Case Report: Variety of Target Antigens During 1 Year Follow-Up of a Patient Initially Diagnosed With Bullous Pemphigoid

Autoimmune bullous diseases (AIBDs), presenting cutaneous and/or mucosal bullous lesions, are classified into pemphigus and pemphigoid diseases. A longtime observation for complicated AIBD cases is rarely reported. In this study, serum samples of one AIBD patient were collected at seven different time points during the disease course including a relapse, which were examined by our conventional and newly developed methods for the detection of autoantibodies. Interestingly, we found changes of both the presence and the titers of various autoantibodies in accordance with the changes of clinical features during the whole disease course, which indicated that the patient started as bullous pemphigoid and relapsed as concurrence of bullous pemphigoid and mucosal-dominant-type pemphigus vulgaris.

The Superficial Anastomosing Veins of the Human Brain Cortex: A Microneurosurgical Anatomical Study

Introduction: In this microneurosurgical and anatomical study, we characterized the superficial anastomosing veins of the human brain cortex in human specimens.Material and Methods: We used 21 brain preparations fixed in formalin (5%) that showed no pathological changes and came from the autopsy sections. The superficial veins were dissected out of the arachnoid with the aid of a surgical microscope.Results: We dissected nine female and 12 male brain specimens, with an average age of 71 ± 11 years (range 51–88 years). We classified the superficial veins in five types: (I) the vein of Trolard as the dominat vein; (II) the vein of Labbé as the dominant vein; (III) a dominant sylvian vein group, and the veins of Trolard and Labbé nonexistent or only rudimentary present without contact to the Sylvian vein group; (IV) very weak sylvian veins with the veins of Trolard and Labbé codominant; and V) direct connection of Trolard and Labbé bypassing the Sylvian vein group. The vein of Trolard was dominant (Type I) in 21.4% and the vein of Labbé (Type II) in 16.7%. A dominant sylvian vein group (Type III) was found in 42.9%. Type IV and Type V were found in 14.3 and 4.7% respectively.Conclusion: No systematic description or numerical distribution of the superior anastomotic vein (V. Trolard) and inferior anastomotic vein (V. Labbé) has been found in the existing literature. This study aimed to fill this gap in current literature and provide data to neurosurgeons for the practical planning of surgical approaches.

Contrast Enhancing Pattern on Pre-Treatment MRI predicts Response to Anti-Angiogenic Treatment in Recurrent Glioblastoma: Comparison of Bevacizumab and Temozolomide Treatment

Objective: To evaluate the value of the contrast enhancing pattern on pre-treatment MRI for predicting the response to anti-angiogenic treatment in patients with IDH-wild type recurrent glioblastoma.Methods: This retrospective study enrolled 65 patients with IDH wild-type recurrent glioblastoma who received standard therapy and then received either bevacizumab (46 patients) or temozolomide (19 patients) as a secondary treatment. The contrast enhancing pattern on pre-treatment MRI was visually analyzed and dichotomized into contrast enhancing lesion (CEL) dominant and non-enhancing lesion (NEL) dominant types. Quantitative volumetric analysis was used to support the dichotomization. The Kaplan-Meier method and Cox proportional hazards regression analysis were used to stratify progression free survival (PFS) according to the treatment in the entire patients, CEL dominant group, and NEL dominant group.Results: In all patients, the PFS of those treated with bevacizumab was not significantly different from those treated with temozolomide (log-rank test, P=.96). When the contrast enhancing pattern was considered, bevacizumab was associated with longer PFS in the CEL dominant group (P=.031), whereas temozolomide showed longer PFS in the NEL dominant group (P=.022). Quantitative analysis revealed cut-offs for the proportion of solid-enhancing tumor of 13.7% for the CEL dominant group and 4.3% for the NEL dominant group. Conclusions: Patients with the CEL dominant type showed a better treatment response to bevacizumab, whereas NEL dominant types showed a better response to temozolomide. The contrast enhancing pattern on pre-treatment MRI can be used to stratify patients with IDH wild-type recurrent glioblastoma according to the effect of anti-angiogenic treatment.

Influence of low-frequency variability on high and low groundwater levels: example of aquifers in Paris Basin

