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Τετάρτη 29 Μαΐου 2019

Health Sciences

Modeling and designing indices of talent identification in the field of basketball based on physical-motor, psychological, anthropometric, and physiological parameters
Keshavarz Loghman, Farahani Aboalfazl, Zarei Bidsorkhi Ali

International Archives of Health Sciences 2019 6(2):59-64

Aims: The purpose of this study was to modeling and designing indices of talent identification (TID) in the field of basketball based on physical-motor, psychological, anthropometric, and physiological parameters. Materials and Methods: The research method was qualitative (grounded theory) that was done on the field by interpretive analysis of deep interviews, including 21 experts in; TID (among professional clubs), basketball coaches (among premier league), and university professors (among professors of Tehran University, Shahid Beheshti University, and Kharazmi University). The validity of the interviews was confirmed by verifying the views of experts in the final results, and the reliability of the interviews was also confirmed through process audits and intrasubject agreement of two coders (84%). The analysis of interviews was done through interpretive analysis technique using open coding, axial coding, and selective coding. Results: As a result of the analysis of the interviews, 10 categories, 30 subcategories, and 101 key concepts were extracted. After axial and selective coding of the categories, a paradigm model was presented for TID in basketball. Conclusions: Finally, further explanations and suggestions are provided for each of the categories. 


Taxation for reducing purchase and consumption of sugar-sweetened beverages: A systematic review
Seyyed Reza Sobhani, Mina Babashahi

International Archives of Health Sciences 2019 6(2):65-72

Aims: Noncommunicable diseases (NCDs) are common in worldwide and lead to a dramatic rise in mortality. Excess consumption of sugar due to dietary changes can lead to arising calorie intake that contributes to weight gain, adiposity, and NCDs. Taxes, subsidies, and other economic executive policy have a key role in discouraging the consumption of unhealthy food. This study was aimed at a systematic review of recent research evidence about the tax impacts on the purchase and consumption of sugar-sweetened beverages (SSBs). Materials and Methods: Five databases, including PubMed, Scopus, Science Direct, CENTERAL, and EMBASE, were systematically searched from 2000 to May 2017. Results: Seven studies were included in this review. In six of the seven experimental studies reviewed demonstrated that consumers can be responsive to changes in food and drink prices. Taxing SSBs effectively could decrease food purchases, increasing SSBs price, and reducing consumption. Reducing the consumption of these beverages results in reduced overweight, obesity, and body mass index among populations. Conclusion: The current evidence base appears to converge and suggests that the fiscal strategy is likely to reduce purchases of high sugar products at least in the short term and likely can lead to decreasing calorie intake. 


Extranodal nasofacial natural killer/T-Cell lymphoma often missed by clinician
Santosh Kumar Swain, Prabodh Kumar Das, Mahesh Chandra Sahu

International Archives of Health Sciences 2019 6(2):73-77

Aim: This study aims to review the current literature and to focus on etiopathogenesis, clinical profile, diagnosis, and treatment of extranodal nasofacial natural killer (NK)/T-cell lymphoma. Materials and Methods: It is based upon the available literatures from PubMed, Scopus, and Google scholar with the keywords: etiopathogenesis, clinical pictures, diagnostic methods, and current treatment of extranodal nasofacial NK/T-cell lymphoma from 2002 to 2017. Results: Primary nasofacial lymphoma is a rare form of malignancy in head and neck area. Extranodal nasofacial NK/T-cell lymphoma is an unusual clinical entity, which is an aggressive entity of non-Hodgkin's lymphoma with distinct clinicopathological pictures. It is possibly associated with Epstein–Barr virus infection. It is highly aggressive disease with poor prognosis. Nasofacial NK/T-cell lymphoma or lethal midline granuloma is often associated with destruction of midface and surrounding areas such as orbit, paranasal sinuses, and palate. The clinical picture is highly variable, often missed by clinician and depends on location and histopathological type of the lesion. Histopathological and immunohistochemistry are important tools for diagnosis of nasofacial NK/T-cell lymphoma. Histopathological picture shows angiocentric and angiodestructive pattern of tumor cells which often mimic vasculitis. Radiotherapy is the treatment of choice which improves quality and longevity of life whereas addition of chemotherapy gives additional benefit to the patients. Conclusion: Practicing physicians and otorhinolaryngologist need to be aware of this nonspecific presentation of lesion to prevent delay in diagnosis. Early diagnosis and intervention prolongs the survival of the patients. 


Evaluation of evolutionary status of 4–60-month-old children in Kashan and Aran-Bidgol and its related factors in 2016–2017
Seyed-Alireza Moraveji, Hamideh Ghaffarian, Fatemeh Atoof, Davarkhah Rabbani, Maryam Ahmadishad

International Archives of Health Sciences 2019 6(2):78-83

Background: Paying attention to Children's evolutionary status help to improve their mental capacity and make them more intelligent and creative adults. The present study aimed to investigate the developmental status in 4–60-month-old children of Kashan and Aran-Bidgol and its related factors in 2016–2017. Methods: This descriptive cross-sectional study was performed on 656 children aged 4–60 months in Kashan and Aran-Bidgol that were recruited by a stratified random sampling method. Data were collected through self-report using Ages and Stages Questionnaire (ASQ) and demographic and clinical questionnaire. The ASQ consists of 30 questions in five domains including communication, gross motor, fine motor, problem-solving, and personal-social skills. The inter-rater agreement coefficient of 93%, the Cronbach's alpha coefficient of 0.51–0.87, and the 2-week test–retest correlation of 0.75 are reported for this questionnaire. Data were analyzed using descriptive statistics as well as Chi-square, ANOVA, and t-test. The significance level was considered <0.05. Results: The results showed that 527 (80.3%) of the 656 children were healthy, and the rest had a disorder at least in one of the developmental domains, including 1.5% disorders in communication skills, 6.2% in gross motor, 1.2% in fine motor skills, 1.2% in problem-solving, and 0.9% in the personal-social area. There was a significant relationship between developmental disorders with the child's gender and birth weight. Among maternal characteristics, there was a significant relationship between the mother's job and age with developmental delay. Conclusion: Despite the normal evolution in most children of Kashan and Aran-Bidgol, a significant number of them had a disorder at least in one of the evolutionary domains. It is essential to sensitize the families about the developmental process of their children and encourage them to alleviate the risk factors to prevent early complications of these disorders in the future. 


Burnout among the Nurses of Kashan Beheshti Hospital During 2014
Manijeh Kadkhodaei, Gholam Abbass Moosavi, Roya Seyyedi

International Archives of Health Sciences 2019 6(2):84-88

Aims: Research suggests that burnout levels have always been higher in the health-care populations and the nurses were at high risk too. It can increase staff turnover and reduce the quality of care. Hence, this study was performed with the purpose of evaluating the rate of professional burnout in the nurses of Beheshti hospital's staff. Materials and Methods: The study population comprised 230 nurses of the Beheshti hospital of Medical Sciences using sampling in 2014. Maslach Burnout Inventory and staff demographic characteristics questionnaire were used in this study. Data were analyzed using the SPSS software, Pearson's independent, Fisher's exact test, ANOVA, and Chi-square test. Results: Most of the participants were in mild-to-moderate levels of exhaustion. they had mild level until severe in depersonalization, and mild in reduced personal accomplishment. however, burnout was higher in women . Health-care staff nurses had a higher level of job burnout than that of administrative staffs (P < 0.001). Conclusions: The findings suggest the research focused could yield important advances in understanding burnout in this group and yield potential interventions to buffer burnout and its consequences. 


Comparing Two Instructing Methods: Instructor-Based (Traditional Lecture) and Student-Based (Class Conference), in Healthcare Learning in Kashan Medical Science University
Ebrahim Koochaki, Monika Motaghi

International Archives of Health Sciences 2019 6(2):89-92

Aims: Evaluating different methods of profound learning and efficient memorizing is a vital solution for medical science students because of the importance of this science. The present study overviews the comparison between the traditional instructing and the class conference methods. Materials and Methods: This quasi-experimental study was conducted on 50 students of Kashan in 2016 and 2017 selected by available sampling method. For the first group (25 students), instructing was performed via traditional lecture, and the second (25 students) experienced class conference approach. At the end of each semester, the satisfaction questionnaire assessment and knowledge of the students distributed among the subjects and filled out, then analyzed by SPSS 16 software. Results: The mean scores obtained from traditional lecture and class conference approaches were 95 with 4.2 ± 0.41 and 96 with 4.44 ± 0.36, respectively (T = 0.6, P = 0.06), which demonstrated no significant difference. Furthermore, the students' satisfaction level of lecture and conference was measured as 3.87 ± 0.41 and 4.58 ± 0.25, respectively, which revealed a significant difference (P = 0.04). Conclusion: Although the two instructing approaches used in this study did not considerably affect the final scores of the students, and no statistically significant difference was observed among the students for the two methods, class conference could mostly draw attention of the students. Therefore, extended research on applying student-based rather than instructor-based approaches is suggested. 


