bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of progesterone receptor status on response to neoadjuvant chemotherapy in estrogen receptor‐positive breast cancer patients
Authors: Boland Michael R. , Ryan Éanna J. , Nugent Timothy , Gilroy Darina , Kelly Michael E. , Kennedy John , Maguire Aoife , Alazawi Dhafir , Boyle Terence J. , Connolly Elizabeth M.
Published: July 2020

Introduction

Breast cancer patients respond differently to neoadjuvant chemotherapy(NAC) based on receptor subtype. The aim of this study was to assess the impact of progesterone receptor (PgR) status on response to neoadjuvant chemotherapy (NAC) in estrogen receptor (ER)+, human epidermal growth factor receptor (HER)− breast cancer patients.

Methods

ER+ and HER− patients receiving NAC over a 7‐year period (2011‐2017) were identified. The primary outcome was breast complete pathological response (pCR) rate. Secondary outcomes included axillary pCR, axillary/breast pCR and complete radiological response (cRR).

Results

A total of 203 patients were identified (149 in the ER+, PgR+, and HER− group and 54 in the ER+, PgR−, and HER− group). Compared with the PgR+ group, PgR− patients were significantly associated with breast pCR (31.5% vs 7.4%; χ² test; P < .01). In multivariable analysis, PgR− status (odds ratio [OR], 4.58; 95% confidence interval [CI]: 1.58,13.28; P = .005), radiological size >50 mm (OR, 5.38; 95% CI: 1.07,27.04; P = .04) and grade (OR, 3.52;95% CI: 1.21,10.23;P = .02) were significant predictors of breast pCR. Only PgR‐ status was a significant predictor of cRR (OR, 6.234; 95% CI: 2.531, 15.355; P < .001). In node positive patients, PgR negativity was associated with a trend towards breast/axillary nodal pCR (22% vs 12.7%; χ² test; P = .055).

Conclusion

Over 30% of ER+, PgR−, and HER− patients will have a breast pCR after NAC. PgR− is the only significant predictor of breast pCR/cRR in this tumor subtype. ER+, PgR−, and HER− patients should be considered for NAC.
Debate on Selection Criteria for Liver Transplantation for Alcoholic Hepatitis: Tighten or Loosen?
Authors: Im Gene Y. , Neuberger James
Published: July 2020

Although liver transplantation (LT) for alcohol‐associated liver disease (ALD) is a well‐accepted practice, LT for severe alcoholic hepatitis (AH) remains controversial due to concerns about the limited organ supply and the risk of return to harmful drinking. Recognizing an increasing body of favorable evidence, a convergence of practice guideline recommendations from leading hepatology and gastroenterology societies have suggested that the length of abstinence should not be a sole criterion for LT selection and, thus, that LT may be considered in carefully selected severe AH patients with favorable psychosocial profiles not responding to medical therapy. We sought to examine this new consensus in greater detail, debating whether candidate selection criteria for LT in AH should be tightened or loosened.
Stability, the NIP, and the NSOP: model theoretic properties of formulas via topological properties of function spaces
Authors: Khanaki Karim
Published: July 2020

We study and characterize stability, the negation of the independence property (NIP) and the negation of the strict order property (NSOP) in terms of topological and measure theoretical properties of classes of functions. We study a measure theoretic property, Talagrand's stability, and explain the relationship between this property and the NIP in continuous logic. Using a result of Bourgain, Fremlin, and Talagrand, we prove almost definability and Baire 1 definability of coheirs assuming the NIP. We show that a formula has the strict order property if and only if there is a convergent sequence of continuous functions on the space of φ‐types such that its limit is not continuous. We deduce from this a theorem of Shelah and point out the correspondence between this theorem and the Eberlein‐Šmulian theorem.
Determining the best candidates for next‐generation sequencing‐based gene panel for evaluation of early‐onset epilepsy
Authors: Lee Jiwon , Lee Chung , Ki Chang‐Seok , Lee Jeehun
Published: July 2020

Background

Genetic testing is an emerging diagnostic approach in early‐onset epilepsy. Identification of the heterogeneous genetic causes of epilepsy may mitigate unnecessary evaluations and allow more accurate diagnosis and therapy. We aimed to uncover genetic causes of early‐onset epilepsy using next‐generation sequencing (NGS) to elucidate the diagnostic candidates and evaluate the diagnostic yield of targeted gene panel testing.

Methods

We evaluated 116 patients with early‐onset epilepsy developed before 2 years old and normal brain imaging using a NGS‐based targeted gene panel. Variants were classified according to their pathogenicity, and the diagnostic yield of the targeted genes and associated clinical factors were determined.

Results

We detected 40 disease‐causing variants with diagnostic yield of 34.5% (19 pathogenic, 21 likely pathogenic). Twelve variants were novel. The most commonly detected genes were SCN1A, associated with Dravet syndrome, and PRRT2, associated with benign familial infantile epilepsy. Other variants were identified in ARX, SCN2A, KCNQ2, PCDH19, STXBP1, DEPDC5, and SCN8A. The age of seizure onset and family history were associated with disease‐causing variants.

Conclusion

Next‐generation sequencing‐based targeted testing is an effective diagnostic test, with 30%–40% comparable diagnostic yield. Patients with earlier seizure onset and family history of epilepsy were the best candidates for testing. For pediatric patients with early‐onset epilepsy, genetic diagnosis is important for accurate prognosis and treatment.
Repeatability of radiomic features in magnetic resonance imaging of glioblastoma: Test–retest and image registration analyses
Authors: Shiri Isaac , Hajianfar Ghasem , Sohrabi Ahmad , Abdollahi Hamid , P. Shayesteh Sajad , Geramifar Parham , Zaidi Habib , Oveisi Mehrdad , Rahmim Arman
Published: July 2020

Purpose

To assess the repeatability of radiomic features in magnetic resonance (MR) imaging of glioblastoma (GBM) tumors with respect to test–retest, different image registration approaches and inhomogeneity bias field correction.

