bluuebunny/crossref_metadata_2025 huggingface dataset:
EP547 - Colorectal Surgery journey of a DGH
Authors: Gurung Ganga , Ullah Fahad
Published: September 2024

Colorectal cancer is the fourth most common cancer in the UK, and the management and practice have evolved over the years. A colorectal surgery performance audit was conducted at Pilgrim Hospital. The data collected was analysed and assessed against performance indicator set by NICE. The aim was to track progress and identify areas for improvement. Retrospective data collected from 2011-2020, paper and electronic. Data analysed with SPSS software. Total Anterior Resection. 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Open 18 41 16 12 3 13 10 11 7 13 Laparoscopic 1 4 13 22 26 23 18 27 24 12 Total 18 26 29 35 33 41 31 39 35 25 Length of Stay 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Total 12 12 13 9 9 9 8 8 8 Enhance Recovery Program 9 9 8 7 7 7 7 8 7 Complications 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Return to Theatre 3 5 6 3 2 5 6 3 1 Surgical Site Infection (SSI) 7 7 11 3 6 4 4 4 5 Anastomotic leak 6 2 1 1 3 3 2 3 0 Wound dehiscence 2 3 5 1 4 2 1 3 2 LRTI 1 1 2 1 3 1 2 2 0

The audit showed that, majority of the surgeries performed were open, with the laparoscopies increasing as the years progressed. Length of stay is shorter with ERP. Common complications were surgical site infections, anastomotic leak, return to theatre. Less common complications were lower respiratory tract infections and wound dehiscence.
Neural dynamics of pain modulation by emotional valence
Authors: Zidda Francesca , Lyu Yuanyuan , Nees Frauke , Radev Stefan T , Sitges Carolina , Montoya Pedro , Flor Herta , Andoh Jamila
Published: September 2024

Definitions of human pain acknowledge at least two dimensions of pain, affective and sensory, described as separable and thus potentially differentially modifiable. Using electroencephalography, we investigated perceptual and neural changes of emotional pain modulation in healthy individuals. Painful electrical stimuli were applied after presentation of priming emotional pictures (negative, neutral, positive) and followed by pain intensity and unpleasantness ratings. We found that perceptual and neural event-related potential responses to painful stimulation were significantly modulated by emotional valence. Specifically, pain unpleasantness but not pain intensity ratings were increased when pain was preceded by negative compared to neutral or positive pictures. Amplitudes of N2 were higher when pain was preceded by neutral compared to negative and positive pictures, and P2 amplitudes were higher for negative compared to neutral and positive pictures. In addition, a hierarchical regression analysis revealed that P2 alone and not N2, predicted pain perception. Finally, source analysis showed the anterior cingulate cortex and the thalamus as main spatial clusters accounting for the neural changes in pain processing. These findings provide evidence for a separation of the sensory and affective dimensions of pain and open new perspectives for mechanisms of pain modulation.
High-level Colonization With Antibiotic-Resistant Enterobacterales Among Individuals in a Semi-Urban Setting in South India: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study
Authors: Kumar C P Girish , Bhatnagar Tarun , Sathya Narayanan G , Swathi S S , Sindhuja V , Siromany Valan A , VanderEnde Daniel , Malpiedi Paul , Smith Rachel M , Bollinger Susan , Babiker Ahmed , Styczynski Ashley ,   Antibiotic Resistance in Communities and Hospitals India Team, Arul K , Asish P R , Kumar M Chella , Varghese Elizabeth , Gowtham M M E , Heamchandsaravanan A R , Kalaiyarasi K , Kanagasivam C , Karthick N N , Kavitha M , Grace D Lavanya , Lavanya P , Mercury R , Mohan M Murali , Purushothaman M , Sabarinathan R , Saranya J , Kumar M P Sarath , Shameena N , Sridharan R A , Rao T Subba , Vasanthi K , Veeravel G , Murhekar Manoj , Desai Meghna , Srivatsan Arasi , Kalgudi Rajshekar , Velayudhan Anoop , Surie Diya
Published: September 2024

Background

Antimicrobial resistance poses a significant threat to public health globally. We studied the prevalence of colonization with extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE), carbapenem-resistant Enterobacterales (CRE), and colistin-resistant Enterobacterales (Col-RE) in hospitals and the surrounding community in South India.

Methods

Adults from 2 hospitals and the catchment community who consented to provide stool specimens were enrolled. Stools were plated on CHROMagar selective for ESCrE, CRE, and Col-RE. Bacterial identification and antibiotic susceptibility testing were done using Vitek 2 Compact and disc diffusion testing. Colistin broth microdilution was performed for a subset of isolates. Prevalence estimates were calculated with 95% confidence intervals (CIs), and differences were compared across populations using the Pearson χ  2 or Fisher exact test.

Results

Between November 2020 and March 2022, 757 adults in the community and 556 hospitalized adults were enrolled. ESCrE colonization prevalence was 71.5% (95% CI, 68.1%–74.6%) in the community and 81.8% (95% CI, 78.4%–84.8%) in the hospital, whereas CRE colonization prevalence was 15.1% (95% CI, 12.7%–17.8%) in the community and 22.7% (95% CI, 19.4%–26.3%) in the hospital. Col-RE colonization prevalence was estimated to be 1.1% (95% CI, .5%–2.1%) in the community and 0.5% (95% CI, .2%–1.6%) in the hospital. ESCrE and CRE colonization in hospital participants was significantly higher compared with community participants (P < .001 for both).

