bluuebunny/crossref_metadata_2025 huggingface dataset:
Phase II study of 131I‐metaiodobenzylguanidine with 5 days of topotecan for refractory or relapsed neuroblastoma: Results of the French study MIITOP
Authors: Sevrin François , Kolesnikov‐Gauthier Hélène , Cougnenc Olivier , Bogart Emilie , Schleiermacher Gudrun , Courbon Frederic , Gambart Marion , Giraudet Anne‐Laure , Corradini Nadège , Badel Jean‐Noël , Rault Erwann , Oudoux Aurore , Deley Marie Cécile Le , Valteau‐Couanet Dominique , Defachelles Anne‐Sophie
Published: August 2023

Purpose

We report the results of the French multicentric phase II study MIITOP (NCT00960739), which evaluated tandem infusions of 131I‐metaiodobenzylguanidine (mIBG) and topotecan in children with relapsed/refractory metastatic neuroblastoma (NBL).

Methods

Patients received 131I‐mIBG on day 1, with intravenous topotecan daily on days 1–5. A second activity of 131I‐mIBG was given on day 21 to deliver a whole‐body radiation dose of 4 Gy, combined with a second course of topotecan on days 21–25. Peripheral blood stem cells were infused on day 31.

Results

Thirty patients were enrolled from November 2008 to June 2015. Median age at diagnosis was 5.5 years (2–20). Twenty‐one had very high‐risk NBL (VHR‐NBL), that is, stage 4 NBL at diagnosis or at relapse, with insufficient response (i.e., less than a partial response of metastases and more than three mIBG spots) after induction chemotherapy; nine had progressive metastatic relapse. Median Curie score at inclusion was 6 (1–26). Median number of prior lines of treatment was 3 (1–7). Objective response rate was 13% (95% confidence interval [CI]: 4–31) for the whole population, 19% for VHR‐NBL, and 0% for progressive relapses. Immediate tolerance was good, with nonhematologic toxicity limited to grade‐2 nausea/vomiting in eight patients. Two‐year event‐free survival was 17% (95% CI: 6–32). Among the 16 patients with VHR‐NBL who had not received prior myeloablative busulfan‐melphalan consolidation, 13 had at least stable disease after MIITOP; 11 subsequently received busulfan‐melphalan; four of them were alive (median follow‐up: 7 years).

Conclusion

MIITOP showed acceptable tolerability in this heavily pretreated population and encouraging survival rates in VHR‐NBL when followed by busulfan‐melphalan.
Use of covalent dynamic networks as binders on epoxy‐based carbon fiber composites: Effect on properties, processing, and recyclability
Authors: Vidal Julio , Hornero Carlos , Garcia Ruth , Cuartero Jesus , Beaucamp Anne , Collins Maurice N. , Garcia Lidia , Ponce David , Royo Mari Carme , Sanchez Elisabeth , Castell Pere
Published: August 2023

Composites are gaining widespread market interest due to their outstanding mechanical properties and light weight. However, this growth is hindered by the lack of sustainable recycling solutions. This research aims to integrate reversible chemistries to advanced carbon fiber‐reinforced composite materials for recycling in a so‐called eco‐design, circular approach. Diene and dienophile reactions are generated at the surface of the carbon fiber allowing a bond–debond interaction with the epoxy matrix. The application of the Diels–Alder adduct on the fiber modifies its polarity and structure. This research assesses a biobased and synthetic epoxy equivalent and demonstrates that this newly developed interphase chemistry has a direct impact on the crosslinking efficiency of the resin, as well as on their interlaminar properties. Furthermore, it has been observed that depending on the type of resin, these changes can have differing impacts on final properties of the composite, reducing the crosslinking density up to 50% in some modifications while in others the Tg remains constant.
A study on whether nonverbal inductive reasoning predicts mathematical performance
Authors: Ren Bingqian , Liang Xiaotong , Li Jingyi , Cao Luyi , Zhou Xinlin
Published: August 2023

Mathematical performance plays a vital role in students' academic development. Studies have shown that some basic cognitive processes, including inductive reasoning, are critical for the development of mathematical performance. However, little empirical evidence has been accumulated regarding the association between inductive reasoning and mathematical performance. This study investigated whether inductive reasoning has a unique predictive effect on situational, verbalized, and symbolic mathematical performance. A total of 203 eighth‐graders were recruited for a series of tasks. Results showed that when only gender and age were controlled for, inductive reasoning ability could significantly predict all types of mathematical performance. However, after controlling for general cognitive abilities, including language, spatial visualization, and working memory, inductive reasoning ability did not significantly predict any mathematical performance. By contrast, language and spatial ability showed independent predictions for mathematical performance. Results suggest that language and spatial abilities, other than inductive reasoning, could support mathematical processing.
Comparing passive and active macroinvertebrate sampling gear efficacy during biomonitoring in Southern Appalachian mountain streams
Authors: Gibbs W. Keith , Cook S. Bradford , Kulp Matthew A.
Published: August 2023

Aquatic invertebrates are important components of any aquatic ecosystem and are frequently monitored to determine the ecological integrity of those systems. Various gear types are used to collect aquatic macroinvertebrates in wadeable streams. We analyzed commonly used active and passive gear types, including kick seines, Hess samplers, drift nets, and Hester–Dendy samplers, across a watershed in the Great Smoky Mountains National Park to determine their efficacy under various habitat conditions in wadeable Southern Appalachian mountain streams. Hester–Dendy samplers were significantly different from other gear types for most univariate and multivariate analyses. Kick and Hess samples were most similar in multivariate comparisons of macroinvertebrate assemblages. Drift samples were similar in most univariate analyses but were distinct from other gear types when analyzed with multivariate techniques. Our results indicate that comprehensive assessments of macroinvertebrate assemblages require multiple gear types, various analytical approaches, and consistent taxonomic resolution. The complexity of the fluvial system in question should be thoroughly assessed prior to formulating a macroinvertebrate biomonitoring protocol to better ensure robust and meaningful results.
Effect of Silica Content on Cellular Structural and Hygroscopicity of Modified Cassava Starch Foam
Authors: Figueiró Camila da Silva , Trojaner Maria Rachel , Calcagno Carmen Iara Walter , Santana Ruth Marlene Campomanes
Published: August 2023

