bluuebunny/crossref_metadata_2025 huggingface dataset:
Self‐incompatibility limits sexual reproduction rather than environmental conditions in an invasive water primrose
Authors: Portillo Lemus Luis O. , Bozec Michel , Harang Marilyne , Coudreuse Julie , Haury Jacques , Stoeckel Solenn , Barloy Dominique
Published: March 2021

Fruit‐set and seed‐set depend on environmental conditions and reproductive systems. They are important components of sexual reproductive success in plants. They also control the ecological success and adaptation of invasive plants within their non‐native ecosystems. We studied which factors bring about fruit‐set and seed‐set in invasive populations of the aquatic plant Ludwigia grandiflora subsp. hexapetala. We analyzed fruit set and seed set in 37 populations growing under variable climatic conditions in Western Europe. Sub‐samples of seven fruitful and fruitless populations were grown in common controlled conditions. We carried out self‐ and cross‐pollinations, and measured the floral morphometry. Environmental conditions did not affect fruit‐set and seed‐set in‐situ and in common controlled environments. Hand‐pollinations showed that individuals from fruitful populations exhibited fruit and seed production whatever the pollen donor, whereas individuals from fruitless populations only did so when pollen came from fruitful populations. Floral morphometry evidenced the existence of two floral morphs that fully overlapped with fruitfulness, and individual incompatibility. Our results rebutted the hypothesis that environmental variations control fruit set and seed set in these invasive populations. We instead showed that fruit set and seed set were controlled by a heteromorphic reproductive system involving a self‐incompatible and inter‐morph compatible morph (long‐styled morph), and a self‐ and inter‐morph compatible reverse morph (short‐styled morph). We collected morphs and fruit set records of this species worldwide and found the same relationship: fruitless populations were all composed only of individuals with long‐styled floral morph. Our study constitutes the first evidence of a heteromorphic self‐incompatible system in Ludwigia genus and Onagraceae family.
Aeroponic systems: A unique tool for estimating plant water relations and NO3 uptake in response to salinity stress
Authors: Tafesse Endale Geta , Aidoo Moses Kwame , Lazarovitch Naftali , Rachmilevitch Shimon
Published: March 2021

The study of transpiration, water, and nutrient uptake during abiotic stress in the root zone is hindered because of the hidden nature of the root zone. In this study, a modified aeroponic system was used to evaluate whole plant transpiration, nitrate and water uptake in the growth and development of tomato plants in response to salinity. Tomato seedlings were exposed to three levels of salinity (1.5, 4.5, and 9 dSm−1) and three levels of nitrate (1, 4, and 8 mM NO3) in a separate experiments conducted concurrently. Whole plant transpiration, water and nitrate uptake were estimated. Our study revealed that ~30 to 35 days after treatment (DAT), water uptake rate per plant increased from a common initial rate of about 0.05 to 1.1, 0.6, and 0.4 kg/day at 1.5, 4.5, and 9 dSm−1 respectively. The NO3 uptake rates in tomatoes grown in 1 and 4 mM NO3 were 5.5 and 22% respectively, of the uptake of tomatoes grown in 8 mM NO3. The estimation of nitrate uptake and lower sensitivity to salinity stress in the aeroponic showed the effectiveness and cost efficiency of the system in the cultivation of vegetables during abiotic stresses. The novelty of the system described is the continuous estimation of root and nutrient uptake by the whole plant at any given time.
PLLA‐ZIF‐8 metal organic framework composites for potential use in food applications: Production, characterization and migration studies
Authors: Kathuria Ajay , Abiad Mohamad G. , Auras Rafael
Published: March 2021

PLLA‐15% ZIF‐8 MOF composites were fabricated by melt compounding followed by injection molding for active packaging applications. The injection‐molded discs were then converted into films by compression molding. The samples were morphological and thermally characterized. Migration studies using Atomic Absorption Spectrometry were conducted on the successful produced PLLA and PLLA‐15% MOF films incubated at 40°C for 240 h with two simulants, Simulant A: aqueous and acidic foods with 10% ethanol, and Simulant B: low and high alcoholic foods with 50% ethanol as per the U.S. Food and Drug Administration guidelines for packaging application testing. After 240 h Zn2+ ion concentrations in Simulants A and B were 354 and 166 mg L−1, respectively. Higher Zn2+ ion migration observed in Simulant A can be ascribed to the decomposition of the ZIF‐8 MOF under acidic environment. Thermo‐gravimetric studies indicated that the thermal stability of PLLA dropped from 338°C to 207°C with the addition of ZIF‐8 MOF, which may be credited to the catalytic depolymerization effect of the MOF. Due to high migration, the studied composite films are not suitable for direct food contact applications in their present form. Future work must be directed to explore how to engineer these composites for food contact applications.
The imperative of embedding sustainability in business: A model for transformational sustainable development
Authors: Trollman Hana , Colwill James
Published: March 2021

Sustainable development is the current strategic trajectory with transformative intent for complex global challenges including eradication of poverty, full social inclusion and prevention of ecological collapse. However, discourses related to the private sector emphasise economic and social development over the environmental components of sustainable development. Embedding sustainability is the related management imperative for business, supported by numerous frameworks, yet there is confusion about implementation in both literature and practice. This research addresses these issues with a mixed methods study combining a scoping literature review with a qualitative e‐Delphi study. The main findings are that the economic system constrains the embedding of sustainability in business; and that a paradigm shift towards ecocentric business models lacks support. The results are used to develop a novel model to aid transformational sustainable development that acknowledges the influences of the economic system in business whilst respecting social and ecological embeddedness.
Affordable Care Act Medicaid expansions and the nurse labor market
Authors: DiNardi Michael
Published: March 2021