Methods

We analyzed MR images of 17 GBM patients including T1‐ and T2‐weighted images (performed within the same imaging unit on two consecutive days). For image segmentation, we used a comprehensive segmentation approach including entire tumor, active area of tumor, necrotic regions in T1‐weighted images, and edema regions in T2‐weighted images (test studies only; registration to retest studies is discussed next). Analysis included N3, N4 as well as no bias correction performed on raw MR images. We evaluated 20 image registration approaches, generated by cross‐combination of four transformation and five cost function methods. In total, 714 images (17 patients × 2 images × ((4 transformations × 5 cost functions) + 1 test image) and 2856 segmentations (714 images × 4 segmentations) were prepared for feature extraction. Various radiomic features were extracted, including the use of preprocessing filters, specifically wavelet (WAV) and Laplacian of Gaussian (LOG), as well as discretization into fixed bin width and fixed bin count (16, 32, 64, 128, and 256), Exponential, Gradient, Logarithm, Square and Square Root scales. Intraclass correlation coefficients (ICC) were calculated to assess the repeatability of MRI radiomic features (high repeatability defined as ICC ≥ 95%).

Results

In our ICC results, we observed high repeatability (ICC ≥ 95%) with respect to image preprocessing, different image registration algorithms, and test–retest analysis, for example: RLNU and GLNU from GLRLM, GLNU and DNU from GLDM, Coarseness and Busyness from NGTDM, GLNU and ZP from GLSZM, and Energy and RMS from first order. Highest fraction (percent) of repeatable features was observed, among registration techniques, for the method Full Affine transformation with 12 degrees of freedom using Mutual Information cost function (mean 32.4%), and among image processing methods, for the method Laplacian of Gaussian (LOG) with Sigma (2.5–4.5 mm) (mean 78.9%). The trends were relatively consistent for N4, N3, or no bias correction.

Conclusion

Our results showed varying performances in repeatability of MR radiomic features for GBM tumors due to test–retest and image registration. The findings have implications for appropriate usage in diagnostic and predictive models.
Numerical simulation of particle plugging in hydraulic fracture by element partition method
Authors: Wang Yujie , Li Xinyong , Zhao Bing , Zhang Zhennan
Published: July 2020

Hydraulic fracturing (HF) treatment often involves particle migration and is applied for propping or plugging fractures. Particle migration behaviors, e.g., bridging, packing, and plugging, significantly affect the HF process. Hence, it is crucial to effectively simulate particle migration. In this study, a new numerical approach is developed based on a coupled element partition method (EPM). The EPM is used to model natural and hydraulic fractures, in which a fracture is allowed to propagate across an element, thereby avoiding remeshing in fracture simulations. To characterize the water flow process in a fracture, a fully hydromechanical coupled equation is adopted in the EPM. To model particle transportation in fractures with water flow, each particle is treated as a discrete element. The particles move in the fracture as a result of being dragged by fluid. Their movement, contact, and packing behaviors are simulated using the discrete element method. To reflect the plugging effect, an equivalent aperture approach is proposed. Using this method, the particle migration and its effect on water flow are well simulated. The simulation results show that this method can effectively reproduce particle bridging, plugging, and unblocking in a hydraulic fracture. Furthermore, it is demonstrated that particle plugging significantly affects water flow in a fracture and hence the propagation of hydraulic fracture. This method provides a simple and feasible approach for the simulation of particle migration in a hydraulic fracture.
Quantensprung auf der Waage
Authors: Schüssler Rima
Published: July 2020

Aufgrund von Einsteins berühmter Formel E = mc2 kann man jeder Energie eine Masse zuordnen. So ist zum Beispiel ein voll geladenes Smartphone schwerer als eins mit einem leeren Akku. Dabei entspricht die maximale Energie des Akkus von etwa 5,5 Wh einer Masse von 10–13 kg. Das kann keine alltägliche Waage messen. Mit einer extrem empfindlichen Apparatur ist es unserer Gruppe am Max‐Planck‐Institut für Kernphysik in Heidelberg aber gelungen, die noch wesentlich geringere Bindungsenergie von Elektronen zu „wiegen“.
Dispersion, Polarisation und belebendes Licht
Authors: Loos Andreas
Published: July 2020

Er stirbt im selben Jahr wie Hermann von Helmholtz und Heinrich Hertz. Für Hermann Theodor Simon, einen eher unbekannten Schüler des Gesuchten, ist dies die traurige Gelegenheit, alle drei in einem pathetischen Nachruf zu würdigen. Über seinen Lehrer schreibt er: „Hier berührt sich unser Wollen und Streben mit dem Glanze einer Genialität, welche belebendes Licht spendet, ohne zu blenden.“
Juli Zehs Quantenkrimi
Authors: Mecke Klaus
Published: July 2020

In dem Kriminalroman Schilf übersetzt Juli Zeh die Idee paralleler Quantenwelten in eine klassische Theaterwelt und fragt, was Zufall und Komplementarität für moralische Entscheidungen und gerechte Urteile bedeuten.
Contrasting susceptibility of lepidopteran pests to diamide and pyrethroid insecticides in a region of overwintering and migratory intersection
Authors: Rabelo Marcelo M , Paula‐Moraes Silvana V , Pereira Eliseu José G , Siegfried Blair D
Published: July 2020

BACKGROUND

Pesticide resistance is a growing issue worldwide, and susceptibility of pest populations should be monitored in migratory intersection regions for successful resistance management. We determined the susceptibility of eight noctuid species from the Florida Panhandle to bifenthrin (pyrethroid) and chlorantraniliprole (diamide). Larvae from field and laboratory populations were exposed to commercial insecticide formulations using the leaf‐dip method in concentration–mortality bioassays.