The growth in polymer production is influenced by the high demand from the packaging sector. Expanded polystyrene (EPS) is one of these materials that is widely used in disposable packaging, however, this generates waste that occupies a large volume and is difficult to degrade. Starch, a naturally occurring and biodegradable polysaccharide, may be an alternative in the search for a renewable source material. However, starch foams have some limitations related to their hygroscopicity. The objective of this study is to analyze the influence of silica content (1%, 2%, and 3%) on the cell structure and surface hygroscopicity of cassava starch foams. The foams containing starch, glycerol, and water are produced by thermo‐compression molding. Results show that, at lower contents, silica acts predominantly as a nucleating agent, generating smaller cells in the foam. At the higher silica content, it plays a more efficient role in reducing the affinity of the starch for water. The formulation with 2% silica shows the highest density (0.232 g cm−3), impact strength (2067 J m−2), and contact angle (84.8°).
A Survey of Decommissioned Photovoltaic Modules from Solar Power Plants in Thailand: Performance and Second Life Opportunities
Authors: Limmanee Amornrat , Sitthiphol Nopphadol , Jaroensathainchok Suttinan , Pluemkamon Rangson , Kotesopa Saifon , Udomdachanut Nuttakarn , Hongsingthong Aswin
Published: August 2023

Four hundred decommissioned solar photovoltaic (PV) modules from nine utility‐scale solar power plants in Thailand have been surveyed on site by means of visual inspection, insulation testing and outdoor current–voltage (I–V) curve measurement. These included amorphous silicon (a‐Si), cadmium telluride (CdTe), copper indium gallium diselenide (CIGS or CIS) and multi crystalline silicon (multi c‐Si) PV modules after 6–9 years of operation. The most observed visual defect was the permanent edge soiling for all types of PV modules. The degradation rate (DR) for maximum power output (Pm) of the PV modules has varied widely, from 1.5%/year to 9%/year. 83% of the total amount of modules in this study still has the Pm of above 70% of their initial value, suggesting a potential for second use. Our findings are informative for a further study on PV reliability in the tropics and also can be used to develop mechanisms for handling decommissioned PV modules from solar farms, e.g., screening procedure concerning performance, safety, and reliability aspects before their second life application. © 2023 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC.
Digitalisation and Financial Data Governance in Africa: Challenges and Opportunities
Authors: Ndemo Bitange , Mkalama Ben
Published: August 2023

Financial technology companies (FinTechs) have taken to digitalisation both to understand their customers and to use data to design more productive and convenient products. As a result, they are credited with making financial resources increasingly available and affordable. In Africa, millions of people use a vast array of proliferating mobile platforms as transactional interfaces. Although these innovations have improved the ease of financial transactions, they are not without challenges. In this paper, we explore digitalisation and financial governance in Africa. We identify the current state of knowledge and explicate how this understanding has been applied on the continent. Finally, we specify existing knowledge gaps in areas that could form the basis of a future research agenda for practitioners and policymakers.
The Use of Photovoltaic Solar Panels to Reduce Temperature-Induced Bridge Deformations
Authors: Borah Sushmita , Al-Habaibeh Amin
Published: August 2023

Civil infrastructure such as bridges undergo deformations such as displacement and strain due to environmental temperature variations. Temperature causes deformations equal to or larger than that due to traffic load on bridges. This research evaluates whether the deformations due to temperature load on bridges can be minimised by incorporating photovoltaic solar panels on the bridge surface. The panels can be attached to the bridge truss, piers, and the periphery of the deck excluding the pavement, i.e., excluding bridge superstructure elements under direct traffic load to avoid wear and tear of the solar panels. The hypothesis is that solar panels will generate electricity from solar radiation and the bridge elements underneath the panels will experience less temperature load. The truss will experience smaller deformations and thereby increasing its lifespan. This hypothesis is tested with a laboratory experiment on a bridge truss. A combination of solar panels is attached to the surface of an Aluminium truss. The truss is subjected to 1-h heating and cooling cycles created using infrared lamps. The truss is monitored with linear variable differential transformers and thermocouples. Displacements and surface temperature of the truss are recorded. Results have shown a 34.0% reduction in displacement due to the installation of solar panels. The temperature of the truss has been also reduced by 15–25.6%. This research shows the benefit of integrating renewable energy means in infrastructure such as bridges to reduce temperature-induced structural deformations. Such integration can enhance the bridge lifespan along with generating green energy to electrify the bridge or the local area.
The Effect of Vane Number in Casing Treatment of an Axial-Flow Compressor
Authors: Soodani Sara , Hosseini SeyedVahid , Hakimi Mohammad , Akhlaghi Mohammad
Published: August 2023

