Αρχειοθήκη ιστολογίου

Κυριακή 14 Ιουλίου 2019

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,


Leitlinie für die chronische lymphatische Leukämie (CLL)
Update der Onkopedia-Leitlinie für die chronische lymphatische Leukämie (CLL) Websiteswww.haematologie-fokus.de |  www.abbvie-care.de/cll  Chemotherapiefreie, zeitlich begrenzte Venetoclax-Kombinationstherapie in der Zweitlinie empfohlen  Im Zuge des aktuellen Leitlinien-Updates zur chronischen lymphatischen Leukämie (CLL) hat die Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO) die Kombinationstherapie aus Venetoclax (Venclyxto®) und Rituximab durchgängig für die Zweitlinientherapie...
Αλέξανδρος Γ. Σφακιανάκης
1m
Chondrosarcoma of the jaw: a retrospective series,            Publication date: August 2019 Source: Oral...
Chondrosarcoma of the jaw: a retrospective series,           Publication date: August 2019Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2Author(s): Akram Abdo Almansoori, Hui-Young Kim, Bongju Kim, Soung-Min Kim, Jong-Ho LeeObjectivesLow-grade chondrosarcoma presents with features similar to those of benign lesions, such as chondroma and synovial chondromatosis, increasing the difficulty in reaching an accurate diagnosis preoperatively. In this study, we...
Αλέξανδρος Γ. Σφακιανάκης
3m
Desmoplastic fibroma associated with tuberous sclerosis: case report and literature review,       ...
Desmoplastic fibroma associated with tuberous sclerosis: case report and literature review,           Publication date: August 2019Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2Author(s): Mina D. Fahmy, Anish Gupta, Ricardo J. Padilla, Annette Segura, Carolyn Dicus BrookesTuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder that affects the skin, brain, kidneys, and other organ systems. It may exhibit a wide spectrum of clinical manifestations....
Αλέξανδρος Γ. Σφακιανάκης
3m
KLF4 expression in the surgical cut margin is associated with disease relapse of oral squamous cell...
KLF4 expression in the surgical cut margin is associated with disease relapse of oral squamous cell carcinoma,Publication date: August 2019Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2Author(s): Souvick Roy, Madhabananda Kar, Shomereeta Roy, Swatishree Padhi, Arka Saha, Birendranath BanerjeeObjectiveThe presence of cancer stem-like cells (CSCs) in the majority of tumors is one of the factors responsible for disease relapse in oral squamous cell carcinoma...
Αλέξανδρος Γ. Σφακιανάκης
3m
Upregulation of eukaryotic translation initiation factor 3 subunit a promotes cell survival in ameloblastoma,...
Upregulation of eukaryotic translation initiation factor 3 subunit a promotes cell survival in ameloblastoma,Publication date: August 2019Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2Author(s): Zhenjiang Ding, Jie Liu, Junting Wang, Biying Huang, Ming ZhongObjectivesThis study aimed to detect the expression of eukaryotic translation initiation factor 3 subunit a (eIF3a) in ameloblastoma (AB) tissues compared with normal oral mucosa (NOM) tissues and investigate...
Αλέξανδρος Γ. Σφακιανάκης
4m
Chronic treatment with zoledronic acid alters the expression levels of inflammatory, bone, and apoptotic...
Chronic treatment with zoledronic acid alters the expression levels of inflammatory, bone, and apoptotic markers and Toll-like receptors 2 and 4 in rat dental pulp,Publication date: August 2019Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2Author(s): Paulo Goberlânio de Barros Silva, Antonio Ernando Carlos Ferreira, Camila Carvalho de Oliveira, Maria Elisa Quesado Lima Verde, Milena Oliveira Freitas, Fabrício Bitu Sousa, Mário Rogério Lima Mota, Ana Paula...
Αλέξανδρος Γ. Σφακιανάκης
4m
Therapeutic efficacy of propranolol for infantile hemangiomas,          Publication date: August 2019...
Therapeutic efficacy of propranolol for infantile hemangiomas,         Publication date: August 2019Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2Author(s): Wenli Wu, Hongtao Wang, Jiansuo Hao, Zijun Gao, Fan Li, Yiyang ChenObjectives.This was a retrospective study to analyze the clinical therapeutic efficacy of propranolol in patients with infantile hemangioma (IH).Study Design.Patients with IH were treated with propranolol (2–4.5 mg/kg/day). Those patients...
Αλέξανδρος Γ. Σφακιανάκης
4m
Serum and salivary interleukin-4 levels in patients with oral lichen planus: A systematic review and...
Serum and salivary interleukin-4 levels in patients with oral lichen planus: A systematic review and meta-analysis,          Publication date: August 2019Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2Author(s): Hamid Reza Mozaffari, Elisa Zavattaro, Mina Saeedi, Pia Lopez-Jornet, Masoud Sadeghi, Mohsen Safaei, Mohammad Moslem Imani, Reza Nourbakhsh, Hedaiat Moradpoor, Amin Golshah, Roohollah SharifiObjectiveCytokines have an important role in keratinocyte...
Αλέξανδρος Γ. Σφακιανάκης
5m
Risk factors for caries development in primary Sjogren syndrome, Publication date: August 2019 Source: Oral...
Risk factors for caries development in primary Sjogren syndrome,Publication date: August 2019Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2Author(s): Nicola Berman, Frederick Vivino, Joshua Baker, Jonathan Dunham, Andres PintoObjectivesThe aim of this study was to compare the risk factors for caries between patients with primary Sjogren syndrome (SS) and those with non-Sjogren syndrome (NSS) salivary hypofunction and to identify the prevalence of incisal...
Αλέξανδρος Γ. Σφακιανάκης
5m
Intralesional Deoxycholic Acid as a Neoadjuvant Treatment for a Large Lipoma
An, Miranda B. BS; Rotunda, Adam M. MDDermatologic Surgery: July 09, 2019 - Volume Publish Ahead of Print - Issue - pdoi: 10.1097/DSS.0000000000002026Commentary: PDF OnlyBUYPAPAuthor InformationArticle Metrics© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
Αλέξανδρος Γ. Σφακιανάκης
11m
Outcomes for Basal Cell Carcinoma Treated With Vismodegib Extended Alternate Day Dosing
Routt, Ethan MD; Ratner, Desiree MDDermatologic Surgery: July 01, 2019 - Volume Publish Ahead of Print - Issue - pdoi: 10.1097/DSS.0000000000001985Letters and Communications: PDF OnlyBUYPAPAuthor InformationArticle Metrics© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
Αλέξανδρος Γ. Σφακιανάκης
12m
Transungual Excision of Glomus Tumors
Baltz, Julia O. MD; Jellinek, Nathaniel J. MDDermatologic Surgery: July 01, 2019 - Volume Publish Ahead of Print - Issue - pdoi: 10.1097/DSS.0000000000001998Commentary: PDF OnlyBUYPAPAuthor InformationArticle Metrics© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
Αλέξανδρος Γ. Σφακιανάκης
13m
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Chondrosarcoma of the jaw: a retrospective seriesPublication date: August 2019Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128, Issue 2Author(s): Akram Abdo Almansoori, Hui-Young Kim, Bongju Kim, Soung-Min Kim, Jong-Ho LeeObjectivesLow-grade chondrosarcoma presents with features similar to those of benign lesions, such as chondroma and synovial chondromatosis, increasing the difficulty in reaching an accurate diagnosis preoperatively. In this study, we retrospectively...
Αλέξανδρος Γ. Σφακιανάκης
13m
Dermatologic Surgery
Introducing the L-Lift—A Novel Approach to Treat Age-Related Facial Skin Ptosis Using A Collagen StimulatorNo abstract availableCommentary on Intralesional Deoxycholic Acid as a Neoadjuvant Treatment for a Large LipomaNo abstract availableTime to Move on From Prescribing Oral Antibiotics as Prophylaxis for Mohs?No abstract availableOutcomes for Basal Cell Carcinoma Treated With Vismodegib Extended Alternate Day DosingNo abstract availableCommentary on Transungual Excision of Glomus TumorsNo abstract...
Αλέξανδρος Γ. Σφακιανάκης
14m
Selim Berker's Combinatorial Argument against Practical Reasons for Belief, Abstract In a recent paper,...
Selim Berker's Combinatorial Argument against Practical Reasons for Belief,AbstractIn a recent paper, Selim Berker (Analytic Philosophy, 59, 427-470, 2018) develops an abductive argument against practical reasons for belief that exploits an alleged difference between epistemic and practical reasons. According to Berker, epistemic reasons for belief balance to suspension. If I have equally strong epistemic reasons to believe and disbelieve some proposition, I lack sufficient reason either to believe...
Αλέξανδρος Γ. Σφακιανάκης
16m
Merkelzellkarzinom,  Zusammenfassung Das Merkelzellkarzinom ist ein seltener, hoch aggressiver Hauttumor...
Merkelzellkarzinom, ZusammenfassungDas Merkelzellkarzinom ist ein seltener, hoch aggressiver Hauttumor des älteren Menschen. Er besitzt neuroendokrine Eigenschaften. Die Pathogenese ist mit chronischer UV-Licht-Exposition und dem Merkelzell-Polyomavirus assoziiert. Klinisch fällt das Merkelzellkarzinom durch einen solitären, kutan oder subkutan gelegenen, roten bis bläulichen Knoten auf. Da der Tumor frühzeitig lymphogen metastasiert, sind zum Zeitpunkt der Diagnosestellung in etwa 30 % der Fälle...
Αλέξανδρος Γ. Σφακιανάκης
21m
Management gutartiger Hirntumoren: Meningeome und Vestibularisschwannome, Zusammenfassung Meningeome...
Management gutartiger Hirntumoren: Meningeome und Vestibularisschwannome,ZusammenfassungMeningeome und Vestibularisschwannome zählen zu den gutartigen intrakraniellen Tumoren und gehen von den Hirnhäuten bzw. den Hirnnerven aus. Die Inzidenz ist mit 4,1 bzw. 1 Neuerkrankung/100.000 Einwohner sehr niedrig, wobei die Anzahl mittels Magnetresonanztomographie (MRT) steigt. Erstbefunde zufällig entdeckter Tumoren ohne neurologisches Defizit, ohne Symptomatik und ohne wesentliche Raumforderung können zunächst...
Αλέξανδρος Γ. Σφακιανάκης
21m
Jüngste Entwicklungen in der Kopf-Hals-Immunologie, Zusammenfassung Immunologische Vorgänge spielen...
Jüngste Entwicklungen in der Kopf-Hals-Immunologie,ZusammenfassungImmunologische Vorgänge spielen eine wesentliche Rolle bei der Pathogenese von Erkrankungen des Kopf-Hals-Bereichs. In diesem Zusammenhang ist nicht nur an Allergien oder an Infektionen im Bereich der Mandeln, der Nasennebenhöhlen und des Ohres zu denken, auch Entstehung, Wachstum und Metastasierung von malignen Tumoren des Kopf-Hals-Bereichs werden maßgeblich vom Immunsystem beeinflusst. Die Rekrutierung von weißen Blutkörperchen...
Αλέξανδρος Γ. Σφακιανάκης
21m
Best Practice Onkologie
Diagnostik und Therapie der akuten myeloischen LeukämieZusammenfassungIm April 2018 ist die Neuauflage der Onkopedia-Leitlinie zur akuten myeloischen Leukämie (AML) als Aktualisierung von Vorversionen aus den Jahren 2010 und 2017 erschienen. Zwei wesentliche positive Entwicklungen auf dem Gebiet dieser immer noch schwer zu behandelnden Erkrankung machten die Überarbeitung erforderlich: erstens neue Erkenntnisse zu Risikostratifizierung und Monitoring und zweitens die Entwicklung und Zulassung neuer...
Αλέξανδρος Γ. Σφακιανάκης
21m
Molecular Neurobiology
Correction to: In Vitro Seeding Activity of Glycoform-Deficient Prions from Variably Protease-Sensitive Prionopathy and Familial CJD Associated with PrP V180I MutationThe original version of this article unfortunately contained a mistake. The email address Dr. Wen-Quan Zou, one of the corresponding authors should be written as "wxz6@case.edu" instead of "wxz@case.edu".Correction to: Role of Chronic Administration of Antidepressant Drugs in the Prenatal Stress-Evoked Inflammatory Response in the Brain...
Αλέξανδρος Γ. Σφακιανάκης
23m
AF1q Expression Associates with CD44 and STAT3 and Impairs Overall Survival in Adenoid Cystic Carcinoma...
AF1q Expression Associates with CD44 and STAT3 and Impairs Overall Survival in Adenoid Cystic Carcinoma of the Head and Neck,AbstractSalivary gland malignancies of the head and neck form a heterogeneous group. Adenoid cystic carcinomas are an aggressive entity of salivary gland malignancies characterized by frequent distant metastases and poor response to radio- and chemotherapy. AF1Q is a MLL fusion partner, which can activate Wnt and STAT3 signaling. Recently, overexpression of AF1q has been identified...
Αλέξανδρος Γ. Σφακιανάκης
26m
Molecular Network-Based Identification of Circular RNA-Associated ceRNA Network in Papillary Thyroid...
Molecular Network-Based Identification of Circular RNA-Associated ceRNA Network in Papillary Thyroid Cancer,AbstractCircular RNAs (circRNAs) have displayed dysregulated expression in several types of cancer. Nevertheless, their function and underlying mechanisms in papillary thyroid cancer (PTC) remains largely unknown. This study aimed to describe the regulatory mechanisms in PTC. The expression profile of circRNA was download from the Gene Expression Omnibus (GEO) database. The mRNA and miRNA data...
Αλέξανδρος Γ. Σφακιανάκης
26m
Pathology & Oncology Research