RESULTS

The field populations of Helicoverpa zea (Boddie), Spodoptera frugiperda (Smith), S. eridania (Stoll), S. exigua (Hubner) and Chloridea virescens (Fabricius) had reduced susceptibility to bifenthrin compared with the laboratory populations. Resistance ratios to bifenthrin were as high as 10 071‐fold in S. exigua and 436‐fold in S. frugiperda, while there was no reduced susceptibility in Agrotis ipsilon (Hufnagel). The susceptibility to chlorantraniliprole was similar between the field and laboratory populations studied, except for S. exigua that exhibited 630‐fold resistance to the diamide. The probit regression equations indicated that the larval mortality of S. exigua and S. frugiperda populations was <80% with bifenthrin at the concentration equivalent to the label rate. Likewise, the estimated mortality of S. exigua larvae with chlorantraniliprole at the label rate concentration was <80%.

CONCLUSIONS

The lepidopteran pest populations tested were variable in susceptibility to bifenthrin by contrast to more consistent susceptibility to chlorantraniliprole. These results help in the choice of effective insecticides for integrated pest management and resistance management in cropping systems colonized by migratory lepidopteran pests from the U.S. Gulf Coast region. © 2020 Society of Chemical Industry
Recent Progress on Cu2BaSn(SxSe1–x)4: From Material to Solar Cell Applications
Authors: Luo Haitian , Zhang Yi , Wang Wenjing , Gu Hongwei , Li Hui
Published: July 2020

Thin film solar cells show great potential applications in building‐integrated photovoltaics (BIPV) and portable devices. Among these thin film solar cells, Cu2BaSn(SxSe1–x)4 solar cells derived from Cu2ZnSn(SxSe1–x)4 solar cells have attracted intense research interests recently because of their high theoretical PCE of ap;31%, easy tunability of band gaps (Eg = 1.28–1.79 eV), large optical absorption coefficient (α > 104 cm−1), environment‐friendly composition, low materials, and fabrication cost. Importantly, Cu2BaSn(SxSe1–x)4 solar cells are expected to have low open‐circuit voltage deficit, leading to high open‐circuit voltage and PCEs. In fact, since their initial development in 2016, the maximum PCE of Cu2BaSn(SxSe1–x)4 solar cells has surpassed 5% via adjustment of the fabrication methods and material properties, optimization of the device structures, and so forth. Here, a review of the recent progress of Cu2BaSn(SxSe1–x)4 solar cells is presented, including properties of Cu2BaSn(SxSe1–x)4, material and device fabrication methods, device performances, potential applications, as well as the bulk and interface recombination. In addition, other solar cells which are similar with the Cu2BaSn(SxSe1–x)4 solar cells are also discussed. Finally, according to these discussions, prospect for PCEs improvement is given to accelerate their development.
A Method to Quantify the Collective Impact of Grain Boundaries on the Internal Quantum Efficiency of Multicrystalline Silicon Solar Cells
Authors: Pacho Aleo Paolo , Rinio Markus
Published: July 2020

Herein, a method to quantify the amount of reduction in the internal quantum efficiency (IQE) of multicrystalline silicon solar cells that can be attributed to grain boundaries is presented. By correlating the IQE maps obtained via light beam induced current (LBIC) topography with optical images of Secco‐etched samples, the distribution of IQE values at the positions of grain boundaries can be compared with the distribution of IQE values for all other positions where other defects may exist. The segmentation of IQE at 826 nm maps of the samples shows grain boundaries to be more detrimental compared with the combined effects of all other defects that may exist in other regions of the cell. The grain boundaries reduce the average IQE by up to 4.07% absolute for the cell from the bottom of the ingot.
Sampled‐data consensus of multiagent systems with switching jointly connected topologies via time‐varying Lyapunov function approach
Authors: Sun Jian , Wang Zhan‐Shan , Rong Nan‐Nan
Published: July 2020

Consensus problem of multiagent systems with switching jointly connected topologies under sampled‐data control is studied in this article. The main contribution is that the consensus problem for such system is solved without the assumption that the system matrices are stable or critically stable. For this purpose, a time‐varying Lyapunov function method is utilized to describe the state characteristics with switching jointly connected topologies. Based on the time‐varying matrix of Lyapunov function, the “decline” characteristics at the switching instants is derived to compensate the divergence among the agents with disconnected topologies. Utilizing the “decline” characteristics, the overall consensus of such system can be guaranteed in the framework of dwell time. Finally, the effectiveness of the proposed result is illustrated by two numerical examples.
Investigation on Photophysical, Solvatochromism and Biological Significance of Substituted 2H‐Indazole Derivatives
Authors: Roniboss Anthonisamy , Chanda Kaushik , Motilal Balamurali Musuvathi
Published: July 2020

The electronic properties of substituted 2H‐indazoles were investigated for their photophysical behavior under isolated conditions and in solvent environment, both computationally and experimentally. DFT calculations with CAM−B3LYP functional and 6–311++G** basis set were performed in the ground and excited states. The effect of solvents on the low and high energy electronic states was studied by following the steady state absorption and fluorescence excitation and emission spectra. Solvatochromic interactions including general and specific solvent effects are reported along with the results of Lippert and ET(30) plots. The biological significance of these 2H‐indazole derivatives was also investigated through docking studies. The interactions of 2H‐indazole derivatives with the active site of subdomain II of human casein kinase (C2 K) alpha are reported.
Metal‐Free Synthesis of Thermally Stable Fluorescent p‐Terphenyls by Ring Transformation of 2H‐Pyran‐2‐ones
Authors: Chandrasekar Subashini , Singh Fateh V.
Published: July 2020