Relationship between developmental assets and addiction potential with regard to mediating role of alexithymia in adolescents of Arak, Iran
Akram Mazloomi, Hossein Davoudi, Hasan Heidari, Mohammad Asgari

International Archives of Health Sciences 2019 6(2):93-100

Aims: This study aimed at presenting a model for addiction potential based on developmental assets mediating by alexithymia in adolescents living in Arak, Iran. Materials and Methods: Five hundred members were selected as samples (n = 500) among female and male second-grade high school students at the tenth and eleventh academic grades in Arak using cluster random sampling. To collect data, Iranian Addiction Potential Scale, Toronto Alexithymia Scale and Developmental Assets Profile were used. The data were analyzed using Structural Equation Modeling and LISREL Software. Results: Model fit indices had suitable model fit with data. Internal developmental assets with path coefficient of B = −0.48 were more effective in reducing addiction potential compared with external developmental assets with path coefficient of B = −0.27. Positive identity, empowerment, and social competency were the most effective components of developmental assets in reducing addiction potential. Internal assets could explain addiction potential in adolescence more than external assets. Conclusion: Direct effect of developmental assets on addiction potential was confirmed and its indirect effect with mediation of alexithymia was significant. Moreover, results showed that only internal developmental asset had an effect on addiction potential in adolescents mediating by alexithymia, so the effect of external developmental asset on addiction potential in adolescents based on the mediation of alexithymia was rejected. 


The effect of acceptance and commitment therapy on the conflict resolution styles of incompatible marital women
Maryam Farahanifar, Hasan Heidari, Hosein Davodi, Seyed Ali Aleyasin

International Archives of Health Sciences 2019 6(2):101-107

Aim: Acceptance and commitment therapy (ACT) is one of the third-generation behavioral therapies in which it is attempted to increase the psychological relationship of an individual with his or her thoughts and feelings instead of changing cognition. The purpose of this study was the effectiveness of ACT on conflict resolution styles of incompatible marital women. Methods: This is a semi-experimental, pretest and posttest design and a 3-month follow-up. The statistical population of the study consisted of all incompatible women who referred to counseling centers in Arak in 2018. Therefore, 24 participants were selected by convenience sampling method and randomly assigned to one test groups and one control group of 12 participants for each. Data were collected in the pretest, posttest and follow-up stages with (the Conflict Resolution Styles Scale or Rahim Organizational Conflict Inventory-II). The test group received a therapeutic intervention based on ACT for twelve 90-min sessions, but no therapy was provided for the control group. After the completion of treatment sessions, both groups were subjected to posttest. The data were analyzed using analysis of variance with repeated measures and Bonferroni post-hoc test. Results: The results showed that there was a statistically significant difference between the posttest scores of the test group compared with that of the control group (P < 0.05), and the difference was suitably sustainable during the time. Conclusion: ACT is considered as an effective intervention in improving conflict resolution styles. 


The effect of visual training on the rate of performance accuracy in girl soccer players
Azam Afshar, Jaleh Baqerli, Morteza Taheri

International Archives of Health Sciences 2019 6(2):108-113

Aims: The purpose of this study was to determine the effect of visual training on the performance of shooting skills of soccer girl players. Materials and Methods: The research method was quasi-experimental, in which the participants were assigned into experimental and control groups, with pre-test and post-test design. The participants were girl soccer players in Alborz province. In this study, among the community, 45 athletes with an average age of 19.3 ± 1.4 years were selected from club in Alborz province. The research tool was based on Raven and Gibor's vision exercises and a researcher-made exercise protocol (colored gates, colored caissons). Specific visual training and researcher-made sports vision exercises were performed for 2 weeks (three sessions per week and 12 min each session). The covariance analysis and Bonferron's post hoc test were used to analyze the data. Results: The results of the study showed that there was a significant difference between the rate of performance accuracy of soccer players in visual training, athletic-based visual training, and control groups (P = 0.000). It was also indicated that visual training had no significant effect on the performance of soccer girls' shots (P = 0.003). However, sports–visual exercises improved their shooting skills (P = 0.002). Conclusion: Specific visual training could be more beneficial in improving the performance of soccer girls' shots. 


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

Acta Neurologica

MRI findings in liquor hypotension syndrome


Dynamic thiol/disulphide homeostasis in children with Duchenne muscular dystrophy

Abstract

Duchenne muscular dystrophy (DMD) is a disorder that alter the expression of the dystrophin protein. Dystrophin deficiency alters the structural integrity of the contractile apparatus/sarcolemmal integrity, leading to dystrophic changes. Dystrophin deficiency results in an increase in oxidative stress. We aimed to investigate the thiol/disulfide balance as an oxidative stress marker in children with DMD. We included 24 DMD, and 22 healthy control group subjects in the study. The total thiol, native thiol, and disulphide levels were measured and the disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios were calculated in DMD patients and healthy subjects. The mean age distribution of the patients and the healthy control group subjects was similar. The total thiol, native thiol, and disulfide levels were lower in DMD group than the healthy controls. In conclusion, the markers and ratios were measured and calculated in the blood, and we detected that the total thiol, and native thiol levels were lower in DMD group than the healthy controls. These results indicate that dynamic thiol-disulphide homeostasis can be used as a marker of oxidative stress in clinical trials with DMD.



Distal 1q21.1 and proximal 1q21.2 microduplication in a child with attention-deficit hyperactivity disorder


Central-variant posterior reversible encephalopathy syndrome in a young patient with systemic lupus erythematosus


Serum troponin T in patients with amyotrophic lateral sclerosis


Brain abscess due to Nocardia infection in an immunocompetent patient with asymptomatic pulmonary alveolar proteinosis


Writer's cramp: a new dystonic feature in spinocerebellar ataxia type 3


Predictors of amyotrophic lateral sclerosis mimic syndrome

Abstract

The term amyotrophic lateral sclerosis mimic syndrome (ALSms) includes pathologies that present signs or symptoms similar to those caused by amyotrophic lateral sclerosis (ALS), which can lead to misdiagnosis. In general, any kind of misdiagnosis can result in negative clinical, psychological and economic consequences as well diagnostic and treatment delay. The objectives were to determine the frequency and to compare the demographic and clinical characteristics of patients with ALS and ALSms in our ALS clinic. We retrospectively studied all patients evaluated from 2007 to 2017 including only patients with a definite final diagnosis. Out of 368 patients with motor neuron disease symptomatology, 43 (11.7%) had an ALSms. The most frequent etiology was compressive myelopathy (32.6%). Multivariate analysis considering positive associations was statistically significant for patients having only upper or lower motor neuron signs in the physical examination, a non-compatible electromyogram (EMG), as well as atypical first symptoms. ALS misdiagnosis is an ongoing and not infrequent problem. From our series of patients, atypical symptoms, absence of EMG pathological findings or isolated upper or lower motor neuron disease should prompt suspicion of a differential diagnosis.



Letter to the editor: phenytoin-induced rhabdomyolysis


Psychotic polyembolokoilamania secondary to left parietal lobe glioblastoma


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

International Organizations

The service economy: U.S. trade coalitions in an era of deindustrialization

Abstract

Services dominate the US economy and are increasingly traded across borders yet little is known about service firms' trade policy objectives or lobbying activities. We fill this gap by examining services' political engagement on trade policy as manifested through lobbying, public positions on trade, and reports issued by U.S. Industry Trade Advisory Committees. We document for the first time that service firms are highly active in the politics of US trade agreements and, compared to firms in goods-producing industries, are much less likely to disagree over trade. Instead, service firms are almost uniformly supportive of US trade agreements, which we explain by focusing on the stark US comparative advantage in services. Service firms are therefore a key constituency for deeper international economic cooperation, helping to explain the present era of global integration despite tough times for uncompetitive US manufacturing. We expect service producers to join the defense of global economic order against emergent populism.



Popular non-support for international organizations: How extensive and what does this represent?

Abstract

This paper investigates popular non-support for international organizations (IO), asking two questions. First, are attitudes within the mass public becoming less supportive of IOs? Second, how can we explain these IO attitudes, especially when the mass public appears to know relatively little about specific international institutions? Using survey data from the International Social Survey Programme's National Identity module, fielded across multiple countries in 1995, 2003, and 2013, it reports that on average and within most countries, citizen attitudes about IOs have become less positive over time. To explain these attitudes, this paper argues that citizens tend to group things that appear as "international" such as cross-border economic flows and IOs. While citizens might feel positively or negatively about these international factors, this grouping implies that they view them similarly, based on what they can feel from the international level related to their job and income. Thus, less (more) skilled citizens who are hurt by (who benefit from) economic globalization should express more negative (positive) views about IOs. Controlling for cultural attitudes socialized through education, we find that skill is a statistically significant and substantively strong predictor of IO attitudes. We also show how this individual-level skill difference gets larger in countries that are more and/or less-favorably exposed to economic globalization.



Hello, goodbye: When do states withdraw from international organizations?

