bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain-Death and Organ Transplantation: The First Japanese Path
Authors: Akabayashi Akira
Published: May 2020

By analyzing the enactment process of the Organ Transplantation Law (OLT) in Japan, I illustrate one characteristic of the Japanese way to address bioethical issues. The final version of the bill did not establish a blanket definition of brain-death as equivalent to human death. Instead, it suggests that brain-death is the end of life only for patients who have given prior written consent to become organ donors. The family’s surrogate consent to donate the organs is not considered sufficient to enact the original 1997 law in every case.

I also examine the extremely low number of brain-dead donors, since the enactment of the Organ Transplant Law twenty years ago, due to, among other things, the Japanese views on corpses (gotai manzoku), perspectives of family members, and characteristics of altruism in what I will refer to as the Japanese “village society.”

I describe government policy that might support transplant tourism, as well as the background behind the prevalence of living donor organ transplantation. Finally, I refer to publications concerning organ reuse.
The Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant Accident
Authors: Akabayashi Akira
Published: May 2020

The Great East Japan Earthquake on March 11, 2011 caused a massive tsunami that led to the nuclear meltdown at the Fukushima Daiichi Nuclear Power Plant. This horrific accident revealed many systemic flaws, including a weak government program for emergency crisis management, non-transparency within governmental information control, and unscientific approaches to epidemiological research and government funding policy.

Following World War II, Japan prioritized economic recovery over many other things, including preparation for severe natural disasters. My aim is to show how the government handled these emergencies and issues related to research ethics. I will address and criticize the non-transparency of the government’s evacuation policy, the secretive position taken by researchers and the government, and the unethical epidemiological research studies conducted under the guise of health surveillance, in particular, child thyroid screening.

I will also discuss the closed nature of the population in Japan’s “Village Society.” Although Japanese people are known internationally for their courtesy and hospitality, I will discuss the dark side of these traits.

Finally, I discuss environmental ethics, focusing on both animal and intergenerational ethics that were brought to light through the Fukushima accident.
Outcome Egalitarianism and Opportunity Egalitarianism
Authors: Akabayashi Akira
Published: May 2020

In this chapter, I will explore the concept of equality in Japan. I ask, what concept of equality is prevalent in Japan? How does this differ from the use of equality in other countries? I will briefly analyze Japan’s (1) medical care (universal access to decent minimum fee-for-service care) and the social welfare system, (2) education system (no grade-skipping, teamwork-oriented education), (3) tax and salary system (a progressive taxation system with a high ceiling, a mechanism that strives to ensure that all citizens end up in the middle-income bracket), and (4) some governmental policies (restoration tax at the time of Great East Japan Earthquake in 2011 and dole-out policies in 1999 and 2009). I will explain how “equal burden” and “mutual aids” are key ideas in these social systems using the example of the Japanese concept of equality. I will further describe the system that has been labeled “Japanese socialism.”

In summary, I argue here that many of Japan’s social systems are based on outcome egalitarianism rather than opportunity egalitarianism.
Modern Medical Professionalism
Authors: Akabayashi Akira
Published: May 2020

In this chapter, I will examine whether or not medical professionalism should take the same form worldwide. Japan has its own culture and ethos, both of which have significance in the clinical setting. However, if a Japanese doctor graduated from a Japanese medical school which is not accredited by international (Western) standards, then the doctor will not be able to work in the USA after 2023. Japanese medical schools are concerned about international standards because “Professionalism” is one of key part of accreditation. However, the question remains: should medical professionalism be measured in a universal and internationally standardized way? How would, for example, Japanese medical schools teach their medical students about the concept of autonomy, for which so many interpretations are possible? (see Chap. 3).

Further, I will explain the difficulties of teaching medical professionalism to medical students and young residents. In this chapter, I present two actual cases to illustrate these points. I bring to this discussion a case of medical professionalism using the Fukushima nuclear power plant accident as an example. Specifically, I question whether physicians are obliged to stay in an area highly contaminated with nuclear radiation. I also discuss whether one’s obligation as a physician might require them to provide care during disasters. This is a different type of discussion about medical professionalism from those focused around clinical ethics.

Finally, I examine the happiness of the healthcare professional, a subject that has received little attention in the literature thus far in any country. I argue that the happiness of the healthcare professional should also be an important part of medical professionalism.
Braneworld effective field theories — holography, consistency and conformal effects
Authors: Fichet Sylvain
Published: May 2020

Abstract

Braneworld theories are often described as low-energy effective field theories (EFTs) featuring an infinitely thin 3-brane and 4D fields exactly localized on it. We investigate whether an exactly localized braneworld can arise as a limit of a theory of 5D fields. Using a holographic formalism we argue that such limit does not exist in the presence of gravity, therefore implying a discontinuity in the space of EFTs. We then present specific models involving exactly localized fields in which inconsistencies appear, which are solved when fields are taken as quasilocalized. Part of our arguments rely on conjectures from the “swampland” program. Our investigation motivates braneworld EFTs built from 5D fields, i.e. quasilocalized braneworlds. Observable effects from quasilocalization are significant for warped braneworlds such as Randall-Sundrum II (RSII), and are reminiscent of a conformal hidden sector. Focusing on the gauge-gravity sector we show that manifestations of the quasilocalized warped braneworld include i) an anomalous running of SM gauge couplings ii) a conformal contribution to SM gauge boson scattering induced by 5D gravity. Constraining these effects puts an upper bound on the 5D EFT cutoff, implying that the warped braneworld hypothesis could — at least in principle — be tested completely.
On-shell heavy particle effective theories
Authors: Aoude Rafael , Haddad Kays , Helset Andreas
Published: May 2020