A metal‐free approach for the synthesis of p‐terphenyls 7 a–i and cyclic p‐terphenyls 9 a–d and 11 a–d is described via carbanion induced ring transformation reaction of 6‐biphenyl‐2H‐pyran‐2‐ones 5 with malononitrile 6, cyclohexanone 8 and 1,4‐cyclohexanedione monoethylene ketal 10 respectively. Additionally, the base‐mediated ring transformation reactions were working smoothly under mild reaction conditions and ring transformation products 7, 9 and 11 were isolated in good to excellent yields. The synthetic approach provides the flexibility of introducing of both electron‐withdrawing and ‐donating functionalities in p‐terphenyl architecture. Moreover, the photo physical properties of compounds 7, 9 and 11 were analyzed using UV‐visible and Fluorescence Spectroscopy. p‐Terphenyls 7 c showed cyan fluorescence in chloroform (λmax (em): 508 nm) and acetonitrile (λmax (em): 420 nm) while cyclic p‐terphenyl 9 a showed blue fluorescence in chloroform and 1,4‐dioxane (λmax (em): 470 nm). Similarly, compound 11 a showed blue fluorescence in chloroform (λmax (em): 468 nm) and 1,4‐dioxane (λmax (em): 473 nm). Additionally, the thermal stability of synthesized cyclic p‐terphenyls 11 a, 11 c and 11 d were also studied using TG and DTA techniques.
Synthesis of Chiral 1,3‐keto‐acetates through Enzymatic Kinetic Resolution with Amano Lipase fromPseudomonas fluorescens
Authors: Can Hacer , Yıldız Tülay , Onar Hülya Çelik
Published: July 2020

This study provides an enzymatic kinetic resolution (EKR) method for the biocatalytic enantioselective synthesis of chiral β‐keto acetates. For the first time, the attitude of several lipase enzymes has been examined under different conditions for the EKR of the racemic 1,3‐keto alcohols. We found that the Amano lipase fromPseudomonas fluorescens(AL‐PF) lipase showed the best results for the resolution of the racemic 1,3‐keto alcohols. We developed a highly effective EKR method by changing the enzyme, temperature, solvent, and enzyme amount in order to synthesize the chiral 1,3‐keto esters, which are useful intermediates in organic synthesis. This study presents an efficient method for the synthesis of 1,3‐keto acetates with a good yield and high enantioselectivity with theRconfiguration.
InP Quantum Dots: Synthesis and Lighting Applications
Authors: Chen Bing , Li Dongyu , Wang Feng
Published: July 2020

InP quantum dots (QDs) are typical III–V group semiconductor nanocrystals that feature large excitonic Bohr radius and high carrier mobility. The merits of InP QDs include large absorption coefficient, broad color tunability, and low toxicity, which render them promising alternatives to classic Cd/Pb‐based QDs for applications in practical settings. Over the past two decades, the advances in wet‐chemistry methods have enabled the synthesis of small‐sized colloidal InP QDs with the assistance of organic ligands. By proper selection of synthetic protocols and precursor materials coupled with surface passivation, the QYs of InP QDs are pushed to near unity with modest color purity. The state‐of‐the‐art InP QDs with appealing optical and electronic properties have excelled in many applications with the potential for commercialization. This work focuses on the recent development of wet‐chemistry protocols and various precursor materials for the synthesis and surface modification of InP QDs. Current methods for constructing light‐emitting diodes using novel InP‐based QDs are also summarized.
Advanced Characterization Techniques for Interface in All‐Solid‐State Batteries
Authors: Li Yuyu , Gao Zhonghui , Hu Fei , Lin Xing , Wei Ying , Peng Jian , Yang Jiayi , Li Zhen , Huang Yunhui , Ding Han
Published: July 2020

The interface is a critical factor of electrochemical performance for all‐solid‐state batteries (ASSBs). Comprehending the composition, structure, morphology, and their evolution in the interface during charge/discharge cycling is greatly important for the development and practical application of ASSBs. The characterization techniques are very crucial and powerful for investigating the interface properties of ASSBs. This review briefly describes how the interface is generated in ASSBs, and then emphatically summarizes some important advanced techniques used to characterize the interface in ASSBs. The principle, advantage, and application of the techniques in the interface investigation are systematically discussed. This review provides fundamental insights and perspectives for developing the characterization techniques to deeply understand the interfacial behaviors of ASSBs, which is valuable for accelerating the commercialization of ASSBs used in electronic devices, electric vehicles, and large‐scale energy storage.
Report of the Nomenclature Committee for Vascular Plants: 71
Authors: Applequist Wendy L.
Published: July 2020

