Gamma Heavy Chain Disease with T-cell Large Granular Lymphocytic Leukemia: A Case Report and Review of the Literature.

Gamma Heavy Chain Disease with T-cell Large Granular Lymphocytic Leukemia: A Case Report and Review of the Literature.

Intern Med. 2016;55(4):399-403

Authors: Iijima M, Sekiguchi N, Nagata A, Wagatsuma M, Midorikawa K, Kurimoto M, Noto S, Yamada K, Takezako N

Abstract
Gamma heavy chain disease (gHCD) is a rare lymphoproliferative disorder characterized by the production of a truncated immunoglobulin heavy chain. Although some cases of gHCD are concurrent with other lymphoid neoplasms, few have been reported. We herein present the case of a 73-year-old woman with gHCD and T-cell large granular lymphocytic leukemia. A multiparameter flow cytometry analysis revealed neoplastic cells that were positive for CD28, a marker of T-cell activation, the anti-apoptotic antigen of neoplastic plasma cells, CD38 and CD45. The results of this multiparameter flow cytometry analysis may contribute to furthering the understanding of the clinicopathological features of gHCD.

PMID: 26875967 [PubMed - in process]

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Intussusception as clinical presentation of primary non-Hodgkin lymphoma of the colon in a HIV-patient.

Intussusception as clinical presentation of primary non-Hodgkin lymphoma of the colon in a HIV-patient.

Rev Esp Enferm Dig. 2016 Feb 15;108

Authors: Corti M, Boschi A, Del Portillo Á, Méndez N, Campitelli A, Narbaitz M

Abstract
Intestinal intussusception rarely occurs in the adult population and accounts only for 1% to 5% of all the causes of intestinal obstruction. This complication is more frequent in the small bowel and can be due to different aetiologies, including inflammatory, infectious or neoplastic diseases. Malignancies account for 50% to 60% of all cases of colon invagination. The gastrointestinal (GI) tract is the most common site for extra-nodal non-Hodgkin lymphomas (NHL), representing 5% to 20% of all the cases. However, primary NHL of the GI tract is a very infrequent clinic-pathological entity and accounts only for 1% to 4% of all the neoplasms of the GI tract. Primary NHL of the colon is a rare disease and it comprises only 0.2% to 1.2% of all colonic malignancies. Here we describe a case of an AIDS adult patient who developed an intussusception secondary to a primary large B cell lymphoma of the transverse colon. English and Spanish literature was reviewed.

PMID: 26875864 [PubMed - as supplied by publisher]

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Cytology of low-grade cribriform cystadenocarcinoma in salivary glands: Cytological and immunohistochemical distinctions from other salivary gland neoplasms.

Cytology of low-grade cribriform cystadenocarcinoma in salivary glands: Cytological and immunohistochemical distinctions from other salivary gland neoplasms.

Diagn Cytopathol. 2016 Mar;44(3):241-5

Authors: Ohta Y, Hirota Y, Kohno Y, Kishimoto K, Norose T, Ohike N, Takimoto M, Shiokawa A, Ota H

Abstract
Low-grade cribriform cystadenocarcinoma of the parotid gland is rare malignancy that is classified as a variant of cystadenocarcinoma. In routine cytologic slides from fine-needle aspiration of a parotid gland, we found several pseudopapillary clusters comprising mucus-producing cells. They included a few tumor cells having three-dimensional nuclear atypia and slight hyperchromatism, although most of the tumor cells showed bland nuclei. Our initial cytological diagnosis was: "Indeterminate. Uncertain whether cystadenocarcinoma or cystadenoma." The subsequent histological diagnosis was low-grade cribriform cystadenocarcinoma. Immunohistochemical staining showed diffuse and strong reactivity for S-100; tumor nests that were rimmed by p63(+) cells, which suggests intraductal proliferation. Here, we report cytomorphological findings of this case, and discuss cytological and immunohistochemical distinctions between low-grade cribriform cystadenocarcinoma and other salivary gland tumors, including a review of the literature. Diagn. Cytopathol. 2016;44:241-245. © 2015 Wiley Periodicals, Inc.

PMID: 26875597 [PubMed - in process]

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Merkel cell carcinoma of the head and neck: poorer prognosis than non-head and neck sites.

Merkel cell carcinoma of the head and neck: poorer prognosis than non-head and neck sites.

J Laryngol Otol. 2016 Feb 15;:1-5

Authors: Morand GB, Madana J, Da Silva SD, Hier MP, Mlynarek AM, Black MJ

Abstract
BACKGROUND: Merkel cell carcinoma is a rare, aggressive neurocutaneous malignancy. This study investigated whether patients with Merkel cell carcinoma in the head and neck had poorer outcomes than patients with Merkel cell carcinoma located elsewhere.
METHODS: A retrospective study was performed of patients with Merkel cell carcinoma treated at the Jewish General Hospital in Montréal, Canada, from 1993 to 2013. Associations between clinicopathological characteristics and disease-free and disease-specific survival rates were examined according to the Kaplan-Meier method.
RESULTS: Twenty-seven patients were identified. Although basic clinicopathological characteristics and treatments were similar between head and neck and non-head and neck Merkel cell carcinoma groups, disease-free and disease-specific survival rates were significantly lower in the head and neck Merkel cell carcinoma group (log-rank test; p = 0.043 and p = 0.001, respectively). Mortality was mainly due to distant metastasis.
CONCLUSION: Patients with head and neck Merkel cell carcinoma had poorer survival rates than patients with non-head and neck Merkel cell carcinoma in our study. The tendency to obtain close margins, a less predictable metastatic pattern, and/or intrinsic tumour factors related to the head and neck may explain this discrepancy.