Shortages in healthcare labor markets were a major concern voiced by critics of the 2010 Patient Protection and Affordable Care Act (ACA). Using a difference‐in‐differences strategy, I find the 2014 ACA Medicaid expansions increased the average workweek by 30 min for registered nurses (RNs) and 50 min for licensed practical nurses (LPNs), driven by an increase in full‐time work. RNs and LPNs were 3 and 5 percentage points more likely to work full‐time, respectively, due to the Medicaid expansions. There is little evidence of increased nurse employment on the extensive margin.
Comparative study on the effect of outrigger on seismic response of tall buildings with braced and Wall Core. II: Determining seismic design parameters
Authors: Samadi Maysam , Jahan Norouz
Published: March 2021

In this paper, the effect of outrigger on key seismic design parameters of tall buildings with braced or shear wall core is studied. Based on the results of modal response spectrum (MRS) and nonlinear time history (NLTH) analyses of 44 models with braced or wall core, discussed in the companion paper and pushover analysis and presented in this part, the effect of outrigger and its placement level on parameters of seismic design including response modification factor R, overstrength factor Ω0, deflection amplification factor Cd, and damping ratio of structures are studied. New local measures for Cd and Ω0 are proposed based on the NLTH results. It is observed that outrigger results in greater increase in strength and stiffness of structures with wall core than buildings with braced core, but decreases the ductility of both systems. The obtained R is less than the values given by the code in most cases. For the main structures without outrigger, using the code prescribed value for Cd underestimates the real displacement of the structures with wall core and overestimates it for those with braced core. Outrigger results in increasing Cd of structures with braced core and reduction of Cd in those with wall core. The considerable variation of two proposed measures for Cd shows the inappropriateness of application of a single value of Cd for all stories. Outrigger increased the damping ratio of buildings with shear wall core considerably.
Table understanding approaches for extracting knowledge from heterogeneous tables
Authors: Bonfitto Sara , Casiraghi Elena , Mesiti Marco
Published: March 2021

Table understanding methods extract, transform, and interpret the information contained in tabular data embedded in documents/files of different formats. Such automatic understanding would allow to exploit tabular information with the aim of accurately answering queries, or integrating heterogeneous repositories of information in a common knowledge base, or exchanging information among different sources. The purpose of this survey is to provide a comprehensive analysis of the research efforts so far devoted to the problem of table understanding and to describe systems that support the transformation of heterogeneous tables into meaningful information.

This article is categorized under:

Application Areas > Data Mining Software Tools

Technologies > Data Preprocessing

Technologies > Structure Discovery and Clustering
Increasing Inequality and the Changing Spatial Distribution of Income in Tel-Aviv
Authors: Modai-Snir Tal
Published: March 2021

Despite its egalitarian past, in recent decades Israel followed the footsteps of the United States in terms of growing inequality levels and reduced welfare arrangements. It is assumed, therefore, to have followed similar trends of increasing residential segregation between income groups. This study focuses on the metropolitan area of Tel-Aviv, Israel’s financial and cultural centre and examines the change in the spatial distribution of income groups between the years 1995–2008. It identifies trends in segregation between top and bottom income earners, as well as those between other income groups, given corresponding trends in income inequality. In addition, it examines spatial patterns of affluence and poverty concentration and assesses the influence of concentrated disadvantage among specific income and religious groups on overall segregation trends.
Making Sense of Segregation in a Well-Connected City: The Case of Berlin
Authors: Blokland Talja , Vief Robert
Published: March 2021

This chapter analyses socioeconomic segregation and segregation by migration background for Berlin, Germany. Berlin’s history of division and reunification affected suburbanization patterns and the unequal economic restructuring of the city over time. Within this historical context, we present our empirical results on segregation, and we reflect on the implications of segregation for the daily use of the city. Arguments that segregation affects access to amenities (as in the literature on ‘food deserts’) or reduces access to jobs (as in spatial mismatch theories) are not so useful for Berlin with its strong public transport infrastructure. We find that socioeconomic segregation was moderate and stable for the working-age population between 2007 and 2016, whereas segregation of poor children increased. At the same time, segregation of foreigners and segregation by migration background strongly declined. And yet, even though segregation levels are low and public services are present everywhere, the social use of the city, we argue, may be more segregated than statistical indicators suggest. Drawing on various case studies, we suggest that the use of the overall city reflects segregation patterns of the use of space for other reasons than commonly suggested.
Income Inequality and Segregation in the Paris Metro Area (1990–2015)
Authors: McAvay Haley , Verdugo Gregory
Published: March 2021