The following six generic names are recommended for conservation: Emmeorhiza against Endlichera, Friesodielsia against Schefferomitra, Haplopteris against Monogramma, Mandevilla against Exothostemon, Miconia against Angeja, and Murraya against Chalcas. The following 15 species names are recommended for conservation: Agave franzosinii against A. beaulueriana, Agave maximiliana against A. gustaviana, Aspidium draconopterum with a conserved type, Aster trinervius Roxb. ex D. Don against A. trinervis (Pers.) Nees, Bupleurum multinerve against B. striatum, Cryptolepis buchananii against Periploca dubia, Hesperis pendula DC. against H. pendula Murr., Kaempferia rotunda with a conserved type, Osmunda multifida with a conserved type, Pinus pseudostrobus Lindl. against P. pseudostrobus Brongn., Psychotria calva against P. umbellata, Quercus ilex with a conserved type, Schoenus hornei with a conserved type, Solanum alatum with a conserved type, and Stipa pulcherrima with a conserved type. The following three species names are not recommended for conservation: Carex oedorrhampha against C. tumida and C. baviensis, Habenaria crassifolia against Platanthera brachyphylla, and Taxus harringtonia with that spelling. The following three species names are recommended for rejection: Convolvulus bufalinus, Ipomoea emetica, and Solanum rubrum. The species name Isoetes sahyadrii is not recommended for rejection. It is recommended that Swartzia Schreb. and Schwartzia Vell. be treated as homonyms. The Committee recommends against making a binding decision on whether Clematis chekiangensis and C. zhejiangensis, or Airopsis and Ariopsis, should be treated as homonyms.
Sequence analysis of Salmonella enterica isolates obtained from shelter dogs throughout Texas
Authors: Cummings Kevin J. , Mitchell Patrick K. , Rodriguez‐Rivera Lorraine D. , Goodman Laura B.
Published: July 2020

Dogs are a potential source of zoonotic Salmonella transmission. We had previously estimated the prevalence of Salmonella shedding among shelter dogs throughout Texas using a repeated cross‐sectional study design. Our current objectives were to fully characterize the Salmonella isolates and to assess their relatedness, using whole‐genome sequencing. Antimicrobial resistance (AMR) genes were detected in 4/27 (15%) of the isolates. The fosfomycin resistance gene fosA7 was identified in two isolates; to our knowledge, there are no published reports of this gene in canine Salmonella isolates. The biocide resistance gene qacEdelta1, conferring resistance to quaternary ammonium compounds, was detected in an isolate that had four additional AMR genes. The most frequently identified serotypes were Newport (6/27, 22%) and Javiana (4/27, 15%), both of which were widespread among animal shelters. For these serotypes, there was evidence of both transmission of Salmonella within the shelter environment and separate introductions of Salmonella into a shelter. Several canine Salmonella isolates were closely related to human clinical isolates (four canine isolates within 10 SNPs and six more within 20 SNPs), suggesting a shared pathogen population. Educational outreach programmes targeting animal shelter workers would be useful for optimizing knowledge of Salmonella and other canine‐associated zoonotic pathogens.
A Sturm–Liouville Problem Arising in the Atmospheric Boundary-Layer Dynamics
Authors: Marynets Kateryna
Published: July 2020

We present an approach that facilitates the generation of explicit solutions to atmospheric Ekman flows with a height-dependent eddy viscosity. The approach relies on applying to the governing equations, of Sturm–Liouville type, a suitable Liouville substitution and then reducing the outcome to a nonlinear first-order differential equation of Riccati type.
Reliability of the assessment of non-technical skills by using video-recorded trauma resuscitations
Authors: van Maarseveen Oscar E. C. , Ham Wietske H. W. , Huijsmans Roel L. N. , Dolmans Rianne G. F. , Leenen Luke P. H.
Published: July 2020

Purpose

Non-technical skills have gained attention, since enhancement of these skills is presumed to improve the process of trauma resuscitation. However, the reliability of assessing non-technical skills is underexposed, especially when using video analysis. Therefore, our primary aim was to assess the reliability of the Trauma Non-Technical Skills (T-NOTECHS) tool by video analysis. Secondarily, we investigated to what extent reliability increased when the T-NOTECHS was assessed by three assessors [average intra-class correlation (ICC)] instead of one (individual ICC).

Methods

As calculated by a pre-study power analysis, 18 videos were reviewed by three research assistants using the T-NOTECHS tool. Average and individual degree of agreement of the assessors was calculated using a two-way mixed model ICC.

Results

Average ICC was ‘excellent’ for the overall score and all five domains. Individual ICC was classified as ‘excellent’ for the overall score. Of the five domains, only one was classified as ‘excellent’, two as ‘good’ and two were even only ‘fair’.

Conclusions

Assessment of non-technical skills using the T-NOTECHS is reliable using video analysis and has an excellent reliability for the overall T-NOTECHS score. Assessment by three raters further improve the reliability, resulting in an excellent reliability for all individual domains.
Implementierung anästhesiologischer Qualitätsindikatoren in Deutschland
Authors: Ziemann S. , Coburn M. , Rossaint R. , Van Waesberghe J. , Bürkle H. , Fries M. , Henrich M. , Henzler D. , Iber T. , Karst J. , Kunitz O. , Löb R. , Meißner W. , Meybohm P. , Mierke B. , Pabst F. , Schaelte G. , Schiff J. , Soehle M. , Winterhalter M. , Kowark A.
Published: July 2020

Hintergrund

Im Jahr 2016 hat die Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI) und der Bund Deutscher Anästhesisten (BDA) 10 Qualitätsindikatoren (QI) veröffentlicht, um die Qualität anästhesiologischer Behandlungen vergleichen und verbessern zu können. Bis heute gibt es keine Evidenz darüber, inwieweit sich die Maßnahmen zur Implementierung der QI in den Kliniken umsetzen lassen.

Ziel der Arbeit

Im Rahmen dieser Studie wurde die Hypothese getestet, inwieweit die vorliegenden 10 QI in deutschen Krankenhäusern implementierbar sind.

