bluuebunny/crossref_metadata_2025 huggingface dataset:
LDR brachytherapy offers superior tumor control to single‐fraction HDR prostate brachytherapy: A prospective study
Authors: Jimenez‐Garcia Isabel E. , Sabater Sebastia , Martinez‐Gutierrez Rocio , Sanchez‐Galiano Pedro , Berenguer‐Serrano Roberto , Castro‐Larefors Susana , Rey‐Lopez Irene , Ruiz‐Herrero Beatriz , Sánchez‐Prieto Ricardo , Rovirosa Angeles , Arenas Meritxell , Gonzalez‐Suarez Herminio A.
Published: May 2023

Purpose

To compare the clinical outcomes of single‐fraction high‐dose‐rate (HDR) brachytherapy and single‐fraction low‐dose‐rate (LDR) brachytherapy as the sole treatment for primary prostate cancer.

Material and Methods

A quasi‐randomized study that allocated, from March 2008 to February 2012, 129 low and intermediate risk prostate cancer patients to one single‐fraction HDR of 19 Gy (61 patients) or to a 145 Gy 125I LDR permanent implant (68 patients. Biochemical relapse‐free survival (bRFS) and overall survival (OS) were compared using the Kaplan–Meier method and Cox regression analysis.

Results

After a median follow‐up of 72 months in the HDR group, 26 patients relapsed, and after a median follow‐up of 84 months in the LDR group, 7 patients relapsed (p < 0.0001). The 5‐year bRFS was significantly better for the LDR group than for the HDR group (93.7% and 61.1%, respectively) (p < 0.0001). The 5‐year OS also was significantly better in the LDR group (95.5% vs. 89.9%) (p = 0.0436).

Conclusions

Permanent LDR prostate implant brachytherapy offers better clinical outcomes than single‐fraction HDR for prostate cancer.
JP‐1366: A novel and potent potassium‐competitive acid blocker that is effective in the treatment of acid‐related diseases
Authors: Ku Jin Mo , Cho Jin Hee , Kim Kangjeon , Kim Ji Yoon , Kim Jong Yup , Kim John , Cha Hyunju , Cheon Banyoon
Published: May 2023

The global prevalence of GERD is substantially increasing each year, and GERD is a chronic disease that reduces the quality of life of patients. The efficacy of conventional drugs is diverse, and most require long‐term or lifetime administration; thus, the development of more effective therapeutic agents is needed. Herein, a more effective treatment for GERD was tested. We investigated whether JP‐1366 affected gastric H+/K+‐ATPase activity and used the Na+/K+‐ATPase assay to confirm the selectivity of H+/K+‐ATPase inhibition. To clarify the mechanism of enzyme inhibition, JP‐1366 and TAK‐438 were analyzed by Lineweaver–Burk. Also, we investigated the effects of JP‐1366 in various models involving reflux esophagitis. We found that JP‐1366 mediates strong, selective, and dose‐dependent inhibition of H+/K+‐ATPase. We found that JP‐1366 significantly suppressed gastric acid secretion in histamine‐treated pylorus‐ligated rats in a dose‐dependent manner. Additionally, we confirmed that JP‐1366 inhibited histamine‐stimulated gastric acid secretion in the HPD model. JP‐1366 exhibited a more than 2‐fold higher inhibitory effect on esophageal injury than TAK‐438 in GERD lesions and had a more potent inhibitory effect in indomethacin‐ or aspirin‐induced gastric ulcer rat models than TAK‐438. Additionally, JP‐1366 inhibited gastric ulcers. These results support the possibility that JP‐1366 is a good candidate drug for treating acid‐related diseases.
Population pharmacokinetic analysis of the P2X3‐receptor antagonist gefapixant
Authors: Chawla Akshita , Largajolli Anna , Hussain Azher , Kleijn Huub , Ait‐Oudhia Sihem , Anton Judith , Krishna Ananthula Hari , Nussbaum Jesse , La Rosa Carmen , Gheyas Ferdous
Published: May 2023

Gefapixant, a P2X3‐receptor antagonist, demonstrated objective and subjective efficacy in individuals with refractory or unexplained chronic cough. We report a population pharmacokinetic (PopPK) analysis that characterizes gefapixant pharmacokinetics (PKs), quantifies between‐ and within‐participant variability, and evaluates the impact of intrinsic and extrinsic factors on gefapixant exposure. The PopPK model was initially developed using PK data from six phase I studies. Stepwise covariate method was utilized to identify covariates impacting PK parameters; the model was re‐estimated and covariate effects were re‐assessed after integrating PK data from three phase II and III studies. Simulations were conducted to evaluate the magnitude of covariate effects on gefapixant exposure. Of 1677 participants included in this data set, 1618 had evaluable PK records. Age, body weight, and sex had statistically significant, but not clinically relevant, effects on exposure. Degree of renal impairment (RI) had statistically significant and clinically relevant effects on exposure; exposure was 17% to 89% higher in those with versus without RI. Simulation results indicated that gefapixant 45 mg administered once daily to patients with severe RI has similar exposure to gefapixant 45 mg administered twice daily to patients with normal renal function. There were no significant effects of proton pump inhibitors or food. Of evaluated intrinsic and extrinsic factors, only RI had a clinically relevant effect on gefapixant exposure. Patients with mild or moderate RI do not require dosage adjustments; however, for patients with severe RI who are not on dialysis, gefapixant 45 mg once daily is recommended.
MARCEL: Mobile active rover chassis for enhanced locomotion
Authors: Bouton Arthur , Gao Yang
Published: May 2023

