bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling renewable energy communities: assessing the impact of different configurations, technologies and types of participants
Authors: Belmar Francisco , Baptista Patrícia , Neves Diana
Published: June 2023

Background

Energy communities (ECs) have emerged as a solution to support governments mitigating climate change and comply with decarbonization goals, while introducing end-users on the energy value chain. In this paradigm, citizens have an active role in reducing electricity demand from the utility grid, by generating, sharing and/or trading locally generated renewable energy, such as solar energy. However, the economic and environmental outputs of energy communities are dependent on a variety of factors, such as technology features (renewable energy generation, existence of flexible equipment and/or energy storage systems), types of participants (consumers and prosumers with different electricity intensity and load profiles), and electricity sharing/trading agreements. As such, assessing the impact these will have on delivering benefits to the energy community and its participants is of paramount importance.

Methods

This work models different energy communities’ design typologies in Lisbon, Portugal considering different types of consumers with heterogenous electricity demand profiles and willingness to participate, multiple technology deployment scenarios (solar systems installation, batteries, and electric vehicles), and electricity trading (collective self-consumption versus peer-to-peer trading).

Results

Results demonstrate community electricity cost savings are up to 42%, with self-sufficiency rate up to 12.5%, which is considerably low due to the participation of high demanding sectors (such as industry or retail). At participants’ individual level, electricity costs savings can reach 48% and 53%, for residential consumers and prosumers, respectively, while for high-demanding participants are slightly lower: 43% for hotel, 44% for retail, 13% for industry and 5% for university. Individual self-sufficiency rates register highest results for the residential prosumers (35% for PV prosumers, 28% for PV + electric vehicles and 54% with PV + batteries) while for other participants results fall between 6% (retail) and 26% (industry).

Conclusions

We conclude that for ECs deployment, individual PV self-consumption assets are not sufficient, thus greater PV sizes and higher adoption rates should be considered, according to consumer and prosumers shares. The share/trade of PV surplus, paired with competitive aggregation tariffs results in positive economic and environmental outputs, for the majority of both consumers and prosumers.
Entrepreneurial leadership, learning organization and organizational culture relationship: a systematic literature review
Authors: Shiferaw Robson Mekonnin , Birbirsa Zerihun Ayenew , Werke Shimels Zewdie
Published: June 2023

The purpose of this study is to examine the relations between organizational culture, learning organizations, and entrepreneurial leadership. The study concentrated on how organizational culture, learning organizations, and entrepreneurial leadership are measured in the literature. The study used a systematic literature review methodology analysis that was published in reputable and peer-reviewed English research journals to look at how organizational culture, learning organizations, and entrepreneurial leadership are related to one another. The study used content analysis on 27 peer-reviewed journal articles that were discovered in various journals examined in the databases, which was based on a systematic examination of the literature. This study offers a comprehensive view of entrepreneurial leadership that has been linked to learning organizations and organizations in various enterprises and nations. The study looked at research approaches, sample sizes, data gathering tools, implications, and limits from the body of literature. The study is also one of the first of its kind to review the research on the connection between entrepreneurial leadership, learning organizations, and organizational culture. The outcomes of this study help the scientific community underline the connection between entrepreneurial leadership, learning organizations, and organizational culture for upcoming policy makers.
Modeling the longitudinal changes of ancestry diversity in the Million Veteran Program
Authors: Wendt Frank R. , Pathak Gita A. , Vahey Jacqueline , Qin Xuejun , Koller Dora , Cabrera-Mendoza Brenda , Haeny Angela , Harrington Kelly M. , Rajeevan Nallakkandi , Duong Linh M. , Levey Daniel F. , De Angelis Flavio , De Lillo Antonella , Bigdeli Tim B. , Pyarajan Saiju ,   VA Million Veteran Program, Gaziano John Michael , Gelernter Joel , Aslan Mihaela , Provenzale Dawn , Helmer Drew A. , Hauser Elizabeth R. , Polimanti Renato ,   Department of Veteran Affairs Cooperative Study Program (#2006)
Published: June 2023

Background

The Million Veteran Program (MVP) participants represent 100 years of US history, including significant social and demographic changes over time. Our study assessed two aspects of the MVP: (i) longitudinal changes in population diversity and (ii) how these changes can be accounted for in genome-wide association studies (GWAS). To investigate these aspects, we divided MVP participants into five birth cohorts (N-range = 123,888 [born from 1943 to 1947] to 136,699 [born from 1948 to 1953]).

Results

Ancestry groups were defined by (i) HARE (harmonized ancestry and race/ethnicity) and (ii) a random-forest clustering approach using the 1000 Genomes Project and the Human Genome Diversity Project (1kGP + HGDP) reference panels (77 world populations representing six continental groups). In these groups, we performed GWASs of height, a trait potentially affected by population stratification. Birth cohorts demonstrate important trends in ancestry diversity over time. More recent HARE-assigned Europeans, Africans, and Hispanics had lower European ancestry proportions than older birth cohorts (0.010 < Cohen’s d < 0.259, p < 7.80 × 10−4). Conversely, HARE-assigned East Asians showed an increase in European ancestry proportion over time. In GWAS of height using HARE assignments, genomic inflation due to population stratification was prevalent across all birth cohorts (linkage disequilibrium score regression intercept = 1.08 ± 0.042). The 1kGP + HGDP-based ancestry assignment significantly reduced the population stratification (mean intercept reduction = 0.045 ± 0.007, p < 0.05) confounding in the GWAS statistics.