Material und Methoden

Diese prospektive, dreiphasige, nationale, Multizenterstudie wurde in 15 deutschen Krankenhäusern und einem ambulanten Anästhesie-Zentrum von März 2017 bis Februar 2018 durchgeführt. Die Studie bestand aus einer initialen Evaluation präexistierender Strukturen und Prozesse durch die Chefärzte der beteiligten Anästhesieabteilungen, gefolgt von einer sechsmonatigen Implementierungsphase der QI und einer finalen Reevaluation. Der Prozess der Implementierung wurde durch web-basierte Implementierungshilfen (www.qi-an.org) und interne Qualitätsmanagementprogramme der Zentren unterstützt. Der primäre Endpunkt war die Differenz der Anzahl implementierter QI pro Zentrum vor und nach der sechsmonatigen Implementierungsphase. Sekundäre Endpunkte waren die Anzahl neu implementierter QI pro Zentrum, die Gesamtzahl erfolgreicher Implementierungen pro einzelnem QI, die Identifizierung von Problemen während der Implementierung sowie die Gründe, die die Implementierung eines QI verhindert haben.

Ergebnisse

Die durchschnittliche Anzahl implementierter QI pro Zentrum stieg von 5,8 auf 6,8 (Mittelwert der Differenzen 1,1 ± 1,3; p < 0,01). Am häufigsten konnten die QI Perioperativer Morbiditäts- und Mortalitätsbericht (5 Zentren) und QI Temperatur-Management (4 Zentren) implementiert werden. Nach der Implementierungsphase waren die QI Fehlermanagement und Patient-Blood-Management in allen Zentren implementiert. Die Implementierung anderer QI scheiterte in den häufigsten Fällen an Zeitmangel sowie fehlenden personellen und strukturellen Ressourcen.

Diskussion

Im Rahmen der Studie konnte die Implementierbarkeit der vorliegenden 10 QI in deutschen Krankenhäusern überwiegend belegt werden. Viele der QI konnten mit relativ geringem Aufwand implementiert werden. Für einige QI wären jedoch mehr Personal sowie größere strukturelle und finanzielle Ressourcen notwendig, so z.B. für den QI Postoperative Visite.
Formation of the Flatreef deposit, northern Bushveld, by hydrodynamic and hydromagmatic processes
Authors: Maier W. D. , Abernethy K. E. L. , Grobler D. F. , Moorhead G.
Published: July 2020

New lithological and whole rock compositional data show that the main platinum-group element (PGE) horizons of the Flatreef succession show strong compositional similarities to the Merensky and Bastard reefs of the western Bushveld Complex (WBC), notably in terms of many immobile and incompatible minor and trace elements such as TiO2, Zr, Y, and REE. However, Al2O3, CaO, and Na2O contents are markedly lower in the Flatreef, whereas MgO contents are higher. In view of broadly similar silicate mineral compositions in the Flatreef and the WBC reefs, we suggest that the major element compositional differences between the rocks are largely due to higher modal proportions of orthopyroxene and olivine and lower proportions of plagioclase in the Flatreef. The thickness of the mineralised interval is much greater in the Flatreef than in the WBC (several 10 s of m vs ~ 1 m) and the abundance of sulfides in the Flatreef is typically somewhat higher (on average ~ 1.5% vs ~ 1%). These data, complemented by textural observations, are interpreted to reflect enhanced hydrodynamic crystal sorting accompanied by percolation of sulfide melt through incompletely solidified cumulates. Further genetic constraints are provided by metal data: The concentration of Ni (~ 3000 ppm) in the Flatreef is broadly similar to that in the Merensky Reef of the WBC, but Cu contents are markedly higher (average ~ 1500 ppm vs 700 ppm in the WBC). The concentrations of most PGE are slightly lower (Flatreef ~ 1.5–2 ppm Pt, ~ 100–150 ppb Rh; WBC MR 3.7 ppm Pt, 240 ppb Rh), but Pd has broadly similar contents (Flatreef ~ 1.2–2 ppm; WBC MR 1.54 ppm). The relatively high Cu content of the Flatreef is interpreted as a result of assimilation of Cu sulfides from the sedimentary floor rocks. The reason for the enrichment of Pd relative to Pt, especially in the basal rocks, remains unclear. It could reflect mobilisation of Pd via a fluid phase from the country rocks or the interior of the intrusion, relatively enhanced partitioning of Pd into the sulfides, or relative Pt depletion of the earliest magma pulses in response to Pt alloy fractionation triggered by contamination with reducing country rocks.
Consensus statements on PSMA PET/CT response assessment criteria in prostate cancer
Authors: Fanti Stefano , Goffin Karolien , Hadaschik Boris A , Herrmann Ken , Maurer Tobias , MacLennan Steven , Oprea-Lager Daniela E. , Oyen Wim JG , Rouvière Olivier , Mottet Nicolas , Bjartell Anders
Published: July 2020

Purpose

Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is used for (re)staging prostate cancer (PCa) and as a biomarker for evaluating response to therapy, but lacks established response criteria. A panel of PCa experts in nuclear medicine, radiology, and/or urology met on February 21, 2020, in Amsterdam, The Netherlands, to formulate criteria for PSMA PET/CT-based response in patients treated for metastatic PCa and optimal timing to use it.

Methods

Panelists received thematic topics and relevant literature prior to the meeting. Statements on how to interpret response and progression on therapy in PCa with PSMA PET/CT and when to use it were developed. Panelists voted anonymously on a nine-point scale, ranging from strongly disagree (1) to strongly agree (9). Median scores described agreement and consensus.