PMID: 26875509 [PubMed - as supplied by publisher]

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A case of hairy cell leukemia variant.

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A case of hairy cell leukemia variant.

Rom J Morphol Embryol. 2015;56(2):553-6

Authors: Găman AM, Dobrea CM, Găman MA

Abstract
Hairy cell leukemia variant (HCLv) is a rare B-cell chronic lymphoproliferative disorder with features of the classic HCL but presenting some particularities, a poor response to conventional therapy of classic HCL and a more aggressive course of disease with shorter survival than classic HCL. We present a case of a 52-year-old man hospitalized in July 2012 in the Clinic of Hematology of Craiova, Romania, having splenomegaly, leukocytosis with lymphocytosis, anemia and thrombocytopenia, without monocytopenia, which exposed, in the peripheral blood and bone marrow cells, intermediate morphology between hairy cells and prolymphocytes and immunophenotype of mature B-cell phenotype CD19, CD20, CD22, CD11c, CD103, low positive for CD25 and negative for CD3, diagnosed with HCL variant, with no response to conventional chemotherapy and interferon-alpha, an aggressive course of disease and a survival of less than a year from diagnosis.

PMID: 26193228 [PubMed - indexed for MEDLINE]

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Arteriovenous synovial hemangioma of the popliteal fossa diagnosed in an adolescent with history of unilateral congenital clubfoot: case report and a single-institution retrospective review.

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Arteriovenous synovial hemangioma of the popliteal fossa diagnosed in an adolescent with history of unilateral congenital clubfoot: case report and a single-institution retrospective review.

Rom J Morphol Embryol. 2015;56(2):549-52

Authors: Derzsi Z, Gurzu S, Jung I, László I, Golea M, Nagy Ö, Pop TS

Abstract
Synovial hemangioma (SH) is a very rare soft tissue tumor; in our department, SH represented 0.07% from all soft tissue tumors (one case from 1311 soft tissue tumors), and 0.78% from all excised hemangiomas (one case from 128 hemangiomas) diagnosed over a five-year period. The aim of this paper was to present the clinicopathologic characteristics of hemangiomas and particularities of one SH of the popliteal fossa diagnosed in an athletic adolescent with previously corrected congenital clubfoot. To our knowledge, this is the 275 case of reported SH. A 13-year-old trick cyclist presented with two-year history of slowly growing mass of the left posterior fossa. The magnetic resonance imaging of the left knee showed a juxta-articular mass with intramuscular component. Open excision of the tumor and partial removal of the synovial membrane was the therapy of choice. Histopathological examination revealed clusters of large arteries and veins embedded in a fibrotic tissue, the tumor mass being lined by synovial membrane. Intramuscular growing was also confirmed. Without any other postoperative therapies, no recurrence or functional disorders were noted after 21 months of follow-up. SH of the knee should be excised as soon as possible to avoid complications such as muscle invasion and risk of recurrence.

PMID: 26193227 [PubMed - indexed for MEDLINE]

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Incidental finding of a sclerosing hemangioma in a Caucasian woman.

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Incidental finding of a sclerosing hemangioma in a Caucasian woman.

Rom J Morphol Embryol. 2015;56(2):545-8

Authors: Danciu M, Lunguleac T, Grigorescu C

Abstract
Sclerosing hemangioma of the lung is a rare and mostly benign lung tumor, which affects especially Asian middle-age women (median age of 48 years). We report the case of a 27-year-old woman in which, a premarital routine chest X-ray investigation revealed a 2 cm well-defined opaque nodule in the lower left pulmonary lobe, confirmed by CT scan. Microscopically, the surgically enucleoresected nodule was represented by a heterogenic tumor (papillary, solid, sclerotic, hemorrhagic patterns), containing two cell populations: cuboidal surface epithelial cells lining the papillary structures and round stromal cells in solid areas, with distinct immunoprofile and low mitotic activity, consistent with sclerosing hemangioma. This case is particular because, being rare in Caucasian persons, intraoperative diagnosis on frozen sections is extremely difficult, and routine histopathological diagnosis needs immunohistochemical tests to set the correct diagnosis, hence the correct therapeutic attitude.

PMID: 26193226 [PubMed - indexed for MEDLINE]

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Papillary thyroid carcinoma with anaplastic dedifferentiation in the lymph node metastasis - a rare form of presentation even for a tall cell variant.

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Papillary thyroid carcinoma with anaplastic dedifferentiation in the lymph node metastasis - a rare form of presentation even for a tall cell variant.

