bluuebunny/crossref_metadata_2025 huggingface dataset:
Solubility of Tar Model Compounds in Various Solvents for Tar Removal in a Dual Fluidized Bed Biomass Gasification Process
Authors: Tonpakdee Pimnara , Hongrapipat Janjira , Siriwongrungson Vilailuck , Pang Shusheng , Rauch Reinhard , Messner Michael
Published: August 2021

Production of high quality product gas via biomass steam gasification is a promising technology. However, impurities in the product gas, namely tars, cause problems in the downstream gas processing operations and thus they need to be removed efficiently. Oil scrubbing is an effective solution for tar removal due to its non-polar characteristic which is similar to tar nature. In this research, solubility values of five simulated tar compounds were experimentally investigated for selecting the new scrubbing solvent. The simulated tar compounds investigated represent those found in the dual fluidized bed steam gasification of wood biomass, which are: naphthalene, biphenyl, anthracene, fluoranthene, and pyrene. The scrubbing solvents tested in this research are classified into biodiesels, vegetable oils, and diesel. Biodiesel used are rapeseed methyl ester (RME) and 2 different palm methyl esters (denoted as PME1 and PME2). Vegetable oils are sunflower oil, refined palm oil, Thai rice bran oil, and crude palm oil. All of the solubility tests were performed in the laboratory-scale test-rig at 30, 50, 70, and 80°C. Biodiesels are found to be the effective solvent in dissolving the tar compounds. PME1 shows the similar tar removal performance to RME but is more readily available; therefore, PME1 is chosen to be used as a scrubbing solvent at the Thailand 1 MWel prototype DFB gasifier at Nong Bua district in Nakhon Sawan province, Thailand.
Application of BIM Technology in Bridge Engineering and Obstacle Research
Authors: Huang Zixing , Tu Chao , Li Gen
Published: August 2021

with the development of economy and the reform of cities, the bridge engineering in China has entered a period of rapid development. By 2009, the number of highway bridges in China has exceeded that of the rest of the world. According to the statistics of 2014, the number of roads and bridges in China is 757100, and its extension meters reach 42.5789 million. The emergence of BIM technology has brought a new experience to China’s construction industry. Compared with the traditional CAD, the most significant change in BIM technology is to change building information from two-dimensional to three-dimensional. At the same time, BIM visualization, synergy and automation help building participants to do a lot of work better and more conveniently. Because of the continuous expansion of bridge engineering in China, bridge engineering has gradually become more complex and diverse, which has also brought problems to many industries. The research on BIM in our country is still in some surface stages. There are deeper things worth digging into.
Development of New Materials for Prefabricated Concrete Elements for Building Construction in Tropical Climatic Conditions
Authors: Vasovic D , Lelovic S , Okrajnov-Bajic R
Published: August 2021

This paper presents the development of new concrete mixtures, which constitutes prefabricated elements for building constructions in tropical conditions in Gabon (Africa). The Client from Gabon required prefabricated buildings fabricated overseas (in Serbia) and assembled at the site (Okolassi, Gabon). The main problem was to achieve sufficient strength and resistance of finishing material, with small weight. New material was developed in order to satisfy the following conditions: low unit weight, high compressive/tensile strength, low shrinkage, reduced spalling, resistance to high temperatures and moisture. The main need for development of these new concrete mixtures lies in characteristics of designed prefabricated concrete elements, with the following main properties: a) concrete panels, with dimensions 240-360 cm (length), 110 cm (height), and 20 cm (width); b) panels should weigh up to 100 kg/pc, but sound and robust, so surface must be casted of ultra-high-performance concrete, while the inner part of the element should have smaller unit weight. New concrete mixtures with the required properties were designed on the basis of the extensive laboratory analysis. Concrete specimens were prepared using the materials available at the market and tested. Testing results were further analysed in order to derive convenient mathematical models for the target concrete properties. The results of this analysis were new concrete mixtures, prepared according to the derived models, to be used for construction of prefabricated concrete panels.
Application of BIM + VR Technology in Immersed Tunnel Construction
Authors: Wang Fang-Zheng , Sui Hai-Chen , Kong Wei-Da , Zhong Hanbin
Published: August 2021

As an important way to relieve the traffic pressure across rivers, immersed tunnel engineering has been gradually promoted. This paper introduces building information modeling and virtual reality technology into immersed tunnel engineering, analyzes its technical characteristics and advantages, expounds the application of BIM + VR technology in immersed tunnel engineering, and carries out practice in immersed tunnel engineering of Shenzhen-Zhongshan Bridge, which verifies the superiority and efficiency of the method.
Sustainability and Existential Risks with Special Reference to Climate Change - An Overview
Authors: Awang M B
Published: August 2021

The initial part of this paper provides an overview on conceptual framework of sustainability and sustainable development in balancing the needs for development and environmental conservation. The concept is based on structural and functional diversity relationship of natural ecosystem functioning and environmental filters that determine its services sustainably. Subsequently, the paper deals with a brief historical perspective of eco-development initiated by the United Nations and other relevant agencies that lead to the promulgation of the “17-Sustainable Development Goals (SDGs)” in 2016. On the existential risks and potential future risks of humanity with special reference to the current and future potential impact of global climate change as consequence of energy transition from fossil fuel to renewable are also discussed. The paper ends with the way forward with an enlightenment optimism rather than romantic declinism in achieving the goal of Paris climate agreement.
The Portrait of Women’s Participation on Inland Fishery Activities in Lao PDR
Authors: Muthmainnah D , Rais A H
Published: August 2021