Results

PSMA PET/CT consensus statements concerned utility, best timing for performing, criteria for evaluation of response, patients who could benefit, and handling of radiolabeled PSMA PET tracers. Consensus was reached on all statements. PSMA PET/CT can be used before and after any local and systemic treatment in patients with metastatic disease to evaluate response to treatment. Ideally, PSMA PET/CT imaging criteria should categorize patients as responders, patients with stable disease, partial response, and complete response, or as non-responders. Specific clinical scenarios such as oligometastatic or polymetastatic disease deserve special consideration.

Conclusions

Adoption of PSMA PET/CT should be supported by indication for appropriate use and precise criteria for interpretation. PSMA PET/CT criteria should categorize patients as responders or non-responders. Specific clinical scenarios deserve special consideration.
Time course of neurological deficits after surgery for primary brain tumours
Authors: Zetterling Maria , Elf Kristin , Semnic Robert , Latini Francesco , Engström Elisabeth Ronne
Published: July 2020

Background

The postoperative course after surgery for primary brain tumours can be difficult to predict. We examined the time course of postoperative neurological deficits and analysed possible predisposing factors.

Method

Hundred adults with a radiological suspicion of low- or high-grade glioma were prospectively included and the postoperative course analysed. Possible predictors of postoperative neurological deterioration were evaluated.

Results

New postoperative neurologic deficits occurred in 37% of the patients, and in 4%, there were worsening of a preoperative deficit. In 78%, the deficits occurred directly after surgery. The probable cause of deterioration was EEG-verified seizures in 7, ischemic lesion in 5 and both in 1, resection of eloquent tissue in 6, resection close to eloquent tissue including SMA in 11 and postoperative haematoma in 1 patient. Seizures were the main cause of delayed neurological deterioration. Two-thirds of patients with postoperative deterioration showed complete regression of the deficits, and in 6% of all patients, there was a slight disturbance of the function after 3 months. Remaining deficits were found in 6% and only in patients with preoperative neurological deficits and high-grade tumours with mainly eloquent locations. Eloquent tumour location was a predictor of postoperative neurological deterioration and preoperative neurological deficits of remaining deficits.

Conclusions

Postoperative neurological deficits occurred in 41% and remained in 6% of patients. Remaining deficits were found in patients with preoperative neurological deficits and high-grade tumours with mainly eloquent locations. Eloquent tumour location was a predictor of neurological deterioration and preoperative neurological deficits of remaining deficits.
Welches Potenzial haben virtuelle Realitäten in der klinischen und forensischen Psychiatrie? Ein Überblick über aktuelle Verfahren und Einsatzmöglichkeiten
Authors: Barbe Hermann , Siegel Bruno , Müller Jürgen L. , Fromberger Peter
Published: July 2020

Virtuelle Realitäten (VR) werden in der Diagnose und Behandlung von Patienten im klinischen Feld bereits seit 20 Jahren erfolgreich eingesetzt und weiterentwickelt. Seit etwas mehr als 5 Jahren gibt es nun auch erste Beispiele über die Anwendung von VR in psychiatrisch-forensischen Kontexten. Für die forensische Psychiatrie ist die Möglichkeit, realistische, sichere und kontrollierbare Diagnostik- und Lernumgebungen zu schaffen, der ausschlaggebende Vorteil der VR-Technologie. So können z. B. Straftäter in Szenarien behandelt oder begutachtet werden, welche im echten Leben risikoreich, unethisch oder ökologisch invalide wären. In diesem Artikel werden unterschiedliche aktuelle Studienbeispiele zu klinischer Behandlung und Diagnose von Patienten sowie der forensischen Prognose und Therapie von Straftätern vorgestellt. Damit zeigt der Überblick, dass VR mittlerweile auch in der forensischen Psychiatrie ein vielversprechendes Werkzeug sein kann, welches bereits etablierte Instrumente ergänzen oder erweitern kann. Auch in der Ausbildung von forensisch-psychiatrischem Fachpersonal können VR-Anwendungen eine Hilfe sein. Hier gibt es bereits erste vielversprechende Einsätze durch das Training mithilfe von virtuellen Patienten, jedoch benötigt es noch umfangreiche Forschungsarbeit auf diesem Feld, um sie im professionellen Alltag einsetzen zu können. Vor dem Einsatz von VR-Anwendungen sollten sich Forscher und Praktiker neben den Vorteilen auch mit den Nachteilen von VR auseinandersetzen und ein besonderes Augenmerk auf die ethischen Richtlinien werfen, welche in den letzten Jahren dazu erarbeitet wurden. Die stetige Weiterentwicklung und der immer breitere Einsatz von VR im klinischen und forensisch-psychiatrischen Feld zeigen, dass VR auch hier das Potenzial hat, ein etabliertes Forschungs- sowie Therapieinstrument zu werden.
Inequality of ratios
Authors: Yalonetzky Gaston
Published: July 2020

Some socioeconomic indicators can be represented in alternative ways. For example, as either attainments (e.g. child survival rates) or shortfalls (e.g. child mortality rates) if the variables are bounded. The literature has long been concerned with the consistency of inequality comparisons across such alternative representations. The case of bounded variables and their two alternative representations (attainments versus shortfalls) has been largely settled. This paper addresses the extent of the consistency problem in inequality comparisons involving ratio indicators which also have two potential representations (e.g. number of people per room or number of rooms per capita in the case of overcrowding). First, we probe welfare comparisons based on the generalised Lorenz curve and find that consistency can be secured in the presence of rank dominance. Second, we show that robust inequality comparisons based on all possible Zoli partial orderings (which include all relative and absolute inequality partial orderings, among others) are inconsistent across alternative representations of ratios. Third, with the identification of a class of inequality indices based on the ratio of the harmonic to the arithmetic mean, we show that complete orderings consistent across alternative representations of ratios do exist. Then we consider and ponder the pros and cons of three alternative solutions: defending one representation, using inequality indices that combine both representations, and functional transformations of the ratio variable. We find that the costs of these alternatives render them inferior to the class of indices based on the harmonic and arithmetic means. Both the consistency problem and its preferred proposed solution are illustrated with an empirical study of intergenerational changes in overcrowding inequality in Mexico.
2D CoOOH Sheet-Encapsulated Ni2P into Tubular Arrays Realizing 1000 mA cm−2-Level-Current-Density Hydrogen Evolution Over 100 h in Neutral Water
Authors: Zhang Shucong , Wang Wenbin , Hu Feilong , Mi Yan , Wang Shuzhe , Liu Youwen , Ai Xiaomeng , Fang Jiakun , Li Huiqiao , Zhai Tianyou
Published: July 2020