Groundwater levels (GWL) very often fluctuate over a wide range of timescales (infra-annual, annual, multi-annual, decadal). In many instances, aquifers act as low-pass filters, dampening the high-frequency variability and amplifying low-frequency variations (from multi-annual to decadal timescales) which basically originate from large-scale climate variability. In the aim of better understanding and ultimately anticipating groundwater droughts and floods, it appears crucial to evaluate whether (and how much) the very high or very low GWLs are sensitive to such low-frequency variability (LFV), which was the main objective of the study presented here. As an example, we focused on exceedance and non-exceedance of the 80 % and 20 % GWL percentiles respectively, in the Paris Basin aquifers over the 1976–2019 period. GWL time series were extracted from a database consisting of relatively undisturbed GWL time series regarding anthropogenic influence (water abstraction by either continuous or periodic pumping) over Metropolitan France. Based on this dataset, our approach consisted of exploring the effect of GWL low-frequency components on threshold exceedance and non-exceedance by successively filtering out low-frequency components of GWL signals using maximum overlap discrete wavelet transform (MODWT). Multi-annual (~7-yr) and decadal (~17-yr) variabilities were found to be the predominant LFVs in GWL signals, in accordance with previous studies in the northern France area. Filtering out these components (either independently or jointly) to (i) examine the proportion of high level (HL) and low level (LL) occurrences generated by these variabilities, (ii) estimate the contribution of each of these variabilities in explaining the occurrence of major historical events associated to well-recognized societal impacts. A typology of GWL variations in Paris Basin aquifers was first determined by quantifying the variance distribution across timescales. Four GWL variation types could be found according to the predominance of annual, multi-annual or/and decadal variabilities in these signals: decadal dominant (type iD), multi-annual and decadal dominant (type iMD), annual dominant (type cA), annual and multi-annual dominant (type cAM). We observed a clear dependence of high and low GWL to LFV for aquifers exhibiting these four GWL variation types. In addition, the respective contribution of multi-annual and decadal variabilities in the threshold exceedance varied according to the event. In numerous aquifers, it also appeared that the sensitivity to LFV was higher for LL than HL. A similar analysis was conducted on the only available long-term GWL time series which covered a hundred years. This allowed us to highlight a potential influence of multidecadal variability on HL and LL too. This study underlined the key role of LFV in the occurrence of HL and LL. Since LFV originates from large-scale stochastic climate variability as demonstrated in many previous studies in the Paris Basin or nearby regions, our results point out that i) poor representation of LFV in General Circulation Models (GCM) outputs used afterwards for developing hydrological projections can result in strong uncertainty in the assessment of future groundwater extremes (GWE), ii) potential changes in the amplitude of LFV, be they natural or induced by global climate change, may lead to substantial changes in the occurrence and severity of GWE for the next decades. Finally, this study also stresses the fact that due to the stochastic nature of LFV, no deterministic prediction of future GWE for the mid- or long term horizons can be achieved even though LFV may look periodic.

Esophageal motility abnormalities in Egyptian patients using high resolution esophageal manometry: a descriptive study

Background and aim For many years, esophageal manometry has been used for assessment of upper gastro-intestinal (GI) symptoms. Chicago classification is the key for diagnosis and managing motility disorders as it is considered as a standardized approach for categorization of esophageal abnormalities. The aim of this study is to analyze types of esophageal motility findings in Egyptian cases who were suffering from upper GI complaints. Methods: This descriptive study included 378 subjects who were suffering from upper GI complaints as dysphagia, vomiting, chest pain and regurgitation in the period between 10/2015–7/2020. Esophageal HRM study was performed for all patients (MMS Laborie device). The catheter was positioned and confirmed passing across the EGJ (esophago-gastric junction) using landmarks. Swallows and resting status were recorded. Anatomical landmarks were placed. Results Most of the patients were complaining of upper GI symptoms. Males were 49.2% of cases. Mean age was 41.3. Dysphagia was the prominent symptom while chest pain was the least symptom. Many manometry findings were observed including ineffective motility, achalasia, absent contractility, EGJ outflow obstruction, jackhammer esophagus and normal findings. Type II achalasia was the dominant type in achalasia patients while Type III was the least. LES was normotensive in most of the cases. Hiatus hernia (HH) was detected in 40.2% of the cases. Conclusion This is considered the first Egyptian descriptive study to determine the prevalence of esophageal motility abnormalities in Egyptian patients complaining of upper GI symptoms. HRM is very important for patients complaining of upper GI symptoms.

Semantic Analysis on Online Apple Advertisements

This research is entitled A Semantic Analysis on Online Apple Advertisements. It is a study of the analysis of meaning in online advertisements contained on the official Apple website. The researchers examine the type of meaning and the function of associative meaning with the aim of finding its relationship with the company’s advertising and sales activities. This research uses descriptive qualitative as a research method. From this analysis, the researchers found 10 data that matched the research criteria and considered as the latest data to complete the research. Connotation becomes the most dominant type of meaning used. As for the function of speech whose meaning is adapted to the context of the ad sentence, assertive and expressive are the most commonly used because it displays facts succinctly. Keywords: advertisements, apple, types of meaning

Sharing Economy

Globally, prominent sharing-based services include Uber, Lyft, and Airbnb, which have become behemoths in terms of their valuation, revenue, and number of users. Uber is reported to have over 100 million users globally. Bangladesh has also witnessed a rise in sharing-based services of both global and local origins. Sharing services have severely disrupted traditional business models and the economy they collectively encompass is referred to as the “sharing economy.” Based on a systematic literature review of top management journals and other scholarly works, the authors present the most overarching conceptualization of sharing-based services. Taking this knowledge forward, this chapter not only conceptualizes and compares sharing-based services in Bangladesh but also identifies “collaborative consumption” as the most dominant type of sharing-based services among them. This chapter also presents scholarly works on the customers' motivators and barriers, which creates grounds for future research efforts in Bangladesh concerning collaborative consumption services.