Abstract

Under what conditions do states withdraw from intergovernmental organizations (IGOs)? Recent events such as Brexit, the US withdrawal from UNESCO, and US threats to withdraw from NAFTA, NATO, and the World Trade Organization have triggered widespread concern because they appear to signify a backlash against international organizations. Some observers attribute this recent surge to increasing nationalism. But does this explanation hold up as a more general explanation for IGO withdrawals across time and space? Despite many studies of why states join IGOs, we know surprisingly little about when and why states exit IGOs. We use research on IGO accession to derive potential explanations for IGO withdrawal related to domestic politics, IGO characteristics, and geo-politics. We quantitatively test these potential explanations for withdrawal using an original dataset of 493 IGOs since 1945, documenting about 200 cases of withdrawal. We find that nationalism is not the key driver of IGO withdrawals in the past. Instead, we show that geo-political factors – such as preference divergence and contagion – are the main factors linked to IGO withdrawals, followed by democracy levels in the country and organization. These findings have important implications for research on the vitality of international organizations, compliance, and the liberal world order.



Global value chains and the political economy of WTO disputes

Abstract

This paper investigates how the rise of global value chains (GVCs) in international trade affects the political economy of trade disputes. It addresses the gap between the domestic and international politics of trade disputes, which is especially relevant in these times as populist nationalism favors protectionist forces. We advance the argument that firms face institutional disadvantages in opposing protectionist forces at home, as observed in how contesting firms fare in US anti-dumping cases. As a consequence, they have incentive to seek cross-border cooperation with firms along the supply chain to escalate the adoption of anti-dumping measures to WTO disputes. The paper implements a two-stage empirical strategy. First, we examine the political contestation around US anti-dumping cases ongoing in the WTO era that takes place in International Trade Commission (ITC) hearings. We observe that while these cases see significant opposition from firms relying on the imports of intermediate goods, most cases end in favor of petitioners supporting the imposition of anti-dumping duties. In a second step, we quantitatively analyze the effect of intermediate and GVC goods trade in products that are the subjects of anti-dumping cases on the incidence of a formal WTO dispute. The results suggest that the high costs of litigation at the WTO are often prohibitive relative to the volume of trade in question and pose an equally difficult challenge for firms seeking to overturn protectionist measures.



"Take back control"? The effects of supranational integration on party-system polarization

Abstract

In this paper, we examine the relationship between supranational integration and domestic party-system polarization (extremism). We first construct a theoretical argument that uncovers the key trade-off between the "output legitimacy" of a supranationally integrated party system and the inevitable loss of "input legitimacy" caused by externally imposed policy constraints. This translates into a strategic tradeoff between responsibility and responsiveness at the party level of electoral competition. We hypothesize that while moderate supranational policy constraints can initially speed-up platform convergence, ever-closer political integration may reverse the trend towards higher levels of party-system polarization and party extremism. We apply our framework to the case of EU integration and test our key non-monotonic prediction both at the party-system level of polarization and at the party level of ideological extremism. Finally, we apply to synthetic control method (SCM) for causal inference in comparative case studies to study how political integration and supranational policy constraints have affected their overall level of party-system polarization over time. Our overall empirical analysis strongly corroborates our theoretical argument.



International organizations in a new era of populist nationalism

Abstract

This article introduces the special issue on International Organizations in a New Era of Populist Nationalism. The special issue aims to clarify the stakes for and the politics of international organizations in a time of rising populist nationalism around the world. In this introductory essay, we attempt to disentangle the rise of populism and a resurgence of nationalism as distinct processes and concepts. While neither force is new, we observe significant variation across countries in the type of level of nationalist and populist objections to international institutions. We develop a typology for thinking about how and when populism, nationalism, or their combination might have different effects on international cooperation and organizations. Finally, we review the specific article contributions to the special issue and how they fit with the themes developed in this essay. The final section concludes with questions and ideas for future research on the topic that will enhance our understanding of the complex challenges – and potential opportunities – for international cooperation and organizations in the years ahead.



Euroscepticism and government accountability in the European Union

Abstract

The European Union has become a contested issue amongst voters in Europe. I analyze how the increasingly salient attitudes toward European integration have affected how voters hold their governments accountable for their policy decisions at the EU-level. I argue that attitudes toward the EU have become an important source of electoral accountability that complement attitudes on the left-right dimension, but they matter differently for pro- and anti-European voters. Whereas Eurosceptic voters are likely to use their attitudes toward the EU to hold their governments accountable, pro-European voters tend to rely on their specific attitudes toward particular policies to assess the responsiveness of their politicians. The paper presents the results of a conjoint experiment in a survey of 2,540 German citizens to analyze how pro- and anti-European voters' attitudes influence their assessment of typical signals of government responsiveness.



The rise of modern taxation: A new comprehensive dataset of tax introductions worldwide

Abstract

This article describes the new Tax Introduction Dataset (TID). Listing the year and the mode of the first permanent introduction of six major taxes (inheritance tax, personal income tax, corporate income tax, social security contributions, general sales tax and value added tax) in 220 countries, 1750–2018, TID is the most comprehensive dataset of its kind. The comprehensiveness of our measure is of critical value to empirical work on the causes of tax innovation and its consequences for state, society and economy. In this paper, we explain the selection of our tax sample and the structure of the dataset, descriptively map temporal and regional patterns of tax introductions around the world, and draw on TID to investigate associations between tax introductions and economic development, war, and democratization.



Publisher Correction to: The KOF Globalisation Index – revisited

The article listed above was initially published with incorrect copyright information. Upon publication of this Correction, the copyright of this article changed to "The Author(s)". The original article has been corrected.



Social standards in trade agreements and free trade preferences: An empirical investigation

Abstract

Free trade generates macroeconomic gains but also creates winners and losers. Historically, to reconcile this tension, governments compensated globalization losers with social spending in exchange for support for free trade, known as the embedded liberalism compromise. In the neoliberal era, what other policies can governments pursue to strengthen support for globalization? We assess the effect of social standards in preferential trade agreements (PTAs) on individual preferences for free trade. We analyze data from an original survey experiment and find that respondents in advanced industrialized countries have greater support for free trade when PTAs include social standards. Differences do exist in how these social standards are perceived: while we do find evidence of an embedded liberalism compromise recast, fair trade norms have the most salience. An external validity check using the PEW global attitudes survey confirms the hypothesis. Our analysis has serious implications for the legitimacy of the global trading system suffering from neo-mercantilist creep.



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

Clinical Immunology

Different Phenotypic Presentations of X-Linked Lymphoproliferative Disease in Siblings with Identical Mutations


Efficacy and Adverse Events During Janus Kinase Inhibitor Treatment of SAVI Syndrome

Abstract

Objectives

Mutations affecting the TMEM173 gene cause STING-associated vasculopathy with onset in infancy (SAVI). No standard immunosuppressive treatment approach is able to control disease progression in patients with SAVI. We studied the efficacy and safety of targeting type I IFN signaling with the Janus kinase inhibitor, ruxolitinib.

Methods

We used DNA sequencing to identify mutations in TMEM173 in patients with peripheral blood type I IFN signature. The JAK1/2 inhibitor ruxolitinib was administered on an off-label basis.

Results

We identified three patients with SAVI presenting with skin involvement and progressive severe interstitial lung disease. Indirect echocardiographic signs of pulmonary hypertension were present in one case. Following treatment with ruxolitinib, we observed improvements of respiratory function including increased forced vital capacity in two patients, with discontinuation of oxygen therapy and resolution of echocardiographic abnormalities in one case. Efficacy was persistent in one patient and only transitory in the other two patients. Clinical control of skin complications was obtained, and one patient discontinued steroid treatment. One patient, who presented with kidney involvement, showed resolution of hematuria. One patient experienced increased recurrence of severe viral respiratory infections. Monitoring of peripheral blood type I interferon signature during ruxolitinib treatment did not show a stable decrease.

Conclusions

We conclude that targeting type I IFN receptor signaling may represent a promising therapeutic option for a subset of patients with SAVI syndrome and severe lung involvement. However, the occurrence of viral respiratory infection might represent an important cautionary note for the application of such form of treatment.



Clinical and Laboratory Features of 184 Italian Pediatric Patients Affected with Selective IgA Deficiency (SIgAD): a Longitudinal Single-Center Study

Abstract

Purpose

Selective IgA deficiency (SIgAD) is the most common humoral primary immunodeficiency. Long-term follow-up data in large cohort of pediatric patients are scarce.

Methods

We report on a single-center cohort of 184 pediatric patients affected with selective IgA deficiency and describe the characteristics at diagnosis and during follow-up.

Results

Respiratory infections were the most common clinical finding leading to the initial diagnosis (62%). Positive family history for antibody deficiencies (selective IgA deficiency, common variable immunodeficiency) led to SIgAD diagnosis in 16% of cases. During follow-up, while the incidence of respiratory infections was not particularly high, gastrointestinal symptoms were reported in 27% of patients. Allergic manifestations were found in 23% at diagnosis and an additional 16% of patients during follow-up, leading to a prevalence of atopy of 39% among SIgAD patients. Autoimmune manifestations, excluding celiac disease, were found in 9% of affected patients during follow-up. Celiac disease was found in a high prevalence (14%). Increase of serum IgA levels to partial deficiency (9%) and normal serum levels for age (4%) was observed during follow-up. A small percentage of patients (2%) progressed to common variable immunodeficiency (CVID).

Conclusions

In conclusion, this is the first study to describe a large single-center pediatric cohort of patients affected with SIgAD, revealing that overall most patients do well with regard to infections. Many develop CD, at a rate much higher than the general population. A few normalize their IgA levels. A few progress to CVID. Thus, careful follow-up is suggested to diagnose and treat potential complications earlier for avoiding potential morbidities.