To extend planetary exploration beyond the current limitations of wheeled vehicles while preserving reliability, simplicity, and efficiency, actuation can be judiciously incorporated into the locomotion system. Based on a static analysis, we propose a new four‐wheeled chassis concept for planetary rovers that can traverse more challenging terrain with the help of two internal active joints. These joints are arranged as follows: a vertical pivot articulates the chassis around its center while a bogie allows the rear wheels to rotate around the longitudinal axis of the vehicle. We also introduce a control method that uses a two‐stage procedure to produce an interpretable controller based on a policy devised by reinforcement learning. This way, we eliminate the black box made of a neural network and facilitate the transfer from simulation to reality. The resulting controller efficiently harnesses the internal mobility of the chassis to climb over obstacles in a sequenced manner while relying only on proprioceptive data provided by the chassis. A rover prototype named MARCEL has been built and tested experimentally. Contrary to any state‐of‐the‐art six‐wheeled passive chassis, the proposed locomotion system and its associated control has proven to be able to overcome solid step obstacles as tall as the diameter of the wheels with a edge and a friction coefficient as low as 0.5. This simple but capable design will enable future missions to explore more challenging areas while providing better guarantees in the face of unforeseen difficulties that could arise.
Furnishing Continuous Efficient Bidirectional Polysulfide Conversion for Long‐Life and High‐Loading Lithium–Sulfur Batteries via the Built‐In Electric Field
Authors: Ren Yilun , Ma Yujie , Wang Biao , Chang Shaozhong , Zhai Qingxi , Wu Hao , Dai Yuming , Yang Yurong , Tang Shaochun , Meng Xiangkang
Published: May 2023

Most catalysts cannot accelerate uninterrupted conversion of polysulfides, resulting in poor long‐cycle and high‐loading performance of lithium–sulfur (Li–S) batteries. Herein, rich p‐n junction CoS2/ZnS heterostructures embedded on N‐doped carbon nanosheets are fabricated by ion‐etching and vulcanization as a continuous and efficient bidirectional catalyst. The p‐n junction built‐in electric field in the CoS2/ZnS heterostructure not only accelerates the transformation of lithium polysulfides (LiPSs), but also promotes the diffusion and decomposition for Li2S the from CoS2 to ZnS avoiding the aggregation of lithium sulfide (Li2S). Meanwhile, the heterostructure possesses a strong chemisorption ability to anchor LiPSs and superior affinity to induce homogeneous Li deposition. The assembled cell with a CoS2/ZnS@PP separator delivers a cycling stability with a capacity decay of 0.058% per cycle at 1.0 C after 1000 cycles, and a decent areal capacity of 8.97 mA h cm−2 at an ultrahigh sulfur mass loading of 6 mg cm−2. This work reveals that the catalyst continuously and efficiently converts polysulfides via abundant built‐in electric fields to promote Li–S chemistry.
High‐Efficiency Low‐Lead Perovskite Photovoltaics Approaching 20% Enabled by a Vacuum‐Drying Strategy
Authors: Qin Zhaotong , Qin Minchao , Lu Xinhui
Published: May 2023

Lead‐tin mixed perovskites are excellent photovoltaic materials that can be used in single‐ or multi‐junction perovskite solar cells (PSCs). However, most high‐performance Pb‐Sn mixed PSCs reported to date are still Pb‐dominant. It is highly demanding to develop environmentally friendly low‐lead PSCs, but the poor film quality caused by the uncontrollable crystallization kinetics has been hindering the efficiency improvement of low‐lead PSCs. Here, a vacuum‐drying strategy in the two‐step method to fabricate low‐lead PSCs (FAPb0.3Sn0.7I3) with an impressive efficiency of 19.67% is employed. The vacuum treatment induces the formation of low crystalline Pb0.3Sn0.7I2 films containing less solvent, thus facilitating the subsequent FAI penetration and suppressing pinholes. Compared with the conventional one‐step method, the two‐step fabricated low‐lead perovskite films with the vacuum‐drying treatment exhibit a larger grain size, lower trap density, and weaker recombination loss, thus giving rise to a record‐high efficiency near 20% with better thermal stability.
Does 3D imaging of the fetal spine improve confidence in interpreting images in the second trimester?
Authors: Harding Catherine M. L. , Davies Braidy , Cowell Simon F. , Saxton Virginia , Choong Shawn , Strainge John
Published: May 2023

Introduction

This study investigated the addition of 3D ultrasound imaging to 2D ultrasound imaging when assessing the fetal spine in the second trimester in relation to: the diagnostic confidence of image assessors in interpretation, sonographer perceptions of the challenges in acquiring 3D images, and the additional time required to acquire 3D images.

Methods

Six image assessors rated their diagnostic confidence when assessing 2D and 3D images of the fetal spine images acquired from second trimester morphology scans. Sonographer perceptions were investigated using a questionnaire assigned to eight sonographers. The mean time required to take 3D images of the fetal spine was retrospectively calculated using the time stamps from the ultrasound images of 100 second trimester morphology scans.