Improvement of the operating range of compressors will help the power and energy plant to work more flexibly to integrate with other energy generation systems. The stall, rotating stall, and resulting surge are the most dominant limiting phenomenon in axial compressor operating envelop. Several active and passive methods have been employed to eliminate occurring of these phenomena and to extend compressors’ stable range. Among these, casing treatment is one of the most useful methods. This study aims to investigate the effect of the number of stationary blades on the performance and stall margin of an axial compressor through numerical simulation. Casing treatments in two different configurations of 33.3 and 53.5% of rotor blade tip exposure and with six different numbers of vanes, 30, 40, 60, 80, 90, and 120, are simulated with computational fluid dynamics in ANSYS software. The numerical simulation is validated with available experimental data. The results reveal that in a high rotor exposure configuration, the highest number of vanes provides the best performance for the compressor. However, in a low exposure configuration, the optimum number of the vanes, 90 for the 33.3% exposure, can be found with the proposed numerical procedure based on stall margin improvement.
Trade and Women’s Economic Empowerment: Qualitative Analysis of SMEs from Ghana, Madagascar, Nigeria, and Senegal
Authors: Samy Yiagadeesen , Adedeji Adeniran , Iraoya Augustine , Dutta Madhurjya Kumar , Fakmawii Jasmine Lal , Hao Wen
Published: August 2023

Using Ghana, Madagascar, Nigeria, and Senegal as case studies, this chapter elucidates the dynamics of trade and women empowerment in Africa through a qualitative analysis that involved focus group discussions (FGDs) and key informant interviews (KIIs) with managers and employers, and employees of SMEs, as well as government officials and Trade Support Organizations (TSOs). After presenting the operational context of trade and economic performance in the four candidate countries, the barriers to women’s participation in trade are discussed using the PESTLE framework. Our qualitative analysis shows that cross-cutting factors that influence job creation for women across the trade sectors include the nature of work, job demands in terms of physical strength and timing, and working conditions of employees. The chapter argues that trade has the potential to empower women. However, if finds that various challenges prevent women from maximizing the gains from trade and proposes that a strong public–private partnership is necessary for trade to lead to women empowerment.
Conclusion
Authors: Samy Yiagadeesen , Adedeji Adeniran , Iraoya Augustine , Dutta Madhurjya Kumar , Fakmawii Jasmine Lal , Hao Wen
Published: August 2023

In this concluding chapter, we bring together the findings of our research, drawn from the survey of SMEs and the qualitative analysis (focus group discussions, key informant interviews and in-depth interviews) that were conducted for the current project across the six selected countries: Cambodia, Ghana, Madagascar, Nigeria, Senegal and Vietnam. We started this book by arguing that international trade has the potential to provide women with more and better employment opportunities, drive productivity and economic growth, and thus empower women and improve gender equality. As we summarize our findings in this concluding chapter, we discuss how and whether this potential is being met, and why it may not always be attained. Finally, we offer our policy recommendations for how women entrepreneurs and workers can better take advantage of the opportunities that are made possible by international trade.
Unmasking Realities: Public Health Communication in India During the COVID-19 Pandemic
Authors: Mirchandani Sonalini , Chitrapu Sunitha
Published: August 2023

The authors take a critical look at India’s public health communications during the COVID-19 pandemic. The case study method is used. Data include what was gleaned from interviews with key informants engaged in outreach communication, news reports, and artefacts from select COVID campaigns as they evolved through the first and second waves of the pandemic. Learnings are drawn from previous health communication campaigns that focused on behavior change including India’s successful and well recognized communications interventions during its HIV and AIDS campaigns, as well as its remarkable Pulse Polio efforts.
Iran’s Experience with the COVID-19 Pandemic: Focusing on Vulnerable Populations
Authors: Moghanibashi-Mansourieh Amir , Arshi Maliheh , Arabgari Amirhesam
Published: August 2023

Iran was one of the first countries to be affected by the COVID-19 pandemic. The onset of the pandemic coincided with the serious ongoing economic problems that Iran was facing and which have seriously impacted the lives of Iranians. According to official statistics, there were about six million infections and 130,000 deaths due to COVID-19 by December 2021. Quarantine, social distancing, and other health protocols had an adverse impact on mental and social health. Vulnerable groups, including children, women heads of households, the homeless, drug addicts, and the disabled were at higher risk. Although initially governmental and non-governmental organizations were not prepared to manage the pandemic, overtime serious efforts were made to implement innovative measures in the areas of education and mental health service provision. Economic conditions in Iran have adversely impacted all these measures. The authors discuss Iran's experience with COVID-19 focusing on the health, social, psychological, and economic factors and draw lessons from these experiences.
The Long Shadow of COVID-19
Authors: Kapila Mukesh
Published: August 2023

The sudden arrival of COVID-19 shook the world and evoked varied—sometimes contradictory—reactions from communities, countries, and institutions around the world. The pandemic brought out the best and worst of humanity even as the complex play of factors underpinning the spread of the coronavirus collided in myriad ways to both facilitate and obstruct effective responses. The experience has generated much angst and questions about the way we are organized and relate to each other. And, most of all, it has the potential to reshape our fundamental premises. The effects will be profound going well beyond the pandemic itself to the notions of collective health as a common global good.
νDoBe — A Python tool for neutrinoless double beta decay
Authors: Scholer Oliver , de Vries Jordy , Gráf Lukáš
Published: August 2023

Abstract

We present νDoBe, a Python tool for the computation of neutrinoless double beta decay (0νββ) rates in terms of lepton-number-violating operators in the Standard Model Effective Field Theory (SMEFT). The tool can be used for automated calculations of 0νββ rates, electron spectra and angular correlations for all isotopes of experimental interest, for lepton-number-violating operators up to and including dimension 9. The tool takes care of renormalization-group running to lower energies and provides the matching to the low-energy effective field theory and, at lower scales, to a chiral effective field theory description of 0νββ rates. The user can specify different sets of nuclear matrix elements from various many-body methods and hadronic low-energy constants. The tool can be used to quickly generate analytical and numerical expressions for 0νββ rates and to generate a large variety of plots. In this work, we provide examples of possible use along with a detailed code documentation. The code can be accessed through:

