On the Relationship Between Oceanic Plate Speed, Tectonic Stress, and Seismic Anisotropy.

Seismic radial anisotropy (the squared ratio between the speeds of horizontally and vertically polarized shear waves, ξ = V S H 2 V S V 2 ) is a powerful tool to probe the direction of mantle flow and accumulated strain. While previous studies have confirmed the dependence of azimuthal anisotropy on plate speed, the first order control on radial anisotropy is unclear. In this study, we develop 2D ridge flow models combined with mantle fabric calculations to report that faster plates generate higher tectonics stresses and strain rates which lower the dislocation creep viscosity and lead to deeper anisotropy than beneath slower plates. We apply the SGLOBE-rani tomographic filter, resulting in a flat depth-age trend and stronger anisotropy beneath faster plates, which correlates well with 3D global anisotropic mantle models. Our predictions and observations suggest that as plate speed increases from 2 to 8 cm/yr, radial anisotropy increases by ∼0.01-0.025 in the upper 100-200 km of the mantle between 10 and 60 Ma.

Colorectal anastomosis after laparoscopic extended left colectomy: techniques and outcome.

AIM: After extended left colectomy, traditional colorectal anastomosis is often not feasible because of insufficient length of the remaining colon to perform a tension-free anastomosis. Total colectomy with ileorectal anastomosis could be an alternative but this can lead to unsatisfactory quality of life. Trans-mesenteric colorectal anastomosis or inverted right colonic transposition (the so-called Deloyers procedure) are two possible solutions for creating a tension-free colorectal anastomosis after extended left colectomy. Few studies have reported their results of these two techniques and mostly via laparotomy. The aim of this study was to describe the trans-mesenteric colorectal anastomosis and the inverted right colonic transposition procedure via a laparoscopic approach and report the outcome in a series of 13 consecutive patients. METHOD: This was retrospective chart review of laparoscopic colorectal surgery with trans-mesenteric colorectal anastomosis or the inverted right colonic transposition procedure from January 2015 up to 2019. An accompanying video demonstrates these two techniques. RESULTS: Thirteen consecutive patients underwent either a laparoscopic trans-mesenteric colorectal anastomosis (n = 9) or an inverted right colonic transposition procedure (n = 4). One patient had intra-operative presacral bleeding that was stopped successfully without conversion. Two patients had a postoperative intra-abdominal abscess, but no anastomotic complications were recorded. The median number of bowel movements per day after 6 months was 2 (range 2-5). CONCLUSIONS: Trans-mesenteric colorectal anastomosis or the inverted right colonic transposition procedure is feasible laparoscopically. The now well-established classical advantages of the laparoscopic approach are associated with good functional outcome after these procedures.

Utilizing size-based thresholds of stiffness gradient to reclassify BI-RADS category 3-4b lesions increases diagnostic performance.

AIM: To investigate the role of utilizing size-based thresholds of stiffness gradient in diagnosing solid breast lesions and optimizing original Breast Imaging-Reporting And Data System (BI-RADS) classifications. MATERIALS AND METHODS: Two-hundred and twenty-seven consecutive women underwent shear-wave elastography (SWE) before ultrasound-guided biopsy, and 234 solid breast lesions categorized as BI-RADS 3-5 were analysed. Receiver operating characteristic curve analysis was performed based on histopathology. Diagnostic performance among SWE, BI-RADS, and their combination were compared. RESULTS: The stiffness gradient correlated with the standard deviation of elasticity (SD, r=0.90), and with Tozaki's pattern classification (r=0.64). The area under the receiver operating characteristic curves (AUC) for stiffness gradient (0.939) outperformed SD (0.897) or colour pattern (0.852). Due to significant association with lesion size (r=0.394, p<0.001), stiffness gradient's size-based thresholds (lesions >15 mm: 82.5 kPa; lesions ≤15 mm: 51.1 kPa) were established to reclassify BI-RADS 3-4b lesions. Upgrading category 3 lesions (over the corresponding cut-off value, 3 to 4a) and downgrading categories 4a-4b lesions (less than or equal to the corresponding cut-off value, 4b to 4a, 4a to 3), yielded significant improvement in specificity (90.28% versus 77.78%, p<0.001) and AUC (0.948 versus 0.926, p=0.035) than BI-RADS alone. No significant loss emerged in the sensitivity (88.89% versus 91.11%, p=0.500). CONCLUSION: Stiffness gradient exhibited better discriminatory ability than SD or four-colour pattern classification in determining solid breast lesions and applying its size-specific thresholds to categorize BI-RADS 3-4b lesions could improve diagnostic performance.

Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: recurrent disease.

This manuscript reports the consensus statements regarding recurrent ovarian cancer (ROC), reached at the fifth Ovarian Cancer Consensus Conference (OCCC), which was held in Tokyo, Japan, in November 2015. Three important questions were identified: (i) What are the subgroups for clinical trials in ROC? The historical definition of using platinum-free interval (PFI) to categorise patients as having platinum-sensitive/resistant disease was replaced by therapy-free interval (TFI). TFI can be broken down into TFIp (PFI), TFInp (non-PFI) and TFIb (biological agent-free interval). Additional criteria to consider include histology, BRCA mutation status, number/type of previous therapies, outcome of prior surgery and patient reported symptoms. (ii) What are the control arms for clinical trials in ROC? When platinum is considered the best option, the control arm should be a platinum-based therapy with or without an anti-angiogenic agent or a poly (ADP-ribose) polymerase (PARP) inhibitor. If platinum is not considered the best option, the control arm could include a non-platinum drug, either as single agent or in combination. (iii) What are the endpoints for clinical trials in ROC? Overall survival (OS) is the preferred endpoint for patient cohorts with an expected median OS < or = 12 months. Progression-free survival (PFS) is an alternative, and it is the preferred endpoint when the expected median OS is > 12 months. However, PFS alone should not be the only endpoint and must be supported by additional endpoints including pre-defined patient reported outcomes (PROs), time to second subsequent therapy (TSST), or time until definitive deterioration of quality of life (TUDD).

The incidence of inguinal hernia and associated risk factors of incarceration in pediatric inguinal hernia: a nation-wide longitudinal population-based study.

PURPOSE: This study uses a national database to evaluate the incidence of inguinal hernia and associated risk factors of incarcerated hernia in children from birth to 15 years of age. METHODS: The study selected children born from 1997 to 2005 from a randomly selected cohort of 1,000,000 from an insured population of 23 million. We regarded children that were classified with code 550 and hernia surgery in accordance to the International Classification of Diseases, 9th Revision, as having inguinal hernia. We used the 2 chi-square test and logistic regression modeling for statistical analyses. RESULTS: In total, 79,794 children (41,767 male and 38,027 female) were enrolled in the study. The cumulative incidence of inguinal hernia in males and females from birth to 15 years old were 6.62 and 0.74 %, respectively (p < 0.01). The peak incidence of inguinal hernia was at 0 years of age for males and 5 years of age for females. The ratio of unilateral vs. bilateral repair was 5.54:1. Females tend to have more bilateral inguinal hernia than males (25.4 vs. 12.9 %, p < 0.01). Incarcerated hernia occurred in 4.19 % children with inguinal hernia without significant gender discrepancy. Approximately 40 % of incarcerated hernia underwent hernia repair immediately after visiting the emergent department. In patients who presented with reducible hernia, we did not find significant correlation between waiting time to hernia repair and occurrence of incarceration. CONCLUSIONS: The cumulative incidence of inguinal hernia from birth to 15 years of age was 6.62 and 0.74 % in males and females, respectively. Incarceration was not related to prematurity or the waiting time for surgery.

Evaluation of dose conversion coefficients for external exposure using Taiwanese reference man and woman.

Reference man has been widely used for external and internal dose evaluation of radiation protection. The parameters of the mathematical model of organs suggested by the International Commission of Radiological Protection (ICRP) are adopted from the average data of Caucasians. However, the organ masses of Asians are significantly different from the data of Caucasians, leading to potentially dosimetric errors. In this study, a total of 40 volunteers whose heights and weights corresponded to the statistical average of Taiwanese adults were recruited. Magnetic resonance imaging was performed, and T2-weighted images were acquired. The Taiwanese reference man and woman were constructed according to the measured organ masses. The dose conversion coefficients (DCFs) for anterior-posterior (AP), posterior-anterior (PA), right lateral (RLAT) and left lateral (LLAT) irradiation geometries were simulated. For the Taiwanese reference man, the average differences of the DCFs compared with the results of ICRP-74 were 7.6, 5.1 and 11.1 % for 0.1, 1 and 10 MeV photons irradiated in the AP direction. The maximum difference reached 51.7 % for the testes irradiated by 10 MeV photons. The size of the trunk, the volume and the geometric position of organs can cause a significant impact on the DCFs for external exposure of radiation. The constructed Taiwanese reference man and woman can be used in radiation protection to increase the accuracy of dose evaluation for the Taiwanese population.