Conclusions

High levels of colonization with antibiotic-resistant Enterobacterales were found in both community and hospital settings. This study highlights the importance of surveillance of colonization in these settings for understanding the burden of antimicrobial resistance.
Critical Results in Laboratory Medicine
Authors: Truijens Kobe , Frans Glynis , Vermeersch Pieter
Published: September 2024

Background

Timely and accurate notification of critical results is crucial in laboratory medicine and mandated by accreditation standards like ISO15189. Alert lists do, however, vary widely and clinical laboratories typically rely on a combination of in-house agreed and/or literature-based critical values. Communication by phone is still the preferred method of notification, but digital communication could help improve communication of critical results.

Content

We review the available evidence concerning critical result thresholds and critical result notification practices. The evidence is ranked using an adaptation of the Stockholm Hierarchy. In addition, we propose an evidence-based list of critical result thresholds for hospitalized patients that laboratories can use as a starter list and further customize based on the clinical needs of their patient population.

A clear distinction between critical results and significantly abnormal results is essential for effective and timely healthcare interventions. Implementation of a policy using differentiated thresholds taking into account individual patient characteristics and how fast medical attention is needed, and the use alternative communication methods could enhance communication efficiency and reduce notification fatigue.
Chromosome-level genome assembly of the medicinal insect Blaps rhynchopetera using Nanopore and Hi-C technologies
Authors: Zhang Wei , Li Yue , Wang Qi , Yu Qun , Ma Yuchen , Huang Lei , Zhang Chenggui , Yang Zizhong , Wang Jiapeng , Xiao Huai
Published: September 2024

Blaps rhynchopetera Fairmaire is a significant medicinal resource in southwestern China. We utilized Nanopore and Hi-C technologies in combination to generate a high-quality, chromosome-level assembly of the B. rhynchopetera genome and described its genetic features. Genome surveys revealed that B. rhynchopetera is a highly heterozygous species. The assembled genome was 379.24 Mb in size, of which 96.03% was assigned to 20 pseudochromosomes. A total of 212.93 Mb of repeat sequences were annotated, and 26,824 protein-coding genes and 837 noncoding RNAs were identified. Phylogenetic analysis indicated the divergence of the ancestors of B. rhynchopetera and its closely related species Tenebrio molitor at about 85.6 million years ago. The colinearity analysis showed that some chromosomes of B. rhynchopetera may have had fission events, and it has a good synteny relationship with Tribolium castaneum. Furthermore, in the enrichment analyses, the gene families related to detoxification and immunity of B. rhynchopetera facilitated the understanding of its environmental adaptations, which will serve as a valuable research resource for pest control strategies and conservation efforts of beneficial insects. This high-quality reference genome will also contribute to the conservation of insect species diversity and genetic resources.
Genetic variation in susceptibility of Phytophthora cinnamomi-infected holm oak in the absence or presence of severe drought
Authors: de la Mata Raul , Cuenca Beatriz , Luquero Laura , Moreno Gerardo , Solla Alejandro
Published: September 2024

The evergreen oaks Quercus ilex and Quercus suber are exposed to widespread Phytophthora infestation in natural forests. To restore diseased forests, deploying trees less susceptible to combined stress is the most promising approach. We aimed to determine whether drought affects the susceptibility of Q. ilex and Q. suber seedlings to Phytophthora cinnamomi (Pc) differently. Additionally, to provide scientific support for a genetic improvement program to reduce the susceptibility of holm oak to decline, genetic variation and heritability in susceptibility to Pc in Q. ilex in the absence or presence of drought were estimated. About 7000 seedlings of 66 Q. ilex and 9 Q. suber trees from the Extremadura region (Spain) were inoculated with Pc at age 1. The following year, half the experimental blocks were regularly watered and half were exposed to severe drought, and inoculated again with Pc. In the absence of drought, Q. ilex was more susceptible than Q. suber to Pc (mortality 97% and 59%, respectively), but in the presence of drought after Pc infection the species were equally susceptible (~97% plant mortality). It could therefore be expected that under the climate change scenarios predicted for the south of the Iberian Peninsula, offspring of Q. suber will be as compromised as offspring of Q. ilex to soil infestation by Pc. Significant additive genetic variation and heritability in the susceptibility of Q. ilex to combined Pc infection and drought were observed (hi2 = 0.46 for time to death of plants), indicating that breeding for tolerance to combined stress is possible. Family variance component estimates of time to death in Q. ilex were highest in the presence of drought, and genetic control of susceptibility in Q. ilex decreased over time as plant stress increased. This is the first study to define a production population against combined stress in oak.
The Current Situation of Japanese Copyright Law Regarding Internet Transmission of Library Materials – The Amendment to the Copyright Act in 2021
Authors: Murai Maiko
Published: September 2024

The COVID-19 pandemic prompted Japan to review Art. 31 of the Copyright Act in 2021, which pertains to limitations on copyright for library usage. As a result, access to library materials via the internet became legally permissible within certain limits. Specifically, the amendment allows (1) the National Diet Library to transmit rare or out-of-print materials to individuals on the internet; and (2) libraries and similar facilities to provide users with public transmission services (transmitting portions of copyrighted works to users for research or study purposes). This article introduces the revisions made to Art. 31 in the 2021 amendment, explains the current situation regarding internet transmission of library materials in Japan, and explores future issues.

