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Τετάρτη, 17 Ιανουαρίου 2018

Discriminating Depth of Response to Therapy in Multiple Myeloma Using Whole-body Diffusion-weighted MRI with Apparent Diffusion Coefficient

Publication date: Available online 17 January 2018
Source:Academic Radiology
Author(s): Chao Wu, Juan Huang, Wen-Bin Xu, Yong-Jing Guan, Hua-Wei Ling, Jian-Qing Mi, Hua Yan
Rationale and ObjectivesThis study aimed to measure apparent diffusion coefficient (ADC) in Chinese patients with newly diagnosed multiple myeloma by whole-body diffusion-weighted magnetic resonance imaging (WB-DWI MRI) and assess the diagnostic accuracy of ADC in the discrimination of deep response to induction chemotherapy.Materials and MethodsSeventeen patients underwent WB-DWI MRI before and after induction chemotherapy (week 20). DWI images and ADC maps were produced and 89 regions of interest were chosen. ADC percent changes were compared between deep (complete response or very good partial response) and non–deep responders (partial response, minimal response, stable disease, or progressive disease) as International Myeloma Working Group criteria. Diagnostic accuracy of ADC was calculated using specific cut offs. Predictive positive value of ADC was calculated to predict deep response to consolidation therapy.ResultsLesions reduced in size and number and signal intensity decreased in follow-up DWI, which did not differ between deep and non–deep responders. ADC percent changes were significantly higher in deep responders (36.79%) than in non–deep responders (11.50%) after induction therapy (P = .02) in per lesion analysis. ADC percent increases by 46.96%, 78.0% yielded specificity at 81.4%, 90.7% in discriminating deep response to induction therapy. Predictive positive value predicting deep response to consolidation therapy was 60.5% by using ADC cutoff >1.00 × 10−3 mm2/s at week 20.ConclusionsADC from WB-DWI MRI increased remarkably in patients who achieved deep response at the end of induction chemotherapy, which represented a confirmatory diagnostic tool to discriminate deep response to induction therapy for patients with multiple myeloma. ADC may have a potential to predict deep response to consolidation therapy.



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Associations of County-level Radiologist and Mammography Facility Supply with Screening Mammography Rates in the United States

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Publication date: Available online 17 January 2018
Source:Academic Radiology
Author(s): Andrew B. Rosenkrantz, Linda Moy, Margaret M. Fleming, Richard Duszak
Rationale and ObjectivesThe present study aims to assess associations of Medicare beneficiary screening mammography rates with local mammography facility and radiologist availability.Materials and MethodsMammography screening rates for Medicare fee-for-service beneficiaries were obtained for US counties using the County Health Rankings data set. County-level certified mammography facility counts were obtained from the United States Food and Drug Administration. County-level mammogram-interpreting radiologist and breast imaging subspecialist counts were determined using Centers for Medicare & Medicaid Services fee-for-service claims files. Spearman correlations and multivariable linear regressions were performed using counties' facility and radiologist counts, as well as counts normalized to counties' Medicare fee-for-service beneficiary volume and land area.ResultsAcross 3035 included counties, average screening mammography rates were 60.5% ± 8.2% (range 26%–88%). Correlations between county-level screening rates and total mammography facilities, facilities per 100,000 square mile county area, total mammography-interpreting radiologists, and mammography-interpreting radiologists per 100,000 county-level Medicare beneficiaries were all weak (r = 0.22–0.26). Correlations between county-level screening rates and mammography rates per 100,000 Medicare beneficiaries, total breast imaging subspecialist radiologists, and breast imaging subspecialist radiologists per 100,000 Medicare beneficiaries were all minimal (r = 0.06–0.16). Multivariable analyses overall demonstrated radiologist supply to have a stronger independent effect than facility supply, although effect sizes remained weak for both.ConclusionMammography facility and radiologist supply-side factors are only weakly associated with county-level Medicare beneficiary screening mammography rates, and as such, screening mammography may differ from many other health-care services. Although efforts to enhance facility and radiologist supply may be helpful, initiatives to improve screening mammography rates should focus more on demand-side factors, such as patient education and primary care physician education and access.



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Does Second Reader Opinion Affect Patient Management in Pancreatic Ductal Adenocarcinoma?

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Publication date: Available online 17 January 2018
Source:Academic Radiology
Author(s): Giuseppe Corrias, Sandra Huicochea Castellanos, Ryan Merkow, Russel Langan, Vinod Balachandran, Monica Ragucci, Gabriella Carollo, Marcello Mancini, Luca Saba, Lorenzo Mannelli
Rationale and ObjectivesTo determine the impact of second-opinion assessment on cancer staging and patient management in patients with pancreatic ductal adenocarcinoma.Methods and MaterialsThis retrospective study was approved by our institutional review board with a waiver of informed consent. Second-opinion reports between January 1, 2009 and December 31, 2013, alongside outside reports for 65 consecutive cases of biopsy-proven pancreatic adenocarcinomas, were presented in random order to two experienced abdominal surgeons who independently reviewed them blinded to the origin of the report, images of the examinations, and patient identifier. Each surgeon filled in a questionnaire for each report recommending cancer staging and patient management. Recommended patient management and staging were evaluated against reference standards (actual patient management at 6 months following second-opinion assessment, and pathology or other clinical and imaging reference standards at 6 months or longer, respectively) using Cohen kappa.ResultsCancer staging differed in 13% (9 of 65) of cases for surgeon 1 and in 18.4% (12 of 65) for surgeon 2. Patient management changed in 38.4% (25 of 65) of cases for surgeon 1 and in 20% (13 of 65) for surgeon 2. When compared to the pathologic staging gold standard, second opinion was correct in 85.7% (six of seven) of the time for both surgeons. Recommended patient management from second-opinion reports showed good agreement with the reference standard (weighted k = 0.6467 [0.4014–0.892] and weighted k = 0.6262 [0.3954–0.857] for surgeon 2).ConclusionSecond-opinion review by subspecialized oncologic radiologists can impact patient care, specifically in terms of management decision.



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Automated Radiology-Pathology Module Correlation Using a Novel Report Matching Algorithm by Organ System

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Publication date: Available online 17 January 2018
Source:Academic Radiology
Author(s): Bari Dane, Ankur Doshi, Soterios Gfytopoulos, Priya Bhattacharji, Michael Recht, William Moore
Objectives and RationaleRadiology-pathology correlation is time-consuming and is not feasible in most clinical settings, with the notable exception of breast imaging. The purpose of this study was to determine if an automated radiology-pathology report pairing system could accurately match radiology and pathology reports, thus creating a feedback loop allowing for more frequent and timely radiology-pathology correlation.MethodsAn experienced radiologist created a matching matrix of radiology and pathology reports. These matching rules were then exported to a novel comprehensive radiology-pathology module. All distinct radiology-pathology pairings at our institution from January 1, 2016 to July 1, 2016 were included (n = 8999). The appropriateness of each radiology-pathology report pairing was scored as either "correlative" or "non-correlative." Pathology reports relating to anatomy imaged in the specific imaging study were deemed correlative, whereas pathology reports describing anatomy not imaged with the particular study were denoted non-correlative.ResultsOverall, there was 88.3% correlation (accuracy) of the radiology and pathology reports (n = 8999). Subset analysis demonstrated that computed tomography (CT) abdomen/pelvis, CT head/neck/face, CT chest, musculoskeletal CT (excluding spine), mammography, magnetic resonance imaging (MRI) abdomen/pelvis, MRI brain, musculoskeletal MRI (excluding spine), breast MRI, positron emission tomography (PET), breast ultrasound, and head/neck ultrasound all demonstrated greater than 91% correlation. When further stratified by imaging modality, CT, MRI, mammography, and PET demonstrated excellent correlation (greater than 96.3%). Ultrasound and non-PET nuclear medicine studies demonstrated poorer correlation (80%).ConclusionThere is excellent correlation of radiology imaging reports and appropriate pathology reports when matched by organ system. Rapid, appropriate radiology-pathology report pairings provide an excellent opportunity to close feedback loop to the interpreting radiologist.



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Die Rolle des PSMA-PET/CT bei Patienten mit metastasiertem Prostatakarzinom

Zusammenfassung

Die PSMA-PET/CT-Bildgebung ist zur Lokalisation des Prostatakarzinoms (PCa) in Deutschland zunehmend verfügbar. Die Vor- und Nachteile in den verschiedenen Krankheitsstadien werden evaluiert. Da die klinische Relevanz des Nachweises einer Oligometastasierung in der Primärdiagnostik bisher nicht ausreichend beurteilt werden kann, sollte die Bildgebung nur in klinischen Studien erfolgen. In der Rezidivdiagnostik nach einer Therapie mit kurativer Intention besitzt die PSMA-PET/CT-Bildgebung wertvolles Potential für die Planung einer möglichen Salvagetherapie. Für die Nutzung der PSMA-PET/CT-Bildgebung im metastasierten kastrationsresistenten PCa gibt es aktuell keine Evidenz.



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Welche Fußfehlbildungen sollte der Radiologe kennen?

Zusammenfassung

Die meisten Fehlbildungen des Fußes sind bereits bei Geburt sichtbar und ohne Bildgebung zu diagnostizieren. Sie können in angeborene flexible, angeborene strukturelle und erworbene Fußfehlbildungen unterteilt werden. Die häufigste angeborene flexible Fußdeformität beim Kind ist der Sichelfuß, der meistens keine längerfristige Therapie benötigt. Bei den kongenital strukturellen Fehlbildungen, wie sie beim Klumpfuß und Talus verticalis vorliegen, sollte im Lauf der ersten Lebenswoche eine Gipstherapie begonnen werden, damit bis zum Ende des ersten Lebensjahrs und Beginn der Vertikalisierung ein schmerzfrei belastbarer Fuß mit normaler Funktion vorhanden ist. Eine Bildgebung ist meist erst dann notwendig, wenn ein Rezidiv entsteht. Eine tarsale Coalitio wird häufig erst im Lauf des Wachstums durch die Entwicklung eines rigiden Knickfußes sichtbar und bedarf immer einer Bildgebung zur Diagnosesicherung. Der vorliegende Artikel soll dem Radiologen eine Übersicht über die wichtigsten Fußfehlbildungen geben und über deren Verlauf und Therapie informieren.