Lao PDR faces the challenges of raising the standard of living because of a rapidly expanding population, and one way is to increase the fishery sector roles. Women also involved in fishery activities, however, information on the roles and functions of women of capture fishery and aquaculture activities, fish processing, and marketing is still completely limited. The field survey was conducted in 2016-2019 in Lao PDR (Nam Xouang Reservoir, Nam Ngum Reservoir, and Nam Houm Reservoir). The study was carried out by collecting the primary data and secondary data. The primary data was obtained by interviewing the women who practiced fishery activities, while the secondary data was from the statistical data. The data was arranged in tabulation and descriptive, as well as analyzed qualitatively. The results showed that the participation status of the women who live surrounding the reservoir is satisfactory. Nevertheless, it needs to improve the women’s consciousness of modern techniques for capturing, culturing, processing the fish, and marketing. It is expected that the finding of this research will help policymakers to take a useful initiative to improve the women’s roles in participating in increase their family welfare and as the actor in the fishery community.
The Shape of Forest, Social and Economic Conditions of Community Living Around Production Forest with Industrial Plantation Forest Permit (Case Study: Forest Management Unit of KPH Meranti)
Authors: Hidayat Y , Alfitri  , Purnama D H , Riswani
Published: August 2021

The industrial plantation forest (HTI) has changed the structure of forest management from natural forest to constructed forest. The changes occured on the biophysical, ecology, area management, and social aspects. The development of HTI has caused not only positive impacts, but also land-based conflicts and issues related to access to forest resource. This research aims to analyze the existing condition of the forest and the social and economic problems faced by the local community living around the concession area. The research was conducted in the vicinity of PT Sentosa Bahagia Bersama’s using qualitative approach and data extracting through in-depth interviews with predetermined key informants. This study finds that the shape of forests in the HTI concession area could be defined based on its cultivation patterns, age and growth of plants, land clearing and area accessibility, forest management organization, ecology and productivity of the area.
The Implementation of Character Building to Improve Resident Participation in Waste Management
Authors: Zebua R S Y , Sunarti
Published: August 2021

Household waste commonly dominates the municipal waste composition, indicating a vital role of residents’ participation in solving waste problems. Various efforts have been made to encourage resident’s participation. However, many approaches implemented cannot keep participation sustainable. Previous studies showed that educating residents through nurturing moral values is influential in improving waste management behaviour. Meanwhile, the moral value becomes the core of character building, implying that character building could have a role in resident-based education to enhance waste management behaviour. In fact, character building can change individual behaviour sustainably. Thus, this study aimed to figure out the possibility of implementing character building to nurture sustainable waste management behaviour and investigate how character-building was implemented. Using a case study approach, we explored a resident-based education in Neglasari, Bandung, Indonesia, that implemented moral value as the educational strategy. This study found that some primary activities were conducted to transfer moral value. The learning activities were focused on nurturing moral knowing, moral feeling, and moral action as central components of character building. However, implementing character building seemed to take time and required iteration to get a sustainable change in the behaviour. Nevertheless, it is worth to continue to gain significant benefits.
Science of Climate Change in Agricultural Courses
Authors: Handayani I P
Published: August 2021

Climate change adaptation is required knowledge for students and graduates from colleges of agriculture since recent crop production and food security are influenced by climate change. Thus, understanding the dynamics of climate change is important to support farmers to adapt to future conditions. However, not all students and graduates understand the concept and application of climate change with regard to the dynamics of food production and future food security. While agriculture faces the challenge of climate change adaptation, agricultural courses have not kept pace by incorporating climate change science into the curricula. To address this issue, eleven syllabi in selected agricultural courses from 100 to 700 levels were reviewed in the year of 2018 and 2019 to observe the integration of climate change science into the syllabi. The results suggest that educators, instructors or course designers should consider the following before creating the courses: (1) the specific interests and needs of students; (2) linking global climate change to local problem in agriculture, (3) applying lessons across disciplines, and (4) encouraging active student participation. In addition, the syllabi should meet the needs of a specific course level, such as the topical interests and learning needs with lesson updates on a regular basis. By applying these components to future syllabi, the integration of climate change science into agricultural courses will better facilitate climate change adaptation concepts, curricula and applications for all students, graduates and crop producers.
Temulawak (Curcuma xanthorrhiza) Extract as a Cancer Chemopreventive Agent Via Up-Regulation p53 and Caspase-3 Gene
Authors: Indrayanti I , Kamila K A , Hernowo B A , Haq F A , Akrom A
Published: August 2021