Xanthogranulomatous inflammation of terminal ileum: report of a case with small bowel involvement.

Xanthogranulomatous inflammation is a rare pathological condition most frequently detected in the kidney and gallbladder. Reported herein is a case of xanthogranulomatous inflammation in a 51-year-old male presenting as a mass-forming lesion in the terminal ileum with mucosal ulceration. Diagnostic laparoscopy followed by ileocecectomy was performed due to intra-operative suspicion of carcinoma of appendix. This is a report of the condition involving the terminal ileum with mucosal ulceration and full-thickness involvement of bowel wall which are uncommon features of xanthogranulomatous inflammation in previously reported lower gastro-intestinal tract lesions.

Estimation of sleep status in sleep apnea patients using a novel head actigraphy technique.

Polysomnography is a comprehensive modality for diagnosing sleep apnea (SA), but it is expensive and not widely available. Several technologies have been developed for portable diagnosis of SA in the home, most of which lack the ability to detect sleep status. Wrist actigraphy (accelerometry) has been adopted to cover this limitation. However, head actigraphy has not been systematically evaluated for this purpose. Therefore, the aim of this study was to evaluate the ability of head actigraphy to detect sleep/wake status. We obtained full overnight 3-axis head accelerometry data from 75 sleep apnea patient recordings. These were split into training and validation groups (2:1). Data were preprocessed and 5 features were extracted. Different feature combinations were fed into 3 different classifiers, namely support vector machine, logistic regression, and random forests, each of which was trained and validated on a different subgroup. The random forest algorithm yielded the highest performance, with an area under the receiver operating characteristic (ROC) curve of 0.81 for detection of sleep status. This shows that this technique has a very good performance in detecting sleep status in SA patients despite the specificities in this population, such as respiration related movements.

Community periodontal treatment needs in South Korea.

OBJECTIVES: This study aimed to assess the relationship between socio-economic factors and community periodontal treatment needs in Korea. METHODS: Data were obtained from the year 2009 Korean National Health and Nutrition Examination Survey. Our analysis included 7510 survey participants over the age of 19 years. To assess the relationship between socio-economic factors and the need for periodontal scaling, we performed multivariate logistic regression analyses for data with a complex sampling structure. PASW statistics 19.0 (SPSS Inc., Chicago, IL, USA) was used to perform the statistical analyses, and the results were expressed as odds ratios (OR) with corresponding 95% confidence intervals (CIs). RESULTS: A very high percentage of Korean adults required periodontal scaling (71.5%). After adjusting for sex, age, and socio-economic factors, the need for periodontal scaling was associated with low levels of education (OR: 1.41, 95% CI: 1.03-1.93), low incomes (OR: 1.27, 95% CI: 1.01-1.60), employment as a service and sales worker (OR: 1.39, 95% CI: 1.10-1.77), and employment as a manual worker (OR: 1.31, 95% CI: 1.02-1.69). CONCLUSIONS: In South Korea, the need for periodontal scaling was associated with socio-economic factors, such as low levels of education, low incomes, employment as a service and sales worker and employment as a manual worker. Consequently, clinical and community dental hygienists should consider adults with these risk factors as belonging to high-priority subgroups to whom they should respond first.

Incomplete bladder emptying is associated with febrile urinary tract infections in infants.