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Mesenchymale Tumoren des Abdomens



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Mitteilungen des Berufsverbandes der Deutschen Radiologen



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Increased whole blood FFA2/GPR43 receptor expression is associated with increased 30-day survival in patients with sepsis

Sepsis is a condition associated with a dysregulated inflammatory response to infection with significant morbidity. Recent advances have elucidated the vital role that the short chain fatty acid glycoprotein r...

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Infantile hypertrophic pyloric stenosis: a 4-year experience from two tertiary care centres in Cameroon

This study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon.

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Correlation between disease activity and serum ferritin in clinically amyopathic dermatomyositis with rapidly-progressive interstitial lung disease: a case report

Clinically amyopathic dermatomyositis with anti-Melanoma Differentiation-Associated gene 5 (MDA5) antibody often presents with severe interstitial lung disease. Although serum ferritin level is known to reflec...

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Nonmedical prescription opioid use and illegal drug use: initiation trajectory and related risks among people who use illegal drugs in Vancouver, Canada

We investigated the prevalence of and risk factors associated with initiating nonmedical prescription opioid use (NMPOU) before and after illegal drugs using data from two linked cohort studies of street youth...

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JFB, Vol. 9, Pages 8: DNA-Based Single-Molecule Electronics: From Concept to Function

JFB, Vol. 9, Pages 8: DNA-Based Single-Molecule Electronics: From Concept to Function

Journal of Functional Biomaterials doi: 10.3390/jfb9010008

Authors: Kun Wang

Beyond being the repository of genetic information, DNA is playing an increasingly important role as a building block for molecular electronics. Its inherent structural and molecular recognition properties render it a leading candidate for molecular electronics applications. The structural stability, diversity and programmability of DNA provide overwhelming freedom for the design and fabrication of molecular-scale devices. In the past two decades DNA has therefore attracted inordinate amounts of attention in molecular electronics. This review gives a brief survey of recent experimental progress in DNA-based single-molecule electronics with special focus on single-molecule conductance and I–V characteristics of individual DNA molecules. Existing challenges and exciting future opportunities are also discussed.



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De Gruyter reaches 1000th open access book milestone

 



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E-Bike–Related Trauma in Children and Adults

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Publication date: Available online 17 January 2018
Source:The Journal of Emergency Medicine
Author(s): Itai Gross, Daniel J. Weiss, Elior Eliasi, Miklosh Bala, Saar Hashavya
BackgroundElectric bike (e-bike) usage is growing worldwide, and so is the e-bike–related injury rate.ObjectiveThis study was undertaken to characterize e-bike–related injuries.MethodsData of all e-bike–related injuries presenting to our level I trauma center between 2014 and 2016 were collected and analyzed. Adult and pediatric (<18 years of age) e-bike–related injuries were then analyzed separately and compared.ResultsForty-eight patients suffering from e-bike–related injuries presented to our trauma center between January 1, 2014 and December 31, 2016. Seventeen (35%) patients were <18 years of age and 40 (85%) were male. The overall most common mechanism of injury was falling off the e-bike in 24 patients (50%), followed by collision with a static object in 9 patients (18.8%). Head (38%) and facial (33%) injuries were most common in children. In adult patients, orthopedic trauma was predominant, with extremity fractures in 35 (73%) followed by significant lacerations in 14 patients (29%). Severe trauma (Injury Severity Score >15) was found in 17 (35%) patients. The duration of hospital stay was 10.8 ± 6 days, 12 patients (25%) required a stay in the intensive care unit, and 21 patients (43.7%) required surgery. Compared to adults, children (<18 years of age) had significantly more head and face injuries (p = 0.05).ConclusionOur study suggests that e-bike–related trauma may involve serious injuries and have typical injury patterns that resemble those seen in motorcycle-related injuries. Children are more likely to suffer head and face injuries because of their higher head to body ratio. We suggest that these injuries should therefore be triaged appropriately, preferably to a medical facility with proper trauma capabilities.



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Rare missense mutations in RECQL and POLG associate with inherited predisposition to breast cancer

Abstract

Several known breast cancer susceptibility genes with moderate-to-high risk alleles encode proteins involved in DNA damage response (DDR). As these explain less than half of the hereditary breast cancer cases, additional predisposing alleles are likely to be discovered. Many of the previous studies utilizing massive parallel sequencing have focused on the protein-truncating variants, and the role of rare missense mutations has remained poorly addressed. In order to identify novel susceptibility factors, we have systematically analyzed the data from our parallel sequencing of 796 DDR genes in 189 Northern Finnish hereditary breast cancer patients for rare missense variants, predicted as deleterious. Thirty-five variants were studied here for the disease association using Finnish breast cancer case (n=492–2035) and control (n=277–1539) cohorts. As a result, two missense variants in genes involved in DNA replication, RECQL p.I156M and POLG p.L392V, the former involving genomic and the latter mitochondrial DNA replication, showed significant association with risk of breast cancer. Rare RECQL p.I156M allele was observed in breast cancer cases only (6/1946, 0.3%, p=0.043), whereas POLG p.L392V was two times more frequent in breast cancer cases (53/2238, 2.4%) compared to controls (18/1539, 1.2%, OR=2.1, 95% CI 1.2–3.5, p=0.010). Based on the current genetic data, both RECQL p.I156M and POLG p.L392V represent novel breast cancer predisposing alleles. This article is protected by copyright. All rights reserved.



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Eurogin Roadmap 2017: Triage strategies for the management of HPV-positive women in cervical screening programmes

Abstract

Cervical cancer screening will rely, increasingly, on HPV testing as a primary screen. The requirement for triage tests which can delineate clinically significant infection is thus prescient. In this EUROGIN 2017 roadmap, justification behind the most evidenced triages is outlined, as are challenges for implementation.

Cytology is the triage with the most follow-up data; the existence of an HR-HPV positive, cytology negative group presents a challenge and re-testing intervals for this group (and choice of re-test) require careful consideration. Furthermore, cytology relies on subjective skills and while adjunctive dual-staining with p16/Ki67 can mitigate inter-operator/site disparities, clinician-taken samples are required. Comparatively, genotyping and methylation markers are objective and are applicable to self-taken samples, offering logistical advantages including in low and middle income settings. However, genotyping may have diminishing returns in immunised populations and type(s) included must balance absolute risk for disease to avoid low specificity. While viral and cellular methylation markers show promise, more prospective data are needed in addition to refinements in automation.

Looking forward, systems that detect multiple targets concurrently such as next generation sequencing platforms will inform the development of triage tools. Multi-step triage strategies may be beneficial provided they do not create complex, unmanageable pathways. Inevitably, the balance of risk to cost(s) will be key in decision making, although defining an acceptable risk will likely differ between settings. Finally, given the significant changes to cervical screening and the variety of triage strategies, appropriate education of both health care providers and the public is essential. This article is protected by copyright. All rights reserved.



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Conditionally reprogrammed cells (CRC) methodology does not allow the in vitro expansion of patient-derived primary and metastatic lung cancer cells

Abstract

Availability of tumor and non-tumor patient-derived models would promote the development of more effective therapeutics for Non Small Cell Lung Cancer (NSCLC). Recently, conditionally reprogrammed cells (CRC) methodology demonstrated exceptional potential for the expansion of epithelial cells from patient tissues. However, the possibility to expand patient-derived lung cancer cells using CRC protocols is controversial. Here, we used CRC approach to expand cells from non-tumoral and tumor biopsies of patients with primary or metastatic NSCLC as well as pulmonary metastases of colorectal or breast cancers. CRC cultures were obtained from both tumor and non-malignant tissues with extraordinary high efficiency. Tumor cells were tracked in vitro through tumorigenicity assay, monitoring of tumor-specific genetic alterations and marker expression. Cultures were composed of EpCAM+ lung epithelial cells lacking tumorigenic potential. NSCLC biopsies-derived cultures rapidly lost patient-specific genetic mutations or tumor antigens. Similarly, pulmonary metastases of colon or breast cancer generated CRC cultures of lung epithelial cells. All CRC cultures examined displayed epithelial lung stem cell phenotype and function. In contrast, brain metastatic lung cancer biopsies failed to generate CRC cultures. In conclusion, patient-derived primary and metastatic lung cancer cells were negatively selected under CRC conditions, limiting the expansion to non-malignant lung epithelial stem cells either from tumor and non-tumor tissue sources. Thus, CRC approach cannot be applied for direct therapeutic testing of patient lung tumor cells, as the tumor-derived CRC cultures are composed of (non tumoral) airway basal cells. This article is protected by copyright. All rights reserved.



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HOXD-AS1/miR-130a sponge regulates glioma development by targeting E2F8

Abstract

Glioma development is an extremely complex process with changes occurring in numerous genes. HOXD antisense growth-associated long non-coding RNA (HOXD-AS1), an important long non-coding RNA (lncRNA), is known to regulate metastasis-related gene expression in bladder cancer, ovarian cancer and neuroblastoma. Here, we elucidated the function and possible molecular mechanisms of lncRNA HOXD-AS1 in human glioma cells. Our results proved that HOXD-AS1 expression was upregulated in glioma tissues and in glioma cell lines. HOXD-AS1 overexpression promoted cell migration and invasion in vitro, whereas knockdown of HOXD-AS1 expression repressed these cellular processes. Mechanistic studies further revealed that HOXD-AS1 could compete with the transcription factor E2F8 to bind with miR-130a, thus affecting E2F8 expression. Additionally, reciprocal repression was observed between HOXD-AS1 and miR-130a, and miR-130a mediated the tumor-suppressive effects of HOXD-AS1 knockdown. Taken together, these results provide a comprehensive analysis of the role of HOXD-AS1 in glioma cells and offer important clues to understand the key roles of competing endogenous RNA (ceRNA) mechanisms in human glioma. This article is protected by copyright. All rights reserved.