Rom J Morphol Embryol. 2015;56(2):527-31

Authors: Barbu CG, Florin A, Neamţu MC, Avramescu ET, Terzea D, Miron A, Dănciulescu Miulescu R, Poiană C, Fica S

Abstract
Papillary thyroid carcinoma (PTC) is well known as a differentiated thyroid carcinoma with an established treatment protocol and high survival rates. Nevertheless, its tall cell variant (TCV) is more frequent diagnosed with larger tumor size, advanced age and metastasis comparing to other PTC cases, resembling an increased level of aggressiveness attributable to the histological subtype according to recent studies. We present the case of a 60-year-old woman who came for a recently increase of the thyroid and a left laterocervical mass associated with pain and alteration of general status. Thyroidectomy revealed a TCV of PTC with infiltration of the extrathyroid tissue. The laterocervical mass posed difficulties to surgical excision but in a second attempt proved to be an undifferentiated carcinoma. The findings were associated to a rapid deterioration of the patient's general condition finalized with death within less than three months from the initial presentation.

PMID: 26193223 [PubMed - indexed for MEDLINE]

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Sellar Chondroma with Endocrine Dysfunction that Resolved after Surgery: Case Report.

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Sellar Chondroma with Endocrine Dysfunction that Resolved after Surgery: Case Report.

J Nippon Med Sch. 2015;82(3):146-50

Authors: Hattori Y, Tahara S, Nakakuki T, Takei M, Ishii Y, Teramoto A, Morita A

Abstract
Chondromas originating from the sella turcica are rare, and the most common initial symptoms are headache and visual disturbance. We describe a case of sellar chondroma with endocrine impairment as an initial manifestation that completely resolved after surgery. A 40-year-old Japanese woman with amenorrhea and galactorrhea for the last 2 years was referred to our department of neurosurgery for the evaluation of high prolactin levels and a tumor in the sella turcica. A biochemical assessment indicated endocrine dysfunction. Magnetic resonance imaging and computed tomography indicated a tumor in the sella turcica. The patient's presentation favored the preoperative diagnosis of pituitary adenoma or Rathke's cleft cyst. However, because calcification was detected, other types of tumors, such as craniopharyngioma, meningioma, and chordoma, were also considered. Endoscopic transsphenoidal surgery was performed, and the possibility of a bony tumor was recognized. Finally, the tumor was completely removed, and the histopathological findings confirmed chondroma. The postoperative course was uneventful, and endocrine function improved. Five years after surgery, the patient is doing well without pituitary insufficiency, pituitary hormone medications, or signs of tumor recurrence. In cases of sellar chondroma, endocrine dysfunction sometimes precedes other symptoms, such as headache and visual disturbance. When examining a patient with an intrasellar tumor harboring calcification, clinicians must consider the possibility of sellar chondroma. Furthermore, to the best of our knowledge, this case is the first of sellar chondroma treated with endoscopic surgery to be reported.

PMID: 26156668 [PubMed - indexed for MEDLINE]

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Placental mesenchymal dysplasia associated with spontaneous ovarian hyperstimulation syndrome.

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Placental mesenchymal dysplasia associated with spontaneous ovarian hyperstimulation syndrome.

BMJ Case Rep. 2015;2015

Authors: Davoudian P

Abstract
Placental mesenchymal dysplasia (PMD) is a rare disorder of unknown aetiology characterised by placentomegaly, serpiginous surface blood vessels and large cystic villi. Although a mimic of molar pregnancies and other entities, it can be distinguished from them by its association with intrauterine growth restriction or death of a relatively normal fetus and its characteristic histopathology. We report the case of a 20-year-old primigravida who presented at 16 weeks with heavy clotty vaginal bleeding and subsequent miscarriage. The placenta was grossly abnormal and resembled a partial molar pregnancy. PMD was confirmed by microscopic examination. Postmiscarriage, ultrasound revealed enlarged and multicystic ovaries similar to those seen in ovarian hyperstimulation syndrome (OHSS), which returned to normal a few weeks after miscarriage. This is the first report of PMD associated with OHSS, and we hypothesise that the most likely pathogenesis is ovarian stimulation from PMD-derived vascular endothelial growth factor.

PMID: 25920736 [PubMed - indexed for MEDLINE]

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Novel Approach to Securing Deep Brain Stimulation Leads: Technique and Analysis of Lead Migration, Breakage, and Surgical Infection

Background: Fixation of the electrode during deep brain stimulation (DBS) surgery is an important aspect of the procedure. We have developed an alternative method for securing leads that utilizes a titanium hemoclip and cement. This technique is described, and the rates of complications are compared to conventional methods of securing leads. Methods: A total of 291 DBS operations performed by a single surgeon were retrospectively analyzed. We reviewed medical records to look for complications. We compared rates of complications based on the technique used. Re sults: 9 patients (3.1%) developed surgical site infections (SSIs), 4 (1.3%) with SSI of the internal pulse generator pocket. Of the 5 SSIs around the leads, none occurred with StimLoc and 5 (1.1%) with the novel technique. Eight patients (2.7%) required surgical readjustment of the DBS leads due to suboptimal clinical benefit; all 8 (1.8%) occurred with the novel technique. Four patients (1.4%) had lead fractures, 2 (2.2%) with StimLoc and 2 (0.5%) with the novel technique. Conclusions: We described a method for securing DBS leads and showed an acceptable incidence of hardware complications when compared to the conventional method. We feel this technique has improved cosmetic results and should be considered as a method for securing DBS leads.
Stereotact Funct Neurosurg 2016;94:18-23

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Damage control management of innominate artery injury with tracheostomy

Abstract

Innominate artery injury is a rare, but catastrophic complication of tracheostomy. We present a case of severe hemorrhagic shock in a 79-year-old male with innominate artery injury that occurred during tracheostomy. Despite temporary innominate artery isolation, the regional forehead saturation was 60 % without laterality. Because adequate cerebral blood flow was apparently maintained through collateral flow, we ligated the innominate, right carotid, and subclavian arteries. We confirmed adequate blood flow to the brain and the right subclavian artery through collateral circulation after ligation using computed tomographic angiography. A damage control management, which involves ligating the injured innominate artery to arrest hemorrhage and monitoring regional forehead saturation for brain ischemia, can be a considerable procedure for the treatment of severe hemorrhagic shock due to innominate artery injury.