The development of biomaterials from herbs needs to be done as a chemopreventive compound to inhibit cervical cancer. Curcuma xanthorrhiza (CX) contains curcumin and xanthorrhizol, which are the main active substances for inhibiting carcinogenesis. Experimental research was carried out on cervical cancer cells from ethanol extracts of CX/EECX. Testing for proapoptosis potential by observing p53 gene expression in the HeLa cell was conducted by the flow cytometry method. Cytotoxic tests were carried out to obtained IC50, the results of 36.12 ± 6.66μg ml-1. The IC50 value is then made into three concentrations, namely, ½ IC50, IC50, 2xIC50. The ICC test results showed an increase in the p53 gene expression index in the 1/2IC50 and IC50 concentration groups. The expression of p53 in the IC50 concentration group was higher than that in the 1/2IC50 group. There were no living cells in the 2xIC50 concentration group, so p53 expression could not be seen. EECX has potential as a chemopreventive biomaterial to prevent cervical cancer because it increases apoptotic activity in HeLa cells. The possibility of cell apoptosis, which is influenced by EECX with the optimal concentration that can be used, is IC50, which is 36.12 ± 6.66 μg ml-1.
The Effect of the Composition of Alginate Flour on the Making of Batik Simbut
Authors: Sholikhah Roudlotus , Nurrohmah Siti , Atika
Published: August 2021

Batik simbut is batik made using cold wax. A breakthrough in the batik making process, now batik can be done using cold wax. If in general, many batik craftsmen use wax heated by the stove, then this cold wax does not need to be heated by the stove. The batik wax is a material that is used to cover the surface of the cloth according to the batik motif so that the covered surface has a resist or rejects the color applied to the cloth. In making batik simbut as a barrier used cold wax, including from alginate flour. The objectives of this study were: to determine the composition of Alginate Flourneeded to make cold wax batik wax and to determine the effect of the composition of Alginate Flouron on the quality of cold wax batik results. The research method used includes the test of composition and test results of manufacture. The procedure for implementing the research stages is as follows: 1). Determination of the wax composition; 2). Making cold batik wax with Alginate Flouraccording to the composition; 3). Batik process and coloring trials; 4). Wax release / pelorodan process; 4). Test the results of the manufacture. The results of sample trials with the composition of 2 ounces of alginate flour, 1 g of palm sugar, 1 tablespoon of coconut oil, ½ spoon of salt, and 30 ml of water have the best quality level of batik smoothness compared to other samples. This sample also has the best quality of the sharpness of the motif compared to other samples.
Hydrothermal synthesis of WO3 film on rough surface to analyze methanol gas at room temperature
Authors: Hajirnis Sarthak , Chavan Prachi , Manapure Vaibhav , Patil Akshay , Khan Ayesha , Nadekar B , More P S , Kadam A V
Published: August 2021

In this paper, we synthesized WO3 thick films on a rough and smooth glass substrate by hydrothermal method and then heated to a temperature of 400-degree Celcius. Characteristic techniques such as XRD and SEM analysis were sequenced to determine the crystallite size and grain composition of the finished samples, respectively. We have discussed the results of the Rietveld refinement made using MAUD to determine useful information regarding the atomic sites, mesh parameters, and micro-stresses in the sample. Subsequently, FTIR analysis has been performed to note the critical bond vibrations associated with the material. AFM studies have also been included to determine the pore sizes and understand the surface-level differences between WO3 films on rough and smooth substrates. The room temperature gas sensing mechanism was then discussed in the presence of humidity with methanol, ethanol, and benzene along with most of the targeted gases with different selective parameters at atmospheric pressure. We have tried to develop a theory incorporating the anomalous observation for the methanol gas sensing experiment and explained the future scope of this work.
Effects of Cu doping on the phase transition and photocatalytic activity of anatase/rutile mixed crystal TiO2 nanocomposites
Authors: Tang Mao , Yang Daixiong , Wang Juan , Zhou Qin , Zhu Xiaodong , Jiao Yu
Published: August 2021

Pure and Cu doped anatase/rutile mixed TiO2 nanomaterials were fabricated through sol-gel method. The obtained photocatalysts were characterized by XRD, SEM, TEM, XPS, PL and DRS, and the influences of Cu doping on the structure and photocatalytic property were studied. The results show that when the molar ratios of Cu/Ti are 1% and 2%, Cu doping promotes anatase → rutile phase transformation. When the molar ratio of Cu/Ti is 4%, the phase transformation is inhibited. Cu element coexists in the form of Cu+ and Cu2+, and Cu doping facilitates the separation of photogenerated electrons and holes. TEM image shows that copper oxides are dispersed on TiO2 particles surface, which significantly reduces the optical absorption of ultraviolet region. The photocatalytic experiment results show that the photocatalytic activity of Cu–TiO2 is lower than pure TiO2, and the higher doping concentration, the lower photocatalytic activity.
Anatomy of a Cyberattack: Part 1: Managing an Anatomic Pathology Laboratory During 25 Days of Downtime
Authors: Stowman Anne M , Frisch Nora , Gibson Pamela C , John Timothy St , Cacciatore Lori S , Cortright Valerie , Schwartz Michelle , Anderson Scott R , Kalof Alexandra N
Published: August 2021

Objectives

Our institution was affected by a multi-institution, systemwide cyberattack that led to a complete shutdown of major patient care, operational, and communication systems. The attack affected our electronic health record (EHR) system, including all department-specific modules, the laboratory information system (LIS), pharmacy, scheduling, billing and coding, imaging software, internet access, and payroll. Downtime for the EHR lasted 25 days, while other systems were nonfunctional for more than 40 days, causing disruptions to patient care and significantly affecting our laboratories. As more institutions transition to network EHR systems, laboratories are increasingly vulnerable to cyberattack. This article focuses on the approaches we developed in the anatomic pathology (AP) laboratory to continue operations, consequences of the prolonged downtime, and strategies for the future.