Upregulation of RUNX1 Suppresses Proliferation and Migration through Repressing VEGFA Expression in Hepatocellular CarcinomaAbstractHepatocellular carcinoma (HCC) is the most common type of primary liver cancer, and occurs in people with chronic liver diseases. Current treatment methods include surgery, transplant, and chemotherapy. Our study demonstrates runt-related transcription factor 1 (RUNX1) as a novel molecule in the initiation and development of HCC, and the role of its interaction with...
Αλέξανδρος Γ. Σφακιανάκης
26m
Open doors, open mind Plädoyer für eine offene Versorgungspsychiatrie, https://link.springer.com/article/10.1007/s00115-019-0715-5?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_115_90_7...
Open doors, open mindPlädoyer für eine offene Versorgungspsychiatrie,https://link.springer.com/article/10.1007/s00115-019-0715-5?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_115_90_7AuthorsAuthors and affiliationsKarl H. Beine1Email author1.Universität Witten/Herdecke – Klinik für Psychiatrie, Psychotherapie und PsychosomatikSt. Marien-Hospital HammHammDeutschlandLeitthemaFirst Online: 23 April 2019142DownloadsZusammenfassungGegen ihren natürlichen Willen...
Αλέξανδρος Γ. Σφακιανάκης
27m
Wodurch wird die geschlossene Tür ersetzt? Konzeptionelle und ethische Überlegungen zu offenen Unterbringungsformen,...
Wodurch wird die geschlossene Tür ersetzt?Konzeptionelle und ethische Überlegungen zu offenen Unterbringungsformen, formellem Zwang und psychologischem Druck,https://link.springer.com/article/10.1007/s00115-019-0717-3?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_115_90_7AuthorsAuthors and affiliationsJakov Gather12Email authorMatthé Scholten2Tanja Henking3Jochen Vollmann2Georg Juckel11.Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-UniversitätsklinikumRuhr-Universität...
Αλέξανδρος Γ. Σφακιανάκης
28m
Der Nervenarzt
Korrektur des Empfehlungsgrades für TDM(Teil-)stationäre Therapie von Voll- und Minderjährigen mit einer hyperkinetischen Störung in der deutschen PsychiatrieZusammenfassungHintergrundDie Datenlage über die (teil-)stationäre Versorgung von Patienten mit einer hyperkinetischen Störung (HKS, ICD: 10 F90.-) ist durch Routinedatenanalysen aus dem ambulanten Behandlungssektor bzw. aus gemischten Stichproben einzelner Krankenkassen geprägt. Diese Studie analysiert erstmalig eine fallbezogene Stichprobe...
Αλέξανδρος Γ. Σφακιανάκης
28m
Effect of inulin polymerization degree on various properties of synbiotic fermented milk including Lactobacillus...
Effect of inulin polymerization degree on various properties of synbiotic fermented milk including Lactobacillus acidophilus La-5 and Bifidobacterium animalis Bb-12,Publication date: August 2019Source: Journal of Dairy Science, Volume 102, Issue 8Author(s): Sebnem Ozturkoglu-Budak, H. Ceren Akal, İlkay Buran, Atila YetişemiyenABSTRACTThe effects of inulin degree of polymerization (DP) on the viabilities of Lactobacillus acidophilus La-5 and Bifidobacterium animalis Bb-12 and on some parameters of...
Αλέξανδρος Γ. Σφακιανάκης
29m
Towards Holistic Supporting of Play-Based Learning Implementation in Kindergartens: A Mixed Method Study, ...
Towards Holistic Supporting of Play-Based Learning Implementation in Kindergartens: A Mixed Method Study,        AbstractUsing a holistic support framework, this study investigated teachers' conceptions of effective play-based learning development and how their perceptions of its effectiveness related to whole-child development. Data were collected from a mixed method study. A total of 286 questionnaires from 50 Hong Kong kindergartens were collected and then 29 principals, head teachers and teachers...
Αλέξανδρος Γ. Σφακιανάκης
30m
Shared Musical Experiences,                Brandon Polite
Shared Musical Experiences,                Brandon Polite
Αλέξανδρος Γ. Σφακιανάκης
31m
LncRNA TUG1 promotes cisplatin resistance in esophageal squamous cell carcinoma cells by regulating...
LncRNA TUG1 promotes cisplatin resistance in esophageal squamous cell carcinoma cells by regulating Nrf2,  Zhenghua Zhang; Ran Xiong; Caiwei Li; Meiqing Xu; Mingfa Guo,  IGFBP7 regulates sepsis-induced epithelial-mesenchymal transition through ERK1/2 signaling,  Xiaolin Wang; Yan Li; Zhenzhen Zhao; Yan Meng ; Jinjun Bian ...  Immunomodulatory effect of human amniotic epithelial cells on restoration of ovarian function in mice with autoimmune ovarian disease  Qiuwan Zhang; Yating Huang; Junyan Sun; Tingting...
Αλέξανδρος Γ. Σφακιανάκης
31m
NeuroOncology
Editorials   Editorial  Kenneth Aldape  New developments and new dilemmas in lower-grade gliomas  Roberta Rudà  Proton beam therapy in pediatric brain tumor patients: improved radiation delivery techniques improve neurocognitive outcomes  Rakesh Jalali; Jayant S Goda  Diet and risk of glioma: targets for prevention remain elusive  Kyle M Walsh; Elizabeth B Claus   Highlights from the Literature   Highlights from the Literature  Roger Abounader; Krishna Bhat ; Riccardo Soffietti; Sourav Ghosh ; Mariano...
Αλέξανδρος Γ. Σφακιανάκης
33m
HIV Pre-Exposure Prophylaxis and Increased Incidence of Sexually Transmitted Infections in the United...
HIV Pre-Exposure Prophylaxis and Increased Incidence of Sexually Transmitted Infections in the United States,  Jose A Serpa, MD, MS; Gabriel N Huynh, PharmD, MBA; Julie B Nickell, BBA, MBA ; Hongyu Miao, MS, PhD
Αλέξανδρος Γ. Σφακιανάκης
34m
S Loi,                                The ESMO clinical practise guidelines for early breast cancer:...
S Loi,                                The ESMO clinical practise guidelines for early breast cancer: diagnosis, treatment and follow-up: on the winding road to personalized medicine,  
Αλέξανδρος Γ. Σφακιανάκης
34m
Intestinal dysbiosis mediates experimental autoimmune pancreatitis via activation of plasmacytoid dendritic...
Intestinal dysbiosis mediates experimental autoimmune pancreatitis via activation of plasmacytoid dendritic cells,  Ken Kamata; Tomohiro Watanabe; Kosuke Minaga; Akane Hara; Tomoe Yoshikawa ...
Αλέξανδρος Γ. Σφακιανάκης
36m
Genome-wide association study of piscine myocarditis virus (PMCV) resistance in Atlantic salmon (Salmo...
Genome-wide association study of piscine myocarditis virus (PMCV) resistance in Atlantic salmon (Salmo salar),  Borghild Hillestad; Hooman K Moghadam,  High frequency of multiple paternity in Eastern red bats, Lasiurus borealis, based on microsatellite analysis,  Loren K Ammerman; Dana N Lee; Brittney A Jones ; Morgan P Holt; Samuel J Harrison ...
Αλέξανδρος Γ. Σφακιανάκης
36m
Clinical Pharmacokinetic and Pharmacodynamic Considerations in the (Modern) Treatment of Melanoma, ...
Clinical Pharmacokinetic and Pharmacodynamic Considerations in the (Modern) Treatment of Melanoma,             AbstractTargeted therapies, based on identification of common oncogenic mutations such as BRAF V600E/K and monoclonal antibody immunotherapies, have transformed the treatment of melanoma. Dual mitogen-activated protein kinase (MAPK) pathway inhibition of BRAF V600E/K and MEK 1/2 kinases with BRAF–MEK inhibitors using dabrafenib–trametinib, vemurafenib–cobimetinib and encorafenib–binimetinib...
Αλέξανδρος Γ. Σφακιανάκης
36m
Clinical Pharmacokinetics
Population-Pharmacokinetic Modeling of Tildrakizumab (MK-3222), an Anti-Interleukin-23-p19 Monoclonal Antibody, in Healthy Volunteers and Subjects with PsoriasisAbstractBackgroundTildrakizumab is an anti-interleukin-23p19 monoclonal antibody recently approved for the treatment of chronic plaque psoriasis.MethodsThis analysis characterizes the population pharmacokinetics of subcutaneous tildrakizumab and identifies covariates influencing exposure in 2098 healthy volunteers and subjects with psoriasis....
Αλέξανδρος Γ. Σφακιανάκης
37m
Médecine & Droit
Enjeux majeurs de santé publique versus autonomie personnelle : le cas spécifique de l'obligation vaccinalePublication date: June 2019Source: Médecine & Droit, Volume 2019, Issue 156Author(s): Marion TraversRésuméSi la triple dimension individuelle, altruiste et collective de l'obligation vaccinale préventive sert un objectif de santé publique majeur, il n'empêche qu'en imposant une contrainte aux individus et en portant ainsi atteinte à plusieurs de leurs droits fondamentaux, un tel choix des...
Αλέξανδρος Γ. Σφακιανάκης
38m
Intersectionality and Critical Realism: A Philosophical Framework for Advancing Nursing Leadership, ...
Intersectionality and Critical Realism: A Philosophical Framework for Advancing Nursing Leadership,            This article presents intersectionality theory with critical realism as a philosophical framework for studying nursing leadership. In response to gaps in the current leadership literature, the aim is to develop an approach that addresses how the multiple social positions nurses hold can create an intersecting matrix of oppression that impacts on their opportunities to develop as leaders....
Αλέξανδρος Γ. Σφακιανάκης
39m
Analyzing Patients' Complaints: Awakening of the Ethic of Belonging,               Nursing ethics...
Analyzing Patients' Complaints: Awakening of the Ethic of Belonging,              Nursing ethics are fundamental principles to nursing practice. The purpose of this study is to analyze patients' complaints filed against nurses from a nursing ethics perspective. This is a qualitative study. The data source is the patients' complaints filed in a university-affiliated hospital in China. The complaints are categorized into 4 themes: uncompassionate attitudes, unprofessional communication, disrespect...
Αλέξανδρος Γ. Σφακιανάκης
39m
Nursing Science
Letter to the EditorNo abstract availableLetter to the EditorNo abstract availableReconceptualizing the Electronic Health Record for a New Decade: A Caring Technology?Since the 2009 publication by Petrovskaya et al on, "Dilemmas, Tetralemmas, Reimagining the Electronic Health Record," and passage of the Health Information Technology for Economic Clinical Health (HITECH) Act, 96% of hospitals and 78% of providers have implemented the electronic health record. While many positive outcomes such as guidelines-based...
Αλέξανδρος Γ. Σφακιανάκης
40m
Physical Medicine & Rehabilitation
An Unusual Case of Foot Weakness Caused by Proximal Extensor Hallucis Longus (EHL) RuptureNo abstract availablePatients with spinal muscular atrophy use high percentages of trunk muscle capacity to perform seated tasksObjective To investigate trunk function during seated upper extremity tasks in patients with spinal muscular atrophy (SMA) type 2 and 3. Design 17 persons with SMA and 15 healthy controls (HC) performed several tasks when sitting unsupported, such as reaching (and placing) forward and...
Αλέξανδρος Γ. Σφακιανάκης
41m
JAMA
THE ARTS AND MEDICINEBasch Unbound—The House of God and Fiction as Resistance at 40Stephen Bergman, MD, DPhilVideo — The Making of The House of GodVideo — The House of God at 40: The Characters SpeakOPINIONJAMAAdvances in Understanding the Pathophysiology of Chronic Fatigue SyndromeAnthony L. Komaroff, MDJAMA Internal MedicineIgnorance of Nutrition Is No Longer DefensibleNeal D. Barnard, MDJAMA PsychiatryDisruptive PsychopharmacologyBoris D. Heifets, MD, PhD; Robert C. Malenka, MD, PhDJAMA CardiologyFear-Based...
Αλέξανδρος Γ. Σφακιανάκης
41m
Multi-Compartment Profiling of Bacterial and Host Metabolites Identifies Intestinal Dysbiosis and Its...
Multi-Compartment Profiling of Bacterial and Host Metabolites Identifies Intestinal Dysbiosis and Its Functional Consequences in the Critically Ill Child,                  Objectives: Adverse physiology and antibiotic exposure devastate the intestinal microbiome in critical illness. Time and cost implications limit the immediate clinical potential of microbial sequencing to identify or treat intestinal dysbiosis. Here, we examined whether metabolic profiling is a feasible method of monitoring intestinal...
Αλέξανδρος Γ. Σφακιανάκης
42m
Management of Peripheral Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock,   ...
Management of Peripheral Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock,                 Objectives: Cardiogenic shock is a highly morbid condition in which inadequate end-organ perfusion leads to death if untreated. Peripheral venoarterial extracorporeal membrane oxygenation is increasingly used to restore systemic perfusion despite limited understanding of how to optimally titrate support. This review provides insights into the physiologic basis of extracorporeal membrane...
Αλέξανδρος Γ. Σφακιανάκης
42m
Quantitative Electroencephalogram Trends Predict Recovery in Hypoxic-Ischemic Encephalopathy,     ...
Quantitative Electroencephalogram Trends Predict Recovery in Hypoxic-Ischemic Encephalopathy,                   Objectives: Electroencephalogram features predict neurologic recovery following cardiac arrest. Recent work has shown that prognostic implications of some key electroencephalogram features change over time. We explore whether time dependence exists for an expanded selection of quantitative electroencephalogram features and whether accounting for this time dependence enables better prognostic...