Water electrolysis at high current density (1000 mA cm−2 level) with excellent durability especially in neutral electrolyte is the pivotal issue for green hydrogen from experiment to industrialization. In addition to the high intrinsic activity determined by the electronic structure, electrocatalysts are also required to be capable of fast mass transfer (electrolyte recharge and bubble overflow) and high mechanical stability. Herein, the 2D CoOOH sheet-encapsulated Ni2P into tubular arrays electrocatalytic system was proposed and realized 1000 mA cm−2-level-current-density hydrogen evolution over 100 h in neutral water. In designed catalysts, 2D stack structure as an adaptive material can buffer the shock of electrolyte convection, hydrogen bubble rupture, and evolution through the release of stress, which insure the long cycle stability. Meanwhile, the rich porosity between stacked units contributed the good infiltration of electrolyte and slippage of hydrogen bubbles, guaranteeing electrolyte fast recharge and bubble evolution at the high-current catalysis. Beyond that, the electron structure modulation induced by interfacial charge transfer is also beneficial to enhance the intrinsic activity. Profoundly, the multiscale coordinated regulation will provide a guide to design high-efficiency industrial electrocatalysts.
Impact of Symmetric Vertical Sinusoid Alignments on Infrastructure Construction Costs: Optimizing Energy Consumption in Metropolitan Railway Lines Using Artificial Neural Networks
Authors: Pineda-Jaramillo J , Salvador-Zuriaga P. , Martínez-Fernández P. , Insa-Franco R.
Published: July 2020

Minimizing energy consumption is a key issue from both an environmental and economic perspectives for railways systems; however, it is also important to reduce infrastructure construction costs. In the present work, an artificial neural network (ANN) was trained to estimate the energy consumption of a metropolitan railway line. This ANN was used to test hypothetical vertical alignments scenarios, proving that symmetric vertical sinusoid alignments (SVSA) can reduce energy consumption by up to 18.4% compared with a flat alignment. Finally, we analyzed the impact of SVSA application on infrastructure construction costs, considering different scenarios based on top–down excavation methods. When balancing reduction in energy consumption against infrastructure construction costs between SVSA and flat alignment, the extra construction costs due to SVSA have a return period of 25–300 years compared with a flat alignment, depending on the soil type and construction method used. Symmetric vertical sinusoid alignment layouts are thus suitable for scattered or soft soils, up to compacted intermediate geomaterials.
Some challenges to the new paternalism
Authors: LE GRAND JULIAN
Published: July 2020

Behavioural public policy analysts have examined cases of individuals’ failures of reason or judgement to attain their ends and have used these to justify ‘means’ paternalism: a form of government intervention that tries to save individuals from the consequences of those reasoning failures and to enable them better to achieve those ends. This has been challenged on a number of grounds, including too great a focus on choice-preserving interventions such as nudges, the privileging of future preferences over current ones and the possibility of state failures as damaging to individual well-being as the original reasoning failure. This paper summarizes the principal arguments in favour of means paternalism and then addresses these challenges.
Privileged Ignorance, “World”-Traveling, and Epistemic Tourism
Authors: Bowman Melanie
Published: July 2020

In this article I am concerned with how relatively privileged people who wish to act in anti-oppressive ways respond to their own ignorance in ways that fall short of what is necessary for building coalitions against oppression. I consider María Lugones's sense of “world”-travel and José Medina's notion of epistemic friction-seeking as strategies for combating privileged ignorance, and assess how well they fare when put into practice by those suffering from privileged ignorance. Drawing on the resources of tourism studies, I critique the political and material context that can turn these attempts to “world”-travel or seek epistemic friction into a morally and epistemically problematic epistemic tourism. Centrally, I argue that trying to learn what it's like to experience oppression is not an effective method of counteracting privileged ignorance, since the epistemic vices and cognitive distortions that created the ignorance in the first place continue to influence knowledge-creation even after they are acknowledged. Rather than attempting to understand “what it's like” to experience oppression, privileged progressives should undertake to learn about the provenance and purpose of their ignorance and the structures of oppression that facilitate and are facilitated by that ignorance.
Youth mental health in the time of COVID-19
Authors: Power E. , Hughes S. , Cotter D. , Cannon M.
Published: July 2020

Youth mental health is a rapidly developing field with a focus on prevention, early identification, treatment innovation and service development. In this perspective piece, we discuss the effects of COVID-19 on young people’s mental health. The psychosocial effects of COVID-19 disproportionately affect young people. Both immediate and longer-term factors through which young people are affected include social isolation, changes to the delivery of therapeutic services and almost complete loss of all structured occupations (school, work and training) within this population group. Longer-term mechanisms include the effects of the predicted recession on young people’s mental health. Opportunities within this crisis exist for service providers to scale up telehealth and digital services that may benefit service provision for young people’s mental health in the future.