Ιατρικά Άρθρα Αλέξανδρος Γ. Σφακιανάκης: 02/19/17

Κυριακή 19 Φεβρουαρίου 2017

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Mycotic Aneurysm after Bacillus Calmette-Guérin Treatment: Case Report and Review of the Literature

Background. Intravesicular Bacillus Calmette-Guérin (BCG) is an effective adjunctive therapy for superficial bladder cancer that has been shown to delay recurrence and progression of disease. Serious side effects are relatively rare but are difficult to diagnosis and commonly overlooked. Case Presentation. We report the case of a patient who was found to have mycotic aortic aneurysms secondary to treatment with BCG after a prolonged course with multiple intervening hospitalizations. Conclusion. Through this report, we discuss our present understanding of BCG infection following treatment and review the literature regarding this particular rare manifestation.

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IL-10: A Multifunctional Cytokine in Viral Infections

The anti-inflammatory master regulator IL-10 is critical to protect the host from tissue damage during acute phases of immune responses. This regulatory mechanism, central to T cell homeostasis, can be hijacked by viruses to evade immunity. IL-10 can be produced by virtually all immune cells, and it can also modulate the function of these cells. Understanding the effects of this multifunctional cytokine is therefore a complex task. In the present review we discuss the factors driving IL-10 production and the cellular sources of the cytokine during antiviral immune responses. We particularly focus on the IL-10 regulatory mechanisms that impact antiviral immune responses and how viruses can use this central regulatory pathway to evade immunity and establish chronic/latent infections.

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Association of gastro-oesophageal reflux and chronic rhinosinusitis: systematic review and meta-analysis.

Association of gastro-oesophageal reflux and chronic rhinosinusitis: systematic review and meta-analysis.

Rhinology. 2017 Feb 18;:

Authors: Leason SR, Barham HP, Oakley G, Rimmer J, DelGaudio JM, Christensen JM, Sacks R, Harvey RJ

Abstract
INTRODUCTION: Gastro-oesophageal reflux disease (GORD) has been implicated in the development of chronic rhinosinusitis (CRS). The association of GORD with CRS is systematically assessed from the medical literature.
METHODOLOGY: Embase and MEDLINE were searched using a comprehensive strategy limited to English language and Human subjects. Any study with original data on the experimental, diagnostic, treatment or prognostic association of CRS with GORD was included. Studies without a control group, case reports and review articles were excluded.
RESULTS: The search returned 958 records, with an additional 10 found from bibliographic lists; this produced 32 studies. The included studies (n=32) consisted of studies reporting pathogenic factors (n=20), epidemiological association (n=8), prognostic interactions (n=3), and a combination of these outcomes (n=1). Potential pathogenic roles for GORD in CRS were supported; CRS subjects had greater prevalence of intranasal Helicobacter pylori and acid reflux than subjects without CRS. CRS is more prevalent in GORD sufferers than those without GORD. Evidence is conflicting for GORD as a factor in CRS treatment failure.
CONCLUSION: The results support a significant association of GORD with CRS. Physicians should be cognizant of the potential for acid and non-acid reflux as a driving factor in CRS.

PMID: 28214353 [PubMed - as supplied by publisher]

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Gastro-oesophageal reflux in patients with chronic rhino-sinusitis investigated with multichannel impedance - pH monitoring.

Gastro-oesophageal reflux in patients with chronic rhino-sinusitis investigated with multichannel impedance - pH monitoring.

Rhinology. 2017 Feb 18;:

Authors:

Abstract
INTRODUCTION: The pathophysiology of chronic rhinosinusitis (CRS) is unclear. It has been discussed for decades whether gastro-oesophageal reflux (GOR) may be a contributing factor for some patients. The aim of the present study was to evaluate the level of GOR in an unselected group of patients with CRS using multichannel impedance-pH monitoring.
METHODS: Consecutive patients with CRS diagnosed using the EPOS2012 criteria, completed questionnaires on GOR symptoms and were offered 24-h multichannel intraluminal impedance (MII)-pH monitoring. The results were compared with a group of healthy controls.
RESULTS: Forty-six patients completed MII-pH-monitoring and were compared with 45 control subjects, with comparable age and gender distributions. The median number of reflux episodes in the patients was 56.5 compared with 33 in controls, while, the numbers of proximal reflux episodes was 27.5 versus 3, respectively. Thirty nine patients had abnormal pH-impedance recordings compared with five controls.
CONCLUSION: The CRS patients had significantly higher incidences of gastro-oesophageal reflux compared with asymptomatic controls. The results of this study suggest that GOR may be a causative or contributing factor of CRS.

PMID: 28214352 [PubMed - as supplied by publisher]

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Evidence-based and precision medicine two of a kind.

Evidence-based and precision medicine two of a kind.

Rhinology. 2017 Feb 18;:

Authors: Fokkens WJ

Abstract
In the last two decades, an enormous expansion of evidence has been produced in upper airway research. When writing the first EPOS document in 2005 only 5 RCT per year were performed in the area of CRS, in 2007 this changed to 25 per year and it became even higher in the recent years. Randomized Controlled Trials (RCTs) are the "gold standard" for evaluating treatment outcomes providing information on treatments "efficacy". To make life easier for clinicians, systematic reviews and meta-analysis further condense the available evidence.

PMID: 28214351 [PubMed - as supplied by publisher]

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Pain Assessment in INTensive care (PAINT): an observational study of physician-documented pain assessment in 45 intensive care units in the United Kingdom

Summary

Pain is a common and distressing symptom experienced by intensive care patients. Assessing pain in this environment is challenging, and published guidelines have been inconsistently implemented. The Pain Assessment in INTensive care (PAINT) study aimed to evaluate the frequency and type of physician pain assessments with respect to published guidelines. This observational service evaluation considered all pain and analgesia-related entries in patients’ records over a 24-h period, in 45 adult intensive care units (ICUs) in London and the South-East of England. Data were collected from 750 patients, reflecting the practice of 362 physicians. Nearly two-thirds of patients (n = 475, 64.5%, 95%CI 60.9–67.8%) received no physician-documented pain assessment during the 24-h study period. Just under one-third (n = 215, 28.6%, 95%CI 25.5–32.0%) received no nursing-documented pain assessment, and over one-fifth (n = 159, 21.2%, 95%CI 19.2–23.4)% received neither a doctor nor a nursing pain assessment. Two of the 45 ICUs used validated behavioural pain assessment tools. The likelihood of receiving a physician pain assessment was affected by the following factors: the number of nursing assessments performed; whether the patient was admitted as a surgical patient; the presence of tracheal tube or tracheostomy; and the length of stay in ICU. Physician-documented pain assessments in the majority of participating ICUs were infrequent and did not utilise recommended behavioural pain assessment tools. Further research to identify factors influencing physician pain assessment behaviour in ICU, such as human factors or cultural attitudes, is urgently needed.

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Muscular dystrophy

Muscular dystrophy: One of a group of genetic diseases characterized by progressive weakness and degeneration of the skeletal or voluntary muscles which control movement. The muscles of the heart and some other involuntary muscles are also affected in some forms of muscular dystrophy, and a few forms involve other organs as well.

The major forms of muscular dystrophy include:

Muscular dystrophy can affect people of all ages. Although some forms first become apparent in infancy or childhood, others may not appear until middle age or later. Duchenne muscular dystrophy is the most common kind of muscular dystrophy affecting children. Myotonic dystrophy is the most common of these diseases in adults.

There is no specific treatment for any of the forms of muscular dystrophy. Physical therapy to prevent contractures (a condition in which shortened muscles around joints cause abnormal and sometimes painful positioning of the joints), orthoses (orthopedic appliances used for support) and corrective orthopedic surgery may be needed to improve the quality of life in some cases. The cardiac problems that occur with Emery-Dreifuss muscular dystrophy and myotonic dystrophy may require a pacemaker. The myotonia (delayed relaxation of a muscle after a strong contraction) occurring in myotonic dystrophy may be treated with medications such as phenytoin or quinine.

The prognosis (outlook) with muscular dystrophy varies according to the type of muscular dystrophy and the progression of the disorder. Some cases may be mild and very slowly progressive with normal lifespan, while other cases may have more marked progression of muscle weakness, functional disability and loss of ambulation. Life expectancy depends on the degree of progression and late respiratory deficit. In Duchenne muscular dystrophy, death usually occurs in the late teens to early 20s.

Muscular dystrophy is abbreviated as MD.

MedTerms (TM) is the Medical Dictionary of MedicineNet.com.
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Trump and science: Protesters gather in Boston to “stand up for science”

Main image: LYNYRD SKYNYRD'S “Sweet Home Alabama” is a strange choice of song to open a rally of scientists. Written in 1973, the southern anthem was a response to Neil Young’s critique of the barbaric treatment of African-Americans in the South—it tells the Canadian songwriter to mind his own business. Ronnie Van Zant, the lead singer, addresses him directly, singing: “I hope Neil Young will remember, a southern man don't need him around anyhow”. On the afternoon of February 19th, in Boston’s Copley Square, hundreds of heads, adorned in the pink hats of the women’s marches that followed Donald Trump’s inauguration in January, bobbed along to the beat.Your blogger suspects that it was the “so blue” Alabaman skies of the chorus, rather than issues of race, that the rally organisers were aiming to evoke. “We want to protect the people and places and things you love,” said Beka Economopoulos, one of the organisers, who works for The Natural History Museum, an activist group which is not a museum at all. “Science is what makes sure that the fishing hole is still something you can enjoy when you’re old.”The tone of the rally was set the previous day, ten minutes west on foot, at a session of the annual meeting of the American Association for the Advancement of Science titled “Defending Science and ...