Αλέξανδρος Γ. Σφακιανάκης
43m
Effect of Prone Positioning on Intraocular Pressure in Patients With Acute Respiratory Distress Syndrome,...
Effect of Prone Positioning on Intraocular Pressure in Patients With Acute Respiratory Distress Syndrome,Objectives: To evaluate the effect of prolonged duration of prone position (with head laterally rotated) on intraocular pressure in acute respiratory distress syndrome patients. Design: Prospective observational study. Setting: University hospital ICU. Patients: Twenty-five acute respiratory distress syndrome patients, age 60 years (51–67 yr), Sequential Organ Failure Assessment score 10 (10–12),...
Αλέξανδρος Γ. Σφακιανάκης
43m
Critical Care Medicine
Implementation of a Bundled Consent Process in the ICU: A Single-Center ExperienceObjectives: A bundled consent process, where patients or surrogates provide consent for all commonly performed procedures on a single form at the time of ICU admission, has been advocated as a method for improving both rates of documented consent and patient/family satisfaction, but there has been little published literature about the use of bundled consent. We sought to determine how residents in an academic medical...
Αλέξανδρος Γ. Σφακιανάκης
43m
Tryptase values in anaphylaxis and insect allergy,                            Purpose of review To...
Tryptase values in anaphylaxis and insect allergy,                            Purpose of review To recognize the relevance of serum tryptase measurement as a useful tool for the diagnosis of allergic diseases and mast cell disorders. Recent findings Recent data on the role of mast cells and tryptase in allergic and other diseases provide new understanding into the mechanisms and causes of anaphylaxis. Summary Measurement of transiently elevated tryptase levels shortly after a severe reaction can...
Αλέξανδρος Γ. Σφακιανάκης
45m
Multimodal analgesia for craniotomy,                Purpose of review To explore the data for and against...
Multimodal analgesia for craniotomy,                Purpose of review To explore the data for and against the use of the various components of multimodal analgesia in cranial neurosurgery. Recent findings Postcraniotomy pain is a challenging clinical problem in that analgesia must be accomplished without affecting neurologic function (i.e. 'losing the neurologic exam'). The traditional approach with low-dose opioids is often insufficient and can cause well recognized side effects. Newer multimodal...
Αλέξανδρος Γ. Σφακιανάκης
45m
Indications for treatment of sarcoidosis,          Purpose of review To describe the current knowledge...
Indications for treatment of sarcoidosis,         Purpose of review To describe the current knowledge on indications for sarcoidosis treatment. Recent findings Despite the lack of evidence-based recommendations, the sarcoidosis community has adopted the concept of starting systemic anti-inflammatory treatment because of potential danger (risk of severe dysfunction on major organs or death) or unacceptable impaired quality of life (QoL). On the contrary, while QoL and functionality are patients' priorities,...
Αλέξανδρος Γ. Σφακιανάκης
56m
Pulmonary Medicine
Approach to tapering antisarcoidosis therapyPurpose of review Sarcoidosis is a multisystemic granulomatous disease, which commonly affects the lung. The natural course of the disease and prognosis are variable from asymptomatic, spontaneous remission to progressive disease, which requires treatment. Once treatment is initiated, tapering therapy can be problematic. Recent findings Corticosteroids are recommended as first-line therapy, but optimal regimen and duration of treatment is not well established....
Αλέξανδρος Γ. Σφακιανάκης
58m
Drug Metabolism and Pharmacokinetics
Conversion from Twice-Daily Prograf ® to Once-Daily Advagraf ® in Multi-ethnic Asian Adult Renal Transplant Recipients With or Without Concomitant Use of Diltiazem: Impact of CYP3A5 and MDR1 Genetic Polymorphisms on Tacrolimus ExposureAbstractBackground and ObjectivesTacrolimus is the mainstay of immunosuppression in renal transplantation. Given that once-daily administration improves patient compliance, 1:1 dose conversion from twice-daily Prograf® to once-daily Advagraf® is recommended. Although...
Αλέξανδρος Γ. Σφακιανάκης
59m
Investigative Radiology
Ultrasound Time-Harmonic Elastography of the Aorta: Effect of Age and Hypertension on Aortic StiffnessObjectives The aim of this study was to investigate ultrasound time-harmonic elastography for quantifying aortic stiffness in vivo in the context of aging and arterial hypertension. Materials and Methods Seventy-four participants (50 healthy participants and 24 participants with long-standing hypertension) were prospectively included between January 2018 and October 2018, and underwent ultrasound...
Αλέξανδρος Γ. Σφακιανάκης
1h
Der Unfallchirurg
Vereinbarung zur Organisation der Schmerztherapie chirurgischer Patienten des Berufsverbandes Deutscher Anästhesisten und des Berufsverbandes der Deutschen Chirurgen (Neufassung 2019)ZusammenfassungDie Therapie möglicher ursächlicher, prozedurenspezifischer und/oder -begleitender Akutschmerzen ist ein essenzielles Qualitätsmerkmal in jedem chirurgischen Fachgebiet. Ziele einer interdisziplinären und interprofessionellen Schmerztherapie sind unmittelbar eine Verbesserung der Lebensqualität durch Schmerzfreiheit,...
Αλέξανδρος Γ. Σφακιανάκης
1h
Repetitive transcranial magnetic stimulation (rTMS) is a technique protecting neurons against diverse neurodegenerative disorders by delivering magnetic stimuli into the brain through the intact scalp.
Repetitive transcranial magnetic stimulation protects mice against 6-OHDA-induced Parkinson's disease symptoms by regulating brain amyloid β 1–42 levelAbstractRepetitive transcranial magnetic stimulation (rTMS) is a technique protecting neurons against diverse neurodegenerative disorders by delivering magnetic stimuli into the brain through the intact scalp. In the current study, the protection effect of rTMS on Parkinson's disease (PD) and the associated mechanism driving the treatment were explored....
Αλέξανδρος Γ. Σφακιανάκης
1h
Berberine is a quaternary ammonium salt from the protoberberine group of benzylisoquinoline alkaloids found in such plants as Berberis. Berberine is usually found in the roots, rhizomes, stems, and bark. Due to berberine's strong yellow color, Berberis species were used to dye wool, leather, and wood
Berberine enhances posttranslational protein stability of p21/cip1 in breast cancer cells via down-regulation of AktAbstractBerberine has shown anticancer properties and has potential for a chemopreventive and/or chemotherapeutic agent for breast cancer. Berberine showed cytotoxicity to breast cancer cells, with an increase in the levels of p21/cip1 and p27/kip1, cyclin-dependent kinase inhibitors (CDKI), but mechanisms involved in up-regulating these molecules are largely unknown. Herein, we studied...
Αλέξανδρος Γ. Σφακιανάκης
1h
Chronic effects of platinum(IV) complex and its diamine ligand on rat heart function: comparison with...
Chronic effects of platinum(IV) complex and its diamine ligand on rat heart function: comparison with cisplatin,AbstractThe aim of the present study was to compare the cardiodynamic parameters in the isolated rat heart in animals chronically treated with cisplatin, platinum(IV) complex and its diamine ligand. Sixty Wistar albino rats (8 weeks old) were divided into five groups: three experimental and two control groups. Animals in all groups were treated with a dose of 4 mg/kg body weight once a...
Αλέξανδρος Γ. Σφακιανάκης
1h
Exosomes derived from microRNA-101-3p-overexpressing human bone marrow mesenchymal stem cells suppress...
Exosomes derived from microRNA-101-3p-overexpressing human bone marrow mesenchymal stem cells suppress oral cancer cell proliferation, invasion, and migrationAbstractDysregulation of microRNAs (miRNAs) has been found to disrupt the progression of oral cancer. However, which miRNAs are most effective against oral cancer and how these miRNAs should be delivered are major unanswered problems. We aimed at investigating if human bone marrow mesenchymal stem cells (hBMSCs)-derived exosomes affect oral...
Αλέξανδρος Γ. Σφακιανάκης
1h
Molecular and Cellular Biochemistry
Co-treatment with interferon-γ and 1-methyl tryptophan ameliorates cardiac fibrosis through cardiac myofibroblasts apoptosisAbstractCardiac remodeling characterized by cardiac fibrosis is a pathologic process occurring after acute myocardial infarction. Fibrosis can be ameliorated by interferon-gamma (IFN-γ), which is a soluble cytokine showing various effects such as anti-fibrosis, apoptosis, anti-proliferation, immunomodulation, and anti-viral activities. However, the role of IFN-γ in cardiac myofibroblasts...
Αλέξανδρος Γ. Σφακιανάκης
1h
Hydrochemical Regime in Riverine Aqual Complexes: Case Study of the Small Il'd River (Rybinsk Reservoir...
Hydrochemical Regime in Riverine Aqual Complexes: Case Study of the Small Il'd River (Rybinsk Reservoir Basin),AbstractThe results of studying the space and time dynamics of the hydrochemical regime in discrete aquatic areas of a riverine aquatic–territorial complex of a small river over period 2001–2010 are given. Each discrete area considered separately has specific features of hydrochemical regime formation.Modelling Technique for Sediment Evaluation at Reservoir (South India)AbstractIn India,...
Αλέξανδρος Γ. Σφακιανάκης
1h
Christmas as Religion: Rethinking Santa, the Secular, and the Sacred. By Christopher Deacy,  Lucinda...
Christmas as Religion: Rethinking Santa, the Secular, and the Sacred. By Christopher Deacy,  Lucinda Murphy
Αλέξανδρος Γ. Σφακιανάκης
1h
Class, Politics, and the Decline of Deference in England, 1968–2000. By Florence Sutcliffe-Braithwaite,  Matthew...
Class, Politics, and the Decline of Deference in England, 1968–2000. By Florence Sutcliffe-Braithwaite,  Matthew Kelly,  Learning to Fight: Military Innovation and Change in the British Army, 1914–1918. By Aimée Fox,  Laura Boyd,
Αλέξανδρος Γ. Σφακιανάκης
1h
Environmental, Social, and Governance Investment: Opportunities and Risks for Asia,              https://www.adb.org/news/events/environmental-social-governance-investment-opportunities-risks-asia
Environmental, Social, and Governance Investment: Opportunities and Risks for Asia,              https://www.adb.org/news/events/environmental-social-governance-investment-opportunities-risks-asia
Αλέξανδρος Γ. Σφακιανάκης
1h
Global Forum for Financial Consumers, https://www.adb.org/news/events/2019-iafico-global-forum-financial-consumers
Global Forum for Financial Consumers, https://www.adb.org/news/events/2019-iafico-global-forum-financial-consumers
Αλέξανδρος Γ. Σφακιανάκης
1h
Improving Food Safety to Enhance a Country's Social and Economic Well-Being,https://www.adb.org/node/512136
Improving Food Safety to Enhance a Country's Social and Economic Well-Being,https://www.adb.org/node/512136
Αλέξανδρος Γ. Σφακιανάκης
1h
Chikungunya, a risk factor for Guillain-Barré syndrome,  Sophie Stegmann-Planchard; Pierre Gallian; Benoit...
Chikungunya, a risk factor for Guillain-Barré syndrome,  Sophie Stegmann-Planchard; Pierre Gallian; Benoit Tressières; Isabelle Leparc-Goffart ; Annie Lannuzel ...,  Predictors of Clostridioidesdifficile Infection among Asymptomatic Colonized Patients: A Retrospective Cohort Study,  Dominic Poirier, MD, PhD; Philippe Gervais, MD; Margit Fuchs, PhD ; Jean-Francois Roussy, MD; Bianka Paquet-Bolduc, RN, MPA ...
Αλέξανδρος Γ. Σφακιανάκης
1h
LaBeouf, Rönkkö & Turner, Digital Remix, and Group Authorship,  Andrew J Corsa 
LaBeouf, Rönkkö & Turner, Digital Remix, and Group Authorship,  Andrew J Corsa 
Αλέξανδρος Γ. Σφακιανάκης
1h
Automated Reasoning
Homotopy Type Theory and Univalent Foundations,Selected Extended Papers of ITP 2017,The James Construction and $$\pi _4(\mathbb {S}^{3})$$ π 4 ( S 3 ) in Homotopy Type TheoryAbstractIn the first part of this paper we present a formalization in Agda of the James construction in homotopy type theory. We include several fragments of code to show what the Agda code looks like, and we explain several techniques that we used in the formalization. In the second part, we use the James construction to give...
Αλέξανδρος Γ. Σφακιανάκης
1h
Trauma and Acute Care Surgery
Development of Transfusion Guidelines for Injured Children Using a Modified Delphi Consensus ProcessNo abstract availableIs Early Chemical Thromboprophylaxis in Patients with Solid Organ Injury a Solid Decision?Background The optimal time to initiate chemical thromboprophylaxis (CTP) in patients who have undergone non-operative management (NOM) of blunt solid organ injuries remains controversial. The aim of our study was to assess the impact of early initiation of CTP in patients with blunt abdominal...