In the last decades, the Paris metro area has experienced important structural changes linked to rising income inequality and a rapidly growing immigrant population. Using census data from 1990, 1999 to 2015, this chapter explores these transformations and how they have shaped trends in residential segregation. We find that the occupational structure of the area shifted upwards in the recent decade with a substantial increase in the share of the top occupational groups. This trend, however, did not primarily concern the immigrant population, which nonetheless experienced a growth in the middle class. These trends were further accompanied by an increase in income inequality driven by rising wages among the top 1% earners. Despite these changes, dissimilarity indexes between socioeconomic groups and between natives and immigrants have remained quite stable over the period. However, interaction indexes suggest that neighbourhoods are becoming more homogenous over time, both in terms of socioeconomic and ethnic diversity. Finally, the findings shed light on the correlation between socioeconomic and immigrant segregation. Socioeconomic disadvantage and the presence of immigrants within neighbourhoods, especially of non-European origin, are tightly correlated, and that correlation became stronger over time.
Income Inequality and Economic Segregation in Los Angeles from 1980 to 2010
Authors: Hipp John R. , Kim Jae Hong
Published: March 2021

Rising income inequality is a critical problem in both the global North and South. In the United States, the Gini coefficient measuring nationwide income inequality rose from 0.403 in 1980 to 0.480 in 2014 (US Census), and residential segregation by income has increasingly occurred in many metropolitan regions and is particularly reflected in the spatial separation of the wealthiest households. This chapter focuses on the change in the level of income inequality in the Los Angeles region since 1980 and how it is related to changes in residential segregation between economic groups over that same time period. We use data from the US Census collected in 1980, 1990, 2000, and 2010. We measure residential segregation between economic groups based on occupational structure, and measure ‘neighbourhoods’ using Census tracts: these are units defined by the US Census and typically average about 4,000 residents. The overall level of inequality in the region is measured at each decade point using the Gini coefficient for household income. Maps demonstrate where different socioeconomic status groups have tended to locate and how economic segregation has changed in Los Angeles over this time period. We also assess the extent to which changes in inequality are related to changes in economic segregation over the last four and a half decades.
Socioeconomic Segregation in Mexico City: Scale, Social Classes, and the Primate City
Authors: Monkkonen Paavo , Paloma Giottonini M. , Comandon Andre
Published: March 2021

Mexico City is known as one of the largest cities in the world and thought by many to be one of the most unequal. Not surprisingly, it has received more attention than other Mexican urban areas. However, the city’s internal social organization is often misunderstood. Mexico City stands out as a city where segregation is relatively low, and levels of inequality are actually lower than perceptions. Moreover, between 1990 and 2010, both segregation and inequality have declined. This chapter examines these changes. We report on changes in occupational structure and patterns of segregation by educational level. Educational level is different from income or occupation, but these three dimensions of socioeconomic conditions are closely linked. While the overall level of segregation between educational groups in the city has slightly decreased, residential patterns of educational groups have changed significantly. The number of neighborhoods with high concentrations of highly educated people increased significantly and expanded geographically. At the same time, the prevalence of neighborhoods with residents with low and middle educational attainment has diminished and neighborhoods that house people of all educational categories or high and middle categories are more numerous. This chapter illustrates the complexity of segregation patterns in such a large metropolitan area, as well as the challenges of determining why patterns have changed.
Social Polarization and Socioeconomic Segregation in Shanghai, China: Evidence from 2000 and 2010 Censuses
Authors: Pan Zhuolin , Liu Ye , Xiao Yang , Li Zhigang
Published: March 2021

China’s rapid economic growth since the early 1980s has been accompanied by a substantial increase in economic inequality. Economic restructuring, rural–urban migration, globalization and marketization have jointly led to a transformation of the socio-spatial structure of large Chinese cities. Although a handful of studies have examined the level and pattern of socioeconomic segregation in a particular Chinese city using neighbourhood-level census data from the year 2000, little research has been done to investigate in-depth changes in the level and pattern of segregation using more up to date and more geographically detailed data. This chapter aims to examine the levels, patterns and drivers of socioeconomic segregation in Shanghai, China, using neighbourhood-level and subdistrict-level data from the 2000 and 2010 decennial population census. This chapter uses the dissimilarity index to measure the overall level of socioeconomic segregation by occupation and household registration (hukou) status. Based on a location quotient and neighbourhood composition, it also illustrates the change in the spatial pattern of segregation. The chapter ends with a discussion on the possible drivers of segregation and policy suggestions to combat segregation in large Chinese cities.
Subprefects: (Trans)Regional Tools of Integration?
Authors: van der Burg Martijn
Published: March 2021

This chapter examines the Napoleonic subprefects who have been in office in the Netherlands and Northwest Germany. Within the prefectoral system, these sous-préfets were the highest officials at arrondissement (disctrict) level. Activities of subprefects, somewhat neglected by historians, give insight into how French tried to rally the locals, and how this affected the daily functioning of the Empire. Discussed are subprefects’ sociocultural backgrounds, imperial careers, and perception of Napoleonic governance. Subprefects had to balance national, local, and personal interest. Integration at district level was hard when the letter of the administrative legislation and the precise instructions from above were rigidly adhered to. Subprefects traveling the Empire linked events in the Netherlands and Northwest Germany to developments elsewhere, promoting integration into the Empire. Circulation patterns reflect different ideas on the required level of integration. It is argued that the figure of the subprefect was a potential ‘tool of integration’. That subprefects were close to the ground could contributed to the effectiveness of Napoleonic governance. But subprefects also coped with demanding prefects, and interference of other agents of the central state. Reversely, unwilling subprefects were in a position to hinder the integration process.
Trends in method-specific suicide in Brazil from 2000 to 2017
Authors: McDonald Keltie , Machado Daiane Borges , Castro-de-Araujo Luís F. S. , Kiss Lígia , Palfreyman Alexis , Barreto Maurício L. , Devakumar Delanjathan , Lewis Glyn
Published: March 2021

Purpose

Understanding long-term patterns of suicide methods can inform public health policy and prevention strategies. In Brazil, firearm-related policies may be one salient target for suicide prevention. This study describes trends in method-specific suicide at the national and state-levels in Brazil, with a particular focus on firearm-related suicides.

