bluuebunny/crossref_metadata_2025 huggingface dataset:
Sterile neutrino dark matter in left-right theories
Authors: Dror Jeff A. , Dunsky David , Hall Lawrence J. , Harigaya Keisuke
Published: July 2020

Abstract

SU(2)L× SU(2)R gauge symmetry requires three right-handed neutrinos (Ni), one of which, N1, can be sufficiently stable to be dark matter. In the early universe, WR exchange with the Standard Model thermal bath keeps the right-handed neutrinos in thermal equilibrium at high temperatures. N1 can make up all of dark matter if they freeze-out while relativistic and are mildly diluted by subsequent decays of a long-lived and heavier right-handed neutrino, N2. We systematically study this parameter space, constraining the symmetry breaking scale of SU(2)R and the mass of N1 to a triangle in the (vR, M1) plane, with vR = (106− 3 × 1012) GeV and M1 = (2 keV–1 MeV). Much of this triangle can be probed by signals of warm dark matter, especially if leptogenesis from N2 decay yields the observed baryon asymmetry. The minimal value of vR is increased to 108 GeV for doublet breaking of SU(2)R, and further to 109 GeV if leptogenesis occurs via N2 decay, while the upper bound on M1 is reduced to 100 keV. In addition, there is a component of hot N1 dark matter resulting from the late decay of N2→ N1ℓ+ℓ− that can be probed by future cosmic microwave background observations. Interestingly, the range of vR allows both precision gauge coupling unification and the Higgs Parity understanding of the vanishing of the Standard Model Higgs quartic at scale vR. Finally, we study freeze-in production of N1 dark matter via the WR interaction, which allows a much wider range of (vR, M1).
The AdHOC (age, head injury, oxygenation, circulation) score: a simple assessment tool for early assessment of severely injured patients with major fractures
Authors: Knoepfel Adrian , Pfeifer Roman , Lefering Rolf , Pape Hans-Christoph ,   TraumaRegister DGU
Published: July 2020

Purpose

We sought to develop a simple, effective and accurate assessment tool using well-known prognostic parameters to predict mortality and morbidity in severely injured patients with major fractures at the stage of the trauma bay.

Methods

European Data from the TraumaRegister DGU® were queried for patients aged 16 or older and with an ISS of 9 and higher with major fractures. The development (2012–2015) and validation (2016) groups were separated. The four prognostic aspects Age, Head injury, Oxygenation and Circulation along with parameters were identified as having a relevant impact on the outcome of severely injured patients with major fractures. The performance of the score was analyzed with the area under the receiver operating characteristics curve and compared to other trauma scores.

Results

An increasing AdHOC (Age, Head injury, Oxygenation, Circulation) score value in the 17,827 included patients correlated with increasing mortality (0 points = 0.3%, 1 point = 5.3%, 2 points = 15.6%, 3 points = 42.5% and 4 points = 62.6%). With an AUROC of 0.858 for the development (n = 14,047) and 0.877 for the validation (n = 3780) group dataset, the score is superior in performance compared to the Injury Severity Score (0.806/0.815).

Conclusion

The AdHOC score appears to be easy and accessible in every emergency room without the requirement of special diagnostic tools or knowledge of the exact injury pattern and can be useful for the planning of further surgical treatment.
Urothelial toxicity of esketamine in the treatment of depression
Authors: Findeis Hannelore , Sauer Cathrin , Cleare Anthony , Bauer Michael , Ritter Philipp
Published: July 2020

Rationale

Ketamine is the first widely used substance with rapid-onset antidepressant action. However, there are uncertainties regarding its potential urothelial toxicity, particularly after repeated application. In the context of rising recreational ketamine use, severe side effects affecting the human urinary tract have been reported. It is assumed that ketamine interacts with bladder urothelial cells and induces apoptosis.

Objectives

This study aimed to assess whether single or repeated doses of esketamine used in an antidepressant indication are associated with urinary toxicity.