Conclusions

This study provides a characterization of ancestry diversity of the MVP cohort over time and compares two strategies to infer genetically defined ancestry groups by assessing differences in controlling population stratification in genome-wide association studies.
X-linked SBMA model mice display relevant non-neurological phenotypes and their expression of mutant androgen receptor protein in motor neurons is not required for neuromuscular disease
Authors: Gromova Anastasia , Cha Byeonggu , Robinson Erica M. , Strickland Laura M. , Nguyen Nhat , ElMallah Mai K. , Cortes Constanza J. , La Spada Albert R.
Published: June 2023

X-linked spinal and bulbar muscular atrophy (SBMA; Kennedy's disease) is a rare neuromuscular disorder characterized by adult-onset proximal muscle weakness and lower motor neuron degeneration. SBMA was the first human disease found to be caused by a repeat expansion mutation, as affected patients possess an expanded tract of CAG repeats, encoding polyglutamine, in the androgen receptor (AR) gene. We previously developed a conditional BAC fxAR121 transgenic mouse model of SBMA and used it to define a primary role for skeletal muscle expression of polyglutamine-expanded AR in causing the motor neuron degeneration. Here we sought to extend our understanding of SBMA disease pathophysiology and cellular basis by detailed examination and directed experimentation with the BAC fxAR121 mice. First, we evaluated BAC fxAR121 mice for non-neurological disease phenotypes recently described in human SBMA patients, and documented prominent non-alcoholic fatty liver disease, cardiomegaly, and ventricular heart wall thinning in aged male BAC fxAR121 mice. Our discovery of significant hepatic and cardiac abnormalities in SBMA mice underscores the need to evaluate human SBMA patients for signs of liver and heart disease. To directly examine the contribution of motor neuron-expressed polyQ-AR protein to SBMA neurodegeneration, we crossed BAC fxAR121 mice with two different lines of transgenic mice expressing Cre recombinase in motor neurons, and after updating characterization of SBMA phenotypes in our current BAC fxAR121 colony, we found that excision of mutant AR from motor neurons did not rescue neuromuscular or systemic disease. These findings further validate a primary role for skeletal muscle as the driver of SBMA motor neuronopathy and indicate that therapies being developed to treat patients should be delivered peripherally.
Comparison and integration of simulation models for horizontal connection pipes in geothermal bore fields
Authors: Düber Stephan , Fuentes Raul , Narsilio Guillermo A.
Published: June 2023

The heat transfer along horizontal connection pipes in geothermal bore fields can have significant effects and should not be neglected. As practical and design-related applications require simple and efficient models, we investigate suitability of different models for the first time within this context. Three ground and three pipe models of different complexity are studied. All model combinations are coupled with a fixed ground load boundary condition on one side and a borehole heat exchanger (BHE) model on the other side. Models are tested under a variety of realistic conditions to evaluate performance. The investigations show that all investigated pipe models are equally suitable for the application. For the ground models, the horizontal finite line source model and the numerical 2D model produce identical results for homogeneous ground properties. The soil resistance model neglects the temperature accumulation in the ground and thus leads to considerable deviations and should be avoided. Based on the findings, we propose a computationally efficient approach using a novel combination of established simple steady-state models for the BHE and connection pipes. In the selected example scenario, the consideration of a 30 m connection pipe attached to the BHE leads to an increase in the BHE load by 40% for the heating case and a reduction in the BHE load by 5% for the cooling case.
Characterizing facilitation practices of learning assistants: an authoritative-to-dialogic spectrum
Authors: Carlos Carina M. L. , Maggiore Nicolette M. , Dini Vesal , Caspari-Gnann Ira
Published: June 2023

Background

Learning assistants (LAs) increase accessibility to instructor–student interactions in large STEM lecture classes. In this research, we used the Formative Assessment Enactment Model developed for K-12 science teachers to characterize LA facilitation practices. The Formative Assessment Enactment Model describes instructor actions as eliciting or advancing student thinking, guided by their purposes and the perspective they center as well as by what they notice about and how they interpret student thinking. Thus, it describes facilitation practices in a holistic way, capturing the way purposes, perspectives, noticing, interpreting, and actions are intertwined and working together to characterize different LA actions. In terms of how perspectives influence actions, eliciting and advancing moves can be enacted either in authoritative ways, driven by one perspective that has authority, or in dialogic ways, driven by multiple perspectives. Dialogic practices are of particular interest because of their potential to empower students and center student thinking.