Αλέξανδρος Γ. Σφακιανάκης
1h
Hail suppression effectiveness for varying solubility of natural aerosols in water, Because of a production...
Hail suppression effectiveness for varying solubility of natural aerosols in water,Because of a production error, the black line in Figure 13c is incorrect. The correct Figure 13c is shown below.Correction to: Projection of seasonal summer precipitation over Indian sub-continent with a high-resolution AGCM based on the RCP scenariosThe authors want to acknowledge the Korea Meteorological Administration research and Development Program under Grant KMI 2018-07910.Impacts of subgrid-scale orography...
Αλέξανδρος Γ. Σφακιανάκης
1h
Conserving Functions across Generations: Heredity in Light of Biological Organization,  Matteo Mossio; Gaëlle...
Conserving Functions across Generations: Heredity in Light of Biological Organization,  Matteo Mossio; Gaëlle Pontarotti
Αλέξανδρος Γ. Σφακιανάκης
1h
Pore pressure observation: pressure response of probe penetration and tides, Abstract Excess pore water...
Pore pressure observation: pressure response of probe penetration and tides,AbstractExcess pore water pressure is an important parameter that can be used to analyze certain physical characteristics of sediment. In this paper, the excess pore water pressure of subseafloor sediment and its variation with tidal movement was measured following the installation of a wharf in Qingdao, China by using a fiber Bragg grating (FBG) piezometer. The results indicated that this FBG piezometer is effective in the...
Αλέξανδρος Γ. Σφακιανάκης
1h
Education Spillovers in Farm Productivity: Revisiting the Evidence,  Véronique Gille,  Biased Policy...
Education Spillovers in Farm Productivity: Revisiting the Evidence,  Véronique Gille,  Biased Policy Professionals,  Sheheryar Banuri; Stefan Dercon; Varun Gauri
Αλέξανδρος Γ. Σφακιανάκης
1h
Abnormal Child Psychology
Protective Factors Buffer Life Stress and Behavioral Health Outcomes among High-Risk YouthAbstractThis study investigated internalizing problems, externalizing problems, and polydrug use among African-American youth residing in high-poverty neighborhoods, and tested the potential protective effects of religiosity, parental monitoring, and neighborhood collective efficacy on life stress and behavioral health outcomes (N = 576; 307 females; Mage = 16 years, SD = 1.44 years). A cumulative risk index...
Αλέξανδρος Γ. Σφακιανάκης
1h
PAIN Report
Functional and histological improvements of small nerve neuropathy after high-concentration capsaicin patch application: A case studyIntroduction: Small fiber neuropathy has been found to occur in a large variety of pathological onditions, and the gold standard for diagnosis of small fiber neuropathy is skin biopsy. Sudorimetry is now considered an accurate technique to evaluate small fiber function with a good sensitivity and specificity for the diagnosis of small fiber neuropathy. Capsaicin high-concentration...
Αλέξανδρος Γ. Σφακιανάκης
1h
Child Indicators Research
School Readiness among U.S. Children: Development of a Pilot MeasureAbstractNo single U.S. data source supports a multidimensional, population-based assessment of young children's readiness to start school. This changed with the 2016 National Survey of Children's Health (NSCH). This study provides an overview of the process by which content related to multiple domains of school readiness was identified, refined and selected for inclusion in the NSCH; describes the analytic processes and resultant...
Αλέξανδρος Γ. Σφακιανάκης
1h
Delayed hearing loss after microvascular decompression for hemifacial spasm—an unsolved conspiracy of...
Delayed hearing loss after microvascular decompression for hemifacial spasm—an unsolved conspiracy of the cochlear apparatus,,How I do it: endoscopic supracerebellar infratentorial approach for torcular meningioma removalAbstractBackgroundTorcular meningioma is a rare type of brain tumor with few reports regarding the appropriate resection approach for this disease. In cases without sinus occlusion, surgeons are advised to spare the sinus; however, the sinus may interfere with the visual field.MethodEndoscopic...
Αλέξανδρος Γ. Σφακιανάκης
1h
Bioactive Oxylipins in Infants and Children With Congenital Heart Disease Undergoing Pediatric Cardiopulmonary...
Bioactive Oxylipins in Infants and Children With Congenital Heart Disease Undergoing Pediatric Cardiopulmonary Bypass,.Kim-Campbell, Nahmah MD, MS1; Gretchen, Catherine MD1; Ritov, Vladimir B. PhD2; Kochanek, Patrick M. MD, MCCM1,3; Balasubramani, Goundappa K. PhD4; Kenny, Elizabeth BS2; Sharma, Mahesh MD5; Viegas, Melita MD5; Callaway, Clifton MD6; Kagan, Valerian E. PhD2; Bayír, Hülya MD1–3Pediatric Critical Care Medicine: July 11, 2019 - Volume Online First - Issue - pdoi: 10.1097/PCC.0000000000002036Online...
Αλέξανδρος Γ. Σφακιανάκης
1h
Information Security
Breaking MPC implementations through compressionAbstractThere are many cryptographic protocols in the literature that are scientifically and mathematically sound. By extension, cryptography today seeks to respond to numerous properties of the communication process beyond confidentiality (secrecy), such as integrity, authenticity, and anonymity. In addition to the theoretical evidence, implementations must be equally secure. Due to the ever-increasing intrusion from governments and other groups, citizens...
Αλέξανδρος Γ. Σφακιανάκης
1h
Neuroscience, Mindfulness and Holistic Wellness Reflections on Interconnectivity in Teaching and Learning,...
Neuroscience, Mindfulness and Holistic Wellness Reflections on Interconnectivity in Teaching and Learning,AbstractNeuroscience offers insight into how we learn. Understanding how to leverage neural development pathways is of interest in teaching because the circuits in the brain respond to effective pedagogical practice; therefore, the role of the teacher is critical. Neuroscientific studies (Damasio in The feeling of what happens: body, emotion and the making of consciousness, Heinemann, London, 1999;...
Αλέξανδρος Γ. Σφακιανάκης
1h
„Blaue Augen" – Fallbericht über die Risiken von kosmetischen Irisimplantaten, https://link.springer.com/article/10.1007/s00347-018-0792-z?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_347_116_7...
„Blaue Augen" – Fallbericht über die Risiken von kosmetischen Irisimplantaten,https://link.springer.com/article/10.1007/s00347-018-0792-z?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_347_116_7AuthorsAuthors and affiliationsS. Kazerounian1Email authorI. Tsirkinidou1M. Kynigopoulos1M. Müller11.Pallas Klinik ZürichZürichSchweizKasuistikenFirst Online: 10 October 201892DownloadsZusammenfassungEine 24-jährige Iranerin stellte sich mit kosmetischen Irisimplantaten...
Αλέξανδρος Γ. Σφακιανάκης
1h
Foveale avaskuläre Zone und OCT-Angiographie. Eine Übersicht aktueller Erkenntnisse, https://link.springer.com/article/10.1007/s00347-018-0838-2?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_347_116_7...
Foveale avaskuläre Zone und OCT-Angiographie. Eine Übersicht aktueller Erkenntnisse,https://link.springer.com/article/10.1007/s00347-018-0838-2?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_347_116_7AuthorsAuthors and affiliationsN. Mihailovic1Email authorN. Eter1M. Alnawaiseh11.Klinik für AugenheilkundeUniversitätsklinikum MünsterMünsterDeutschlandÜbersichtenFirst Online: 19 December 2018237DownloadsZusammenfassungHintergrundDie foveale avaskuläre Zone (FAZ)...
Αλέξανδρος Γ. Σφακιανάκης
1h
Der Ophthalmologe
Macular-Pucker-Chirurgie mit und ohne Delamination der Membrana limitans interna – eine prospektive randomisierte StudieZusammenfassungHintergrundEs gibt Hinweise darauf, dass die zusätzliche Entfernung der ILM (Membrana limitans interna) die Rezidivrate nach Pucker-Chirurgie bei ähnlichem funktionellem Ergebnis reduziert. Andererseits wurden morphologische Veränderungen der inneren Netzhautschichten nach ILM-Peeling beschrieben. Ziel dieser Studie war, die Langzeitdaten nach Vitrektomie mit und...
Αλέξανδρος Γ. Σφακιανάκης
1h
Critical Care Medicine, Driving Pressure Is Associated with Outcome during Assisted Ventilation in...
Critical Care Medicine,Driving Pressure Is Associated with Outcome during Assisted Ventilation in Acute Respiratory Distress SyndromeGiacomo Bellani, M.D., Ph.D.; Alice Grassi, M.D.; Simone Sosio, M.D.; Stefano Gatti, M.D.; Brian P. Kavanagh, M.B.; Antonio Pesenti, M.D.; Giuseppe Foti, M.DAnesthesiology Published online July 12, 2019. doi:10.1097/ALN.0000000000002846Mind to MindDown Under the DeepSonia AroraAnesthesiology Published online July 12, 2019. doi:10.1097/ALN.0000000000002869The Waiting...
Αλέξανδρος Γ. Σφακιανάκης
1h
ΦEMS Microbiology Ecology
Minireview  Mini Review The outer membrane glycolipids of bacteria from cold environments: isolation, characterization, and biological activity  Angela Casillo; Ermenegilda Parrilli ; Maria Luisa Tutino; Maria Michela Corsaro Review describing peculiar structural features of glycolipids from the outer membrane of Gram-negative psychrophiles and their contribution to cold adaptation.   Research Articles  Editor's Choice Viral degradation of marine bacterial exopolysaccharides  F Lelchat; P Y Mocaer; T...
Αλέξανδρος Γ. Σφακιανάκης
1h
FEMS Microbiology Letters
Editorial   Editorial: Microbial food and feed ingredients – reconciling tradition and novelty  Egon Bech Hansen; Dennis Sandris Nielsen; Gisèle LaPointe   Biotechnology and Synthetic Biology   Conserved motifs in the CRISPR leader sequence control spacer acquisition levels in Type I-D CRISPR-Cas systems  Sebastian N Kieper ; Cristóbal Almendros; Stan J J Brouns Conserved nucleotide motifs in the CRISPR leader sequence control spacer acquisition levels of CRISPR-Cas systems   Environmental Microbiology   Brazilian-adapted...
Αλέξανδρος Γ. Σφακιανάκης
1h
Expression of Ki67, EGFR, VEGF, HIF-1α, and p53 and Cell Count in Head and Neck Squamous Cell Carcinoma
Histogram Analysis Parameters Derived from Conventional T1- and T2-Weighted Images Can Predict Different Histopathological Features Including Expression of Ki67, EGFR, VEGF, HIF-1α, and p53 and Cell Count in Head and Neck Squamous Cell CarcinomaAbstractPurposeTo analyze associations between histogram analysis parameters derived from conventional magnetic resonance imaging (MRI) and different histopathological features in head and neck squamous cell carcinoma (HNSCC).ProceduresThirty-four patients...
Αλέξανδρος Γ. Σφακιανάκης
1h
Molecular Imaging and Biology
Whole Body PET Imaging with a Norepinephrine Transporter Probe 4-[ 18 F]Fluorobenzylguanidine: Biodistribution and Radiation DosimetryAbstractPurpose4-[18F]Fluorobenzylguanidine ([18F]PFBG) is a positron emission tomography (PET) probe for non-invasive targeting of the norepinephrine transporter. The aim of this study was to assess uptake and distribution characteristics of this PET probe.ProceduresThree cynomolgus monkeys were injected with 269 ± 51 MBq (7.3 ± 1.4 mCi) of [18F]PFBG and 21 whole...
Αλέξανδρος Γ. Σφακιανάκης
1h
Environmental Science & Engineering
Screening of textile finishing agents available on the Chinese market: An important source of per- and polyfluoroalkyl substances to the environmentAbstractOrganofluorinated surfactants are widely employed in textile finishing agents (TFAs) to achieve oil, water, and stain repellency. This has been regarded as an important emission source of per-and polyfluoroalkyl substances (PFASs) to the environment. China is the biggest manufacturer of clothes, and thus TFA production is also a relevant industrial...
Αλέξανδρος Γ. Σφακιανάκης
1h
Applied Microbiology and Biotechnology
Synthesis of silver nanoparticles and its contribution to the capability of Bacillus subtilis to deal with polluted watersAbstractBacillus subtilis widely exists in environment and shows a capability to deal with heavy metals and dyes in polluted waters by adsorption or biological oxidation and reduction. Little is known about the roles of lipopeptides in this capability of B. subtilis. In this study, we found that the lipopeptides produced by B. subtilis could reduce silver ions to silver nanoparticles...
Αλέξανδρος Γ. Σφακιανάκης
1h
Oto-Rhino-Laryngology
Correction to: Compare two surgical interventions for otitis media with effusion in young childrenIn the original publication, Table 5 and 6 were interchanged by mistake. The correct tables are given here."Barbed snore surgery" simulator: a low-cost surgical modelAbstractBackground"Barbed snore surgery" (BSS) represents one of the last innovation for obstructive sleep apnea syndrome (OSAS) surgical management. Although this technique represents an effective and minimally invasive surgery, it is not...
Αλέξανδρος Γ. Σφακιανάκης
1h