Methods

We included male and female inpatients with a current episode of depression and a diagnosis of recurrent depressive disorder, bipolar disorder or schizoaffective disorder according to ICD-10 criteria (n = 25). The esketamine treatment schedule involved a maximum of 3× weekly dosing at 0.25–0.5 mg/kg i.v. or s.c. The primary outcome was the change in urine toxicity markers (leukocytes, erythrocytes, protein and free haemoglobin). Description of demographic, clinical and laboratory data was conducted using means, standard deviations, frequencies and percentages. Changes in urinary toxicity markers over time were evaluated using linear mixed models with gender as a covariate.

Results

The participants received an average of 11.4 (SD 8) esketamine treatments, and an average number of 11.2 (SD 8) urine samples were analysed over the course of treatment. Neither urinary leukocyte concentration (F(20; 3.0) = 3.1; p = 0.2) nor erythrocyte concentration (F(20;2.2) = 4.1; p = 0.2) showed a significant trend towards increase during the course of esketamine treatment. Similarly, free haemoglobin and protein concentrations, which were analysed descriptively, did not display a rise during treatment. There was a significant improvement in depression ratings after esketamine treatment (p < 0.001).

Conclusions

This study is, to the best of our knowledge, the first to focus on urothelial toxicity of esketamine used in antidepressant indication and dose. The results indicate that the use of single or repeated doses of esketamine is unlikely to cause urothelial toxicity. The results are in need of confirmation as sample size was small.
Diet and prey preferences of larval and pelagic juvenile Faroe Plateau cod (Gadus morhua)
Authors: Jacobsen Sólvá , Nielsen Kristoffer Klitgaard , Kristiansen Rune , Grønkjær Peter , Gaard Eilif , Steingrund Petur
Published: July 2020

The availability of suitable prey during the early life of fish may determine recruitment to the adult population. Since larval and juvenile feeding can be highly selective, their preferences for certain prey species and sizes should be considered when estimating the availability of prey. In this study, diet composition (and prey preferences) of 4984 (1366) Faroe Plateau cod (Gadus morhua) larvae and juveniles between 3 and 63 mm sampled on the central Faroe shelf (62°N, 6.8°W) over an 8-year period was investigated. Cod preyed on successively larger food items as they grew. Yolk-sac larvae consumed phytoplankton, copepod eggs and nauplii before the yolk sac was exhausted. Copepod eggs followed by calanoid nauplii were the predominant and preferred food items in the early larval stage. In the late larval stage these were replaced by small to medium sized (0.6–1.2 mm) copepod species mainly Pseudocalanus sp., Acartia sp. and early stage Calanus finmarchicus, of which the two former species appeared most preferred. Temora longicornis was highly abundant in juvenile cod, but the preference for this species was neutral. Positive selection and high abundance of late stage (≥ 1.5 mm) C. finmarchicus was observed in early juveniles, but C. finmarchicus was replaced by decapod larvae in late juveniles. Other abundant prey species such as Oithona sp. and barnacle larvae occurred in varying numbers in the guts, but were generally not positively selected at any stage. Late larval and early juvenile cod appeared to suffer from unfavourable feeding conditions as they fed on smaller prey than what they prefer potentially indicating bottle necks in the feeding at these development stages.
Telemetry reveals strong effects of offshore wind farms on behaviour and habitat use of common guillemots (Uria aalge) during the breeding season
Authors: Peschko Verena , Mercker Moritz , Garthe Stefan
Published: July 2020

Seabirds have increasingly encountered offshore wind farms (OWFs) in European waters in the past 10 years, resulting in potential conflicts with offshore foraging areas. During the breeding season, seabirds are restricted in their choice of foraging habitat and are under increased pressure to find enough prey to raise their offspring. However, information on the individual reactions of seabirds towards OWFs during the breeding season is lacking. Three OWFs located 23–35 km north of the island of Helgoland have operated since October 2015. We studied their possible effects on locally breeding common guillemots (Uria aalge) using GPS tracking. GPS tags were deployed on 12 breeding guillemots from Helgoland for 8–26 days during 2016–2017. Most individuals avoided the OWFs, but one individual in each year briefly entered the OWFs on two or three occasions. Using a point process model, we revealed a 63% reduction in the resource selection of the OWF areas compared with the surroundings (lower confidence interval (CI) = 79% reduction, upper CI = 36% reduction). Furthermore, OWF avoidance was increased to 75% when the turbine blades were rotating (lower CI = 93% reduction, upper CI = 11% reduction). Guillemots mainly approached the OWFs from their eastern edge when resting or diving, and rarely approached the areas when commuting. These results provide a detailed description of guillemot reactions to OWFs during the breeding season, and the first comprehensive analysis of OWF effects on this species based on telemetry data. The strong avoidance effect for guillemots during the breeding season indicates the need to consider the presence of OWFs when interpreting future trends in the abundance and breeding success of this species.
Cyclophosphamide for salvage therapy of chronic graft-versus-host disease: a retrospective analysis
Authors: Fante Matthias A. , Holler Barbara , Weber Daniela , Angstwurm Klemens , Bergler Tobias , Holler Ernst , Edinger Matthias , Herr Wolfgang , Wertheimer Tobias , Wolff Daniel
Published: July 2020

