Bilateral symmetrical lymphangiomas of the gingiva: case report

BACKGROUND: Lymphangioma is a benign lesion that is related to proliferation of lymphatic vessels. Lymphangioma of the gingiva is a rare lesion that manifest as a pebbly hyperplasia on gingiva. The purpose of this study is to report a case of bilateral symmetrical lymphangioma of the gingiva. CASE PRESENTATION: A 32-year-old man was presented with bilateral hyperplasia of gingiva in upper canine regions. The lesions were resected completely and evaluated histologically. The microscopic evaluation revealed lymphangioma. CONCLUSION: Bilateral lymphangioma of the gingiva is a very rare lesion which its origin is controversial

A Two-Stage Metaheuristic Algorithm for the Dynamic Vehicle Routing Problem in Industry 4.0 approach

Industry 4.0 is a concept that assists companies in developing a modern supply chain (MSC) system when they are faced with a dynamic process. Because Industry 4.0 focuses on mobility and real-time integration, it is a good framework for a dynamic vehicle routing problem (DVRP). This research works on DVRP. The aim of this research is to minimize transportation cost without exceeding the capacity constraint of each vehicle while serving customer demands from a common depot. Meanwhile, new orders arrive at a specific time into the system while the vehicles are executing the delivery of existing orders. This paper presents a two-stage hybrid algorithm for solving the DVRP. In the first stage, construction algorithms are applied to develop the initial route. In the second stage, improvement algorithms are applied. Experimental results were designed for different sizes of problems. Analysis results show the effectiveness of the proposed algorithm.Comment: 22 pages, 4 figures, 1 table. Journal of Management Analytics (2020

Aggressive Surgical Treatment in Late-Diagnosed Esophageal Perforation: A Report of 11 Cases

Introduction. Esophageal perforation is a relatively uncommon and lethal disease usually resulting from endoscopic procedures. Delay in the diagnosis and treatment occurs in more than 50% of cases, leading to a mortality rate of 40% to 60%, but this rate decreases is 10%–25% if treatment is carried out within 24 hours of perforation. Case Presentation. To analyze the characteristics, etiology, site of perforation, presentation, time interval till diagnosis, treatment and outcome of patients with esophageal perforation. Over a five-year period, from October 2004 through March 2009, 11 patients with esophageal perforation were referred to the division of thoracic surgery of a tertiary referral hospital. In eight patients, perforations were thoracic with delayed diagnosis for at least 48 hours. Two patients had cervical esophageal perforation, and one patient had early-diagnosed Boerhaave's syndrome. Eight patients are alive after followup for a period ranging from eight months to five years. In the remaining three patients, cancer was the underlying disease and the reason of death. Conclusion. No patient with esophageal perforation should be deprived from surgical repair due to delayed diagnosis. All, except preterminal patients, should undergo exploration after resuscitation, and appropriate treatment should be carried out depending on the findings during operation. Aggressive treatment is necessary in the case of established mediastinitis

Collaborative BIM Teaching. Per tradition and directed by architectural graphic expression

[EN] The inclusion of the BIM (Building Information Modelling) methodology in Architecture Degree studies is an unavoidable fact. Its introduction particularly affects how the teaching of Architectural Graphic Expression (AGE) is addressed. After studying the most significant congresses and publications on this subject, an Educational Innovation Project was undertaken based on collaboration between courses and conducted by the AGE Section. The implementation characteristics are determined, concluding that the key lies in collaboration, wherein AGE plays a lead role. Innovative teaching methodologies for BIM are put forward without rejecting certain traditional techniques indispensable for AGE.[ES] La inclusión de la metodología BIM (Building Information Modeling) en los estudios de Grado de Arquitectura es un hecho ineludible. Esta implantación afecta, especialmente, al modo de plantear la docencia en Expresión Gráfica Arquitectónica (EGA). Tras el estudio de los congresos y publicaciones más relevantes en la materia, se ha desarrollado un Proyecto de Innovación Educativa basado en la colaboración entre asignaturas y dirigido por el Área EGA. Se definen las características de la implantación, en la que se concluye que la clave está en la colaboración, donde EGA tiene un papel líder. Se trata de plantear metodologías docentes innovadoras para BIM, sin rechazar ciertas técnicas tradicionales imprescindibles de EGA.León Cascante, Í.; Pérez Martínez, JJ. (2018). Docencia colaborativa en BIM. Desde la tradición y dirigida por la expresión gráfica arquitectónica. EGA. Revista de Expresión Gráfica Arquitectónica. 23(32):76-87. doi:10.4995/ega.2018.9077SWORD7687233