Methods

Brazilian mortality data for suicide and undetermined intent among people aged 10 years and older between 2000 and 2017 were obtained from the National Mortality Information System. We examined national and state-level trends in age-standardised suicide rates for hanging, self-poisoning, firearms, jumping from a high place, other, and unspecified methods. We also compared total rates of mortality from suicide and undetermined intent over the period. Applying Joinpoint regression, we tested changes in trends of firearm-specific suicide rates.

Results

The total suicide rate increased between 2000 and 2017. Rates of hanging, self-poisoning by drugs or alcohol and jumping from a high place showed the largest increases, while firearm-specific suicide rates decreased over the study period. Trends in methods of suicide varied by sex and state.

Conclusion

It is of public health concern that suicide rates in Brazil have risen this millennium. Restricting access to firearms might be an effective approach for reducing firearm-specific suicides, especially in states where firearm availability remains particularly high. Treatment and management of substance misuse may also be an important target for suicide prevention policies. More work is needed to understand the causes of rising suicide rates in Brazil and to improve the mental health of the population.
Experiences, knowledge of functions, and social acceptance of robots: an exploratory case study focusing on Japan
Authors: Nomura Tatsuya , Tanaka Motoharu
Published: March 2021

Although Japanese society has become aware of some types of robots, social acceptance of robots is still not widespread. This study conducted an online questionnaire survey to investigate the relationships between experiences with and knowledge of vacuum, pet-type, and communication robots and acceptance of these robots, including the intention to use and trust. The results suggested that experiences with, knowledge of functions, and acceptance of the robots differed depending on the type of robot, and the influence of these factors on acceptance of the robots also differed depending on the robot types.
Computational analysis of an infinite magneto-thermoelastic solid periodically dispersed with varying heat flow based on non-local Moore–Gibson–Thompson approach
Authors: Abouelregal Ahmed E. , Mohammad-Sedighi Hamid , Shirazi Ali H. , Malikan Mohammad , Eremeyev Victor A.
Published: March 2021

In this investigation, a computational analysis is conducted to study a magneto-thermoelastic problem for an isotropic perfectly conducting half-space medium. The medium is subjected to a periodic heat flow in the presence of a continuous longitude magnetic field. Based on Moore–Gibson–Thompson equation, a new generalized model has been investigated to address the considered problem. The introduced model can be formulated by combining the Green–Naghdi Type III and Lord–Shulman models. Eringen’s non-local theory has also been applied to demonstrate the effect of thermoelastic materials which depends on small scale. Some special cases as well as previous thermoelasticity models are deduced from the presented approach. In the domain of the Laplace transform, the system of equations is expressed and the problem is solved using state space method. The converted physical expressions are numerically reversed by Zakian’s computational algorithm. The analysis indicates the significant influence on field variables of non-local modulus and magnetic field with larger values. Moreover, with the established literature, the numerical results are satisfactorily examined.
Comparison of yield, chemical composition and farinograph properties of common and ancient wheat grains
Authors: Biel Wioletta , Jaroszewska Anna , Stankowski Sławomir , Sobolewska Magdalena , Kępińska-Pacelik Jagoda
Published: March 2021

The chemical composition of 4 spring wheat species was analyzed: einkorn (Triticum monococcum) (local cv.), emmer (Triticum dicoccon) (Lamella cv.), spelt (Triticum spelta) (Wirtas cv.), and common wheat (Triticum aestivum) (Rospuda cv.). Mean emmer and einkorn yield was significantly lower than that of common wheat. The analyses of the wheat grain included the content of total protein, crude ash, crude fat, crude fibre, carbohydrates, phosphorus, potassium, magnesium, calcium, copper, iron, manganese, and zinc. The grains of the tested ancient wheats were richer in protein, lipids, crude fibre, and crude ash than the common wheat grains. The significantly highest levels of crude protein, ether extract, and crude ash were found in einkorn. As the protein concentration in the grain increased, the calcium, magnesium, and potassium levels increased, and the zinc and manganese levels decreased. Genotypic differences between the studied wheats were reflected in the concentrations of the minerals and nutrients, an observation which can be useful in further cross-linkage studies. Dough made from common wheat and spelt flour showed better performance quality classifying it to be used for bread production. In turn, flour from emmer and einkorn wheat may be intended for pastry products, due to short dough development time and constancy as well as high softening.
When two worlds collide: the influence of an obstacle in peripersonal space on multisensory encoding
Authors: Menger Rudmer , De Haan Alyanne M. , Van der Stigchel Stefan , Dijkerman H. Chris
Published: March 2021