Life-Threatening Infections Due to Live-Attenuated Vaccines: Early Manifestations of Inborn Errors of Immunity

Abstract

Live-attenuated vaccines (LAVs) can protect humans against 12 viral and three bacterial diseases. By definition, any clinical infection caused by a LAV that is sufficiently severe to require medical intervention attests to an inherited or acquired immunodeficiency that must be diagnosed or identified. Self-healing infections can also result from milder forms of immunodeficiency. We review here the inherited forms of immunodeficiency underlying severe infections of LAVs. Inborn errors of immunity (IEIs) underlying bacille Calmette-Guérin (BCG), oral poliovirus (OPV), vaccine measles virus (vMeV), and oral rotavirus vaccine (ORV) disease have been described from 1951, 1963, 1966, and 2009 onward, respectively. For each of these four LAVs, the underlying IEIs show immunological homogeneity despite genetic heterogeneity. Specifically, BCG disease is due to inborn errors of IFN-γ immunity, OPV disease to inborn errors of B cell immunity, vMeV disease to inborn errors of IFN-α/β and IFN-λ immunity, and ORV disease to adaptive immunity. Severe reactions to the other 11 LAVs have been described yet remain "idiopathic," in the absence of known underlying inherited or acquired immunodeficiencies, and are warranted to be the focus of research efforts. The study of IEIs underlying life-threatening LAV infections is clinically important for the affected patients and their families, as well as immunologically, for the study of the molecular and cellular basis of host defense against both attenuated and parental pathogens.



Autoinflammation Masquerading as Autoimmunity in an Adult with Heterozygous p.E250K PSTPIP1 Mutation


Variable Responses to Tocilizumab in Four Patients with Schnitzler Syndrome


Role of Allogeneic Hematopoietic Stem Cell Transplant for Chronic Granulomatous Disease (CGD): a Report of the United States Immunodeficiency Network

Abstract

Purpose

Chronic granulomatous disease (CGD) is a primary immunodeficiency for which allogeneic hematopoietic stem cell transplant (HSCT) offers potential cure. Direct comparison of HSCT to non-HSCT management in the North American population was performed to identify clinical factors associated with overall survival (OS) and transplant-related survival (TRS).

Methods

Retrospective review of CGD subjects enrolled in the United States Immunodeficiency Network. Survival was estimated by the Kaplan-Meier method and modeled by proportional hazards regression.

Results

We identified 507 patients (66% CYBB mutants) diagnosed in 1953–2016. Fifty underwent allogeneic HSCT. Median follow-up was 9.1 years after diagnosis (0–45.8 years). OS was negatively associated with CYBBmutation (HR = 6.25; p = 0.034) and not associated with HSCT (88% v. 85% ± HCT) (HR = 1.26; p = 0.65). Transplant at ≤ 14 years old was associated with improved TRS (93% v. 82% at T + 60 months) (HR = − 4.51; p = 0.035). Patients transplanted before 15 years old had fewer severe infections pre-HSCT (mean 0.95 v. 2.13; p = 0.047). No mortality was reported in patients receiving stem cells from matched siblings. Infection incidence declined post-HSCT in subjects with greater than or equal to four infections pre-HSCT (p = 0.0010). Compared to non-HSCT patients ≥ 15 years old, post-transplant survivors had higher mean performance score (93.2 v. 85.9; p = 0.0039) and lower frequency of disability (11% v. 52%; p = 0.014).

Conclusion

Allogeneic HSCT was associated with reduced infection incidence and improved functional performance, but not with a change in overall survival. Transplant-related survival was elevated in patients undergoing HSCT before 15 years old. Consider HSCT prior to late adolescence in patients with severely diminished reactive oxygen intermediate synthesis, particularly if a matched sibling is available.



Enterovirus-Associated HLH: Addition of Anakinra to IVIG and Corticosteroids


Fifteen Years of the J Project


Recurrent Salmonella typhi Infection and Autoimmunity in a Young Boy with Complete IL-12 Receptor β1 Deficiency


