ALBERT

Description: Background This study examined the effectiveness of using Physical Activity Consultation (PAC) as an addition to the standard smoking cessation treatment in Malaysia. We explored participants’ experiences in terms of physical activity and smoking abstinence with the combined PAC and smoking cessation intervention. Methods Walk-in smokers from a local smoking cessation clinic volunteered for the 8-week intervention program, while undergoing standard smoking cessation treatment. In Week 1, a facilitator conducted a face-to-face intervention to explore participants’ involvement in physical activity and helped to set physical activity strategies and goals for participants to increase physical activity levels. Participants were provided with follow-up phone calls at Weeks 3 and 6. Participants answered questionnaires that measured smoking withdrawal (Shiffman–Jarvik Withdrawal Scale), cessation self-efficacy (Cessation Self-efficacy Questionnaire), physical activity involvement (International Physical Activity Questionnaire), and mood (Brunel Mood Scale) upon recruitment, at post-intervention and at follow-up 3 months after the intervention ended. Participants also responded to interviews about their experiences with the PAC and smoking cessation treatment at post-intervention and at 3-month follow-up. Results Seven participants completed the program until follow-up. All were successfully abstinent. Only two participants increased physical activity levels, whereas others maintained their physical activity levels or showed slight decreases. Several themes were identified in this study, including participants’ experiences with withdrawal symptoms, smoking cessation self-efficacy, triggers to smoking cessation, thoughts on standard smoking cessation treatment in Malaysia, physical activity involvement, mood, and thoughts and beliefs on combining smoking cessation and physical activity. Conclusions This study suggests PAC was helpful in maintaining or increasing the overall physical activity levels of participants and could assist with smoking abstinence. Findings showed that all participants who stayed in the program were successfully abstinent. In general, the findings in this study provided promising results for further research on PAC as an adjunct to smoking cessation treatments in Malaysia. Trial registration This intervention is registered with the Australian New Zealand Clinical Trials Registry (Trial registration number: ACTRN12616000269437).

Description: Background Ultrasound-guided cannulation of deep mid-arm veins by a modified Seldinger (US-Seldinger) technique has been demonstrated to yield better puncture success rates and lower postoperative complication rates than direct cannulation of superficial veins near the elbow with a short peripheral cannula and peripherally inserted central catheter (PICC) insertion through the cannula (non-US conventional method). Economic factors have been evaluated across different operators (i.e. nurses, radiologists, and general practitioners) and different venous catheter types (i.e. PICCs vs. central venous catheters). However, to our knowledge, data describing the economic evaluation on the aforementioned modified Seldinger technique are lacking. Hence, the aim of this study was to evaluate the cost-effectiveness of US-Seldinger technique (experimental group) compared with that of the non-US conventional method based on direct vein visualization (control group). Results A cohort of 360 subjects were assigned randomly to the experimental and control groups. Cost-effectiveness ratio (CER) analyses indicated that the effectiveness index (EI) for the experimental group was 89.29% (final CER = 3732.75), whereas that for the control group was 59.18% (final CER = 2492.98). Conclusion The US-Seldinger technique was found to be more cost-effective than the non-US conventional method. These findings support the use of the former in place of the traditional latter technique as a routine puncture technique and suggest that the update would improve intravenous therapy treatment for patients needing PICCs. This study should serve as a reference for national healthcare policy. Trial registration ChiCTR-TRC-14004993

Description: Background: The cerebellum plays a vital role in equilibrium, motor control, and motor learning. The discrete neural and glial fates of cerebellar cells are determined by the molecular specifications (e.g. transcription factors) of neuroprogenitor cells that are influenced by local microenvironment signals. In this study, we evaluated the expression and function of Sox3, a single-exon gene located on the X chromosome, in the developing cerebellum.ResultIn the embryonic and early postnatal cerebellum, SOX3-positive-cells were detected in the ventricular zone, indicating that SOX3 expression is present in a subset of the cerebellar precursor cell population. In the young adult cerebellum, this expression was diminished in cerebellar cells, suggesting its limited role in cerebellar progenitors. SOX3-positive-cells were also found in the cerebellar mantle zone. Further immunohistochemistry analyses revealed that SOX3 was not expressed in Purkinje neurons. Using glial markers in the early postnatal cerebellum, we found that virtually all of the SOX3-positive-cells were glial cells, although not all glial cells were SOX3-positive-cells. We also determined the impact of transgenic expression using a loss-of-function (Sox3 null) model. We did not observe any developmental defects in the cerebellum of the Sox3 null mice. Conclusions: Our results indicate that the SOX3 protein is not expressed in cerebellar neurons and is instead expressed exclusively in the cerebellar glial system in a subset of mature glial cells. Although the expression of Sox3 cerebellar glial development is lineage-restricted, it appears that the absence of Sox3 in the ventricular germinal epithelium and migrating glia does not affect cerebellar development, suggesting functional redundancy with other SoxB1 subgroup genes.

