We report an unusual case of primary amyloidosis of the stomach in a patient complaining of dyspeptic symptoms. The diagnosis was confirmed histologically and other gastrointestinal site or systemic involvement was ru...We report an unusual case of primary amyloidosis of the stomach in a patient complaining of dyspeptic symptoms. The diagnosis was confirmed histologically and other gastrointestinal site or systemic involvement was ruled out. Uncharacteristic dyspeptic symptoms may hide this rare metabolic disease.展开更多
Emergence from anesthesia(AE) is the ending stage of anesthesia featuring the transition from unconsciousness to complete wakefulness and recovery of consciousness(RoC). A wide range of undesirable complications, incl...Emergence from anesthesia(AE) is the ending stage of anesthesia featuring the transition from unconsciousness to complete wakefulness and recovery of consciousness(RoC). A wide range of undesirable complications, including coughing, respiratory/cardiovascular events, and mental status changes such as emergence delirium, and delayed RoC, may occur during this critical phase. In general anesthesia processes, induction and AE represent a neurobiological example of "hysteresis". Indeed, AE mechanisms should not be simply considered as reverse events of those occurring in the induction phase. Anesthesia-induced loss of consciousness(LoC) and AE until RoC are quite distinct phenomena with, in part, a distinct neurobiology. Althoughanaesthetics produce LoC mostly by affecting cortical connectivity, arousal processes at the end of anesthesia are triggered by structures deep in the brain, rather than being induced within the neocortex. This work aimed to provide an overview on AE processes research, in terms of mechanisms, and EEG findings. Because most of the research in this field concerns preclinical investigations, translational suggestions and research perspectives are proposed. However, little is known about the relationship between AE neurobiology, and potential complications occurring during the emergence, and after the RoC. Thus, another scope of this review is to underline why a better understanding of AE mechanisms could have significant clinical implications, such as improving the patients' quality of recovery, and avoiding early and late postoperative complications.展开更多
Pancreatic cancer(PC)is a devastating malignancy with fewer than 10%of patients being alive at 5 years after diagnosis.Venous thromboembolism(VTE)occurs in approximatively 20%of patients with PC,resulting in increased...Pancreatic cancer(PC)is a devastating malignancy with fewer than 10%of patients being alive at 5 years after diagnosis.Venous thromboembolism(VTE)occurs in approximatively 20%of patients with PC,resulting in increased morbidity,mortality and significant health care costs.The management of VTE is particularly challenging in these frail patients.Adequate selection of the most appropriate anticoagulant for each individual patient according to the current international guidelines is warranted for overcoming treatment challenges.The International Initiative on Thrombosis and Cancer multi-language web-based mobile application(downloadable for free at www.itaccme.com)has been developed to help clinicians in decision making in the most complex situations.In this narrative review,we will discuss the contemporary epidemiology and burden of VTE in PC patients,the performances and limitations of current risk assessment models to predict the risk of VTE,as well as evidence from recent clinical trials for the primary prophylaxis and treatment of cancer-associated VTE that support updated clinical practice guidelines.展开更多
Background and Study Aims: In nonpolypoid colorectal lesions, the presence of irregular, distorted glands in the colon (a disrupted crypt pattern) on magnification chromoendoscopy (MCE) is strongly associated with sub...Background and Study Aims: In nonpolypoid colorectal lesions, the presence of irregular, distorted glands in the colon (a disrupted crypt pattern) on magnification chromoendoscopy (MCE) is strongly associated with submucosal invasive cancer. The aim of the present study was to evaluate the ability of MCE to differentiate between an invasive crypt pattern and a noninvasive crypt pattern, including nonneoplastic lesions,and to assess the ability of this MCE classification to predict invasiveness and allow patients to be selected for endoscopic resection or surgical resection. Patients and Methods: In a prospective study including 1560 colonoscopies, 153 flat or depressed colorectal lesions were evaluated with MCE among 534 colorectal lesions; the remainder had a polypoid appearance. The pit pattern was classified as nonneoplastic (type II) or neoplastic (types IIIV) and the latter was subdivided into noninvasive.