Rationale and design of the multicentric, double-blind, double-placebo, randomized trial APrepitant versus HYdroxyzine in association with cytoreductive treatments for patients with myeloproliferative neoplasia suffering from Persistent Aquagenic Pruritus. Trial acronym: APHYPAP.

BACKGROUND: Aquagenic pruritus (AP), an intense sensation of scratching induced after water contact, is the most troublesome aspect of BCR-ABL1-negative myeloproliferative neoplasms (MPNs). Mostly described in polycythemia vera (PV, ~ 40%), it is also present in essential thrombocythemia (ET) and primary myelofibrosis (PMF) (10%). Even if this symptom can decrease or disappear under cytoreductive treatments, 30% of treated MPN patients still persist with a real impact on the quality of life (QoL). Because its pathophysiology is poorly understood, efficient symptomatic treatments of AP are missing. The neuropeptide substance P (SP) plays a crucial role in the induction of pruritus. Several studies showed the efficacy of aprepitant, an antagonist of SP receptor (NK-1R), in the treatment of chronic pruritus but never evaluated in AP. The objectives of APHYPAP are twofold: a clinical aim with the evaluation of the efficacy of two drugs in the treatment of a persistent AP for MPN patients and a biological aim to find clues to elucidate AP pathophysiology. METHODS/DESIGN: A multicentric, double-blind, double-placebo, randomized study will include 80 patients with MPN (PV or ET or PMF) treated since at least 6 months for their hemopathy but suffering from a persistent AP (VAS intensity ≥6/10). Patients will be randomized between aprepitant (80 mg daily) + placebo to match to hydroxyzine OR hydroxyzine (25 mg daily) + placebo to match to aprepitant for 14 days. At D0, baseline information will be collected and drugs dispense. Outcome measures will be assessed at D15, D30, D45, and D60. The primary study endpoint will be the reduction of pruritus intensity below (or equal) at 3/10 on VAS at D15. Secondary outcome measures will include the number of patients with a reduction or cessation of AP at D15 or D60; evaluation of QoL and AP characteristics at D0, D15, D30, D45, and D60 with MPN-SAF and AP questionnaires, respectively; modification of plasmatic concentrations of cytokines and neuropeptides at D0, D15, D30, and D60; and modification of epidermal innervation density and pruriceptor expression at D0 and D15. DISCUSSION: The APHYPAP trial will examine the efficacy of aprepitant vs hydroxyzine (reference treatment for AP) to treat persistent AP in MPN patients. The primary objective is to demonstrate the superiority of aprepitant vs hydroxyzine to treat persistent AP of MPN patients. The treatment received will be considered efficient if the AP intensity will be reduced at 3/10 or below on VAS after 14 days of treatment. The results of this study may provide a new treatment option for this troublesome symptom and also give us more insights in the pathophysiology understanding of AP. TRIAL REGISTRATION: APHYPAP. NCT03808805 , first posted: January 18, 2019; last update posted: June 10, 2021. EudraCT 2018-090426-66.

The contribution of personal audio system use and commuting by bus on daily noise dose.

BACKGROUND: For many young people, exposure to music from personal audio system use may represent a significant component of daily noise dose. Moreover, there is increasing concern for the hearing of those who listen at high volumes. The purpose of this study was to determine the noise levels experienced on commuter buses, and to investigate how these impact on the volume-setting behavior of young adult personal audio system users. METHODS: A questionnaire was used to probe transport use, personal audio system-listening behaviors and the extent of understanding about noise-induced hearing loss. The influence of bus noise on volume-setting behavior was determined by measuring, in a lab setting, the sound-level preferences of participants when listening to their favorite song, a generic song, or a podcast in the absence and presence of various levels of bus noise, simulated using output-adjusted recordings made of bus noise. Statistical analysis was conducted using analysis of variance. RESULTS: While the bus noise itself was below 85 dB Leq, as the sound level of the buses increased, so did the percentage of commuters who were found to exceed the equivalent of 8 hours of exposure at 85 dB Leq. IMPLICATIONS: Investment in buses with lower noise levels or the use of noise-canceling or noise-occluding headphones would help to reduce the likelihood of noise-induced hearing loss for bus commuters.

Relationship among oral health status, bolus formation and food comfortability during consumption of model cheeses in elderly.