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

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


Metabolic Syndrome Modulates Protein Import into the Mitochondria of Porcine Mesenchymal Stem Cells...
Metabolic Syndrome Modulates Protein Import into the Mitochondria of Porcine Mesenchymal Stem CellsAbstractMesenchymal stem cells (MSCs) are currently being tested in several clinical trials. Mitochondria regulate many aspects of MSC function. Mitochondrial preproteins are rapidly translated and trafficked into the mitochondrion for assembly in their final destination, but whether coexisting cardiovascular risk factors modulate this process is unknown. We hypothesized that metabolic syndrome (MetS)...
Αλέξανδρος Γ. Σφακιανάκης
now
The Therapeutic Potential of Mesenchymal Stromal Cells in the Treatment of Chemotherapy-Induced Tissue...
The Therapeutic Potential of Mesenchymal Stromal Cells in the Treatment of Chemotherapy-Induced Tissue DamageAbstractChemotherapy constitutes one of the key treatment modalities for solid and hematological malignancies. Albeit being an effective treatment, chemotherapy application is often limited by its damage to healthy tissues, and curative treatment options for chemotherapy-related side effects are largely missing. As mesenchymal stromal cells (MSCs) are known to exhibit regenerative capacity...
Αλέξανδρος Γ. Σφακιανάκης
1m
The Nlrp3 Inflammasome Orchestrates Mobilization of Bone Marrow-Residing Stem Cells into Peripheral...
The Nlrp3 Inflammasome Orchestrates Mobilization of Bone Marrow-Residing Stem Cells into Peripheral BloodAbstractMobilization of stem cells from bone marrow (BM) into peripheral blood (PB) in response to tissue or organ injury, infections, strenuous exercise, or mobilization-inducing drugs is as we postulated result of a "sterile inflammation" in the BM microenvironment that triggers activation of the Complement Cascade (ComC). Therefore, we became interested in the role of the Nlrp3 inflammasome...
Αλέξανδρος Γ. Σφακιανάκης
2m
Targeting T Cell Malignancies Using CD4CAR T-Cells and Implementing a Natural Safety Switch Abstract...
Targeting T Cell Malignancies Using CD4CAR T-Cells and Implementing a Natural Safety SwitchAbstractT cell malignancies are aggressive diseases with no standard treatment available, often resulting in poor patient outcomes. Lately, the recent FDA approval of a CD19 CAR T cell therapy for B cell acute lymphoblastic leukemia has earned nationwide attention, leading to the possibility that success of CD19 CAR therapy can be extended to T cell malignancies. However, the impact of T cell depletion due...
Αλέξανδρος Γ. Σφακιανάκης
2m
Wnt Signaling Mediates the Aging-Induced Differentiation Impairment of Intestinal Stem Cells Abstract...
Wnt Signaling Mediates the Aging-Induced Differentiation Impairment of Intestinal Stem CellsAbstractStem cell aging underlies aging-associated disorders, such as steeply increased incidences of tumors and impaired regeneration capacity upon stress. However, whether and how the intestinal stem cells age remains largely unknown. Here we show that intestinal stem cells derived from 24-month-old mice hardly form typical organoids with crypt-villus structures, but rather mainly form big, rounded cysts...
Αλέξανδρος Γ. Σφακιανάκης
2m
Gelatin Based Polymer Cell Coating Improves Bone Marrow-Derived Cell Retention in the Heart after...
Gelatin Based Polymer Cell Coating Improves Bone Marrow-Derived Cell Retention in the Heart after Myocardial InfarctionAbstractBackgroundAcute myocardial infarction (AMI) and the ensuing ischemic heart disease are approaching an epidemic state. Limited stem cell retention following intracoronary administration has reduced the clinical efficacy of this novel therapy. Polymer based cell coating is biocompatible and has been shown to be safe. Here, we assessed the therapeutic utility of gelatin-based...
Αλέξανδρος Γ. Σφακιανάκης
2m
Stem Cell Reviews and Reports
Evolving Definition of Adult Stem/Progenitor CellsOne-Year Observation of the SCID-Repopulating Cell Activities of Human Cord Blood-Derived CD34-Positive and -Negative Hematopoietic Stem CellsGelatin Based Polymer Cell Coating Improves Bone Marrow-Derived Cell Retention in the Heart after Myocardial InfarctionAbstractBackgroundAcute myocardial infarction (AMI) and the ensuing ischemic heart disease are approaching an epidemic state. Limited stem cell retention following intracoronary administration...
Αλέξανδρος Γ. Σφακιανάκης
3m
Functional Foods
Gossypol but not cottonseed extracts or lipopolysaccharides stimulates HuR gene expression in mouse cellsPublication date: August 2019Source: Journal of Functional Foods, Volume 59Author(s): Heping Cao, Kandan SethumadhavanAbstractHuman antigen R (HuR) stabilizes cytokine mRNAs and plays an important role in tumorigenesis and inflammation. Plant extracts and compounds that can regulate HuR gene expression may have nutritional and therapeutic value, but little research has been done in this area....
Αλέξανδρος Γ. Σφακιανάκης
4m
Remote Sensing
Appraisal of Urban Heat Island Detection of Peshawar Using Land Surface Temperature and Its Impacts on EnvironmentAbstractLast couple of decades witnessed a rapid escalation in urban temperature of Peshawar city and its neighboring localities. This alarming condition gave birth to climatic term urban heat island-created drastic alteration in surface temperatures. In this study, thermal infrared remote sensing data have been employed to map out and monitor such micro-climatic variation in temperatures...
Αλέξανδρος Γ. Σφακιανάκης
6m
Rendiconti Lincei. Scienze Fisiche e Naturali
Accademia dei Lincei was founded in 1603 by Marchese Federico Cesi. The Linceo (lynx) was chosen as the symbol of the institution, because of the presumed keenness of its eye. The aim of the Accademia  was, and still is, the study of scientific disciplines from a global point of view, and the fostering of cooperation among researchers in any field all over the world. Some 540 members, both Italian and non-Italian, belong to the Accademia, and are grouped into two classes: Scienze Matematiche, Fisiche...
Αλέξανδρος Γ. Σφακιανάκης
7m
Pituitary Adenylate Cyclase-Activating Polypeptide Modulates Dendritic Spine Maturation and Morphogenesis...
Pituitary Adenylate Cyclase-Activating Polypeptide Modulates Dendritic Spine Maturation and Morphogenesis via MicroRNA-132 UpregulationAtsuko Hayata-Takano, Toshihiko Kamo, Harui Kijima, Kaoru Seiriki, Katsuya Ogata, Yukio Ago, Takanobu Nakazawa, Yusuke Shintani, Kosuke Higashino, Kazuki Nagayasu, Norihito Shintani, Atsushi Kasai, James A. Waschek and Hitoshi HashimotoJournal of Neuroscience 29 May 2019, 39 (22) 4208-4220; DOI: https://doi.org/10.1523/JNEUROSCI.2468-18.2019ArticleFigures & DataInfo...
Αλέξανδρος Γ. Σφακιανάκης
8m
Semaphorin4D Induces Inhibitory Synapse Formation by Rapid Stabilization of Presynaptic Boutons via...
Semaphorin4D Induces Inhibitory Synapse Formation by Rapid Stabilization of Presynaptic Boutons via MET CoactivationCátia P. Frias, Jian Liang, Tom Bresser, Lisa Scheefhals, Matthijs van Kesteren, René van Dorland, Hai Yin Hu, Anna Bodzeta, Paul M.P. van Bergen en Henegouwen, Casper C. Hoogenraad and Corette J. WierengaJournal of Neuroscience 29 May 2019, 39 (22) 4221-4237; DOI: https://doi.org/10.1523/JNEUROSCI.0215-19.2019ArticleFigures & DataInfo & MetricseLetters PDFAbstractChanges in...
Αλέξανδρος Γ. Σφακιανάκης
8m
Quality of life in pre- and postmenopausal patients with early breast cancer: a comprehensive analysis...
Quality of life in pre- and postmenopausal patients with early breast cancer: a comprehensive analysis from the prospective MaLife projectAbstractPurposeQuality of life (QoL) plays an important role in recovery—especially after an incisive diagnosis such as breast cancer. Here, we present a comprehensive assessment of QoL for pre- and postmenopausal patients, starting from initial systemic treatment of early breast cancer until 3 years later, in patients from a so-called "real-world" setting.Methods251...
Αλέξανδρος Γ. Σφακιανάκης
23m
The effect of scalp cooling on CIA-related quality of life in breast cancer patients: a systematic...
The effect of scalp cooling on CIA-related quality of life in breast cancer patients: a systematic reviewAbstractPurposeChemotherapy-induced alopecia (CIA) remains a distressing adverse event of cancer treatment but may be prevented by scalp cooling. The effectiveness of scalp cooling, however, is dependent on the chemotherapy regimen with successful hair preservation (i.e., < 50% hair loss) in 41–59% of women on taxane-based therapies in comparison to 16–36% on anthracycline-based therapies....
Αλέξανδρος Γ. Σφακιανάκης
23m
SNAIL is induced by tamoxifen and leads to growth inhibition in invasive lobular breast carcinoma AbstractPurpose...
SNAIL is induced by tamoxifen and leads to growth inhibition in invasive lobular breast carcinomaAbstractPurposeInvasive lobular carcinoma (ILC) is a histological subtype of breast cancer that is predominantly estrogen receptor alpha (ER)-positive (+) and is thus treated with endocrine therapies. Herein, we sought to understand the molecular underpinnings of the 4-hydroxytamoxifen (4OHT) resistance in ILC by assessing the potential role of the epithelial-to-mesenchymal transition transcription factor...
Αλέξανδρος Γ. Σφακιανάκης
24m
Loss of HER2 after HER2-targeted treatment AbstractPurpose HER2 expression has been reported to be...
Loss of HER2 after HER2-targeted treatmentAbstractPurposeHER2 expression has been reported to be discordant between primary tumor and metastatic tissue.Patients and methodsHER2 discordance and relation to HER2-targeted treatment was investigated in 227 patients with primary breast cancer.ResultsHER2 discordance between primary biopsy and second biopsy after neoadjuvant or adjuvant treatment was observed in 20.7%. This discordance was related only to the use of HER2-targeted treatment: 30 of 33 (90.9%)...