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E-Bike–Related Trauma in Children and Adults

Publication date: Available online 17 January 2018
Source:The Journal of Emergency Medicine
Author(s): Itai Gross, Daniel J. Weiss, Elior Eliasi, Miklosh Bala, Saar Hashavya
BackgroundElectric bike (e-bike) usage is growing worldwide, and so is the e-bike–related injury rate.ObjectiveThis study was undertaken to characterize e-bike–related injuries.MethodsData of all e-bike–related injuries presenting to our level I trauma center between 2014 and 2016 were collected and analyzed. Adult and pediatric (<18 years of age) e-bike–related injuries were then analyzed separately and compared.ResultsForty-eight patients suffering from e-bike–related injuries presented to our trauma center between January 1, 2014 and December 31, 2016. Seventeen (35%) patients were <18 years of age and 40 (85%) were male. The overall most common mechanism of injury was falling off the e-bike in 24 patients (50%), followed by collision with a static object in 9 patients (18.8%). Head (38%) and facial (33%) injuries were most common in children. In adult patients, orthopedic trauma was predominant, with extremity fractures in 35 (73%) followed by significant lacerations in 14 patients (29%). Severe trauma (Injury Severity Score >15) was found in 17 (35%) patients. The duration of hospital stay was 10.8 ± 6 days, 12 patients (25%) required a stay in the intensive care unit, and 21 patients (43.7%) required surgery. Compared to adults, children (<18 years of age) had significantly more head and face injuries (p = 0.05).ConclusionOur study suggests that e-bike–related trauma may involve serious injuries and have typical injury patterns that resemble those seen in motorcycle-related injuries. Children are more likely to suffer head and face injuries because of their higher head to body ratio. We suggest that these injuries should therefore be triaged appropriately, preferably to a medical facility with proper trauma capabilities.



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Heat Capacity and Thermodynamic Property of Lithium Pentaborate Pentahydrate

The heat capacity of lithium pentaborate pentahydrate has been measured using an adiabatic calorimeter at the temperature from 297 to 375 K. No phase transition and thermal anomalies were observed. The molar heat capacity of LiB5O8·5H2O can be expressed as (J·mol−1·K−1) = 396.79376 + 35.87528 + + , where is the temperature in Kelvin, , and . The thermodynamic functions of , , and of LiB5O8·5H2O are obtained via the molar heat capacity at the temperature of 5 K intervals.

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Cannabis Essential Oil: A Preliminary Study for the Evaluation of the Brain Effects

We examined the effects of essential oil from legal (THC

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A Mathematical Pressure Transient Analysis Model for Multiple Fractured Horizontal Wells in Shale Gas Reservoirs

Multistage fractured horizontal wells (MFHWs) have become the main technology for shale gas exploration. However, the existing models have neglected the percolation mechanism in nanopores of organic matter and failed to consider the differences among the reservoir properties in different areas. On that account, in this study, a modified apparent permeability model was proposed describing gas flow in shale gas reservoirs by integrating bulk gas flow in nanopores and gas desorption from nanopores. The apparent permeability was introduced into the macroseepage model to establish a dynamic pressure analysis model for MFHWs dual-porosity formations. The Laplace transformation and the regular perturbation method were used to obtain an analytical solution. The influences of fracture half-length, fracture permeability, Langmuir volume, matrix radius, matrix permeability, and induced fracture permeability on pressure and production were discussed. Results show that fracture half-length, fracture permeability, and induced fracture permeability exert a significant influence on production. A larger Langmuir volume results in a smaller pressure and pressure derivative. An increase in matrix permeability increases the production rate. Besides, this model fits the actual field data relatively well. It has a reliable theoretical foundation and can preferably describe the dynamic changes of pressure in the exploration process.

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A Case of Fibrous Pseudotumor in the Scrotum: Challenge for Diagnosis and Testicular Preservation

A paratesticular fibrous pseudotumor is a relatively rare benign disease. Preoperatively diagnosing a fibrous pseudotumor is challenging because distinguishing these masses from malignant tumors on the basis of clinical and radiological findings can be difficult. We present a case of a 28-year-old man who presented with a painless palpable mass in the right scrotum; the fibrous pseudotumor of the tunica vaginalis was treated with organ-sparing surgery. Computed tomography and magnetic resonance imaging revealed paratesticular tumors. Testicular tumor marker levels were within normal limits. We scheduled the patient to undergo tumor biopsy combined with intraoperative rapid diagnosis. Frozen section assessment suggested a fibrous pseudotumor without malignancy. We successfully performed organ-sparing surgery. Testicular-sparing surgery combined with frozen section assessment is primarily used for treating paratesticular fibrous pseudotumors.

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A Case of Rare Complication of Inguinal Parietoplasty according to Lichtenstein: Entero Cutaneous Fistula

Lichtenstein intervention is currently the classic model of the regulated treatment of inguinal hernias by direct local approach. This “tension-free” technique satisfies both patients and practitioners. However, it does not often evade severe complications of parietal surgery. The authors report their treatment experience in rural Africa of a late enterocutaneous fistula which aggravated an inguinal hernia repair according to the Lichtenstein procedure. Physiopathology, diagnosis, and treatment of that disease are analyzed in the light of literature.

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Current Strategies of Endocrine Therapy in Elderly Patients with Breast Cancer

Currently, the growing population of the elderly is one of biggest problems in terms of increase in geriatric diseases. Lack of data from large prospective studies on geriatric breast cancer patients often makes it difficult for clinicians to make treatments decisions for them. Because both benefit and risk of treatment should be taken into account, treatment is usually determined considering life expectancy or comorbidities in elderly patients. Treatment of breast cancer is differentiated according to histologic classifications, and hormone therapy is even adopted for patients with metastatic breast cancer if tumor tissue expresses hormone receptors. Endocrine therapy can offer great benefit to elderly patients considering its equivalent efficacy to chemotherapy with fewer toxicities if it is appropriately used. Aromatase inhibitors are usually prescribed agents in hormone therapy for elderly breast cancer patients due to their physiology after menopause. Here, endocrine therapy for elderly patients with breast cancer in neoadjuvant, adjuvant, and palliative setting is reviewed along with predictive adverse events resulting from the use of hormone agents.

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Sarcomatoid Variant of Urothelial Carcinoma of the Renal Pelvis with Inferior Vena Cava Tumour Thrombus: A Case Report and Literature Review

Sarcomatoid variant of urothelial carcinoma (SVUC) of the renal pelvis is a rare entity. To the best of our knowledge, around 25 cases of this neoplasm have been reported in the literature to date, most of which were of high stage. The inferior vena cava tumour thrombus, which is a hallmark of renal cell carcinoma (RCC), may rarely be found in urothelial carcinoma of renal pelvis. In this report, a case of SVUC associated with tumour extension to inferior vena cava is documented. This association has been encountered in only one previously reported case. The possibility of urothelial carcinoma of the renal pelvis should therefore be included in the differential diagnosis of tumour thrombus of the inferior vena cava.

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ZP2495 Protects against Myocardial Ischemia/Reperfusion Injury in Diabetic Mice through Improvement of Cardiac Metabolism and Mitochondrial Function: The Possible Involvement of AMPK-FoxO3a Signal Pathway

Coronary heart disease patients with type 2 diabetes were subject to higher vulnerability for cardiac ischemia-reperfusion (I/R) injury. This study was designed to evaluate the impact of ZP2495 (a glucagon-GLP-1 dual-agonist) on cardiac function and energy metabolism after myocardial I/R injury in db/db mice with a focus on mitochondrial function. C57BLKS/J-lepr+/lepr+ (BKS) and db/db mice received 4-week treatment of glucagon, ZP131 (GLP-1 receptor agonist), or ZP2495, followed by cardiac I/R injury. The results showed that cardiac function, cardiac glucose metabolism, cardiomyocyte apoptosis, cardiac mitochondrial morphology, and energetic transition were improved or ameliorated by ZP2495 to a greater extent than that of glucagon and ZP131. In vitro study showed that ZP2495, rather than glucagon, alleviated mitochondrial depolarization, cytochrome C release, and mitochondria ROS generation in neonatal rat ventricular myocytes subjected to high-glucose and simulated I/R injury conditions, the effects of which were weaker in the ZP131 group. Furthermore, the expressions of Akt, FoxO3a, and AMPK phosphorylation were elevated by ZP2495 to a greater extent than that of ZP131. In conclusion, ZP2495 may contribute to the improvement of cardiac function and energy metabolism in db/db mice after myocardial I/R injury by improving mitochondrial function possibly through Akt/FoxO3a and AMPK/FoxO3a signal pathways.

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Noninvasive Glioblastoma Testing: Multimodal Approach to Monitoring and Predicting Treatment Response

Glioblastoma is the most aggressive adult primary brain tumor which is incurable despite intensive multimodal treatment. Inter- and intratumoral heterogeneity poses one of the biggest barriers in the diagnosis and treatment of glioblastoma, causing differences in treatment response and outcome. Noninvasive prognostic and predictive tests are highly needed to complement the current armamentarium. Noninvasive testing of glioblastoma uses multiple techniques that can capture the heterogeneity of glioblastoma. This set of diagnostic approaches comprises advanced MRI techniques, nuclear imaging, liquid biopsy, and new integrated approaches including radiogenomics and radiomics. New treatment options such as agents targeted at driver oncogenes and immunotherapy are currently being developed, but benefit for glioblastoma patients still has to be demonstrated. Understanding and unraveling tumor heterogeneity and microenvironment can help to create a treatment regime that is patient-tailored to these specific tumor characteristics. Improved noninvasive tests are crucial to this success. This review discusses multiple diagnostic approaches and their effect on predicting and monitoring treatment response in glioblastoma.

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Metastases from distant primary tumours on the head and neck: clinical manifestation and diagnostics of 91 cases

Abstract

Purpose

The aim of this study was to evaluate which primary tumours metastasize on the head and neck region, identify the kind of clinical manifestation, the types of diagnostics that should be performed, and prove that the therapy appears possible and useful.

Patients

As many as 91 patients with a distant metastasis on the head and neck were enrolled in this retrospective clinical study from January 2004 to September 2016. All the patients were evaluated for clinical symptoms, primary tumour, localization, diagnostics, and surgical procedure.