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Modelling of the Deformation Diffusion Areas on a Para-Aramid Fabric with B-Spline Curves

The geometrical modelling of the planar energy diffusion behaviors of the deformations on a para-aramid fabric has been performed. In the application process of the study, in the experimental period, drop test with bullets of different weights has been applied. The B-spline curve-generating technique has been used in the study. This is an efficient method for geometrical modelling of the deformation diffusion areas formed after the drop test. Proper control points have been chosen to be able to draw the borders of the diffusion areas on the fabric which is deformed, and then the De Casteljau and De Boor algorithms have been used. The Holditch area calculation according to the beams taken at certain fixed lengths has been performed for the B-spline border curve obtained as a closed form. After the calculations, it has been determined that the diffusion area where the bullet with pointed end was dropped on a para-aramid fabric is bigger and the diffusion area where the bullet with rounded end was dropped is smaller when compared with the areas where other bullets with different ends were dropped.

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Microbiological Study of Cast Posts before Cementation

This study identifies the most common microorganisms present in type III gold cast posts related to pulpal disease and evaluates the sterilization/disinfection method before cementation in the root canal. Forty-five type III gold cast posts were aseptically collected in sterile sealed plastic bags and taken to the microbiology laboratory to carry out the study: fifteen cast posts had no treatment, fifteen were disinfected (immersion in 70% alcohol during 15 minutes), and fifteen were autoclaved at 121°C for 15 minutes by using saturated steam under 15 psi pressure. By using a two-proportion -test, the difference was statistically significant () and demonstrates that, in spite of the aseptic pattern used in the cast post collection and laboratory procedures, some cast posts arrive contaminated at the consulting office. The disinfection process worked out in a high percentage and demonstrated that the sterilization by autoclaving eliminated completely the pathogenic microbiota without affecting the cast post shape and integrity that could compromise their final fitting.

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Green Synthesis and Characterization of Silver Nanoparticles Using Citrullus lanatus Fruit Rind Extract

The wide-scale application of silver nanoparticles (AgNPs) in areas such as chemical sensing, nanomedicine, and electronics has led to their increased demand. Current methods of AgNPs synthesis involve the use of hazardous reagents and toxic solvents. There is a need for the development of new methods of synthesizing AgNPs that use environmentally safe reagents and solvents. This work reports a green method where silver nanoparticles (AgNPs) were synthesized using silver nitrate and the aqueous extract of Citrullus lanatus fruit rind as the reductant and the capping agent. The optimized conditions for the AgNPs synthesis were a temperature of 80°C, pH 10, 0.001 M AgNO3, 250 g/L watermelon rind extract (WMRE), and a reactant ratio of 4 : 5 (AgNO3 to WMRE). The AgNPs were characterized by Ultraviolet-Visible (UV-Vis) spectroscopy exhibiting a at 404 nm which was consistent with the spectra of spherical AgNPs within the wavelength range of 380–450 nm, and Cyclic Voltammetry (CV) results showed a distinct oxidation peak at +291 mV while the standard reference AgNPs (20 nm diameter) oxidation peak occurred at +290 mV, and Transmission Electron Microscopy (TEM) revealed spherical shaped AgNPs. The AgNPs were found to have an average diameter of nm.

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Detection and Analytical Capabilities for Trace Level of Carbon in High-Purity Metals by Laser-Induced Breakdown Spectroscopy with a Frequency Quintupled 213 nm Nd:YAG Laser

The laser-induced breakdown spectroscopy (LIBS) with a frequency quintupled 213 nm Nd:YAG laser was examined to the analysis of trace level of carbon (C) in high-purity metals and its detection and analytical capabilities were evaluated. Though C signal in a wavelength of 247.9 nm, which showed the highest sensitivity of C, could be obtained from Cd, Ti, and Zn ca. 7000 mg kg−1 C in Fe could not be detected due to the interferences from a lot of Fe spectra. Alternative C signal in a wavelength of 193.1 nm could not be also detected from Fe due to the insufficient laser output energy of the frequency quintupled 213 nm Nd:YAG laser. The depth analysis of C by LIBS was also demonstrated and the C in Cd and Zn was found to be contaminated in only surface area whereas the C in Ti was distributed in bulk. From these results, the frequency quintupled 213 nm Nd:YAG laser, which was adopted widely as a commercial laser ablation (LA) system coupled with inductively coupled plasma mass spectrometry (ICPMS) for trace element analysis in solid materials, could be used for C analysis to achieve simultaneous measurements for both C and trace elements in metals by LIBS and LA-ICPMS, respectively.

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Pattern Synthesis of Linear Antenna Arrays Using Enhanced Flower Pollination Algorithm

In this paper, a new variant of flower pollination algorithm (FPA), namely, enhanced flower pollination algorithm (EFPA), has been proposed for the pattern synthesis of nonuniform linear antenna arrays (LAA). The proposed algorithm uses the concept of Cauchy mutation in global pollination and enhanced local search to improve the exploration and exploitation tendencies of FPA. It also uses dynamic switching to control the rate of exploration and exploitation. The algorithm is tested on standard benchmark problems and has been compared statistically with state of the art to prove its worthiness. LAA design is a tricky and difficult electromagnetic problem. Hence to check the efficacy of the proposed algorithm it has been used for synthesis of four different LAA with different sizes. Experimental results show that EFPA algorithm provides enhanced performance in terms of side lobe suppression and null control compared to FPA and other popular algorithms.

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MIMO PI Controllers for LTI Systems with Multiple Time Delays Based on ILMIs and Sensitivity Functions

In this paper, a MIMO PI design procedure is proposed for linear time invariant (LTI) systems with multiple time delays. The controller tuning is established in two stages and guarantees performances for set-point changes, disturbance variations, and parametric uncertainties. In the first stage, an iterative linear matrix inequality (ILMI) approach is extended to design PI controllers for systems with multiple time delays without performance guarantee, a priori. The second stage is devoted to improve the closed-loop performances by minimizing sensitivity functions. Simulations results carried out on the unstable distillation column, the stable industrial scale polymerization (ISP) reactor, and the non-minimum phase 4-tank benchmark prove the efficiency of the proposed approach. A comparative analysis with the conventional internal model control (IMC) approach, a multiloop IMC-PI approach, and a previous ILMI PID approach proves the superiority of the proposed approach compared to the related ones.

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A Novel Graph Constructor for Semisupervised Discriminant Analysis: Combined Low-Rank and -Nearest Neighbor Graph

Semisupervised Discriminant Analysis (SDA) is a semisupervised dimensionality reduction algorithm, which can easily resolve the out-of-sample problem. Relative works usually focus on the geometric relationships of data points, which are not obvious, to enhance the performance of SDA. Different from these relative works, the regularized graph construction is researched here, which is important in the graph-based semisupervised learning methods. In this paper, we propose a novel graph for Semisupervised Discriminant Analysis, which is called combined low-rank and -nearest neighbor (LRKNN) graph. In our LRKNN graph, we map the data to the LR feature space and then the is adopted to satisfy the algorithmic requirements of SDA. Since the low-rank representation can capture the global structure and the -nearest neighbor algorithm can maximally preserve the local geometrical structure of the data, the LRKNN graph can significantly improve the performance of SDA. Extensive experiments on several real-world databases show that the proposed LRKNN graph is an efficient graph constructor, which can largely outperform other commonly used baselines.

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Patients with Epididymo-Orchitis and Meteorological Impact in Taiwan: A Nationwide Population-Based Study

Background. Epididymo-orchitis is a common infectious disease among men, especially men aged 20 to 39 years. The aim of this study was to analyze possible associations of various meteorological indicators on the incidence of epididymo-orchitis in Taiwan. Methods and Materials. This nationwide population-based study collected data on cases of epididymo-orchitis that were newly diagnosed from 2001 to 2013 in Taiwan. Monthly meteorological indicators, including average temperatures, humidity, rainfall, total rain days, and sunshine hours, were collected from the Central Weather Bureau of Taiwan. Data for a total of 7,233 patients with epididymo-orchitis were collected for this study. Results. The monthly incidence of epididymo-orchitis was positively correlated with temperature, rainfall, and sunshine hours. The average monthly temperature had a linear correlation with the incidence of epididymo-orchitis (). The monthly average temperature is significantly related, with a positive linear correlation, to the incidence of epididymo-orchitis in Taiwan. Conclusion. This finding may constitute useful information in terms of helping physicians to distinguish between patients with epididymo-orchitis and testicular torsion in hot or cold weather.

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Diallyl Trisulfide Suppresses Oxidative Stress-Induced Activation of Hepatic Stellate Cells through Production of Hydrogen Sulfide

Accumulating data reveal that garlic has beneficial effects against chronic liver disease. We previously reported that diallyl trisulfide (DATS), the primary organosulfur compound in garlic, reduced fibrosis and attenuated oxidative stress in rat fibrotic liver. The present study was aimed at elucidating the underlying mechanisms. The primary rat hepatic stellate cells (HSCs) were cultured and stimulated with hydrogen peroxide (H2O2) for inducing HSC activation under oxidative stress. We examined the effects of DATS on the profibrogenic properties and oxidative stress in H2O2-treated HSCs. The results showed that DATS suppressed and reduced fibrotic marker expression in HSCs. DATS arrested cell cycle at G2/M checkpoint associated with downregulating cyclin B1 and cyclin-dependent kinase 1, induced caspase-dependent apoptosis, and reduced migration in HSCs. Moreover, intracellular levels of reactive oxygen species and lipid peroxide were decreased by DATS, but intracellular levels of glutathione were increased in HSCs. Furthermore, DATS significantly elevated hydrogen sulfide (H2S) levels within HSCs, but iodoacetamide (IAM) reduced H2S levels and significantly abrogated DATS production of H2S within HSCs. IAM also abolished all the inhibitory effects of DATS on the profibrogenic properties and oxidative stress in HSCs. Altogether, we demonstrated an H2S-associated mechanism underlying DATS inhibition of profibrogenic properties and alleviation of oxidative stress in HSCs. Modulation of H2S production may represent a therapeutic remedy for liver fibrosis.