Multisensory coding of the space surrounding our body, the peripersonal space, is crucial for motor control. Recently, it has been proposed that an important function of multisensory coding is that it allows anticipation of the tactile consequences of contact with a nearby object. Indeed, performing goal-directed actions (i.e. pointing and grasping) induces a continuous visuotactile remapping as a function of on-line sensorimotor requirements. Here, we investigated whether visuotactile remapping can be induced by obstacles, e.g. objects that are not the target of the grasping movement. In the current experiment, we used a cross-modal obstacle avoidance paradigm, in which participants reached past an obstacle to grasp a second object. Participants indicated the location of tactile targets delivered to the hand during the grasping movement, while a visual cue was sometimes presented simultaneously on the to-be-avoided object. The tactile and visual stimulation was triggered when the reaching hand passed a position that was drawn randomly from a continuous set of predetermined locations (between 0 and 200 mm depth at 5 mm intervals). We observed differences in visuotactile interaction during obstacle avoidance dependent on the location of the stimulation trigger: visual interference was enhanced for tactile stimulation that occurred when the hand was near the to-be-avoided object. We show that to-be-avoided obstacles, which are relevant for action but are not to-be-interacted with (as the terminus of an action), automatically evoke the tactile consequences of interaction. This shows that visuotactile remapping extends to obstacle avoidance and that this process is flexible.
Radioembolization versus portal vein embolization for contralateral liver lobe hypertrophy: effect of cirrhosis
Authors: Nebelung Heiner , Wolf Thomas , Bund Sebastian , Radosa Christoph Georg , Plodeck Verena , Grosche-Schlee Sabine , Riediger Carina , Hoffmann Ralf-Thorsten , Kühn Jens-Peter
Published: March 2021

Purpose

Preoperative hypertrophy induction of future liver remnant (FLR) reduces the risk of postoperative liver insufficiency after partial hepatectomy. One of the most commonly used methods to induce hypertrophy of FLR is portal vein embolization (PVE). Recent studies have shown that transarterial radioembolization (TARE) also induces hypertrophy of the contralateral liver lobe. The aim of our study was to evaluate contralateral hypertrophy after TARE versus after PVE taking into account the effect of cirrhosis.

Methods

Forty-nine patients undergoing PVE before hemihepatectomy and 24 patients with TARE as palliative treatment for liver malignancy were retrospectively included. Semi-automated volumetry of the FLR/contralateral liver lobe before and after intervention (20 to 65 days) was performed on CT or MRI, and the relative increase in volume was calculated. Cirrhosis was evaluated independently by two radiologists on CT/MRI, and interrater reliability was calculated.

Results

Hypertrophy after PVE was significantly more pronounced than after TARE (25.3% vs. 7.4%; p < 0.001). In the subgroup of patients without cirrhosis, the difference was also statistically significant (25.9% vs. 8.6%; p = 0.002), whereas in patients with cirrhosis, the difference was not statistically significant (18.2% vs. 7.4%; p = 0.212). After PVE, hypertrophy in patients without cirrhosis was more pronounced than in patients with cirrhosis (25.9% vs. 18.2%; p = 0.203), while after TARE, hypertrophy was comparable in patients with and without cirrhosis (7.4% vs. 8.6%; p = 0.928).

Conclusion

TARE induces less pronounced hypertrophy of the FLR compared to PVE. Cirrhosis seems to be less of a limiting factor for hypertrophy after TARE, compared to PVE.

Graphic abstract
Distinct genomic features across cytolytic subgroups in skin melanoma
Authors: Roufas Constantinos , Georgakopoulos-Soares Ilias , Zaravinos Apostolos
Published: March 2021

Background

Skin melanoma is a highly immunogenic cancer. The intratumoral immune cytolytic activity (CYT) reflects the ability of cytotoxic T and NK cells to eliminate cancer cells, and is associated with improved patient survival. Despite the enthusiastic clinical results seen in advanced-stage metastatic melanoma patients treated with immune checkpoint inhibitors, a subgroup of them will later relapse and develop acquired resistance. We questioned whether CYT associates with different genomic profiles and thus, patient outcome, in skin melanoma.

Methods

We explored the TCGA-SKCM dataset and stratified patients to distinct subgroups of cytolytic activity. The tumor immune contexture, somatic mutations and recurrent copy number aberrations were calculated using quanTIseq, MutSigCV and GISTIC2. Chromothriptic events were explored using CTLPScanner and cancer neoepitopes were predicted with antigen garnish. Each tumor's immunophenoscore was calculated using Immunophenogram. Mutational signatures and kataegis were explored using SigProfiler and compared to the known single or doublet base substitution signatures from COSMIC.

Results

Metastatic skin melanomas had significantly higher CYT levels compared to primary tumors. We assessed enrichment for immune-related gene sets within CYT-high tumors, whereas, CYT-low tumors were enriched for non-immune related gene sets. In addition, distinct mutational and neoantigen loads, primarily composed of C > T transitions, along with specific types of copy number aberrations, characterized each cytolytic subgroup. We found a broader pattern of chromothripsis across CYT-low tumors, where chromosomal regions harboring chromothriptic events, contained a higher number of cancer genes. SBS7a/b, SBS5 and SBS1 were the most prevalent mutational signatures across both cytolytic subgroups, but SBS1 differed significantly between them. SBS7a/b was mutually exclusive with SBS5 and SBS1 in both CYT subgroups. CYT-high patients had markedly higher immunophenoscore, suggesting that they should display a clinical benefit upon treatment with immune checkpoint inhibition therapy, compared to CYT-low patients.