Σάββατο 13 Ιουλίου 2019

Molecular Neuroscience

CADASIL with Atypical Clinical Symptoms, Magnetic Resonance Imaging, and Novel Mutations: Two Case Reports and a Review of the Literature

Abstract

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary microangiopathy with adult onset caused by a missense mutation in the NOTCH3 gene in chromosome 19p13. It presents with autosomal dominant arteriopathy, subcortical infarctions, and leukoencephalopathy. Its common clinical presentations are seen as recurrent strokes, migraine or migraine-like headaches, progressive dementia, pseudobulbar paralysis, and psychiatric conditions. Two patients with CADASIL syndrome, whose diagnosis was made based on clinical course, age of onset, imaging findings, and genetic assays in the patients and family members, are presented here because of new familial polymorphisms. The first patient, with cerebellar and psychotic findings, had widespread non-confluent hyperintense lesions as well as moderate cerebellar atrophy in cranial magnetic resonance scanning. The other patient, with headache, dizziness, and forgetfulness, had gliotic lesions in both cerebral hemispheres. CADASIL gene studies revealed a new polymorphism in exon 33 in the first patient. In the other patient, the NOTCH3 gene was identified as a new variant of p.H243P (c.728A > C heterozygous). By reporting a family presenting with various clinical symptoms in the presence of new polymorphisms, we emphasize that CADASIL syndrome may present with various clinical courses and should be considered in differential diagnoses.



Impact of Auditory Integration Therapy (AIT) on the Plasma Levels of Human Glial Cell Line–Derived Neurotrophic Factor (GDNF) in Autism Spectrum Disorder

Abstract

Neurotrophic factors, including the glial cell line–derived neurotrophic factor (GDNF), are of importance for synaptic plasticity regulation, intended as the synapses' ability to strengthen or weaken their responses to differences in neuronal activity. Such plasticity is essential for sensory processing, which has been shown to be impaired in autism spectrum disorder (ASD). This study is the first to investigate the impact of auditory integration therapy (AIT) of sensory processing abnormalities in autism on plasma GDNF levels. Fifteen ASD children, aged between 5 and 12 years, were enrolled and underwent the present research study. AIT was performed throughout 10 days with a 30-min session twice a day. Before and after AIT, Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and Short Sensory Profile (SSP) scores were calculated, and plasma GDNF levels were assayed by an EIA test. A substantial decline in autistic behavior was observed after AIT in the scaling parameters used. Median plasma GDNF level was 52.142 pg/ml before AIT. This level greatly increased immediately after AIT to 242.05 pg/ml (P < 0.001). The levels were depressed to 154.00 pg/ml and 125.594 pg/ml 1 month and 3 months later, respectively, but they were still significantly higher compared with the levels before the treatment (P = 0.001, P = 0.01, respectively). There was an improvement in the measures of autism severity as an effect of AIT which induced the up-regulation of GDNF in plasma. Further research, on a large scale, is needed to evaluate if the cognitive improvement of ASD children after AIT is related or not connected to the up-regulation of GDNF.



Identification of Important Invasion-Related Genes in Non-functional Pituitary Adenomas

Abstract

Non-functioning pituitary adenomas (NFPAs) are locally invasive with high morbidity. The objective of this study was to diagnose important genes and pathways related to the invasiveness of NFPAs and gain more insights into the underlying molecular mechanisms of NFPAs. The gene expression profiles of GSE51618 were downloaded from the Gene Expression Omnibus database with 4 non-invasive NFPA samples, 3 invasive NFPA samples, and 3 normal pituitary gland samples. Differentially expressed genes (DEGs) are screened between invasive NFPA samples and normal pituitary gland samples, followed by pathway and ontology (GO) enrichment analyses. Subsequently, a protein–protein interaction (PPI) network was constructed and analyzed for these DEGs, and module analysis was performed. In addition, a target gene–miRNA network and target gene–TF (transcription factor) network were analyzed for these DEGs. A total of 879 DEGs were obtained. Among them, 439 genes were upregulated and 440 genes were downregulated. Pathway enrichment analysis indicated that the upregulated genes were significantly enriched in cysteine biosynthesis/homocysteine degradation (trans-sulfuration) and PI3K-Akt signaling pathway, while the downregulated genes were mainly associated with docosahexaenoate biosynthesis III (mammals) and chemokine signaling pathway. GO enrichment analysis indicated that the upregulated genes were significantly enriched in animal organ morphogenesis, extracellular matrix, and hormone activity, while the downregulated genes were mainly associated with leukocyte chemotaxis, dendrites, and RAGE receptor binding. Subsequently, ESR1, SOX2, TTN, GFAP, WIF1, TTR, XIST, SPAG5, PPBP, AR, IL1R2, and HIST1H1C were diagnosed as the top hub genes in the upregulated and downregulated PPI networks and modules. In addition, HS3ST1, GPC4, CCND2, and SCD were diagnosed as the top hub genes in the upregulated and downregulated target gene–miRNA networks, while CISH, ISLR, UBE2E3, and CCNG2 were diagnosed as the top hub genes in the upregulated and downregulated target gene–TF networks. The new important DEGs and pathways diagnosed in this study may serve key roles in the invasiveness of NFPAs and indicate more molecular targets for the treatment of NFPAs.



From the Editors Desk: Angela Zawacki-Downing Writing to Professor Illana Gozes, Editor-in-Chief Journal of Molecular Neuroscience—Speaking from a Mother's Heart, AD's ADNP Syndrome


Application of Single-Nucleotide Polymorphisms in the Diagnosis of Autism Spectrum Disorders: A Preliminary Study with Artificial Neural Networks

Abstract

Autism spectrum disorder (ASD) includes different neurodevelopmental disorders characterized by deficits in social communication, and restricted, repetitive patterns of behavior, interests or activities. Based on the importance of early diagnosis for effective therapeutic intervention, several strategies have been employed for detection of the disorder. The artificial neural network (ANN) as a type of machine learning method is a common strategy. In the current study, we extracted genomic data for 487 ASD patients and 455 healthy individuals. All individuals were genotyped in certain single-nucleotide polymorphisms within retinoic acid-related orphan receptor alpha (RORA), gamma-aminobutyric acid type A receptor beta3 subunit (GABRB3), synaptosomal-associated protein 25 (SNAP25) and metabotropic glutamate receptor 7 (GRM7) genes. Subsequently, we used the "Keras" package to create and train the ANN model. For cross-validation, samples were divided into ten folds. In the training process, initially, the first fold was preserved for validation and the other folds were used to train the model. The validation fold was then used to evaluate model performance. The k-fold cross-validation method was used to ensure model generalizability and to prevent overfitting. Local interpretable model-agnostic explanations (LIME) were applied to explain model predictions at the data sample level. The output of loss function was evaluated in the training process for each fold in the k-fold cross-validation model. Finally, the number of losses was reduced to less than 0.6 after 200 epochs (except in two cases). The accuracy, sensitivity and specificity of our model were 73.67%, 82.75% and 63.95%, respectively. The area under the curve (AUC) was 80.59. Consequently, in the current study, we propose an ANN-based method for differentiating ASD status from healthy status with adequate power.



14-3-3/Tau Interaction and Tau Amyloidogenesis

Abstract

The major function of microtubule-associated protein tau is to promote microtubule assembly in the central nervous system. However, aggregation of abnormally phosphorylated tau is a hallmark of tauopathies. Although the molecular mechanisms of conformational transitions and assembling of tau molecules into amyloid fibril remain largely unknown, several factors have been shown to promote tau aggregation, including mutations, polyanions, phosphorylation, and interactions with other proteins. 14-3-3 proteins are a family of highly conserved, multifunctional proteins that are mainly expressed in the central nervous system. Being a scaffolding protein, 14-3-3 proteins interact with tau and regulate tau phosphorylation by bridging tau with various protein kinases. 14-3-3 proteins also directly regulate tau aggregation via specific and non-specific interactions with tau. In this review, we summarize recent advances in characterization of tau conformation and tau/14-3-3 interaction. We discuss the connection between 14-3-3 binding and tau aggregation with a special emphasis on the regulatory role of 14-3-3 on tau conformation.