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Proteomics in Toxicology – added value or waste of energies?

Publication date: Available online 15 February 2016
Source:Journal of Proteomics
Author(s): T. Serchi, A.C. Gutleb, I. Miller




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Efficacy and Safety of Aclidinium/Formoterol versus Tiotropium in COPD: Results of an Indirect Treatment Comparison

Abstract

Introduction

The objective of this study was to estimate the relative efficacy and safety of fixed-dose combination aclidinium/formoterol 400/12 μg twice daily compared to tiotropium 18 μg once daily in adult patients with moderate-to-severe chronic obstructive pulmonary disease (COPD).

Methods

A systematic literature review performed in March 2014, using a predefined search strategy in MEDLINE, EMBASE and Cochrane Library, identified 17 randomized placebo-controlled trials, (tiotropium n = 15; aclidinium/formoterol n = 2). Outcomes of interest were: bronchodilation (peak and trough forced expiratory volume in 1 s (FEV₁)), COPD symptoms [Transition Dyspnea Index (TDI) focal score and % of responders (>1 unit improvement)] and Health Related Quality of Life (HRQoL) [St. George's Respiratory Questionnaire (SGRQ) total score and % responders (>4 unit improvement)], % of patients with ≥1 exacerbations, adverse events (AE), serious adverse events (SAE), hospitalization and mortality, all at 24 weeks. In the absence of head-to-head trials between aclidinium/formoterol and tiotropium, a Bayesian indirect treatment comparison (ITC) was used with placebo as common control.

Results

Regarding bronchodilation, aclidinium/formoterol was found to be more efficacious than tiotropium at peak FEV₁, with mean difference in change from baseline (DCFB) 143 mL [95% credible interval (CrI): 112, 174] and at trough FEV₁ [DCFB 26 mL (95% CrI −2, 55)]. Aclidinium/formoterol is expected to be more efficacious than tiotropium in improving dyspnea symptoms measured by TDI [DCFB 0.54 points (95% CrI 0.09, 0.99); odds ratio (OR) of responders 1.51 (95% CrI 1.11, 2.06)]. SGRQ results are comparable for aclidinium/formoterol versus tiotropium [DCFB −0.52 (95% CrI −2.21, 1.17); OR of responders 1.16 (95% CrI 0.47, 2.87)]. The ITC results suggest similar safety profiles regarding AEs, SAEs and hospitalization.

Conclusion

Based on the ITC, aclidinium/formoterol is expected to be more efficacious than tiotropium in terms of lung function and symptom control while providing comparable HRQoL results and safety profile.

Funding

AstraZeneca.

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Exploring elements that support teachers engagement in online professional development

This study sought to identify the most effective elements required in online professional development to enable teachers to improve their use of Information and Communications Technologies (ICT) in their classrooms. Four schools in Queensland were involved, with twelve classroom teachers participating in a year-long online professional development program over the school year supported by an online mentor. The online professional development program did not provide course based or sequential learning activities. Rather it was design to enable individual learning pathways and draw on the many professional learning opportunities available through web 2.0 tools and Internet resources. The focus was to explore the process of online ICT professional development to contribute to the conceptualization of how teachers learn in the 21st Century. Findings indicate that teachers need to engage in three elements: investigation, reflection, and constructive dialogue; build a sense of group and individual online presence; and be supported by mentorship that responds to the various cognitive and affective demands of autonomous learners.

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Methodologische Herausforderungen der empirischen Fremdsprachenerwerbsforschung am Beispiel des Kasuserwerbs: Die "Elicited Imitation Task"

One of the major challenges in empirical second language acquisition research is the collection of sufficient as well as the right language production data. This article presents and discusses the methodological challenges encountered in research that deals with the acquisition of German case marking by foreign language learners. With regard to German case marking, the right data entail functional uses of the cases, i.e. case use with arguments that do not take their canonical position. Previous studies experienced that it is difficult to elicit functional case use in oral language production (e.g., object topicalisation). To remedy the lack of the right data the present article proposes to apply the so-called Elicited Imitation Task.

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Policies and regulations in Mexico with regard to genetic technology and food security

In 1988 the first application for field trials of a GMO was formally received in Mexico. Since then a Biosafety law, few bylaws and national official standards were enacted in order to regulate the safe use of GMOs and to evaluate, control and avoid adverse effects to human health and the environment. The Law on Biosafety of Genetically Modified Organisms was enacted in 2005 in order to comply with international obligations derived from the Cartagena Protocol on Biosafety signed by Mexico in 2000. This law established a biosafety legal framework to regulate the use of GMOs, protect biodiversity, and promote the conservation of organisms which Mexico is center of origin and center of genetic diversity. Since then, 561 permits for the release of GMOs into the environment have been granted between 2005 and 2014. This report gives and overview of the country's approach to the use of GMOs, the current status of the biosafety legislation in Mexico and the development of policies and regulations since the first introduction of GM crops in the country.