(types III or IV) or submucosally invasive (type V). Lesions with a nonneoplastic and noninvasive neoplastic appearance were resected endoscopically if technically feasible, whereas those with a type V pattern were resected surgically. The resection specimens were analyzed histologically in relation to the Vienna classification. Results: Using this management strategy based on the pit pattern, 86%(n = 70) of the type II lesions were hyperplastic; the remaining 11 had low-grade intraepithelial neoplasia. Type III and IV lesions (n = 58) represented either low-grade or high-grade intraepithelial neoplasia in 95%of the cases. Three patients had sm1 (n = 2) or sm2/3 invasive cancers. Among the patientswith typeVlesions (n = 14), 11 had invasive cancers (four sm1 and seven sm2/3). Endoscopic differentiation based on the pit pattern thus had a positive predictive value (PPV) of 86%and a negative predictive value of 96%for distinguishing between nonneoplastic and neoplastic lesions. The pit pattern criteria for distinguishing between invasive and noninvasive neoplasia (including nonneoplastic lesions), and hence the choice between endoscopic and surgical resection, had a PPVof 79%and a NPV of 98%. Excluding nonneoplastic lesions, the NPV would be 95%. Conclusions: The endoscopic pit pattern on MCE has only a moderate predictive value for nonneoplastic lesions, so that leaving these flat hyperplastic lesions in place on the basis of the endoscopic magnification appearance alone cannot be generally recommended. However, MCE has a good predictive value for guiding management toward either endoscopic resection (if technically feasible) or surgical resection.展开更多
Numerous amphibian species occupy microhabitats with buffered thermal and moisture conditions,typically under forest canopies.Here,we assessed whether the insular endemic Salamandra corsica also uses this type of habi...Numerous amphibian species occupy microhabitats with buffered thermal and moisture conditions,typically under forest canopies.Here,we assessed whether the insular endemic Salamandra corsica also uses this type of habitat,which could have important implications for its conservation.We used data loggers to record the air temperature and air humidity at 4 h intervals over a period of 2 years,at 13 stations with a confirmed presence of S.corsica.These data were compared with those recorded at Corsican weather stations and those generated by a climate model(WorldClim 2).The weather station data showed significant deviations from the probe data,by an average of-1.26℃(minimum temperature),+2.61℃(maximum temperature),and-0.04%(relative humidity).Similarly,the WorldClim 2 data showed significant deviations from the probe data,by an average of-2.49°C(minimum temperature)and+1.69℃(maximum temperature).These discrepancies refl ect the use of densely vegetated and topographically complex habitats by S.corsica,which reduce temperature fluctuations.Overall,our results highlight the importance of natural vegetal cover in the conservation of populations of this endemic salamander.展开更多
Background:Island species are vulnerable to rapid extinction,so it is important to develop accurate methods to determine their occurrence and habitat preferences.In this study,we assessed two methods for modeling the ...Background:Island species are vulnerable to rapid extinction,so it is important to develop accurate methods to determine their occurrence and habitat preferences.In this study,we assessed two methods for modeling the occurrence of the Corsican endemic Salamandra corsica,based on macro-ecological and fine habitat descriptors.We expected that models based on habitat descriptors would better estimate S.corsica occurrence,because its distribution could be influenced by micro-environmental gradients.The occurrence of S.corsica was modeled according to two ensembles of variables using random forests.Results:Salamandra corsica was mainly found in forested habitats,with a complex vertical structure.These habitats are associated with more stable environmental conditions.The model based on fine habitat descriptors was better able to predict occurrence,and gave no false negatives.The model based on macro-ecological variables underestimated the occurrence of the species on its ecological boundary,which is important as such locations may facilitate interpopulation connectivity.Conclusions:Implementing fine spatial resolution models requires greater investment of resources,but this is advisable for study of microendemic species,where it is important to reduce type II error(false negatives).展开更多
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and severe adverse effects related to cancer treatment. Unfortunately, although several agents and protocols have been proposed, no prophyl...Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and severe adverse effects related to cancer treatment. Unfortunately, although several agents and protocols have been proposed, no prophylactic strategies have yet to be proven useful. Therefore, new alternative therapies have been considered for CIPN prevention. Herbal medicine in Japan, called Kampo medicine, is derived from traditional Chinese medicine. Goshajinkigan (GJG) is a Kampo medicine, that is comprised of ten herbs. The aim of this work is to analyse the results of pre-clinical and clinical studies on the potential applications of GJG in CIPN prevention.展开更多
The Mediterranean region possesses a rich diversity of salamanders,which also exhibit a high degree of ecological diversification.It is assumed that the presence of salamanders is dependent on the level of vegetation ...The Mediterranean region possesses a rich diversity of salamanders,which also exhibit a high degree of ecological diversification.It is assumed that the presence of salamanders is dependent on the level of vegetation cover in terrestrial habitats,but the strength of this association is likely to vary among species.In this study,we investigated the patterns of habitat utilization for Mediterranean salamanders based on 589 records of 33 species.We tested the hypothesis that the association between salamander presence and vegetation density varies among genera or reproductive modes(i.e.terrestrial vs aquatic).The results show that vegetation cover has similar influences on terrestrial and aquatic groups but important differences are identified for lotic and lentic aquatic species.Our findings also indicate that the aquatic lotic,terrestrial,and small-body species deviate significantly from that expected from the background range of variation.展开更多