Results

A total of 31 patients had asymptomatic swelling, 27 patients had symptomatic swelling, and nine experienced isolated pain without swelling. Most other symptoms were organ-specific. The most frequent localizations were the orbit (44 metastases), mandible (19), neck region (9), and skin (7). The most common primary tumours were breast carcinoma (44), bronchial carcinoma (12), and renal carcinoma (9). A biopsy was performed on 38 patients, a partial resection was done on 28 patients, extirpation on six patients, and a radical resection on 19 patients.

Conclusion

Distant metastases on the head and neck are rare and, therefore, pose a challenge for the oncologist and other involved disciplines. Most distant metastases occur within the first five years. Late metastases, especially in breast carcinoma, are still possible after 20 years. A surgical examination should be carried out if the findings are not clear due to multiple differential diagnoses. In particular, surgical options under palliative aspects should be examined.



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Aging and the Pelvic Floor

Abstract

Purpose of Review

To define the unique effects of age on the pelvic floor muscle and to outline current treatments of pelvic floor dysfunction in the older population.

Recent Findings

Aging has muscular, hormonal, and neurological effects on the pelvic floor that may lead to pelvic floor dysfunction. Muscular changes lead to decreased force output and weakness on clinical examination. Hormonal effects exacerbate pelvic tissue changes, most notably in the postmenopausal woman. Neurological changes are less well-defined, but gradual denervation of the pelvic floor, especially noted in parous women, has been implicated as a possible cause of pelvic floor weakness and dysfunction. Medical treatments include pessaries, medications, implanted electrical stimulation, and surgery. Pelvic floor physical therapy, including strength training and coordination training, as well as pain-relieving modalities at the level of the pelvic floor muscle, is an effective conservative management option for older adults with pelvic floor dysfunction. The literature available regarding treatment of pelvic floor dysfunction is more robust for older females compared to males.

Summary

There are numerous unique considerations in the treatment of the older adult with pelvic floor dysfunction, due to muscular, hormonal, and neurological changes with age. Conservative management, including physical therapy, should be considered prior to surgical intervention. Further research is especially needed regarding the effects of age and the treatment of age-related pelvic dysfunction in the older male.



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Microbial Characterization of Methanogenic and Iron-reducing Consortium in Reactors with Polychlorinated Biphenyls

Abstract

Recent papers have confirmed current environmental pollution and the continuous release of polychlorinated biphenyls (PCBs) despite the prohibition of its manufacture worldwide. As the dehalogenating microorganisms are able to remove halogens from various analogous compounds, the characterization of PCB metabolisms can improve the degradation of similar compounds. Thus, this study extensively evaluated the microbial community developed in methanogenic and iron-reducing reactors. The horizontal-flow anaerobic reactor (HAIB) with real waste of Aroclor (1 mL L−1) was fed with mineral medium, ethanol, and sodium formate. Bacteria belonging to Thermotogaceae (Thermotogae), Geobacteraceae, Chloroflexi, Proteobacteria, and Firmicutes (Clostridium) were identified in the HAIB reactor. Bacteria belonging to the Chloroflexi, Firmicutes, and Geobacteraceae are associated with the degradation of hydrocarbons and could be related to the Aroclor waste in this paper. Furthermore, 5.26 × 1012 cells gTVS−1 of iron-reducing bacteria were quantified by the most probable number method in the HAIB reactor, suggesting that this group has an important role in aromatic degradation. Moreover, the evaluation of methanogenic and iron-reducing microorganisms in batch reactors with Aroclor 1260 was performed and the biomass growth was not affected by the addition of PCB. The methane production reached 0.38 µmol CH4 gTVS−1 and the iron reduction attained 90% in batch reactors. Through microbial analyses from HAIB and batch reactors, lower diversity was evidenced in the presence of PCB. This paper indicates the relevant role of iron-reducing organisms and Chloroflexi, Geobacteraceae, and Firmicutes group in PCB metabolism.



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Supercritical CO 2 extraction in chia oils production: impact of process duration and co-solvent addition

Abstract

This study was conducted to show impact of supercritical fluid extraction using pure SC-CO2 or SC-CO2 enriched by 2, 6, and 10% of acetone, simultaneously varied by the extraction time (1 vs. 5 h), on the quality of chia seed oils. Obtained oils were relatively similar in the fatty acid composition, but they differed in total content of phytochemicals (from 4956 to 6391 mg/kg of oil). Among them, three oils were the most different: oil extracted 1 h with pure SC-CO2 (the most abundant in squalene, sterols, and tocopherols), oil extracted 5 h with pure SC-CO2 (the poorest in squalene, polyphenols, and carotenoids, with medium level of sterols and tocopherols) and oil extracted 1 h with SC-CO2 enriched by 10% acetone (the most abundant in polyphenols and carotenoids). Such unique chia oils can be valuable for special market needs, such as cosmetics, pharmaceuticals, functional food or diet supplement production.



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Influence of highly concentrated fluoride dentifrices on remineralization characteristics of enamel in vitro

Abstract

Objectives

The aim of this in vitro study was to evaluate the role of highly fluoridated dentifrice on remineralization characteristics of lowly and highly pre-demineralized enamel artificial caries lesions.

Methods

Bovine enamel specimens were prepared (pH 4.95; 21 days) and discriminated in either lowly [L] or highly [H] pre-demineralized artificial caries lesions. Specimens with a mean ΔZbaseline,L (95% CI) of 5120 (4995; 5245) vol.% × μm and a mean ΔZbaseline,H of 8187 (8036; 8339) vol.% × μm were selected and randomly allocated to 12 groups (n = 20). Treatments during pH-cycling (28 days; 6 × 60 min demineralization/day) were brushing 2×/day with fluoride-free (0 ppm F [L0/H0]), 1100 ppm F [L1100/H1100], 2800 ppm F [L2800/H2800], 5000 ppm F [L5000/H5000], 5000 ppm F + glycerin [L5000 + glycerin/H5000 + glycerin], and 5000 ppm F + TCP [L5000 + TCP/H5000 + TCP] containing dentifrices. Dentifrice slurries were prepared with deionized water (1:3wt/wt). After cycling specimens presenting lesion surface loss were discarded and for the remaining 202 specimens, transversal microradiographic (TMR) analyses (ΔZpH-cycle/LDpH-cycle) were performed again. Changes in mineral loss (ΔΔZ = ΔZbaseline − ΔZpH-cycle) and lesion depth (ΔLD = LDbaseline − LDpH-cycle) were calculated.

Results

Significant differences for ΔΔZ could be found between L0, L1100, and L5000 as well as H0, H1100, and H2800/H5000 (p ≤ 0.01; ANCOVA). Except for 0 ppm F, higher ΔΔZ could be found in highly compared with lowly demineralized specimens (p ≤ 0.004; ANCOVA). After pH-cycling, a second lesion front could only be observed in H5000 and H5000 + TCP. The correlation between ΔΔZ and F was moderate for lowly and highly demineralized lesions (rL = 0.591; pL < 0.001; rH = 0.746; pH < 0.001), indicating a fluoride dose response for both.

Conclusion

For both baseline substrate conditions, a dose response for fluoride could be revealed.

Clinical significance

Remineralization characteristics of enamel directly depended on baseline mineral loss.



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The exibility of models of recognition memory: An analysis by the minimum-description length principle

Ten continuous, discrete, and hybrid models of recognition memory are considered in the traditional paradigm with manipulation of response bias via baserates or payoff schedules. We present an efficient method for computing the Fisher information approximation (FIA) to the normalized maximum likelihood index (NML) for these models, and a relatively efficient method for computing NML itself. This leads to a comparative evaluation of the complexity of the different models from the minimum-description-length perspective. Furthermore, we evaluate the goodness of the approximation of FIA to NML. Finally, model-recovery studies reveal that use of the minimum-description-length principle consistently identifies the true model more frequently than AIC and BIC. These results should be useful for research in recognition memory, but also in other fields (such as perception, reasoning, working memory, and so forth) in which these models play a role. Highlights ► The Fisher information approximation is efficiently computed for ten memory models. ► A relatively general method to compute the normalized maximum likelihood is derived. ► The relative complexity of ten recognition-memory models is evaluated. ► The small-sample adequacy of the Fisher information approximation is evaluated. ► The minimum-description length indices outperform AIC and BIC in model recovery.

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Atomic scale friction phenomena

Friction has long been the subject of research: the empirical da Vinci-Amontons friction laws have been common knowledge for centuries. Macroscopic experiments performed by the school of Bowden and Tabor revealed that macroscopic friction can be related to the collective action of small asperities. Over the last 25 years, experiments performed with the atomic force microscope have provided new insights into the physics of single asperities sliding over surfaces. This development, together with the results from complementary experiments using surface force apparatus and the quartz microbalance, have led to the new field of nanotribology. At the same time, increasing computing power has permitted the simulation of processes that occur during sliding contact involving several hundreds of atoms. It has become clear that atomic processes cannot be neglected when interpreting nanotribology experiments. Even on well-defined surfaces, experiments have revealed that atomic structure is directly linked to friction force. This chapter will describe friction force microscopy experiments that reveal, more or less directly, atomic processes during sliding contact. We will begin by introducing friction force microscopy, including the calibration of cantilever force sensors and special aspects of the ultrahigh vacuum environment. The empirical Prandtl-Tomlinson model often used to describe atomic stick-slip results is therefore presented in detail. We review experimental results regarding atomic friction, including thermal activation, velocity dependence and temperature dependence. The geometry of the contact is crucial to the interpretation of experimental results, such as the calculation of the lateral contact stiffness. The onset of wear on the atomic scale has recently been studied experimentally and it is described here. The chapter ends with a discussion of recent experiments aimed to detect the dissipative forces acting when a sharp tip is moved parallel and very close to a solid surface without being in contact with it, or when small entities such as single polymer chains, graphene nanoribbons or large organic molecules are manipulated.