GitHub: https://github.com/OScholer/nudobe

Online User-Interface: https://oscholer-nudobe-streamlit-4foz22.streamlit.app/
Weighted energy method for semilinear wave equations with time-dependent damping
Authors: Sobajima Motohiro
Published: August 2023

Of concern is the energy decay property of solutions to wave equations with time-dependent damping. A reasonable class of damping coefficients for the framework of weighted energy methods is proposed, which contains not only the model of “effective” damping$$(1+t)^{-\beta }$$(1+t)-β$$(-1\le \beta <1)$$(-1≤β<1), but also non-differentiable functions with a suitable behavior at$$t\rightarrow \infty $$t→∞. As an application of the weighted energy estimate, global existence for the corresponding semilinear wave equation is discussed.
Einfluss der Quadrizepsmuskulatur auf den patellofemoralen Kontaktmechanismus bei Patienten mit strecknaher patellofemoraler Instabilität nach MPFL-Rekonstruktion
Authors: Siegel Markus , Taghizadeh Elham , Fuchs Andreas , Maier Philipp , Schmal Hagen , Lange Thomas , Yilmaz Tayfun , Meine Hans , Izadpanah Kaywan
Published: August 2023

Einleitung

Die MPFL-Rekonstruktion stellt eine der wichtigsten operativen Therapiemöglichkeiten beim Auftreten rezidivierender Patellaluxationen bei strecknaher patellofemoraler Instabilität dar. Dennoch ist die Rolle der Quadrizepsmuskulatur bei Patienten mit patellofemoraler Instabilität vor und nach einer patellofemoralen Stabilisierung mittels MPFL-Plastik bislang nicht vollständig geklärt. Die vorliegende Studie untersucht den Einfluss der Quadrizepsmuskulatur auf den patellofemoralen Kontaktmechanismus bei Patienten mit strecknaher patellofemoraler Instabilität (PFI) vor und nach einer operativen patellofemoralen Stabilisierung mittels MPFL-Plastik anhand von statisch-dynamischen 3‑Tesla MRT-Datensätzen in frühen Beugegraden (0–30°).

Methoden

In dieser prospektiven Kohortenstudie wurden 15 Patienten mit strecknaher PFI vor und 11 ± 5 Wochen nach einer isolierten MPFL-Rekonstruktion und 15 Probanden mit gesunden Kniegelenken mittels dynamischen MRT-Scans untersucht. Die MRT-Scans wurden in einer individuell angefertigten pneumatischen Kniebelastungsvorrichtung zur Bestimmung der patellofemoralen Knorpelkontaktfläche (CCA) mit und ohne Quadrizepsaktivierung (50 N axiale Last) durchgeführt. Vergleichende Messungen wurden anhand von 3D-Knorpel- und Knochen-Meshes in 0–30° Kniebeugung an den Patienten mit patellofemoraler Instabilität prä- und postoperativ und an den kniegesunden Probanden durchgeführt.

Ergebnisse

Die präoperativ ermittelte patellofemorale CCA von Patienten mit strecknaher PFI betrug 67,3 ± 47,3 mm2 in 0°-Flexion, 118,9 ± 56,6 mm2 in 15°-Flexion und 267,6 ± 96,1 mm2 in 30°-Flexion. Unter aktivierter Quadrizepsmuskulatur (50 N) zeigte sich eine Kontaktfläche von 72,4 ± 45,9 mm2 in Streckung, 112,5 ± 54,9 mm2 in 15° Beugung und 286,1 ± 92,7 mm2 in 30° Beugung ohne statistische Signifikanz im Vergleich. Die postoperativ bestimmte CCA ergab in 0°, 15° und 30°-Flexion 159,3 ± 51,4 mm2, 189,6 ± 62,2 mm2 und 347,3 ± 52,1 mm2. Unter Quadrizepsaktivierung mit 50 N zeigte sich eine CCA in Streckung von 141,0 ± 63,8 mm2, 206,6 ± 67,7 mm2 in 15° und 353,5 ± 64,6 mm2 in 30° Beugung, ebenso ohne statistischen Unterschied im Vergleich zur unbelasteten CCA. Bei Probanden mit gesunden Kniegelenken zeigt sich bei 30° Beugung ein Zuwachs der CCA von 10,3 % (p = 0,003).

Schlussfolgerung

Obwohl sich die patellofemorale CCA nach MPFL-Plastik bei Patienten mit strecknaher patellofemoraler Instabilität signifikant vergrößert, zeigt sich weder prä- noch postoperativ ein signifikanter Einfluss der Quadrizepsmuskulatur.
Unsupervised single-shot depth estimation using perceptual reconstruction
Authors: Angermann Christoph , Schwab Matthias , Haltmeier Markus , Laubichler Christian , Jónsson Steinbjörn
Published: August 2023