Abstract

We introduce on-shell variables for Heavy Particle Effective Theories (HPETs) with the goal of extending Heavy Black Hole Effective Theory to higher spins and of facilitating its application to higher post-Minkowskian orders. These variables inherit the separation of spinless and spin-inclusive effects from the HPET fields, resulting in an explicit spin-multipole expansion of the three-point amplitude for any spin. By matching amplitudes expressed using the on-shell HPET variables to those derived from the one-particle effective action, we find that the spin-multipole expansion of a heavy spin-s particle corresponds exactly to the multipole expansion (up to order 2s) of a Kerr black hole, that is, without needing to take the infinite spin limit. Finally, we show that tree-level radiative processes with same-helicity bosons emitted from a heavy spin-s particle exhibit a spin-multipole universality.
Impact of 18F-FDG-PET/CT on the identification of regional lymph node metastases and delineation of the primary tumor in esophageal squamous cell carcinoma patients
Authors: Münch Stefan , Marr Lisa , Feuerecker Benedikt , Dapper Hendrik , Braren Rickmer , Combs Stephanie E. , Duma Marciana-Nona
Published: May 2020

Purpose

In patients undergoing chemoradiation for esophageal squamous cell carcinoma (ESCC), the extent of elective nodal irradiation (ENI) is still discussed controversially. This study aimed to analyze patterns of lymph node metastases and their correlation with the primary tumor using 18F‑fludeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans.

Methods

102 ESCC patients with pre-treatment FDG-PET/CT scans were evaluated retrospectively. After exclusion of patients with low FDG uptake and patients without FDG-PET-positive lymph node metastases (LNM), 76 patients were included in the final analysis. All LNM were assigned to 16 pre-defined anatomical regions and classified according to their position relative to the primary tumor (above, at the same height, or below the primary tumor). In addition, the longitudinal distance to the primary tumor was measured for all LNM above or below the primary tumor. The craniocaudal extent (i.e., length) of the primary tumor was measured using FDG-PET imaging (LPET) and also based on all other available clinical and imaging data (endoscopy, computed tomography, biopsy results) except FDG-PET (LCT/EUS).

Results

Significantly more LNM were identified with 18F‑FDG-PET/CT (177 LNM) compared to CT alone (131 LNM, p < 0.001). The most common sites of LNM were paraesophageal (63% of patients, 37% of LNM) and paratracheal (33% of patients, 20% of LNM), while less than 5% of patients had supraclavicular, subaortic, diaphragmatic, or hilar LNM. With regard to the primary tumor, 51% of LNM were at the same height, while 25% and 24% of lymph node metastases were above and below the primary tumor, respectively. For thirty-three LNM (19%), the distance to the primary tumor was larger than 4 cm. No significant difference was seen between LCT/EUS (median 6 cm) and LPET (median 6 cm, p = 0.846)

Conclusion

18F‑FDG-PET can help to identify subclinical lymph node metastases which are located outside of recommended radiation fields. PET-based involved-field irradiation might be the ideal compromise between small treatment volumes and decreasing the risk of undertreatment of subclinical metastatic lymph nodes and should be further evaluated.
Perkutane Leberbiopsie vor Organentnahme – Einfluss auf Organallokation und Kosten in der Lebertransplantation
Authors: Beltzer Christian , Quante Markus , Rheinberger Myriam , Baba Hideo Andreas , Saner Fuat , Fend Falko , Biet Thomas , Königsrainer Alfred , Nadalin Silvio
Published: May 2020

Hintergrund

Der Stellenwert und die Sicherheit einer perkutanen Leberbiopsie (PLB) bei hirntoten Spendern vor Organentnahme sowie der Einfluss der PLB auf die Organallokation und die Kosten im Rahmen der Lebertransplantation (LT) in der Eurotransplant-Region (ET), werden weiterhin diskutiert.

Material und Methoden

Eine perkutane Leberbiopsie vor Organentnahme erfolgte bei 36 hirntoten Spendern. Die Komplikationsrate, Spendercharakteristika, Ultraschallbefunde, die makroskopische Einschätzung und die histologischen Ergebnisse der PLB wurden analysiert. Zusätzlich wurde eine landesweite Umfrage unter 11 Lebertransplantationsexperten durchgeführt. Der Bedarf einer PLB und ihre Auswirkungen auf den Prozess der Organallokation wurden evaluiert. Mögliche Kosteneinsparungen wurden für verschiedene Szenarien auf der Grundlage von Kostendaten der Deutschen Stiftung Organtransplantation berechnet.

Ergebnisse

Es wurden keine Komplikationen durch die PLB beobachtet. Die Umfrage ergab, dass das Ergebnis der PLB einen erheblichen Einfluss auf die Allokation von Spenderorganen hat, insbesondere bei solchen mit „extended donor criteria (EDC)“. Die Kostenberechnung ergab ein enormes Kosteneinsparungspotenzial durch eine optimierte Allokation und die Vermeidung unnötiger Organentnahmen.