Conclusions

Overall, our data highlight the existence of distinct genomic features across cytolytic subgroups in skin melanoma, which might affect the patients' relapse rate or their acquisition of resistance to immune checkpoint inhibition therapies.
Simultaneous Casualty Admissions—Do they Affect Treatment in the Receiving Trauma Center?
Authors: Teuben Michel Paul Johan , Mand Carsten , Moosdorf Laura , Sprengel Kai , Shehu Alba , Pfeifer Roman , Ruchholtz Steffen , Lefering Rolf , Pape Hans‐Christoph , Jensen Kai Oliver
Published: March 2021

Background

Simultaneous trauma admissions expose medical professionals to increased workload. The impact of simultaneous trauma admissions on hospital allocation, therapy, and outcome is currently unclear. We hypothesized that multiple admission‐scenarios impact the diagnostic pathway and outcome.

Methods

The TraumaRegister DGU® was utilized. Patients admitted between 2002–2015 with an ISS ≥ 9, treated with ATLS®‐ algorithms were included. Group ´IND´ included individual admissions, two individuals that were admitted within 60 min of each other were selected for group ´MULT´. Patients admitted within 10 min were considered as simultaneous (´SIM´) admissions. We compared patient and trauma characteristics, treatment, and outcomes between both groups.

Results

132,382 admissions were included, and 4,462/3.4% MULTiple admissions were found. The SIM‐group contained 1,686/1.3% patients. The overall median injury severity score was 17 and a mean age of 48 years was found. MULT patients were more frequently admitted to level‐one trauma centers (68%) than individual trauma admissions were (58%, p < 0.001). Mean time to CT‐scanning (24 vs. 26/28 min) was longer in MULT / SIM patients compared to individual admissions. No differences in utilization of damage control principles were seen. Moreover, mortality rates did not differ between the groups (13.1% in regular admissions and 11.4%/10,6% in MULT/SIM patients).

Conclusion

This study demonstrates that simultaneous treatment of injured patients is rare. Individuals treated in parallel with other patients were more often admitted to level‐one trauma centers compared with individual patients. Although diagnostics take longer, treatment principles and mortality are equal in individual admissions and simultaneously admitted patients. More studies are required to optimize health care under these conditions.
Ergebnisse der filtrierenden Trabekulotomie (FTO) im Vergleich zur konventionellen Trabekulektomie (TE) – eine gematchte Fall-Kontroll-Studie
Authors: Glatzel Caroline Maria , Patzkó Ágnes , Matlach Juliane , Grehn Franz
Published: March 2021

Ziel

Ziel dieser Studie war es, die 2‑Jahres-Ergebnisse der filtrierenden Trabekulotomie (FTO) im Vergleich zur konventionellen Trabekulektomie (TE) bei primärem Offenwinkelglaukom, Pseudoexfoliationsglaukom und Pigmentglaukom zu untersuchen.

Patienten und Methoden

Es wurden 30 konsekutive Patienten nach FTO und 87 Patienten nach TE nach intraokularem Druck (IOD) und Alter im Verhältnis 1:3 gematcht. Primärer Endpunkt war das Erreichen des Zieldrucks nach 2 Jahren. Als vollständiger Erfolg wurde ein IOD ohne Medikamente von ≤ 18 mm Hg bei gleichzeitiger IOD-Reduktion um ≥ 30 % definiert, als qualifizierter Erfolg, wenn hierfür zusätzlich Medikamente erforderlich waren. Sekundäre Endpunkte waren mittlere Drucksenkung, resultierende Sehschärfe, Komplikationen und nachfolgende Operationen. Die Operationstechnik der filtrierenden Trabekulotomie ist als Video zu diesem Beitrag abrufbar.

Ergebnisse

Zwei-Jahres-Daten konnten von 27 Patienten aus der FTO-Gruppe und 68 Patienten aus der TE-Gruppe erhoben werden. Die Patienten beider Gruppen wurden vor Beginn der Studie bezüglich Alter und IOD gematcht, waren aber auch bezüglich Sehschärfe, Geschlecht und Medikation nicht unterschiedlich. Der Median des präoperativen IOD unter Therapie betrug in beiden Gruppen 23,0 mm Hg. Nach den oben genannten Kriterien wurde ein qualifizierter 2‑Jahres-Erfolg bei 70,4 % der FTO-Gruppe und bei 77,6 % der TE-Gruppe erzielt (p = 0,60), ein vollständiger 2‑Jahres-Erfolg bei 33,3 % der FTO-Gruppe und bei 56,7 % der TE-Gruppe (p = 0,07). Beide Operationsmethoden senkten den Augeninnendruck nach 24 Monaten signifikant (p < 0,001), und zwar auf 12,8 mm Hg in der FTO-Gruppe und 11,0 mm Hg in der TE-Gruppe. Die Sehschärfe war postoperativ bei beiden Gruppen etwas verringert, unterschied sich jedoch nicht signifikant zwischen beiden Gruppen. Komplikations- und Reoperationsrate waren gering und unterschieden sich nicht zwischen den Gruppen.