OBJECTIVE: To investigate lower urinary tract dysfunction in pre-toilet trained infants with and without history of febrile UTI (f-UTI). MATERIALS AND METHODS: Pre-toilet trained infants with f-UTI (Group 1) from pediatric nephrology and urology clinics, and those without f-UTI (Group 2) from infant-care centers were enrolled for the present study. Infants in Group 1 underwent four-hourly (4-H) observations for at least one month after treatment for UTI. Voided volume (VV) and post-void residual urine (PVR) were measured by weighting diaper and suprapubic ultrasound after finishing voiding, respectively. Average PVR was defined as the mean value of PVR during 4-H observation. Interrupted voiding was defined as two or three voidings within 10 min. Voiding efficiency was defined as VV/(VV+PVR). RESULTS: The mean ages of Group 1 (n=64) and Group 2 infants (n=56) were 10.6±7.5 months vs 10.2±5.1 months, respectively (p=0.70). Group 1 infants had significantly higher voiding frequency (3.0 times±1.2 vs 2.6 times±0.9, p=0.04), average PVR (14.5 ml±14.2 vs 8.9 ml±8.8, p<0.01) and lower voiding efficiency (71.2%±20.5 vs 80.2%±18.5, p=0.01) than Group 2. ROC curve analysis showed that the optimal cutoff values for PVR and voiding efficiency to differentiate Group 1 and Group 2 infants were 10 ml and 80%, respectively. Group 1 infants had significantly more repeat elevated PVR (≧10 ml) and repeat low voiding efficiency (≦80%) than Group 2 (44.8% vs 22.4%, p=0.03; 62.0% vs 28.6%, p<0.01, respectively). CONCLUSION: Pre-toilet trained infants with f-UTI were associated with elevated PVR and lower voiding efficiency than normal controls.

Gout patients have an increased risk of developing most cancers, especially urological cancers.

OBJECTIVES: Inflammation and hyperuricaemia, which are the major characteristics of gout disease, are thought to be associated with carcinogenesis and anti-carcinogenesis, respectively. Therefore, we aimed to explore the causal effect on cancers from those with gout disease. METHOD: New gout patients without a history of cancer were included from 1998 to 2000, and they had been followed up from 2001 to 2008 to observe the incidence of cancers from national outpatient records in Taiwan. RESULTS: A total of 8408 male gout patients and 25,010 male controls were included by matching gout patients' age and year and month of first diagnosis during the including period. The mean ages at diagnosis were 51.03 ± 14.52 and 50.90 ± 14.45 years for gout patients and controls, respectively. The overall incidence of all cancers was 9.82 cases per 1000 person-years among gout patients compared to 4.35 cases per 1000 person-years among controls after 8 years of follow-up. The age-adjusted standardized incidence ratios (SIRs) were 2.26 [95% confidence interval (CI) 2.06-2.49], 3.31 (95% CI 2.55-4.31), 3.14 (95% CI 2.12-4.64), and 2.18 (95% CI 1.34-3.56) for all cancers, prostate cancer, bladder cancer, and renal cancer, respectively. The cumulative hazard ratios (HRs) were significantly higher in gout patients than in controls with regard to developing prostate, bladder, and renal cancers (all p < 0.001). CONCLUSIONS: This study shows that gout patients are more likely to develop most cancers, especially the urological cancers: prostate, bladder, and renal cancers. The data also support the hypothesis of a link between metabolic syndrome (MetS) and cancer disorders.

Improvements on a patient-specific dose estimation system in nuclear medicine examination.

The purpose of this paper is to develop a patient-specific dose estimation system in nuclear medicine examination. A dose deposition routine to store the deposited energy of the photons during their flights was embedded in the widely used SimSET Monte Carlo code and a user-friendly interface for reading PET and CT images was developed. Dose calculated on ORNL phantom was used to validate the accuracy of this system. The ratios of S value for (99m)Tc, (18)F and (131)I computed by this system to those obtained with OLINDA for various organs were ranged from 0.93 to 1.18, which were comparable to that obtained from MCNPX2.6 code (0.88-1.22). Our system developed provides opportunity for tumor dose estimation which cannot be known from the MIRD. The radiation dose can provide useful information in the amount of radioisotopes to be administered in radioimmunotherapy.

Reduction in dental plaque in patients with mental disorders through the dental hygiene care programme.