Methods

Our AP laboratory developed manual processes for surgical and cytopathology processing, redeployed staff, and used resources within the department and of nearby facilities to regain and maintain operations.

Results

During the downtime, our AP laboratory processed 1,362 surgical pathology and consult cases as well as 299 cytology specimens and outsourced 1,308 surgical pathology and 1,250 cytology cases.

Conclusions

Our laboratory successfully transitioned to downtime processes during a 25-day complete network outage. The crisis allowed for innovative approaches in managing resources.
Serverless computing in omics data analysis and integration
Authors: Grzesik Piotr , Augustyn Dariusz R , Wyciślik Łukasz , Mrozek Dariusz
Published: August 2021

A comprehensive analysis of omics data can require vast computational resources and access to varied data sources that must be integrated into complex, multi-step analysis pipelines. Execution of many such analyses can be accelerated by applying the cloud computing paradigm, which provides scalable resources for storing data of different types and parallelizing data analysis computations. Moreover, these resources can be reused for different multi-omics analysis scenarios. Traditionally, developers are required to manage a cloud platform’s underlying infrastructure, configuration, maintenance and capacity planning. The serverless computing paradigm simplifies these operations by automatically allocating and maintaining both servers and virtual machines, as required for analysis tasks. This paradigm offers highly parallel execution and high scalability without manual management of the underlying infrastructure, freeing developers to focus on operational logic. This paper reviews serverless solutions in bioinformatics and evaluates their usage in omics data analysis and integration. We start by reviewing the application of the cloud computing model to a multi-omics data analysis and exposing some shortcomings of the early approaches. We then introduce the serverless computing paradigm and show its applicability for performing an integrative analysis of multiple omics data sources in the context of the COVID-19 pandemic.
Comparison of left atrial strain measured by feature tracking computed tomography and speckle tracking echocardiography in patients with aortic stenosis
Authors: Hirasawa Kensuke , Kuneman Jurrien H , Singh Gurpreet K , Gegenava Tea , Hautemann David , Reiber Johan H C , Ajmone Marsan Nina , Bax Jeroen J , Delgado Victoria
Published: August 2021

Aims

Peak left atrial longitudinal strain (PALS) is a marker of the left atrial (LA) reservoir function. Novel feature tracking (FT) software allows assessment of LA strain from multidetector computed tomography (MDCT) data. This study aimed at evaluating the agreement between speckle tracking echocardiography (STE) and FT MDCT for the measurement of PALS in patients with sinus rhythm (SR) and with atrial fibrillation (AF).

Methods and results

The current study included 318 patients (80 ± 7 years, 54% male) with dynamic MDCT data acquired prior to transcatheter aortic valve implantation. PALS was measured by transthoracic echocardiography using STE (PALSecho) and MDCT using dedicated FT software (PALSCT). In the overall population, the median values of PALSecho and PALSCT were 19.0 [interquartile range (IQR) 12.0–25.0] % and 15.3 (IQR 9.2–19.7) %, respectively. High correlation between PALSecho and PALSCT was observed (r = 0.789, P < 0.001) with a mean bias of −3.7%. The correlation between PALSecho and PALSCT was better among patients with SR (N = 258; r = 0.704, P < 0.001) as compared to patients with AF (N = 60; r = 0.622, P < 0.001).

Conclusion

PALSecho and PALSCT showed a good agreement in patients with severe aortic stenosis (AS) regardless of the cardiac rhythm. FT MDCT may be an important adjuvant modality for assessing LA reservoir function in patients with severe AS.
Prosthetic valve endocarditis presenting as meningoencephalitis complicated by pseudo-aneurysms in a remote Aboriginal healthcare setting in Australia: a case report
Authors: Watson Anna Louise , Rice Gregory , Hieu Vo Tony , Kangaharan Nadarajah
Published: August 2021

Background

The Australian Aboriginal population has a high burden of cardiac conditions predisposing patients to infective endocarditis. Pseudo-aneurysms are a rare and potentially fatal complication of both prior valvular surgery and endocarditis.

Case summary

A 31-year-old female with a history of bicuspid aortic valve requiring valve replacement presented with meningoencephalitis. Transoesophageal echo and positive blood cultures for Staphylococcus aureus confirmed prosthetic valve endocarditis (PVE). Aortic root mycotic pseudo-aneurysms developed during antimicrobial therapy and two large pseudo-aneurysms remain post-redo valve, root and arch replacement.

Discussion

Complications associated with PVE are common, especially due to S. aureus. Redo cardiac surgery is high risk, percutaneous treatments may be technically difficult due to altered post-operative anatomy, and medication adherence issues and lack of healthcare engagement further compromise optimal care in this patient population.
Does face mask use elicit risk-compensation? Quasi-experimental evidence from Denmark during the SARS-CoV-2 pandemic
Authors: Jørgensen Frederik , Lindholt Marie Fly , Bor , Alexander , Petersen Michael Bang
Published: August 2021

Background

Public use of face masks has been widely adopted to halter the SARS-CoV-2 pandemic, but a key concern has been whether the effectiveness of face mask use is limited due to the elicitation of false feelings of security that decrease the observance of other protective behaviors, the so-called risk-compensation.