Transmission via the internet is not subject to physical or locational constraints. The provision of library materials via the internet will thus involve considering how to position and organize the relationship between the individual transmission service for rare or out-of-print library materials by the National Diet Library and public transmission services by individual libraries.
Anti-populism and the Trump trauma in US foreign policy
Authors: Biegon Rubrick , Hamdaoui Soraya
Published: September 2024

In challenging normal patterns of foreign policy legitimation and undermining the internationalist consensus in favour of liberal hegemony, Donald Trump's populism constituted a political trauma for the foreign policy establishment (FPE) of the United States. How did the FPE respond? Based on a discursive approach and using the methodology of qualitative frame analysis, we examine the anti-populist response to the Trump trauma on the part of the FPE. The findings show how the FPE framed Trumpian populism as a political anomaly through interlocking frames of authoritarianism, irresponsibility and immaturity. This could only be rectified through a process of foreign policy normalization, carried through the first two years of the Joe Biden administration, which aimed to stabilize US leadership and restore the consensus that existed prior to the populist disruption. Highlighting the emotional dimensions of anti-populism, the article contends that to fully understand the effects of global populism, we must examine elite responses to populist ‘ruptures’ of the kind Trump represented. By extending the concept of anti-populism to debates on foreign policy, the article addresses existing gaps in the literatures on anti-populism and the effects of populist foreign policy.
Populist hyperpersonalization and politicization of foreign policy institutions
Authors: Özdamar Özgür , Yanik Lerna K
Published: September 2024

This article explains how right-wing populist leaders in Hungary, Poland, Russia and Turkey have transformed their states' foreign policy institutions through personalization and politicization. We examine the transformation of foreign policy institutions in the four cases and make two contributions. First, we differentiate between disparate types of personalization by proposing the term ‘hyperpersonalization’—populist leaders' reliance on security institutions in foreign policy decision-making—which distinguishes the populist transformation of foreign policy institutions in Russia and Turkey. We argue that lower levels and speed of autocratization lead to politicization combined with milder cases of personalization of the foreign policy bureaucracy, while higher levels and speed of autocratization lead to higher levels of personalization in the foreign policy institutions. Second, we lay out the steps and patterns of populist politicization and hyperpersonalization that bring ‘deinstitutionalizing restructuring’ to foreign policy institutions. As we illustrate, this deinstitutionalizing restructuring involves concurrent bureaucratic expansion and bureaucratic retrenchment. The process is accompanied by a populist narrative that this restructuring is done to realize the ‘popular will’ or to regain ‘full sovereignty’. We conclude the article with the policy implications of this populist transformation of foreign policy institutions.
The Trump effect: the perpetuation of populism in US–China trade
Authors: Skonieczny Amy , Sherel Ancita
Published: September 2024

Our article analyses the enduring influence of Donald Trump's populist narrative on United States–China trade policies under Joe Biden's administration. We extend the literature on the effect of populism and populist leaders by examining what happens after a populist leader leaves office, and to what extent an expectation of populism perpetuates a populist narrative despite a change in leadership. In the case of US–China trade, the Biden administration that followed Trump's has carried on with a populist trade narrative and protectionist policies towards China, despite predictions that the US would return to ‘normal’ economic relations after Trump left office. Through textual analysis of speeches by both administrations, we identify a narrative coherence between Trump's nationalist–populist discourse and the trade rhetoric of the Biden administration, revealing a legacy of narrative expectation that constrains policy choices. Our findings demonstrate how Trump's populist framework persists, shaping White House discourse and policy decisions in the economic realm even after he has left office, and we showcase the enduring effect of populist language in political spheres.
IDS-Neo2020+: A Novel Resource for New German Words in Use
Authors: Storjohann Petra
Published: September 2024

Researching and recording new lexical items and senses holds a well-established position within German linguistics. The first corpus-based online dictionary (the Neologism Dictionary 2006ff.) was introduced in 2006 and focused on collecting and describing neologisms which had emerged and become established over the three decades from 1900 to 2020. In 2022, a new concept was developed to elevate lexicographic aspirations by integrating linguistic as well as encyclopaedic knowledge, and by introducing innovative presentational approaches. In this paper, the key changes and concepts of the new resource (published in platform OWID) will be highlighted, in particular its main aim, which is to merge an online dictionary with a dynamic informative dashboard. This combination offers headword-specific details for general reference and comprehensive information related to neologisms that transcends individual units, presented in various formats. Particular emphasis will be placed on the significant connection between neology and (critical) discourse, a facet that has previously played a minor role in lexicographic practices.
A mini immersed finite element method for two-phase Stokes problems on Cartesian meshes
Authors: Ji Haifeng , Liang Dong , Zhang Qian
Published: September 2024