OBJECTIVE: To develop a dental hygiene care programme based on the specific needs of patients with mental disorders and to suggest practical guidelines to improve the oral health care of these patients. METHODS: A total of 73 patients with mental illness participated in the study. The patients were randomly classified into three groups and followed over 12 weeks at 4-week intervals. A newly designed dental hygiene care programme using flash-based video, brochures and a toothpick method was implemented by five dental hygienists. Plaque index, stimulated saliva, subjective oral dryness and dental caries activity were analysed as outcome variables. RESULTS: Results showed that the dental plaque index significantly decreased after each session (P < 0.0001) in all three groups, and significant differences were found between groups (P = 0.036). Patients' oral dryness decreased significantly, but stimulated saliva and dental caries activity did not improve. CONCLUSION: The results of this study suggest that the dental hygiene care programme, which made use of a short, 10-min flash-based video and brochures every 4 weeks, was effective in reducing the dental plaque index of patients with mental disorders.

Design and testing of a uniformly solar energy TIR-R concentration lenses for HCPV systems.

In this paper, total internal reflection-refraction (TIR-R) concentration (U-TIR-R-C) lens module were designed for uniformity using the energy configuration method to eliminate hot spots on the surface of solar cell and increase conversion efficiency. The design of most current solar concentrators emphasizes the high-power concentration of solar energy, however neglects the conversion inefficiency resulting from hot spots generated by uneven distributions of solar energy concentrated on solar cells. The energy configuration method proposed in this study employs the concept of ray tracing to uniformly distribute solar energy to solar cells through a U-TIR-R-C lens module. The U-TIR-R-C lens module adopted in this study possessed a 76-mm diameter, a 41-mm thickness, concentration ratio of 1134 Suns, 82.6% optical efficiency, and 94.7% uniformity. The experiments demonstrated that the U-TIR-R-C lens module reduced the core temperature of the solar cell from 108 °C to 69 °C and the overall temperature difference from 45 °C to 10 °C, and effectively relative increased the conversion efficiency by approximately 3.8%. Therefore, the U-TIR-R-C lens module designed can effectively concentrate a large area of sunlight onto a small solar cell, and the concentrated solar energy can be evenly distributed in the solar cell to achieve uniform irradiance and effectively eliminate hot spots.

Microbiological and clinical characteristics of bacteraemia caused by the hypermucoviscosity phenotype of Klebsiella pneumoniae in Korea.

Hypermucoviscous (HV) isolates of Klebsiella pneumoniae have been linked to virulence potential in experimental infections. We examined 33 isolates of K. pneumoniae from patients with bacteraemia for the HV phenotype on agar culture, and determined their virulence potential by screening for capsular (K) serotype by polymerase chain reaction and the presence of seven virulence factor genes. Fourteen (42·4%) isolates expressed the HV phenotype and 11 of these were serotype K1 or K2; these serotypes were not identified in HV-negative isolates. The genes rmpA, rmpA2, aerobactin, wabG and allS were significantly more frequent in HV than non-HV isolates. Multilocus sequence typing identified 21 sequence types (ST), eight of which were found in HV-positive isolates and the clonal relatedness of isolates of the most frequent types (ST23 and ST11) from different hospitals was confirmed by pulsed-field gel electrophoresis. The HV phenotype was more associated with community-acquired infection with a lower frequency of fatal underlying illness, but with significantly more focal infections, notably liver abscesses. Clinicians should be aware of such clinical impacts of the HV phenotype.

Dose point kernel simulation for monoenergetic electrons and radionuclides using Monte Carlo techniques.

Monte Carlo (MC) simulation has been commonly used in the dose evaluation of radiation accidents and for medical purposes. The accuracy of simulated results is affected by the particle-tracking algorithm, cross-sectional database, random number generator and statistical error. The differences among MC simulation software packages must be validated. This study simulated the dose point kernel (DPK) and the cellular S-values of monoenergetic electrons ranging from 0.01 to 2 MeV and the radionuclides of (90)Y, (177)Lu and (103 m)Rh, using Fluktuierende Kaskade (FLUKA) and MC N-Particle Transport Code Version 5 (MCNP5). A 6-µm-radius cell model consisting of the cell surface, cytoplasm and cell nucleus was constructed for cellular S-value calculation. The mean absolute percentage errors (MAPEs) of the scaled DPKs, simulated using FLUKA and MCNP5, were 7.92, 9.64, 4.62, 3.71 and 3.84 % for 0.01, 0.1, 0.5, 1 and 2 MeV, respectively. For the three radionuclides, the MAPEs of the scaled DPKs were within 5 %. The maximum deviations of S(N←N), S(N←Cy) and S(N←CS) for the electron energy larger than 10 keV were 6.63, 6.77 and 5.24 %, respectively. The deviations for the self-absorbed S-values and cross-dose S-values of the three radionuclides were within 4 %. On the basis of the results of this study, it was concluded that the simulation results are consistent between FLUKA and MCNP5. However, there is a minor inconsistency for low energy range. The DPK and the cellular S-value should be used as the quality assurance tools before the MC simulation results are adopted as the gold standard.