Methods

We exploit quasi-experimental variation, prompted by three major changes in policy, to assess whether public use of face masks elicit risk-compensation by increasing the number of close contacts or decreasing attention to distancing and hygiene measured in daily nationally representative surveys (N = 106 880).

Results

Number of close contacts: face mask use prompted by the policy changes decrease the number of contacts in two of the three interventions. In the remaining intervention, it has no effect. Attention to hygiene: across the changes, face masks use does not affect people’s attention to hygiene. Attention to distancing: in two of three interventions, face mask use increase attention to distancing. In the remaining intervention, we see a decrease in attention.

Conclusions

Overall, public use of face masks may occasionally elicit a narrow form of risk-compensation; specifically, reducing engagement in physical distancing. However, such narrow forms of risk-compensation are limited: the results do not reveal any effects on the actual number of physical contacts, only on the psychological attention to distancing advice. Moreover, the negative effect only appears for one of three interventions. The other two interventions suggest that face mask use increases attention to physical distancing.
Six Decades of Growth and Yield and Financial Return in a Silviculture Experiment in Northern Hardwoods
Authors: Draper Maeve C , Froese Robert E
Published: August 2021

The Cutting Methods Study at the Ford Forest in the Upper Peninsula of Michigan, USA, was established in 1956 and has been maintained continuously on a 10-year cycle. Methods consist of three diameter limits (DL; 13, 30, and 41 cm), single-tree selection to three residual basal area limits (STS; 11, 16, and 21 m2ha−1), and light improvement (LI) focused on improving tree grade. Long-term results show that the 41 cm DL produced the greatest managed forest value and cumulative sawlog production, followed by the STS to 11 m2ha−1 residual basal area. STS treatments and LI were uniformly superior at improving standing tree grade. In contrast, treatments that emphasize removal of large diameter trees while retaining moderate residual basal area (the 41 cm DL and 11 m2ha−1 STS) produced the largest harvest volumes of high-grade sawlogs, driving financial performance. Stand density has declined in all treatments except the 30 and 41 cm DL, where it has increased, and these two treatments have larger abundance of saplings and poles. Alternative partial cutting methods such as selection to lower residual basal areas and medium-intensity diameter-limit cuts thus may provide greater financial returns and higher average quality, and could have implications on regeneration and long-term sustainability.
Effective moduli of rocks predicted by the Kuster–Toksöz and Mori–Tanaka models
Authors: Wang Zidong , Zhang Qian , Liu Jianlin , Fu Li-Yun
Published: August 2021

Natural rocks are polymineral composites with complex microstructures. Such strong heterogeneities significantly affect the estimation of effective moduli by some theoretical models. First, we have compared the effective moduli of isotropic rocks predicted by the Kuster–Toksöz (KT) model and the Mori–Tanaka (MT) model. The widely used KT model only has finite precision in many cases because of its assumption that is restricted to the first-order scattering approximation. However, the MT model based on the Eshelby tensor in mesomechanics has the advantage of predicting effective moduli of rocks, especially when the volume fraction of embedded inclusions is sufficiently large. In addition, the MT model can be used to predict the effective modulus of anisotropic rocks, but the KT model cannot. For a certain kind of shale or tight sandstones, which are viewed as isotropic composites, both the models work well. For the medium containing spherical pores, both the models produce the same results, whereas for ellipsoidal pores the MT model is more accurate than the KT model, validated by the finite element simulations. In what follows, the applicable ranges of simplified formulas for pores with needle, coin and disk shapes, widely used in engineering, are quantitatively given based on the comparison with the results according to the reduced ellipsoidal formulas of the MT and KT models. These findings provide a comprehensive understanding of the two models in calculating the effective modulus of rocks, which are beneficial to such areas as petroleum exploration and exploitation, civil engineering, and geophysics.
Segmental arterial mediolysis: a rare cause of an acute abdomen
Authors: Kennedy Czara A , Toomey Desmond P
Published: August 2021

Segmental arterial mediolysis (SAM) is a nonatherosclerotic, noninflammatory and nonimmune arteriopathy of unknown aetiology. We present the case of a 43-year-old male who presented to the emergency department with abdominal pain. A computed tomography of abdomen and pelvis showed a narrow, hypodense superior mesenteric artery after the origin, raising the possibility of thrombus or vasculitis. He was commenced on rivaroxaban and steroids. He subsequently presented with an acute abdomen in a collapsed state. Repeat imaging of his abdomen and pelvis revealed an ischaemic ileal segment and caecum. He required an emergency laparotomy with resection of the ischaemic segment and formation of a double-barrelled stoma. SAM is an important diagnosis for clinicians and radiologists to be aware of, given the risks of life-threatening haemorrhage and acute organ ischaemia. This is a commonly overlooked cause of abdominal pain, where an early diagnosis with lifestyle modifications may prevent disease progression and subsequent development of life-threatening complications.
Psychophysiological Predictors of Soldier Performance in Tunnel Warfare: A Field Study on the Correlates of Optimal Performance in a Simulation of Subterranean Combat
Authors: Berger Corinne , Ben-Shalom Uzi , Gold Niv , Antonovsky Avishai
Published: August 2021