Results

Our analysis of video recordings of LA–student interactions and stimulated recall interviews with 37 introductory physical science lectures’ LAs demonstrates that instead of as a dichotomy between authoritative and dialogic, LA actions exist along a spectrum of authoritative to dialogic based on the perspectives centered. Between the very authoritative perspective that centers on canonically correct science and the very dialogic perspective that centers the perspectives of the students involved in the discussion, we find two intermediary categories. The two new categories encompass a moderately authoritative perspective focused on the LA’s perspective without the claim of being correct and a moderately dialogic perspective focused on ideas from outside the current train of thought such as from students in the class that are not part of the current discussion.

Conclusions

This spectrum further adds to theory around authoritative and dialogic practices as it reconsiders what perspectives can drive LA enactment of facilitation other than the perspective of canonically correct science and the perspectives of the students involved in the discussion. This emerging characterization may be used to give LAs and possibly other instructors a tool to intentionally shift between authoritative and dialogic practices. It may also be used to transition towards more student-centered practices.
Repeatability of a fully automated swept-source optical coherence tomography biometer and agreement with a low coherence reflectometry biometer
Authors: Domínguez-Vicent Alberto , Venkataraman Abinaya Priya , Dalin Amanda , Brautaset Rune , Montés-Micó Robert
Published: June 2023

Background

To evaluate the repeatability of a fully automated swept-source optical coherence tomography (SS-OCT) and its agreement with an optical low coherence reflectometry (OLCR) for several biometric parameters.

Methods

In this study, 74 eyes of 74 patients were measured using the Eyestar 900 SS-OCT and Lenstar LS 900 OLCR. Flat keratometry (K1) and steep keratometry (K2), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were measured three times with each device. The repeatability was analyzed with the intrasubject standard deviation, coefficient of variability (CoV), and coefficient of repeatability (CoR) for each instrument. The agreement between the instruments was evaluated with Bland-Altman analysis.

Results

K1, K2 and CCT CoV values were < 0.2%, < 0.4% and < 0.55%, respectively. Higher CoV values were found for ACD and LT ranging from 0.56% to 1.74%. The lowest CoV values were found for the AL measurements (0.03% and 0.06% for the Eyestar 900 and the Lenstar LS 900, respectively). AL measurements provided the highest repeatability, measured with both CoV and CoR values, and the CCT was the parameter with the lowest repeatability. The CCT and LT measurements were statistically significant between the two biometers (P < 0.001). The interval of the limits of agreement was < 0.6 D for K1 and K2, 15.78 µm for CCT, 0.21 mm for ACD, 0.34 mm for LT, and 0.08 mm for AL.

Conclusions

Both biometers provide repeatable measurements for the different parameters analyzed and can be used interchangeably.
Automation in cargo loading/unloading processes: do unmanned loading technologies bring benefits when both purchase and operational cost are considered?
Authors: Carlan Valentin , Ceulemans David , van Hassel Edwin , Derammelaere Stijn , Vanelslander Thierry
Published: June 2023

The use of technologies that automate handling goods and loading units in warehouses and depots is not new. Yet, the purchase process of these technologies issues troubles and the estimation of the economic advantages brought by one or another technology to the entire chain of operations in logistics are not always known. Faults or not documented decisions put pressure on managers and prices for services. They can cause a drop in the competitiveness of warehouse operators, particularly in uncertain conditions. Academia documented the cost of warehouse storage well. Yet, little research has looked into the economic justification of implementing automatic systems for loading or unloading activities and the impact on complementary operations. For this reason, a model is needed to calculate the cost of operations when different technical equipment is used. This research further investigates the cost categories that must be considered when purchasing automated loading/unloading technologies. The model includes the purchase and operational loading costs that new technologies generate and the cost of adjacent operations to loading activity. The case study uses forklifts as the reference scenario and provides an overview of the return on investment and a break-even period when other technologies are in use. The calculation model shows that increasing cargo volume leads to a better RoI. The same observation is also made regarding the rise in labour costs. For the latter, using human operators to handle pallets on a one-by-one basis generates an exponential increase in operational cost due to delays and faults. On the other side, the cost of implementing automated loading/unloading technologies and the consideration of technology risk determine the low economic advantages. An in-depth cost and benefit analysis shows in which situation a technology generates greater benefits. Further results of this paper show that better use of trucks' loading capacity can positively impact the financial performance of automated loading technologies, as a higher volume of cargo is moved (at once) without human intervention.
Boosting biopesticide potential of Trichoderma harzianum for controlling the downy mildew and improving the growth and the productivity of King Ruby seedless grape
Authors: El-Sharkawy Hany H. A. , Abo-El-Wafa Thoraya S. A. , Mostafa Nada A. , Yousef Safaa A. M.
Published: June 2023

Background

Plasmopara viticola, the causal agent of grape downy mildew, is one of the most serious grape diseases. Application of Trichoderma harzianum grown on different potato dextrose supplemented broth media using some chemical inducers (TSDCIS), i.e., thiamine (T2), a mixture of micronutrients (T3) and potassium tartrate (T4), compared to Trichoderma without amendment (T1), was conducted under field conditions to evaluate the potential of T. harzianum against grape downy mildew, improving the growth, as well as the yield quality, and quantity.