Real-time estimation of actual object depth is an essential module for various autonomous system tasks such as 3D reconstruction, scene understanding and condition assessment. During the last decade of machine learning, extensive deployment of deep learning methods to computer vision tasks has yielded approaches that succeed in achieving realistic depth synthesis out of a simple RGB modality. Most of these models are based on paired RGB-depth data and/or the availability of video sequences and stereo images. However, the lack of RGB-depth pairs, video sequences, or stereo images makes depth estimation a challenging task that needs to be explored in more detail. This study builds on recent advances in the field of generative neural networks in order to establish fully unsupervised single-shot depth estimation. Two generators for RGB-to-depth and depth-to-RGB transfer are implemented and simultaneously optimized using the Wasserstein-1 distance, a novel perceptual reconstruction term, and hand-crafted image filters. We comprehensively evaluate the models using a custom-generated industrial surface depth data set as well as the Texas 3D Face Recognition Database, the CelebAMask-HQ database of human portraits and the SURREAL dataset that records body depth. For each evaluation dataset, the proposed method shows a significant increase in depth accuracy compared to state-of-the-art single-image transfer methods.
Fenofibrate suppresses the progression of hepatoma by downregulating osteopontin through inhibiting the PI3K/AKT/Twist pathway
Authors: Chen Weiqing , Chen Feihua , Gong Mouchun , Ye Lijun , Weng Dengcheng , Jin Zhaoqing , Wang Jianjiang
Published: August 2023

Primary hepatic carcinoma (PHC) is a leading threat to cancer patients with few effective treatment strategies. OPN is found to be an oncogene in hepatocellular carcinoma (HCC) with potential as a treating target for PHC. Fenofibrate is a lipid-lowering drug with potential anti-tumor properties, which is claimed with suppressive effects on OPN expression. Our study proposes to explore the molecular mechanism of fenofibrate in inhibiting HCC. OPN was found extremely upregulated in 6 HCC cell lines, especially Hep3B cells. Hep3B and Huh7 cells were treated with 75 and 100 μM fenofibrate, while OPN-overexpressed Hep3B cells were treated with 100 μM fenofibrate. Decreased clone number, elevated apoptotic rate, reduced number of migrated cells, and shortened migration distance were observed in fenofibrate-treated Hep3B and Huh7 cells, which were markedly abolished by the overexpression of OPN. Furthermore, the facilitating effect against apoptosis and the inhibitory effect against migration of fenofibrate in Hep3B cells were abolished by 740 Y-P, an agonist of PI3K. Hep3B xenograft model was established, followed by treated with 100 mg/kg and 200 mg/kg fenofibrate, while OPN-overexpressed Hep3B xenograft was treated with 200 mg/kg fenofibrate. The tumor growth was repressed by fenofibrate, which was notably abolished by OPN overexpression. Furthermore, the inhibitory effect of fenofibrate on the PI3K/AKT/Twist pathway in Hep3B cells and Hep3B xenograft model was abrogated by OPN overexpression. Collectively, fenofibrate suppressed progression of hepatoma downregulating OPN through inhibiting the PI3K/AKT/Twist pathway.
Constraint Qualification with Schauder Basis for Infinite Programming Problems
Authors: Bednarczuk E. M. , Leśniewski K. W. , Rutkowski K. E.
Published: August 2023

We consider infinite programming problems with constraint sets defined by systems of infinite number of inequalities and equations given by continuously differentiable functions defined on Banach spaces. In the approach proposed here we represent these systems with the help of coefficients in a given Schauder basis. We prove Abadie constraint qualification under the new infinite-dimensional Relaxed Constant Rank Constraint Qualification Plus and we discuss the existence of Lagrange multipliers via Hurwicz set. The main tools are: Rank Theorem and Lyusternik–Graves theorem.
Enhanced antibiotic release from bone cement spacers utilizing dual antibiotic loading with elevated vancomycin concentrations in two-stage revision for periprosthetic joint infection
Authors: Lunz Andre , Schonhoff Mareike , Omlor Georg W. , Knappe Kevin , Bangert Yannic , Lehner Burkhard , Renkawitz Tobias , Jaeger Sebastian
Published: August 2023

Purpose

Antibiotic loaded bone cement spacers provide high local antibiotic concentrations, preserve bone stock, and reduce soft tissue contractions. The objective of this in-vitro study was to compare antibiotic release from spacers, aiming to discover the most optimal preparation and identify modifiable factors that can further enhance antibiotic release.

Methods

Six distinct spacer preparation were created using three different bone cements and manual incorporation of antibiotics. During a six-week period, the release of antibiotics from each spacer was measured individually at ten predetermined time points using a chemiluminescent immunoassay.

Results

Manually adding 4 g of vancomycin to every 40 g of “Palacos R + G” yielded the most favorable release profile. Throughout all preparations, antibiotic release consistently and significantly decreased over the six-week period. When incorporating a higher concentration of vancomycin, a significantly higher cumulative release of vancomycin was observed, with varying effects on the release of gentamicin. The choice of bone cement had a significant impact on antibiotic release.

Conclusion

To enhance antibiotic release from spacers, surgeons should manually incorporate high antibiotic concentrations into the most appropriate bone cement and keep the interim period as short as possible. Specifically, we suggest manual incorporation of 4 g of vancomycin to every 40 g of gentamicin premixed "Palacos R + G" to create bone cement spacers.
The radiology job market in the Netherlands: which subspecialties and other skills are in demand?
Authors: Velleman Ton , Noordzij Walter , Dierckx Rudi A.J.O. , Kwee Thomas C.
Published: August 2023

Objectives

To evaluate the current job market for medical specialists in radiology and nuclear medicine (NM) in the Netherlands.

Methods

Vacancies posted for radiologists and nuclear medicine physicians in the Netherlands between December 2020 and February 2022 were collected and analyzed.

Results

A total of 157 vacancies (146 for radiologist and 11 for nuclear medicine physicians) were included. The most sought-after subspecialties were all-round (22%), abdominal (19%), and interventional radiology (14%), and 30% of vacancies preferred applicants with additional non-clinical skills (research, teaching, management, information and communications technology (ICT)/artificial intelligence (AI)). Non-academic hospitals significantly more frequently requested all-round radiologists (n = 31) than academic hospitals (n = 1) (p = 0.001), while the distribution of other requested subspecialties was not significantly different between non-academic and academic vacancies. Non-academic hospitals also significantly more frequently requested additional research tasks in their vacancies (n = 35) compared to academic hospitals (n = 4) (p = 0.011). There were non-significant trends for non-academic hospitals more frequently requesting teaching tasks in their vacancies (n =18) than academic hospitals (n = 1) (p = 0.051), and for non-academic hospitals more frequently asking for management skills (n = 11) than academic hospitals (n = 0) (p = 0.075).