This paper presents a mini immersed finite element (IFE) method for solving two- and three-dimensional two-phase Stokes problems on Cartesian meshes. The IFE space is constructed from the conventional mini element, with shape functions modified on interface elements according to interface jump conditions while keeping the degrees of freedom unchanged. Both discontinuous viscosity coefficients and surface forces are taken into account in the construction. The interface is approximated using discrete level set functions, and explicit formulas for IFE basis functions and correction functions are derived, facilitating ease of implementation.The inf-sup stability and the optimal a priori error estimate of the IFE method, along with the optimal approximation capabilities of the IFE space, are derived rigorously, with constants that are independent of the mesh size and the manner in which the interface intersects the mesh, but may depend on the discontinuous viscosity coefficients. Additionally, it is proved that the condition number has the usual bound independent of the interface. Numerical experiments are provided to confirm the theoretical results.
Vaginal Bacteria and Proinflammatory Host Immune Mediators as Biomarkers of Human Immunodeficiency Virus Acquisition Risk Among African Women
Authors: Srinivasan Sujatha , Richardson Barbra A , Wallis Jacqueline M , Fiedler Tina L , Strenk Susan M , Hoffman Noah G , Proll Sean , Chirenje Z Mike , Livant Edward W , Fredricks David N , Hillier Sharon L , Marrazzo Jeanne M
Published: September 2024

Background

Few investigations have assessed contributions of both vaginal bacteria and proinflammatory immune mediators to human immunodeficiency virus (HIV) acquisition risk in a prospective cohort.

Methods

We conducted a nested case-control study of African women who participated in a randomized placebo-controlled trial of daily oral versus vaginal tenofovir-based preexposure prophylaxis for HIV infection. Vaginal concentrations of 23 bacterial taxa and 16 immune mediators were measured. Relationships between individual bacterial concentrations or immune mediators and HIV risk were analyzed using generalized estimating equations in a multivariable model. Factor analysis assessed relationships between combinations of bacterial taxa, immune mediators, and HIV acquisition risk.

Results

We identified 177 HIV pre-seroconversion visits from 150 women who acquired HIV and 531 visits from 436 women who remained HIV uninfected. Fourteen bacterial taxa and 6 proinflammatory cytokines and chemokines were individually associated with greater HIV risk after adjusting for confounders. Women with all 14 taxa versus <14 taxa (adjusted odds ratio [aOR], 4.45 [95% confidence interval {CI}, 2.20–8.98]; P < .001) or all 6 immune mediators versus <6 mediators (aOR, 1.77 [95% CI, 1.24–2.52]; P < .001) had greater risk for HIV acquisition. Factor analysis demonstrated that a bacterial factor comprised of 14 high-risk bacterial taxa (aOR, 1.57 [95% CI, 1.27–1.93]; P < 0.001) and the interferon gamma–induced protein 10 (highest quartile: aOR, 3.19 [95% CI, 1.32–7.72]; P = 0.002) contributed to the highest HIV risk.

Conclusions

Bacterial and host biomarkers for predicting HIV acquisition risk identify women at greatest risk for HIV infection and can focus prevention efforts.
The utility of appellate review at the WTO and its optimal structure
Authors: Sykes Alan O
Published: September 2024

The impasse over the appointment of judges to the World Trade Organization (WTO) Appellate Body shows no signs of abating, raising considerable doubt about the future of appellate review in WTO disputes. This paper examines the rationale for appellate review in the WTO, drawing on both the history of the General Agreement on Tariffs and Trade and the economic literature assessing the desirability of appellate review in judicial systems. It argues that the WTO does not present a compelling economic case for a two-stage judicial process. It further argues that if some form of appellate review is to be retained in the WTO, a discretionary ‘certiorari-like’ mechanism may be the best option.
Rethinking the ‘Full Reparation’ standard in energy investment arbitration: how to take climate change into account
Authors: Zheng Yawen
Published: September 2024

One crucial measure to curb global warming is the phasing out of fossil fuel production, but doing so can deprive the value of foreign investments in fossil fuels and amount to breaches of investment treaties. Normally, investment treaties are silent about the standards of compensation when treaty violations are established. Tribunals mostly refer to the ‘full reparation’ standard in general international law, potentially resulting in high amounts of compensation that place a significant burden on States implementing climate actions. This paper argues that the amount of compensation under the ‘full reparation’ standard can be reduced on four grounds: (i) depressed energy price in the peak demand era, (ii) unviability of fossil fuel projects, (iii) international environmental obligations, and (iv) international environmental principles. An interpretation document entered into by States can clarify the application of the ‘full reparation’ standard and ensure that these factors are taken into account in quantifying compensation.
Detection of transiting exoplanets and phase-folding their host star’s light curves from K2 data with 1D-CNN
Authors: Álvarez Santiago Iglesias , Alonso Enrique Díez , Rodríguez Javier Rodríguez , Fernández Saúl Pérez , Tutasig Ronny Steveen Anangonó , Gutiérrez Carlos González , Roca Alejandro Buendía , Díaz Julia María Fernández , Rodríguez Maria Luisa Sánchez
Published: September 2024