Schlussfolgerung

Die PLB ist ein sicheres Verfahren und besitzt ein enormes Potenzial für die Optimierung der Organallokation vor Organentnahme durch eine Reduzierung der kalten Ischämiezeit, Vermeidung unnötiger Verwerfungen von Spenderorganen sowie Kosteneinsparungen. Die klinische Relevanz und der Einfluss der PLB auf die Organallokation konnte durch unsere Daten herausgestellt werden.
Variational sensitivity analysis of elastoplastic structures applied to optimal shape of specimens
Authors: Liedmann Jan , Barthold Franz-Joseph
Published: May 2020

The aim of this paper is to improve the shape of specimens for biaxial experiments with respect to optimal stress states, characterized by the stress triaxiality. Gradient-based optimization strategies are used to achieve this goal. Thus, it is crucial to know how the stress state changes if the geometric shape of the specimen is varied. The design sensitivity analysis (DSA) of the stress triaxiality is performed using a variational approach based on an enhanced kinematic concept that offers a rigorous separation of structural and physical quantities. In the present case of elastoplastic material behavior, the deformation history has to be taken into account for the structural analysis as well as for the determination of response sensitivities. The presented method is flexible in terms of the choice of design variables. In a first step, the approach is used to identify material parameters. Thus, material parameters are chosen as design variables. Subsequently, the design parameters are chosen as geometric quantities so as to optimize the specimen shape with the aim to obtain a preferably homogeneous stress triaxiality distribution in the relevant cross section of the specimen.
Ricci-Flat Metrics on Vector Bundles Over Flag Manifolds
Authors: Achmed-Zade Ismail , Bykov Dmitri
Published: May 2020

We construct explicit complete Ricci-flat metrics on the total spaces of certain vector bundles over flag manifolds of the group SU(n), for all Kähler classes. These metrics are natural generalizations of the metrics of Candelas–de la Ossa on the conifold, Pando Zayas–Tseytlin on the canonical bundle over $$\mathbb {CP}^1\times \mathbb {CP}^1$$CP1×CP1, as well as the metrics on canonical bundles over flag manifolds, recently constructed by van Coevering.
Determination of the absolute bioavailability of oral imatinib using a stable isotopically labeled intravenous imatinib-d8 microdose
Authors: Roosendaal Jeroen , Groenland Stefanie L. , Rosing Hilde , Lucas Luc , Venekamp Nikkie , Nuijen Bastiaan , Huitema Alwin D. R. , Beijnen Jos H. , Steeghs Neeltje
Published: May 2020

Purpose

The aim of this study was to ascertain whether the absolute bioavailability of oral imatinib (Glivec®) during steady state plasma pharmacokinetics in cancer patients could be determined through a concomitant intravenous administration of a single 100 μg microdose of deuterium labeled imatinib (imatinib-d8). Secondly, the usefulness of liquid chromatography–tandem mass spectrometry (LC-MS/MS) was investigated for simultaneous analysis of orally and intravenously administered imatinib.

Methods

Included patients were on a stable daily dose of 400 mg oral imatinib prior to study participation. On day 1, patients received a 100 μg intravenous imatinib-d8 microdose 2.5 h after intake of the oral dose. Plasma samples were collected for 48 h. Imatinib and imatinib-d8 concentrations were simultaneously quantified using a validated LC-MS/MS assay. The absolute bioavailability was calculated by comparing the dose-normalized exposure with unlabeled and stable isotopically labeled imatinib in plasma.

Results

A total of six patients were enrolled. All patients had a history of gastrointestinal stromal tumors (GIST). The median absolute bioavailability of oral imatinib at steady state was 76% (range 44–106%). Imatinib and imatinib-d8 plasma concentrations were quantified in all collected plasma samples, with no samples below the limit of quantification for imatinib-d8.

Conclusion

The absolute bioavailability of imatinib was successfully estimated at steady state plasma pharmacokinetics using the stable isotopically labeled microdose trial design. This study exhibits the use of a stable isotopically labeled intravenous microdose to determine the absolute bioavailability of an oral anticancer agent in patients with LC-MS/MS as the analytical tool.
Kinetic modeling and parametric imaging with dynamic PET for oncological applications: general considerations, current clinical applications, and future perspectives
Authors: Dimitrakopoulou-Strauss Antonia , Pan Leyun , Sachpekidis Christos
Published: May 2020

Dynamic PET (dPET) studies have been used until now primarily within research purposes. Although it is generally accepted that the information provided by dPET is superior to that of conventional static PET acquisitions acquired usually 60 min post injection of the radiotracer, the duration of dynamic protocols, the limited axial field of view (FOV) of current generation clinical PET systems covering a relatively small axial extent of the human body for a dynamic measurement, and the complexity of data evaluation have hampered its implementation into clinical routine. However, the development of new-generation PET/CT scanners with an extended FOV as well as of more sophisticated evaluation software packages that offer better segmentation algorithms, automatic retrieval of the arterial input function, and automatic calculation of parametric imaging, in combination with dedicated shorter dynamic protocols, will facilitate the wider use of dPET. This is expected to aid in oncological diagnostics and therapy assessment. The aim of this review is to present some general considerations about dPET analysis in oncology by means of kinetic modeling, based on compartmental and noncompartmental approaches, and parametric imaging. Moreover, the current clinical applications and future perspectives of the modality are outlined.
Morbidity and Mortality of Typhoid Intestinal Perforation Among Children in Sub‐Saharan Africa 1995–2019: A Scoping Review
Authors: Birkhold Megan , Coulibaly Yacaria , Coulibaly Oumar , Dembélé Philadelphie , Kim Daniel S. , Sow Samba , Neuzil Kathleen M.
Published: May 2020