Conclusion

All-round, abdominal, and interventional radiologists are most in demand on the job market in the Netherlands. All-round radiologists are particularly sought after by non-academic hospitals, whereas nuclear radiologists who completed the Dutch integrated NM and radiology residency seem to be welcomed by hospitals searching for a nuclear medicine specialist. Finally, non-clinical skills (research, teaching, management, ICT/AI) are commonly requested. These data can be useful for residents and developers of training curricula.

Clinical relevance statement

An overview of the radiology job market and the requested skills is important for residents, for those who seek work as a radiologist, and for those who are involved in the design and revision of residency programs.

Key Points

Review of job vacancies over an extended period of time provides valuable information to residents and feedback to potentially improve radiology and nuclear medicine (NM) residency programs.

All-round radiologists are wanted in non-academic hospitals and nuclear radiologists (those who have completed an integrated NM-radiology curriculum) are welcomed by hospitals searching for nuclear medicine specialists in the Netherlands.

There is a need to train residents in important non-clinical skills, such as research and teaching, but also management and communications technology/artificial intelligence.
Radiomics in the characterization of lipid-poor adrenal adenomas at unenhanced CT: time to look beyond usual density metrics
Authors: Feliciani Giacomo , Serra Francesco , Menghi Enrico , Ferroni Fabio , Sarnelli Anna , Feo Carlo , Zatelli Maria Chiara , Ambrosio Maria Rosaria , Giganti Melchiore , Carnevale Aldo
Published: August 2023

Objectives

In this study, we developed a radiomic signature for the classification of benign lipid-poor adenomas, which may potentially help clinicians limit the number of unnecessary investigations in clinical practice. Indeterminate adrenal lesions of benign and malignant nature may exhibit different values of key radiomics features.

Methods

Patients who had available histopathology reports and a non-contrast-enhanced CT scan were included in the study. Radiomics feature extraction was done after the adrenal lesions were contoured. The primary feature selection and prediction performance scores were calculated using the least absolute shrinkage and selection operator (LASSO). To eliminate redundancy, the best-performing features were further examined using the Pearson correlation coefficient, and new predictive models were created.

Results

This investigation covered 50 lesions in 48 patients. After LASSO-based radiomics feature selection, the test dataset’s 30 iterations of logistic regression models produced an average performance of 0.72. The model with the best performance, made up of 13 radiomics features, had an AUC of 0.99 in the training phase and 1.00 in the test phase. The number of features was lowered to 5 after performing Pearson’s correlation to prevent overfitting. The final radiomic signature trained a number of machine learning classifiers, with an average AUC of 0.93.

Conclusions

Including more radiomics features in the identification of adenomas may improve the accuracy of NECT and reduce the need for additional imaging procedures and clinical workup, according to this and other recent radiomics studies that have clear points of contact with current clinical practice.

Clinical relevance statement

The study developed a radiomic signature using unenhanced CT scans for classifying lipid-poor adenomas, potentially reducing unnecessary investigations that scored a final accuracy of 93%.

Key Points

• Radiomics has potential for differentiating lipid-poor adenomas and avoiding unnecessary further investigations.

• Quadratic mean, strength, maximum 3D diameter, volume density, and area density are promising predictors for adenomas.

• Radiomics models reach high performance with average AUC of 0.95 in the training phase and 0.72 in the test phase.
Arterial spin labelling MRI for brain tumour surveillance: do we really need cerebral blood flow maps?
Authors: Teunissen Wouter H. T. , Lavrova Anna , van den Bent Martin , van der Hoorn Anouk , Warnert Esther A. H. , Smits Marion
Published: August 2023

Objectives

Arterial spin labelling (ASL) perfusion MRI is one of the available advanced MRI techniques for brain tumour surveillance. The first aim of this study was to investigate the correlation between quantitative cerebral blood flow (CBF) and non-quantitative perfusion weighted imaging (ASL-PWI) measurements. The second aim was to investigate the diagnostic accuracy of ASL-CBF and ASL-PWI measurements as well as visual assessment for identifying tumour progression.

Methods

A consecutive cohort of patients who underwent 3-T MRI surveillance containing ASL for treated brain tumours was used. ROIs were drawn in representative parts of tumours in the ASL-CBF maps and copied to the ASL-PWI. ASL-CBF ratios and ASL-PWI ratios of the tumour ROI versus normal appearing white matter (NAWM) were correlated (Pearson correlation) and AUCs were calculated to assess diagnostic accuracy. Additionally, lesions were visually classified as hypointense, isointense, or hyperintense. We calculated accuracy at two thresholds: low threshold (between hypointense-isointense) and high threshold (between isointense-hyperintense).

Results

A total of 173 lesions, both enhancing and non-enhancing, measured in 115 patients (93 glioma, 16 metastasis, and 6 lymphoma) showed a very high correlation of 0.96 (95% CI: 0.88–0.99) between ASL-CBF ratios and ASL-PWI ratios. AUC was 0.76 (95%CI: 0.65–0.88) for ASL-CBF ratios and 0.72 (95%CI: 0.58–0.85) for ASL-PWI ratios. Diagnostic accuracy of visual assessment for enhancing lesions was 0.72.