Results

Foliar application of all TSDCIS significantly reduced the disease severity and increased the phenolic content, peroxidase, polyphenol oxidase enzyme activity, growth parameters, and yield parameters. Trichoderma growing on medium supplemented with potassium tartrate (T4) achieved the most significant reduction in the disease severity (78.9, 81.8%) than the control treatment in two growing seasons, respectively. In contrast, it decreased H2O2 content, lipid peroxidation, and cellular electrolyte leakage. Scanning electron microscopy observations revealed that the number of opened stomata, average stomatal area, and stomatal pore area decreased significantly in response to T4 treatment.

Conclusions

It can be concluded that using Trichoderma growing on medium supplemented with potassium tartrate (T4) to biosafety control the downy mildew disease of grape and improve its growth, yield, and fruit quality is recommended.
Anesthetic management of a parturient with tuberous sclerosis for emergency cesarean section- a case report
Authors: Yadav Nitu , Kumar Amit , Arora Vandna , Sharma Pragya , Arora Rashmi , Singhal Suresh K.
Published: June 2023

Background

Tuberous sclerosis is an autosomal dominant neurocutaneous disorder characterized by hamartoma formation in various organ systems leading to highly variable clinical presentation. These patients pose a challenge to anesthesiologists due to multisystem involvement.

Case presentation

Herein, we report the successful anesthetic management of a 25-year-old parturient with tuberous sclerosis who underwent an emergency cesarean section in view of cephalopelvic disproportion. She had a seizure disorder, bilateral renal angiomyolipomas, angiofibroma over the cheeks, periungual fibroma on the right toe, and nodular lesions near the base of the tongue and oropharynx. We opted for regional anesthesia to avoid airway instrumentation, drug interaction, and renal insult.

Conclusions

Anesthetic management of tuberous sclerosis depends upon the extent and severity of the involvement of various organs. Careful assessment, thorough evaluation, and preoperative planning are crucial for dealing with the difficulties and complications encountered during the management of these cases.
Chitin synthases containing myosin motor-like domain are required for cell wall integrity and virulence of vascular wilt pathogen Verticillium dahliae
Authors: Chen Bin , Tian Juan , Feng Zhidi , Wang Huan , Sun Jie , Kong Zhaosheng
Published: June 2023

Verticillium wilt (VW) of cotton poses a serious threat to the quality and yield of cotton. Verticillium dahliae is the primary causal agent of cotton VW. Moreover, V. dahliae can infect more than 200 species of dicotyledonous plants. The fungal cell wall plays a crucial role in its growth, development and pathogenicity. However, the mechanism of cell wall synthesis in V. dahliae and its role in pathogenesis remains unclear. In this study, we identified two chitin synthase (CHS) genes VdChs5 and VdChs7 containing myosin motor-like domain (MMD) and characterized their role in virulence of V. dahliae. The results showed that the functions of VdChs5 and VdChs7 were largely redundant, and target deletion of both VdChs5 and VdChs7 in V. dahliae did not affect vegetative growth, but reduced conidial production. ΔVdChs5Chs7 deletion mutant failed to colonize and proliferate in cotton vascular tissue, and exhibited significantly reduced virulence on cotton, suggesting that VdChs5 and VdChs7 are necessary for pathogenesis. In addition, the thickness of the cell wall in ΔVdChs5Chs7 showed significantly decreased, and ΔVdChs5Chs7 mutant exhibited hypersensitivity to cell wall perturbing agents and reactive oxygen species (ROS), indicating that VdChs5 and VdChs7 play key roles in cell wall integrity. Further, host-induced gene silencing (HIGS) silenced transcripts of VdChs5 and VdChs7 in susceptible cotton (Gossypium hirsutum L. acc. TM-1) enhanced resistance to cotton VW. Taken together, our data demonstrated that VdChs5 and VdChs7 play pivotal roles in proliferation, cell wall integrity, and pathogenicity, and provided a novel strategy to improve Verticillium wilt resistance in cotton and other susceptible host plants.
New analytical LC–MS/MS method for fluconazole and ivermectin estimation in combined pharmaceutical dosage form: development and validation
Authors: Mohite Popat , Nimse Satish Balasaheb , Joy Jomon George , Kulkarni Rohini , Pandhare Ramdas , Pawar Anil
Published: June 2023

Background

Fluconazole, an antifungal drug, prevents fungi growth by inhibiting the formation of a protective covering. Ivermectin has several biological activities, such as antibacterial, antiviral, and anti-cancer characteristics, and offers various therapeutic outcomes. There are several commercial products containing these two drugs. Therefore, developing a method that can allow the simultaneous estimation of Fluconazole and ivermectin is inevitable to monitor them in commercial dosage forms. The hyphenated methodology that combines spectroscopic and chromatographic techniques is gaining high interest in the pharmaceutical industry. Consequently, the objective of present research work was to investigate robust and sensitive LC–MS/MS avenue for simultaneous determination of Fluconazole and ivermectin in pure material and combined dosage form.