We describe the valued Gabriel quiver of a wedge product of coalgebras and study the category of comodules of a semiprime coalgebra. In particular, we prove that any monomial semiprime k-tame fc-tame coalgebra is stri...We describe the valued Gabriel quiver of a wedge product of coalgebras and study the category of comodules of a semiprime coalgebra. In particular, we prove that any monomial semiprime k-tame fc-tame coalgebra is string. We also prove a version of Eisenbud-Griffith theorem for coalgebras, namely, any hereditary semiprime strictly quasi-finite coalgebra is serial.展开更多
The development of transportation systems has significantly enhanced the welfare and modernization of society. Wooden vehicles pulled by animals have been used for land transportation since the early Bronze Age. Whole...The development of transportation systems has significantly enhanced the welfare and modernization of society. Wooden vehicles pulled by animals have been used for land transportation since the early Bronze Age. Whole-body gharries with rigid wheels pulled by oxen appeared in Crete by 2000 BC or earlier. Horses originating from the East were depicted in early Cretan seal-rings of the same period. The two-wheeled horse- drawn chariot was one of the most important inventions in history. This vehicle provided humanity its first concept of personal transport and was the key technology of war for 2000 years. Chariots of Mycenaean and Archaic Greece with light and flexible four-spoked wheels acting as spring suspensions were depicted in vase paintings. The development of this vehicle incorporated the seeds of a primitive design activity and was important for engineering. The Trojan horse since 1194 BC and the helepolis since 700 BC were the first known machines on a wheeled base transported by horses or self-powered. Ancient engineers invented bearings lubricated with fat, and Romans introduced the ancestors of ball bearings for their wagons and carts. The historic evolution of wheeled transportation systems, along with early traction, suspension, and braking systems, is presented in this paper. Analytical and numerical methods are incorporated to analyze the most conceivable loading situations of typically reconstructed wheeled transportation systems in ancient times. Traction requirements both for horse-driven machines and the power for internal motors are also analyzed. This study can serve as a basis for further development of detailed reconstruction of transportation systems in antiquity.展开更多
A brief description of the windmills from the second millennium BC to the Renaissance is presented. This survey is a part of several studies conducted by the authors on technology in the ancient world. The windmills a...A brief description of the windmills from the second millennium BC to the Renaissance is presented. This survey is a part of several studies conducted by the authors on technology in the ancient world. The windmills are the first motor, other than human muscles, and are the ancestors of the modem wind turbines. Some authors' virtual reconstructions of old windmills are also presented. The paper shows that the operating principle of many modem machines had already been conceived in the ancient times by using a technology that was more advanced than expected, but with two main differences, as follows: Similar tasks were accomplished by using much less energy; and the environmental impact was nil or very low. Modem designers should sometimes consider simplicity rather than the use of a large amount of energy.展开更多
We focus our attention to the set Gr(ξ) of grouplike elements of a coring ξover a ring A. We do some observations on the actions of the groups U(A) and Aut(ξ~) of units of A and of automorphisms of corings of...We focus our attention to the set Gr(ξ) of grouplike elements of a coring ξover a ring A. We do some observations on the actions of the groups U(A) and Aut(ξ~) of units of A and of automorphisms of corings of ξ, respectively, on Gr(ξ), and on the subset Gal(ξ)of all Galois grouplike elements. Among them, we give conditions on ξ under which Gal(ξ) is a group, in such a way that there is an exact sequence of groups {1} → U(Ag) → U(A) → Gal(ξ) → {1}, where Ag is the subalgebra of coinvaxiants for some g ∈ Gal(ξ).展开更多
How the morphology of captive-reared fish is affected by structural enrichment in their rearing tanks is not well understood.Some studies have suggested that deficiencies in rearing environments could produce inapprop...How the morphology of captive-reared fish is affected by structural enrichment in their rearing tanks is not well understood.Some studies have suggested that deficiencies in rearing environments could produce inappropriate body shape in salmonids(Vehanen and Huusko 2011).Garduho-Paz et al.(2010)have found significant differences in body and head shapes of 3-spine stickleback Gasterosteus aculeatus,depending on whether fish were reared in an environment with just gravel or in an environment enriched with large stones and artificial plants.展开更多
文摘We report an unusual case of primary amyloidosis of the stomach in a patient complaining of dyspeptic symptoms. The diagnosis was confirmed histologically and other gastrointestinal site or systemic involvement was ruled out. Uncharacteristic dyspeptic symptoms may hide this rare metabolic disease.