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The impact of the foreland on the transatlantic migrant trade: the port of New York as 'the' nodal point between foreland and hinterland

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International Encyclopedia of law-Religion: Ethiopia

Religion has had a profound impact in the public sphere in Ethiopia, influencing politics, laws and public institutions and the state in general. The state started to dissociate itself from religion in the early 1970s following the demise of the imperial regime that declared the Ethiopian Orthodox Church a state religion. The military regime (1974-1991) adopted not only secularism but also anti-religious rhetoric and forced the Church to take a back-seat in public sphere. Since the military junta was toppled in 1991, the state and religion have officially been separated and religious communities have relatively been enjoying religious freedom. However, state and religion relationship is said to be undergoing fundamental changes as a result of, among others, religious freedom, and religious pluralism and diversity guaranteed. While the Orthodox Church is in retreat in terms of its dwindling influence and numbers of its followers, the Evangelical Church and Islam have shown growing activism. Growing religious renaissance has given rise to concerns. Government officials and some commentators claim that religious fundamentalism is taking root in the nation, particularly among Muslim community that has experienced an unprecedented religious freedom. The state seems poised to re-define its relationship with religious communities. However, a comprehensive statute that defines their relationships has not been put in place. A state and religion relationship is rather based on pieces of provisions inserted in constitutional text, statutes and by-laws. The absence of such law makes it difficult, if not impossible, to have a clear picture on the role of religion in public sphere and of the state in religious affairs. On top of this there are few cases shedding light on state and church relationship. However, the state, among others, is not to financially support any religious group. Notion of religious financing and church taxation are thus not recognized in Ethiopia. This Monograph presents a glimpse of factual situation of religious groups in Ethiopia and discusses legal framework on religious freedom and state and religion relationships.

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Compressed Sensing Using Sparse Binary Measurements: A Rateless Coding Perspective

Compressed Sensing (CS) methods using sparse binary measurement matrices and iterative message-passing re- covery procedures have been recently investigated due to their low computational complexity and excellent performance. Drawing much of inspiration from sparse-graph codes such as Low-Density Parity-Check (LDPC) codes, these studies use analytical tools from modern coding theory to analyze CS solutions. In this paper, we consider and systematically analyze the CS setup inspired by a class of efficient, popular and flexible sparse-graph codes called rateless codes. The proposed rateless CS setup is asymptotically analyzed using tools such as Density Evolution and EXIT charts and fine-tuned using degree distribution optimization techniques.

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Evidence based beleid en praktijk bij de politie in Nederland en België

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De vele ruimtes tussen stem en stilte: Deaf epistemologies, participatorisch burgerschap en duurzame ontwikkeling

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Daily life in a Nineteenth-Century Officers' Mess: Historical Archaeology at the Inquisitor's Palace

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Combination of non-thermal plasma and Pd/LaMnO3 for dilute trichloroethylene abatement

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From Erasure to Recognition (and Back Again?): The Case of Flemish Sign Language

This chapter deals with linguistic ideologies and deaf people's attitudes towards Flemish Sign Language (VGT), in the past, in the present, and to some extent also in the future. In its historical evolution, VGT has developed from complete linguistic erasure (Irvine & Gal 2000) to symbolic recognition by mainstream society and legal recognition by Flemish Parliament, via implicit recognition within the VGT linguistic minority community. This has gone hand in hand with changing attitudes within the Deaf community towards the status of VGT. The 2006 recognition has unmistakably had an empowering effect in the Flemish Deaf community, even though the actual knowledge as to the contents of the recognition decree may be rather meager. At the same time new indications of erasure can be exposed in Flanders, which are leading to serious concerns within the Flemish Deaf community.

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Resting-state functional connectivity of the sensorimotor network in individuals with non-specific low back pain and the association with the sit-to-stand-to-sit task

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From the nebular city to the horizontal Metropolis: notes on the continued urbanisation of the Flemish territory

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Unreliability in non-fiction: the case of the unreliable addressee

In this article, I aim to explore unreliability in non-fictional narration. Departing from the widespread conviction that unreliable narration is only possible in fiction, I set out to define the contours of rhetorical approaches to narratology that have paved the way for the discussion of unreliability in non-fiction. I then explore unreliability in relation to non-fictional discourse, especially that found in hybrid genres such as literary documentary and docu-fiction. My argument begins by identifying stylistic criteria as a key element in the assessment of degrees of reliability and unreliability. I then engage questions of the cultural and ethical underpinnings of unreliability judgments by dealing with forms of experimental journalism and with Laurent Binet's documentary novel HHhH, which is discussed as a third-person antithesis to Jonathan Littell's Les Bienveillantes. I conclude by advocating a more addressee-oriented narratology.

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Atmospheric pressure plasma penetration inside flexible polymeric tubes

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Local analysis of pet surface functionalization by an atmospheric pressure plasma jet

In this work, space-resolved analysis of polyethylene terephthalate surface functionalization induced by an atmospheric pressure argon plasma jet has been conducted. In particular, the plasma jet footprint has been determined by examining radial water contact angle profiles. For the first time, space-resolved X-ray photoelectron measurements have also been carried out and have been correlated with the results of the water contact angle profiles. Different plasma treatment conditions, like discharge power, exposure time, sample distance and gas flow, have been varied to observe their effect on the plasma jet radial profiles. From this investigation, it has become clear that variations in exposure time and sample distance can strongly influence the radial hydrophilic region, while changes in gas flow rate and discharge power only result in small differences.