Description: PurposePhysical activity (PA) has a myriad of benefits for breast cancer survivors, including a reduced risk of cancer recurrence. Latinas are less physically active than are women in the general population and little is known about Latina breast cancer survivors’ levels of PA or their beliefs related to PA. We conducted a survey of 50 Puerto Rican (PR), 50 Mexican-American (MA) and 50 non-Hispanic white (NHW) breast cancer survivors to investigate similarities and differences in PA and social cognitive theory (SCT) constructs associated with PA. Methods: We collected information on current PA using the Godin Leisure Time Exercise Questionnaire (GLTEQ); comorbidities; anthropometric measures of body mass index [BMI (kg/m 2 )] and waist-to-hip (W:H) ratio; and SCT measures, including exercise self-efficacy, exercise barriers self-efficacy, modeling and social support from friends and family. Descriptive statistics, one-way analysis of variance of differences between groups and regression models of the predictors of PA were performed. Results: Survivors from the three groups were similar in age (M = 56.8, SD = 11.0), BMI (M = 29.0, SD = 5.7) and co-morbidity (M = 2.09, SD = 1.69). Survivors differed in PA (p 

Description: IntroductionWe provide this brief case report on Hamman’s sign, as a reminder that both pneumomediastinum and pneumothorax can cause sounds that may disclose the abnormal presence of air in these respective locations. Background: Attributed originally to the observations and report of Louis Hamman in 1937, abnormal sounds may emanate from air in the otherwise quiet mediastinum or pleural space.Case presentationOur patient, a 36 year old white male, reported the occurrence of an abnormal “rhythmic clicking” sound emanating from his upper body when lying on his left side, 3 weeks following nasal septal surgery. The patient’s clear report of particularly loud sounds, beginning post-operatively, was corroborated by the patient’s wife. A CT scan of the chest which confirmed the presence of air in the left pleural space. Conclusions: The presence of a sound, loud enough to be heard at a distance from the patient (corroborated by another individual) is unusual. The value of patient history is underscored by the finding of a pneumothorax, suggesting Hamman’s sign.

Description: Research on symmetry detection focuses on identifying and detecting new types of symmetry. The paper presents an algorithm that is capable of detecting any type of permutation-based symmetry, including many types for which there are no existing algorithms. General symmetry detection is library-based, but symmetries that can be parameterized, (i.e. total, partial, rotational, and dihedral symmetry), can be detected without using libraries. In many cases it is faster than existing techniques. Furthermore, it is simpler than most existing techniques, and can easily be incorporated into existing software. The algorithm can also be used with virtually any type of matrix-based symmetry, including conjugate symmetry.

Description: Background: Type 2 diabetes mellitus (T2DM) has gained pandemic proportions becoming a global threat within the last few decades. In parallel to the increasing prevalence, healthcare costs have become a huge economic burden for the hospital and governments. Bariatric surgery has been proven to induce glycemic control in obese type 2 diabetics. However, the cost effectiveness of metabolic surgery in overweight, obese and morbidly obese individuals has not been documented. We aimed to demonstrate the efficacy and reduced diabetic-medication cost after diverted sleeve gastrectomy with ileal interposition (DSIT) in type 2 diabetic individuals followed more than 1 year. Methods: Records of 116 type 2 diabetic patients operated by DSIT at a dedicated metabolic surgery clinic between October 2011 and April 2013 were retrospectively reviewed. A comparison was made between the annual diabetic medication cost before and after surgery using the paired t test. The alterations in BMI and HbA1c were recorded and analyzed. Results: Diverted sleeve gastrectomy with ileal interposition led to a marked reduction in BMI and improved glycemic control after 1 year follow-up. Mean HbA1c levels decreased from a mean of 8.9 ± 1.7 to 6.6 ± 1.1 1 year after surgery (p 

Description: We report on an infant who underwent gross total resection (GTR) of a posterior fossa ependymoblastoma in the second month of life followed by chemotherapy with uneventful long-term survival for 12 years. Postoperative radiotherapy has been considered obligate to have a chance for prolonged survival, but is inadvisable in infants. To our knowledge, this is the first reported long-term survival in an infant treated for ependymoblastoma.

Description: IntroductionClostridium innocuum is an anaerobic Gram-positive bacterium, unable to produce toxins and rarely causes infections. We report the first case of C. innocuum osteomyelitis and bacteremia in a patient with acute lymphoblastic leukemia (ALL). Findings were compared with previously reported cases of C. innocuum infections in immunocompromised patients, e.g., patients with acquired immune deficiency syndrome, leukemia, and organ transplantation.Case descriptionA 32-year-old Japanese male was admitted for persistent low-grade fever and purpura lasting for 1 month. Complete blood counts and cytogenetic analysis identified Ph1-positive ALL, which was successfully treated using chemotherapy. However, the patient developed high fever and lumbar pain during complete remission. Fluorodeoxyglucose-positron emission tomography and computed tomography demonstrated osteomyelitis. C. innocuum was identified as the causative agent and the patient was successfully treated using antibiotic therapy.Discussion and evaluationWe performed a literature review revealing a number of common aspects to the clinical presentation of C. innocuum infection and an association with various comorbidities. Further, we highlight the most efficient diagnostic and treatment strategies for C. innocuum osteomyelitis. Conclusions: Clostridium innocuum can be a causative pathogen of osteomyelitis and bacteremia in immunocompromised patients.

Description: Let E be a 2-uniformly convex real Banach space with uniformly Gâteaux differentiable norm, and E ∗ its dual space. Let A : E → E ∗ be a bounded strongly monotone mapping such that A - 1 ( 0 ) ≠ ∅ . For given x 1 ∈ E , let { x n } be generated by the algorithm:x n + 1 = J - 1 ( J x n - α n A x n ) , n ≥ 1 ,where J is the normalized duality mapping from E into E ∗ and { α n } is a real sequence in (0, 1) satisfying suitable conditions. Then it is proved that { x n } converges strongly to the unique point x ∗ ∈ A - 1 ( 0 ) . Finally, our theorems are applied to the convex minimization problem.