Background

Typhoid fever incidence and complications, including intestinal perforation, have declined significantly in high‐income countries, with mortality rates <1%. However, an estimated 10.9 million cases still occur annually, most in low‐ and middle‐income countries. With the availability of a new typhoid conjugate vaccine licensed for children and recommended by the World Health Organization, understanding severe complications, including associated mortality rates, is essential to inform country‐level decisions on introduction of this vaccine. This scoping review summarizes over 20 years of the literature on typhoid intestinal perforation in sub‐Saharan Africa.

Methods

We searched EMBASE, PubMed, Medline, and Cochrane databases for studies reporting mortality rates due to typhoid intestinal perforation in children, under 18 years old, in sub‐Saharan Africa published from January 1995 through June 2019.

Results

Twenty‐four papers from six countries were included. Reported mortality rates ranged from 4.6–75%, with 16 of the 24 studies between 11 and 30%. Thirteen papers included postoperative morbidity rates, ranging from 16–100%. The most documented complications included surgical site infections, intra‐abdominal abscesses, and enterocutaneous fistulas. High mortality rates can be attributed to late presentation to tertiary centers, sepsis and electrolyte abnormalities requiring preoperative resuscitation, prolonged perforation‐to‐surgery interval, and lack of access to critical care or an intensive care unit postoperatively.

Conclusions

Current estimates of mortality related to typhoid intestinal perforation among children in sub‐Saharan Africa remain unacceptably high. Prevention of typhoid fever is essential to reduce mortality, with the ultimate goal of a comprehensive approach that utilizes vaccination, improvements in water, sanitation, and hygiene, and greater access to surgical care.
Emergency Laparotomy in Denmark: A Nationwide Descriptive Study
Authors: Liljendahl Mie S. , Gögenur Ismail , Thygesen Lau C.
Published: May 2020

Background

The term ‘emergency open abdominal surgery’ covers a range of common procedures with high complication and mortality risks; however, previous studies have not included descriptive analyses of the patients undergoing the procedures. The aim of this study is to present a nationwide description of all patients who undergo an emergency bowel resection, ostomy placement or drainage involving laparotomy at Danish hospitals and to report the 30‐ and 365‐day mortality risks.

Method

We identified all of the patients in the Danish National Patient Register aged 18 + who underwent emergency open abdominal surgery in the form of a laparotomy during the period 2003‐14. Using Poisson and logistic regression models, we analyzed incidence rates and mortality risk.

Result

The sample consisted of 15,680 patients, with an overall open abdominal surgery incidence rate of 30.4 cases per 100,000 person‐years. The 30‐day mortality risk was 19.3% for both sexes, and increased with age (at 80–89, mortality risk was 39.4% for males and 34.5% for females). The 30‐day mortality risk fell by 5.4% during the study period, from 22.2% to 16.7%.

Conclusion

Open abdominal surgery is a common, high‐risk procedure with a high incidence rate and mortality risk, especially for elderly patients. The incidence rate and mortality risk fell during the period studied. In Denmark, there is no standard post‐discharge care program for patients who undergo emergency laparotomies. Our results support the need to investigate standardized post‐operative follow‐up and rehabilitation plans to reduce mortality.
A Novel Technique to Predict Liver Damage After Laparoscopic Gastrectomy From the Stomach Volume Overlapping the Liver by Preoperative Computed Tomography
Authors: Kaida Sachiko , Murakami Yoko , Ohta Shinichi , Yamaguchi Tsuyoshi , Takebayashi Katsushi , Murata Satoshi , Nitta Norihisa , Shimizu Tomoharu , Tani Masaji
Published: May 2020

Background

During laparoscopic gastrectomy (LG), it is necessary to manipulate the lateral segment of the liver to secure the surgical field. Liver retraction during surgery often causes liver dysfunction after LG. However, no previous studies have used preoperative image evaluations to predict postoperative liver damage associated with surgical retraction. We aimed to predict postoperative liver damage after LG.

Methods

In all, 117 consecutive patients with gastric cancer who underwent LG were included in this study. Using preoperative computed tomography (CT), the volume of the stomach overlapping the liver was integrated and calculated as the liver projecting stomach volume (LPSV). The liver projection ratio (LPR) was calculated by dividing the LPSV by the volume of the whole stomach. The relationships among liver damage, the LPSV and LPR were evaluated.

Results

A total of 112 patients were divided into two groups as follows: 33 patients in the liver dysfunction group (D group) and 79 patients in the non‐dysfunction group (N group). The LPSV was significantly larger in the D group than in the N group (median 77.1 vs 50.1 cm3; p = 0.0061). Similarly, LPR values in the D group were significantly higher than those in the N group (median 33.6 vs 26.2%; p = 0.003). Receiver operating characteristic curve analysis indicated a statistically significant ability of the LPSV and LPR to predict postoperative liver damage (area under the curve; 0.705 and 0.735, respectively). Furthermore, multivariate logistic regression analysis revealed that the increase in the LPR was an independent predictor of postoperative liver damage (odds ratio: 1.042; 95% confidence interval: 1.009–1.078; p = 0.019).