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A review of trabecular bone functional adaptation: what have we learned from trabecular analyses in extant hominoids and what can we apply to fossils?

Abstract

Many of the unresolved debates in palaeoanthropology regarding evolution of particular locomotor or manipulative behaviours are founded in differing opinions about the functional significance of the preserved external fossil morphology. However, the plasticity of internal bone morphology, and particularly trabecular bone, allowing it to respond to mechanical loading during life means that it can reveal greater insight into how a bone or joint was used during an individual's lifetime. Analyses of trabecular bone have been commonplace for several decades in a human clinical context. In contrast, the study of trabecular bone as a method for reconstructing joint position, joint loading and ultimately behaviour in extant and fossil non-human primates is comparatively new. Since the initial 2D studies in the late 1970s and 3D analyses in the 1990s, the utility of trabecular bone to reconstruct behaviour in primates has grown to incorporate experimental studies, expanded taxonomic samples and skeletal elements, and improved methodologies. However, this work, in conjunction with research on humans and non-primate mammals, has also revealed the substantial complexity inherent in making functional inferences from variation in trabecular architecture. This review addresses the current understanding of trabecular bone functional adaptation, how it has been applied to hominoids, as well as other primates and, ultimately, how this can be used to better interpret fossil hominoid and hominin morphology. Because the fossil record constrains us to interpreting function largely from bony morphology alone, and typically from isolated bones, analyses of trabecular structure, ideally in conjunction with that of cortical structure and external morphology, can offer the best resource for reconstructing behaviour in the past.

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Gadd45b prevents autophagy and apoptosis against rat cerebral neuron oxygen-glucose deprivation/reperfusion injury

Abstract

Autophagic (type II) cell death has been suggested to play pathogenetic roles in cerebral ischemia. Growth arrest and DNA damage response 45b (Gadd45b) has been shown to protect against rat brain ischemia injury through inhibiting apoptosis. However, the relationship between Gadd45b and autophagy in cerebral ischemia/reperfusion (I/R) injury remains uncertain. The aim of this study is to investigate the effect of Gadd45b on autophagy. We adopt the oxygen-glucose deprivation and reperfusion (OGD/R) model of rat primary cortex neurons, and lentivirus interference used to silence Gadd45b expression. Cell viability and injury assay were performed using CCK-8 and LDH kit. Autophagy activation was monitored by expression of ATG5, LC3, Beclin-1, ATG7 and ATG3. Neuron apoptosis was monitored by expression of Bcl-2, Bax, cleaved caspase3, p53 and TUNEL assay. Neuron neurites were assayed by double immunofluorescent labeling with Tuj1 and LC3B. Here, we demonstrated that the expression of Gadd45b was strongly up-regulated at 24 h after 3 h OGD treatment. ShRNA-Gadd45b increased the expression of autophagy related proteins, aggravated OGD/R-induced neuron cell apoptosis and neurites injury. ShRNA-Gadd45b co-treatment with autophagy inhibitor 3-methyladenine (3-MA) or Wortmannin partly inhibited the ratio of LC3II/LC3I, and slightly ameliorated neuron cell apoptosis under OGD/R. Furthermore, shRNA-Gadd45b inhibited the p-p38 level involved in autophagy, but increased the p-JNK level involved in apoptosis. ShRNA-Gadd45b co-treatment with p38 inhibitor obviously induced autophagy. ShRNA-Gadd45b co-treatment with JNK inhibitor alleviated neuron cell apoptosis. In conclusion, our data suggested that Gadd45b inhibited autophagy and apoptosis under OGD/R. Gadd45b may be a common regulatory protein to control autophagy and apoptosis.

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Knowledge and Attitudes Towards Human Papillomavirus (HPV) Among Academic and Community Physicians in Mangalore, India

Abstract

Cervical cancer is the most common cancer found in Indian women. Two human papillomavirus (HPV) vaccines were approved for use in India in 2006; however, neither has become readily accepted. Physician attitudes and recommendations are crucial in the uptake of HPV vaccines among adolescent women in the USA; thus, we ought to investigate provider attitudes and practices related to HPV vaccination in India via a survey administered to 210 Indian physicians. Of the 210 physicians, 46 % were community physicians and 54 % were academic physicians. The correct response to HPV knowledge questions was identified around 50 % of the time in 6/11 questions. Only 47 % of the physicians knew that there was an HPV vaccine approved for use in India. Only 11 % and 15 % of physicians strongly agree that the HPV vaccine will lead to long-lasting immunity and has a safe side effect profile, respectively. A total of 30 % of those surveyed reported that they would recommend the HPV vaccine to their patients, while 73 % agreed that the cost of the HPV vaccine is a major barrier to acceptance. After multivariate analysis, there were two significant variables independently associated with a physician's decision to recommend HPV vaccine. These variables were as follows: "whether the vaccine was freely available from the government sector" and "uncertainty about whether HPV must be persistent to cause cervical cancer vs not." Given the lack of knowledge among practicing physicians in Mangalore, increasing the education about HPV infection and HPV vaccination towards health care providers has the potential to increase vaccine recommendations.