We retrospectively analyzed the safety and efficacy of cyclophosphamide (cyclo) for salvage treatment of chronic graft-versus-host disease (cGvHD) and cGvHD-associated (glomerulo-)nephritis at our center between 01/2010 and 11/2019. We identified 13 patients (pts) receiving cyclo for treatment of moderate (3/13) and severe (6/13) steroid-refractory cGvHD, cGvHD-associated (glomerulo-)nephritis (3/13), or vasculitis-like CNS manifestation of cGvHD (1/13). Cyclo was started on median day 509 (range 42–8193) after cGvHD onset; the median duration of application was 153 days (range 14–486) with 2/13 currently continuing treatment. The National Institute of Health organ grading and the intensity of immunosuppression (IS) were assessed at cyclo start and repeated after 3, 6, and 12 months. Response assessment was stopped at the start of any additional new IS. The median time of follow up was 407 days (range 86–1534). Best response was 1/13 CR, 6/13 PR, 4/13 SD, 1/13 MR, and 1/13 PD (ORR 54%). Significant and durable response was observed especially in cGvHD-associated (glomerulo-)nephritis (3/3). Infectious complications > CTCAE grade III were observed in 3/12 pts. During cyclo therapy, none of the pts suffered from recurrence of underlying malignancy. Overall, cyclo was relatively well tolerated and showed responses in heavily pretreated patients but requires further evaluation within clinical trials.
Augmented reality for base plate component placement in reverse total shoulder arthroplasty: a feasibility study
Authors: Kriechling Philipp , Roner Simon , Liebmann Florentin , Casari Fabio , Fürnstahl Philipp , Wieser Karl
Published: July 2020

Background

Accurate glenoid positioning in reverse total shoulder arthroplasty (RSA) is important to achieve satisfying functional outcome and prosthesis longevity. Optimal component placement can be challenging, especially in severe glenoid deformities. The use of patient-specific instruments (PSI) and 3D computer-assisted optical tracking navigation (NAV) are already established methods to improve surgical precision. Augmented reality technology (AR) promises similar results at low cost and ease of use. With AR, the planned component placement can be superimposed to the surgical situs and shown directly in the operating field using a head mounted display. We introduce a new navigation technique using AR via head mounted display for surgical navigation in this feasibility study, aiming to improve and enhance the surgical planning.

Methods

3D surface models of ten human scapulae were printed from computed tomography (CT) data of cadaver scapulae. Guidewire positioning of the central back of the glenoid baseplate was planned with a dedicated computer software. A hologram of the planned guidewire with dynamic navigation was then projected onto the 3D-created models of the cadaver shoulders. The registration of the plan to the anatomy was realized by digitizing the glenoid surface and the base of the coracoid with optical tracking using a fiducial marker. After navigated placement of the central guidewires, another CT imaging was recorded, and the 3D model was superimposed with the preoperative planning to analyze the deviation from the planned and executed central guides trajectory and entry point.

Results

The mean deviation of the ten placed guidewires from the planned trajectory was 2.7° ± 1.3° (95% CI 1.9°; 3.6°). The mean deviation to the planned entry point of the ten placed guidewires measured 2.3 mm ± 1.1 mm (95% CI 1.5 mm; 3.1 mm).