Αλέξανδρος Γ. Σφακιανάκης
25m
Incidence of peripheral edema in patients receiving PI3K/mTOR/CDK4/6 inhibitors for metastatic breast...
Incidence of peripheral edema in patients receiving PI3K/mTOR/CDK4/6 inhibitors for metastatic breast cancerAbstractPurposeThis study evaluated development of edema in patients receiving PI3K/mTOR/CDK4/6 targeted therapy for metastatic breast cancer (MBC).MethodsWe reviewed medical records of 160 patients receiving targeted therapy with PI3K/mTOR/CDK4/6 inhibitors to treat MBC (n = 160; 185 treatment occurrences). Clinicopathologic data, treatment details, and edema incidence were recorded.ResultsEdema...
Αλέξανδρος Γ. Σφακιανάκης
25m
Risk of ipsilateral breast tumor recurrence in primary invasive breast cancer following breast-conserving...
Risk of ipsilateral breast tumor recurrence in primary invasive breast cancer following breast-conserving surgery with BRCA1 and BRCA2 mutation in ChinaAbstractPurposeBRCA1/2 germline mutations are associated with a high risk of breast cancer, which may preclude mutation carriers from breast-conserving surgery (BCS). This study retrospectively examined whether mutation status influenced the rate of ipsilateral breast tumor recurrence (IBTR) after BCS  in Chinese women.MethodsPatients who underwent...
Αλέξανδρος Γ. Σφακιανάκης
25m
Association of antidiabetic medication and statins with breast cancer incidence in women with type...
Association of antidiabetic medication and statins with breast cancer incidence in women with type 2 diabetesAbstractPurposeTo address the possible association between the use of metformin, other forms of antidiabetic medication (ADM) and statins with the incidence of breast cancer in women with type 2 diabetes (T2D).MethodsData were collected from a Finnish nationwide diabetes database (FinDM). The study cohort consisted of women diagnosed with T2D in 1996–2011 in Finland. In full-cohort analysis,...
Αλέξανδρος Γ. Σφακιανάκης
26m
Influence of adherence to adjuvant endocrine therapy on disease-free and overall survival: a population-based...
Influence of adherence to adjuvant endocrine therapy on disease-free and overall survival: a population-based study in Catalonia, SpainAbstractObjectiveTo assess adherence to endocrine therapy and its relation to recurrence and mortality in women with early breast cancer.MethodsThis is a retrospective cohort study in population-based cancer registries in two Catalonian provinces of Spain. We included all cases of invasive stage I–III breast cancer diagnosed from 2007 to 2011 and with follow-up to...
Αλέξανδρος Γ. Σφακιανάκης
26m
4-Hydroxytamoxifen enhances sensitivity of estrogen receptor α-positive breast cancer to docetaxel...
4-Hydroxytamoxifen enhances sensitivity of estrogen receptor α-positive breast cancer to docetaxel in an estrogen and ZNF423 SNP-dependent fashionAbstractPurposeIn early stage, ERα-positive breast cancer, concurrent use of endocrine therapy and chemotherapy has not been shown to be superior to sequential use. We hypothesized that genetic biomarkers can aid in selecting patients who would benefit from chemo-endocrine therapy. Our previous studies revealed that ZNF423 is a transcription factor for...
Αλέξανδρος Γ. Σφακιανάκης
26m
Anti-tumor and anti-metastasis efficacy of E6201, a MEK1 inhibitor, in preclinical models of triple-negative...
Anti-tumor and anti-metastasis efficacy of E6201, a MEK1 inhibitor, in preclinical models of triple-negative breast cancerAbstractPurposeTriple-negative breast cancer (TNBC) lacks the receptor targets estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, and thus, it does not respond to receptor-targeted treatments. TNBC has higher recurrence, metastasis, and mortality rates than other subtypes of breast cancer. Mounting data suggest that the MAPK (also known as...
Αλέξανδρος Γ. Σφακιανάκης
27m
On Why Mathematics Can Not be Ontology Abstract The formalism of mathematics has always inspired ontological...
On Why Mathematics Can Not be OntologyAbstractThe formalism of mathematics has always inspired ontological theorization based on it. As is evident from his magnum opus Being and Event, Alain Badiou remains one of the most important contemporary contributors to this enterprise. His famous maxim—"mathematics is ontology" has its basis in the ingenuity that he has shown in capitalizing on Gödel's and Cohen's work in the field of set theory. Their work jointly establish the independence of the continuum...
Αλέξανδρος Γ. Σφακιανάκης
27m
Axiomathes
A Note on Carnap's Result and the ConnectivesAbstractCarnap's result about classical proof-theories not ruling out non-normal valuations of propositional logic formulae has seen renewed philosophical interest in recent years. In this note I contribute some considerations which may be helpful in its philosophical assessment. I suggest a vantage point from which to see the way in which classical proof-theories do, at least to a considerable extent, encode the meanings of the connectives (not by determining...
Αλέξανδρος Γ. Σφακιανάκης
27m
Breast Cancer Research and Treatment
Anti-tumor and anti-metastasis efficacy of E6201, a MEK1 inhibitor, in preclinical models of triple-negative breast cancerAbstractPurposeTriple-negative breast cancer (TNBC) lacks the receptor targets estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, and thus, it does not respond to receptor-targeted treatments. TNBC has higher recurrence, metastasis, and mortality rates than other subtypes of breast cancer. Mounting data suggest that the MAPK (also known as...
Αλέξανδρος Γ. Σφακιανάκης
28m
Applied Biochemistry and Microbiology
Erratum to: Purification and Characterization of β-Glucosidase Produced by Trichoderma Citrinoviride Cultivated on Microalga Chlorella VulgarisThe article is published in the original.Biotransformation of Glycoginsenosides to Intermediate Products and Aglycones using a Hemicellulosome Produced by Cellulosimicrobium cellulanAbstractGinsenosides Rb1, Rb2 and Re were converted into corresponding intermediates and aglycones using a multienzyme complex produced by Cellulosimicrobium cellulans F16. The...
Αλέξανδρος Γ. Σφακιανάκης
31m
ECG Consult: 63yo Female, Onset of Weakness while Cleaning JEMS ECG of the Month: May 2019 Wed, May...
ECG Consult: 63yo Female, Onset of Weakness while CleaningJEMS ECG of the Month: May 2019Wed, May 29, 2019 By John Hayden, MD, EdD, FACEP , Jonathan Barney, BA, EMT, MS3A 63-year-old female complains of a gradual onset of weakness while cleaning as well as, fatigue, nausea and epigastric discomfort.ByJohn Hayden, MD, EdD, FACEPJ. William Hayden, MD, EdD, FACEP, has practiced emergency medicine for more than 28 years in rural and urban hospitals, university medical centers, and single as well as large...
Αλέξανδρος Γ. Σφακιανάκης
33m
A Push for Push Dose Epinephrine Prehospital use of push dose epinephrine for hypotension By Sammy...
A Push for Push Dose EpinephrinePrehospital use of push dose epinephrine for hypotension By Sammy Hodroge, MD , Amelia Breyre, MDStarting in 2018, push dose epinephrine replaced dopamine as the vasopressor of choice for the management of prehospital shock in Alameda County, California.         You transport a 79-year-old woman to the hospital for fever and urinary incontinence. Her family mentions a history of frequent urinary tract infections. Her initial vital signs are a heart rate of 115 bpm,...
Αλέξανδρος Γ. Σφακιανάκης
34m
Use of Antihypotensive Medications in Shock Patients   By Robert P. Girardeau, BS, NREMT-P, FP-C ...
Use of Antihypotensive Medications in Shock Patients By Robert P. Girardeau, BS, NREMT-P, FP-C Robert GirardeauAre you still going to reach for that dopamine with this patient in obvious septic shock? Photo Kevin Link         LEARNING Objectives Learn how antihypotensive medications work. Identify the main antihypotensive medications (inotropes and vasopressors) that can be used to treat patients suffering from end-organ hypoperfusion. Understand how and when to administer antihyoptensive medications.Key TermsAdrenergic: Chemicals...
Αλέξανδρος Γ. Σφακιανάκης
36m
Push Dose Epinephrine as a Temporizing Measure for Drugs Causing Hypotension Mon, Sep 15, 2014  By William...
Push Dose Epinephrine as a Temporizing Measure for Drugs Causing HypotensionMon, Sep 15, 2014  By William Selde, MD        You transport a 55-year-old male to the hospital on continuous positive airway pressure (CPAP) for respiratory distress and fever. Initially, the CPAP at a pressure of 10 cm of water improved the patient's oxygen saturation from 73% to 93%. An IV is established and a bolus of normal saline is started. During transport the patient has increasing difficulty keeping his eyes open....
Αλέξανδρος Γ. Σφακιανάκης
38m
Stop the Bleed & Start the Heart Teaching Texas middle schoolers to 'see something & do a lot'...
Stop the Bleed & Start the HeartTeaching Texas middle schoolers to 'see something & do a lot'Thu, May 23, 2019  By Ashley Hoppe, BBA, NREMT , Courtney Nesloney, RN, BSN , Kelsey Brown, AS , Elizabeth Dillard, BA, NREMT , Harry "Steve" Stevenson, MPA, NREMT Smithson Valley Middle School students in Spring Branch, Texas, learned to Stop the Bleed and Start the Heart.Smithson Valley Middle School students in Spring Branch, Texas, learned to Stop the Bleed and Start the Heart.On June 14, 2014,...
Αλέξανδρος Γ. Σφακιανάκης
39m
Three Pillars for Pediatric Resuscitation Success Wed, Feb 27, 2019  By Peter Antevy, MD, MPH  EMS leadership...