Results

Common reasons for assessor's lack of confidence in reporting were poor quality or insufficient images of the upper spine (cervical/thoracic), the scapulae and/or the ribs. Diagnostic confidence of image assessors increased significantly (<.001) when 3D imaging was added to 2D imaging. All sonographers who completed the questionnaire stated that they found 3D ultrasound of the fetal spine useful in addition to 2D. 87.5% of these sonographers sometimes found 3D ultrasound challenging, mostly due to fetal position, or maternal obesity. The mean additional time required to perform 3D ultrasound to assess the fetal spine was 2 minutes and 19 seconds.

Conclusion

Adding 3D ultrasound of the fetal spine to a 2D second trimester obstetric morphology scan increased the diagnostic confidence of image assessors with only a small additional time requirement.
Predicting NSMR–concrete bond strength using artificial neural networks: A comparative‐analysis study
Authors: Haddad Rami , Qarqaz Noor
Published: May 2023

Near Surface‐Mounted Fiber Reinforced Polymer (NSM FRP) strips have become a popular technique for the rehabilitation of existing deteriorated concrete structures, the effectiveness of which is vitally related to its bond to concrete. The present Artificial Neural Network (ANN) model, aimed at providing precise predictions for bond strength, utilizes nearly 550 refined dataset points and accounts for more influential parameters, namely elastic modulus, cross‐sectional area, bond length of FRP strips, groove size, concrete edge distance, groove spacing, and concrete's compressive strength. The very few relevant publications for the prediction of bond strength between NSM FRP composites and concrete employing artificial intelligence bond models considered limited database sizes and few key parameters. The Matlab software was utilized to build, train, and test the network model using seven input variables and one targeted output. Detailed statistical analysis was presented to test the model's validity with Taylor charts produced using the Matlab software for the purpose of comparing the performance of the present model against different literature models. The proposed ANN model showed a high prediction ability and a low mean square error. Indeed, the mean square error for the testing and validation data remained below 0.00055, whereas the coefficient of determination exceeded 0.99. The error charts for training and testing database revealed normal distribution of bond strength residuals; supporting further the validity of the proposed model. The trending behavior of the ultimate bond force versus the key parameters was consistent with that captured in the various literature models. The statistical and the sensitively analyses performed stipulated the validity of the present model for producing reliable prediction for bond strength between NSM FRP strips and concrete.
Gender and climate change: A sustainable tourism perspective
Authors: Ratten Vanessa
Published: May 2023

The aim of this article is to examine whether female tourism entrepreneurs are more interested in climate change than male entrepreneurs are as part of their focus on sustainable entrepreneurial endeavors. A qualitative study of female tourism entrepreneurs is examined that focuses on three main climate change strategies: conservative, compliant, and proactive. The findings suggest that female tourism entrepreneurs are more influenced by their social circle and general interest in environmental issues that lead them to focus on climate change actions. The results of this study will help tourism providers, businesses, government, and the community better understand the role of gender in sustainable tourism entrepreneurship. Climate change is a topic of immense interest in society particularly for those in the tourism industry. Sustainable tourism entrepreneurs often focus on climate change action as a way to compete in the global marketplace and to derive a competitive advantage. Less well understood is the role of gender in sustainable tourism entrepreneurship particularly in terms of perceptions around climate change action.
Factors affecting captive female giraffe stress response: Male presence, small enclosure, and low temperature
Authors: Saito Miho , Matsunaga Masayuki , Fukuizumi Hiroki , Nakamichi Masayuki , Kinoshita Kodzue
Published: May 2023

To improve animal welfare based on suitable social housing conditions, it is important to understand the factors that trigger high‐stress responses. Wild giraffes live in a fission–fusion society and males and females are rarely in the same herd for a long period. The captive condition of belonging to a herd with the same individuals for months or years is uncommon in nature. To understand the effect of male presence on female stress levels, fecal glucocorticoid metabolite (fGCM) levels and social interactions in two captive female giraffes were investigated. Additionally, the effect of enclosure size and temperature on fGCM level and social interactions were examined. The results showed no significant difference in the fGCM levels of females based on male presence. The frequency of agonistic behavior by the dominant female toward the subordinate female was significantly increased when a male was present. The subordinate female was significantly less likely to approach the dominant female and showed decreased affiliative and agonistic interactions toward the dominant female when a male was present. The frequencies of agonistic interactions between females were higher in the small enclosure regardless of male presence. Low temperature triggered higher fGCM levels and increased agonistic interaction in an aged female. The findings of this study suggest that these multiple factors should be considered individually to promote the welfare of captive giraffes.
On the correspondence between black holes, domain walls and fluxes
Authors: Cribiori Niccolò , Gnecchi Alessandra , Lüst Dieter , Scalisi Marco
Published: May 2023

Abstract

We revisit and extend the correspondence between black holes, domain walls and fluxes in type IIA compactifications. We argue that these three systems can be described by the same supergravity effective action, modulo proper identifications and adjustments. Then, we apply the correspondence to investigate swampland conjectures on de Sitter and anti-de Sitter vacua, as well as on the black hole entropy. We show that, in certain cases, swampland conjectures can be motivated from properties of black hole solutions, such as positiveness of the entropy. This provides a bottom-up rationale which is complementary to the usual tests in string theory. When asking for an agreement between the anti-de Sitter and the black hole entropy distance conjectures, we are led to an extension of the correspondence which includes geometric fluxes and the associated Kaluza-Klein monopoles domain walls. Finally, we point out that the anti-de Sitter distance conjecture is naturally implemented in certain asymptotically anti-de Sitter black holes as a consequence of a constraint involving black hole charges and supergravity gauge couplings.
Notes on Ramond-Ramond spinors and bispinors in double field theory
Authors: Butter Daniel
Published: May 2023