Schlussfolgerung

FTO und TE sind nach 2 Jahren weitgehend gleichwertig bezüglich Zieldruck, IOD-Senkung, Sehschärfe und Komplikationen.
Meningeal inflammation in multiple sclerosis induces phenotypic changes in cortical microglia that differentially associate with neurodegeneration
Authors: van Olst Lynn , Rodriguez-Mogeda Carla , Picon Carmen , Kiljan Svenja , James Rachel E. , Kamermans Alwin , van der Pol Susanne M. A. , Knoop Lydian , Michailidou Iliana , Drost Evelien , Franssen Marc , Schenk Geert J. , Geurts Jeroen J. G. , Amor Sandra , Mazarakis Nicholas D. , van Horssen Jack , de Vries Helga E. , Reynolds Richard , Witte Maarten E.
Published: March 2021

Meningeal inflammation strongly associates with demyelination and neuronal loss in the underlying cortex of progressive MS patients, thereby contributing significantly to clinical disability. However, the pathological mechanisms of meningeal inflammation-induced cortical pathology are still largely elusive. By extensive analysis of cortical microglia in post-mortem progressive MS tissue, we identified cortical areas with two MS-specific microglial populations, termed MS1 and MS2 cortex. The microglial population in MS1 cortex was characterized by a higher density and increased expression of the activation markers HLA class II and CD68, whereas microglia in MS2 cortex showed increased morphological complexity and loss of P2Y12 and TMEM119 expression. Interestingly, both populations associated with inflammation of the overlying meninges and were time-dependently replicated in an in vivo rat model for progressive MS-like chronic meningeal inflammation. In this recently developed animal model, cortical microglia at 1-month post-induction of experimental meningeal inflammation resembled microglia in MS1 cortex, and microglia at 2 months post-induction acquired a MS2-like phenotype. Furthermore, we observed that MS1 microglia in both MS cortex and the animal model were found closely apposing neuronal cell bodies and to mediate pre-synaptic displacement and phagocytosis, which coincided with a relative sparing of neurons. In contrast, microglia in MS2 cortex were not involved in these synaptic alterations, but instead associated with substantial neuronal loss. Taken together, our results show that in response to meningeal inflammation, microglia acquire two distinct phenotypes that differentially associate with neurodegeneration in the progressive MS cortex. Furthermore, our in vivo data suggests that microglia initially protect neurons from meningeal inflammation-induced cell death by removing pre-synapses from the neuronal soma, but eventually lose these protective properties contributing to neuronal loss.
Reliability and clinical applicability of a novel tear film imaging tool
Authors: Tóth Noémi , Szalai Eszter , Rák Tibor , Lillik Veronika , Nagy Attila , Csutak Adrienne
Published: March 2021

Purpose

The aim of our research was to investigate the reliability and clinical applicability of a modern tear film imaging tool by comparing the inter- and intragrader difference. The further goal was to compare the non-invasive tear break-up time (NIBUT) measured with the LacryDiag® device with traditional tear film break-up time (TBUT).

Methods

Comprehensive ophthalmological examination was performed, including LacryDiag® (Quantel Medical, France) (lower tear meniscus height measuring (LTMH), superior and inferior eyelid meibography (MeibS MeibI), interferometry (INT), NIBUT), slit lamp examination, and TBUT. Two independent, well-trained graders selected and analyzed the LTMH, MeibI, MeibS, and INT. The second grader reanalyzed the data 1 month later. Intra- and inter-examiner reliabilities were evaluated using intraclass correlation coefficients (ICC), while for categorical variable, Cohen’s kappa statistics were provided. The Bland-Altman plot was used for visualization of the agreement between measurements.

Results

Fifty healthy volunteers were examined. For LTMH both the inter- and intragrader variabilities were excellent. Between two graders, the ICC of MeibI was poor; however, between two graders, the ICC of MeibS was good, and the intragrader variability in MeibI and MeibS was excellent. For the INT, both intra- and intergrading were in fair and moderate agreement, although the intragrader agreement was higher. Comparing the NIBUT and TBUT, the agreement was slight.

Conclusion

Based on our results, examination of a patient during follow-up should be performed by the same examiner, because of the slight agreement. The LacryDiag® is a non-invasive, easy-to-use device, which can examine the tear film and save the recordings for easier follow-up.
Gender composition in occupations and branches and medically certified sick leave: a prospective population study
Authors: Lidwall Ulrik
Published: March 2021

Objective

To investigate whether gender-segregated occupations and branches are associated with future medically certified sick leave for women and men.

Methods

All gainfully employed residents in Sweden in December 31st 2014 aged 16–69 years (n = 4 473 964) were identified in national registers. Subjects working in segregated (61–90%) and extremely segregated (> 90%) occupations and branches were evaluated v/s subjects in gender-integrated occupations and branches (40–60%). Combinations of segregation by occupation and branch were also investigated. Two-year prospective medically certified sick leaves (> 14 days) were evaluated using logistic regression with odds ratios recalculated to relative risks (RR), adjusted for work, demographic and health related factors.

Results

The sick leave risk was higher for those working in extremely female-dominated occupations (women RR 1.06 and men RR 1.13), and in extremely female-dominated branches (women RR 1.09 and men RR 1.12), and for men in extremely male-dominated branches (RR 1.04). The sick leave risk was also higher for both women and men in female-dominated occupations regardless of the gender segregation in the branch they were working in. However, the differences in sick leave risks associated with gender segregation were considerably smaller than the differences between occupations and branches in general.