Results

The simultaneous quantification of Fluconazole and ivermectin in tablet dosage form has been developed and validated using a straightforward, sensitive, practical, and repeatable LC–MS/MS approach. The separation was performed using a C18 (150 × 4.6 mm) column, injection volume of 10 µL, and elution with acetonitrile: formic acid at a ratio of 70:30, with the column temperature at 30 °C, and a flow rate of 4.0 mL/min. The retention times of Ivermectin and Fluconazole were 1.10 min and 1.05 min, respectively. The calibration curves for Fluconazole and ivermectin demonstrated significant linearities indicated by the correlation coefficients (r2 = 0.999 and r2 = 0.997) and precision (% R.S.D. of 1.58 and 1.13). The linear correlation between peak area and concentration allowed high percentage recoveries of 98.5%–99.4% and 97.8%–99.3% for Fluconazole and Ivermectin, respectively. The L.O.D.s for Fluconazole and ivermectin were found to be 0.0034 and 0.074 g/mL, respectively. The L.O.Q.s for Fluconazole and ivermectin were 0.010 and 0.225 g/mL, respectively.

Conclusion

All the analytical parameters were identified and found to be within the acceptable range set forth by the ICH guidelines, demonstrating the devised method's acceptability in the simultaneous detection and estimation of Fluconazole and ivermectin in the commercial dosage forms.
Characteristics of 24-hour movement behaviours and their associations with mental health in children and adolescents
Authors: Fairclough Stuart J. , Clifford Lauren , Brown Denver , Tyler Richard
Published: June 2023

Background

Time-use estimates are typically used to describe 24-hour movement behaviours. However, these behaviours can additionally be characterised by other easily measured metrics. These include sleep quality (e.g., sleep efficiency), 24-hour rest-activity rhythmicity (e.g., between-day rhythm variability), and directly measured acceleration metrics (e.g., intensity gradient). Associations between these characteristics and youth mental health are unclear. This study aimed to [1] compare 24-hour movement behaviour characteristics by sex and age groups, [2] determine which movement behaviour characteristics were most strongly associated with mental health outcomes, and [3] investigate the optimal time-use behaviour compositions for different mental health outcomes.

Methods

Three-hundred-and-one children and adolescents (age 9–13 y; 60% girls) wore accelerometers for 24-hours/day over 7-days. Overall mental health, externalising, and internalising problems were self-reported using the Strengths and Difficulties Questionnaire. 24-hour movement behaviour characteristics were categorised as time-use estimates, sleep quality, 24-hour activity rhythmicity, and directly measured acceleration. Linear mixed models and compositional data analysis were used to analyse the data in alignment with the study aims.

Results

Time-use estimates, directly measured accelerations, and 24-hour rest-activity rhythm metrics indicated that children were significantly more physically active (p = .01-<0.001) than adolescents. Children were also less sedentary (p < .01), slept longer (p = .02-0.01), and had lower sleep efficiency. Boys were significantly more active than girls (p < .001) who in turn accrued more time in sleep (p = .02). The timing of peak activity was significantly later among adolescents (p = .047). Overall mental health and externalising problems were significantly associated with sleep, sedentary time, sleep efficiency, amplitude, and inter-daily stability (p = .04-0.01). The optimal time-use compositions were specific to overall mental health and externalising problems and were characterised by more sleep, light and vigorous physical activity, and less sedentary time and moderate physical activity than the sample’s mean time-use composition.

Conclusions

Extracting and examining multiple movement behaviour characteristics from 24-hour accelerometer data can provide a more rounded picture of the interplay between different elements of movement behaviours and their relationships with mental health than single characteristics alone, such as time-use estimates. Applying multiple movement behaviour characteristics to the translation of research findings may enhance the impact of the data for research users.
Early Treatment Intensification in Metastatic Hormone-Sensitive Prostate Cancer
Authors: Wala Jeremiah , Nguyen Paul , Pomerantz Mark
Published: June 2023

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in the Journal of Clinical Oncology, to patients seen in their own clinical practice.

For generations, oncologists and urologists have used androgen deprivation therapy (ADT) to manage metastatic hormone-sensitive prostate cancer (mHSPC). Until recently, ADT monotherapy was standard. Within the past decade, a series of trials have clearly demonstrated improved outcomes with a more aggressive up-front approach. Doublet intensification therapy, involving either ADT plus docetaxel or ADT plus any of several second-generation oral androgen-receptor pathway inhibitors (ARPIs), provide considerable survival advantages compared with ADT alone. In 2022, two trials, PEACE-1 and ARASENS, demonstrated the potential of triplet therapy, adding an ARPI to an ADT-docetaxel doublet. In the Original Report that accompanies this article, the authors provide a post hoc analysis of ARASENS (ADT plus docetaxel, with or without darolutamide), identifying the subpopulations of patients with mHSPC who might benefit most from a triplet regimen. They segment the ARASENS cohort by disease volume and disease risk profile, finding that triplet therapy is associated with improved outcomes regardless of category (although with limited power in the low-volume cohort). Meanwhile, trials are ongoing examining the role of radiotherapy (RT) in mHSPC, a modality previously reserved for localized disease or isolated, symptomatic metastases. Here, we present a mHSPC case and discuss our approach to mHSPC considering recent studies. We recommend triplet therapy for patients who are suitable candidates for chemotherapy, especially for patients with high-volume disease. We also favor aggressive use of RT, when feasible, for patients with low-volume mHSPC.
Mediastinal Staging in Non–Small-Cell Lung Cancer: Saying Goodbye to Mediastinoscopy
Authors: Dunne Elizabeth G. , Fick Cameron N. , Jones David R.
Published: June 2023

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.