The Mechanism of Rap1 Regulates N-cadherin to Control Neuronal Migration

Abstract

Rap1 and N-cadherin regulate glia-independent translocation of cortical neurons. It remains unclear how Rap1 regulates N-cadherin-mediated neuronal migration. Here, we overexpressed Rap1gap in mouse brains (embryonic day 16) to inactivate Rap1, and observed that neurons did not migrate to the outer layer. We confirmed that Rap1 was involved in the regulation of late neurons in vivo. Rap1gap overexpression and Rap1 suppression in CHO cells decreased the expression of cytoskeletal proteins such as tubulin. Changes in the expression of cell morphology regulators, such as N-cadherin and β-catenin, were also observed. Inhibition of N-cadherin in mouse brains prevented neuronal migration to the outer layer. The morphology of CHO cells was changed after overexpression of Rap1gap. We propose that Rap1 regulates the expression of N-cadherin during embryonic development, which affects β-catenin expression. Beta-catenin in turn regulates cytoskeletal protein expression, ultimately affecting neuronal morphology and migration.



Adult-Onset Hypothyroidism Alters the Metaplastic Properties of Dentate Granule Cells by Decreasing Akt Phosphorylation

Abstract

The expression of homosynaptic long-term depression (LTD) governs the subsequent induction of long-term potentiation (LTP) at hippocampal synapses. This process, called metaplasticity, is associated with a transient increase in the levels of several kinases, such as extracellular signal-regulated protein kinases 1/2 (ERK1/2), c-Jun N-terminal kinase (JNK), and Akt kinase. It has been increasingly realized that the chemical changes in the hippocampus caused by hypothyroidism may be the key underlying causes of the learning deficits, memory loss, and impaired LTP associated with this disease. However, the functional role of thyroid hormones in the "plasticity of synaptic plasticity" has only begun to be elucidated. To address this issue, we sought to determine whether the administration of 6-n-propyl-2-thiouracil (PTU) alters the relationship between priming and the induction of subsequent LTP and related signaling molecules. The activation of ERK1/2, JNK, and Akt was measured in the hippocampus at least 95 min after priming onset. We found that priming stimulation at 5 Hz for 3 s negatively impacted the induction of LTP by subsequent tetanic stimulation in hypothyroid animals, as manifested by a more rapid decrease in the fEPSP slope and population spike amplitude. This phenomenon was accompanied by lower levels of phosphorylated Akt in the surgically removed hippocampus of the hypothyroid rats compared to the euthyroid rats. The metaplastic response and the expression of these proteins in the 1-Hz-primed hippocampus were not different between the two groups. These observations suggest that decreased PI3K/Akt signaling may be involved in the compromised metaplastic regulation of LTP observed in hypothyroidism, which may account for the learning difficulties/cognitive impairments associated with this condition.



TP53 Polymorphism Contributes to the Susceptibility to Bipolar Disorder but Not to Schizophrenia in the Chinese Han Population

Abstract

TP53 has been reported to be involved in diverse neurological processes related to the pathogenesis of psychosis. In this study, we aim to determine the association of TP53 polymorphisms, rs1042522 and rs17879353, with the susceptibility to schizophrenia (SCZ) or bipolar disorder (BD) in Chinese Han population. A total of 548 SCZ patients, 512 BD patients, and 598 healthy controls were recruited. Genotyping was conducted through Sequenom MassARRAY technology platform. The quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect TP53 expression level. Results revealed that the allele frequency and genotype distribution of rs1042522 within BD patients were significantly different from those of the controls. Rs1042522 was significantly associated with BD risk under diverse genetic models. However, no significant association was found for rs17879353 and BD risk and for rs1042522 and rs17879353 and SCZ risk. TP53 expression was significantly increased in SCZ patients and BD patients compared with that in the controls but was significantly decreased in BD patients with CC genotype of rs1042522 compared with that in other BD patients with either CG or GG genotype. In summary, we observed for the first time that rs1042522 is significantly associated with BD risk in the Chinese Han population. The increased TP53 expression might affect the occurrence of BD and SCZ, and rs1042522 might affect the progress of BD by disturbing gene expression.



Myeloid-Related Protein 8/14 Participates in the Progression of Experimental Pneumococcal Meningitis by Augmentation of Inflammation

Abstract

It has been reported that myeloid-related protein 8/14 (MRP8/14) participates in the progression of inflammation after release from neutrophils and monocytes. This study aimed to clarify the mechanism(s) of the MRP8/14-augmented inflammatory response in mice with pneumococcal meningitis. Streptococcus pneumoniae (SP) meningitis was established by intracerebral injection of SP suspension. Balb/c mice were randomly divided into four groups and received the following injections: phosphate-buffer saline (PBS), MRP8/14 alone, SP alone, and SP plus MRP8/14. At 6 h, 24 h and 48 h postinfection, the clinical disease status was measured by the modified neurological severity score test, body weight loss and degree of cerebral edema; mice were anaesthetized, blood samples and brain samples were collected and brain inflammation was detected by haematoxylin and eosin (HE) staining; tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) levels in serum and brain homogenates were assessed by an enzyme-linked immunosorbent assay (ELISA), and the mRNA levels of the above cytokines in brain homogenates were measured by polymerase chain reaction (PCR); and the expression of nuclear factor-kappa B (NF-κB) p65 in brain tissues was determined by immunohistochemical assay. In this study, we identified that MRP8/14 substantially augmented the SP-stimulated inflammatory response, aggravated clinical disease status and exacerbated SP-induced brain edema in a murine model of pneumococcal meningitis. Exogenous administration of MRP8/14 significantly enhanced mRNA and protein expression of the proinflammatory cytokines and chemokines TNF-α, CRP, IL-6 and MCP-1 in brain homogenates and serum from mice with pneumococcal meningitis, which may be related to the NF-κB signalling pathway. We further found that MRP8/14 strongly augmented SP-induced phosphorylation of NF-κB p65 in brain tissue slices from the same model. In conclusion, our results indicated that MRP8/14 augmented the inflammatory response in mice with pneumococcal meningitis and contributed to the development of disease, which was probably through NF-κB signalling pathway activation.



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Osteoporosis

What information can the lay public find about osteoporosis treatment? A descriptive study coding the content and quality of bisphosphonate information on the internet

Abstract

Summary

Despite its effectiveness, bisphosphonate use for osteoporosis is low. We assessed bisphosphonate information on the internet and found the most commonly listed benefits/risks were bone density loss, gastrointestinal issues, and jaw necrosis, that risk quantification was rare, and information quality varied. Findings underscore the importance of clinical communication about bisphosphonates.

Introduction

The US Preventative Services Task Force recommends osteoporosis screening and treatment with bisphosphonates in high-risk populations. However, bisphosphonate use among individuals with osteoporosis remains low. The content and quality of information from outside sources may influence individuals' bisphosphonate decisions. Therefore, we sought to assess the content and quality of osteoporosis treatment information available to the public by conducting an internet search and coding available bisphosphonate information.

Methods

Eleven search terms about osteoporosis and bisphosphonates were entered into four search engines. Two raters assessed websites for information about bisphosphonates, whether and how benefits and side effects were described and quantified, contraindications, and dosing instructions. Coders also assessed website interface and slant/balance of information.

Results

One thousand four hundred seventy-three websites were identified. Two hundred twenty-seven websites met inclusion criteria and were coded. The most common bisphosphonate benefit described was prevention of bone density loss (77.1% of websites). The most common side effects described were gastrointestinal problems (66.1%) and jaw osteonecrosis (58.6%). Most websites did not quantify bisphosphonate benefits (78.0%) or side effects (82.4%). Complementary/integrative health websites (p < .001) and pharmaceutical litigation websites (p < .001) were more often slanted against taking bisphosphonates, compared to all websites coded. General medical knowledge websites were more balanced than other websites (p = .023).

Conclusions

The quality of bisphosphonate information on the internet varies substantially. Providers counseling patients about osteoporosis treatment should inquire about patients' baseline bisphosphonate knowledge. Providers can complement accurate information and address potential bisphosphonate misconceptions.



Correction to: Secondary prevention of osteoporotic fractures: evaluation of the Lille University Hospital's Fracture Liaison Service between January 2016 and January 2018

The original version of this article, published on 5 June 2019, an author's name was misspelled.



Multiple vertebral compression fractures after sleeve gastrectomy and a subsequent pregnancy: a case report

Abstract

We report that a 33-year-old woman developed multiple compression fractures several years after a sleeve gastrectomy followed by pregnancy. Despite normal areal BMD values assessed by dual-energy X-ray absorptiometry and no family history of osteoporosis, the patient demonstrated low lumbar spine trabecular bone score, as well as low peripheral trabecular volumetric BMD and deterioration of trabecular microarchitecture assessed by high-resolution peripheral quantitative computed tomography. Women of reproductive age should be provided with lifestyle management targeting bone health following bariatric surgery.



Association between serum uric acid and bone health in adolescents

Abstract

Summary

Previous studies are suggestive of the protective role of uric acid on bone in the middle-aged and elderly. Whether this association exists in younger individuals has not been examined. This investigation showed a significant positive association between serum uric acid and bone parameters among Iranian adolescents.

Introduction

Uric acid (UA) might be linked to bone health, but it is unclear whether its effects on bone are limited to certain population subgroups. This study is aimed at investigating the correlation between serum uric acid levels and bone mineral density (BMD) in Iranian adolescents.

Methods

This cross-sectional study was conducted on 413 (221 girls and 192 boys) Iranian adolescents aged 9–19 years. An analysis of anthropometric, biochemical parameters and bone density was performed on the participants. Measurements included serum uric acid, calcium, phosphorus, alkaline phosphatase, albumin, and vitamin D. They were divided according to their serum UA into the low UA group who had UA ≤ 6 mg/dL and the high UA group with UA > 6 mg/dL. BMD and bone mineral content (BMC) were measured in the total body, lumbar spine, and left femoral neck, using dual energy X-ray absorptiometry (DXA), and bone mineral apparent density (BMAD) was calculated.

Results

A Pearson correlation analysis revealed a significant correlation between UA and bone parameters. In multiple regression analyses adjusted for potential confounders, serum UA was proven to be associated with BMD and BMC at all sites. There was no association between UA, serum calcium, and vitamin D concentrations.

Conclusion

Our study, as the first research on adolescents, demonstrated a higher bone density in those who had higher UA levels.



History of cardiovascular disease and cardiovascular biomarkers are associated with 30-day mortality in patients with hip fracture

Abstract

Summary

Hip fractures are associated with increased mortality and it is important to identify risk factors. This study demonstrates that preexisting cardiovascular disease as well as cardiovascular biomarkers that are associated with increased 30-day mortality. These findings can be used to identify high-risk patients who might benefit from specialized care.

Introduction

This study investigates the association between cardiovascular disease (CVD), cardiovascular biomarkers, and 30-day mortality following a hip fracture.

Methods

The Danish National Patient Registry was used to investigate the association between CVD and mortality following hip fracture in a nationwide population-based cohort study. In a subset of the included patients (n = 355), blood samples were available from a local biobank. These samples were used for analyzing the association between specific biochemical markers and mortality. The primary outcome was 30-day mortality.

Results

A total of 113,211 patients were included in the population-based cohort study. Among these, heart failure was present in 9.4%, ischemic heart disease in 15.9%, and ischemic stroke in 12.0%. Within 30 days after the hip fracture, 11,488 patients died, resulting in an overall 30-day mortality of 10.1%. The 30-day mortality was significantly increased in individuals with preexisting CVD with multivariably adjusted odds ratios of 1.69 (95% confidence interval, 1.60–1.78) for heart failure, 1.23 (1.17–1.29) for ischemic heart disease, and 1.06 (1.00–1.12) for ischemic stroke. In the local database including 355 patients, 41 (11.5%) died within 30 days. The multivariably adjusted odds ratio for 30-day mortality increased with increasing NT-proBNP (2.36 [1.53–3.64] per quartile) and decreased with increasing HDL cholesterol (0.58 [0.41–0.82] per quartile). On this basis, we established a model for predicting the probability of death based on the biochemical markers.

Conclusion

Preexisting CVD was associated with increased 30-day mortality after a hip fracture. Furthermore, high levels of NT-proBNP and low levels of HDL cholesterol were associated with increased 30-day mortality.