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An Effective Way to Control Numerical Instability of a Nonordinary State-Based Peridynamic Elastic Model

The constitutive modeling and numerical implementation of a nonordinary state-based peridynamic (NOSB-PD) model corresponding to the classical elastic model are presented. Besides, the numerical instability problem of the NOSB-PD model is analyzed, and a penalty method involving the hourglass force is proposed to control the instabilities. Further, two benchmark problems, the static elastic deformation of a simple supported beam and the elastic wave propagation in a two-dimensional rod, are discussed with the present method. It proves that the penalty instability control method is effective in suppressing the displacement oscillations and improving the accuracy of calculated stress fields with a proper hourglass force coefficient, and the NOSB-PD approach with instability control can analyze the problems of structure deformation and elastic wave propagation well.

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High Frequency InGaAs MOSFET with Nitride Sidewall Design for Low Power Application

devices have been widely researched for low power high frequency applications due to the outstanding electron mobility and small bandgap of the materials. Regrown source/drain technology is highly appreciated in InGaAs MOSFET, since it is able to reduce the thermal budget induced by ion implantation, as well as reduce the source/drain resistance. However, regrown source/drain technology has problems such as high parasitic capacitance and high electric field at gate edge towards the drain side, which will lead to large drain leakage current and compromise the frequency performance. To alleviate the drain leakage current problem for low power applications and to improve the high frequency performance, a novel Si3N4 sidewall structure was introduced to the InGaAs MOSFET. Device simulation was carried out with different newly proposed sidewall designs. The results showed that both the drain leakage current and the source/drain parasitic capacitance were reduced by applying Si3N4 sidewall together with InP extended layer in InGaAs MOSFET. The simulation results also suggested that the newly created “recessed” sidewall was able to bring about the most frequency favorable characteristic with no current sacrifice.

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Nuclear Factor of Activated T Cells and Cytokines Gene Expression of the T Cells in AIDS Patients with Immune Reconstitution Inflammatory Syndrome during Highly Active Antiretroviral Therapy

Background. The etiology of immune reconstitution inflammatory syndrome (IRIS) in AIDS patients after the initiation of HAART remains unknown. Several researches indicated that the development of IRIS is associated with the production and variation of cytokines, whose gene expression are closely related to the Ca2+/CN-nuclear factor of activated T cells (NFAT) pathway. Methods. We studied the expression of NFAT isoforms and their major target cytokines genes in peripheral blood CD3+ T cells of subjects through fluorescence quantitative PCR and explored the expression changes of these genes before and after HAART. Results. After the initiation of HARRT, NFAT1, IL-6, and IL-8 gene expression showed a reversal trend in the CD3+ T cells of the IRIS group and changed from low expression before HARRT to high expression after HARRT. In particular, the relative gene expression of NFAT1 was markedly higher compared with the other three isoforms. The IRIS group also showed higher NFAT4, NFAT2, NFAT1, IL-1β, IL-10, IL-2, IL-18, and TNF-α gene expression than the non-IRIS group. Conclusion. This study suggested that high expression levels of IL-2, IL-6, IL-8, TNF-α, IL-1β, IL-10, IL-12, and IL-18 can predict the risk of IRIS. The increased expression of NFAT1 and NFAT4 may promote the expression of cytokines, such as IL-6, IL-8, and TNF-α, which may promote the occurrence of IRIS.

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Assessment of Wave Energy in the South China Sea Based on GIS Technology

China is now the world’s largest user of coal and also has the highest greenhouse gas emissions associated with the mining and use of coal. Under today’s enormous pressures of the growing shortage of conventional energy sources and the need for emission reductions, the search for clean energy is the most effective strategy to address the energy crisis and global warming. This study utilized satellite remote sensing technology, geographic information system (GIS) technology, and simulated wave data for the South China Sea. The characteristic features of the wave energy were obtained by analysis through the wave resource assessment formula and the results were stored in a GIS database. Software for the evaluation of wave energy in the South China Sea was written. The results should provide accurate, efficient references for wave energy researchers and decision-makers. Based on a 24-year WW3 model simulation wave data and GIS technology, this study presented the characteristic of the wave energy in the SCS; results demonstrated that the SCS has the feasibility and viability for wave energy farming.

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Experimental Aspects in the Vibration-Based Condition Monitoring of Large Hydrogenerators

Based on experimental observations on a set of twenty 700 MW hydrogenerators, compiled from several technical reports issued over the last three decades and collected from the reprocessing of the vibration signals recorded during the last commissioning tests, this paper shows that the accurate determination of the journal bearings operating conditions may be a difficult task. It shows that the outsize bearing brackets of large hydrogenerators are subject to substantial dimensional changes caused by external agents, like the generator electromagnetic field and the bearing cooling water temperature. It also shows that the shaft eccentricity of a journal bearing of a healthy large hydrogenerator, operating in steady-state condition, may experience unpredictable, sudden, and significant changes without apparent reasons. Some of these phenomena are reproduced in ordinary commissioning tests or may be noticed even during normal operation, while others are rarely observed or are only detected through special tests. These phenomena modify journal bearings stiffness and damping, changing the hydrogenerator dynamics, creating discrepancies between theoretical predictions and experimental measurements, and making damage detection and diagnostics difficult. Therefore, these phenomena must be analyzed and considered in the application of vibration-based condition monitoring to these rotating machines.

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Prevalence and Antimicrobial Susceptibility Pattern of E. coli O157:H7 Isolated from Traditionally Marketed Raw Cow Milk in and around Asosa Town, Western Ethiopia

A cross-sectional study was conducted from October 2014 to July 2015 to determine the prevalence and populations of E. coli as well as the prevalence and antimicrobial susceptibility of E. coli O157:H7 isolated from raw milk. Biochemical and serological tests methods were used to confirm E. coli and E. coli O157:H7 and isolates were subjected to antimicrobial susceptibility test using the agar disc diffusion method. Out of 380 raw milk samples examined, 129 (33.9%) and 11 (2.9%) were contaminated with E. coli and E. coli O157:H7, respectively. The highest prevalence was recorded in samples obtained from vendors (39.1%, 4.978 ± 0.180 log10/ml) compared with samples from farmers (28.1%, 3.93 ± 0.01 log10/ml) with significant differences . The frequency of contamination was higher in the samples collected from milk that was stored and transported in plastic containers (39.4%) than in the containers made of stainless steel (23.0%) . The antimicrobial susceptibility profile showed that E. coli O157:H7 were resistant to tetracycline (81.8%), streptomycin (81.8%), and kanamycin (63.6%). Milk samples were produced and handled under poor hygienic conditions, stored, and transported in inappropriate containers and under temperature abuse conditions leading to high health risk to the consumers. Additional studies would be needed to establish association between the occurrences of E. coli O157:H7 in raw milk and all the risk factors involved in and around Asosa town.

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Overview of Celiac Disease in Russia: Regional Data and Estimated Prevalence

Celiac disease (CD) is an autoimmune enteropathy triggered by the ingestion of dietary gluten from some cereals mainly in individuals carrying the HLA-DQ2 and/or HLA-DQ8 haplotypes. As an autoimmune disease, CD is manifested in the small intestine in the form of a progressive and reversible inflammatory lesion due to immune response to self-antigens. Indeed, CD is one of the most challenging medicosocial problems in current gastroenterology. At present, the global CD prevalence is estimated at approximately 1% based on data sent from different locations and available CD screening strategies used. However, it is impossible to estimate global CD prevalence without all the data from the world, including Russia. In this review, we summarize the data on the incidence and prevalence of CD across geographically distinct regions of Russia, which are mostly present in local Russian scientific sources. Our conclusion is that the situation of CD prevalence in Russia is higher than is commonly believed and follows global tendencies that correspond to the epidemiologic situation in Europe, America, and Southwest Asia.

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A Novel Green Synthesis of Thalidomide and Analogs

Thalidomide and its derivatives are currently under investigation for their antiangiogenic, immunomodulative, and anticancer properties. Current methods used to synthesize these compounds involve multiple steps and extensive workup procedures. Described herein is an efficient microwave irradiation green synthesis method that allows preparation of thalidomide and its analogs in a one-pot multicomponent synthesis system. The multicomponent synthesis system developed involves an array of cyclic anhydrides, glutamic acid, and ammonium chloride in the presence of catalytic amounts of 4-N,N-dimethylaminopyridine (DMAP) to produce thalidomide and structurally related compounds within minutes in good isolated yields.

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Giant Splenorenal Shunt in a Young Patient with Autoimmune Hepatitis/Primary Biliary Cholangitis Overlap Syndrome and Portal Vein Thrombosis

We present a case of giant Splenorenal Shunt (SRS) associated with portal vein thrombosis in a 37-year-old woman with a twelve-year history of autoimmune hepatitis/primary biliary cholangitis overlap syndrome. At the moment of the CT examination laboratory tests showed creatinine 1.5 mg/dl, bilirubin 1.5 mg/dl, INR 3, and Na 145 mmol/l and the Model End-Stage Liver Disease score was 24. Extensive calcified thrombosis causing complete occlusion of the portal vein lumen and partially occluding the origin of the superior mesenteric vein was present and a small calcified thrombus in the Splenic Vein lumen was also evident. SRS was located among the spleen hilum and the left kidney with a maximum diameter of 3.25 cm and was associated with dilatation of left renal vein and inferior vena cava. After a multidisciplinary evaluation the patient was put on the Regional Liver Transplant waiting list and liver transplantation was performed successfully. Although portal vein thrombosis and SRS are common occurrences in cirrhotic patients, the impact in the natural history of the disease is still unclear. Careful management and accurate imaging protocols are essential in the evaluation of those patients.