Accurate staging of the mediastinal lymph nodes in resectable non–small-cell lung cancer (NSCLC) is critically important to determine the overall stage of the tumor and guide subsequent management. The staging process typically begins with positron emission tomography (PET) or computed tomography imaging; however, imaging alone is inadequate, and tissue acquisition is required for confirmation of nodal disease. Mediastinoscopy was long considered the gold standard for staging of mediastinal lymph nodes, but, recently, endobronchial ultrasound–guided (EBUS) fine-needle aspiration (FNA) has become the standard of care. EBUS-FNA, in combination with supplementary technologies, such as intranodal forceps biopsy and esophageal ultrasonography, has a high sensitivity and specificity for the diagnosis of nodal metastases. EBUS-FNA is also capable of assessing N1 disease and obtaining adequate tissue for tumor genomic analysis to help guide treatment. In the case of negative findings on EBUS, a confirmatory video mediastinoscopy is still recommended by the European Society of Thoracic Surgeons guidelines. However, whether confirmatory mediastinoscopy is necessary is a matter of debate, and it is not commonly performed in North America. To address this question, Bousema and colleagues performed a randomized noninferiority trial to determine rates of unforeseen nodal metastases after EBUS alone versus EBUS with confirmatory mediastinoscopy in patients with resectable NSCLC. The authors concluded that EBUS alone is noninferior to EBUS with confirmatory mediastinoscopy. These findings affirm our current practice to forgo confirmatory mediastinoscopy after negative findings on EBUS.
Outcomes of ATA Low-Risk Pediatric Thyroid Cancer Patients Not Treated With Radioactive Iodine Therapy
Authors: Bojarsky Mya , Baran Julia A , Halada Stephen , Isaza Amber , Zhuang Hongming , States Lisa , Grant Frederick D , Robbins Stephanie , Sisko Lindsay , Ricarte-Filho Julio C , Kazahaya Ken , Adzick N Scott , Mostoufi-Moab Sogol , Bauer Andrew J
Published: June 2023

Context

The American Thyroid Association (ATA) Pediatric Guidelines recommend patients not receive radioactive iodine therapy (RAIT) for differentiated thyroid cancer (DTC) confined to the thyroid. Since publication, there is ongoing concern whether withholding RAIT will result in a lower rate of remission.

Objective

This study explores whether ATA low-risk patients treated with and without RAIT achieved similar remission rates.

Methods

Medical records of patients <19 years old diagnosed with DTC and treated with total thyroidectomy between 2010 and 2020 were reviewed. Multivariate logistic regression was performed to evaluate factors influencing RAIT administration and remission rate.

Results

Ninety-five patients with ATA low-risk DTC were analyzed: 53% (50/95) and 47% (45/95) were treated with and without RAIT, respectively. RAIT was used to treat 82% of patients before 2015 compared with 33% of patients after 2015 (P < .01). No significant difference in 1-year remission rate was found between patients treated with and without RAIT, 70% (35/50) vs 69% (31/45), respectively. With longer surveillance, remission rates increased to 82% and 76% for patients treated with and without RAIT, respectively. Median follow-up was 5.8 years (IQR 4.3-7.9, range 0.9-10.9) and 3.6 years (IQR 2.7-6.6; range 0.9–9.3) for both cohorts. No risk factors for persistent or indeterminate disease status were found, including RAIT administration, N1a disease, and surgery after 2015.

Conclusion

Withholding RAIT for pediatric patients with ATA low-risk DTC avoids exposure to radiation and does not have a negative impact on remission rates. Dynamic risk stratification at 1-year after initial treatment is a suitable time point to assess the impact of withholding RAIT for these patients.
Effects of Aerobic Training and Semaglutide Treatment on Pancreatic β-Cell Secretory Function in Patients With Type 2 Diabetes
Authors: Ingersen Arthur , Schmücker Malte , Alexandersen Christina , Graungaard Benjamin , Thorngreen Tobias , Borch Jacob , Holst Jens Juul , Helge Jørn Wulff , Dela Flemming
Published: June 2023

Context

Prior to this study, it is known that type 2 diabetes is linked to obesity and a sedentary lifestyle, leading to inadequate β-cell function and insulin resistance. Limited research has explored the metabolic effects of combining exercise training with antidiabetic medications, particularly focusing on insulin secretion in patients with type 2 diabetes and moderately preserved β-cell function.

Objective

The effect of the interaction of semaglutide and physical training on pancreatic β-cell secretory function is unknown in patients with type 2 diabetes.

Methods

Thirty-one patients with type 2 diabetes underwent 12 weeks of aerobic training alone or concurrent to treatment with semaglutide. Patients randomly allocated to concurrent semaglutide and training were treated with semaglutide for 20 weeks before the training and evaluated at inclusion and again before and after the training intervention. Patients randomized to training were evaluated before and after training. The primary outcome was a change in insulin secretory capacity with training, evaluated by a 2-stepped hyperglycemic (20 and 30 mM) clamp.