In this research, we present two 1D Convolutional Neural Network (CNN) models that were trained, validated and tested using simulated light curves designed to mimic those expected from the Kepler Space Telescope during its extended mission (K2). We also tested them on real K2 data. Our light curve simulator considers different stellar variability phenomena, such as rotations, pulsations and flares, which along with the stellar noise expected for K2 data, hinders the transit signal detection, as in real data. The first model effectively identifies transit-like signals in light curves, classifying them based on the presence or absence of such signals. Furthermore, the second model not only phase-folds the light curves but also eliminates stellar noise, a crucial step when fitting transits to the Mandel and Agol theoretical transit shape. The obtained results include an accuracy of $\sim 99\%$ when classifying the light curves based on the presence or absence of transit-like signals, and $MAPE\sim 6\%$ regarding to the transits’ depth and duration when phase folding the light curves, showing the great capabilities of 1D-CNN for automatizing the transit search in light curves, both on simulated and real data.
Influence of genetic similarity and social setting on extra-pair parentage in prairie voles
Authors: Keane Brian , Stevens Martin H H , Solomon Nancy G
Published: September 2024

Social monogamy is rare in mammals, but in those species in which it occurs, individuals frequently engage in extra-pair copulation (EPC). Numerous hypotheses have been proposed to explain EPC, but relatively few field studies have examined factors influencing EPC in socially monogamous mammals. Prairie voles (Microtus ochrogaster) are a socially monogamous rodent in which extra-pair paternity (EPP) is common. Using genetic data from a 3-year study of a natural population of prairie voles, we investigated whether the negative consequences of inbreeding and the structure of social units (male–female pairs vs. groups; adult sex ratio within groups) were factors affecting EPC. We found strong evidence that genetic similarity between males and females that produced offspring via EPC was less than that between social partners, as would be expected if avoiding inbreeding depression influenced the occurrence of EPC. Social unit structure was also a factor involved with extra-pair parentage. Contrary to our expectations, the greater the proportion of females in the group, the lower the chance of EPC resulting in offspring production by females, and, similarly, the chance of EPP by males declined as the proportion of males within the group increased. However, neither males nor females were more likely to produce offspring from EPC when they were living in pairs versus groups. One implication of these results is that EPC may be influenced more by female behaviors, such as mate choice, than male mate guarding. Overall, our results suggest that the proximate factors influencing EPC in prairie voles are complex but include the cost of inbreeding depression and the structure of social units.
Behavioral adaptation to seasonal resource scarcity by Caribou (Rangifer tarandus) and its role in partial migration
Authors: Joly Kyle , Cameron Matthew D , White Robert G
Published: September 2024

Animals living in seasonal environments have adopted a wide array of tactics used to deal with seasonal resource scarcity. Many species migrate between habitats to reach areas where food resources are more plentiful as an attempt to address energetic demands through foraging. We assessed the winter behavioral adaptations of Caribou (Rangifer tarandus), a large ungulate inhabiting Arctic and sub-Arctic regions known for seasonal resource scarcity. Movement rates of Caribou are the lowest of the year during winter, revealing 1 mechanism individuals use to reduce energy expenditures. However, migratory individuals moved nearly twice as much as nonmigratory individuals during winter, suggesting that migratory individuals rely more upon income (forage), whereas nonmigratory individuals rely more upon capital (bodily reserves). Lichens are the primary winter forage for large, migratory herds of Caribou, and migratory individuals experienced more than 2.5 times greater lichen cover than nonmigratory individuals. We documented that both groups slowed their movement in areas of greater lichen cover, suggesting increased foraging time in these areas. Movement rates were greater near villages, which may be suggestive of disturbance, but the effect was weak. Overall energy saved by reduced movement rates was modest. However, energy savings were 11% of daily body energy lost or 47% of the demands of early pregnancy, which potentially could affect individual condition and/or fetal growth if not offset by increases in forage intake.
Long-term survival across Breslow thickness categories: findings from a population-based study of 210 042 Australian melanoma patients
Authors: Lo Serigne N , Williams Gabrielle J , Cust Anne E , Varey Alexander H R , Ch’ng Sydney , Scolyer Richard A , Thompson John F
Published: September 2024

The prognosis of a patient with a primary cutaneous melanoma is known to be related to the Breslow thickness of their tumor. This study sought to determine long-term (30-year) survival rates for the 4 American Joint Committee on Cancer 8th edition T categories by analyzing Australian registry data for 210 042 melanoma patients diagnosed from 1982 to 2014. The 30-year incidence rates of death due to melanoma and nonmelanoma (with 95% confidence intervals [CIs]) were 7.1% (95% CI = 6.9% to 7.3%) and 32.8% (95% CI = 32.3% to 33.3%), respectively. For T2 melanomas, the corresponding rates were 21.6% (95% CI = 21.0% to 22.3%) and 35.6% (95% CI = 34.7% to 36.6%), for T3 melanomas 34.2% (95% CI = 33.4% to 35.1%) and 39.6% (95% CI = 38.5% to 40.8%), and for T4 melanomas 44.3% (95% CI = 43.2% to 45.3%) and 39.6% (95% CI = 38.3% to 41.0%). A plateau in melanoma-related deaths occurred in T4 patients after 20 years, but there were ongoing melanoma-related deaths for the other T categories beyond 30 years. A progressive rise in the risk of death from other causes occurred across all T categories.
Lower survival for surgical treatment of human papillomavirus–related oropharynx cancer at community cancer centers
Authors: Trakimas Danielle R , Mydlarz Wojciech K , Mady Leila J , Gourin Christine G , Koch Wayne , London Nyall R , Quon Harry , Kiess Ana P , Seiwert Tanguy Y , Fakhry Carole
Published: September 2024