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Capacity Fast Prediction and Residual Useful Life Estimation of Valve Regulated Lead Acid Battery

The usable capacity of acid lead batteries is often used as the degradation feature for online RUL (residual useful life) estimation. In engineering applications, the “standard” fully discharging method for capacity measure is quite time-consuming and harmful for the high-capacity batteries. In this paper, a data-driven framework providing capacity fast prediction and RUL estimation for high-capacity VRLA (valve regulated lead acid) batteries is presented. These batteries are used as backup power sources on the ships. The relationship between fully discharging time and partially discharging voltage curve is established for usable capacity extrapolation. Based on the predicted capacity, the particle filtering approach is utilized to obtain battery RUL distribution. A case study is conducted with the experimental data of GFM-200 battery. Results confirm that our method not only reduces the prediction time greatly but also performs quite well in prediction accuracy of battery capacity and RUL.

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Fault Diagnosis Method Based on Information Entropy and Relative Principal Component Analysis

In traditional principle component analysis (PCA), because of the neglect of the dimensions influence between different variables in the system, the selected principal components (PCs) often fail to be representative. While the relative transformation PCA is able to solve the above problem, it is not easy to calculate the weight for each characteristic variable. In order to solve it, this paper proposes a kind of fault diagnosis method based on information entropy and Relative Principle Component Analysis. Firstly, the algorithm calculates the information entropy for each characteristic variable in the original dataset based on the information gain algorithm. Secondly, it standardizes every variable’s dimension in the dataset. And, then, according to the information entropy, it allocates the weight for each standardized characteristic variable. Finally, it utilizes the relative-principal-components model established for fault diagnosis. Furthermore, the simulation experiments based on Tennessee Eastman process and Wine datasets demonstrate the feasibility and effectiveness of the new method.

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Increased life expectancy as a result of non-hormonal targeted therapies for HER2 or hormone receptor positive metastatic breast cancer: a systematic review and meta-analysis

Advanced breast cancer is encountered in around 5-10% of patients with primary breast cancers [1], and another 10% of the patients develop distant recurrence within 5 years after primary disease and treatment [2,3]. Once breast cancer has metastasized to distant locations, it is generally considered amenable to palliative rather than curative care. Therefore, the goals of treatment at this later stage are focused on delaying the progression of the metastatic disease, relief of cancer-related symptoms and maintaining quality of life [1].

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IGF1/IGF1R/STAT3 signaling-inducible IFITM2 promotes gastric cancer growth and metastasis

Interferon-induced transmembrane proteins (IFITMs) are expressed in some types of cancer. However, their precise roles in tumor progression remain unclear. The present study investigated the function of IFITM2 in gastric cancer (GC) progression. A retrospective analysis of a public database and 167 GC patients revealed that IFITM2 expression was upregulated in gastric tumor samples, which was positively correlated with disease progression, more frequent postoperative recurrence, and higher mortality rate.

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Increased life expectancy as a result of non-hormonal targeted therapies for HER2 or hormone receptor positive metastatic breast cancer: a systematic review and meta-analysis

Russell Marcus and Mark McEvoy, eds. An Historical Introduction to the Philosophy of Mathematics: A Reader.

MarcusRussell and McEvoyMark eds. An Historical Introduction to the Philosophy of Mathematics: A Reader.London:Bloomsbury, 2016. ISBN: 978-1-4725-2534-5 (hbk); 978-1-4725-2567-3 (pbk), 978-1-4725-3291-6 (e-pdf), 978-1-4725-2948-0 (e-pub). Pp. xxx + 815.

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Rafał Urbaniak. Leśniewski’s Systems of Logic and Foundations of Mathematics .

UrbaniakRafałLeśniewski’s Systems of Logic and Foundations of Mathematics. Trends in Logic; 37. Springer, 2014. ISBN: 978-3-319-00481-5 (hbk), 978-3-319-34416-4 (pbk), 978-3-319-00482-2 (e-book). Pp. xiii + 229.

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Referring to Mathematical Objects via Definite Descriptions †

Linsky and Zalta try to explain how we can refer to mathematical objects by saying that this happens through definite descriptions which may appeal to mathematical theories. I present two issues for their account. First, there is a problem of finding appropriate pre-conditions to reference, which are currently difficult to satisfy. Second, there is a problem of ensuring the stability of the resulting reference. Slight changes in the properties ascribed to a mathematical object can result in a shift of reference and this leads to various problems, e.g., it makes inferring knowledge much harder than it is.

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Beauty is not all there is to Aesthetics in Mathematics †

Aesthetics in philosophy of mathematics is too narrowly construed. Beauty is not the only feature in mathematics that is arguably aesthetic. While not the highest aesthetic value, being interesting is a sine qua non for publishability. Of the many ways to be interesting, being explanatory has recently been discussed. The motivational power of what is interesting is important for both directing research and stimulating education. The scientific satisfaction of curiosity and the artistic desire for beautiful results are complementary but both aesthetic.

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Mohan Ganesalingam. The Language of Mathematics: A Linguistic and Philosophical Investigation .

GanesalingamMohan. The Language of Mathematics: A Linguistic and Philosophical Investigation. FoLLI Publications on Logic, Language and Information. Springer, 2013. ISBN: 978-3-642-37011-3 (hbk); 978-3-642- 37012-0 (ebook). Pp. xx + 260.

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José Ferreirós. Mathematical Knowledge and the Interplay of Practices .

FerreirósJosé. Mathematical Knowledge and the Interplay of Practices.Princeton: Princeton University Press, 2015. ISBN: 978-0-691-16751-0. Pp. xvii + 337.††

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Abstraction and Four Kinds of Invariance (Or: What’s So Logical About Counting) †

Fine and Antonelli introduce two generalizations of permutation invariance — internal invariance and simple/double invariance respectively. After sketching reasons why a solution to the Bad Company problem might require that abstraction principles be invariant in one or both senses, I identify the most fine-grained abstraction principle that is invariant in each sense. Hume’s Principle is the most fine-grained abstraction principle invariant in both senses. I conclude by suggesting that this partially explains the success of Hume’s Principle, and the comparative lack of success in reconstructing areas of mathematics other than arithmetic based on non-invariant abstraction principles.

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Categories for the Neologicist

Abstraction principles provide implicit definitions of mathematical objects. In this paper, an abstraction principle defining categories is proposed. It is unsatisfiable and inconsistent in the expected ways. Two restricted versions of the principle which are consistent are presented.

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Mircea Pitici, ed. The Best Writing on Mathematics 2015 .

PiticiMircea, ed. The Best Writing on Mathematics 2015. Princeton University Press, 2016. ISBN 978-0-691-16965-1 (pbk). Pp. xxviii + 363.

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Gabriella Crocco and Eva-Maria Engelen, eds. Kurt Gödel: Philosopher-Scientist .

CroccoGabriella and EngelenEva-Maria, eds. Kurt Gödel: Philosopher-Scientist. Aix en Provence: Presses Universitaires de Provence, 2016. ISBN 978-2-85399-976-2 (pbk). Pp.491.

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Erratum

Rafal Urbaniak. Leśniewski's Systems of Logic and Foundations of Mathematics. Trends in Logic; 37. Springer, 2014. ISBN: 978-3-319-00481-5 (hbk), 978-3-319-34416-4 (pbk), 978-3-319-00482-2 (e-book). Pp. xiii + 229.

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Introduction to Special Issue: Abstraction Principles

Three decades after their contemporary rediscovery, abstraction principles continue to be at the center of one of the most active areas of research in philosophy of mathematics. The present special issue bears witness to this fact. It collects some of the work presented at two events held in 2014. The first was the workshop ‘Abstractionism / Neologicism’ organized by Marcus Rossberg at the University of Connecticut (April 26–27). The second was the summer school and workshop ‘Abstraction: Philosophy and Mathematics’ organized by Øystein Linnebo and me at the University of Oslo (May 22–24). The events were generously supported by the host universities. Additional funding for the summer school was provided by Kansas State University.

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Colin R. Caret and Ole T. Hjortland, eds. Foundations of Logical Consequence

CaretColin R. and HjortlandOle T., eds. Foundations of Logical Consequence. Oxford University Press, 2015. ISBN 978-0-19-871569-6 (hbk). Pp. viii + 357.

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Structural-Abstraction Principles †

In this paper, I present a class of ‘structural’ abstraction principles, and describe how they are suggested by some features of Cantor's and Dedekind's approach to abstraction. Structural abstraction is a promising source of mathematically tractable new axioms for the neo-logicist. I illustrate this by showing, first, how a theorem of Shelah gives a sufficient condition for consistency in the structural setting, solving what neo-logicists call the ‘bad company’ problem for structural abstraction. Second, I show how, in the structural setting, we can measure the logical strength of abstraction principles using categories of interpretations between theories.

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A Generic Russellian Elimination of Abstract Objects

In this paper I explore a position on which it is possible to eliminate the need for postulating abstract objects through abstraction principles by treating terms for abstracta as ‘incomplete symbols’, using Russell's no-classes theory as a template from which to generalize. I defend views of this stripe against objections, most notably Richard Heck's charge that syntactic forms of nominalism cannot correctly deal with non-first-orderizable quantifcation over apparent abstracta. I further discuss how number theory may be developed in a system treating apparent terms for numbers using these definitions.