Conclusions

We have developed a novel technique for predicting postoperative liver damage associated with surgical liver retraction following LG. This method confirms the degree of the LPSV and LPR of the stomach via preoperative CT.
The effect of vertical ocean mixing on the tropical Atlantic in a coupled global climate model
Authors: Deppenmeier Anna-Lena , Haarsma Rein J. , LeSager Philippe , Hazeleger Wilco
Published: May 2020

Sea surface temperature (SST) biases in the tropical Atlantic are a long-standing problem among coupled global climate models (CGCMs). They occur in equilibrated state, as well as in initialised seasonal to decadal simulations. The bias is typically characterised by too high SST in upwelling regions and associated errors of wind and precipitation. We examine the SST bias in the state-of-the-art CGCM EC-Earth by means of an upper ocean heat budget analysis. Horizontal advection processes affect the SST bias development only to a small extent, and surface heat fluxes mostly dampen the warm bias. Subgrid-scale upper ocean vertical mixing is too low in EC-Earth when compared to estimates from reanalysis data, potentially giving rise to the warm bias. We perform sensitivity experiments to examine the effect of enhanced vertical mixing on the SST bias in quasi equilibrium present day climate and its impact on projected climate change. Enhanced mixing in historical simulation mode ($${\text {MixUp}}_{pr}$$

MixUp

pr

) reduces the SST bias in the tropical Atlantic compared to the control experiment ($${\text {Control}}_{pr}$$

Control

pr

). Associated atmospheric biases of precipitation and surface winds are also reduced in $${\text {MixUp}}_{pr}$$

MixUp

pr

. We further perform climate projections under the RCP8.5 emission scenario ($${\text {Control}}_{fu}$$

Control

fu

and $${\text {MixUp}}_{fu}$$

MixUp

fu

). Under increasing greenhouse gas forcing, the tropical Atlantic warms by up to $$4.5\,^{\circ }{\text {C}}$$

4.5

∘

C

locally, and maritime precipitation increases in boreal winter and spring. We show that the vertical mixing parameterisation influences future climate. In $${\text {MixUp}}_{fu}$$

MixUp

fu

, SSTs remain $$0.5\,^{\circ }{\text {C}}$$

0.5

∘

C

colder in boreal winter and spring, but increase with the same amplitude in summer and fall. The strength and location of the projected intertropical convergence zone also depends on the ocean vertical mixing efficiency. The rain band moves southward in summer, and its strength increases in winter in $${\text {MixUp}}_{fu}$$

MixUp

fu

as compared to $${\text {Control}}_{fu}$$

Control

fu

.
Horsefly reactions to black surfaces: attractiveness to male and female tabanids versus surface tilt angle and temperature
Authors: Horváth Gábor , Pereszlényi Ádám , Egri Ádám , Fritz Benjamin , Guttmann Markus , Lemmer Uli , Gomard Guillaume , Kriska György
Published: May 2020

Tabanid flies (Diptera: Tabanidae) are attracted to shiny black targets, prefer warmer hosts against colder ones and generally attack them in sunshine. Horizontally polarised light reflected from surfaces means water for water-seeking male and female tabanids. A shiny black target above the ground, reflecting light with high degrees and various directions of linear polarisation is recognised as a host animal by female tabanids seeking for blood. Since the body of host animals has differently oriented surface parts, the following question arises: How does the attractiveness of a tilted shiny black surface to male and female tabanids depend on the tilt angle δ? Another question relates to the reaction of horseflies to horizontal black test surfaces with respect to their surface temperature. Solar panels, for example, can induce horizontally polarised light and can reach temperatures above 55 °C. How long times would horseflies stay on such hot solar panels? The answer of these questions is important not only in tabanid control, but also in the reduction of polarised light pollution caused by solar panels. To study these questions, we performed field experiments in Hungary in the summer of 2019 with horseflies and black sticky and dry test surfaces. We found that the total number of trapped (male and female) tabanids is highest if the surface is horizontal (δ = 0°), and it is minimal at δ = 75°. The number of trapped males decreases monotonously to zero with increasing δ, while the female catch has a primary maximum and minimum at δ = 0° and δ = 75°, respectively, and a further secondary peak at δ = 90°. Both sexes are strongly attracted to nearly horizontal (0° ≤ δ ≤ 15°) surfaces, and the vertical surface is also very attractive but only for females. The numbers of touchdowns and landings of tabanids are practically independent of the surface temperature T. The time period of tabanids spent on the shiny black horizontal surface decreases with increasing T so that above 58 °C tabanids spent no longer than 1 s on the surface. The horizontally polarised light reflected from solar panels attracts aquatic insects. This attraction is adverse, if the lured insects lay their eggs onto the black surface and/or cannot escape from the polarised signal and perish due to dehydration. Using polarotactic horseflies as indicator insects in our field experiment, we determined the magnitude of polarised light pollution (being proportional to the visual attractiveness to tabanids) of smooth black oblique surfaces as functions of δ and T.
Interoceptive awareness and self-regulation contribute to psychosomatic competence as measured by a new inventory
Authors: Fazekas Christian , Avian Alexander , Noehrer Rita , Matzer Franziska , Vajda Christian , Hannich Hans , Neubauer Aljoscha
Published: May 2020

Background

The interrelation of interoception, cognitive appraisal of bodily signals and conscious self-regulatory behavior is insufficiently understood although it may be relevant for health and disease. Therefore, it was intended to develop a novel self-report measure targeting this link.