The aim of this study was to investigate the impact of oral impairment on chewing behaviour, food bolus properties and food comfortability during elderly consumption of model cheeses. Seventy-two elderly persons (aged 66 to 88) was recruited and classified into two groups according to dental status (poor vs. satisfactory). They showed a wide range of salivary flow rates whatever their dental status (stimulated: 0.2-3.8 mL min-1, resting: 0.1-0.8 mL min-1). Standardized bites of four model cheeses with an identical composition but different textures (soft, hard, processed and whipped) were tested. The time and number of chewing cycles required to form a bolus were measured. The rheological properties of the bolus were studied, as was saliva moistening. Food comfortability was assessed by means of a questionnaire composed of 5 sections (1-oral comfort, 2-bolus formation, 3-pain, 4-texture and 5-flavour perception). The chewing parameters measured were not modified by the oral health. However, elderly with poor dentition formed harder boluses than elderly with satisfactory dentition. Moreover, for elderly with poor dentition, the quantity of saliva incorporated into the bolus was correlated with the stimulated salivary flow rate, which was not the case for elderly with satisfactory dentition. General oral comfort and its different attributes were poorly associated with the oral health of the elderly. A multifactorial analysis performed on an average cheese showed that food comfortability is independent of changes in the hardness and moistening of the bolus, regardless of dental status. In particular, poor dental status increases the hardness of the bolus without modifying its comfortability.

Bolus quality and food comfortability of model cheeses for the elderly as influenced by their texture.

The aim of this study was to examine the influence of the texture of dairy products on bolus properties and food comfortability as perceived by elderly persons. Four cheese models identical in terms of their nutritional composition but different by the type of texture (Soft, Hard, Processed and Whipped) were developed to resemble market cheese. Study was performed with a panel of 38 elderly persons without dental impairment but with variable rate of saliva flow. The time of chewing required to form the bolus was measured. The rheological properties of the bolus obtained were studied as well as the quantity of saliva incorporated. Food comfortability was assessed by means of a questionnaire asking about in-mouth comfort, bolus formation, pain, and perceived texture and flavor. Results showed that food comfortability was positively correlated to the ease of forming the bolus which depended on the food texture. Thus, the bolus formed with the Whipped product which required more saliva, was harder than the other three products and so judged the least comfortable. This product was characterized by a dry and sticky texture. On the other hand, the Soft and Processed products led to a softer food bolus that was more easily formed, and thus were judged as more comfortable. Their textures were perceived as soft, fatty and melting. This work highlights the importance of considering food bolus formation and related properties when looking for the link between food product characteristics and the enjoyment of eating in the case of the elderly population.

Li4Ti5O12/graphene nanoribbons composite as anodes for lithium ion batteries.

In this paper, we report the synthesis of a Li4Ti5O12/Graphene Nanoribbons (LTO/GNRs) composite using a solid-coating method. Electron microscope images of the LTO/GNRs composite have shown that LTO particles were wrapped around graphene nanoribbons. The introduction of GNRs was observed to have significantly improved the rate performance of LTO/GNTs. The specific capacities determined of the obtained composite at rates of 0.2, 0.5, 1, 2, and 5 C are 206.5, 200.9, 188, 178.1 and 142.3 mAh·g(-1), respectively. This is significantly higher than those of pure LTO (169.1, 160, 150, 106 and 71.1 mAh·g(-1), respectively) especially at high rate (2 and 5 C). The LTO/GNRs also shows better cycling stability at high rates. Enhanced conductivity of LTO/GNRs contributed from the GNR frameworks accelerated the kinetics of lithium intercalation/deintercalation in LIBs that also leads to excellent rate capacity of LTO/GNRs. This is attributed to its lower charge-transfer resistance (Rct = 23.38 Ω) compared with LTO (108.05 Ω), and higher exchange current density (j = 1.1 × 10(-3) mA cm(-2))-about 20 times than those of the LTO (j = 2.38 × 10(-4) mA cm(-2)).

Paradiplozoon ichthyoxanthon n. sp. (Monogenea: Diplozoidae) from Labeobarbus aeneus (Cyprinidae) in the Vaal River, South Africa.