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Frege Meets Aristotle: Points as Abstracts †

There are a number of regions-based accounts of space/time, due to Whitehead, Roeper, Menger, Tarski, the present authors, and others. They all follow the Aristotelian theme that continua are not composed of points: each region has a proper part. The purpose of this note is to show how to recapture ‘points’ in such frameworks via Scottish neo-logicist abstraction principles (instead of Whiteheadian ‘extensive abstraction’). The results recapitulate some Aristotelian themes. A second agenda is to provide a new arena to help decide what is at stake when adjudicating issues concerning the identity of neo-logicist abstracts — so-called ‘Caesar questions’.

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Language and Error-Correcting Codes

Contemplating communication with Claude Shannon

-- Read more on ScientificAmerican.com

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The new issue is now available.Physical Therapy Japan

Vol.44 No.1

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The new issue is now available.Annals of Thoracic and Cardiovascular Surgery

Vol.23 No.1

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The new issue is now available.Chikyukagaku

Vol.46 No.3

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The new issue is now available.Journal of the Japan Society of Colour Material

Vol.89 No.11

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The new issue is now available.Japanese Journal of Social Psychology

Vol.25 No.1

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The new issue is now available.Journal of the Society of Materials Science, Japan

Vol.66 No.2

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The new issue is now available.Journal of Japan Society of Civil Engineers, Ser. F2 (Underground Space Research)

Vol.73 No.1

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The new issue is now available.Journal of Japan Society of Civil Engineers, Ser. F6 (Safety Problem)

Vol.73 No.1

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The new issue is now available.Journal of Japan Society of Civil Engineers, Ser. B3 (Ocean Engineering)

Vol.73 No.1

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The new issue is now available.Journal of Japan Society of Civil Engineers, Ser. G (Environmental Research)

Vol.72 No.5

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The new issue is now available.AIJ Journal of Technology and Design

Vol.23 No.53

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The new issue is now available.Japanese Journal of Social Psychology

Vol.25 No.3

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The new issue is now available.Proceedings of JSPE Semestrial Meeting

Vol.2016A

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The new issue is now available.Japanese Journal of Social Psychology

Vol.25 No.2

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The new issue is now available.Shikaigaku

Vol.53 No.1

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newly available online.Shinrin Kagaku

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The new issue is now available.Nihon Naika Gakkai Zasshi

Vol.105 No.Suppl

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The new issue is now available.Shikaigaku

Vol.53 No.6

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The new issue is now available.Shikaigaku

Vol.53 No.2

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The new issue is now available.Shikaigaku

Vol.53 No.5

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Myopericytoma in urinary bladder: a case report

Myopericytoma is reported to occur mainly in the skin and superficial soft tissue of the extremities. In contrast, occurrence in the urinary bladder is extremely rare.

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Feature Extraction and Classification of EHG between Pregnancy and Labour Group Using Hilbert-Huang Transform and Extreme Learning Machine

Preterm birth (PTB) is the leading cause of perinatal mortality and long-term morbidity, which results in significant health and economic problems. The early detection of PTB has great significance for its prevention. The electrohysterogram (EHG) related to uterine contraction is a noninvasive, real-time, and automatic novel technology which can be used to detect, diagnose, or predict PTB. This paper presents a method for feature extraction and classification of EHG between pregnancy and labour group, based on Hilbert-Huang transform (HHT) and extreme learning machine (ELM). For each sample, each channel was decomposed into a set of intrinsic mode functions (IMFs) using empirical mode decomposition (EMD). Then, the Hilbert transform was applied to IMF to obtain analytic function. The maximum amplitude of analytic function was extracted as feature. The identification model was constructed based on ELM. Experimental results reveal that the best classification performance of the proposed method can reach an accuracy of 88.00%, a sensitivity of 91.30%, and a specificity of 85.19%. The area under receiver operating characteristic (ROC) curve is 0.88. Finally, experimental results indicate that the method developed in this work could be effective in the classification of EHG between pregnancy and labour group.

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Skin Cancer and Its Treatment: Novel Treatment Approaches with Emphasis on Nanotechnology

The life expectancy in the Western world is increasing for a long time, which is the courtesy of a higher life standard, a more thorough hygiene, and, of course, the progress of modern medicine. Nevertheless, one of the illnesses that still proves to be a great challenge regardless of the recent advancements in medicine is cancer. Skin cancer is, according to the World Health Organization, the most common malignancy for the white population. The beginning of the paper offers a brief overview of the latest available information concerning epidemiology, aetiology, diagnostics, and treatment options for skin cancer, whereas the rest of the article deals with modern approaches to skin cancer treatment, highlighting recent development of nanotechnology based treatment approaches. Among these, we focus especially on the newest nanotechnological approaches combined with chemotherapy, a field which specialises in target specificity, drug release control, and real time monitoring with the goal being to diminish unwanted side effects and their severity, achieving a cheaper treatment and a generally more efficient chemotherapy. The field of nanotechnology is a rapidly developing one, judging by already approved clinical studies or by new theranostic agents that combine both the therapeutic and diagnostic modalities.

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A Combined Random Forests and Active Contour Model Approach for Fully Automatic Segmentation of the Left Atrium in Volumetric MRI

Segmentation of the left atrium (LA) from cardiac magnetic resonance imaging (MRI) datasets is of great importance for image guided atrial fibrillation ablation, LA fibrosis quantification, and cardiac biophysical modelling. However, automated LA segmentation from cardiac MRI is challenging due to limited image resolution, considerable variability in anatomical structures across subjects, and dynamic motion of the heart. In this work, we propose a combined random forests (RFs) and active contour model (ACM) approach for fully automatic segmentation of the LA from cardiac volumetric MRI. Specifically, we employ the RFs within an autocontext scheme to effectively integrate contextual and appearance information from multisource images together for LA shape inferring. The inferred shape is then incorporated into a volume-scalable ACM for further improving the segmentation accuracy. We validated the proposed method on the cardiac volumetric MRI datasets from the STACOM 2013 and HVSMR 2016 databases and showed that it outperforms other latest automated LA segmentation methods. Validation metrics, average Dice coefficient (DC) and average surface-to-surface distance (S2S), were computed as and mm, versus those of 0.6222–0.878 and 1.34–8.72 mm, obtained by other methods, respectively.

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On a New Epidemic Model with Asymptomatic and Dead-Infective Subpopulations with Feedback Controls Useful for Ebola Disease

This paper studies the nonnegativity and local and global stability properties of the solutions of a newly proposed SEIADR model which incorporates asymptomatic and dead-infective subpopulations into the standard SEIR model and, in parallel, it incorporates feedback vaccination plus a constant term on the susceptible and feedback antiviral treatment controls on the symptomatic infectious subpopulation. A third control action of impulsive type (or “culling”) consists of the periodic retirement of all or a fraction of the lying corpses which can become infective in certain diseases, for instance, the Ebola infection. The three controls are allowed to be eventually time varying and contain a total of four design control gains. The local stability analysis around both the disease-free and endemic equilibrium points is performed by the investigation of the eigenvalues of the corresponding Jacobian matrices. The global stability is formally discussed by using tools of qualitative theory of differential equations by using Gauss-Stokes and Bendixson theorems so that neither Lyapunov equation candidates nor the explicit solutions are used. It is proved that stability holds as a parallel property to positivity and that disease-free and the endemic equilibrium states cannot be simultaneously either stable or unstable. The periodic limit solution trajectories and equilibrium points are analyzed in a combined fashion in the sense that the endemic periodic solutions become, in particular, equilibrium points if the control gains converge to constant values and the control gain for culling the infective corpses is asymptotically zeroed.

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Time-Varying Identification Model for Crack Monitoring Data from Concrete Dams Based on Support Vector Regression and the Bayesian Framework

The modeling of cracks and identification of dam behavior changes are difficult issues in dam health monitoring research. In this paper, a time-varying identification model for crack monitoring data is built using support vector regression (SVR) and the Bayesian evidence framework (BEF). First, the SVR method is adopted for better modeling of the nonlinear relationship between the crack opening displacement (COD) and its influencing factors. Second, the BEF approach is applied to determine the optimal SVR modeling parameters, including the penalty coefficient, the loss coefficient, and the width coefficient of the radial kernel function, under the principle that the prediction errors between the monitored and the model forecasted values are as small as possible. Then, considering the predicted COD, the historical maximum COD, and the time-dependent component, forewarning criteria are proposed for identifying the time-varying behavior of cracks and the degree of abnormality of dam health. Finally, an example of modeling and forewarning analysis is presented using two monitoring subsequences from a real structural crack in the Chencun concrete arch-gravity dam. The findings indicate that the proposed time-varying model can provide predicted results that are more accurately nonlinearity fitted and is suitable for use in evaluating the behavior of cracks in dams.

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Back Analysis of Geomechanical Parameters of Rock Masses Based on Seepage-Stress Coupled Analysis

Given that rock masses are complex, the geomechanical parameters of rock masses are hard to determine in underground engineering. In this paper, the inverse model and method are established to identify the parameters based on the coupled stress and fluid flow model combined with the finite element method and adaptive genetic algorithm. Moreover, the model and method are applied in the Lianghekou highway tunnel, and the initial permeability coefficients of the stratum and the lateral pressure coefficients of the initial ground stress are identified by the back analysis with relative errors of the measured and fitted values at measuring points below 5%. Results show that the inverse model and method are effective and sound.