Tunnel operations produce unique psychophysiological activation that is correlated with cognitive impairment and lower performance. This study introduces a new concept: subterranean operational potential (SOP) and assesses its psychophysiological correlates for performance prediction in underground spaces. 138 soldiers of elite infantry battalions, with/without previous experience, who participated in a simulation of tunnel warfare. Physical, psychological, cognitive style, and performance measures were collected. SOP has three sub-components: performance, leadership, and orientation. Leadership and performance both were negatively correlated with perceived stress. Claustrophobia was negatively correlated with leadership. The cognitive style was positively correlated with performance. Saliva cortisol levels were significantly higher before the simulation. Inexperienced and experienced differed in the change in before-after saliva cortisol levels.
TRLS-01. Trial in Progress: A Prospective, Multicenter Phase 2b Study to Establish Image Interpretation Criteria for 18F-Fluciclovine PET in Detecting Recurrent Brain Metastases after Radiation Therapy (PURSUE)
Authors: Kotecha Rupesh , Chaglassian Alain , Tainer Nancy , Teoh Eugene
Published: August 2021

Background

Brain metastases are the most common intracranial tumor in adults, occurring in 10–40% of patients with cancer. Despite multimodal treatment approaches, the prognosis remains poor and post-treatment follow-up with conventional MRI (CE-T1-weighted and FLAIR/T2-weighted) of the brain is recommended to monitor for disease recurrence. However, owing to the similar appearance of treatment-related changes like radiation necrosis with that of true recurrence, conventional MRI has low specificity.

Given the high mortality of patients with brain metastases and the considerable treatment-associated morbidity, a need remains for an imaging modality that accurately differentiates recurrence from treatment-related changes. Accurate imaging could help physicians identify patients for whom non-effective or unneeded treatments can be ceased in order to minimize treatment-associated morbidity, and to avoid erroneous premature cessation of potentially effective therapy.

18F-Fluciclovine is a synthetic amino acid-based PET imaging agent that has potential to evaluate primary and metastatic brain cancers owing to its low normal background uptake in the brain and increased uptake in brain tumors.

Methods

NCT04410367 is a prospective, open-label, single-arm, single-dose (185 MBq ± 20%) study with a primary objective to establish visual image interpretation criteria for 18F-fluciclovine PET studies of recurrent brain metastases. Forty subjects with solid tumor brain metastases who have undergone radiation therapy will be enrolled across 8 US sites if they have a reference lesion considered equivocal on MRI for recurrent brain metastasis and are planned for craniotomy. Subjects will undergo 18F-fluciclovine PET <28 days after the equivocal MRI and 2–21 days before planned craniotomy. Outcome measures comprise diagnostic performance of 18F-fluciclovine PET at different thresholds of 18F-fluciclovine uptake compared with histopathology, subject- and lesion-level diagnostic performance based on application of the established image interpretation criteria, and safety evaluations. Enrolment began in August 2020 and the trial is open at the time of submission.
TRLS-07. Intracavitary carrier-embedded Cs131 brachytherapy for recurrent brain metastases: A randomized phase II study
Authors: Moss Nelson S , Imber Brandon S , Cohen Gilad , Prasad Kavya , Nunez David Aramburu , Brennan Cameron W , Tabar Viviane , Beal Kathryn P
Published: August 2021

Background

The salvage treatment of recurrent brain metastases after failed irradiation is a clinical challenge. Adjuvant SRS is standard of care for resected brain metastases in the upfront post-resection setting given a significant local control advantage over surgery alone. However, the role of reirradiation following salvage resection of recurrent post-irradiation metastases is unclear owing to both reduced efficacy of subsequent courses of external beam radiation, and likely increased risk of radiation injury. Intracavitary cesium 131 (Cs131) brachytherapy offers a highly conformal adjunct radiation option that we hypothesize may allow for improved local control while also theoretically conveying a low risk of radiation necrosis. In this randomized controlled study, we aim to define the potential benefits and risks of resection plus permanently implanted, carrier-embedded intracavitary Cs131 brachytherapy versus conventional care (surgery alone).

Methods

This is a single-center randomized controlled study of patients undergoing resection of recurrent, previously-irradiated brain metastases. Exclusion criteria include prior in-field infection, prior radiation >100Gy (in 2Gy fraction equivalents), >5 additional active or untreated CNS lesions, or leptomeningeal carcinomatosis. Subjects are randomized 1:1 to undergo either surgery with placement of Cs131 brachytherapy or surgery alone. The primary endpoint is freedom from treated-site progression at 9 months. Secondary endpoints include wound complications at 3 months and time to local retreatment at the index site, and exploratory objectives include neurocognitive function prior to surgery and at 3 and 12 months postoperatively, with correlative analyses of the previously irradiated brain metastasis tissue. Accrual began on December 24, 2020 and 5 of a planned 76 patients have enrolled. This is the first randomized controlled trial of surgery plus permanently implanted intracavitary Cs131 brachytherapy versus surgery alone for recurrent brain metastases.

ClinicalTrials.gov Identifier: NCT04690348
LMD-09. Outcomes and symptom benefit from palliative radiotherapy for leptomeningeal disease in breast cancer patients
Authors: Takayesu Jamie , Sapir Eli , Xie Jiaheng , Sun Yilun , Morikawa Aki , Junck Larry , Leung Denise , Umemura Yoshie , Heth Jason , Al-Holou Wajd , Wahl Daniel , Lawrence Theodore , Mayo Charles , Hayman James , Kim Michelle
Published: August 2021

Objective

The benefit of radiotherapy (RT) in patients with leptomeningeal disease (LMD) is poorly characterized. This study assessed the overall survival (OS) and clinical improvement of a largely symptomatic cohort of breast cancer patients with LMD, to identify patient subsets most likely to benefit from palliative RT.