Results

Training increased the incremental area under the curve for insulin from 21 to 27 nM × 2 hours (ratio 1.28, 95% CI 1.02-1.60) during clamp step 1 and from 40 to 64 nM × 2 hours (ratio 1.61, 95% CI 1.25-2.07) during step 2. Semaglutide treatment increased insulin secretion from 16 to 111 nM × 2 hours (ratio 7.10, 95% CI 3.68-13.71), and from 35 to 447 nM × 2 hours (ratio 12.74, 95% CI 5.65-28.71), correspondingly. Semaglutide and training increased insulin secretion from 130 to 171 nM × 2 hours (ratio 1.31, 95% CI 1.06-1.63), and from 525 to 697 nM × 2 hours (ratio 1.33, 95% CI 1.02-1.72), correspondingly. The median increase in total insulin secretion with the combination was 134 nM × 2 hours greater (95% CI 108-232) than with training.

Conclusion

The combination of aerobic training and semaglutide treatment synergistically improved β-cell secretory function. (ClinicalTrials.gov number, ID NCT04383197).
Opioid-Free Versus Opioid-Based Anesthesia on Postoperative Pain After Thoracoscopic Surgery: The Use of Intravenous and Epidural Esketamine
Authors: Yan Huan , Chen Wannan , Chen Youwen , Gao Huayuan , Fan Yu , Feng Mingxiang , Wang Xiaoming , Tang Han , Yin Jiacheng , Qian Yunjia , Ding Ming , Cang Jing , Miao Changhong , Wang Hao
Published: June 2023

BACKGROUND:

The effectiveness and safety of opioid-free anesthesia (OFA) regimens in distinct types of surgeries remain controversial. In this study, we investigated whether OFA could reduce the occurrence of chronic postoperative pain in patients receiving video-assisted thoracoscopic surgery (VATS).

METHODS:

We conducted a 2-center, randomized, controlled trial from September 2021 to January 2022. A total of 162 lung tumor patients scheduled to undergo VATS were randomly divided into an opioid-based anesthesia (OA) group and an OFA group. The OA group received general anesthesia combined with thoracic epidural block using morphine, while the OFA group received general anesthesia combined with thoracic epidural block using esketamine. Patient-controlled epidural analgesia (PCEA) was used after surgery (ropivacaine and morphine for the OA group versus ropivacaine and esketamine for the OFA group). The primary end point was chronic pain rates at 3 months after VATS, which were analyzed using a logistic regression model. The secondary end points were chronic pain rates at 6 months, acute pain rates at 24 hours and 48 hours postoperatively, postoperative side effects, and perioperative variables.

RESULTS:

The final analysis included 159 patients. Acute postoperative pain at 24 hours occurred in 0 of the 79 (0%) patients in the OA group and 10 of the 80 (17.5%) patients in the OFA group (odds ratio, 52.14; 95% confidence interval [CI], 6.47–420.10; P < .001). Acute postoperative pain at 48 hours occurred in 3 of the 79 (3.8%) patients in the OA group and 2 of the 80 (2.5%) patients in the OFA group (odds ratio, 2.07; 95% CI, 0.99–4.32; P = .053). In this study, none of the patients had moderate or severe pain in either group at 3 and 6 months postsurgically. Mild chronic postoperative pain at 3 months occurred in 27 of the 79 (34.2%) patients in the OA group and 14 of the 80 (17.5%) patients in the OFA group (odds ratio, 3.52; 95% CI, 1.49–8.31; P = .004). At 6 months, mild chronic pain still occurred in 23 of the 79 (29.1%) patients in the OA group and 9 of the 80 (11.3%) patients in the OFA group (odds ratio, 5.55; 95% CI, 2.01–15.33; P = .001). In addition, the OFA group included fewer patients with side effects, including nausea, vomiting, and pruritus, within 48 hours after surgery.

CONCLUSIONS:

Replacement of opioids by esketamine, intraoperatively as intravenous injection and epidural infusion and postoperatively as epidural infusion, reduces the incidence of mild chronic postoperative pain and side effects in patients after VATS.
Andaiye and Audre Lorde’s Black Transnational Sisterhood; or, “I Want You in This World”
Authors: Panaram Sasha Ann
Published: June 2023

So many Black revolutionaries lived with and died from cancer. How did they make sense of their vulnerability when confronted with this illness? How did they balance fighting for the world and for themselves? When modern medicine could neither ameliorate their pain nor eliminate the disease, to whom did they turn for support? This essay centers letters from 1989 to 1990 that Andaiye sent to Audre Lorde shortly after they met at the Caribbean Association for Feminist Research and Action conference in 1988. Drawing on these letters, a tribute titled “Sister Survivor” that Andaiye wrote for Lorde following her death, a copy of A Burst of Light that Lorde sent to Andaiye, and Black feminist scholarship on how listening constitutes care work, the author explores what Andaiye and Lorde taught each other about the possibilities for living with cancer and listening across differences.
Canonizing De Kom
Authors: Balkenhol Markus
Published: June 2023