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Dynamical Analysis and FPGA Implementation of a Novel Hyperchaotic System and Its Synchronization Using Adaptive Sliding Mode Control and Genetically Optimized PID Control

We announce a new 4D hyperchaotic system with four parameters. The dynamic properties of the proposed hyperchaotic system are studied in detail; the Lyapunov exponents, Kaplan-Yorke dimension, bifurcation, and bicoherence contours of the novel hyperchaotic system are derived. Furthermore, control algorithms are designed for the complete synchronization of the identical hyperchaotic systems with unknown parameters using sliding mode controllers and genetically optimized PID controllers. The stabilities of the controllers and parameter update laws are proved using Lyapunov stability theory. Use of the optimized PID controllers ensures less time of convergence and fast synchronization speed. Finally the proposed novel hyperchaotic system is realized in FPGA.

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Biosensors, Vol. 7, Pages 10: A Single-Use, In Vitro Biosensor for the Detection of T-Tau Protein, A Biomarker of Neuro-Degenerative Disorders, in PBS and Human Serum Using Differential Pulse Voltammetry (DPV)

A single-use, in vitro biosensor for the detection of T-Tau protein in phosphate-buffer saline (PBS) and undiluted human serum was designed, manufactured, and tested. Differential pulse voltammetry (DPV) served as the transduction mechanism. This biosensor consisted of three electrodes: working, counter, and reference electrodes fabricated on a PET sheet. Both working and counter electrodes were thin gold film, 10 nm in thickness. Laser ablation technique was used to define the size and structure of the biosensor. The biosensor was produced using cost-effective roll-to-roll process. Self-assembled monolayers (SAM) of 3-mercaptopropionic acid (MPA) were employed to covalently immobilize the anti-T-Tau (T-Tau antibody) on the gold working electrode. A carbodiimide conjugation approach using N-(3-dimethylaminopropyl)-N’-ethylcarbodiimide hydrochloride (EDC) and N–hydroxysuccinimide (NHS) cross-linked anti-T-Tau to the carboxylic groups on one end of the MPA. A T-Tau protein ladder with six isoforms was used in this study. The anti-T-Tau concentration used was 500,000 pg/mL. The T-Tau protein concentration ranged from 1000 pg/mL to 100,000 pg/mL. DPV measurements showed excellent responses, with a good calibration curve. Thus, a practical tool for simple detection of T-Tau protein, a biomarker of neuro-degenerative disorders, has been successfully developed. This tool could also be extended to detect other biomarkers for neuro-degenerative disorders, such as P-Tau protein and β-amyloid 42.

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Retinal Vessel Density in Optical Coherence Tomography Angiography in Optic Atrophy after Nonarteritic Anterior Ischemic Optic Neuropathy

Aims. To compare optical coherence tomography angiography (OCT-A) retinal vasculature measurements between normal and optic atrophy after nonarteritic anterior ischemic optic neuropathy (NAION) subjects. Design. This prospective observational study was conducted between July 2015 and August 2016 at the ophthalmology outpatient department of a referral center in Taiwan. Peripapillary (4.5 × 4.5 mm) and parafoveal (6 × 6 mm) OCT-A scans were acquired. Measurements of the peripapillary region were obtained in two areas: (1) circumpapillary vessel density (cpVD) and (2) whole enface image vessel density (wiVD). Results. 13 participants with optic atrophy after NAION had lower peripapillary vessel density than the 18 age-matched participants in the healthy control (HC) group ( for both cpVD and wiVD). However, the parafoveal vessel density was not significantly different between the two groups (). The areas under the receiver operating characteristic curve for the HC and NAION eyes were 0.992 for cpVD and 0.970 for wiVD. cpVD and wiVD were significantly correlated with the average retinal nerve fiber layer thickness ( for both). Conclusion. Peripapillary retinal perfusion is significantly decreased in optic atrophy after NAION. OCT-A may aid in the understanding of structure-function-perfusion relationships in NAION.

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Clinical Characteristics of Patients with Newly Diagnosed Diabetic Macular Edema in Turkey: A Real-Life Registry Study—TURK-DEM

Purpose. To evaluate the clinical and diagnostic characteristics of patients with newly diagnosed diabetic macular edema (DME) in Turkey in a real-life setting. Methods. A total of 945 consecutive patients (mean (SD) age: 61.3 (9.9) years, 55.2% male) with newly diagnosed DME were included. Data on patient demographics, comorbidities, ocular history, ophthalmic examination findings including type of DME, central macular thickness (CMT) via time domain (TD) and spectral domain (SD) optical coherence tomography (OCT), and planned treatments were recorded. Results. OCT (98.8%) and fundoscopy (92.9%) were the two most common diagnostic methods. Diffuse and focal DMEs were detected in 39.2% and 36.9% of cases, respectively. Laser photocoagulation (32.1%) and antivascular endothelial growth factors (anti-VEGF; 31.8%) were the most commonly planned treatments. The median CMT in the right eye was significantly greater in untreated than in treated patients [376.5 μm (range: 160–840) versus 342 μm (range: 146–999) ()] and in the left eye [370 μm (range: 201–780) versus 329 μm (range: 148–999) ()]. Conclusions. This study is the first large-scale real-life registry of DME patients in Turkey. SD-OCT and fundoscopy were the most common diagnostic methods. Laser photocoagulation and anti-VEGF therapy were the most common treatments.

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A Spectrum Detection Approach for Bearing Fault Signal Based on Spectral Kurtosis

According to the similarity between Morlet wavelet and fault signal and the sensitive characteristics of spectral kurtosis for the impact signal, a new wavelet spectrum detection approach based on spectral kurtosis for bearing fault signal is proposed. This method decreased the band-pass filter range and reduced the wavelet window width significantly. As a consequence, the bearing fault signal was detected adaptively, and time-frequency characteristics of the fault signal can be extracted accurately. The validity of this method was verified by the identifications of simulated shock signal and test bearing fault signal. The method provides a new understanding of wavelet spectrum detection based on spectral kurtosis for rolling element bearing fault signal.

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Effect of Graded Facetectomy on Lumbar Biomechanics

Facetectomy is an important intervention for spinal stenosis but may lead to spinal instability. Biomechanical knowledge for facetectomy can be beneficial when deciding whether fusion is necessary. Therefore, the aim of this study was to investigate the biomechanical effect of different grades of facetectomy. A three-dimensional nonlinear finite element model of L3–L5 was constructed. The mobility of the model and the intradiscal pressure (IDP) of L4-L5 for standing were inside the data from the literature. The effect of graded facetectomy on intervertebral rotation, IDP, facet joint forces, and maximum von Mises equivalent stresses in the annuli was analyzed under flexion, extension, left/right lateral bending, and left/right axial rotation. Compared with the intact model, under extension, unilateral facetectomy increased the range of intervertebral rotation (IVR) by 11.7% and IDP by 10.7%, while the bilateral facetectomy increased IVR by 40.7% and IDP by 23.6%. Under axial rotation, the unilateral facetectomy and the bilateral facetectomy increased the IVR by 101.3% and 354.3%, respectively, when turned to the right and by 1.1% and 265.3%, respectively, when turned to the left. The results conclude that, after unilateral and bilateral facetectomy, care must be taken when placing the spine into extension and axial rotation posture from the biomechanical point of view.

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A Lifetime Optimization Algorithm Limited by Data Transmission Delay and Hops for Mobile Sink-Based Wireless Sensor Networks

To improve the lifetime of mobile sink-based wireless sensor networks and considering that data transmission delay and hops are limited in actual system, a lifetime optimization algorithm limited by data transmission delay and hops (LOA_DH) for mobile sink-based wireless sensor networks is proposed. In LOA_DH, some constraints are analyzed, and an optimization model is proposed. Maximum capacity path routing algorithm is used to calculate the energy consumption of communication. Improved genetic algorithm which modifies individuals to meet all constraints is used to solve the optimization model. The optimal solution of sink node’s sojourn grid centers and sojourn times which maximizes network lifetime is obtained. Simulation results show that, in three node distribution scenes, LOA_DH can find the movement solution of sink node which covers all sensor nodes. Compared with MCP_RAND, MCP_GMRE, and EASR, the solution improves network lifetime and reduces average amount of node discarded data and average energy consumption of nodes.

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Estimation of Crash Severity on Mountainous Freeways in Chongqing

Mountainous freeways always suffer from accidents due to special terrain, weather conditions, driving environment, and so on. Based on the records of 898 accidents that occurred on mountainous freeways in Chongqing during the past 6 years, the partial proportional odds model is used to identify the factors affecting the accident severity. The time of the accident, season, involvement of trucks, accident characteristics, speeding, maximum driving experience of involved drivers, and weather and road conditions are found to be important for the levels of accident severity. Zero to 6 a.m. and 19 to 24 p.m. are the times prone to serious traffic accidents. The probability of serious traffic accidents in summer and autumn is greater than that in spring and winter. Once a truck is involved in an accident, the consequence is often more severe. Turnover and speeding will result in a grave accident. When there is an experienced driver, the probability of serious traffic accidents is low. The fog is extremely unfavorable weather conditions. The probability of serious accident happening in the downgrade, ramp, curve, bridge, and tunnel sections is greater than the others. The results aim to provide valuable reference for traffic safety on mountainous freeways.