Abstract

The Ramond-Ramond sector of double field theory (DFT) can be described either as an O(D, D) spinor or an O(D − 1, 1) × O(1, D − 1) bispinor. Both formulations may be related to the standard polyform expansion in terms of even or odd rank field strengths corresponding to IIA or IIB duality frames. The spinor approach is natural in a (bosonic) metric formulation of DFT, while the bispinor is indispensable for supersymmetric DFT. In these notes, we show how these two approaches may be covariantly connected using a spinorial version of the DFT vielbein, which flattens an O(D, D) spinor into a bispinor. We also elaborate on details of the bispinor formulation in both even and odd D and elaborate on the distinction between the IIA/IIB/IIA*/IIB* duality frames.
Quantization of Jackiw-Teitelboim gravity with a massless scalar
Authors: Bak Dongsu , Kim Chanju , Yi Sang-Heon
Published: May 2023

Abstract

We study canonical quantization of Jackiw-Teibelboim (JT) gravity coupled to a massless scalar field. We provide concrete expressions of matter SL(2, R) charges and the boundary matter operators in terms of the creation and annihilation operators in the scalar field. The matter charges are represented in the form of an oscillator (Jordon-Schwinger) realization of the SL(2, R) algebra. We also show how the gauge constraints are implemented classically, by matching explicitly classical solutions of Schwarzian dynamics with bulk solutions. We introduce n-point transition functions defined by insertions of boundary matter operators along the two-sided Lorentzian evolution, which may fully spell out the quantum dynamics in the presence of matter. For the Euclidean case, we proceed with a two-sided picture of the disk geometry and consider the two-sided 2-point correlation function where initial and final states are arranged by inserting matter operators in a specific way. For some simple initial states, we evaluate the correlation function perturbatively. We also discuss some basic features of the two-sided correlation functions with additional insertions of boundary matter operators along the two-sided evolution.
Bruhat intervals, subword complexes and brick polyhedra for finite Coxeter groups
Authors: Jahn Dennis , Stump Christian
Published: May 2023

We study the interplay between the discrete geometry of Bruhat poset intervals and subword complexes of finite Coxeter systems. We establish connections between the cones generated by cover labels for Bruhat intervals and of root configurations for subword complexes, culminating in the notion of brick polyhedra for general subword complexes.
Cognitive and visual task effects on gaze behaviour and gait of younger and older adults
Authors: Walsh Gregory S. , Snowball James
Published: May 2023

Cognitive dual tasks alter gait of younger and older adults and recent research has demonstrated that they also influence gaze behaviour and standing postural control. These findings suggest that age-related changes in cognitive and gaze function might increase fall risk in older adults. The purpose of this study was to determine the effect cognitive and visual dual tasks on the gait and gaze behaviour of younger and older adults. Ten older and ten younger adults walked for 3 min on a treadmill at preferred walking speed under three conditions, single task, cognitive and visual dual task conditions. Gait dynamics were measured using accelerometry and gaze behaviour was measured using wearable eye-trackers. Stride time variability and centre of mass (COM) motion complexity increased in dual-task conditions in older adults but had no difference for younger adults. Dual tasks had limited effect on gaze behaviour; however, visual input duration was greater, and visual input frequency and saccade frequency were lower in older than younger adults. The gaze adaptations in older adults may be the result of slower visual processing or represent a compensatory strategy to suppress postural movement. The increase in gait COM motion complexity in older adults suggests the dual tasks led to more automatic gait control resulting from both cognitive and visual tasks.
Radial HR-pQCT and Finite Element Analysis in HPP Patients are Superior in Identifying Susceptibility to Fracture-Associated Skeletal Affections Compared to DXA and Laboratory Tests
Authors: Schmidt Felix N. , Schmidt Constantin , Delsmann Julian , Amling Michael , Barvencik Florian
Published: May 2023

Hypophosphatasia (HPP) is an inborn disease that causes a rare form of osteomalacia, a mineralization disorder affecting mineralized tissues. Identification of patients at high risk for fractures or other skeletal manifestations (such as insufficiency fractures or excessive bone marrow edema) by bone densitometry and laboratory tests remains clinically challenging. Therefore, we examined two cohorts of patients with variants in the ALPL gene grouped by bone manifestations. These groups were compared by means of bone microarchitecture using high-resolution peripheral quantitative computed tomography (HR-pQCT) and simulated mechanical performance utilizing finite element analysis (FEA). Whereas the incidence of skeletal manifestations among the patients could not be determined by dual energy X-ray absorptiometry (DXA) or laboratory assessment, HR-pQCT evaluation showed a distinct pattern of HPP patients with such manifestations. Specifically, these patients had a pronounced loss of trabecular bone mineral density, increased trabecular spacing, and decreased ultimate force at the distal radius. Interestingly, the derived results indicate that the non-weight-bearing radius is superior to the weight-bearing tibia in identifying deteriorated skeletal patterns. Overall, the assessment by HR-pQCT appears to be of high clinical relevance due to the improved identification of HPP patients with an increased risk for fractures or other skeletal manifestations, especially at the distal radius.
A Metagenomic and Amplicon Sequencing Combined Approach Reveals the Best Primers to Study Marine Aerobic Anoxygenic Phototrophs
Authors: Gazulla Carlota R. , Cabello Ana María , Sánchez Pablo , Gasol Josep M. , Sánchez Olga , Ferrera Isabel
Published: May 2023