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Laparoscopic transgastric circumferential stapler-assisted vs. endoscopic esophageal mucosectomy in a porcine model

Background and study aims Extensive endoscopic mucosal resection (EMR) for Barrett's esophagus (BE) may lead to stenosis. Laparoscopic, transgastric, stapler-assisted mucosectomy (SAM) with the retrieval of a circumferential specimen is proposed. Methods SAM was evaluated in two phases. The feasibility of SAM and the quality of specimens were assessed in eight animals. The mucosal healing was evaluated in a 6-week survival experiment comparing SAM (n = 6) with EMR (n = 6). The ratio of the esophageal lumen width (REL) at the resection level measured on fluoroscopy at 6 weeks divided by the width immediately after resection was compared. Results In all animals, a circular mucosectomy specimen was successfully obtained, with a median area of 492 mm2 (interquartile range [IQR] 426 - 573 mm2) and 941 mm2 (IQR 813 - 1209 mm2) using a 21 mm and 25 mm stapler, respectively. In the survival experiments, symptomatic stenosis developed in two animals after EMR and in none after SAM. The REL was 0.27 (0.18 - 0.39) and 0.96 (0.9 - 1.04; P < 0.0001) for EMR and SAM, respectively. Conclusions SAM provides a novel technique for en bloc mucosectomy in BE. In contrast to EMR, mucosal healing after SAM was not associated with stenosis up to 6 weeks after intervention.

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Politika soudržnosti v ČR a její regionální dimenze



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Effect of two cooling protocols on the post-thaw characteristics of Iberian ibex sperms

Publication date: Available online 17 January 2018
Source:Cryobiology
Author(s): Milagros C. Esteso, Adolfo Toledano-Díaz, Cristina Castaño, Jorgea Pradiee, Antonio Lopez-Sebastián, Julián Santiago-Moreno
The rate at which lethal intracellular ice forms during sperm cryopreservation is highly dependent on the cooling protocol. The present work compares two cooling protocols for use with Iberian ibex (Capra pyrenaica) sperm by assessing the effects on the motility, viability, and size of frozen-thawed sperm cells. Ejaculates, obtained from six adult ibex males via transrectal, ultrasound-guided massage of the accessory sex glands plus electroejaculation if necessary, were cooled via either 1) Protocol 1 (decelerating cooling), involving cooling in liquid nitrogen vapor from 5 °C to −35 °C (40 °C/min), from −35 °C to −65 °C (17 °C/min), and then from −65 °C to −85 °C (3 °C/min); or 2) Protocol 2 (accelerating cooling) involving cooling in a biological freezer from 5 °C to −5 °C (4 °C/min), from −5 °C to −110 °C (25 °C/min), and then from −110 °C to −140 °C (35 °C/min). Compared to fresh ejaculates, sperm quality at thawing was found to be reduced by both protocols (p < .05), but especially by Protocol 1. Sperm head size was also significantly reduced by both protocols, although the Protocol 1 sperm heads were also significantly smaller than those of Protocol 2 sperms heads (p < .05). In fresh sperm samples, clustering analyses revealed two subpopulations of sperms with different morphometric characteristics, SP1 with larger cells, and SP2 with smaller cells. Both cooling protocols caused reduction in the proportion of SP1 cells, and an increase in the proportion of SP2 cells. In conclusion, the decelerating cooling protocol (Protocol 1) caused greater cryodamage to the sperm cells than the accelerating protocol (Protocol 2).



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Evaluation of sheep ovarian tissue cryopreserved by slow freezing or vitrificaton after chick embryo chorioallantoic membrane transplantation

Publication date: Available online 17 January 2018
Source:Cryobiology
Author(s): Mahboubeh Vatanparast, Mohammad Ali Khalili, Nahid Yari, Marjan Omidi, Mehdi Mohsenzadeh
The aim of our investigations was to compare the effectiveness of two methods for cryopreservation of sheep ovarian tissue, slow freezing and vitrification. The quality of cryopreserved tissues was evaluated after 5 days of thawing and chorioallantoic membrane (CAM) transplantation. Follicular structure, stromal integrity and neovascularization were assessed. The areas of fibrosis and necrosis were measured using MICROVISIBLE software, and proliferation was assessed with Ki-67 immunostaning. After 5 days of culture, the proportion of primordial follicles decreased, whereas the primary and intermediary follicles increased insignificantly (p > .05). Only necrosis in the vitrified culture group increased significantly (p < .05). It was established also that 5 days CAM culture was not suitable methodology for detection of folliculogenesis. Follicular quality decreased after culture, but was better in fresh and slow frozen tissues than after vitrification (p < .05). Cellular proliferative activity fell, but it preserved to some extent in all groups. In conclusion, follicles was preserved better in grafted tissue after slow freezing than vitrification and stroma was more susceptible to ischemia in vitrified rather than conventional freezing in this view. Vitrification may not be a suitable alternative to the slow freezing.



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Hair Cortisol is Elevated in Erythropoietic Protoporphyria Patients and Correlates with Body Mass Index and Quality of Life



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IJMS, Vol. 19, Pages 274: Telomeric Repeat-Containing RNAs (TERRA) Decrease in Squamous Cell Carcinoma of the Head and Neck Is Associated with Worsened Clinical Outcome

IJMS, Vol. 19, Pages 274: Telomeric Repeat-Containing RNAs (TERRA) Decrease in Squamous Cell Carcinoma of the Head and Neck Is Associated with Worsened Clinical Outcome

International Journal of Molecular Sciences doi: 10.3390/ijms19010274

Authors: Valerio Vitelli Paolo Falvo Solomon G. Nergadze Marco Santagostino Lela Khoriauli Paola Pellanda Giulia Bertino Antonio Occhini Marco Benazzo Patrizia Morbini Marco Paulli Camillo Porta Elena Giulotto

Telomeres are transcribed into noncoding telomeric repeat-containing RNAs (TERRA), which are essential for telomere maintenance. Deregulation of TERRA transcription impairs telomere metabolism and a role in tumorigenesis has been proposed. Head and neck cancer (HNC) is one of the most frequent cancers worldwide, with head and neck squamous cell carcinoma (HNSCC) being the predominant type. Since HNSCC patients are characterized by altered telomere maintenance, a dysfunction in telomere transcription can be hypothesized. In this prospective study, we compared TERRA levels in the tumor and matched normal tissue from 23 HNSCC patients. We then classified patients in two categories according to the level of TERRA expression in the tumor compared to the normal tissue: (1) lower expression in the tumor, (2) higher or similar expression in tumor. A significant proportion of patients in the first group died of the disease within less than 34 months postsurgery, while the majority of patients in the second group were alive and disease-free. Our results highlight a striking correlation between TERRA expression and tumor aggressiveness in HNSCC suggesting that TERRA levels may be proposed as a novel molecular prognostic marker for HNSCC.



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An Experimental Investigation on the Mechanical Properties of Gangue Concrete as a Roadside Support Body Material for Backfilling Gob-Side Entry Retaining

Development of a safe and economical roadside support body (RSB) material is the key to successful backfilling gob-side entry retaining (GER). By means of laboratory tests, this paper studied the effects of the water-cement ratio, aggregate content, and age on the contractibility and resistance increasing speed, compressive strength, and postpeak carrying capacity of the concrete with gangues as an aggregate. It also discussed the rationality and adaptability of gangue concrete as a RSB material for backfilling GER. The experimental results show that the compressive strength of gangue concrete increases with age, and that the strength of gangue concrete demonstrates a nonlinear decreasing trend with the increase of the cementing material’s water-cement ratio. The water-cement ratio in the range of 0.46–0.60 has the most significant regulation effect on the strength of gangue concrete. Mixing with a certain amount of coal gangue enhances the postpeak carrying capacity of concrete, preventing the sample from impact failure. The field experimental results report that as a RSB material, gangue concrete can meet the design and application requirements of GER with gangue backfilling mining. A RSB material featuring high safety, high waste utilization rate, fast construction speed, and low costs is provided.

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Mediational Model of Multiple Sclerosis Impairments, Family Needs, and Caregiver Mental Health in Guadalajara, Mexico

Individuals with multiple sclerosis (MS), especially those living in Latin America, often require assistance from family caregivers throughout the duration of the disease. Previous research suggests that family caregivers may experience positive and negative outcomes from providing care to individuals with MS, but few studies have examined the unmet needs of individuals providing care to family members with MS and how these unmet needs may mediate the relationship between MS symptoms and caregiver mental health. The current study examined the relationships among MS impairments (functional, neurological, cognitive, behavioral, and emotional), unmet family needs (household, informational, financial, social support, and health), and caregiver mental health (satisfaction with life, anxiety, burden, and depression) in a sample of 81 MS caregivers from Guadalajara, Mexico. A structural equation model demonstrated the mediational effect of unmet family needs on the relationship between MS impairments and caregiver mental health. These findings suggest that intervention research on MS caregivers in Latin America may consider focusing on caregiver mental health problems by addressing unmet family needs and teaching caregivers ways to manage the impairments of the individual with MS.

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Embedding of Bacterial Cellulose Nanofibers within PHEMA Hydrogel Matrices: Tunable Stiffness Composites with Potential for Biomedical Applications

Bacterial cellulose (BC) and poly(2-hydroxyethyl methacrylate) (PHEMA) hydrogels are both considered as biocompatible materials with potential use in various biomedical applications including cartilage, cardiovascular stent, and soft tissue engineering. In this work, the “ever-wet” process based on in situ UV radical polymerization of HEMA monomer in BC nanofibrous structure impregnated with HEMA was used, and a series of BC-PHEMA composites was prepared. The composite structures were characterized by ATR FT-IR spectroscopy, WAXD, SEM, and TEM techniques. The strategy of using densified BC material of various cellulose fiber contents was applied to improve mechanical properties. The mechanical properties were tested under tensile, dynamic shear, and relaxation modes. The final composites contained 1 to 20 wt% of BC; the effect of the reinforcement degree on morphology, swelling capacity, and mechanical properties was investigated. The biocompatibility test of BC-PHEMA composites was performed using mouse mesenchymal stem cells.