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SDN-Based Mobile Data Offloading Scheme Using a Femtocell and WiFi Networks

Because of the many applications running on smartphones, the load of mobile data traffic on cellular networks is increasing rapidly. A femtocell is a solution to increase the cellular network capacity and coverage. However, because it uses the same frequency bands as a macrocell, interference problems have prevented its widespread adoption. In this paper, we propose a scheme for traffic offloading between femtocells and WiFi networks utilizing software-defined networking (SDN) technology. In the proposed offloading scheme, the SDN technology allows a terminal to maintain existing sessions after offloading through a centralized control of the SDN-based equipment. We also propose an offloading target selection scheme based on available bandwidth estimation and an association control mechanism to reduce the femtocell load while ensuring quality of service (QoS) in terms of throughput. Experimental results on an actual testbed showed that the proposed offloading scheme provides seamless connectivity and reduces the femtocell load by up to 46% with the aid of the proposed target selection scheme, while ensuring QoS after offloading. We also observed that the proposed target selection scheme offloads 28% more traffic to WiFi networks compared to received signal strength indicator-based target selection in a low background traffic environment.

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Serum Cytokine Levels and Their Relation to Clinical Features in Patients with Autoimmune Liver Diseases

Serum cytokine levels were explored in a combined group of patients with autoimmune liver diseases (AILDs) and separately in patients with autoimmune hepatitis (AIH) and overlap syndrome. Overall, 60 patients with AILD, among them 32 patients with AIH and 28 patients with overlap syndrome, were included in the cross-sectional study. Serum cytokine levels were measured at baseline and compared to those of 21 healthy controls. Patients with AILD had significantly higher levels of IL-6 (0.70 (range 0.17–99.86) in patients with AILD compared to 0.40 (range 0.14–2.65) in controls, ), IL-8 (1.66 (0.45–34.58) versus 0.53 (0.35–2.38), resp., ), and TNF-α (2.61 (0.23–120.88) versus 1.65 (0.21–7.54), resp., ). Adjusted logistic regression analysis revealed a pronounced relation of IL-8 and AILD, 48.36 (3.63–643.60), as well as AIH, 18.54 (1.08–318.54), and overlap syndrome, 23.85 (2.37–240.23), while the associations between the level of other cytokines and AILD were assessed as nonsignificant. In the language of absolute numbers, the increase of IL-8 serum level by 1 pg/mL had increased the chance for a patient to find himself in a group of AILD by 48.36 times. Also, high IL-8 serum levels were strongly related to clinical parameters.

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High Stability Performance of Superhydrophobic Modified Fluorinated Graphene Films on Copper Alloy Substrates

A stable self-cleaning superhydrophobic modified fluorinated graphene surface with micro/nanostructure was successfully fabricated on copper substrates via drop coating process. Irregularly stacked island-like multilayered fluorinated graphene nanoflakes comprised the microstructure. The fabricated films exhibited outstanding superhydrophobic property with a water contact angle 167° and water sliding angle lower than 4°. The developed superhydrophobic surface showed excellent corrosion resistance with insignificant decrease of water contact angle 166° in 3.5 wt.% NaCl solution. This stable highly hydrophobic performance of the fluorinated graphene films could be useful in self-cleaning, antifogging, corrosion resistive coatings and microfluidic devices.

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Consolidative local therapy in oligometastatic patients - Authors' reply.

Consolidative local therapy in oligometastatic patients - Authors' reply.

Lancet Oncol. 2017 Feb;18(2):e62

Authors: Gomez D, Swisher S, Heymach J

PMID: 28214416 [PubMed - in process]

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Association of gastro-oesophageal reflux and chronic rhinosinusitis: systematic review and meta-analysis.

Association of gastro-oesophageal reflux and chronic rhinosinusitis: systematic review and meta-analysis.

Rhinology. 2017 Feb 18;:

Authors: Leason SR, Barham HP, Oakley G, Rimmer J, DelGaudio JM, Christensen JM, Sacks R, Harvey RJ

PMID: 28214353 [PubMed - as supplied by publisher]

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Cancer stem cell, cytokeratins and epithelial to mesenchymal transition markers expression in oral squamous cell carcinoma derived from ortothopic xenoimplantation of CD44(high) cells.

Cancer stem cell, cytokeratins and epithelial to mesenchymal transition markers expression in oral squamous cell carcinoma derived from ortothopic xenoimplantation of CD44(high) cells.

Pathol Res Pract. 2016 Dec 23;:

Authors: de Andrade NP, Rodrigues MF, Rodini CO, Nunes FD

Abstract
Oral squamous cell carcinoma (OSCC) is the most prevalent neoplasia of oral cavity worldwide and prognosis remains unchanged in decades. Recently, different authors reported that head and neck squamous cell carcinomas have a subpopulation of tumor initiating cells that apparently correspond to cancer stem cells (CSC) and are also responsible for tumor growth and metastasis. The purpose of the present study was to investigate the microscopic and phenotypic characteristics of OSCC tumors induced after orthotopic xenoimplantation of SCC9(WT) cell line and CSC-enriched subpopulation isolated from SCC9 cell line based on high expression of the putative CSC marker CD44. Different numbers of FACS-sorted SCC9 CD44(high) and CD44(low) cells as well as SCC9(WT) (wild type) were transplanted into the tongue of BALB/C nude (NOD/SCID) mice to evaluate their tumorigenic potential. Sixty days post-induction, tumors were morphologically characterized and immunostained for CSC markers (CD44, Nanog and Bmi-1), epithelial-mesenchymal transition (Snail, Slug) and epithelial differentiating cell markers (cytokeratins 4, 13, 15, 17 and 19), as well as E-cadherin and β-catenin. The data presented here shows that SCC9 CD44(high) cells have higher ability to form tumors than SCC9 CD44(low) cells, even when significantly lower numbers of SCC9 CD44(high) cells were transplanted. Immunoassessment of tumors derived from SCC9 CD44(high) cells revealed high expression of cytokeratin CK19, β-catenin, E-cadherin and CD44, and negative or low expression of CK17, CK4, CK15, CK13, Nanog, Bmi-1, Snail and Slug. While tumors derived from SCC9(WT) showed high expression of CK17, CK19, CD44, Nanog, Bmi-1, Snail and Slug, and negative or low expression of CK4, CK15, CK13, β-catenin and E-cadherin. Thus, SCC9 CD44(high) cells were highly tumorigenic, capable of originating heterogeneous tumors and these tumors have a immunohistochemical profile different from those formed by the wild type cell line.

PMID: 28214216 [PubMed - as supplied by publisher]

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Validation of the University of Washington Quality of Life Chinese Version (UWQOL-C) for head and neck cancer patients in Taiwan.

Validation of the University of Washington Quality of Life Chinese Version (UWQOL-C) for head and neck cancer patients in Taiwan.

J Formos Med Assoc. 2017 Feb 14;:

Authors: Lee YH, Lai YH, Yueh B, Chu PY, Chen YJ, Chen SC, Wang CP

Abstract
BACKGROUND/PURPOSE: The purposes of this three-phase study were to: (1) translate and evaluate the burden, content, and face validity of the Chinese version of the University of Washington Quality of Life Scale, version 4 (UWQOL-v4-C); and (2) examine the psychometric properties of the UWQOL-v4-C in oral cancer and laryngeal cancer patients in Taiwan.
METHODS: This instrument translation and validation study was part of a major research project. The first phase of this study developed and validated the content of the UWQOL-v4-C. The second phase sought to validate the internal consistency, reliability, and construct and discriminant validity in two major groups of head and neck cancer (HNC) patients: oral cavity cancers (n=109) and laryngeal cancer (n=102). Construct validity was measured using theoretically supported correlations between the UWQOL and related constructs. Discriminant validity was also assessed. In the third phase, test-retest reliability of UWQOL-v4-C was examined through the 1-week interval in another group of HNC patients (n=50).
RESULTS: The translated UWQOL-v4-C demonstrated satisfactory face validity, content validity, and minimal patient burden. Additionally, the UWQOL-v4-C showed excellent construct validity in patient testing, supported by significant correlations between the UWQOL-v4-C and hypothesized constructs, including generic measures of QOL and performance status. The developed scale correlated inversely with symptom severity and psychological distress. Discriminant validity was seen in patients with different cancer diagnoses, stages, and treatments. Finally, excellent stability was supported by a 1-week test-retest reliability of 0.88.
CONCLUSION: The UWQOL-v4-C was a brief, low-burden, and valid instrument to measure the QOL in Chinese-speaking HNC patients in Taiwan.

PMID: 28214178 [PubMed - as supplied by publisher]

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Japanese guidelines for allergic rhinitis 2017.

Japanese guidelines for allergic rhinitis 2017.

Allergol Int. 2017 Feb 14;:

Authors: Okubo K, Kurono Y, Ichimura K, Enomoto T, Okamoto Y, Kawauchi H, Suzaki H, Fujieda S, Masuyama K, Japanese Society of Allergology

Abstract
Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 8th edition was published in 2016, and is widely used today. To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2016. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.

PMID: 28214137 [PubMed - as supplied by publisher]

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Re: Should we consider devolution of "head and neck" surgery from the specialties of oral and maxillofacial surgery; ear, nose and throat surgery; and plastic surgery?

Re: Should we consider devolution of "head and neck" surgery from the specialties of oral and maxillofacial surgery; ear, nose and throat surgery; and plastic surgery?

Br J Oral Maxillofac Surg. 2017 Feb 14;:

Authors: Elledge R, Walton G, Sandhu R, Prasad S, Howe D

PMID: 28214026 [PubMed - as supplied by publisher]

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Long-term outcomes of endolymphatic sac shunting with local steroids for Meniere's disease.

Long-term outcomes of endolymphatic sac shunting with local steroids for Meniere's disease.