Studies based on protein-coding genes are essential to describe the diversity within bacterial functional groups. In the case of aerobic anoxygenic phototrophic (AAP) bacteria, the pufM gene has been established as the genetic marker for this particular functional group, although available primers are known to have amplification biases. We review here the existing primers for pufM gene amplification, design new ones, and evaluate their phylogenetic coverage. We then use samples from contrasting marine environments to evaluate their performance. By comparing the taxonomic composition of communities retrieved with metagenomics and with different amplicon approaches, we show that the commonly used PCR primers are biased towards the Gammaproteobacteria phylum and some Alphaproteobacteria clades. The metagenomic approach, as well as the use of other combinations of the existing and newly designed primers, show that these groups are in fact less abundant than previously observed, and that a great proportion of pufM sequences are affiliated to uncultured representatives, particularly in the open ocean. Altogether, the framework developed here becomes a better alternative for future studies based on the pufM gene and, additionally, serves as a reference for primer evaluation of other functional genes.
Detection efficacy of [89Zr]Zr-PSMA-617 PET/CT in [68Ga]Ga-PSMA-11 PET/CT-negative biochemical recurrence of prostate cancer
Authors: Rosar Florian , Khreish Fadi , Marlowe Robert J. , Schaefer-Schuler Andrea , Burgard Caroline , Maus Stephan , Petto Sven , Bartholomä Mark , Ezziddin Samer
Published: May 2023

Rationale

In patients with biochemical recurrence of prostate cancer (BCR), preliminary data suggest that prostate-specific membrane antigen (PSMA) ligand radiotracers labeled with zirconium-89 (89Zr; half-life ~ 78.41 h), which allow imaging ≥ 24 h post-injection, detect suspicious lesions that are missed when using tracers incorporating short-lived radionuclides.

Materials and methods

To confirm [89Zr]Zr-PSMA-617 positron emission tomography/computed tomography (PET/CT) detection efficacy regarding such lesions, and compare quality of 1-h, 24-h, and 48-h [89Zr]Zr-PSMA-617 scans, we retrospectively analyzed visual findings and PET variables reflecting lesional [89Zr]Zr-PSMA-617 uptake and lesion-to-background ratio. The cohort comprised 23 men with BCR post-prostatectomy, median (minimum–maximum) prostate-specific antigen (PSA) 0.54 (0.11–2.50) ng/mL, and negative [68Ga]Ga-PSMA-11 scans 40 ± 28 d earlier. Primary endpoints were percentages of patients with, and classifications of, suspicious lesions.

Results

Altogether, 18/23 patients (78%) had 36 suspicious lesions (minimum–maximum per patient: 1–4) on both 24-h and 48-h scans (n = 33 lesions) or only 48-h scans (n = 3 lesions). Only one lesion appeared on a 1-h scan. Lesions putatively represented local recurrence in 11 cases, and nodal or bone metastasis in 21 or 4 cases, respectively; 1/1 lesion was histologically confirmed as a nodal metastasis. In all 15 patients given radiotherapy based on [89Zr]Zr-PSMA-617 PET/CT, PSA values decreased after this treatment. Comparison of PET variables in 24-h vs 48-h scans suggested no clear superiority of either regarding radiotracer uptake, but improved lesion-to-background ratio at 48 h.

Conclusions

In men with BCR and low PSA, [89Zr]Zr-PSMA-617 PET/CT seems effective in finding prostate malignancy not seen on [68Ga]Ga-PSMA-11 PET/CT. The higher detection rates and lesion-to-background ratios of 48-h scans versus 24-h scans suggest that imaging at the later time may be preferable. Prospective study of [89Zr]Zr-PSMA-617 PET/CT is warranted.
Evaluating Implementation Costs of an Enhanced Recovery After Surgery (ERAS) Protocol in Colorectal Surgery: A Systematic Review
Authors: Hong Minki , Ghajar Mina , Allen William , Jasti Shravya , Alvarez‐Downing Melissa M.
Published: May 2023

Background

Enhanced recovery after surgery (ERAS) protocols have been well documented in the current literature to improve healthcare outcomes by decreasing length of stay, resource utilization, and morbidity without increasing readmission rates or complications. This subsequently leads to a net decrease in hospital costs. However, the initial costs of implementing such a program have not been well described, which is crucial information for hospitals with less resources. The aim of this study was to provide a cohesive review of the current literature for the costs of implementing a colorectal surgery ERAS protocol.

Methods

A comprehensive review was conducted on five databases (Google Scholar, Web of Science, PROSPERO, PubMed, and Cochrane) with the assistance of a professional librarian. All relevant English articles published between 1995 and June 2021 were screened for eligibility prior to inclusion in the review. Cost data were converted to US dollars based on the exchange rate at the end time of the study period for standardization.

Results

Seven studies were included for review. The studies evaluated a range of 50–1295 patients through their respective ERAS programs, which were followed for 5 to 22 months. ERAS implementation costs ranged from $57 to $1536 per patient. Components for each ERAS program varied for each study, but ultimately, the greatest costs were attributed to personnel.