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Cross-clamping of bony stumps in preparation for osteosynthesis in digital replantation

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The anterolateral thigh fold-over flap for total and subtotal glossectomy reconstruction

Background

We present a fold-over technique for total and subtotal glossectomy reconstruction utilizing the ALT flap with the goal of increasing soft tissue bulk.

Methods

Retrospective review of total and subtotal glossectomy patients undergoing ALT fold-over flap reconstruction from January 2007 to December 2012.

Results

Eight patients fit inclusion criteria. Average length of follow-up was 35 months. There were no flap failures. At last follow-up, no patients were tracheostomy dependent. Six out of 8 patients (75%) did not require a g-tube and were able to maintain their weight. Speech intelligibility was good in 6/8 patients (75%).

Conclusions

The ALT fold-over flap technique provides sufficient bulk to allow decannulation and airway protection as well as PO intake in most patients. Given the minimal donor site morbidity, it is our technique of choice for total and subtotal glossectomy defects. © 2016 Wiley Periodicals, Inc. Microsurgery, 2016.

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A little trick to make inside out vein graft technique easier in experimental animal models

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An investigation of IGF-I isoforms in human skeletal muscle. The effects of age and exercise.

Hammeed, M.; (2004) An investigation of IGF-I isoforms in human skeletal muscle. The effects of age and exercise. Doctoral thesis, University of London. Green open access

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On moving targets and magic bullets: Can the UK lead the way with responsible data linkage for health research?

Laurie, G; Ainsworth, J; Cunningham, J; Dobbs, C; Jones, KH; Kalra, D; Lea, NC; Laurie, G; Ainsworth, J; Cunningham, J; Dobbs, C; Jones, KH; Kalra, D; Lea, NC; Sethi, N; - view fewer (2015) On moving targets and magic bullets: Can the UK lead the way with responsible data linkage for health research? International Journal of Medical Informatics , 84 (11) pp. 933-940. 10.1016/j.ijmedinf.2015.08.011 . Green open access

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The emerging role of Nrf2 in mitochondrial function

Dinkova-Kostova, AT; Abramov, AY; (2015) The emerging role of Nrf2 in mitochondrial function. Free Radical Biology and Medicine , 88 (B) pp. 179-188. 10.1016/j.freeradbiomed.2015.04.036 . Green open access

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The effect of sibutramine prescribing in routine clinical practice on cardiovascular outcomes: a cohort study in the United Kingdom

Hayes, JF; Bhaskaran, K; Batterham, R; Smeeth, L; Douglas, I; (2015) The effect of sibutramine prescribing in routine clinical practice on cardiovascular outcomes: a cohort study in the United Kingdom. International Journal of Obesit , 39 (9) pp. 1359-1364. 10.1038/ijo.2015.86 . Green open access

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Lateral Tarsotomy: A Practical Alternative to Lateral Canthotomy to Increase Orbital Access

Publication date: Available online 16 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Hany A. Emam, Mark R. Stevens, Peter E. Larsen, Courtney A. Jatana
ObjectiveTransconjunctival approach to the lower 1/3 of the orbit is commonly used to avoid transcutaneous incisions when surgical access is needed. A lateral canthotomy is used in conjunction with this approach if increased lateral exposure is required. A major disadvantage to the lateral canthotomy is difficulty in re-suspension of the lateral canthal tendon that can lead to unaesthetic outcomes. The present report describes 2 cases of a lateral tarsal incision or as we decided to call it a 'lateral tarsotomy' technique. This simple approach is used to aide with increasing lateral access orbit without the need for a lateral canthotomy.Study DesignTwo patients presented with internal orbital wall trauma requiring repair were accessed with a transconjunctival approach in conjunction with a lateral tarsotomy. They were followed at 1 week, 1 month, and 3 months to document the development of possible unaesthetic and poor functional outcomes.ResultsExcellent cosmetic results were observed with no noticeable deformity at the tarsotomy site. There was no evidence of ectropion, entropion, scleral show and visible scars.ConclusionThe above results suggest that the lateral tarsotomy approach is a practical alternative to a lateral canthotomy when increased lateral exposure is required.



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Integrin αE(CD103) is induced but plays no pathogenic role in psoriasiform skin lesions of TGFβ1 transgenic mice

Abstract

T-cells expressing α_E(CD103), an integrin induced by TGFβ on T-cells in vitro, accumulate within epithelia in inflammatory disorders, including psoriasis. However, it is unclear, if and how α_E(CD103) contributes to skin inflammation.

Using two complementary approaches, we have investigated α_E(CD103) in psoriasis-like skin inflammation of mice with transgenic epidermal expression of human TGFβ1: α_E(CD103) was inhibited by function-blocking antibodies in vivo, and double-mutants with additional α_E(CD103)-depletion were generated in two different genetic backgrounds.

Epidermal hTGFβ1 expression was associated with prominent expression of α_E(CD103) on infiltrating cells. However, neither treatment with α_E(CD103)-blocking antibodies nor deficiency of α_E(CD103) in double-mutant mice altered the psoriasis-like phenotype. In addition, histopathological and flow cytometric analyses revealed similar pathological skin alterations and lymphocyte subgroups in the different mouse strains. Thus, while α_E(CD103) expression is indeed associated with hTGFβ1 in vivo, it has little, if any, influence on the course of the psoriasis-like phenotype in K5.hTGFβ1-transgenic mice.