AN ANALYSIS ON CODE-SWITCHING AND MIXING AMONG ENGLISH LEARNERS OF GAYONESE-SPEAKING STUDENTS

This research tries to find out types and their dominance of code-switching and code-mixing among EFL students with Gayonese backgrounds. This research also looks at whether a certain type of ethnic group is affluent to a specific type of code-switching and mixing. The employed method is a qualitative study, in which this study manages to identify a social phenomenon in a certain community. The data is obtained from the 13 participants in their conversations. Instruments used are observation, recording, transcribing to identify code-switching, and mixing. The result of this study shows that the participants, who are all entitled to Gayonese identity, employed all kinds of code-switching and mixing, which were extra-sentential, inter-sentential, and intra-sentential. All types of code-switching and mixing are apparent in all sets of conversations. Along with some previous research, this study affirms that there is little evidence that a certain type of ethnicity employs a certain dominant form of code-switching and mixing. There appear all types of code-switching and mixing, without one dominant type, is found in all sets of conversations. Thus, code-switching and mixing were believed to assist the learners to deliver them through to be completely understood and meaningful in the communication.

EXPRESSIVE SPEECH ACTS ON NETIZENS’ COMMENTS IN JOE BIDEN’S INSTAGRAM ACCOUNT

United States presidential election 2020 is the most awaited event for the citizens of the United States. People usually want to get to know how good the presidential candidates are by searching for information about the presidential candidates. Checking the presidential candidates’ social media is one way to find outtheirprofiles.Joe Biden as one of the presidential candidates uses the growing popularity of Instagram to gain public attention by posting some of his responses to current issues and promoting himself as the next President of the United States. It made Joe Biden’s Instagram account is filled with netizens’ comments. This research aims to identify the expressive speech acts that appear in Joe Biden's comments published on September 13, 2020, to January 20, 2021, and to describe the reasons for their use of these expressive speech acts. The instrument of this research is a document. The data were collected by browsing the comments on Joe Biden’s Instagram post, then the data were selected, and identified the expressive speech acts used by netizens, then the research showed the findings of the research by presenting data and analysis. There are 26 data contained an expressive speech act, in which 10 data as expressive of thanking, 3data as expressive of congratulating, 5 data as expressive of wishing, 8 data as expressive of attitude. The expressive speech act of thanking is the most dominant type of expressive speech act found on the netizens’ comments of Joe Biden Instagram post. In conclusion, netizens’ comments contained the expressive speech act of thanking since netizens appreciated the good things that Joe Biden had planned when he ran for President of the United States. Joe Biden frequently posts his thoughts on various issues and promises a good solution in the future. Netizens expressed their gratitude for Joe Biden because they felt they had found a leader who cared about society.

The study of reactive and active modes of educational communication in the process of solving educational tasks by students in a virtual reality environment

Introduction. The introduction of virtual technologies into the vocational training system makes it urgent to solve the task of adjusting communication in a situation where the student is in a virtual reality environment, while the teacher is in the real world. The research purpose is to study the role of two types of educational communication (reactive and active ones) with a student solving an educational task in a virtual reality environment, taking into account the gaming experience and the dominant type of student's perception. Materials and methods. During the laboratory experiment with the use of virtual reality headsets, the skill of hand-eye coordination was worked out on a sample of undergraduate teacher-training students (N=36). The author's questionnaire was used to assess the gaming experience, the dominant type of student's perception was assessed using the VARK Questionnaire (Version 7.8) by N. Fleming and S. Mills. The reliability of the data obtained was assessed using the chi-square test and the Student's t-test. Research results. There are no statistically significant differences between the groups of reactive and active communication in all indicators, with the exception of the experience of getting acquainted with virtual reality. The number of questions regarding the methods and sequence of performing game actions in the reactive group was the greatest (2.28), the same indicator in the group with active communication was insignificant (0.40). In the group with reactive communication, the subjects asked twice as many questions as in the group with active communication (4.78 and 2.44, respectively). Conclusions. The results confirm the hypothesis that the reactive and active modes of educational communication play different roles in the interaction between the teacher and the student. The dominant type of student's perception does not affect the process of organizing educational communication in a virtual reality environment. It is useful to take into account the results obtained at the stage of support of students' educational activities in a virtual reality environment in the context of providing active and reactive assistance by the teacher.