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Molecular Association Studies on Polyvinyl Alcohol at Different Concentrations

Ultrasonic velocities, densities, and viscosities have been measured for the solution of polyvinyl alcohol in water at concentration range of 0.3% to 1% at temperature 35°C. Ultrasonic velocities have been measured using variable path ultrasonic interferometer at 1 MHz frequency. The acoustical parameters like adiabatic compressibility, acoustic impedance, intermolecular free length, and relaxation time have been calculated by using above-mentioned values of ultrasonic velocities, densities, and viscosities. The variation of these acoustical parameters is explained in terms of solute-solvent interaction in a polymer solution.

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Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study

Background. Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.

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Carbothermal Reduction of Iron Ore in Its Concentrate-Agricultural Waste Pellets

Carbon-containing pellets were prepared with the carbonized product of agricultural wastes and iron concentrate, and an experimental study on the direct reduction was carried out. The experimental results demonstrated that carbon-containing pellets could be rapidly reduced at 1200 to 1300°C in 15 minutes, and the proper holding time at high temperature was 15 to 20 min. The degree of reduction gradually increased with temperature rising, and the appropriate temperature of reducing pellets was 1200°C. The weight loss rate and reduction degree of pellets increased with the rise of carbon proportion, and the relatively reasonable mole ratio of carbon to oxygen was 0.9. A higher content of carbon and an appropriate content of volatile matters in biomass char were beneficial to the reduction of pellets. The carbon-containing pellets could be reduced at high speeds in the air, but there was some reoxidization phenomenon.

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Diclofenac Potassium in Acute Postoperative Pain and Dysmenorrhoea: Results from Comprehensive Clinical Trial Reports

We compared the efficacy of diclofenac potassium in unpublished clinical study reports (CSRs) and published reports to examine publication bias, industry bias, and comprehensiveness. Novartis provided CSRs of randomised double-blind trials of diclofenac potassium involving postoperative patients following third molar extraction (3 trials, ), gynaecological surgery (3 trials, ), and dysmenorrhoea (2 trials, ) conducted in 1988–1990. Searches identified published reports of 6 trials. Information from 599/1909 patients was not published; trials with 846/1909 patients were published in a defunct journal. Greater methodological information in CSRs contributed to lesser risk of bias than published trials. Numbers needed to treat (NNT) from CSRs for all six postoperative trials for at least 50% of maximum pain relief over 6 h were 2.2 (95% confidence interval, 1.9–2.6) and 2.1 (1.8–2.4) for 50 and 100 mg diclofenac potassium, respectively. A Cochrane review of published trial data reported NNTs of 2.1 and 1.9, and one comprehensive analysis reported NNTs of 2.2 and 2.1, respectively. All analyses had similar results for patients remedicating within 8 h. No data from dysmenorrhoea CSRs appeared in a Cochrane review. CSRs provide useful information and increase confidence. Stable efficacy estimates with standard study designs reduce the need for updating reviews.

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Optimal Cement Mixtures Containing Mineral Admixtures under Multiple and Conflicting Criteria

In modern construction industry, fabrication of sustainable concrete has turned the decision-making process into a challenging endeavor. One alternative is using fly ash and nanostructured silica as cement replacements. In these modern mixtures, proper concrete bulk density, percentage of voids, and compressive strength normally cannot be optimized individually. Hereby, a decision-making strategy on the replacement of those components is presented while taking into account those three performance measurements. The relationships among those components upon concrete fabrication required a design of experiments of mixtures to characterize those mineral admixtures. This approach integrates different objective functions that are in conflict and obtains the best compromise mixtures for the performance measures being considered. This optimization strategy permitted to recommend the combined use of fly ash and nanosilica to improve the concrete properties at its early age.

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Nivolumab-Induced Encephalitis in Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome

The treatment of cancer is a rapidly evolving field. As more chemotherapeutic agents become available, reporting the side effects of these agents in clinical practice becomes increasingly important. Nivolumab is one of the chemotherapeutic agents commonly used for treatment of renal cell carcinoma, metastatic melanoma, and metastatic non-small cell lung cancer. While common side effects are known and well documented, encephalitis is documented as an extremely rare side effect. We present the case of an extremely rare side effect to a common chemotherapeutic agent.

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Osteosarcomas of the Head and Neck Region: A Case Series with a Review of Literature

Abstract

Background

Osteosarcomas of head and neck region have unique biology and exhibit a clinical behavior and natural history that is distinct from osteosarcomas of the trunk and extremities. Our understanding of this malignant bone tumor is largely based on data from single institutions or compiled from registries, and hence the clinical practice guidelines seem confusing and conflicting.

Aims and Objectives

To analyze the demographic profile, disease characteristics and survival outcomes of osteosarcoma of head and neck region.

Materials and Methods

Retrospective analysis of the patients treated for osteosarcoma of head and neck region with curative intent in the period between the years 2001–2013 at a tertiary cancer center from South India.

Results

A total of 14 patients were treated in the said period with a mean age of 37 years. The most common site was mandible (n = 9 patients) followed by maxilla (n = 4) and paranasal sinuses (n = 1). Conventional osteoblastic variant of OS was the most common histological variant (n = 8) followed by the chondroblastic variant (n = 5). The median disease-free survival was 41.7 months, whereas the median overall survival of our patient cohort was 47.6 months. A formal analysis of various prognostic factors showed only postoperative margin positivity to be the single important factor affecting the survival outcomes.

Conclusion

Head and neck osteosarcoma that most commonly afflicts the jaw bones occurs in the fourth decade of life. Despite being a small series, our study does highlight the importance of achieving a margin-negative resection as a part of the multimodality treatment of head and neck osteosarcomas. Considering the relative paucity of data, there is a need for multi-institutional collaborative studies to refine the therapeutic strategies for the management of patients with head and neck osteosarcomas.



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Leech related Aeromonas veronii complex infection after reconstruction with a microvascular forearm flap

Abstract

Medical leeches (Hirudo medicinalis) in plastic and reconstructive surgery are often used for the treatment of vascular failure after microvascular surgery. Leeches are a reservoir for bacteria of the Aeromonas group that help digesting the blood meal. In some cases these bacteria are able to cause severe wound infections that can lead to loss of tissue transplants. We report about a patient with a common microvascular forearm flap after resection of an oral squamous cell carcinoma which got infected by Aeromonas spp. after treatment with medical leeches. Most of these species are resistant for common antibiotic treatment after surgery. This report shows the importance of an early concomitant antibiotic prophylaxis in the treatment of venous congestion with medical leeches.



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Clinical and MRI Evaluation of Orthodontic Mini-Screws for Disc Repositioning in Internal Derangement of TMJ: A Prospective Study

Abstract

Purpose

The purpose of this study was to assess the efficacy of orthodontic mini-screws as a modified suture anchor for disc repositioning in cases of internal derangement of the temporomandibular joint.

Patients and Methods

A prospective evaluation of ten patients was undertaken for a period of 6 months using this modified approach from Jan 2014 to Jun 2016. Symptomatic patients with clinical and MRI features suggestive of internal derangement of TMJ and willing to undergo surgical repositioning of articular disc to alleviate symptoms of temporomandibular dysfunction were taken up for the study. Post-operatively, functional outcomes were assessed in terms of reduction in pain, joint movement and absence of joint noise and clicking sounds. Post-operative MRI was used to assess the disc position and morphological changes in the disc and arthritic changes in the condyle.

Results

All patients underwent a surgical repositioning of the anteriorly displaced disc by the modified orthodontic suture anchor. Patients were post-surgically followed up at intervals of 1, 3 and 6 months. Immediate complications in terms of pain, restriction of functional motion and transient facial nerve palsy were noted. Late complications include temporal nerve palsy in one case. All patients experienced significant improvement with good functional outcomes and stable repositioning of disc was noticed at the end of 6 months.

Conclusion

The modified disc repositioning using an orthodontic screw via a mini preauricular approach provided a good functional outcome in all patients as assessed over a period of 6 months. However, the long-term functional sequel of the procedure and changes in the articular disc needs to be assessed.



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Nasal Mucosal Cyst a Clinical and Surgical Dilemma

Abstract

A mucous cyst is a lesion which can show a wide range of symptoms but is benign and most of them can even appear several months or even years after nasal surgeries. Size of the displaced epithelial fragment is a crucial factor for the development of the mucous cyst. Complete resection of the mucous cyst is the ideal treatment. Surfing through the literature we came across 18 cases of mucous cyst formation following nasal surgery. Here we describe a mucous cyst which had resulted from a rhinoplasty procedure the patient had undergone earlier in her life.



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Screw and Wire Technique for Condylar Fracture Reduction

Abstract

In case of displaced condylar fractures, ideal reduction during open reduction and internal fixation poses a challenge to the surgeon. This article describes a simple technique to aid reduction with the use of a screw and wire during open treatment.



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Chronic Recurrent Temporomandibular Joint Dislocation: A Comparison of Various Surgical Treatment Options, and Demonstration of the Versatility and Efficacy of the Dautrey’s Procedure

Abstract

Introduction

There has been a changing trend of treating temporomandibular joint subluxation, which range from conservative non-surgical measures to various soft and hard tissue surgical procedures aimed at either augmenting or restricting the condylar path.

Aim

This study was aimed at comparing the efficacy of three major surgical treatment modalities: condylar obstruction creation, obstruction removal and anti-translatory procedures. Also, the location, anatomy and morphology of the TMJs pre- and post-surgery were evaluated and compared using radiographs, sagittal and 3-D Computed Tomographic scans.

Materials and Methods

A 6-year study was carried out on seventy-five patients of various age groups. Twenty-five were operated by the Dautrey’s procedure, 25 by articular eminectomy alone and the remaining 25 by eminectomy followed by meniscal plication and tethering. The distribution of patients in the three groups was random. Effectiveness of the surgical procedure and incidence of complications including recurrence were carefully compiled and compared between the three groups.

Results and Conclusion

Dautrey’s procedure yielded more gratifying and stable results, leading to a successful and permanent correction of chronic recurrent dislocation of the TMJs, with practically nil complications, thus demonstrating it to be an extremely safe, effective and versatile technique, making the joints function normally and securing sufficient volume of mouth opening. There was observed an average increase in articular tubercle height by 3.65 mm and a mean anterior shift of its lowest point by 4.5 mm following the Dautrey’s procedure, which were statistically significant findings. The upper age limit to carry out the Dautrey’s procedure can be safely taken up to 45 years.