Methods

Item development was theoretically based on the multidimensional conceptual framework of the psychosomatic intelligence hypothesis and included an iterative process of refinement of items. In a preliminary test a principal components analysis (PROMAX rotation) and item analysis were calculated for item reduction. In the field test an item response theory approach was used for development of final scales and items. For validation purposes, associations with established measures of related constructs were analyzed.

Results

The final 44-item questionnaire consisted of 6 interrelated scales: (1) interoceptive awareness, (2) mentalization, (3) body-related cognitive congruence, (4) body-related health literacy, (5) general self-regulation, and (6) stress experience and stress regulation. Psychometric properties of this instrument demonstrated good model fit, internal consistency and construct validity. According to the validation, the final instrument measures a form of competence rather than intelligence and was termed the psychosomatic competence inventory.

Conclusion

Interoceptive awareness and conscious body-related self-regulation seem to jointly contribute to a basic competence which may serve homeostatic/allostatic control; however, further research is needed to confirm the reported preliminary findings in a large-scale test.
Monitor-based exoscopic 3D4k neurosurgical interventions: a two-phase prospective-randomized clinical evaluation of a novel hybrid device
Authors: Roethe Anna L. , Landgraf Philipp , Schröder Torsten , Misch Martin , Vajkoczy Peter , Picht Thomas
Published: May 2020

Background

Promoting a disruptive innovation in microsurgery, exoscopes promise alleviation of physical strain and improved image quality through digital visualization during microneurosurgical interventions. This study investigates the impact of a novel 3D4k hybrid exoscope (i.e., combining digital and optical visualization) on surgical performance and team workflow in preclinical and clinical neurosurgical settings.

Methods

A pre-clinical workshop setting has been developed to assess usability and implementability through skill-based scenarios (neurosurgical participants n = 12). An intraoperative exploration in head and spine surgery (n = 9) and a randomized clinical study comparing ocular and monitor mode in supratentorial brain tumor cases (n = 20) followed within 12 months. Setup, procedure, case characteristics, surgical performance, and user experience have been analyzed for both ocular group (OG) and monitor group (MG).

Results

Brain tumor cases using frontal, frontoparietal, or temporal approaches have been identified as favorable use cases for introducing exoscopic neurosurgery. Mean monitor distance and angle were 180 cm and 10°. Surgical ergonomics when sitting improved significantly in MG compared with OG (P = .03). Hand-eye coordination required familiarization in MG. Preclinical data showed a positive correlation between lateral camera inclination and impact on hand-eye coordination (rs = 0.756, P = .01). There was no significant added surgical time in MG. Image quality in current generation 3D4k monitors has been rated inferior to optic visualization yet awaits updates.

Conclusions

The hybrid exoscopic device can be integrated into established neurosurgical workflows. Currently, exoscopic interventions seem most suited for cranial tumor surgery in lesions that are not deep-seated. Ergonomics improve in monitor mode compared to conventional microsurgery.
Assessment of SAPT(DFT) with meta-GGA functionals
Authors: Hapka Michał , Modrzejewski Marcin , Chałasiński Grzegorz , Szczęśniak Małgorzata M.
Published: May 2020

This work examines the suitability of meta-GGA functionals for symmetry-adapted perturbation theory (SAPT) calculations. The assessment is based on the term-by-term comparison with the benchmark SAPT variant based on coupled-cluster singles and doubles description of monomers, SAPT(CCSD). Testing systems include molecular complexes ranging from strong to weak and the He dimer. The following nonempirical meta-GGAs are examined: TPSS, revTPSS, MVS, SCAN, and SCAN0 with and without the asymptotic correction (AC) of the exchange-correlation potential. One range-separated meta-GGA functional, LC-PBETPSS, is also included. The AC-corrected pure meta-GGAs (with the exception of MVS) represent a definite progress in SAPT(DFT) compared to pure GGA, such as PBEAC, with their more consistent predictions of energy components. However, none of the meta-GGAs is better than the hybrid GGA approach SAPT(PBE0AC). The SAPT(DFT) electrostatic energy offers the most sensitive probe of the quality of the underlying DFT density. Both SCAN- and TPSS-based electrostatic energies agree with reference to within 5% or better which is an excellent result. We find that SCAN0 can be used in SAPT without the AC correction. The long-range corrected LC-PBETPSS is a reliable performer both for the components and total interaction energies.
Congruence between nursing students’ and patients’ views of student–patient relationships
Authors: Suikkala Arja , Koskinen Sanna , Katajisto Jouko , Leino-Kilpi Helena
Published: May 2020