Three Pillars for Pediatric Resuscitation SuccessWed, Feb 27, 2019  By Peter Antevy, MD, MPH EMS leadership and their communication center counterparts should review all pediatric arrest calls within 72 hours to better understand and correct issues that may exist. Photo Chris SwabbEMS leadership and their communication center counterparts should review all pediatric arrest calls within 72 hours to better understand and correct issues that may exist. Photo Chris Swabb        Data from the American...
Αλέξανδρος Γ. Σφακιανάκης
40m
Dental remineralization via poly(amido amine) and restorative materials containing calcium phosphate...
Dental remineralization via poly(amido amine) and restorative materials containing calcium phosphate nanoparticlesKunneng Liang, Suping Wang, Siying Tao, Shimeng Xiao, Han Zhou, Ping Wang, Lei Cheng, Xuedong Zhou, Michael D. Weir, Thomas W. Oates, Jiyao Li & Hockin H. K. Xu International Journal of Oral Science 11, Article number: 15 (2019) | Download CitationAbstractTooth decay is prevalent, and secondary caries causes restoration failures, both of which are related to demineralization. There...
Αλέξανδρος Γ. Σφακιανάκης
42m
Recent advances in cell sheet technology for bone and cartilage regeneration: from preparation to applicationYuezhi...
Recent advances in cell sheet technology for bone and cartilage regeneration: from preparation to applicationYuezhi Lu, Wenjie Zhang, Jie Wang, Guangzheng Yang, Shi Yin, Tingting Tang, Chunhua Yu & Xinquan Jiang International Journal of Oral Science 11, Article number: 17 (2019) | Download CitationAbstractBone defects caused by trauma, tumour resection, infection and congenital deformities, together with articular cartilage defects and cartilage–subchondral bone complex defects caused by trauma...
Αλέξανδρος Γ. Σφακιανάκης
44m
Trace Elements in Medicine and Biology
Strontium stimulates alkaline phosphatase and bone morphogenetic protein-4 expression in rat chondrocytes cultured in vitroPublication date: September 2019Source: Journal of Trace Elements in Medicine and Biology, Volume 55Author(s): Jinfeng Zhang, Xiaoyan Zhu, Yezi Kong, Yan Huang, Xukun Dang, Linshan Mei, Baoyu Zhao, Qing Lin, Jianguo WangAbstractThe trace element strontium has a significant impact on cartilage metabolism. However, the direct effects of strontium on alkaline phosphatase (ALP),...
Αλέξανδρος Γ. Σφακιανάκης
49m
Telematics and Informatics
Issue competition on social media in China: The interplay among media, verified users, and unverified usersPublication date: July 2019Source: Telematics and Informatics, Volume 40Author(s): Pianpian WangThe bifurcation of the Nigerian cybercriminals: Narratives of the Economic and Financial Crimes Commission (EFCC) agentsPublication date: July 2019Source: Telematics and Informatics, Volume 40Author(s): Suleman Lazarus, Geoffrey U. OkolorieAbstractWhile this article sets out to advance our knowledge...
Αλέξανδρος Γ. Σφακιανάκης
53m
School performance, social networking effects, and learning of school children: Evidence of reciprocal...
School performance, social networking effects, and learning of school children: Evidence of reciprocal relationships in Abu DhabiAuthor links open overlay panelMasoodBadriaAli AlNuaimibYangGuangbAsma AlRashedibaAbu Dhabi Education Council and UAE University, Khalifa Park Abu Dhabi, United Arab EmiratesbAbu Dhabi Education Council, United Arab EmiratesReceived 1 May 2017, Accepted 11 June 2017, Available online 16 June 2017.Show lesshttps://doi.org/10.1016/j.tele.2017.06.006Get rights and contentUnder...
Αλέξανδρος Γ. Σφακιανάκης
1h
Aluminium in brain tissue in autism Author links open overlay panelMatthewMoldaDorcasUmarbAndrewKingcChristopherExleyaaThe...
Aluminium in brain tissue in autismAuthor links open overlay panelMatthewMoldaDorcasUmarbAndrewKingcChristopherExleyaaThe Birchall Centre, Lennard-Jones Laboratories, Keele University, Staffordshire, ST5 5BG, United KingdombLife Sciences, Keele University, Staffordshire, ST5 5BG, United KingdomcDepartment of Clinical Neuropathology, Kings College Hospital, London, SE5 9RS, United Kingdomhttps://doi.org/10.1016/j.jtemb.2017.11.012Get rights and contentUnder a Creative Commons licenseopen accessAbstractAutism...
Αλέξανδρος Γ. Σφακιανάκης
1h
Treatment for lymphedema following head and neck cancer therapy: A systematic review Author links open...
Treatment for lymphedema following head and neck cancer therapy: A systematic reviewAuthor links open overlay panelAlbinaTykeraJoelFrancobSean T.MassacShaun C.DesaidScott G.WalenbaSaint Louis University School of Medicine, 1402 S Grand Blvd, St. Louis, MO 63104, United States of AmericabSaint Louis University Department of Otolaryngology, 3665 Vista Ave, St. Louis, MO 63110, United States of AmericacWashington University in Saint Louis Department of Otolaryngology, 1 Barnes-Jewish Hospital Plaza,...
Αλέξανδρος Γ. Σφακιανάκης
1h
What is the evidence for cannabis use in otolaryngology?: A narrative review Author links open overlay...
What is the evidence for cannabis use in otolaryngology?: A narrative reviewAuthor links open overlay panelWilliam L.ValentinoaBrianMcKinnonbaDepartment of Surgery, Temple University Hospital, United States of AmericabDepartment of Otolaryngology - Head and Neck Surgery, Department of Neurosurgery, Drexel University College of Medicine, United States of AmericaReceived 20 May 2019, Available online 30 May 2019.Show lesshttps://doi.org/10.1016/j.amjoto.2019.05.025Get rights and contentAbstractObjectivesReview...
Αλέξανδρος Γ. Σφακιανάκης
1h
Evaluating a Fully Automated Pulmonary Nodule Detection Approach and Its Impact on Radiologist Performance...
Evaluating a Fully Automated Pulmonary Nodule Detection Approach and Its Impact on Radiologist PerformanceKai Liu, Qiong Li, Jiechao Ma, Zijian Zhou, Mengmeng Sun, Yufeng Deng, Wenting Tu, Yun Wang, Li Fan, Chen Xia, Yi Xiao, Rongguo Zhang, Shiyuan LiuAuthor AffiliationsFrom the Department of Radiology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Rd, Shanghai, China 20003 (K.L., Q.L., W.T., Y.W., L.F., Y.X., S.L.); and Infervision Advanced Institute, Beijing, China (J.M.,...
Αλέξανδρος Γ. Σφακιανάκης
1h
Fully Automated Diagnosis of Anterior Cruciate Ligament Tears on Knee MR Images by Using Deep Learning...
Fully Automated Diagnosis of Anterior Cruciate Ligament Tears on Knee MR Images by Using Deep LearningFang Liu* , Bochen Guan*, Zhaoye Zhou, Alexey Samsonov, Humberto Rosas, Kevin Lian, Ruchi Sharma, Andrew Kanarek, John Kim, Ali Guermazi, Richard Kijowski* F.L. and B.G. contributed equally to this work.Author AffiliationsFrom the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53705 (F.L., B.G., A.S., H.R., K.L., R.S., A.K.,...
Αλέξανδρος Γ. Σφακιανάκης
1h
Computer-aided detection (CAD)
The Rebirth of CAD: How Is Modern AI Different from the CAD We Know?Luke Oakden-RaynerAuthor AffiliationsFrom the Department of Radiology, Royal Adelaide Hospital, North Terrace, Adelaide, SA, Australia 5000; School of Public Health, University of Adelaide, Adelaide, Australia; and Australian Institute for Machine Learning, Adelaide, Australia.Address correspondence to the author (e-mail: luke.oakden-rayner@adelaide.edu.au).Published Online:May 29 2019https://doi.org/10.1148/ryai.2019180089PDFToolsShareComputer-aided...
Αλέξανδρος Γ. Σφακιανάκης
1h
Radiology: Artificial Intelligence
EditorialWill Artificial Intelligence Replace Radiologists? Artificial intelligence algorithms will not replace radiologists but will modify the work of radiologists.  Curtis P. LanglotzOriginal ResearchDetection and Classification of Myocardial Delayed Enhancement Patterns on MR Images with Deep Neural Networks: A Feasibility Study Deep learning with deep neural networks can detect the presence of myocardial delayed enhancement (MDE) on cardiovascular MR images and may obtain the ability to classify...
Αλέξανδρος Γ. Σφακιανάκης
1h
A comprehensive review of surgical margin in oral squamous cell carcinoma highlighting the significance...
A comprehensive review of surgical margin in oral squamous cell carcinoma highlighting the significance of tumor-free surgical marginsMamata Kamat, Bhagawan Das Rai, Rudrayya S Puranik, Uma Vasant DatarJournal of Cancer Research and Therapeutics 2019 15(3):449-454Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity, and surgery is the most accepted line of treatment. The surgical margins (SMs) or resection margins are boundaries of resection specimen excised by the...
Αλέξανδρος Γ. Σφακιανάκης
16h
Molecular characterization of metastasizing ameloblastoma: A comprehensive review Anjali P Ganjre,...
Molecular characterization of metastasizing ameloblastoma: A comprehensive reviewAnjali P Ganjre, Gargi Sarode, Sachin SarodeJournal of Cancer Research and Therapeutics 2019 15(3):455-462Metastasizing ameloblastoma (MA) is a very rare odontogenic tumor with 2% of incidence rate. It exhibits benign histopathological features and malignant intrinsic quality in the form of metastasis which makes it a little more than a pathological curiosity. Various molecular aspects related with malignant behavior...
Αλέξανδρος Γ. Σφακιανάκης
16h
Oral submucous fibrosis: An enigmatic morpho-insight Alka Harish Hande, Minal S Chaudhary, Madhuri...
Oral submucous fibrosis: An enigmatic morpho-insightAlka Harish Hande, Minal S Chaudhary, Madhuri N Gawande, Amol R Gadbail, Prajakta R Zade, Shree Bajaj, Swati K Patil, Satyajit TekadeJournal of Cancer Research and Therapeutics 2019 15(3):463-469Oral submucous fibrosis (OSMF) is a chronic progressive, scarring disease affecting oral, oropharyngeal, and sometimes the esophageal mucosa. It is characterized by the progressive fibrosis of the submucosal tissue. The pathogenesis of OSMF has been directly...
Αλέξανδρος Γ. Σφακιανάκης
16h
Kilovoltage cone-beam computed tomography imaging dose estimation and optimization: Need of daily cone-beam...