Cost-effectiveness of pharmacological fracture prevention for osteoporosis as prescribed in clinical practice in France, Germany, Italy, Spain, and the United Kingdom

Abstract

Summary

This study estimated the cost-effectiveness of pharmacological fracture prevention as prescribed in the five largest European countries (EU5) using the IOF reference cost-effectiveness model. Pharmacological fracture prevention as prescribed in clinical practice was cost-saving (provided more QALYs at lower costs) compared to no treatment in each of the EU5.

Purpose

To estimate the real-world cost-effectiveness of pharmacological fracture prevention as prescribed in the five largest European countries by population size: France, Germany, Italy, Spain, and the United Kingdom (UK) (collectively EU5).

Materials and methods

We analyzed sales data on osteoporosis drugs in each of the EU5 to derive a hypothetical intervention that corresponds to the mix of osteoporosis medication prescribed in clinical practice. The costs for this treatment mix were obtained directly from the sales data, and the efficacy of the treatment mix was estimated by weighing the treatment-specific fracture risk reductions from a published meta-analysis. Subsequently, we estimated the cost-effectiveness using costs per quality adjusted life year (QALY) of the intervention compared to no treatment in each of the EU5 using the International Osteoporosis Foundation (IOF) reference cost-effectiveness model. The model population comprised postmenopausal women, mean age 72 years with established osteoporosis (T-score ≤ − 2.5) among whom 23.6% had a prevalent vertebral fracture. The model was populated with country-specific data from the literature.

Results

Pharmacological fracture prevention as prescribed in clinical practice was cost-saving (provided more QALYs at lower costs) compared to no treatment in each country. The findings were robust in scenario analyses.

Conclusions

Pharmacological fracture prevention as prescribed in clinical practice is cost-saving in each of the EU5. Because of the under-diagnosis and under-treatment of post-menopausal osteoporosis, from a health economic perspective, further cost-savings may be reached by expanding treatment to those at increased risk of fracture currently not receiving any treatment.



A population-based study of postfracture care in Manitoba, Canada 2000/2001–2014/2015

Abstract

Summary

We previously found that population-based postfracture notification, which informed primary care physicians of their patient's recent fracture and suggested assessment for osteoporosis, led to an improvement in postfracture care in the context of a randomized controlled trial (ClinicalTrials.gov identifier NCT00594789, fractures from late 2007 to mid-2010). Since June 2010, a province-wide postfracture notification program was implemented. This study was to (1) determine whether this program has resulted in sustained improvement in postfracture care and (2) test factors associated with receiving osteoporosis care.

Methods

A retrospective matched cohort study was performed using population-based health administrative data in Manitoba, Canada. We selected individuals aged 50+ years with an incident major osteoporosis fracture (MOF; N = 18,541) in fiscal years 2000/2001 to 2013/2014 and controls without a MOF (N = 92,705) matched (5:1) on age, sex, and residential area. The Cochran-Armitage test tested for a linear trend in osteoporosis care outcomes for cases and controls. Logistic regressions were used to test characteristics associated with the likelihood of receiving osteoporosis care.

Results

The percentage of individuals receiving DXA testing and/or osteoporosis medication increased in fracture cases (p < 0.001), but decreased in controls (p < 0.001). Odds ratios for osteoporosis care in years following the postfracture notification program were approximately double of those prior to the clinical trial. In addition to prior MOF (OR 9.03, 95% CI 8.60–9.48), factors associated with osteoporosis care included lower income (OR   0.72, 95% CI 0.67–0.78), glucocorticoid use (OR   4.37, 95% CI 3.72–5.14), diabetes diagnosis (OR =  0.74, 95% CI 0.68–0.80), and Charlson Comorbidity Index (indexes 1–2: OR 1.27, 95% CI 1.20–1.34; indexes 3–5: OR 1.26, 95% CI 1.13–1.40).

Conclusions

Adopting a population-based postfracture notification program led to sustained improvements in postfracture care.



World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2019): Posters Abstracts


WORLD CONGRESS ON OSTEOPOROSIS, OSTEOARTHRITIS AND MUSCULOSKELETAL DISEASES


World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2019): ESCEO-IOF USA Symposium Abstracts


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

General Internal Medicine

Capsule Commentary on Jetelina et al., Patient-Reported Barriers to Completing a Diagnostic Colonoscopy Following Abnormal Fecal Immunochemical Test among Uninsured Patients


How Do We Address the Influence of Social Determinants on Health?


Practicing Clinicians' Recommendations to Reduce Burden from the Electronic Health Record Inbox: a Mixed-Methods Study

Abstract

Background

Workload from electronic health record (EHR) inbox notifications leads to information overload and contributes to job dissatisfaction and physician burnout. Better understanding of physicians' inbox requirements and workflows could optimize inbox designs, enhance efficiency, and reduce safety risks from information overload.

Design

We conducted a mixed-methods study to identify strategies to enhance EHR inbox design and workflow. First, we performed a secondary analysis of national survey data of all Department of Veterans Affairs (VA) primary care practitioners (PCP) to identify major themes in responses to a free-text question soliciting suggestions to improve EHR inbox design and workflows. We then conducted expert interviews of clinicians at five health care systems (1 VA and 4 non-VA settings using 4 different EHRs) to understand existing optimal strategies to improve efficiency and situational awareness related to EHR inbox use. Themes from survey data were cross-validated with interview findings.

Results

We analyzed responses from 2104 PCPs who completed the free-text inbox question (of 5001 PCPs who responded to survey) and used an inductive approach to identify five themes: (1) Inbox notification content should be actionable for patient care and relevant to recipient clinician, (2) Inboxes should reduce risk of losing messages, (3) Inbox functionality should be optimized to improve efficiency of processing notifications, (4) Team support should be leveraged to help with EHR inbox notification burden, (5) Sufficient time should be provided to all clinicians to process EHR inbox notifications. We subsequently interviewed 15 VA and non-VA clinicians and identified 11 unique strategies, each corresponding directly with one of these five themes.

Conclusion

Feedback from practicing end-user clinicians provides robust evidence to improve content and design of the EHR inbox and related clinical workflows and organizational policies. Several strategies we identified could improve clinicians' EHR efficiency and satisfaction as well as empower them to work with their local administrators, health IT personnel, and EHR developers to improve these systems.



Strengthening the Medical Error "Meme Pool"

Abstract

The exact number of patients in the USA who die from preventable medical errors each year is highly debated. Despite uncertainty in the underlying science, two very large estimates have spread rapidly through both the academic and popular media. We utilize Richard Dawkins' concept of the "meme" to explore why these imprecise estimates remain so compelling, and examine what potential harms can occur from their dissemination. We conclude by suggesting that instead of simply providing more precise estimates, physicians should encourage nuance in public medical error discussions, and strive to provide narrative context about the reality of the complex biological and social systems in which we practice medicine.



Physicians Interrupting Patients


Capsule Commentary on Gordon et al., The Impact of Medicaid Expansion on Continuous Enrollment: a Two-State Analysis


Veteran Satisfaction with Early Experiences of Health Care Through the Veterans Choice Program: a Concurrent Mixed Methods Study

Abstract

Background

The 2014 Veterans Access, Choice and Accountability Act (i.e., "Choice") allows eligible Veterans to receive covered health care outside the Veterans Affairs (VA) Healthcare System. The initial implementation of Choice was challenging, and use was limited in the first year.

Objective

To assess satisfaction with Choice, and identify reasons for satisfaction and dissatisfaction during its early implementation.

Design and Participants

Semi-structured telephone interviews from July to September 2015 with Choice-eligible Veterans from 25 VA facilities across the USA.

Main Measures

Satisfaction was assessed with 5-point Likert scales and open-ended questions. We compared ratings of satisfaction with Choice and VA health care, and identified reasons for satisfaction/dissatisfaction with Choice in a thematic analysis of open-ended qualitative data.

Results

Of 195 participants, 35 had not attempted to use Choice; 43 attempted but had not received Choice care (i.e., attempted only); and 117 attempted and received Choice care. Among those who attempted only, a smaller percentage were somewhat/very satisfied with Choice than with VA health care (17.9% and 71.8%, p < 0.001); among participants who received Choice, similar percentages were somewhat/very satisfied with Choice and VA health care (66.6% and 71.1%, p = 0.45). When asked what contributed to Choice ratings, participants who attempted but did not receive Choice care reported poor access (50%), scheduling problems (20%), and care coordination issues (10%); participants who received Choice care reported improved access (27%), good quality of care (19%), and good distance to Choice provider (16%). Regardless of receipt of Choice care, most participants expressed interest in using Choice in the future (70–82%).

Conclusions

Access and scheduling barriers contributed to dissatisfaction for Veterans unsuccessfully attempting to use Choice during its initial implementation, whereas improved access and good care contributed to satisfaction for those receiving Choice care. With Veterans' continued interest in using services outside VA facilities, subsequent policy changes should address Veterans' barriers to care.



Capsule Commentary on Homoya et al., Uncertainty as a Key Influence in the Decision to Admit Patients with Transient Ischemic Attack


Capsule Commentary on Bond et al., Real-time Feedback in Pay-for-Performance: Does More Information Lead to Improvement?


Capsule Commentary on Zhang et al., Combined healthy lifestyle behaviors and disability-free survival: the Ohsaki Cohort 2006 Study


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Medicine

Symptomatic posterior fossa and supratentorial subdural hygromas as a rare complication following transarticular screw fixation with posterior wiring for atlantoaxial instability: A case report
imageRationale: Atlantoaxial transarticular screw fixation has been an effective and appealing method for inducing fusion of the C1-C2 complex. This technique is usually performed with Gallie fusion. In performing Gallie fusion using sublaminar wiring, a major concern is the risk of dural tear associated with passing sublaminar wires through the epidural space. We present the first report on symptomatic symptomatic subdural hygroma (SDH) due to transarticular screw fixation with posterior wiring. Patients concerns: A 50-year-old man had sustained dens fracture 20 years ago and presented with severe neck pain following a recent traffic accident. The images showed atlantoaxial instability due to nonunion of the dens fracture and the patient underwent transarticular screw fixation with posterior sublaminar wiring using Gallie technique. When the U-shaped wire was passed under the arch of C1 from inferior to superior, a dural tear and cerebrospinal fluid (CSF) leak occurred. The site of dural tear was repaired by direct application of sutures. The patient was discharged in good condition. Fifteen day after surgery, the patient was readmitted with a history of a progressive headache associated with vomiting and vertigo. Diagnonsis: Brain CT and MRI showed bilateral posterior fossa and a right-sided supratentorial SDH. Interventions: The patient underwent right occipital burr hole and evacuation of posterior fossa SDH due to deteriorating neurological status. Outcomes: The patient's condition gradually improved after the operation and became asymptomatic at 3-year follow-up. Lessons: Posterior fossa and supratentorial SDH could occur resulting from any intraoperative dural tear and CSF leakage during posterior cervical spinal surgery. Symptomatic SDH after posterior cervical spinal surgery should be cautiously assessed and treated. Level of Evidence: 5

Diagnostic and prognostic role of HE4 expression in multiple carcinomas: A protocol for systematic review and meta-analysis
imageBackground: Human epididymis protein 4 (HE4) protein has garnered a great degree of interest as a complementary biomarker to carbohydrate antigen 125 (CA125), or even as an independent biomarker for monitoring, diagnosis, and prognostication of ovarian cancer. Its use is currently limited to ovarian cancer. Recent studies have suggested that it could also be used in other types of cancers. Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines was used to design this meta-analysis protocol. The final study will also be conducted under the PRISMA guidelines for systematic reviews and meta-analyses. The core bibliographic database search will be carried out by 2 reviewers working individually, with each conducting an initial screening based on titles and abstracts. The shortlisted articles will be selected for review and statistical analysis based on predefined inclusion and exclusion criteria. Study characteristics, relevant clinicopathological characteristics and statistical data required for meta-analysis (hazard ratios [HRs] and 95% confidence interval [CIs) will be extracted and compiled into a MS Excel datasheet. Meta-analysis will be performed, using a random-effects model, and the results (pooled HR and 95% CI) will be presented in the form of a forest plot. Publication bias will also be assessed by use of Egger bias indicator test and funnel plot symmetry. If data are insufficient, a narrative line of review will be pursued. Discussion: HE4 protein has been shown to have great potential for clinical use as a diagnostic and prognostic marker in epithelial ovarian cancer (EOC). However, HE4 is not only limited to expression in ovarian cancer, but is also overexpressed in lung and endometrial cancers. The effectiveness of HE4 as a biomarker in cancers (other than EOC) has not yet been studied in the form of a comprehensive systematic review and meta-analysis. The results of this study should allow for expanded use of HE4 as a multiutility biomarker in multiple cancer types, thereby, elevating HE4's value as a cancer biomarker. PROSPERO registration: CRD42019120326.