The growing emphasis on learning with and from patients has shifted the focus from education and healthcare professionals to the student–patient relationship. The relationship between student and patient, with a supportive preceptor as a resource, can influence the progression and development of an authentic person-centred approach to care among students. The purpose of this study was to analyse the congruence between nursing students’ and patients’ views of their relationship during students’ clinical placement. The study compared data from cross-sectional matched cohort pairs of nursing students (n = 187) and patients (n = 187) in Finland. The data were collected between March 2015 and May 2016 using corresponding questionnaires and procedures in both cases. Both students’ and patients’ views were moderately or weakly congruent in terms of facilitative relationship, characterised as a mutually enriching relationship for both students and patients through dialogue. Patients, however, tended to see the relationship significantly more often as mechanistic, focusing on students learning practical skills, compared to students who saw the relationship more often as facilitative. Patients’ age and the reasons for care were the only background variables that predicted the congruence between students’ and patients’ views of their relationships. These findings suggest ways in which student–patient relationships can be made more meaningful in supporting learning in clinical education.
HER2-targeted therapy influences CTC status in metastatic breast cancer
Authors: Deutsch Thomas M. , Riethdorf Sabine , Fremd Carlo , Feisst Manuel , Nees Juliane , Fischer Chiara , Hartkopf Andreas D. , Pantel Klaus , Trumpp Andreas , Schütz Florian , Schneeweiss Andreas , Wallwiener Markus
Published: May 2020

Purpose

As an independent, negative-prognostic biomarker for progression-free survival (PFS) and overall survival (OS), circulating tumor cells (CTCs) constitute a promising component for developing a liquid biopsy for patients with metastatic breast cancer (MBC). The effects of HER2-targeted therapy such as trastuzumab, pertuzumab, T-DM1, and lapatinib on CTC status and longitudinal enumeration were assessed in this trial.

Methods

CTC status of 264 patients with MBC was analyzed prior to and after 4 weeks of a new line of palliative systemic therapy. CTCs were assessed using CellSearch®. Three groups were compared: patients with HER2-positive MBC receiving ongoing HER2-targeted therapy (n = 28), patients with de novo HER2-positive MBC and no HER2-targeted therapy in the last 12 months prior to enrollment and start of HER2-targeted therapy (n = 15), and patients with HER2-nonamplified disease and no HER2-targeted therapy (n = 212).

Results

Positive CTC status (≥ 5 CTC/7.5 ml blood) at enrollment was observed in the 3 groups for 17.9, 46.7, and 46.2% (p = 0.02) of patients, respectively. At least one CTC/7.5 ml was seen in 28.6, 53.3, and 67.0% (p < 0.001) of these patients. Furthermore, 3.6, 40.0, and 3.3% (p < 0.001) of the patients had at least one HER2-positive CTC. After 4 weeks of therapy 7.1, 0.0, and 31.1% (p = 0.001) of patients had still a positive CTC status (≥ 5 CTC/7.5 ml blood). At least one CTC/7.5 ml was still observed in 25.0, 20.0, and 50.5% (p = 0.004) of the patients. Furthermore, 7.1, 0.0, and 1.9% (p = 0.187) had at least one HER2-positive CTC. After 3 months of therapy, 35.7, 20.0, and 28.3% (p = 0.536) showed disease progression.

Conclusions

HER2-targeted therapy seems to reduce the overall CTC count in patients with MBC. This should be taken into account when CTC status is used as an indicator for aggressive or indolent metastatic tumor disease.
Conserving on the edge: genetic variation and structure in northern populations of the endangered plant Dracocephalum ruyschiana L. (Lamiaceae)
Authors: Kyrkjeeide Magni Olsen , Westergaard Kristine Bakke , Kleven Oddmund , Evju Marianne , Endrestøl Anders , Brandrud Marie Kristine , Stabbetorp Odd
Published: May 2020

Loss of biodiversity is accelerating, including the loss of genetic diversity. Conservation of small, isolated populations may be important, as they can provide valuable contributions to overall genetic variation and long-term viability of species. Furthermore, such populations may play an essential role in adaptation to new environments following changes in e.g. land-use and climate. Dracocephalum ruyschiana is a threatened plant species throughout its European distribution, but 25% of the European populations are situated within Norway. Therefore, the species has its own action plan in Norway, which includes demographic monitoring. However, this monitoring does not cover genetic variation nor is the selection of monitored populations based on genetic differentiation, therefore this fundamental level of biodiversity is overlooked. We analyzed 43 sites using 96 SNPs developed for D. ruyschiana, to investigate whether the monitored populations cover the genetic variation and differentiation found within the Norwegian distribution. The results show structuring and differentiation between populations and indicate that there are at least four distinct genetic groups, of which only two are covered extensively by current demographic monitoring. We suggest that two sites representing the two other genetic groups should be included in the national monitoring program to better conserve the genetic variation found in the Norwegian population of D. ruyschiana. Overall, our results highlight the importance of an integrated, interdisciplinary framework to better monitor and conserve biodiversity at several levels.
Number of prior negative screening outcomes does not influence future risk of breast cancer
Authors: Lilleborge Marie , Falk Ragnhild S. , Hofvind Solveig
Published: May 2020