Conclusions

Despite data heterogeneity and inconsistencies between cost breakdowns, a majority of the implementation cost was found to be secondary to personnel. This review demonstrates the need for a more standardized approach for reporting ERAS implementation costs through an open database as well as a potential streamlining of the ERAS protocol to facilitate implementation in institutions with less financial resources.
Investigation on potential and limitations of ERA5 Reanalysis downscaled on Italy by a convection-permitting model
Authors: Adinolfi Marianna , Raffa Mario , Reder Alfredo , Mercogliano Paola
Published: May 2023

This study presents a comprehensive assessment of a dynamical downscaling of ERA5 Reanalysis recently performed over Italy through the COSMO-CLM model at a convection-permitting scale (0.02°) over the period 1989–2020. Results are analysed against several independent observational datasets and reanalysis products. The capability of the downscaling to realistically represent the climatology for 2 m temperature and precipitation is analysed over the whole peninsula and subdomains. Hourly precipitation patterns, orography effects, and urban climate dynamics are also investigated, highlighting the weaknesses and strengths of the convection-permitting model. In particular, gains in performances are achieved in mountainous areas where the climate characteristics are correctly represented, as are the hourly precipitation characteristics. Losses in performances occur in coastal and flat areas of the Italian peninsula, where the convection-permitting model performance does not seem to be satisfactory, as opposed to complex orographic areas. The adopted urban parameterisation is demonstrated to simulate heat detection for two Italian cities: Rome and Milan. Finally, a subset of extreme climate indicators is evaluated, finding: (i) a region-dependent response, (ii) a notable performance of the convection-permitting model over mountainous areas and (iii) discrepancies in the South, Central and Insular subdomains. Climate indicators detect extreme events at a detailed scale, becoming an important tool for turning climate data into information.
Rates of clinical remission and inadequate response to advanced therapies among patients with ulcerative colitis in Germany
Authors: Bokemeyer Bernd , Picker Nils , Kromer Daniel , Rosin Ludger , Patel Haridarshan
Published: May 2023

Purpose

Many patients treated for ulcerative colitis (UC) do not achieve clinical remission. This real-world study assessed clinical remission and inadequate response rates among patients with UC in Germany treated with advanced therapies.

Methods

This retrospective chart review included patients with UC newly initiating advanced (index) therapy (anti-TNFα agents, vedolizumab, tofacitinib) from January 2017–September 2019 (index date). Included patients had data for ≥ 12 months before (baseline period) and after the index date (follow-up period). Remission was defined as a partial Mayo score ≤ 1. Indicators of inadequate response were: index therapy discontinuation; therapy adjustments (index therapy dose escalation; augmentation with non-advanced therapies; corticosteroid [CS] use during maintenance therapy); CS dependency (use for ≥ 12 weeks); and UC-related hospitalisation, surgery or emergency department visit. Time to first remission and inadequate response were analyzed using Kaplan–Meier analyses.

Results

Among 149 patients with UC (median age: 40 years), 96 (64.4%) were biologic-naïve and 42 (28.2%) received CS at the index date. Within 12 months, 52 patients (47.2%) were in remission; of these, 13 patients (25.0%) received ≥ 1 therapy adjustment. At 12 months, 55 patients (37.6%) had ≥ 1 indicator of an inadequate response. Median time to remission was longer among biologic-experienced vs biologic-naïve patients (24 vs 7 months; p = 0.012).

Conclusion

Over half of the patients were not in clinical remission after 12 months and more than one-third experienced inadequate response. One-quarter of patients in remission required therapy adjustments. Patients with UC require therapies that are more effective than those currently available to achieve better treatment outcomes.
Hippocampal neurogenesis and Arc expression are enhanced in high-fat fed prepubertal female pigs by a diet including omega-3 fatty acids and Bifidobacterium breve CECT8242
Authors: Huguet Gemma , Puig-Parnau Irene , Serrano Jose C. E. , Martin-Gari Meritxell , Rodríguez-Palmero María , Moreno-Muñoz Jose Antonio , Tibau Joan , Kádár Elisabet
Published: May 2023

Purpose

Obesity during childhood has become a pandemic disease, mainly caused by a diet rich in sugars and fatty acids. Among other negative effects, these diets can induce cognitive impairment and reduce neuroplasticity. It is well known that omega-3 and probiotics have a beneficial impact on health and cognition, and we have hypothesized that a diet enriched with Bifidobacterium breve and omega-3 could potentiate neuroplasticity in prepubertal pigs on a high-fat diet.

Methods

Young female piglets were fed during 10 weeks with: standard diet (T1), high-fat (HF) diet (T2), HF diet including B. breve CECT8242 (T3) and HF diet including the probiotic and omega-3 fatty acids (T4). Using hippocampal sections, we analyzed by immunocytochemistry the levels of doublecortin (DCX) to study neurogenesis, and activity-regulated cytoskeleton-associated protein (Arc) as a synaptic plasticity related protein.

Results

No effect of T2 or T3 was observed, whereas T4 increased both DCX+ cells and Arc expression. Therefore, a diet enriched with supplements of B. breve and omega-3 increases neurogenesis and synaptic plasticity in prepubertal females on a HF diet from nine weeks of age to sexual maturity. Furthermore, the analysis of serum cholesterol and HDL indicate that neurogenesis was related to lipidic demand in piglets fed with control or HF diets, but the neurogenic effect induced by the T4 diet was exerted by mechanisms independent of this lipidic demand.