Prognostic significance of polyvascular disease in heart failure with preserved left ventricular ejection fraction
imageThe prognostic significance of systemic atherothrombosis in heart failure (HF) with preserved ejection fraction (HFpEF) remains unclear. This study aimed to investigate the relation between the presence of polyvascular disease (PVD) and cardiovascular outcomes in HFpEF patients. A total of 510 consecutive HFpEF patients were prospectively observed for up to 1500 days or until occurrence of cardiovascular events. PVD was defined as ≥2 coexistence of coronary artery disease, peripheral arterial disease, and cerebrovascular disease. Overall, 124 cardiovascular events were observed during follow-up (median: 1430 days). Kaplan–Meier curve showed HFpEF with PVD (n = 84) experienced more cardiovascular events than did those without PVD patients (44.0% vs 20.4%, log-rank: P < .001). Multivariable Cox proportional hazards analysis with significant factors from univariate analysis showed the presence of PVD (hazard ratio [HR]: 2.875, 95% [CI]: 1.894–4.365, P < .001), previous HF hospitalization (HR: 1.578, 95% CI: 1.031–2.414, P = .036), hemoglobin (HR: 0.889, 95% CI: 0.805–0.983, P = .021), serum sodium (HR: 0.946, 95% CI 0.896–1.000, P = .048), ln-BNP (per 1.0, HR: 1.255, 95% CI: 1.055–1.494, P = .010), and E/e' (HR: 1.047, 95% CI: 1.020–1.075, P < .001) significantly predicted future cardiovascular events. Multivariable Cox hazard analysis with 4 established factors (age, BNP, diabetes mellitus, and previous HF hospitalization) from the I-PRESERVE (Irbesartan in HFpEF) study showed PVD was independently associated with cardiovascular events in HFpEF patients (HR: 2.562, 95% CI: 1.715–3.827, P < .001). The presence of PVD is significantly associated with cardiovascular events in HFpEF, suggesting the importance of screening PVD in HFpEF.

Disappearance of the blood supply to a giant uterine myoma due to childbirth: A CARE-compliant article
imageRationale: Giant uterine myomas may be life-threatening due to pressure effects on the lungs and other contiguous organs. Patient concerns: A 32-year-old pregnant Asian woman was admitted to our hospital early in her pregnancy with a pre-pregnancy history of multiple uterine myomas. Diagnosis: She was diagnosed with multiple giant uterine myomas in pregnancy. Interventions: No intervention was performed on the woman. Outcomes: A reduction in tumor size and disappearance of tumor blood supply were seen on conventional and contrast-enhanced ultrasounds (CEUS) on postpartum day 34. Mass volume gradually decreased and no blood flow signals were seen on CEUS during postpartum follow-up. Lessons: Childbirth can block the blood supply of giant uterine myomas and reduce mass size. In such cases, childbirth may be considered therapeutic.

Effect and safety of LCZ696 in the treatment of hypertension: A meta-analysis of 9 RCT studies
imageBackground: LCZ696 has been introduced in patients with hypertension in several trials. Here, we performed a meta-analysis to evaluate the effect and safety of LCZ696 in hypertensive patients. Methods: PubMed, Embase, the Cochrane Library and ClinicalTrials.gov databases were searched to identify the available randomized controlled trials (RCTs) investigating the effect and safety of LCZ696 in hypertension patients. The last search date was October 31, 2018. Results: Nine RCTs with 6765 subjects were finally included, in which 8 trials compared the effect and safety between LCZ696 and angiotensin receptor antagonists (ARBs). Evidences showed LCZ696, compared with ARBs, achieved a better blood pressure control rate (OR 1.24, 95% CI: 1.14–1.35), specifically, LCZ696 were better at reducing systolic blood pressure [WMD −4.11 mmHg, 95% CI: (−5.13, −3.08) mmHg], diastolic blood pressure [WMD −1.79 mmHg, 95% CI: (−2.22, −1.37) mmHg], mean 24-hour ambulatory systolic blood pressure [WMD −3.24 mmHg, 95% CI: (−4.48, −1.99) mmHg] and mean 24-hour ambulatory diastolic blood pressure [WMD −1.25 mmHg, 95% CI: (−1.81, −0.69) mmHg]. There was no difference in the events of adverse events (risk ratio [RR] 1.01, 95% CI: 0.39–1.09), serious adverse events (RR 0.80, 95% CI: 0.52–1.22) and discontinuation of treatment for any adverse events (RR 0.79, 95% CI: 0.56–1.11) between LCZ696 group and ARB/placebo group, except LCZ696 reduced the rate of headaches (RR 0.69, 95% CI: 0.48-0.99) while increased cough (RR 2.12, 95% CI: 1.11–4.04; P = .02; I2 = 25%). Conclusion: Our finding provides evidence that LCZ 696 was more effective than ARB on blood pressure control and was safe enough in patients with hypertension.

Association between tongue coating thickness and ultraviolet fluorescence in patients with functional dyspepsia: A prospective observational study
imageThe aim of this study was to examine the correlation between the tongue coating thickness (TCT) and ultraviolet (UV) fluorescence and propose a new method for the estimation of TCT using a computerized tongue image acquisition system (CTIS). In this prospective and observational single-center study, we acquired tongue images under visible light and near-UV light for 60 patients with functional dyspepsia. Tongue images were acquired twice within a 30-minute interval to assess the reliability of CTIS. Then, the tongue coating was scraped and weighed to derive the wet weight of the tongue coating (WWTC). The percentage of the tongue coating area was calculated from the tongue images acquired under visible light. Mean color values (mCVs) for the UV fluorescence of the dorsal surface of the tongue were also computed. The reliabilities of the derived mCVs and percentage of the tongue coating area were acceptable (intraclass correlation coefficients, 0.907–0.947). The mCVs were more strongly correlated with WWTC than with the area, with mCV of modified lightness showing the strongest association (r = 0.785, P < .01). Finally, we suggested an estimation model for TCT based on the results. The results of this study suggest that both UV fluorescence of the dorsal tongue and the distribution area of tongue coating are useful parameters for the quantitative assessment of tongue coating. We believe that these findings will contribute to the development of a clinically useful CTIS.

A network meta-analysis protocol of adjuvant chemotherapy for unresectable patients with advanced gastric cancer
Background: The treatment methods about surgery, chemotherapy, and radiation therapy were recommended for gastric cancer (GC) patients by National Comprehensive Cancer Network (NCCN) guidelines. However, for the advanced gastric cancer patients or with metastatic lesions who have lost their chance of surgery, the current adjuvant chemotherapy treatments are still controversial. Therefore, this network meta-analysis is mainly to assess the relative efficacy of different adjuvant chemotherapy regimens for advanced gastric cancer (AGC). Methods: In order to compare the relative efficacy among different adjuvant chemotherapy regimens for AGC patients, randomized controlled trials (RCTs) and non-RCTs were systematic searched in PubMed, Web of Science, Clinical Trials, Cochrane Library and Embase database. R-3.4.1 software will be used for data analysis. The risk of bias in RCTs and non-RCTs will be evaluated through the risk of bias tool from the Cochrane Handbook version 5.1.0 and non-randomized studies of interventions (ROBINS-I), respectively. Results and conclusion: The results of this network meta-analysis will evaluate the relative effectiveness and rank the interventions among all chemotherapy methods for unresectable AGC patients, and provide more evidence-based guidance in clinical practice. Protocol registration number: CRD42018111835.

The effect of magnesium sulfate on surgical field during endoscopic sinus surgery: A meta-analysis of randomized controlled trials
imageIntroduction: The benefits of magnesium sulfate for surgical field during endoscopic sinus surgery remain controversial. We conduct a systematic review and meta-analysis to explore the influence of magnesium sulfate versus placebo on surgical field during endoscopic sinus surgery. Methods: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through November 2018 for randomized controlled trials (RCTs) assessing the effect of magnesium sulfate versus placebo on surgical field during endoscopic sinus surgery. This meta-analysis is performed using the random-effect model. Results: Four RCTs and 404 patients are included in the meta-analysis. Overall, compared with control group endoscopic sinus surgery, magnesium sulfate has remarkably positive impact on surgical field scores (MD = −1.76; 95% CI = −2.33 to −1.18; P < .00001), and intraoperative blood loss (MD = −89.09; 95% CI = −163.20 to −14.97; P = .02), but shows no markedly effect on surgery duration (MD = −7.08; 95% CI = −21.38 to 7.22; P = .33), fentanyl (MD = −0.64; 95% CI = −1.97 to 0.70; P = .35), and vecuronium (MD = −3.64; 95% CI = −10.99 to 3.70; P = .33). Conclusions: Magnesium sulfate exerts positive impact on surgical field and blood loss reduction for endoscopic sinus surgery.

Uniport video assisted thoracoscopic surgery (U-VATS) exhibits increased feasibility, non-inferior tolerance, and equal efficiency compared with multiport VATS and open thoracotomy in the elderly non-small cell lung cancer patients at early stage
imageThis study aimed to compare the feasibility, efficacy and safety among uniport video assisted thoracoscopic surgery (U-VATS), multiport VATS (M-TATS), and open thoracotomy in elderly non-small cell lung cancer (NSCLC) patients at early stage. One hundred ninety-one elderly NSCLC patients at early stage underwent U-VATS (N = 73), M-VATS (N = 56) or open thoracotomy (N = 62) were included. Perioperative parameters, short-term outcomes, postoperative complications, and overall survival (OS) were assessed. Three-group analysis disclosed that operational duration, blood loss, drainage duration, hospital stay, pain score on the first day (D1) and D3, patients' global assessment (PGA), lasing air leak, infection, arrhythmia, and cardio-cerebrovascular events incidences were different among U-VATS, M-VATS, and open thoracotomy groups. Subsequently, 2-group analysis revealed that: Pain score on D1 and D3 and PGA score were decreased in U-VATS group compared with M-VATS group;The operational duration was longer, blood loss, drainage duration, hospital stay, pain score on D1 and D3, PGA score, lasing air leak, infection, arrhythmia, and cardio-cerebrovascular events were decreased in U-VATS group than open thoracotomy group;The operational duration was longer, blood loss, drainage duration, hospital stay, pain score on D1 and D3, lasing air leak, infection, and arrhythmia were reduced in M-VATS group than open thoracotomy group. In addition, there was no difference of OS among 3 groups, nor between any of the 2 groups. U-VATS presents with elevated feasibility, non-inferior tolerance, and similar efficacy compared with M-VATS and open thoracotomy in the elderly NSCLC patients at early stage.

The mediating and moderating roles of self-acceptance and self-reported health in the relationship between self-worth and subjective well-being among elderly Chinese rural empty-nester: An observational study
imageThis study aims to test the moderation and mediation effects of self-acceptance and self-reported health on self-worth's impact on subjective well-being among elderly Chinese rural empty-nester elderly, and confirm whether self-report health is a moderating variable between self-worth and subjective well-being. This cross-sectional study was performed from May 2017 to April 2018; the participants were 365 empty-nest elderly adults from rural areas of Chifeng City in Inner Mongolia. Data were collected with the General information questionnaire, Self-worth questionnaire for adults, Self-acceptance Questionnaire, and Memorial University of New Found land Scale of Happiness. For the analyses, correlations, regressions, and structural equation models were used. Bootstrapping was performed to confirm the mediation effect. Multiple regression analysis was performed to confirm the moderation effect. Self-worth showed significant correlations with self-acceptance and subjective well-being (all P < .01). Bootstrapping indicated that the mediating role of self-acceptance was statistically significant. And self-reported health moderated the self-worth and subjective well-being association. Self-acceptance partially mediated the relationship between self-worth and subjective well-being of the rural empty-nest elderly and self-reported health moderated self-worth and subjective well-being association. Consequently, to improve the subjective well-being of the rural empty-nest elderly, self-acceptance and personal health should be the focus.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480