Conclusion

AR may be a promising new technology for highly precise surgical execution of 3D preoperative planning in RSA.
Optimising functional outcomes in rectal cancer surgery
Authors: Nocera Fabio , Angehrn Fiorenzo , von Flüe Markus , Steinemann Daniel C.
Published: July 2020

Background

By improved surgical technique such as total mesorectal excision (TME), multimodal treatment and advances in imaging survival and an increased rate of sphincter preservation have been achieved in rectal cancer surgery. Minimal-invasive approaches such as laparoscopic, robotic and transanal-TME (ta-TME) enhance recovery after surgery. Nevertheless, disorders of bowel, anorectal and urogenital function are still common and need attention.

Purpose

This review aims at exploring the causes of dysfunction after anterior resection (AR) and the accordingly preventive strategies. Furthermore, the indication for low AR in the light of functional outcome is discussed. The last therapeutic strategies to deal with bowel, anorectal, and urogenital disorders are depicted.

Conclusion

Functional disorders after rectal cancer surgery are frequent and underestimated. More evidence is needed to define an indication for non-operative management or local excision as alternatives to AR. The decision for restorative resection should be made in consideration of the relevant risk factors for dysfunction. In the case of restoration, a side-to-end anastomosis should be the preferred anastomotic technique. Further high-evidence clinical studies are required to clarify the benefit of intraoperative neuromonitoring. While the function of ta-TME seems not to be superior to laparoscopy, case-control studies suggest the benefits of robotic TME mainly in terms of preservation of the urogenital function. Low AR syndrome is treated by stool regulation, pelvic floor therapy, and transanal irrigation. There is good evidence for sacral nerve modulation for incontinence after low AR.
Efficacy and safety of an innovative prolonged-release combination drug in patients with distal renal tubular acidosis: an open-label comparative trial versus standard of care treatments
Authors: Bertholet-Thomas Aurélia , Guittet Catherine , Manso-Silván Maria A. , Castang Arnaud , Baudouin Véronique , Cailliez Mathilde , Di Maio Massimo , Gillion-Boyer Olivia , Golubovic Emilija , Harambat Jérôme , Klein Alexandre , Knebelmann Bertrand , Nobili François , Novo Robert , Podracka Ludmila , Roussey-Kesler Gwenaëlle , Stylianou Christos , Granier Luc-André
Published: July 2020

Background

Distal renal tubular acidosis (dRTA), due to impaired acid secretion in the urine, can lead to severe long-term consequences. Standard of care (SoC) oral alkalizers, requiring several daily intakes, are currently used to restore normal plasma bicarbonate levels. A new prolonged-release formulation, ADV7103, has been developed to achieve a sustained effect with an improved dosing scheme.

Methods

In a multicenter, open-label, non-inferiority trial (n = 37), patients with dRTA were switched from SoC to ADV7103. Mean plasma bicarbonate values and proportion of responders during steady state therapy with both treatments were compared, as were other blood and urine parameters, as well as acceptability, tolerability, and safety.

Results

When switching from SoC to ADV7103, the number of daily intakes was reduced from a median of three to twice daily. Mean plasma bicarbonate was increased and non-inferiority of ADV7103 was demonstrated (p < 0.0001, per protocol), as was statistical superiority (p = 0.0008, intention to treat [ITT]), and the response rate increased from 43 to 90% with ADV7103 (p < 0.001, ITT). Urine calcium/citrate ratio was reduced below the threshold for risk of lithogenesis with ADV7103 in 56% of previously non-responders with SoC (p = 0.021, ITT). Palatability was improved (difference [95% CI] of 25 [10.7, 39.2] mm) and gastrointestinal discomfort was reduced (difference [95% CI] of − 14.2 [− 25.9, − 2.6] mm) with ADV7103.

Conclusions

Plasma bicarbonate levels and response rate were significantly higher with ADV7103 than with SoC. Urine calcium/citrate ratio, palatability, and gastrointestinal safety were significantly improved, supporting the use of ADV7103 as first-line treatment for dRTA.