Conclusion

Our results show that the T4 dietary treatment is effective in potentiating neural plasticity in the dorsal hippocampus of prepubertal females on a HF diet.
Knife wound or nosebleed—where does the blood at the crime scene come from?
Authors: Konrad Helen , Lawniczek Janina , Bajramjan Christine , Weber Lisa , Bajanowski Thomas , Poetsch Micaela
Published: May 2023

Secretion analysis is a useful tool in forensic genetics, since it establishes the (cellular) origin of the DNA prior in addition to the identification of the DNA donor. This information can be crucial for the construction of the crime sequence or verification of statements of people involved in the crime. For some secretions, rapid/pretests already exist (blood, semen, urine, and saliva) or can be determined via published methylation analyses or expression analyses (blood, saliva vaginal secretions, menstrual blood, and semen). To discriminate nasal secretion/blood from other secretions (like oral mucosa/saliva, blood, vaginal secretion, menstrual blood, and seminal fluid), assays based on specific methylation patterns at several CpGs were set up in this study. Out of an initial 54 different CpG markers tested, two markers showed a specific methylation value for nasal samples: N21 and N27 with a methylation mean value of 64.4% ± 17.6% and 33.2% ± 8.7%, respectively. Although identification or discrimination was not possible for all nasal samples (due to partial overlap in methylation values to other secretions), 63% and 26% of the nasal samples could be unambiguously identified and distinguished from the other secretions using the CpG marker N21 and N27, respectively. In combination with a blood pretest/rapid test, a third marker (N10) was able to detect nasal cells in 53% of samples. Moreover, the employment of this pretest increases the proportion of identifiable or discriminable nasal secretion samples using marker N27 to 68%. In summary, our CpG assays proved to be promising tools in forensic analysis for the detection of nasal cells in samples from a crime scene.
Computing Longest Lyndon Subsequences and Longest Common Lyndon Subsequences
Authors: Bannai Hideo , I. Tomohiro , Kociumaka Tomasz , Köppl Dominik , Puglisi Simon J.
Published: May 2023

Given a string T of length n whose characters are drawn from an ordered alphabet of size $$\sigma $$
σ
, its longest Lyndon subsequence is a maximum-length subsequence of T that is a Lyndon word. We propose algorithms for finding such a subsequence in $$\mathop {}\mathopen {}\mathcal {O}\mathopen {}(n^3)$$

O

(

n
3

)

time with $$\mathop {}\mathopen {}\mathcal {O}\mathopen {}(n)$$

O

(
n
)

space, or online in $$\mathop {}\mathopen {}\mathcal {O}\mathopen {}(n^3)$$

O

(

n
3

)

space and time. Our first result can be extended to find the longest common Lyndon subsequence of two strings of length at most n in $$\mathop {}\mathopen {}\mathcal {O}\mathopen {}(n^4 \sigma )$$

O

(

n
4

σ
)

time using $$\mathop {}\mathopen {}\mathcal {O}\mathopen {}(n^2)$$

O

(

n
2

)

space.
Pollen production of downy birch (Betula pubescens Ehrh.) along an altitudinal gradient in the European Alps
Authors: Ranpal Surendra , von Bargen Susanne , Gilles Stefanie , Luschkova Daria , Landgraf Maria , Traidl-Hoffmann Claudia , Büttner Carmen , Damialis Athanasios , Jochner-Oette Susanne
Published: May 2023

High-altitude environments are highly susceptible to the effects of climate change. Thus, it is crucial to examine and understand the behaviour of specific plant traits along altitudinal gradients, which offer a real-life laboratory for analysing future impacts of climate change. The available information on how pollen production varies at different altitudes in mountainous areas is limited. In this study, we investigated pollen production of 17 birch (Betula pubescens Ehrh.) individuals along an altitudinal gradient in the European Alps. We sampled catkins at nine locations in the years 2020–2021 and monitored air temperatures. We investigated how birch pollen, flowers and inflorescences are produced in relation to thermal factors at various elevations. We found that mean pollen production of Betula pubescens Ehrh. varied between 0.4 and 8.3 million pollen grains per catkin. We did not observe any significant relationships between the studied reproductive metrics and altitude. However, minimum temperature of the previous summer was found to be significantly correlated to pollen (rs = 0.504, p = 0.039), flower (rs = 0.613, p = 0.009) and catkin (rs = 0.642, p = 0.005) production per volume unit of crown. Therefore, we suggest that temperature variability even at such small scales is very important for studying the response related to pollen production.
Retrospective study on the trajectories of lower limb volume after outpatient-based complex decongestive therapy in post-operative gynecological cancer patients with lymphedema
Authors: Masui Ayano , Harada Tsuyoshi , Noda Yoshihiro , Soeda Ryo , Kida Hisashi , Tsuji Tetsuya
Published: May 2023

Purpose

To determine the effect of outpatient-based complex decongestive therapy in patients with secondary lower limb lymphedema (LLL) after gynecologic cancer surgery using group-based trajectory modeling (GBTM), and to examine factors predictive of the treatment course.