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Treatment planning with intensity modulated particle therapy for multiple targets in stage IV non-small cell lung cancer

Intensity modulated particle therapy (IMPT) can produce highly conformal plans, but is limited in advanced lung cancer patients with multiple lesions due to motion and planning complexity. A 4D IMPT optimization including all motion states was expanded to include multiple targets, where each target (isocenter) is designated to specific field(s). Furthermore, to achieve stereotactic treatment planning objectives, target and OAR weights plus objective doses were automatically iteratively adapted. Finally, 4D doses were calculated for different motion scenarios. The results from our algorithm were compared to clinical stereotactic body radiation treatment (SBRT) plans. The study included eight patients with 24 lesions in total. Intended dose regimen for SBRT was 24 Gy in one fraction, but lower fractionated doses had to be delivered in three cases due to OAR constraints or failed plan quality assurance. The resulting IMPT treatment plans had no significant difference in target cove...

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Proton range verification in homogeneous materials through acoustic measurements

Clinical proton beam quality assurance (QA) requires a simple and accurate method to measure the proton beam Bragg peak (BP) depth. Protoacoustics, the measurement of the pressure waves emitted by thermal expansion resulting from proton dose deposition, may be used to obtain the depth of the BP in a phantom by measuring the time-of-flight of the pressure wave. Rectangular and cylindrical phantoms of different materials (aluminum, lead, and polyethylene) were used for protoacoustic studies. Four different methods for analyzing the protoacoustic signals are compared. Data analysis shows that, for Methods 1 and 2, plastic phantoms have better accuracy than metallic ones because of the lower speed of sound. Method 3 does not require characterizing the speed of sound in the material, but it results in the largest error. Method 4 exhibits minimal error, less than 3 mm (with an uncertainty  ⩽1.5 mm) for all the materials and geometries. Psuedospectral wave-equation simulations ( k

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PET attenuation correction for flexible MRI surface coils in hybrid PET/MRI using a 3D depth camera

PET attenuation correction for flexible MRI radio frequency surface coils in hybrid PET/MRI is still a challenging task, as position and shape of these coils conform to large inter-patient variabilities. The purpose of this feasibility study is to develop a novel method for the incorporation of attenuation information about flexible surface coils in PET reconstruction using the Microsoft Kinect V2 depth camera. The depth information is used to determine a dense point cloud of the coil’s surface representing the shape of the coil. From a CT template—acquired once in advance—surface information of the coil is extracted likewise and converted into a point cloud. The two point clouds are then registered using a combination of an iterative-closest-point (ICP) method and a partially rigid registration step. Using the transformation derived through the point clouds, the CT template is warped and thereby adapted to the PET/MRI scan setup. The transformed CT template is converted into an...

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First results of a highly granulated 3D CdTe detector module for PET

We present the performance of a highly granulated 3D detector module for PET, consisting of a stack of pixelated CdTe detectors. Each detector module has 2 cm  ×  2 cm  ×  2 cm of CdTe material, subdivided into 4000 voxels, where each voxel has size 1 mm  ×  1 mm  ×  2 mm and is connected to its own read-out electronics via a BiSn solder ball. Each read-out channel consists of a preamp, a discriminator, a shaper, a peak-and-hold circuit and a 10 bits SAR ADC. The preamp has variable gain where at the maximum gain the ADC resolution is equivalent to 0.7 keV. Each ASIC chip reads 100 CdTe pixel channels and has one TDC to measure the time stamp of the triggered events, with a time resolution of less than 1 ns. With the bias voltage set at  −250 V mm −1 and for 17838 working channels out of a total of 20 000, we have obtained an average energy resolution of 2.2% FWHM for 511 keV photons. For 511 keV photons that have undergone Compton scattering, we measured an energy res...

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Bone surface enhancement in ultrasound images using a new Doppler-based acquisition/processing method

Ultrasound (US) imaging has long been considered as a potential aid in orthopedic surgeries. US technologies are safe, portable and do not use radiations. This would make them a desirable tool for real-time assessment of fractures and to monitor fracture healing. However, image quality of US imaging methods in bone applications is limited by speckle, attenuation, shadow, multiple reflections and other imaging artifacts. While bone surfaces typically appear in US images as somewhat ‘brighter’ than soft tissue, they are often not easily distinguishable from the surrounding tissue. Therefore, US imaging methods aimed at segmenting bone surfaces need enhancement in image contrast prior to segmentation to improve the quality of the detected bone surface. In this paper, we present a novel acquisition/processing technique for bone surface enhancement in US images. Inspired by elastography and Doppler imaging methods, this technique takes advantage of the difference between the m...

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Counterfactual impact evaluation of human resources development

The methods of Counterfactual Impact Evaluation (CIE) have not been extensively applied in the case of the Structural Funds assistance in the EU. The main research question is whether the Counterfactual Impact Evaluation methods are applicable in the case of OP HRE (Operational program Human Resources and Employment), area of support 1.1 in the Czech Republic and what requirements have to be met. In case of this intervention, the “treatment” investigated by this paper is the enterprise support to training of employees.The crucial part of conducting Counterfactual Impact Evaluations is the quality of data set. The OP HRE was tested for the compliance with the data requirements (sample size, randomization for approval of the assistance, homogeneity of the assistance). The area of support 1.1 in the OP HRE met the basic requirement for the Counterfactual Impact Evaluation. There is enough assisted firms and the assistance is homogenous (i.e. there are trainings in just a few type of educational themes). The OP HRE support 1.1 offers possibility for the Counterfactual Impact Evaluation.

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Insulintherapie - das Für und Wider individuell abwägen. / Insulinothérapie - Evaluez toutes les options pour chaque patient



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Knowledge of risk factors and modes of gene transmission among women at risk for hereditary breast and ovarian cancer syndrome

Background: Hereditary Breast and Ovarian Cancer (HBOC) is a collective term used to describe genetic susceptibility to breast and/or ovarian cancer. Most HBOC cases are attributed to BRCA1 and BRCA2 genes (BRCA1/2). Once a case of HBOC is identified, the risk of carrying a BRCA1/2 mutation and its implications extends to family members. This study examined whether female relatives from HBOC families can identify risk factors associated with HBOC and modes of BRCA1/2 gene transmission. Methods: This quantitative, descriptive, cross-sectional study assessed frequencies of correct responses to 19 items assessing knowledge of HBOC risk factors and 17 items assessing knowledge of modes of gene inheritance. All items have been previously validated. The sample consisted of 172 women, who based on pedigree analysis had >10% of carrying an-HBOC predisposing genetic mutation, but had NOT pursued genetic testing. Results:The majority of items assissing risk factors associated with HBOC were correcty identified by more than 50% of respondents. Sporadic occurence of breast cancer was correctly identified by 95% of the sample. Of the 17 items assessing knowledge of gene mutation transmission, 2 items were correctly identified by 87% of participants: that inherited and non-inherited mutations can cause cancer, and that genetic testing cannot predict risk of developing cancer. Approximately 50% knew that men can pass on a BRCA1/2 mutation to their children, and correctly identified all family history signs indicative of a mutation-harboring family. Fewer women (<35%) correctly identified the numeric probabilities of developing HBOC and of passing on a BRCA1/2 mutation to offspring. Conclusions: Educational interventions are needed to educate women at risk for HBOC. Identifying appropriate information dissemination information strategies to target these women should be a priority for healthcare providers. These strategies should also focus on encouraging communication among women at high risk for HBOC and their family members.

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Paleostress analysis of Cenozoic faulting in the Kraishte area, SW Bulgaria

Paleostress calculations from fault planes in Paleogene sediments and in the underlying basement were used to determine the orientation and the chronology of the principal stresses during the Cenozoic tectonic evolution of the Kraishte area (southwest Bulgaria). The results show that middle Eocene–early Oligocene WSW–ENE extension led to the formation of grabens and half grabens filled with thick continental to marine deposits in the hanging wall of extensional detachments. The Paleogene sediments and their basement were then intruded by subvolcanic bodies and dykes during SW–NE extension between 32 and 29 Ma. These WSW–ENE and SW–NE extensional stages are related to the general rollback of the Hellenic slab. From the late Oligocene to the earliest Miocene, SSE–NNW transtension generated coal-bearing sedimentary basins. The anticlockwise rotation of the main tensile axis by almost 50° with respect to the previous tectonic stage was probably related to a switch from the Aegean back-arc extension to crustal stretching and extrusion of continental fragments around the Moesian platform. Since the middle Miocene extension in the Kraishte area, accommodated by faults with relatively small displacement, led to the formation of restricted basins filled with alluvial to lacustrine deposits. Highlights ►Our work presents the first paleostress analysis of fault-slip data from the Kraishte area, SW Bulgaria. ► We can clearly distinguish three successive faulting events during Cenozoic extension. ► Middle Eocene–early Oligocene WSW–ENE extension led to the exhumation of an extensional core complex. ► Between 32 and 29 Ma, SW–NE-oriented syn-magmatic extension followed. ► The late Oligocene to the earliest Miocene was characterized by SSE–NNW transtension.

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Cenozoic granitoids in the Dinarides of southern Serbia: age of intrusion, isotope geochemistry, exhumation history and significance for the geodynamic evolution of the Balkan Peninsula

Two age groups were determined for the Cenozoic granitoids in the Dinarides of southern Serbia by high-precision single grain U–Pb dating of thermally annealed and chemically abraded zircons: (1) Oligocene ages (Kopaonik, Drenje, Željin) ranging from 31.7 to 30.6 Ma (2) Miocene ages (Golija and Polumir) at 20.58–20.17 and 18.06–17.74 Ma, respectively. Apatite fission-track central ages, modelling combined with zircon central ages and additionally, local structural observations constrain the subsequent exhumation history of the magmatic rocks. They indicate rapid cooling from above 300°C to ca. 80°C between 16 and 10 Ma for both age groups, induced by extensional exhumation of the plutons located in the footwall of core complexes. Hence, Miocene magmatism and core-complex formation not only affected the Pannonian basin but also a part of the mountainous areas of the internal Dinarides. Based on an extensive set of existing age data combined with our own analyses, we propose a geodynamical model for the Balkan Peninsula: The Late Eocene to Oligocene magmatism, which affects the Adria-derived lower plate units of the internal Dinarides, was caused by delamination of the Adriatic mantle from the overlying crust, associated with post-collisional convergence that propagated outward into the external Dinarides. Miocene magmatism, on the other hand, is associated with core-complex formation along the southern margin of the Pannonian basin, probably associated with the W-directed subduction of the European lithosphere beneath the Carpathians and interfering with ongoing Dinaridic–Hellenic back-arc extension.