Trial registration

Registered as EudraCT 2013-002988-25 on the 1st July 2013
Different approaches to long-term treatment of aHUS due to MCP mutations: a multicenter analysis
Authors: Klämbt Verena , Gimpel Charlotte , Bald Martin , Gerken Christopher , Billing Heiko , Loos Sebastian , Hansen Matthias , König Jens , Vinke Tobias , Montoya Carmen , Lange-Sperandio Bärbel , Kirschstein Martin , Hennies Imke , Pohl Martin , Häffner Karsten
Published: July 2020

Background

Atypical hemolytic uremic syndrome (aHUS) is a rare, life-threatening microangiopathy, frequently causing kidney failure. Inhibition of the terminal complement complex with eculizumab is the only licensed treatment but mostly requires long-term administration and risks severe side effects. The underlying genetic cause of aHUS is thought to influence the severity of initial and recurring episodes, with milder courses in patients with mutations in membrane cofactor protein (MCP).

Methods

Twenty pediatric cases of aHUS due to isolated heterozygous MCP mutations were reported from 12 German pediatric nephrology centers to describe initial presentation, timing of relapses, treatment, and kidney outcome.

Results

The median age of onset was 4.6 years, with a female to male ratio of 1:3. Without eculizumab maintenance therapy, 50% (9/18) of the patients experienced a first relapse after a median period of 3.8 years. Kaplan-Meier analysis showed a relapse-free survival of 93% at 1 year. Four patients received eculizumab long-term treatment, while 3 patients received short courses. We could not show a benefit from complement blockade therapy on long term kidney function, independent of short-term or long-term treatment. To prevent 1 relapse with eculizumab, the theoretical number-needed-to-treat (NNT) was 15 for the first year and 3 for the first 5 years after initial presentation.

Conclusion

Our study shows that heterozygous MCP mutations cause aHUS with a risk of first relapse of about 10% per year, resulting in large NNTs for prevention of relapses with eculizumab. More studies are needed to define an optimal treatment schedule for patients with MCP mutations to minimize the risks of the disease and treatment.
The logic induced by effect algebras
Authors: Chajda Ivan , Halaš Radomír , Länger Helmut
Published: July 2020

Effect algebras form an algebraic formalization of the logic of quantum mechanics. For lattice effect algebras $${\mathbf {E}}$$
E
, we investigate a natural implication and prove that the implication reduct of $${\mathbf {E}}$$
E
is term equivalent to $${\mathbf {E}}$$
E
. Then, we present a simple axiom system in Gentzen style in order to axiomatize the logic induced by lattice effect algebras. For effect algebras which need not be lattice-ordered, we introduce a certain kind of implication which is everywhere defined but whose result need not be a single element. Then, we study effect implication algebras and prove the correspondence between these algebras and effect algebras satisfying the ascending chain condition. We present an axiom system in Gentzen style also for not necessarily lattice-ordered effect algebras and prove that it is an algebraic semantics for the logic induced by finite effect algebras.
Modeling and simulation of the IEEE 802.11e wireless protocol with hidden nodes using Colored Petri Nets
Authors: Coronado Estefanía , Valero Valentín , Orozco-Barbosa Luis , Cambronero María-Emilia , Pelayo Fernando L.
Published: July 2020

Wireless technologies are continuously evolving, including features such as the extension to mid- and long-range communications and the support of an increasing number of devices. However, longer ranges increase the probability of suffering from hidden terminal issues. In the particular case of Wireless Local Area Networks (WLANs), the use of Quality of Service (QoS) mechanisms introduced in IEEE 802.11e compromises scalability, exacerbates the hidden node problem, and creates congestion as the number of users and the variety of services in the network grow. In this context, this paper presents a configurable Colored Petri Net (CPN) model for the IEEE 802.11e protocol with the aim of analyzing the QoS support in mid- and long-range WLANs The CPN model covers the behavior of the protocol in the presence of hidden nodes to examine the performance of the RTS/CTS exchange in scenarios where the QoS differentiation may involve massive collision chains and high delays. Our CPN model sets the basis for further exploring the performance of the various mechanisms defined by the IEEE 802.11 standard. We then use this CPN model to provide a comprehensive study of the effectiveness of this protocol by using the simulation and monitoring capabilities of CPN Tools.
Quantitative analysis of the risk to road networks exposed to slow-moving landslides: a case study in the Campania region (southern Italy)
Authors: Ferlisi Settimio , Marchese Antonio , Peduto Dario
Published: July 2020