Background

The rate of primary surgery for human papillomavirus (HPV)–related oropharynx cancer has recently declined, whereas use of transoral robotic surgery has lagged at community cancer centers. We hypothesize that differences in overall survival exist between patients undergoing surgery for HPV-related oropharynx cancer at community centers and low transoral robotic surgery volume (<15 transoral robotic surgeries per year) academic centers and high transoral robotic surgery volume (≥15 transoral robotic surgeries per year) academic centers.

Methods

Patients from the US National Cancer Database with a diagnosis of HPV-related oropharynx cancer from 2010 to 2019 who underwent primary surgical treatment were included. Trends in transoral robotic surgery use, rates of positive surgical margins, quality of adjuvant treatment, and 5-year overall survival were compared between community centers, low transoral robotic surgery volume academic centers, and high transoral robotic surgery volume academic centers.

Results

A total of 5406 patients met study criteria. A clinically and statistically significantly lower proportion of patients at community centers underwent transoral robotic surgery than at low transoral robotic surgery volume academic centers or high transoral robotic surgery volume academic centers (26.2% vs 44.0% vs 73.9%, respectively; P < .001). The rate of positive surgical margins was clinically and statistically significantly higher at community centers than at low transoral robotic surgery volume academic centers or high transoral robotic surgery volume academic centers (25.7% vs 15.3% vs 9.2%, respectively; P < .001). A greater proportion of patients undergoing adjuvant radiotherapy (RT) received prolonged courses (23.6% vs 13.1% vs 8.8%; P < .001) or excessive doses (16.5% vs 11.5% vs 8.7%; P < .001) of RT at community centers than at low transoral robotic surgery volume academic centers or high transoral robotic surgery volume academic centers, respectively. Five-year overall survival was lowest at community centers (85.2%, 95% confidence interval [CI] = 81.7% to 88.2%), intermediate at low transoral robotic surgery volume academic centers (88.9%, 95% CI = 87.2% to 90.4%), and highest at high transoral robotic surgery volume academic centers (91.4%, 95% CI = 89.5% to 92.9%; Plog-rank < .01).

Conclusions

Clinically and statistically significant differences in the type and quality of surgical and adjuvant treatment for HPV-related oropharynx cancer exist between facility types based on transoral robotic surgery volume. Overall survival was lowest at community centers, intermediate at low transoral robotic surgery volume academic centers, and highest at high transoral robotic surgery volume academic centers.
Long-term behavioral symptom clusters among survivors of early-stage breast cancer: Development and validation of a predictive model
Authors: Pagliuca Martina , Havas Julie , Thomas Emilie , Drouet Youenn , Soldato Davide , Franzoi Maria Alice , Ribeiro Joana , Chiodi Camila K , Gillanders Emma , Pistilli Barbara , Menvielle Gwenn , Joly Florence , Lerebours Florence , Rigal Olivier , Petit Thierry , Giacchetti Sylvie , Dalenc Florence , Wassermann Johanna , Arsene Olivier , Martin Anne Laure , Everhard Sibille , Tredan Olivier , Boyault Sandrine , De Laurentiis Michelino , Viari Alain , Deleuze Jean Francois , Bertaut Aurelie , André Fabrice , Vaz-Luis Ines , Di Meglio Antonio
Published: September 2024

Background

Fatigue, cognitive impairment, anxiety, depression, and sleep disturbance are cancer-related behavioral symptoms that may persist years after early-stage breast cancer, affecting quality of life. We aimed to generate a predictive model of long-term cancer-related behavioral symptoms clusters among breast cancer survivors 4 years after diagnosis.

Methods

Patients with early-stage breast cancer were included from the CANcer TOxicity trial (ClinicalTrials.gov identifier NCT01993498). Our outcome was the proportion of patients reporting cancer-related behavioral symptoms clusters 4 years after diagnosis (≥3 severe symptoms). Predictors, including clinical, behavioral, and treatment-related characteristics; Behavioral Symptoms Score (BSS; 1 point per severe cancer-related behavioral symptom at diagnosis); and a proinflammatory cytokine (interleukin 1b; interleukin 6; tumor necrosis factor α) genetic risk score were tested using multivariable logistic regression, implementing bootstrapped augmented backwards elimination. A 2-sided P less than .05 defined statistical significance.