Differential expression patterns of growth-related microRNAs in the skeletal muscle of Nile tilapia (Oreochromis niloticus).

MicroRNA (miRNA) are a class of small, single-stranded, non-coding RNA that regulate mRNA expression at the post-transcriptional level and play important roles in many fundamental biological processes. There is emerging evidence that miRNA are critical regulators of widespread cellular functions, such as differentiation, proliferation, and migration. At present, little is known about miRNA expression profiles related to skeletal muscle growth in aquatic organisms. This study aimed to investigate the phenotypic variation in the body growth of the Nile tilapia (Oreochromis niloticus) and to identify and quantify the differential expression levels of selected growth-related transcriptomic miRNA in the skeletal muscle of this fish. To this end, we performed next-generation sequencing to define the full miRNA transcriptome in muscle tissue from Nile tilapia and to detect differentially expressed miRNA between 2 strains of Nile tilapia. These tilapia strains exhibited significant (P < 0.05) phenotypic variation with respect to growth-related traits (body length and BW), mitochondrial DNA (mtDNA) haplotype diversity, and the differential expression of selected growth-related genes. The results obtained from the transcriptome analysis and real-time quantitative reverse transcription PCR (qRT-PCR) revealed significant differences in miRNA expression between fast-growing and control strains of tilapia. Digital gene expression (DGE) profiling was performed based on the obtained read abundance, and we identified down-regulated miRNA, including let-7j, miR-140, miR-192, miR-204, miR-218a, miR-218b, miR-301c, and miR-460, and up-regulated miRNA, including let-7b, let-7c, miR-133, miR-152, miR-15a, miR-193a, miR-30b, and miR-34, associated with body growth in tilapia. These results were further validated using real-time qRT-PCR and microarray profiling. In summary, the up- and down-regulation of miRNA involved in the GH/IGF-1 axis signaling pathway suggests that the differential expression levels of growth-related miRNA may serve as molecular markers that are predictive of specific functional and diagnostic implications. The obtained data on genetic polymorphisms in miRNA-target interactions are particularly useful for Nile tilapia breeding programs.

The age-risk relationship of haematologic malignancies in female patients with systemic lupus erythematosus: a nationwide retrospective cohort study.

BACKGROUND: The risks of haematologic malignancies in female patients with systemic lupus erythematosus (SLE) have been observed to be higher in young age groups than in old age groups. However, the age-risk relationship between haematologic malignancies and SLE is poorly defined. DESIGN AND METHODS: A retrospective cohort study was conducted nationwide with newly diagnosed SLE female patients during the period of 1997 to 2001 using the database acquired from the Taiwan National Health Research Institute. Each patient in the study was randomly frequency matched with five SLE-free people based on age. The subsequent developments of haematologic malignancies were observed until the date haematologic cancer was diagnosed or December 2008. The age-adjusted standardized incidence ratios (SIRs), the incidence per 1000 person-years, the follow-up duration to the diagnosis of haematologic malignancies and the cumulative hazard rates of haematologic malignancies between SLE and controls were analysed. RESULTS: A total of 35 lymphoid and 14 myeloid malignancies were observed among 9349 female SLE patients. Further, significantly higher incidences of both lymphoid and myeloid malignancies were found in SLE patients (SIR: 3.30, 95% confidence interval (CI) = 2.20-4.93 and SIR: 2.86, 95% CI = 1.49-5.09). Also, two peaks of risk ratios for lymphoid malignancies were found in patients aged 21-30 years and 41-50 years. It was observed that the follow-up duration for haematologic malignancies was significantly shorter in SLE patients than in controls (73.21 vs. 105.25 months, respectively). In addition, higher cumulative hazard rates in both lymphoid and myeloid malignancies were found in SLE patients (p < 0.0001). CONCLUSION: Female SLE patients have a higher incidence of haematologic malignancy in different age groups, and with shorter incubating time than SLE-free people.