A new species, Paradiplozoon ichthyoxanthon (Monogenea: Diplozoidae) is described from the gills of Labeobarbus aeneus (Cyprinidae) in the Vaal Dam and Vaal River Barrage in the Vaal River, South Africa. This species is the first in this genus from southern Africa; Paradiplozoon aegtyptense and Paradiplozoon ghanense have been described from northern Africa. The new species differs from all other Paradiplozoon species on the basis of the combination of morphological characteristics, namely disk-like haptor, eggs without filaments, clamp and central hook morphology and size of specimens. The species description is accompanied by a description of the reproductive organs. The internal transcribed spacer of the ribosomal gene (ITS2) was studied and the South African individuals formed a distinct clade, supporting the establishment of a new species.

The Experiential World of the Oncology Nurse

In her1 experiential world; the oncology nurse experiences unique; challenging and rewarding relationships in a multidimensional; dynamic way. The aim of this study was to describe; from her viewpoint and perspective; how she experiences and reacts to this world. Through this study the researcher wants the oncology nurse's voice to be heard; the richness of her story acknowledged and the derived data to be applied to the benefit of the field of oncology. In-depth; unstructured phenomenological interviews provided the saturated data from which the uniqueness of the world of the oncology nurse unfolded as the uniqueness of the oncology patients and their world emerged clearly. Findings show that the oncology nurse; attending to the cancer patients and their family; experiences many different relationships. The uniqueness of the oncology nurse-patient relation-ship is described as unlike any other nurse-patient relationship. The challenging interpersonal relationships with management and other members of the multiprofessional team; as experienced from the perspective of the oncology nurse; are also highlighted. Furthermore; a unifying intrapersonal relationship with the self was identified. This enables the oncology nurse to be both on the giving and receiving end of the intensely emotional environment she works in; explaining; at least partly; the high job satisfaction that permeated the interviews in this study. Recommendations for nursing practice; education and research were formulated

Floral development and the formation of unisexual spikelets in the Andropogoneae (Poaceae).

We investigated spikelet development in four distantly related species of the grass tribe Andropogoneae to determine whether spikelet development and the formation of unisexual florets are uniform throughout the tribe. We studied development in Bothriochloa bladhii, Coelorachis aurita, Heteropogon contortus, and Hyparrhenia hirta, and compared these with Panicum, a member of the sister tribe Paniceae. Many aspects of spikelet development in the species we have studied correlate with what is already known for Tripsacum and maize (both Andropogoneae), despite variation in how unisexual florets are distributed on the plant. The formation of unisexual spikelets is also uniform. All florets initiate both pistil and stamen primordia. In florets destined to be male, cell death occurs in the subepidermal layers of the gynoecium after the formation of a gynoecial ridge. In florets destined to be female, there is no apparent cell death in the stamens, but growth ceases after anther formation. The similarity in spikelet development and the formation of unisexual florets point to a common genetic mechanism for sex determination throughout the Andropogoneae and possibly the entire Panicoideae. Use of a cell death pathway to cause gynoecial abortion may be the basis of one morphological character that defines the subfamily.

Is olfactory reference syndrome an obsessive-compulsive spectrum disorder?: two cases and a discussion.

A number of disorders characterized by intrusive repetitive symptoms and varying degrees of insight may overlap phenomenologically and neurobiologically with obsessive-compulsive disorder (OCD). There is a question as to whether olfactory reference syndrome, a disorder characterized by persistent preoccupations about body odor accompanied by shame and embarrassment, is also an OCD spectrum disorder. Two cases of olfactory reference syndrome, with accompanying phenomenological and neurobiological data, are presented in order to discuss the possible overlap with OCD. A number of phenomenological and neurobiological features in these patients were at least partially reminiscent of OCD. In particular, despite having poor insight, both patients demonstrated significant improvement upon treatment with a serotonin reuptake inhibitor.

Methodological considerations in employing the continuous discourse tracking procedure with hearing-impaired adults.

This article addresses the various methodological issues involved in the use of the Continuous Discourse Tracking (CDT) procedure as a test instrument for evaluating communication efficiency in hearing-impaired adults. An overview of the potentially confounding variables associated with the CDT technique is provided and consideration is given to the reliability of this procedure with reference to areas requiring systematic investigation. It is proposed that the adoption of an alternative paradigm as well as interdisciplinary approach to test construction may facilitate a multi-dimensional perspective to the assessment of speechreading and communicative ability in the hearing-impaired population.