Conclusion

ASL-PWI ratios and ASL-CBF ratios showed a high correlation and comparable AUCs; therefore, quantification of ASL-CBF could be omitted in these patients. Visual classification had comparable diagnostic accuracy to the ASL-PWI or ASL-CBF ratios.

Clinical relevance statement

This study shows that CBF quantification of ASL perfusion MRI could be omitted for brain tumour surveillance and that visual assessment provides the same diagnostic accuracy. This greatly reduces the complexity of the use of ASL in routine clinical practice.

Key Points

• Arterial spin labelling MRI for clinical brain tumour surveillance is undervalued and underinvestigated.

• Non-quantitative and quantitative arterial spin labelling assessments show high correlation and comparable diagnostic accuracy.

• Quantification of arterial spin labelling MRI could be omitted to improve daily clinical workflow.
Die Lübecker Skala der Basis-Mobilität
Authors: Krupp Sonja , Wentzel Robert , Balck Friedrich , Willkomm Martin , Kasper Jennifer
Published: August 2023

Hintergrund

Im geriatrischen Assessment der Mobilität wird oft der Timed-up-and-go(TUG)-Test eingesetzt. Viele stationäre Patienten können diesen aber nicht bewältigen. Als Performance-Test für diese Zielgruppe wurde die Lübecker Skala der Basis-Mobilität (LSBM) entwickelt.

Ziel

Die Studie untersuchte Eigenschaften der 7 Aufgaben umfassenden LSBM, die auf Item-Ebene eine an die 5‑stufige Bewertung von Beeinträchtigungen gemäß der ICF angelehnte Skalierung aufweist.

Material und Methoden

Bei 77 Patienten, die bei akutgeriatrischer Klinikaufnahme den TUG-Test nicht bewältigt hatten, wurde im Abstand von 7 bis 18 Tagen (t0, t1) die LSBM absolviert, davon einmal durch 2 Untersucher bewertet. Für die konvergente Validität wurde der De Morton Mobility Index (DEMMI) eingesetzt.

Ergebnisse

Der LSBM-Score und der DEMMI-Score korrelierten hoch (−0,880, p < 0,001). Ein Bodeneffekt trat mit der LSBM nicht auf, mit dem DEMMI bei 5 Patienten (6,5 %). Die prädiktive Validität für die Voraussage der Bewältigung des TUG-Tests bei Entlassung aufgrund des Summenscores zu t0 betrug für die LSBM −0,577, für den DEMMI 0,542 (Korrelation nach Spearman, p = 0,001). Die Interrater-Reliabilität der LSBM lag bei 0,983 (p < 0,001), die Korrelation zwischen Test und Retest bei 0,836 (p < 0,001), die interne Konsistenz über Cronbachs α bei 0,876. Die LSBM korrelierte mit der physiotherapeutischen Verlaufsbeurteilung (0,482, p < 0,001), die Effektstärke als Maß für die Änderungssensitivität lag bei Cohen’s d 0,711.

Diskussion

Die LSBM erleichtert das Setzen von Therapiezielen und ermöglicht die standardisierte Dokumentation bereits kleiner Verbesserungen und Verschlechterungen bei Patienten mit reduzierter Basis-Mobilität.
Endoscopic mucosal resection and endoscopic submucosal dissection with an external additional working channel (EMR+ and ESD+) are equivalent to using a double-channel endoscope: a systematic evaluation in a porcine ex vivo model
Authors: Knoop Richard F. , Amanzada Ahmad , Petzold Golo , Ellenrieder Volker , Engelhardt Michael , Neesse Albrecht , Bremer Sebastian C. B. , Kunsch Steffen
Published: August 2023

Background and aims

With an external additional working channel (AWC) endoscopic mucosal resection (EMR) as well as endoscopic submucosal dissection (ESD) can be extended to techniques termed “EMR+” and “ESD+.” These novel techniques are systematically compared to EMR and ESD under the use of a double-channel endoscope (DC).

Methods

Our trial was conducted prospectively in a pre-clinical porcine animal model (EASIE-R simulator) with standardized gastric lesions measuring 3 or 4 cm.

Results

EMR+ and EMR DC showed both good results for 3 cm lesions with no adverse events and an en bloc resection rate of 73.33% (EMR+) and 60.00% (EMR DC, p = 0.70). They came to their limits in 4 cm lesions with muscularis damages of 20.00% (EMR+), 13.33% (EMR DC, p ≥ 0.99) and decreasing en bloc resection rates of 60.00% (EMR+) and 46.67% (EMR DC, p = 0.72).

ESD+ and ESD DC were both reliable concerning en bloc resection rates (100% in all groups) and adverse events (0.00% in 3 cm lesions, 12.50% muscularis damages in both ESD+ and ESD DC in 4 cm lesions).

Resection time was slightly shorter in all groups with the AWC compared to DC although only reaching significance in 3 cm ESD lesions (p < 0.05*).

Conclusions

With the AWC, a standard endoscope can easily be transformed to double-channel functionality. We could show that EMR+ and ESD+ are non-inferior to EMR and ESD under the use of a double-channel endoscope. Consequently, the AWC presents an affordable alternative to a double-channel endoscope for both EMR and ESD.
Real-world evidence on the dosing and safety of C.E.R.A. in pediatric dialysis patients: findings from the International Pediatric Dialysis Network registries
Authors: Kohlhas Laura , Studer Milena , Rutten-Jacobs Loes , Reigner Sylvie Meyer , Sander Anja , Yap Hui-Kim , Vondrak Karel , Coccia Paula A. , Cano Francisco , Schmitt Claus Peter , Warady Bradley A. , Schaefer Franz ,   IPDN collaborators, Vondrak Karel , Coccia Paula A. , Yap Yok-Chin , Yap Hui-Kim , Cano Francisco , Ha Il Soo , Büscher Rainer , Pape Lars , Samaille Charlotte , Warady Bradley A. , Drozdz Dorota , van Hoeck Koen , Vanegas Juan Jose , Zambrano Pedro , Weitz Marcus , Szczepanska Maria
Published: August 2023

Background

This retrospective real-world study used data from two registries, International Pediatric Peritoneal Dialysis Network (IPPN) and International Pediatric Hemodialysis Network (IPHN), to characterize the efficacy and safety of continuous erythropoietin receptor activator (C.E.R.A.) in pediatric patients with chronic kidney disease (CKD) on peritoneal dialysis (PD) or hemodialysis (HD).