文摘Emergence from anesthesia(AE) is the ending stage of anesthesia featuring the transition from unconsciousness to complete wakefulness and recovery of consciousness(RoC). A wide range of undesirable complications, including coughing, respiratory/cardiovascular events, and mental status changes such as emergence delirium, and delayed RoC, may occur during this critical phase. In general anesthesia processes, induction and AE represent a neurobiological example of "hysteresis". Indeed, AE mechanisms should not be simply considered as reverse events of those occurring in the induction phase. Anesthesia-induced loss of consciousness(LoC) and AE until RoC are quite distinct phenomena with, in part, a distinct neurobiology. Althoughanaesthetics produce LoC mostly by affecting cortical connectivity, arousal processes at the end of anesthesia are triggered by structures deep in the brain, rather than being induced within the neocortex. This work aimed to provide an overview on AE processes research, in terms of mechanisms, and EEG findings. Because most of the research in this field concerns preclinical investigations, translational suggestions and research perspectives are proposed. However, little is known about the relationship between AE neurobiology, and potential complications occurring during the emergence, and after the RoC. Thus, another scope of this review is to underline why a better understanding of AE mechanisms could have significant clinical implications, such as improving the patients' quality of recovery, and avoiding early and late postoperative complications.
文摘Pancreatic cancer(PC)is a devastating malignancy with fewer than 10%of patients being alive at 5 years after diagnosis.Venous thromboembolism(VTE)occurs in approximatively 20%of patients with PC,resulting in increased morbidity,mortality and significant health care costs.The management of VTE is particularly challenging in these frail patients.Adequate selection of the most appropriate anticoagulant for each individual patient according to the current international guidelines is warranted for overcoming treatment challenges.The International Initiative on Thrombosis and Cancer multi-language web-based mobile application(downloadable for free at www.itaccme.com)has been developed to help clinicians in decision making in the most complex situations.In this narrative review,we will discuss the contemporary epidemiology and burden of VTE in PC patients,the performances and limitations of current risk assessment models to predict the risk of VTE,as well as evidence from recent clinical trials for the primary prophylaxis and treatment of cancer-associated VTE that support updated clinical practice guidelines.