Methods

Patients with breast cancer-related classic radiographic LMD (36% cytology-confirmed) were treated with palliative whole brain and/or partial spine RT between 2000–2020 at a single academic institution in this retrospective analysis. OS was calculated from date of LMD diagnosis using the Kaplan-Meier method. A multivariate logistic regression model incorporating ER/PR status, HER2 status, ECOG and steroid use was developed to identify factors associated with symptom benefit, which was ascertained retrospectively by chart review.

Results

Among 64 patients, the radiographic distribution of LMD was in the brain (58%), spine (22%), or both (20%). A total of 63% had brain metastases, and 57% of patients had ER+ and/or PR+, 22% HER2+, and 38% triple-negative disease. Of the symptomatic patients (94%), primary symptom domains included cranial nerve deficits (34%), sensory/motor deficits from intracranial disease (25%) or spinal disease (27%), and headaches/nausea (14%), with 42% of patients reporting >1 symptom domain. Two-thirds of patients were on steroids prior to RT, and 13% of patients received intrathecal therapy. OS was 3.75 months. Following a median dose of 30Gy in 10 fractions, 59% of symptomatic patients experienced symptom improvement, with similar improvement rate across domains (12%, 15%, 19%, 14%, respectively); 21% of patients had improvement in >1 symptom domain. Hormone receptor positivity was independently associated with symptom improvement following RT (OR 3.5, 95% CI 1.2–11, p=0.029).

Conclusions

In this poor-prognosis cohort of breast cancer patients with LMD, palliative RT yielded symptomatic improvement, and may be particularly beneficial among better-prognosis patients with hormone receptor-positive disease.
LMD-12. Ubiquitin Conjugating Enzymes promote leptomeningeal dissemination and decrease survival in patients with brain metastatic disease
Authors: Paisana Eunice , Cascão Rita , Custódia Carlos , Qin Nan , Picard Daniel , Pauck David , Carvalho Tânia , Ruivo Pedro , Pereira Pedro , Roque Rafael , Pimentel José , Miguéns José , Remke Marc , Barata João T , Faria Claudia C
Published: August 2021

The dissemination of cancer cells to the brain parenchyma (brain metastases - BMs) and to the leptomeninges (leptomeningeal dissemination – LD) are a late-stage complication of systemic cancers, with a poor survival. Despite advances in radiation and chemotherapy, including intrathecal administration of anticancer agents, these forms of advanced cancer are incurable. Therefore, there is an unmet clinical need for novel effective therapies that target both parenchymal and leptomeningeal disease.

We analysed the transcriptomic profile of BMs from patients with diverse primary tumors, treated at CHULN, to identify genetic drivers of cancer cell dissemination to the brain and potential novel targets for therapy. The most differentially expressed gene codifies a ubiquitin conjugating enzyme (UCE). UCE levels were evaluated in tissue microarrays of BMs from an independent cohort of patients and correlated with clinical data. UCE functional role was assessed in vitro and in vivo using modulated lung and breast cancer cell lines. A high-throughput drug screening was performed to find UCE-targeting compounds.

High protein levels of the UCE were associated with decreased survival in patients with BMs, independently of the primary tumor origin. High levels of UCE led to increased migration and invasion abilities in cancer cell lines in vitro, with no effect in proliferation. In vivo, high levels of UCE increased leptomeningeal dissemination and decreased survival in orthotopic models of breast cancer BMs. Leptomeningeal disease promoted by UCE was prevented by oral administration of inhibitor A, identified in our high-throughput drug screening.

In conclusion, we have identified UCE as a prognostic marker in patients with BMs from different primary tumors. In orthotopic mouse models of the disease, UCE led to a worse survival and promoted leptomeningeal dissemination. Strikingly, this aggressive disease phenotype was prevented by oral therapy with inhibitor A.
LMD-14. Preclinical safety and activity of intraventricular Rhenium-186 Nanoliposome (186RNL) for leptomeningeal metastases
Authors: Guerra-Garcia Maria , Balinda Henriette , Bao Ande , Garcia Michael , Gilbert Andrea , Phillips William , Floyd John , Brenner Andrew
Published: August 2021

Introduction

Leptomeningeal metastases (LM) is a clinical complication that occurs when cancer cells invade the leptomeninges and cerebrospinal fluid of patients with malignant tumors. Once diagnosed, limited treatment options exist, and survival is poor. Rhenium-186 Nanoliposome (186RNL) is a liposomal encapsulated beta emitter with a short path length of 1.8 mm, thereby allowing high specific activity brachytherapy with limited exposure to surrounding tissues.

Methods

To establish the maximum tolerated dose (MTD) of 186RNL by intraventricular (IT) injection, eight cohorts of Wistar rats (n=3 each) were injected IT with increasing activity of 186RNL at doses of 0 (control), 0.480, 0.800, 1.000, 1.150, and 1.340 mCi. Toxicity was assessed by daily food and water intake, daily weights, and observing for neurological deficits. To assess efficacy, C6-Luc glioma cells were injected IT and 15 days post inoculation the animals were treated with 0.69 mCi of 186RNL. Absorbed doses were assessed with gamma camera imaging at 0h, 24h, and 48h post-treatment. Tumor growth was assessed by luciferase bioluminescence.