We questioned whether a history of negative screening outcomes could be used to predict breast cancer risk, and thus be used as a potential factor for stratification of mammographic screening. Data from the Norwegian population based breast cancer screening program, BreastScreen Norway, was used to estimate cumulative hazard rates for breast cancer by number of prior negative screening outcomes among participants from 1995 through 2016. We followed three age cohorts of women, who started screening at age 50–54, 55–59, and 60–64 years. Further, we estimated the absolute and relative risk of breast cancer by number of prior negative screening outcomes. The cumulative hazard curves were parallel for all numbers of negative screening outcomes for all age cohorts. The absolute risk of breast cancer increased with number of negative screening outcomes for the youngest age cohort. For the oldest age cohorts, the absolute risk was stable during the screening period and decreased thereafter. The number of negative screening outcomes was not associated with risk of breast cancer, adjusted for age, percent screening attendance and calendar years (HR 1.00, 95% CI 0.98–1.02). Our results suggest that the number of negative screening outcomes does not predict breast cancer risk among participants in BreastScreen Norway.
Robots responding to care needs? A multitasking care robot pursued for 25 years, available products offer simple entertainment and instrumental assistance
Authors: Van Aerschot Lina , Parviainen Jaana
Published: May 2020

Twenty-five years ago, robotics guru Joseph Engelberger had a mission to motivate research teams all over the world to design the ‘Elderly Care Giver’, a multitasking personal robot assistant for everyday care needs in old age. In this article, we discuss how this vision of omnipotent care robots has influenced the design strategies of care robotics, the development of R&D initiatives and ethics research on use of care robots. Despite the expectations of robots revolutionizing care of older people, the role of robots in human care has remained marginal. The value of world trade in service robots, including care robots, is rather small. We argue that the implementation of robots in care is not primarily due to negative user attitudes or ethical problems, but to problems in R&D and manufacturing. The care robots currently available on the market are capable of simple, repetitive tasks or colloquial interaction. Thus far, also research on care robots is mostly conducted using imaginary scenarios or small-scale tests built up for research purposes. To develop useful and affordable robot solutions that are ethically, socially and ecologically sustainable, we suggest that robot initiatives should be evaluated within the framework of care ecosystems. This implies that attention has to be paid to the social, emotional and practical contexts in which care is given and received. Also, the political, economic and ecological realities of organizing care and producing technological commodities have to be acknowledged. It is time to openly discuss the drivers behind care robot initiatives to outline the bigger picture of organizing care under conditions of limited resources.
Comparative Analysis of Cone Resistances in Cone Penetration Test (CPTu) and Dynamic Probe Heavy Test (DPH)
Authors: Bagińska Irena
Published: May 2020

This paper presents a comparison of geotechnical soil testing with the use of Piezocone Penetration Test (CPTu) and Dynamic Probing Heavy (DPH) in a uniform coarse-grained medium located in southwest part of Poland. The soil medium was identified in detail. The interpretation of results included both grain-size analysis of samples from drillholes and soil behavior type results obtained from the Robertson nomograph (Soil behaviour type from the CPT: an update. In: 2nd international symposium on cone penetration testing, USA, 2010). Cone penetration resistances qc obtained in the static CPTu tests were compared with the results of dynamic probing N10H and of dynamic point resistance qd obtained in the dynamic DPH tests. The evaluation of soil density index was based on both dynamic DPH and static CPTu probing. The obtained results were analyzed and plotted in a form of graphs corresponding to the Eurocode 7 and other works describing coarse-grained soils.
Polycomb-like 2 regulates PRC2 components to affect proliferation in glioma cells
Authors: Wang Fei , Gao Yongying , Lv Ye , Wu Yanwei , Guo Yongzhen , Du Fang , Wang Shixiong , Yu Jiaxiang , Cao Xiangmei , Li P. Andy
Published: May 2020

Introduction

The Polycomb group (PcG) is an important family of transcriptional regulators that controls growth and tumorigenesis. The PcG mainly consists of two complexes, PRC1 and Polycomb Repressive Complex 2 (PRC2). Polycomb-like 2 (PCL2) is known to interact with the PRC2 protein. The role of PCL2 in the development and progression of glioma is unclear.

Methods

We use The Cancer Genome Atlas (TCGA) database to detect the expression of PCL2 in various tumors. 117 cases of clinical glioma (WHOI–IV) were collected, and PCL2 expression and localization were detected by immunohistochemical staining. Glioma cells U87/U251 were infected with overexpressed and interfered PCL2. CCK8 assay, colony formation assay, EdU method, cell cycle and apoptosis were used to detect cell proliferation and apoptosis. Western blot was used to detect the expression of PRC2-related core proteins. After DZNeP intervention, PRC2 protein expression was again measured to discuss the mechanism of PCL2 action.

Results

TCGA database results and immunohistochemical staining results suggest that PCL2 is highly expressed in gliomas. We found that the PCL2 gene promoted tumor cell proliferation, enhanced the colony formation ability, and increased S phase in the cell cycle. The overexpression of PCL2 upregulated the expression levels of EZH2 and EED (two core members of PRC2), decreased the expression of SUZ12, increased the level of H3K27 trimethylation (H3K27me3), H3K4 dimethylation (H3K4me2), and decreased H3K9 dimethylation (H3K9me2). The result after interfering with PCL2 was the opposite.

Conclusions

As an important accessory protein of PRC2, PCL2 can not only change the expression of PRC2 components, but also affect the expression level of Histone methylation. Therefore, PCL2 may be an important hub for regulating the synergy among PRC2 members. This study revealed PCL2 as a new target for tumor research and open up a new avenue for future research in glioma.