinical placement grades and; ii) examine if this relationship differs when student’s in a Master’s level program as well as student’s in a Bachelor’s level program are explored separately.

Methods

This cross-sectional study with 132 (F = 78, M = 54) physiotherapy students was conducted across two Australian university settings. Measures included Everything DiSC Workplace profile, Assessment of Physiotherapy Practice (APP).

Results

Physiotherapy students (n = 133) profiled the following ways: Dominance (D) style n = 20 (15%), Influence (i) style n = 33 (25%), Steadiness (S) style n = 36 (27%) and Conscientiousness (C) n = 44 (33%). Students with the individual DiSC styles of i and Conscientiousness / Steadiness (CS) were in the lowest APP quartile for clinical grades and the D style was in the highest quartile. Binary logistic regressions revealed students with an i DiSC style had 3.96 times higher odds, and students with a CS DiSC style had 4.34 times higher odds, of failing a clinical placement. When explored independently, the same trend remained for Master’s level students. Bachelor’s level students with DiSC styles of S and C had failed placements, however these styles were not significantly associated with failure (DiSC S Style: Exp(B) 1.667, p = 0.713 (CI: 0.109 to 25.433), DiSC C Style: Exp(B) 11.00, p = 0.097 (CI: 0.646 to 187.166)).

Conclusion

Physiotherapy students with DiSC styles i and CS appear to be more likely to fail physiotherapy clinical placements. Further research with larger undergraduate samples is required to establish if relations differ for undergraduate versus postgraduate students.