How did Anton de Kom become national heritage? This essay argues that De Kom’s successful canonization is owed in significant part to his sacralization. It shows that in De Kom’s case, the sacralizing power of heritage has three dimensions: his narrative framing, his image, and his status as ancestor. Highlighting these processes of sacralization allows a critical rereading of how De Kom is inscribed in postcolonial politics of memory in the Netherlands. The focus by postcolonial historians on historical accuracy and reading archives against or “along the grain” is crucial, but a secular perspective does not fully answer what makes certain historical narratives persuasive to particular audiences. Paying closer attention to this sacralizing power of heritage can provide new insights into workings of postcolonial memory and heritage.
Appropriating Anton de Kom Today
Authors: Fatah-Black Karwan
Published: June 2023

This essay explores the renewed attention for Anton de Kom and the ways this engagement revisits older questions about his life and work and opens new avenues for inquiry. This renewed interest has led to new forms of appropriation: the use of his likeness and his name by institutions to communicate a connection between the meanings attached to De Kom and the institution. These societal uses of De Kom in turn shape the meanings ascribed to him, resulting in an increasingly stylized and abstract understandings of his life and work. This piece hopes to serve as a corrective and an aid to further reflection.
More Relevant Than Ever
Authors: Esajas Mitchell
Published: June 2023

Anton de Kom was an anticolonial thinker, resistance fighter, father, author, and poet—a renaissance man par excellance born in the Dutch colony Suriname. In his Wij slaven van Suriname (1934), De Kom, as a descendant of enslaved peoples in Suriname, described with razor-sharpness the oppression and exploitation of people on the basis of “race” and class, both during the period of slavery and after its abolition. Although he became known as a national hero in Suriname, in the former colonial metropole of the Netherlands his name, work, and life story were relatively unknown. In 2020, however, Wij slaven became a bestseller, eighty-six years after its original publication, and De Kom became part of the Dutch canon. This essay explores this new, even unexpected, “success” of Wij slaven, and indeed of Anton de Kom, within the Dutch public and political spheres.
IMPRINT
Authors: Alonzo Shannon
Published: June 2023

This visual essay explores a fragment of the journey to know our ancestors in their absence. The pregnant silences of archives, skewed by years of historical erasure and the remnants of colonial legacy, so often obscure our walk toward collective belonging and a deeper understanding of self as Caribbean people. Washerwoman (2018), the sculpture featured in the essay, is the product of an attempt to know our progenitors through the labor of our hands, silently working alongside theirs, across temporalities. We mourn the blurred edges of their photographs and pay homage to the mundane moments of their existence, so densely knitted together to create our own reality.
Suzanne and Suzanne
Authors: Sanders Johnson Grace L.
Published: June 2023

This conversation piece celebrates Annette K. Joseph-Gabriel’s inspiring study Reimagining Liberation: How Black Women Transformed Citizenship in the French Empire (2020) through the parallel histories of the Martinican theorist Suzanne Césaire and the Haitian intellectual Suzanne Comhaire-Sylvain. Thinking about Suzanne’s and Suzanne’s respective and overlapping relationships to Haiti, this essay is an exercise in implementing the decolonial methods and reimagining of national belonging that Joseph-Gabriel presents.
Black Women and Their Discontents in the French Context
Authors: Jean-Baptiste Shanna
Published: June 2023

This essay explores the decolonial future imagined by the Black women who make up Annette K. Joseph-Gabriel’s Reimagining Liberation: How Black Women Transformed Citizenship in the French Empire (2020). A much-needed project of historical redress, Joseph-Gabriel’s study proposes the concept “decolonial citizenship” as a framework to tackle the archival and scholarly invisibility of Black women’s contributions to decolonial movements and their espousing new ways of belonging that are grounded in practices, geographies, epistemologies, and communities that persist despite the French colonial orb. This essay argues that the contemporary Afrofeminist movement in France’s fight for Black liberation and articulations of new forms of belonging point to the continued discontents of the country’s Black population with the universalist pretenses of the French republic.
Decolonizing the Married Woman
Authors: Warner Tobias
Published: June 2023

Annette K. Joseph-Gabriel’s Reimagining Liberation: How Black Women Transformed Citizenship in the French Empire (2020) models the critical possibilities of attending to the overlooked records of Black women’s political imaginations. This discussion essay explores what happens if we extend Joseph-Gabriel’s recuperative method past the 1960s and into the early independence era. No one would call the Senegalese novelist Mariama Bâ overlooked, and yet Bâ herself has often been absent from her own reception history. One understudied archive for Bâ is a biography of the novelist written by her daughter Mame Coumba Ndiaye. Harmonizing with Joseph-Gabriel’s notion of decolonial citizenship, this essay asks how the stakes of Bâ’s work shift if we read her alongside Ndiaye’s overlooked text. While Black women of Bâ’s generation may have been more likely to be widely recognized than those explored in Reimagining Liberation, their political imaginations have sometimes been misconstrued as nationalist in ways that obscure their articulation through the transnational feminist networks that sustained them.