Methods

IPPN and IPHN collect prospective data (baseline and every 6 months) from pediatric PD and HD centers worldwide. Demographics, clinical characteristics, dialysis information, treatment, laboratory parameters, number and causes of hospitalization events, and deaths were extracted for patients on C.E.R.A. treatment (IPPN: 2007–2021; IPHN: 2013–2021).

Results

We analyzed 177 patients on PD (median age 10.6 years) and 52 patients on HD (median age 14.1 years) who had ≥ 1 observation while being treated with C.E.R.A. The median (interquartile range [IQR]) observation time under C.E.R.A. exposure was 6 (0–12.5) and 12 (0–18) months, respectively. Hemoglobin concentrations were stable over time; respective means (standard deviation) at last observation were 10.9 (1.7) g/dL and 10.4 (1.7) g/dL. Respective median (IQR) monthly C.E.R.A. doses at last observation were 3.5 (2.3–5.1) µg/kg, or 95 (62–145) µg/m2 and 2.1 (1.2–3.4) µg/kg, or 63 (40–98) µg/m2. Non-elective hospitalizations occurred in 102 (58%) PD and 32 (62%) HD patients. Seven deaths occurred (19.8 deaths per 1000 observation years).

Conclusions

C.E.R.A. was associated with efficient maintenance of hemoglobin concentrations in pediatric patients with CKD on dialysis, and appeared to have a favorable safety profile. The current analysis revealed no safety signals.

Graphical abstract
Study protocol: value of 7-T MRI with prospective motion correction and postprocessing for patients with nonlesional epilepsy
Authors: Kukhlenko O. , Kukhlenko R. , Tempelmann C. , Speck O. , Hinrichs H. , Heinze H.-J. , Heers M. , House P. M. , Woermann F. G. , Knake S. , Urbach H. , Huppertz H.-J. , Haghikia A. , Schmitt F. C.
Published: August 2023

The diagnostic yield of magnetic resonance imaging (MRI) postprocessing using 7‑T data for patients with nonlesional epilepsy has been rarely evaluated, but has shown acceptable diagnostic outcomes. However, to date there have been no prospective clinical studies comparing MP2RAGE sequences in 3‑T and 7‑T MRI in parallel using the same protocol for morphometric analysis. We present a study protocol developed to address the hypothesis that application of 7‑T structural MRI increases the rate of detection of structural lesions with morphometric analysis when compared with parallel coherent study protocols in 3‑T MRI. The 7‑T MRI study protocol is designed to supply data showing the clinical practicability and proof of principle for increasing the detection rate of subtle epileptogenic lesions.
Impact Assessment of Road Construction on Landslide Susceptibility in Mountainous Region using GIS-Based Statistical Modelling
Authors: Sharma Amol , Prakash Chander
Published: August 2023

Landslide susceptibility is crucial for effective hazard management, planning mitigation, and risk reduction strategies. The present study assessed the impact of road construction on landslide susceptibility for the Mandi district. 1723 landslides data for Mandi district was compiled from the various sources with eleven causative factors. The eleven landslide causative factors were selected from numerous hydrological, geological, and topographical factors. The landslide susceptibility analysis was carried out using three bivariate statistical models, namely, Frequency Ratio (FR), Certainty Factor (CF), and Shannon Entropy (SE). Two sets of Landslide Susceptibility Maps were generated to assess the impact of road construction and divided into five landslide susceptibility classes. The SE model had the highest prediction and validation accuracy of (83-86%). The percentage area in high and very high classes of landslide susceptibility increased by 2.67-4.17% due to road construction activities in the study area.
Approaches for Groundwater Vulnerability Assessment in Relation to Pollution Potential: A Critical Evaluation and Challenges
Authors: Haidery Afreen , Umar Rashid , Saba Naseem us
Published: August 2023

Escalated groundwater contamination around the world developed the idea of aquifer vulnerability, which has widely been employed globally to safeguard groundwater from contamination. Several extensive studies have been done to evaluate the degree of groundwater vulnerability using various techniques. However, a comprehensive assessment of existing literature in order to identify major research gaps associated with aquifer vulnerability is still required. The current study provides a critical overview of several groundwater risk assessment methodologies, including the GIS-based DRASTIC and modified DRASTIC methods, application of Artificial Intelligence (AI) and Machine Learning techniques, and integrated approach for both intrinsic and specific vulnerability assessment. The study discusses validation of DRASTIC model and its comparison with a few other methodologies as well. The paper also highlights the international approach (time dimension in groundwater vulnerability, integrated process based and isotopic studies, etc.) that needs to be practiced rigorously on a larger scale in India. A descriptive summary of the literature indicates that a multidisciplinary and integrated framework such as understanding contaminant type, uncertainties in vadose zone need to be implemented in a much more comprehensive way, especially in India. A conceptual framework that is both reasonably adaptable and scientifically sound must be created for specific vulnerability assessment.