Results

In the development cohort (n = 3555), 642 patients (19.1%) reported a cluster of cancer-related behavioral symptoms at diagnosis, and 755 (21.2%) did so 4 years after diagnosis. Younger age (adjusted odds ratio for 1-year decrement = 1.012, 95% confidence interval [CI] = 1.003 to 1.020), previous psychiatric disorders (adjusted odds ratio vs no = 1.27, 95% CI = 1.01 to 1.60), and BSS (adjusted odds ratio ranged from 2.17 [95% CI = 1.66 to 2.85] for BSS = 1 vs 0 to 12.3 [95% CI = 7.33 to 20.87] for BSS = 5 vs 0) were predictors of reporting a cluster of cancer-related behavioral symptoms (area under the curve = 0.73, 95% CI = 0.71 to 0.75). Genetic risk score was not predictive of these symptoms. Results were confirmed in the validation cohort (n = 1533).

Conclusion

Younger patients with previous psychiatric disorders and higher baseline symptom burden have greater risk of long-term clusters of cancer-related behavioral symptoms. Our model might be implemented in clinical pathways to improve management and test the effectiveness of risk-mitigation interventions among breast cancer survivors.
Analysis of human errors in the operation of various treatment planning systems over a 10-year period
Authors: Iijima Kotaro , Nakayama Hiroki , Nakamura Satoshi , Chiba Takahito , Shuto Yasunori , Urago Yuka , Nishina Shuka , Kishida Hironori , Kobayashi Yuta , Takatsu Jun , Kuwahara Junichi , Aikawa Ako , Goka Tomonori , Kaneda Tomoya , Murakami Naoya , Igaki Hiroshi , Okamoto Hiroyuki
Published: September 2024

The present study aimed to summarize and report data on errors related to treatment planning, which were collected by medical physicists. The following analyses were performed based on the 10-year error report data: (1) listing of high-risk errors that occurred and (2) the relationship between the number of treatments and error rates, (3) usefulness of the Automated Plan Checking System (APCS) with the Eclipse Scripting Application Programming Interface and (4) the relationship between human factors and error rates. Differences in error rates were observed before and after the use of APCS. APCS reduced the error rate by ~1% for high-risk errors and 3% for low-risk errors. The number of treatments was negatively correlated with error rates. Therefore, we examined the relationship between the workload of medical physicists and error occurrence and revealed that a very large workload may contribute to overlooking errors. Meanwhile, an increase in the number of medical physicists may lead to the detection of more errors. The number of errors was correlated with the number of physicians with less clinical experience; the error rates were higher when there were more physicians with less experience. This is likely due to the lack of training among clinically inexperienced physicians. An environment to provide adequate training is important, as inexperience in clinical practice can easily and directly lead to the occurrence of errors. In any environment, the need for additional plan checkers is an essential factor for eliminating errors.
Through Violence to Eternal Kingdom: Revolutionary Avengers, Suburban Violence, and the Crisis of Imperial Governance in post-1905 Russian Poland
Authors: Porayski-Pomsta Antoni
Published: September 2024

This article studies the case of a notorious criminal group, the Revolutionary Avengers (Rewolucjoniści Mściciele), to explore the “theatre of violence” in fin-de-siècle Russian Poland. First, it considers the reactions to the group’s activities and how they exposed the absence of state monopoly on violence, as well as the imperial bureaucracy’s slipping control over the means of communication following the October Manifesto and the abolition of censorship. Second, the group’s story is analyzed as representative of the post-revolutionary emergence of large numbers of men accustomed to, fluent in, and profoundly changed by violence, yet excluded from party structures. The article argues that the small-scale, anti-elite and anti-governmental violence perpetrated by the Avengers was a form of self-assertion, an attempt to live with dignity after the revolutionary promise had failed. Third, the article spatializes the Avengers’ activities within the industrial suburbs of Russian Poland. Although the urban outskirts were not the only places where the group operated, they were fundamental to their actions: it is where many Avengers came from, where they hid and recruited, as well as where their communities were based. Using Walter Benjamin’s theory of violence, the article suggests that many of the Avengers’ acts were “lawmaking” in nature, effectively delineating suburban “spaces of the poor.”
Impact of extragalactic point sources on the low-frequency sky spectrum and cosmic dawn global 21-cm measurements
Authors: Mittal Shikhar , Kulkarni Girish , Anstey Dominic , de Lera Acedo Eloy
Published: September 2024

The contribution of resolved and unresolved extragalactic point sources to the low-frequency sky spectrum is a potentially non-negligible part of the astrophysical foregrounds for cosmic dawn 21-cm experiments. The clustering of such point sources on the sky, combined with the frequency dependence of the antenna beam, can also make this contribution chromatic. By combining low-frequency measurements of the luminosity function and the angular correlation function of extragalactic point sources, we develop a model for the contribution of these sources to the low-frequency sky spectrum. Using this model, we find that the contribution of sources with flux density ${\gt} 10^{-6}$ Jy to the sky-averaged spectrum is smooth and of the order of a few kelvins at 50–200 MHz. We combine this model with measurements of the galactic foreground spectrum and weigh the resultant sky by the beam directivity of the conical log-spiral antenna planned as part of the Radio Experiment for the Analysis of Cosmic Hydrogen (REACH) project. We find that the contribution of point sources to the resultant spectrum is ${\sim}\, 0.4 {{\, \rm per\, cent}}$ of the total foregrounds, but still larger by at least an order of magnitude than the standard predictions for the cosmological 21-cm signal. As a result, not accounting for the point-source contribution leads to a systematic bias in 21-cm signal recovery. We show, however, that in the REACH case, this reconstruction bias can be removed by modelling the point-source contribution as a power law with a running spectral index. We make our code publicly available as a python package labelled epspy.
Probing general relativistic spin–orbit coupling with gravitational waves from hierarchical triple systems
Authors: Oancea Marius A , Stiskalek Richard , Zumalacárregui Miguel
Published: September 2024