This article is protected by copyright. All rights reserved.

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Tuning algorithms for fractional order internal model controllers for time delay processes

This paper presents two tuning algorithms for fractional-order internal model control (IMC) controllers for time delay processes. The two tuning algorithms are based on two specific closed-loop control configurations: the IMC control structure and the Smith predictor structure. In the latter, the equivalency between IMC and Smith predictor control structures is used to tune a fractional-order IMC controller as the primary controller of the Smith predictor structure. Fractional-order IMC controllers are designed in both cases in order to enhance the closed-loop performance and robustness of classical integer order IMC controllers. The tuning procedures are exemplified for both single-input-single-output as well as multivariable processes, described by first-order and second-order transfer functions with time delays. Different numerical examples are provided, including a general multivariable time delay process. Integer order IMC controllers are designed in each case, as well as fractional-order IMC controllers. The simulation results show that the proposed fractional-order IMC controller ensures an increased robustness to modelling uncertainties. Experimental results are also provided, for the design of a multivariable fractional-order IMC controller in a Smith predictor structure for a quadruple-tank system.

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Nanoscale and single-dot patterning of colloidal quantum dots

Using an optimized lift-off process we develop a technique for both nanoscale and single-dot patterning of colloidal quantum dot films, demonstrating feature sizes down to similar to 30 nm for uniform films and a yield of 40% for single-dot positioning, which is in good agreement with a newly developed theoretical model. While first of all presenting a unique tool for studying physics of single quantum dots, the process also provides a pathway toward practical quantum dot-based optoelectronic devices.

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Neatness isn't a very good reason to think about art

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Recent advances in composite AEP/EEG indices for estimating hypnotic depth during general anesthesia

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Patient outcomes following second surgery for recurrent glioblastoma

Future Oncology Ahead of Print.


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Current topics in the multimodality treatment of locally advanced rectal cancer

Future Oncology Ahead of Print.


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Oral epithelial cells and their interactions with HIV-1

As the AIDS pandemic has continued, our understanding of the events that occur during the entry and infection of conventional, susceptible cells has increased dramatically, leading to the development of control therapies for HIV-infected individuals. However, an ongoing hole in our understanding is how HIV crosses the mucosal barriers to gain access to permissive cells, despite how important this information would be in developing successful vaccines and other preventative measures such as topical anti-HIV microbicides. In particular, our knowledge of the role that epithelial cells of the mucosal surfaces play in infection – both during early phases and throughout the life of an infected individual, is currently hazy at best. However, several studies in recent years suggest that HIV can bind to and traverse these mucosal epithelial cells, providing a reservoir of infection that can subsequently infect underlying permissive cells. Despite this interaction with epithelial cells, evidence suggests HIV-1 does not productively infect these cells, although they are capable of transferring surface-bound and transcytosed virus to other, permissive cells. Further, there appear to be key differences between adult and infant epithelial cells in the degree to which HIV can transcytose and infect the epithelium. Thus, it is clear that, whilst not primary targets for infection and virus replication, epithelial cells play an important role in the infection cycle and improving our understanding of their interactions with HIV could potentially provide key insights necessary to develop effective preventative therapies.

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The child and adolescent with HIV in resource poor countries

Although sub-Saharan Africa caries the burden of paediatric and adult HIV/AIDS infections, the epidemic is spreading most rapidly in the Middle East and North Africa Region where between 2005 and 2013, AIDS-related deaths increased by 66% in comparison with a worldwide fall of 35%. For the first time, in 2011, more than half of people in need of antiretroviral drugs were receiving them, with coverage reaching 54%; yet only 28% of children have access to HIV treatment. This review sought to provide an update of paediatric and adolescent oral HIV/AIDS issues in resource poor countries.

Objectives

To review the literature on paediatric & adolescent HIV with a focus on oral lesions as predictors of HIV infection; as markers of the efficacy of HAART and quality of life; caries risk; management of oral lesions; and epidemiological tests for clinical significance of oral lesions.

Methods

A search strategy was developed for PubMed to identify papers on paediatric oral HIV. Publications in English were selected on the basis that their titles and abstracts were relevant to the review objectives. The reference lists of included papers were screened for additional articles. The time-search for publications was limited from 2009 to 15 October 2014.

Results

Papers on the prevalence of oral lesions lacked standardization in diagnostic criteria and the introduction of HAART had significantly reduced prevalence; oral lesions remain useful predictors for HIV infection and as markers for the efficacy of HAART. Evidence suggest that caries risk is increased with HIV infection; management of oral lesions is inconsistent with available resources and surprisingly little recent information has been published in the past 5 years. Revised case definitions are proposed for large-scale epidemiologic studies with the development of an oral lesion index showing promise. Oral health quality of life indicators for children and adolescents are becoming important as more of these indicators are being developed and their negative oral impacts in individuals with oral lesions are now well established.

Conclusions

Paediatric and adolescent oral HIV research needs to be prioritized as current studies are few and are characterized by poor quality study designs, small study samples and a lack of multicentre collaborations. There is a lack of high quality evidence for a number of interventions available for management of oral lesions.

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