Results

No evidence of adverse 186RNL-related effects was observed in rats through 3 months following administration of up to 1.34 mCi with an absorbed dose of up to 1075 Gy. Hence, the MTD exceeded the doses evaluated in this study. A significant difference in survival between the control and treatment groups (n=8 each) was observed at 2 weeks post treatment, with 50% survival in the control group and 100% survival in the treatment group (p=0.0087). The only significant treatment-related histologic finding among treated rats was slight focal thickening of the leptomeninges, suggesting a mild reactive hypertrophy.

Conclusion

Intraventricular delivery of 186RNL is well tolerated and improves animal survival at 2 weeks in a rat model of LM.
MLTI-02. Impact of driver mutations on timing, pattern, treatment, and outcome in patients with brain metastases from non-small cell lung cancer
Authors: Jünger Stephanie , Eich Marie-Lisa , Meissner Anna-Katharina , Ruge Maximilian , Goldbrunner Roland , Grau Stefan
Published: August 2021

Objective

To assess the impact of driver mutations in non-small cell lung cancer (NSCLC) on the formation and treatment outcome of brain metastases (BM).

Patients and methods

We retrospectively analyzed patients with BM from NSCLC with respect to driver mutations and assessed timing and pattern of BM development as well as local cerebral control and survival after BM treatment.

Results

We included 253 patients. Histology was adenocarcinoma in 223, squamous cell carcinoma in 25 and not otherwise specified (NOS) in five patients. All tumors were analyzed for known alterations in NSCLC by panel sequencing and fluorescence in situ hybridization (FISH). An activating KRAS mutation (n=85) was the most prevalent mutation, followed by activating EGFR mutation (n=31) and MET amplification (n=29). Other mutations were detected in 27 patients. No alterations were found in 102 patients. Time to BM development did not differ between the molecular groups (p=.22), nor did the number (p=.72) or location (supra- vs. infratentorial; p=.76) of the BM. Patients underwent multimodal cerebral treatment comprising surgery followed by radiotherapy and/or stereotactic radiosurgery (n=138), whole brain radiotherapy (n=13) or stereotactic radiosurgery alone (n=102). Systemic treatment was initiated or continued after BM therapy in 169 patients and its frequency did not differ significantly between genotypes (p=.08) while the modality of medical treatment depended on genotype (p<0.0001). The latter showed longer local cerebral control rates compared to other mutations (0.23) and a longer overall survival compared to KRAS and wild type genotypes (p=.015). Systemic treatment (HR 2.1 95%CI 1.4–3.0; p<.0001) and a good clinical status (HR 2.1 95%CI 1.2–3.7; p=0.014) were the only independent factors for further survival.

Conclusion

The actual known driver mutations do not influence BM formation. Specific genotypes show a better oncological course, presumably due to available molecular treatment.
OTHR-03. Brain Metastasis Among Ovarian Cancer Patients
Authors: Limon Dror , Shachar Eliya , Adar Lyri , Hasson Shira Peleg , Safra Tamar
Published: August 2021

Background

Brain metastasis (BM) are uncommon among ovarian cancer (OC) patients. Their frequency, risk factors and clinical repercussions are not well described. We assessed OC patients who developed BM, the role of BRCA status and survival implications.

Methods

Study cohort included OC patients treated at our center, from 2002–2020. We retrospectively evaluated clinical parameters, risk for BM development and association with survival data.

Results

Among 972 OC patients, 28 (2.9%) were diagnosed with BM. Comparing the BM to non-BM group, median age of 60 across both groups, stage III-IV at diagnosis was more common among BM group (96.4% vs. 84.8%, p=0.0065) while platinum sensitivity was similar (92.3% in BM vs. 80.8% in non-BM, p=0.2193). Out of 658 patients tested for BRCA, 33.6% (n=221) were BRCA mutation carriers (BRCA+). Of the patients with BM, 22 tested for BRCA, 13 were carriers. BRCA+ was significantly higher in the BM group compared to the non-BM group (59.1% vs. 32.9%, p=0.0123). Among BRCA+ the rate of BM was higher than among BRCA- (5.8% vs. 2.1%, p=0.0123, HR=3.029; 95%CI: 1.4–6.5). Median time from OC diagnosis to BM and from disease recurrence to BM, was longer for BRCA+ compared to BRCA- (44.3mo vs. 32.3mo and 11.8mo vs. 0.7mo, respectively). Median survival (mOS) was not significantly different among patients with BM compared to those without BM (59.4mo vs. 71.2mo, p=0.36). Following diagnosis of BM, mOS was 20.6mo among BRCA+ and 12.3mo among BRCA- (p=0.4266). No correlation was demonstrated with PARP inhibitors or bevacizumab treatment and subsequent development of BM.

Conclusion

BM are an infrequent event among OC patients. However, the risk is three-folds higher among BRCA+. Interestingly, BM do not significantly alter survival among OC patients. Our work suggests that the higher rate of BM in BRCA+ may be related to longer survival. Another hypothesis requiring further evaluation, is possible higher brain tropism among this population.