Wave packets propagating in inhomogeneous media experience a coupling between internal and external degrees of freedom and, as a consequence, follow spin-dependent trajectories. These phenomena, well known in optics and condensed matter physics, are referred to as spin Hall effects. Similarly, the gravitational spin Hall effect is expected to affect the propagation of gravitational waves on curved spacetimes. In this general-relativistic setup, the curvature of spacetime acts as impurities in a semiconductor or inhomogeneities in an optical medium, leading to a frequency- and polarization-dependent propagation of wave packets. In this letter, we study this effect for strong-field lensed gravitational waves generated in hierarchical triple black hole systems in which a stellar-mass binary merges near a more massive black hole. We calculate how the gravitational spin Hall effect modifies the gravitational waveforms and show its potential for experimental observation. If detected, these effects will have profound implications for astrophysics and tests of general relativity.
Evolution of the Correlated Genomic Variation Landscape Across a Divergence Continuum in the Genus Castanopsis
Authors: Chen Xue-Yan , Zhou Biao-Feng , Shi Yong , Liu Hui , Liang Yi-Ye , Ingvarsson Pär K , Wang Baosheng
Published: September 2024

The heterogeneous landscape of genomic variation has been well documented in population genomic studies. However, disentangling the intricate interplay of evolutionary forces influencing the genetic variation landscape over time remains challenging. In this study, we assembled a chromosome-level genome for Castanopsis eyrei and sequenced the whole genomes of 276 individuals from 12 Castanopsis species, spanning a broad divergence continuum. We found highly correlated genomic variation landscapes across these species. Furthermore, variations in genetic diversity and differentiation along the genome were strongly associated with recombination rates and gene density. These results suggest that long-term linked selection and conserved genomic features have contributed to the formation of a common genomic variation landscape. By examining how correlations between population summary statistics change throughout the species divergence continuum, we determined that background selection alone does not fully explain the observed patterns of genomic variation; the effects of recurrent selective sweeps must be considered. We further revealed that extensive gene flow has significantly influenced patterns of genomic variation in Castanopsis species. The estimated admixture proportion correlated positively with recombination rate and negatively with gene density, supporting a scenario of selection against gene flow. Additionally, putative introgression regions exhibited strong signals of positive selection, an enrichment of functional genes, and reduced genetic burdens, indicating that adaptive introgression has played a role in shaping the genomes of hybridizing species. This study provides insights into how different evolutionary forces have interacted in driving the evolution of the genomic variation landscape.
Cognitive phenotypes: Unraveling the heterogeneity in cognitive dysfunction among patients with primary brain tumors receiving radiotherapy
Authors: Reyes Anny , Stasenko Alena , Hopper Austin , Kohli Jiwandeep S , Helm Jonathan L , Salans Mia , Prabhakaran Divya , Kamalyan Lily , Wilkinson Molly , Unnikrishnan Soumya , Karunamuni Roshan , Hattangadi-Gluth Jona , McDonald Carrie R
Published: September 2024

Background

Patients with primary brain tumors demonstrate heterogeneous patterns of cognitive dysfunction, which we explore using latent profile analysis to identify cognitive phenotypes and their trajectories in patients receiving radiotherapy (RT).

Methods

Ninety-six patients completed neuropsychological testing before and post-RT (3, 6, and 12 months) on a prospective longitudinal trial, including measures of processing speed, executive function, language, and verbal and visual memory. Models with 2–4 classes were examined. Demographic and clinical data were examined across phenotypes and post-RT cognitive change was evaluated.

Results

The optimal model identified 3 unique cognitive phenotypes including a group of patients with generalized impairments (11.5%), a group with isolated verbal memory impairments (21.9%), and a group with minimal impairments (66.7%). The Verbal Memory phenotype had fewer years of education (P = .007) and a greater proportion of males (P < .001); the Generalized group had a greater proportion of patients with IDH-wild type gliomas and showed greater symptoms of anxiety and poorer quality of life (P-values < .05); and the Minimal Impairment phenotype had higher rates of IDH-Mutant gliomas. Approximately 50% of patients declined on at least one cognitive domain with memory being the most vulnerable. Patients who declined reported greater symptoms of depression (P = .007) and poorer quality of life (P = .025).

Conclusions

We identified 3 distinct cognitive phenotypes in patients with primary brain tumors receiving RT, each associated with unique demographic and clinical (eg, IDH mutational status) profiles, with mood symptoms associated with late cognitive decline. This patient-centered approach enhances our understanding of clinical profiles associated with cognitive dysfunction and treatment-related neurotoxicity.