Building Information Modelling adoption in the European Union: An overview

Building information modelling (BIM) is one of the most promising recent developments in the Architecture, Engineering, Construction and Operation (AECO) industry. However, its adoption remains a challenge for the AECO industry because it requires a shift to a new way of working, leading to a current discrepancy in the adoption of BIM in the EU. The paper aims at assessing the gaps in the BIM adoption between the 28 EU countries and the barriers related to its implementation. The methodology adopted here is twofold: first, secondary data are given by a systematic literature review, completed with the review of current projects funded by the European Commission, and dealing with fostering the BIM adoption. Second, primary data are provided by a questionnaire survey to classify BIM initiatives regarding policies, the level of adoption and the barriers encountered in the 28 EU countries. In order to grade the heterogeneity of BIM adoption in the EU, we have classified the countries into four categories with different levels of awareness, from early adopters (BIM already mandated) to countries without any plan. The survey has enabled the analysis of twenty barriers to BIM adoption using the four grades in relation to the respondent country. We found barriers that are acknowledged by all countries irrespective of their level of BIM adoption. Other barriers have been already tackled by the early adopters but not by the newcomers who have yet to experience some of these issues. Finally, the assessment of the disparities of BIM adoption within the EU can help the European Commission towards unifying European standard on BIM

HER2 Overexpression in Borderline and Malignant Ovarian Tumors: A Cross-sectional Study in an Iranian Population and Literature Review

Background: Different studies have investigated the overexpression of human epidermal growth factor receptor 2 in ovarian cancers, in addition to the association between the level of its overexpression and tumor characteristics (tumor grade, subtype, stage, and prognosis). However, the prognostic significance of human epidermal growth factor receptor 2/neu dysregulation in epithelial ovarian tumors is controversial. The current study aims to assess human epidermal growth factor receptor 2 overexpression in different types and stages of epithelial borderline and malignant ovarian tumors in a population of Iranian patients. Methods: We conducted this cross-sectional study on 100 patients diagnosed with epithelial borderline and malignant ovarian tumors who referred to the Cancer Institute of Imam Khomeini Hospital at Tehran between 2012 and 2014. After selection of the appropriate tissue block, we prepared slides for immunohistochemical staining with the human epidermal growth factor receptor 2 marker. Human epidermal growth factor receptor 2 positivity was evaluated and scored according to Ellis and Wolff recommendations. Cases with equivocal immunohistochemical results (score 2) also underwent chromogenic in situ hybridization. Results: The most prevalent tumor in our study was serous carcinoma (54%). Human epidermal growth factor receptor 2 scores were: 0 in 69%, 1+ in 26%, 2+ in 4%, and 3+ in 1% of tumors. Chromogenic in situ hybridization examination of cases with human epidermal growth factor receptor 2 score of 2 showed negative results for human epidermal growth factor receptor 2 gene amplification. We observed no association between human epidermal growth factor receptor 2 and the level of tumor differentiation, histologic subtype, clinical stage, tumor size, and patient’s age. Conclusion: Controversial results and wide range of prevalence in human epidermal growth factor receptor 2 overexpression in different studies could be due to several causes. Technical considerations, tumor heterogeneity, and lack of standard guidelines for interpretation could influence the results. We did not find any relationship between human epidermal growth factor receptor 2 overexpression and prognostic indices of grade, clinical stage or histologic subtype as many other reports. Future studies should be conducted on larger numbers of patients with different disease stages and adequate numbers of different histologic subtypes

Epstein-Barr virus associated gastric carcinoma: a report from Iran in the last four decades

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Determinants of Epstein-Barr virus-positive gastric cancer: an international pooled analysis

BACKGROUND: Meta-analyses of the published literature indicate that about 9% of gastric cancers contain Epstein-Barr virus (EBV), with consistent and significant differences by sex and anatomic subsite. This study aimed to identify additional determinants of EBV positivity and their joint effects.METHODS: From 15 international populations with consistent laboratory testing for EBV, we pooled individual-level data for 5081 gastric cancer cases including information on age, sex, subsite, histologic type, diagnostic stage, geographic region, and period of diagnosis. First, we combined population-specific EBV prevalence estimates using random effects meta-analysis. We then aggregated individual-level data to estimate odds ratios of EBV positivity in relation to all variables, accounting for within-population clustering.RESULTS: In unadjusted analyses, EBV positivity was significantly higher in males, young subjects, non-antral subsites, diffuse-type histology, and in studies from the Americas. Multivariable analyses confirmed significant associations with histology and region. Sex interacted with age (P = 0.003) and subsite (P = 0.002) such that male predominance decreased with age for both subsites. The positivity of EBV was not significantly associated with either stage or time period.CONCLUSION: Aggregating individual-level data provides additional information over meta-analyses. Distinguishing histologic and geographic features as well as interactions among age, sex, and subsite further support classification of EBV-associated gastric cancer as a distinct aetiologic entity. British Journal of Cancer (2011) 105, 38-43. doi: 10.1038/bjc.2011.215 www.bjcancer.com Published online 7 June 2011 (C) 2011 Cancer Research UKNational Cancer Institute, National Institutes of Healt