文摘Background and Study Aims: In nonpolypoid colorectal lesions, the presence of irregular, distorted glands in the colon (a disrupted crypt pattern) on magnification chromoendoscopy (MCE) is strongly associated with submucosal invasive cancer. The aim of the present study was to evaluate the ability of MCE to differentiate between an invasive crypt pattern and a noninvasive crypt pattern, including nonneoplastic lesions,and to assess the ability of this MCE classification to predict invasiveness and allow patients to be selected for endoscopic resection or surgical resection. Patients and Methods: In a prospective study including 1560 colonoscopies, 153 flat or depressed colorectal lesions were evaluated with MCE among 534 colorectal lesions; the remainder had a polypoid appearance. The pit pattern was classified as nonneoplastic (type II) or neoplastic (types IIIV) and the latter was subdivided into noninvasive.(types III or IV) or submucosally invasive (type V). Lesions with a nonneoplastic and noninvasive neoplastic appearance were resected endoscopically if technically feasible, whereas those with a type V pattern were resected surgically. The resection specimens were analyzed histologically in relation to the Vienna classification. Results: Using this management strategy based on the pit pattern, 86%(n = 70) of the type II lesions were hyperplastic; the remaining 11 had low-grade intraepithelial neoplasia. Type III and IV lesions (n = 58) represented either low-grade or high-grade intraepithelial neoplasia in 95%of the cases. Three patients had sm1 (n = 2) or sm2/3 invasive cancers. Among the patientswith typeVlesions (n = 14), 11 had invasive cancers (four sm1 and seven sm2/3). Endoscopic differentiation based on the pit pattern thus had a positive predictive value (PPV) of 86%and a negative predictive value of 96%for distinguishing between nonneoplastic and neoplastic lesions. The pit pattern criteria for distinguishing between invasive and noninvasive neoplasia (including nonneoplastic lesions), and hence the choice between endoscopic and surgical resection, had a PPVof 79%and a NPV of 98%. Excluding nonneoplastic lesions, the NPV would be 95%. Conclusions: The endoscopic pit pattern on MCE has only a moderate predictive value for nonneoplastic lesions, so that leaving these flat hyperplastic lesions in place on the basis of the endoscopic magnification appearance alone cannot be generally recommended. However, MCE has a good predictive value for guiding management toward either endoscopic resection (if technically feasible) or surgical resection.
文摘Numerous amphibian species occupy microhabitats with buffered thermal and moisture conditions,typically under forest canopies.Here,we assessed whether the insular endemic Salamandra corsica also uses this type of habitat,which could have important implications for its conservation.We used data loggers to record the air temperature and air humidity at 4 h intervals over a period of 2 years,at 13 stations with a confirmed presence of S.corsica.These data were compared with those recorded at Corsican weather stations and those generated by a climate model(WorldClim 2).The weather station data showed significant deviations from the probe data,by an average of-1.26℃(minimum temperature),+2.61℃(maximum temperature),and-0.04%(relative humidity).Similarly,the WorldClim 2 data showed significant deviations from the probe data,by an average of-2.49°C(minimum temperature)and+1.69℃(maximum temperature).These discrepancies refl ect the use of densely vegetated and topographically complex habitats by S.corsica,which reduce temperature fluctuations.Overall,our results highlight the importance of natural vegetal cover in the conservation of populations of this endemic salamander.
文摘Background:Island species are vulnerable to rapid extinction,so it is important to develop accurate methods to determine their occurrence and habitat preferences.In this study,we assessed two methods for modeling the occurrence of the Corsican endemic Salamandra corsica,based on macro-ecological and fine habitat descriptors.We expected that models based on habitat descriptors would better estimate S.corsica occurrence,because its distribution could be influenced by micro-environmental gradients.The occurrence of S.corsica was modeled according to two ensembles of variables using random forests.Results:Salamandra corsica was mainly found in forested habitats,with a complex vertical structure.These habitats are associated with more stable environmental conditions.The model based on fine habitat descriptors was better able to predict occurrence,and gave no false negatives.The model based on macro-ecological variables underestimated the occurrence of the species on its ecological boundary,which is important as such locations may facilitate interpopulation connectivity.Conclusions:Implementing fine spatial resolution models requires greater investment of resources,but this is advisable for study of microendemic species,where it is important to reduce type II error(false negatives).
文摘Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and severe adverse effects related to cancer treatment. Unfortunately, although several agents and protocols have been proposed, no prophylactic strategies have yet to be proven useful. Therefore, new alternative therapies have been considered for CIPN prevention. Herbal medicine in Japan, called Kampo medicine, is derived from traditional Chinese medicine. Goshajinkigan (GJG) is a Kampo medicine, that is comprised of ten herbs. The aim of this work is to analyse the results of pre-clinical and clinical studies on the potential applications of GJG in CIPN prevention.