Am J Otolaryngol. 2017 Jan 20;:

Authors: Wick CC, Manzoor NF, McKenna C, Semaan MT, Megerian CA

Abstract
OBJECTIVES: To evaluate the long-term efficacy of endolymphatic sac shunt techniques with and without local steroid administration.
STUDY DESIGN: Retrospective case series and patient survey.
SETTING: Tertiary university hospital.
PATIENTS: Meniere's disease (MD) patients that failed medical therapy and subsequently underwent an endolymphatic sac shunt procedure. All patients had definitive or probable MD and at least 18-months of follow-up.
INTERVENTIONS: Three variations on endolymphatic sac decompression with shunt placement were performed: Group A received no local steroids, Group B received intratympanic dexamethasone prior to incision, and Group C received dexamethasone via both intratympanic injection and direct endolymphatic sac instillation.
MAIN OUTCOME MEASURE(S): Vertigo control, hearing results, and survey responses.
RESULTS: Between 2002 and 2013, 124 patients with MD underwent endolymphatic sac decompression with shunt placement. 53 patients met inclusion criteria. Groups A, B, and C had 6 patients, 20 patients, and 27 patients, respectively. Mean follow-up was 56months. Vertigo control improved in 66%, 83%, and 93% of Groups A, B, and C. Functional level improved for Group B (-2.0) and Group C (-2.2) but was unchanged in Group A. Pure-tone average and speech discrimination scores changed by +22dB and -30%, +6dB and -13%, and +6dB and -5% in Groups A, B, and C. The long-term hearing results were significantly better with steroids (Groups B and C) according to the AAO-HNS 1995 criteria but did not meet significance on non-parametric testing.
CONCLUSIONS: Endolymphatic sac shunt procedures may benefit from steroid instillation at the time of shunt placement.

PMID: 28214024 [PubMed - as supplied by publisher]

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Paraneoplastic pemphigus associated with Castleman disease: Progression from mucous to mucocutaneous lesions with epitope-spreading phenomena.

Paraneoplastic pemphigus associated with Castleman disease: Progression from mucous to mucocutaneous lesions with epitope-spreading phenomena.

Br J Dermatol. 2017 Feb 18;:

Authors: Okahashi K, Oiso N, Ishii N, Miyake M, Uchida S, Matsuda H, Kitano M, Hida J, Kawai S, Sano A, Hashimoto T, Kawada A

Abstract
Paraneoplastic pemphigus (PNP) is a frequently fatal autoimmune blistering disease of the skin and mucous membranes.(1) PNP is commonly associated with malignant neoplasms or haematological disorders like Castleman disease (CD). The eruptions may resemble those seen in various other conditions such as lichen planus (LP), graft-versus-host disease, erythema multiforme (EM), bullous pemphigoid and pemphigus vulgaris (PV).(2) This article is protected by copyright. All rights reserved.

PMID: 28213962 [PubMed - as supplied by publisher]

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Invasive Aspergillus Laryngotracheobronchitis in an Adult with Primary CNS Lymphoma.

Invasive Aspergillus Laryngotracheobronchitis in an Adult with Primary CNS Lymphoma.

Mycopathologia. 2017 Feb 17;:

Authors: Barry ME, Thomas WW, Song B, Mirza N

Abstract
Invasive aspergillosis can be difficult to diagnose, and early recognition and initiation of therapy is imperative for improving patient outcomes. A case of invasive Aspergillus laryngotracheobronchitis is presented here with a review of the relevant literature. A 58-year-old male undergoing treatment for CNS lymphoma presented with neutropenic sepsis and acute respiratory distress requiring intubation. Following extubation, he reported persistent hoarseness for 1-month duration and he was found to have pseudomembranous plaques and ulcers of the larynx, trachea, and right mainstem bronchus consistent with Aspergillus laryngotracheobronchitis. Invasive Aspergillus laryngotracheobronchitis should be considered in immunocompromised patients presenting with persistent hoarseness.

PMID: 28213800 [PubMed - as supplied by publisher]

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The importance of drug-induced sedation endoscopy (D.I.S.E.) techniques in surgical decision making: conventional versus target controlled infusion techniques-a prospective randomized controlled study and a retrospective surgical outcomes analysis.

The importance of drug-induced sedation endoscopy (D.I.S.E.) techniques in surgical decision making: conventional versus target controlled infusion techniques-a prospective randomized controlled study and a retrospective surgical outcomes analysis.

Eur Arch Otorhinolaryngol. 2017 Feb 17;:

Authors: De Vito A, Agnoletti V, Zani G, Corso RM, D'Agostino G, Firinu E, Marchi C, Hsu YS, Maitan S, Vicini C

Abstract
Drug-Induced Sedation Endoscopy (DISE) consists of the direct observation of the upper airways during sedative-induced sleep, allowing the identification of the sites of pharyngeal collapse, which is the main pathological event in Obstructive Sleep Apnea (OSA). The Authors have compared Target Controlled Infusion (TCI) sedation endoscopy (TCI-DISE) technique to conventional DISE (CDISE), performed by a manual bolus injection of sedative agent, to recreate accurately and safely snoring and apnea patterns comparable to natural sleep. The authors conducted a prospective, randomized, long-term study and a retrospective analysis of surgical outcomes. The apnea-event observation and its correlation with pharyngeal collapse patterns is the primary endpoint; secondary endpoints are defined as stability and safety of sedation plan of DISE-TCI technique. From January 2009 to January 2011, OSA patients were included in the study and randomly allocated into two groups: the bolus injection conventional DISE group and the TCI-DISE group. Third endpoint is to compare the surgical outcomes enrolling OSA patients from January 2009 to June 2015. We recorded the complete apnea-event at oropharynx and hypopharynx levels in 15/50 pts in conventional DISE group (30%) and in 99/123 pts in TCI-DISE group (81%) (p < 0.0001). Four pts needed oxygen in conventional DISE group because a severe desaturation occurred during the first bolus of propofol (1 mg/kg) (p = 0.4872 ns). We recorded instability of the sedation plan in 13 patients of conventional DISE group (65%) and 1 patient of the TCI-DISE group (5%) (p = 0.0001). In 37 TCI-DISE group surgical patients we reported a significant reduction of postoperative AHI (from 42.7 ± 20.2 to 11.4 ± 10.3) in comparison with postoperative AHI in 15 C-DISE group surgical patients (from 41.3 ± 23.4 to 20.4 ± 15.5) (p = 0.05). Our results suggest the DISE-TCI technique as first choice in performing sleep-endoscopy because of its increased accuracy, stability and safety. However, it is mandatory an accurate assessment of PSG/PM, which allows us to differentiate OSA patients in whom UA anatomical abnormalities are predominant in comparison with not-anatomical pathophysiologic factors, achieving good surgical patient's selection and outcomes as a consequence.

PMID: 28213776 [PubMed - as supplied by publisher]

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Real-time MRI-guided percutaneous sclerotherapy of low-flow head and neck lymphatic malformations in the pediatric population - a stepwise approach.

Real-time MRI-guided percutaneous sclerotherapy of low-flow head and neck lymphatic malformations in the pediatric population - a stepwise approach.

Pediatr Radiol. 2017 Feb 17;:

Authors: Partovi S, Vidal L, Lu Z, Nakamoto DA, Buethe J, Clampitt M, Coffey M, Patel IJ

Abstract
Real-time MRI-guided percutaneous sclerotherapy is a novel and evolving treatment for congenital lymphatic malformations in the head and neck. We elaborate on the specific steps necessary to perform an MRI-guided percutaneous sclerotherapy of lymphatic malformations including pre-procedure patient work-up and preparation, stepwise intraprocedural interventional techniques and post-procedure management. Based on our institutional experience, MRI-guided sclerotherapy with a doxycycline-gadolinium-based mixture as a sclerosant for lymphatic malformations of the head and neck region in children is well tolerated and effective.

PMID: 28213627 [PubMed - as supplied by publisher]

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Informing efficient randomised controlled trials: exploration of challenges in developing progression criteria for internal pilot studies.

Informing efficient randomised controlled trials: exploration of challenges in developing progression criteria for internal pilot studies.

BMJ Open. 2017 Feb 17;7(2):e013537

Authors: Avery KN, Williamson PR, Gamble C, O'Connell Francischetto E, Metcalfe C, Davidson P, Williams H, Blazeby JM, members of the Internal Pilot Trials Workshop supported by the Hubs for Trials Methodology Research

Abstract
OBJECTIVES: Designing studies with an internal pilot phase may optimise the use of pilot work to inform more efficient randomised controlled trials (RCTs). Careful selection of preagreed decision or 'progression' criteria at the juncture between the internal pilot and main trial phases provides a valuable opportunity to evaluate the likely success of the main trial and optimise its design or, if necessary, to make the decision not to proceed with the main trial. Guidance on the appropriate selection and application of progression criteria is, however, lacking. This paper outlines the key issues to consider in the optimal development and review of operational progression criteria for RCTs with an internal pilot phase.
DESIGN: A structured literature review and exploration of stakeholders' opinions at a Medical Research Council (MRC) Hubs for Trials Methodology Research workshop. Key stakeholders included triallists, methodologists, statisticians and funders.
RESULTS: There is considerable variation in the use of progression criteria for RCTs with an internal pilot phase, although 3 common issues predominate: trial recruitment, protocol adherence and outcome data. Detailed and systematic reporting around the decision-making process for stopping, amending or proceeding to a main trial is uncommon, which may hamper understanding in the research community about the appropriate and optimal use of RCTs with an internal pilot phase. 10 top tips for the development, use and reporting of progression criteria for internal pilot studies are presented.
CONCLUSIONS: Systematic and transparent reporting of the design, results and evaluation of internal pilot trials in the literature should be encouraged in order to facilitate understanding in the research community and to inform future trials.

PMID: 28213598 [PubMed - in process]

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Πληροφορίες

Κυριακή 19 Φεβρουαρίου 2017

Summary

Δημοφιλείς αναρτήσεις