Methods

This retrospective study included participants who underwent surgery for gynecological cancer with pelvic lymph node dissection and subsequently visited the outpatient clinic for the treatment of stage II LLL according to the International Society of Lymphology. The improvement rate of edema at the initial visit and 3, 6, and 12 months later was assessed by calculating the volume of the lower extremity using the circumferential method. For evaluation of the patterns of treatment course, logistic regression analysis was performed after group estimation by the trend of the treatment course using GBTM.

Results

A total of 148 women (mean age 60.6 years (standard deviation: 13.4 years)) were analyzed. Three improvement trajectories were identified: (1) no response group, with worsening rather than improvement (n = 26); (2) moderate response group, with a slow improvement rate (n = 89); and (3) high response group, with a high improvement rate (n = 33). In addition, adherence to compression therapy at 3 months post-intervention was found to be a predictor in the no response group.

Conclusions

GBTM estimated that there are three patterns of the treatment course in patients with LLL after gynecologic cancer surgery. Adherence to compression therapy at 3 months post-intervention is a predictor of the treatment effectiveness.
Using immersive virtual reality to remotely examine performance differences between dominant and non-dominant hands
Authors: Evans Jack Owen , Tsaneva-Atanasova Krasimira , Buckingham Gavin
Published: May 2023

Circle drawing may be a useful task to study upper-limb function in patient populations. However, previous studies rely on expensive and bulky robotics to measure performance. For clinics or hospitals with limited budgets and space, this may be unfeasible. Virtual reality (VR) provides a portable and low-cost tool with integrated motion capture. It offers potentially a more feasible medium by which to assess upper-limb motor function. Prior to use with patient populations, it is important to validate and test the capabilities of VR with healthy users. This study examined whether a VR-based circle drawing task, completed remotely using participant’s own devices, could capture differences between movement kinematics of the dominant and non-dominant hands in healthy individuals. Participants (n = 47) traced the outline of a circle presented on their VR head-mounted displays with each hand, while the positions of the hand-held controllers were continuously recorded. Although there were no differences observed in the size or roundness of circles drawn with each hand, consistent with prior literature our results did show that the circles drawn with the dominant hand were completed faster than those with the non-dominant hand. This provides preliminary evidence that a VR-based circle drawing task may be a feasible method for detecting subtle differences in function in clinical populations.
Experimental evidence that toe-tapping behavior in the green-and-black poison frog (Dendrobates auratus) is related to prey detection
Authors: Schulte Lisa M. , König Yannis
Published: May 2023

Toe-tapping, the quick movement of the middle toes of the hind legs, has been observed in many frogs and toads, and is usually associated with feeding, calling, or courtship behaviors. While plenty of observations of toe-tapping exist for different species, experimental evidence regarding the stimuli triggering this behavior is almost non-existent. Here, we systematically tested the influence of different stimuli on the toe-tapping behavior in the green-and-black poison frog (Dendrobates auratus, Dendrobatidae) from a captive colony in the Zoo Frankfurt. We found that, compared to a control, both big and small prey animals (crickets and fruit flies) elicited much more toe-tapping behavior, and that toe-tapping was positively correlated to feeding events. Playback advertisement calls in contrast did not trigger toe-tapping. We further showed that also juvenile frogs already toe-tap, but less frequently than adults. Our results support the observation-based data that toe-tapping is associated with hunting behaviors. While the auditory part of courtship does not seem to trigger toe-tapping, experimental evidence regarding visual and/or tactile courtship stimuli is still lacking.
Effects of myocardial sheetlet sliding on left ventricular function
Authors: Zheng Yu , Chan Wei Xuan , Nielles-Vallespin Sonia , Scott Andrew D. , Ferreira Pedro F. , Leo Hwa Liang , Yap Choon Hwai
Published: May 2023

Left ventricle myocardium has a complex micro-architecture, which was revealed to consist of myocyte bundles arranged in a series of laminar sheetlets. Recent imaging studies demonstrated that these sheetlets re-orientated and likely slided over each other during the deformations between systole and diastole, and that sheetlet dynamics were altered during cardiomyopathy. However, the biomechanical effect of sheetlet sliding is not well-understood, which is the focus here. We conducted finite element simulations of the left ventricle (LV) coupled with a windkessel lumped parameter model to study sheetlet sliding, based on cardiac MRI of a healthy human subject, and modifications to account for hypertrophic and dilated geometric changes during cardiomyopathy remodeling. We modeled sheetlet sliding as a reduced shear stiffness in the sheet-normal direction and observed that (1) the diastolic sheetlet orientations must depart from alignment with the LV wall plane in order for sheetlet sliding to have an effect on cardiac function, that (2) sheetlet sliding modestly aided cardiac function of the healthy and dilated hearts, in terms of ejection fraction, stroke volume, and systolic pressure generation, but its effects were amplified during hypertrophic cardiomyopathy and diminished during dilated cardiomyopathy due to both sheetlet angle configuration and geometry, and that (3) where sheetlet sliding aided cardiac function, it increased tissue stresses, particularly in the myofibre direction. We speculate that sheetlet sliding is a tissue architectural adaptation to allow easier deformations of the LV walls so that LV wall stiffness will not hinder function, and to provide a balance between function and tissue stresses. A limitation here is that sheetlet sliding is modeled as a simple reduction in shear stiffness, without consideration of micro-scale sheetlet mechanics and dynamics.