文摘The Mediterranean region possesses a rich diversity of salamanders,which also exhibit a high degree of ecological diversification.It is assumed that the presence of salamanders is dependent on the level of vegetation cover in terrestrial habitats,but the strength of this association is likely to vary among species.In this study,we investigated the patterns of habitat utilization for Mediterranean salamanders based on 589 records of 33 species.We tested the hypothesis that the association between salamander presence and vegetation density varies among genera or reproductive modes(i.e.terrestrial vs aquatic).The results show that vegetation cover has similar influences on terrestrial and aquatic groups but important differences are identified for lotic and lentic aquatic species.Our findings also indicate that the aquatic lotic,terrestrial,and small-body species deviate significantly from that expected from the background range of variation.
文摘We describe the valued Gabriel quiver of a wedge product of coalgebras and study the category of comodules of a semiprime coalgebra. In particular, we prove that any monomial semiprime k-tame fc-tame coalgebra is string. We also prove a version of Eisenbud-Griffith theorem for coalgebras, namely, any hereditary semiprime strictly quasi-finite coalgebra is serial.
文摘The development of transportation systems has significantly enhanced the welfare and modernization of society. Wooden vehicles pulled by animals have been used for land transportation since the early Bronze Age. Whole-body gharries with rigid wheels pulled by oxen appeared in Crete by 2000 BC or earlier. Horses originating from the East were depicted in early Cretan seal-rings of the same period. The two-wheeled horse- drawn chariot was one of the most important inventions in history. This vehicle provided humanity its first concept of personal transport and was the key technology of war for 2000 years. Chariots of Mycenaean and Archaic Greece with light and flexible four-spoked wheels acting as spring suspensions were depicted in vase paintings. The development of this vehicle incorporated the seeds of a primitive design activity and was important for engineering. The Trojan horse since 1194 BC and the helepolis since 700 BC were the first known machines on a wheeled base transported by horses or self-powered. Ancient engineers invented bearings lubricated with fat, and Romans introduced the ancestors of ball bearings for their wagons and carts. The historic evolution of wheeled transportation systems, along with early traction, suspension, and braking systems, is presented in this paper. Analytical and numerical methods are incorporated to analyze the most conceivable loading situations of typically reconstructed wheeled transportation systems in ancient times. Traction requirements both for horse-driven machines and the power for internal motors are also analyzed. This study can serve as a basis for further development of detailed reconstruction of transportation systems in antiquity.
文摘A brief description of the windmills from the second millennium BC to the Renaissance is presented. This survey is a part of several studies conducted by the authors on technology in the ancient world. The windmills are the first motor, other than human muscles, and are the ancestors of the modem wind turbines. Some authors' virtual reconstructions of old windmills are also presented. The paper shows that the operating principle of many modem machines had already been conceived in the ancient times by using a technology that was more advanced than expected, but with two main differences, as follows: Similar tasks were accomplished by using much less energy; and the environmental impact was nil or very low. Modem designers should sometimes consider simplicity rather than the use of a large amount of energy.
基金Supported by grant MTM2007-61673 from the Ministerio de Educación y Ciencia of SpainP06-FQM-01889 from Junta de Andalucía
文摘We focus our attention to the set Gr(ξ) of grouplike elements of a coring ξover a ring A. We do some observations on the actions of the groups U(A) and Aut(ξ~) of units of A and of automorphisms of corings of ξ, respectively, on Gr(ξ), and on the subset Gal(ξ)of all Galois grouplike elements. Among them, we give conditions on ξ under which Gal(ξ) is a group, in such a way that there is an exact sequence of groups {1} → U(Ag) → U(A) → Gal(ξ) → {1}, where Ag is the subalgebra of coinvaxiants for some g ∈ Gal(ξ).
基金The authors are grateful to E.Garcia-Galea,B.Elvira,and S.Dougherty for lab and analysis assistance and to the team from the animal facilities of the Faculty of Biology for their help in the maintenance of aquaria.The authors are grateful to 3 anonymous reviewers and V.Bonet for the English review.
文摘How the morphology of captive-reared fish is affected by structural enrichment in their rearing tanks is not well understood.Some studies have suggested that deficiencies in rearing environments could produce inappropriate body shape in salmonids(Vehanen and Huusko 2011).Garduho-Paz et al.(2010)have found significant differences in body and head shapes of 3-spine stickleback Gasterosteus aculeatus,depending on whether fish were reared in an environment with just gravel or in an environment enriched with large stones and artificial plants.