Conclusions

Gender segregation in occupations and branches play a role for sick leave among women and men, especially within extremely female-dominated occupations and branches. However, gender segregation appears to be subordinate to particular occupational hazards faced in diverse occupations and branches.
From dyad to triad: a survey on fathers’ knowledge and attitudes toward breastfeeding
Authors: Crippa Beatrice Letizia , Consales Alessandra , Morniroli Daniela , Lunetto Flavia , Bettinelli Maria Enrica , Sannino Patrizio , Rampini Serena , Zanotta Lidia , Marchisio Paola , Plevani Laura , Giannì Maria Lorella , Mosca Fabio , Colombo Lorenzo
Published: March 2021

Fathers are known to impact breastfeeding outcomes. We aimed to explore paternal knowledge and attitude toward breastfeeding, and possible association with breastfeeding rates at discharge. In this cross-sectional study, we enrolled 200 fathers of healthy term neonates. At discharge, fathers were asked to rate their degree of agreement to 12 items on a 5-point Likert scale. A total score was obtained from their answers. Univariate binary logistic regression analysis was used to verify if the total score was predictive of exclusive breastfeeding at discharge. A multivariable logistic regression model was then used to adjust for possible confounders. ROC analysis was performed, and a Youden’s total score cut-off value was determined to define total score’s performance in predicting exclusive breastfeeding at discharge. Fathers showed a solid knowledge of maternal (87%) and neonatal (98%) benefits of breastfeeding, skin-to-skin (99.5%), rooming-in (79%), and responsive feeding (67.5%); conversely, only 51% knew about the recommended use of pacifiers. Fathers felt personally involved in babies’ feeding in 79% of cases. An association was found between total score and exclusive breastfeeding at discharge at univariate (OR: 1.07, p = 0.04) but not at multivariable analysis (OR: 1.07, p = 0.067). ROC analysis was not statistically significant (AUC 0.58, p = 0.083).

Conclusion: By using a novel instrument aimed at quantifying fathers’ knowledge and overall attitude toward breastfeeding, this study underlines the importance of including fathers in the promotion of breastfeeding. Expanding the classic mother-baby dyad to a more modern mother-father-baby triad may impact breastfeeding outcomes at discharge.

What is known:• Social support plays a major role in improving breastfeeding outcomes.• Fathers may greatly influence initiation and duration of breastfeeding; the more they know, the more helpful they can be.What is new:• A multidisciplinary team created a structured questionnaire aimed at quantifying fathers’ knowledge and attitude toward breastfeeding.• The association between a higher questionnaire total score and exclusive breastfeeding rates at discharge highlights the importance of including fathers in the promotion of breastfeeding, as part of the breastfeeding team.
Mapping and anatomo-surgical techniques for SMA-cingulum-corpus callosum gliomas; how I do it
Authors: Klitsinikos Dimitris , Ekert Justyna O. , Carels Annefloor , Samandouras George
Published: March 2021

Background

Awake brain mapping paradigms are variable, particularly in SMA, and not personalised to each patient. In addition, subpial resections do not offer full protection to vascular injury, as the pia can be easily violated.

Methods

Mapping paradigms developed by a multidisciplinary brain mapping team. During resection, a combined subpial/interhemispheric approach allowed early identification and arterial skeletonization. Precise anatomo-surgical dissection of the affected cingulum and corpus callosum was achieved.

Conclusions

In SMA-cingulum-CC tumours, a combined subpial/interhemispheric approach reduces risk of vascular injury allowing precise anatomo-surgical dissections. Knowledge of cognitive functions of affected parcels is likely to offer best outcomes.
How is neck dissection performed in Oral and Maxillofacial Surgery? Results of a representative nationwide survey among university and non-university hospitals in Germany
Authors: Pabst Andreas , Thiem Daniel G. E. , Goetze Elisabeth , Bartella Alexander K. , Neuhaus Michael T. , Hoffmann Jürgen , Zeller Alexander-N.
Published: March 2021

Introduction

Neck dissection (ND) is a surgical procedure addressing cervical lymph nodes and metastases in patients with oral squamous cell carcinoma (OSCC). The aim of this study was to analyze clinical decisions regarding indications and variations of ND in Oral and Maxillofacial Surgery (OMFS) in Germany.

Material and methods

A nationwide survey of the German Association of Oral and Maxillofacial Surgery was performed using dynamic online questionnaires including 38 questions. Data about oncological centers, case numbers, and staging procedures were collected. Relevant aspects, such as inclusion of level IIb and levels IV and V to ND, uni- vs. bilateral ND, and the influence of extra-nodal extension (ENE) of metastases on extension of ND were evaluated.

Results

Eighty-four OMFS of university and non-university hospitals participated in the study (responding rate 21.4%). Sixty-six (78.57%) stated to work at certified cancer centers and 53.57% of the hospitals treated between 50 and 100 OSCC cases per year. CT and/or MRI of the head and neck was performed in most of the staging procedures. Level IIb was included by 71 (93.42%) of the participants in selective ND. Levels IV and V were included by 53 (69.74%) in node-positive neck. In solitary ipsilateral metastases (ENE−), 49 participants (62.82%) stated to perform exclusively an ipsilateral ND and 40 (51.95%) stated to perform only an ipsilateral ND in ENE+.

Conclusion

This study demonstrated a high rate of certified cancer centers in Germany showing differences regarding staging procedures, indications, and extension of ND, especially in increasingly complex cases.

Clinical relevance

Clinical decisions regarding ND are dependent on case-individual aspects and must be decided individually.