Kilovoltage cone-beam computed tomography imaging dose estimation and optimization: Need of daily cone-beam computed tomographyGaurav Trivedi, Chandra K Dixit, Arun S Oinam, Rakesh Kapoor, Amit BahlJournal of Cancer Research and Therapeutics 2019 15(3):470-474Aim: The aim of the present study was to access the need of daily cone-beam computed tomography (CBCT) and the requirement of in-house protocols of image acquisition frequency to reduce unnecessary exposure to the patients undergoing radiotherapy...
Αλέξανδρος Γ. Σφακιανάκης
16h
Optimization of low-energy electron beam production for superficial cancer treatments by Monte Carlo...
Optimization of low-energy electron beam production for superficial cancer treatments by Monte Carlo codeRana Akbarpoor, Navid Khaledi, Xufei Wang, Farhad SamieiJournal of Cancer Research and Therapeutics 2019 15(3):475-479Context: Low energy electron beam has been being used widely for superficial cancer treatments. In the current study a design for production of very low energy electron beam, by different thickness of Perspex spoilers, is presented that may be used for skin cancer. Aims: MCNPX...
Αλέξανδρος Γ. Σφακιανάκης
16h
Development of α-tocopherol surface-modified targeted delivery of 5-fluorouracil-loaded poly-D, L-lactic-co-glycolic...
Development of α-tocopherol surface-modified targeted delivery of 5-fluorouracil-loaded poly-D, L-lactic-co-glycolic acid nanoparticles against oral squamous cell carcinomaSaurabh Srivastava, Shalini Gupta, Shadab Mohammad, Irfan AhmadJournal of Cancer Research and Therapeutics 2019 15(3):480-490Objective: The aim of the study to develop surface modified targeted moiety α-tocopherol (α-t) encapsulated with 5-fluorouracil (5-FU)-poly-D, L-lactic-co-glycolic acid nanoparticles (PLGA NPs) toward the...
Αλέξανδρος Γ. Σφακιανάκης
16h
A Monte Carlo study on dose perturbation due to dental restorations in a 15 MV photon beam Mona Azizi,...
A Monte Carlo study on dose perturbation due to dental restorations in a 15 MV photon beamMona Azizi, Ali Asghar Mowlavi, Mehdi Ghorbani, Courtney Knuap, Marziyeh BehmadiJournal of Cancer Research and Therapeutics 2019 15(3):491-497Aim: The main purpose of this study is to evaluate the effect of dose perturbation due to common dental restoration materials in the head and neck radiotherapy with a 15 MV external photon beam. Setting and Design: Teeth with three dental restorations such as tooth filled...
Αλέξανδρος Γ. Σφακιανάκης
16h
Analysis of induced error by susceptibility effect in low-density gel dosimeters Farideh Pak, Vahid...
Analysis of induced error by susceptibility effect in low-density gel dosimetersFarideh Pak, Vahid Vaezzadeh, Ehsan Eqlimi, Mona MirheydariJournal of Cancer Research and Therapeutics 2019 15(3):498-503Purpose: In low-density (LD) gel dosimeter, diffusive spin–spin relaxation rate (R2)-dispersion caused by susceptibility-induced internal gradient leads to a significant deviation in the measured R2 from the real value. In this study, the effect of induced internal gradient on R2 was visualized and...
Αλέξανδρος Γ. Σφακιανάκης
16h
Improvement of dose distribution in ocular brachytherapy with 125I seeds 20-mm COMS plaque followed...
Improvement of dose distribution in ocular brachytherapy with 125I seeds 20-mm COMS plaque followed to loading of choroidal tumor by gold nanoparticlesMansour Zabihzadeh, Hadi Rezaee, Seyed Mohammad Hosseini, Mostafa Feghhi, Amir Danyaei, Mojtaba Hoseini-GhahfarokhiJournal of Cancer Research and Therapeutics 2019 15(3):504-511Aims and Objectives: Brachytherapy using removable ophthalmic plaques loaded with suitable small sealed radioactive seeds adjacent to the ocular's tumor has been widely used...
Αλέξανδρος Γ. Σφακιανάκης
16h
Murine experimental leprosy: Evaluation of immune response by analysis of peritoneal lavage cells and...
Murine experimental leprosy: Evaluation of immune response by analysis of peritoneal lavage cells and footpad histopathologyFátima Regina Vilani‐Moreno  Adriana Sierra Assêncio Almeida Barbosa  Beatriz Gomes Carreira Sartori  Suzana Madeira Diório  Sônia Maria Usó Ruiz Silva  Patrícia Sammarco Rosa … See all authorsFirst published: 24 May 2019 https://doi.org/10.1111/iep.12319Read the full textePDFPDFTOOLS SHARESummaryThis study evaluated the immune response of nude and BALB/c mice inoculated in...
Αλέξανδρος Γ. Σφακιανάκης
16h
Radioprotective effect of grape seed extract against gamma irradiation in mouse bone marrow cells Reza...
Radioprotective effect of grape seed extract against gamma irradiation in mouse bone marrow cellsReza Ghasemnezhad Targhi, Amin Banaei, Valiallah SabaJournal of Cancer Research and Therapeutics 2019 15(3):512-516Introduction: Ionizing radiations produce free radicals which are often responsible for DNA damage or cell death. Grape seed extract (GSE) is a natural compound having an antioxidant that protects DNA, lipids, and proteins from free radical damages. In this study, radioprotective effect of...
Αλέξανδρος Γ. Σφακιανάκης
16h
Cancer Research and Therapeutics
A comprehensive review of surgical margin in oral squamous cell carcinoma highlighting the significance of tumor-free surgical marginsMamata Kamat, Bhagawan Das Rai, Rudrayya S Puranik, Uma Vasant DatarJournal of Cancer Research and Therapeutics 2019 15(3):449-454Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity, and surgery is the most accepted line of treatment. The surgical margins (SMs) or resection margins are boundaries of resection specimen excised by the...
Αλέξανδρος Γ. Σφακιανάκης
16h
Radiochemotherapie des Zervixkarzinoms Zusammenfassung Die primäre kombinierte Radiochemotherapie...
Radiochemotherapie des ZervixkarzinomsZusammenfassungDie primäre kombinierte Radiochemotherapie ist Standard beim lokal fortgeschrittenen und nodal positivem Zervixkarzinom. Eine Kombination aus radikaler Hysterektomie und Radiochemotherapie sollte vermieden werden. Bei histologisch gesicherten Lymphknotenmetastasen paraaortal wird mit EFRT („extended field radiation therapy") eine exzellente lokale Kontrolle erzielt, die Hälfte der Betroffenen erreicht ein Langzeitüberleben. Die neoadjuvante Chemotherapie...
Αλέξανδρος Γ. Σφακιανάκης
16h
Lokale Therapie des Nierenzellkarzinoms ZusammenfassungZiel Ziel der Arbeit ist es, eine Übersicht...
Lokale Therapie des NierenzellkarzinomsZusammenfassungZielZiel der Arbeit ist es, eine Übersicht über den aktuellen Stand in der lokalen Therapie des lokalisierten Nierenzellkarzinom zu geben.Material und MethodenEs wurden die aktuelle Literatur sowie die Leitlinien in der Behandlung des Nierenzellkarzinoms analysiert.ErgebnisseGoldstandard beim lokalisierten Nierenzellkarzinom ist die operative Resektion des Tumors im Gesunden. Die organerhaltende Nierenteilresektion sollte im klinischen Stadium...
Αλέξανδρος Γ. Σφακιανάκης
16h
Systemtherapie des Nierenzellkarzinoms ZusammenfassungHintergrund Die medikamentöse Behandlung des...
Systemtherapie des NierenzellkarzinomsZusammenfassungHintergrundDie medikamentöse Behandlung des metastasierten Nierenzellkarzinoms (mRCC) hat sich in der letzten Dekade massiv verändert und wird sich weiterhin verändern.ZielIm Folgenden soll ein Überblick über die gegenwärtige und zukünftige Behandlungssituation dargestellt werden.Material und MethodenDie Übersicht wurde unter Beachtung, Recherche und kritischer Interpretation der relevanten Phase-II- und -III-Studien (PubMed) sowie aktueller Kongressbeiträge...
Αλέξανδρος Γ. Σφακιανάκης
16h
Neue Therapieansätze beim metastasierten Nierenzellkarzinom ZusammenfassungHintergrund Die medikamentöse...
Neue Therapieansätze beim metastasierten NierenzellkarzinomZusammenfassungHintergrundDie medikamentöse Therapie des metastasierten Nierenzellkarzinoms (mNZK) basiert derzeit auf Tyrosinkinaseinhibitoren (TKI), „mechanistic target of rapamycin"(mTOR)-Inhibitoren und Immun-Checkpoint-Inhibitoren (ICI). Aktuell belegen Phase-III-Daten eine überlegene Wirksamkeit der Kombination von TKI + ICI bzw. von verschiedenen ICI im Vergleich zu bisherigen Monotherapien in der Erstlinie.Ziel der ArbeitIm Rahmen...
Αλέξανδρος Γ. Σφακιανάκης
16h
Bildgebung bei Nierenzellkarzinom ZusammenfassungHintergrund Durch die Zunahme der Ultraschalluntersuchungen...
Bildgebung bei NierenzellkarzinomZusammenfassungHintergrundDurch die Zunahme der Ultraschalluntersuchungen und der gleichzeitigen Verbesserung von Labortests (Blutnachweis im Urin) werden heute weiterführende bildgebende Verfahren angewandt, um unklare Läsionen der Nieren weiter abzuklären. Auf der anderen Seite führen bessere Ultraschallgeräte und die Einführung von Ultraschallkontrastmitteln (Ultraschall-KMl) zu einer deutlichen Verbesserung der Ultraschalluntersuchungen mit einer Zunahme an Nachweisraten...
Αλέξανδρος Γ. Σφακιανάκης
16h
Der Onkologe
NierenzellkarzinomErratum zu: Bildgebung bei NierenzellkarzinomErratum zu:Onkologe 2019https://doi.org/10.1007/s00761-019-0536-yLeider sind durch ein Versehen die Legenden der Abb. 2 und 3 vertauscht worden. Nachstehend sehen Sie die beiden Abbildungen mit den richtigen Legenden. Der Originalbeitrag wurde korrigiert. Wir bitten den Fehler zu …Viel Neues in Diagnostik und Therapie des NierenzellkarzinomsBildgebung bei NierenzellkarzinomZusammenfassungHintergrundDurch die Zunahme der Ultraschalluntersuchungen...
Αλέξανδρος Γ. Σφακιανάκης
16h
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
A Foundational Framework for Andragogy in Oral and Maxillofacial Surgery II: Interactive Andragogies...A Foundational Framework for Andragogy in Oral and Maxillofacial Surgery II: Interactive AndragogiesEric R. Carlson, DMD, MD, EdM ∗,∗,'Correspondence information about the author DMD, MD, EdM Eric R. CarlsonEmail the author DMD, MD, EdM Eric R. Carlson, R. John Tannyhill, DDS, MD †DOI: https://doi.org/10.1016/j.joms.2019.01.054 |AbstractFull TextReferencesInteractive andragogies have been effectively...
Αλέξανδρος Γ. Σφακιανάκης

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