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Antioxidants, Vol. 7, Pages 15: Regulation of Mitochondrial Dynamics by Proteolytic Processing and Protein Turnover

Antioxidants, Vol. 7, Pages 15: Regulation of Mitochondrial Dynamics by Proteolytic Processing and Protein Turnover

Antioxidants doi: 10.3390/antiox7010015

Authors: Sumaira Ali Gavin McStay

The mitochondrial network is a dynamic organization within eukaryotic cells that participates in a variety of essential cellular processes, such as adenosine triphosphate (ATP) synthesis, central metabolism, apoptosis and inflammation. The mitochondrial network is balanced between rates of fusion and fission that respond to pathophysiologic signals to coordinate appropriate mitochondrial processes. Mitochondrial fusion and fission are regulated by proteins that either reside in or translocate to the inner or outer mitochondrial membranes or are soluble in the inter-membrane space. Mitochondrial fission and fusion are performed by guanosine triphosphatases (GTPases) on the outer and inner mitochondrial membranes with the assistance of other mitochondrial proteins. Due to the essential nature of mitochondrial function for cellular homeostasis, regulation of mitochondrial dynamics is under strict control. Some of the mechanisms used to regulate the function of these proteins are post-translational proteolysis and/or turnover, and this review will discuss these mechanisms required for correct mitochondrial network organization.



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Antioxidants, Vol. 7, Pages 16: Metabolic Alterations in Cancer Cells and the Emerging Role of Oncometabolites as Drivers of Neoplastic Change

Antioxidants, Vol. 7, Pages 16: Metabolic Alterations in Cancer Cells and the Emerging Role of Oncometabolites as Drivers of Neoplastic Change

Antioxidants doi: 10.3390/antiox7010016

Authors: Zhengqiu Zhou Elochukwu Ibekwe Yevgen Chornenkyy

The mitochondrion is an important organelle and provides energy for a plethora of intracellular reactions. Metabolic dysregulation has dire consequences for the cell, and alteration in metabolism has been identified in multiple disease states—cancer being one. Otto Warburg demonstrated that cancer cells, in the presence of oxygen, undergo glycolysis by reprogramming their metabolism—termed “aerobic glycolysis”. Alterations in metabolism enable cancer cells to gain a growth advantage by obtaining precursors for macromolecule biosynthesis, such as nucleic acids and lipids. To date, several molecules, termed “oncometabolites”, have been identified to be elevated in cancer cells and arise from mutations in nuclear encoded mitochondrial enzymes. Furthermore, there is evidence that oncometabolites can affect mitochondrial dynamics. It is believed that oncometabolites can assist in reprogramming enzymatic pathways and providing cancer cells with selective advantages. In this review, we will touch upon the effects of normal and aberrant mitochondrial metabolism in normal and cancer cells, the advantages of metabolic reprogramming, effects of oncometabolites on metabolism and mitochondrial dynamics and therapies aimed at targeting oncometabolites and metabolic aberrations.



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Fractional-Order Sliding Mode Synchronization for Fractional-Order Chaotic Systems

Some sufficient conditions, which are valid for stability check of fractional-order nonlinear systems, are given in this paper. Based on these results, the synchronization of two fractional-order chaotic systems is investigated. A novel fractional-order sliding surface, which is composed of a synchronization error and its fractional-order integral, is introduced. The asymptotical stability of the synchronization error dynamical system can be guaranteed by the proposed fractional-order sliding mode controller. Finally, two numerical examples are given to show the feasibility of the proposed methods.

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Mechanism of Periostin Production in Human Bronchial Smooth Muscle Cells

Background: Asthma is a chronic airway inflammatory disease characterized by airway remodeling, in which the bronchial smooth muscle (BSM) cells play an important role. Periostin, a biomarker that reflects Th2-driven inflammatory diseases such as asthma, may play an important role in the asthmatic airway. Although periostin is mainly produced in airway epithelial cells and fibroblasts after interleukin (IL)-13 stimulation, whether BSM cells produce periostin remains unclear. Therefore, we investigated periostin production in BSM cells and the mechanisms involved. Methods: Human BSM cells were cultured, and the effect of IL-13 stimulation on periostin production was evaluated using quantitative polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA). We evaluated the phosphorylation of signal transducer and activator of transcription factor 6 (STAT6), extracellular signal-regulated kinase (ERK)1/2, and Akt after IL-13 stimulation. Furthermore, using ELISA, we evaluated the influence of several phosphorylation inhibitors on periostin production. Results: Periostin mRNA expression increased in a dose- and time-dependent manner after IL-13 stimulation; periostin production was induced 24 and 48 h after stimulation. IL-13 stimulation induced the phosphorylation of STAT6, ERK1/2, and Akt. IL-13-induced periostin production was attenuated by inhibiting STAT6 phosphorylation and strongly suppressed by inhibiting mitogen-activated protein kinase kinase 1/2 phosphorylation or phosphatidylinositol 3-kinase (PI3K) phosphorylation. Conclusions: BSM cells produced periostin after IL-13 stimulation, via the JAK/STAT6, ERK1/2, and PI3K/Akt pathways. Understanding the mechanism of periostin production in BSM cells may help to clarify asthma pathogenesis.
Int Arch Allergy Immunol

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Risk Factors and Clinical Features in Cashew Nut Oral Food Challenges

Background: Cashew nuts (CN) are capable of causing severe allergic reactions. However, little has been reported about the details of CN oral food challenges (OFC). Methods: CN-specific IgE (sIgE) levels were measured for 1 year in 66 patients who underwent an OFC with >3 g CN for diagnosis or confirmation of tolerance acquisition between June 2006 and August 2014. We retrospectively analyzed the OFC and patient background. Results: The median (IQR) age of the 66 patients (48 boys/men and 18 girls/women) was 7.0 years (5.7-8.8). Twelve patients (18.2%) had a positive OFC result; 6 of 8 (75%) patients with a history of an immediate reaction to CN failed the OFC. Anaphylaxis was experienced by 5 of these 12 (42%) patients. A history of an immediate reaction to CN and the CN sIgE levels were significantly different for patients with a positive or negative OFC result (p A/L. Conclusions: A history of an immediate reaction to CN and high CN sIgE were risk factors for a positive OFC result. The number of positive OFC results was relatively low, but there was a high probability of anaphylaxis. We should consider the indication of OFC carefully for patients with a history of immediate reactions to CN and avoid OFC for patients without such a history whose CN sIgE values are >66.1 kUA/L (95% PPV).
Int Arch Allergy Immunol

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Chronic sleep reduction in adolescents—clinical cut-off scores for the Chronic Sleep Reduction Questionnaire (CSRQ)

Summary

The Chronic Sleep Reduction Questionnaire is a validated questionnaire that measures symptoms of prolonged insufficient and/or poor sleep and therefore accounts for individuals’ sleep need and sleep debt. This study extends its psychometric properties by providing cut-off scores, using a matched sample of 298 healthy adolescents (15.38 ± 1.63 years, 37.9% male, mean Chronic Sleep Reduction Questionnaire score: 32.98 ± 6.51) and 298 adolescents with insomnia/delayed sleep–wake phase disorder (15.48 ± 1.62 years; 37.9% male, mean Chronic Sleep Reduction Questionnaire score: 42.59 ± 7.06). We found an area under the curve of 0.84 (95% confidence interval: 0.81–0.87). Cut-off scores for optimal sensitivity, optimal specificity and based on Youden's criterion are provided. These cut-off scores are highly relevant for use of the Chronic Sleep Reduction Questionnaire in future studies and clinical practice.



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Genes, Vol. 9, Pages 42: Copy Number Variation in SOX6 Contributes to Chicken Muscle Development

Genes, Vol. 9, Pages 42: Copy Number Variation in SOX6 Contributes to Chicken Muscle Development

Genes doi: 10.3390/genes9010042

Authors: Shudai Lin Xiran Lin Zihao Zhang Mingya Jiang Yousheng Rao Qinghua Nie Xiquan Zhang

Copy number variations (CNVs), which cover many functional genes, are associated with complex diseases, phenotypic diversity and traits that are economically important to raising chickens. The sex-determining region Y-box 6 (Sox6) plays a key role in fast-twitch muscle fiber differentiation of zebrafish and mice, but it is still unknown whether SOX6 plays a role in chicken skeletal muscle development. We identified two copy number polymorphisms (CNPs) which were significantly related to different traits on the genome level in chickens by AccuCopy® and CNVplex® analyses. Notably, five white recessive rock (CN = 1, CN = 3) variant individuals and two Xinghua (CN = 3) variant individuals contain a CNP13 (chromosome5: 10,500,294–10,675,531) which overlaps with SOX6. There is a disordered region in SOX6 proteins 265–579 aa coded by a partial CNV overlapping region. A quantitative real-time polymerase chain reaction showed that the expression level of SOX6 mRNA was positively associated with CNV and highly expressed during the skeletal muscle cell differentiation in chickens. After the knockdown of the SOX6, the expression levels of IGFIR1, MYF6, SOX9, SHOX and CCND1 were significantly down-regulated. All of them directly linked to muscle development. These results suggest that the number of CNVs in the CNP13 is positively associated with the expression level of SOX6, which promotes the proliferation and differentiation of skeletal muscle cells by up-regulating the expression levels of the muscle-growth-related genes in chickens as in other animal species.



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Abstracts of the 30th Spring Symposium of the German Society of Allergy and Clinical Immunology



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