This paper shows the results of a study aimed at quantitatively estimating—in terms of direct (repair) costs, at large scale (1:5000)—the slow-moving landslide risk to a road network assumed as undamaged as well as the consequences to the same network in damaged conditions. The newly conceived methodological approaches address some challenging tasks concerning (i) the hazard analysis, which is expressed in terms of probability of occurrence of slow-moving landslides with a given intensity level that, in turn, is established based on empirical fragility curves, and (ii) the consequence analysis, which brings to the generation of time-dependent vulnerability curves. Their applicability is successfully tested in a case study in the Campania region (southern Italy) for which both very high-resolution DInSAR data and information gathered from in situ surveys on the severity of damage sustained by the selected road sections are available. Benefits associated with the use of the obtained results in informed decision-making processes are finally discussed.
Working Towards the Development and Implementation of Precision Mental Healthcare: An Example
Authors: Lutz Wolfgang , Schwartz Brian , Martín Gómez Penedo Juan , Boyle Kaitlyn , Deisenhofer Anne-Katharina
Published: July 2020

Leonard Bickman’s (2020) Festschrift paper in the special issue “The Future of Children’s Mental Health Services” on improving mental health services is an impressive reflection of his career, highlighting his major insights and the development of mental health services research as a whole. Five major difficulties in this field’s current research and practice are attentively delineated: poor diagnostics, measurement problems, disadvantages of randomized controlled trials (RCTs), lack of feedback and personalized treatments. Dr. Bickman recommends possible solutions based on his extensive experience and empirical findings. We agree with his thoughts and illustrate how we, challenged with the same problems, have attempted to develop clinically informed research and evidence-based clinical practice. A comprehensive feedback system that deals with the aforementioned problems is briefly described. It includes pre-treatment recommendations for treatment strategies and an empirically informed dropout prediction based on a variety of data sources. In addition to treatment recommendations, continuous feedback as well as individualized treatment adaptation tools are provided during ongoing therapy. New projects are being implemented to further improve the system by including new data assessment strategies and sources, e.g., ecological momentary assessment (EMA) and automated video analysis.
Eco-evo-devo and iterated learning: towards an integrated approach in the light of niche construction
Authors: Segovia-Martín José , Balari Sergio
Published: July 2020

In this paper we argue that ecological evolutionary developmental biology (eco-evo-devo) accounts of cognitive modernity are compatible with cultural evolution theories of language built upon iterated learning models. Cultural evolution models show that the emergence of near universal properties of language do not require the preexistence of strong specific constraints. Instead, the development of general abilities, unrelated to informational specificity, like the copying of complex signals and sharing of communicative intentions is required for cultural evolution to yield specific properties, such as language structure. We argue that eco-evo-devo provides the appropriate conceptual background to ground an account for the many interconnected genetic, environmental and developmental factors that facilitated the emergence of an organic system able to develop language through the iterated transmission of information. We use the concept of niche construction to connect evolutionary developmental accounts for sensory guided motor capacities and cultural evolution guided by iterated learning models. This integrated theoretical model aims to build bridges between biological and cultural approaches.
Structure-based inhibitor design of mutant RAS proteins—a paradigm shift
Authors: Nyíri Kinga , Koppány Gergely , Vértessy Beáta G.
Published: July 2020

As a member of small GTPase family, KRAS protein is a key physiological modulator of various cellular activities including proliferation. However, mutations of KRAS present in numerous cancer types, most frequently in pancreatic (> 60%), colorectal (> 40%), and lung cancers, drive oncogenic processes through overactivation of proliferation. The G12C mutation of KRAS protein is especially abundant in the case of these types of malignancies. Despite its key importance in human disease, KRAS was assumed to be non-druggable for a long time since the protein seemingly lacks potential drug-binding pockets except the nucleotide-binding site, which is difficult to be targeted due to the high affinity of KRAS for both GDP and GTP. Recently, a new approach broke the ice and provided evidence that upon covalent targeting of the G12C mutant KRAS, a highly dynamic pocket was revealed. This novel targeting is especially important since it serves with an inherent solution for drug selectivity. Based on these results, various structure-based drug design projects have been launched to develop selective KRAS mutant inhibitors. In addition to the covalent modification strategy mostly applicable for G12C mutation, different innovative solutions have been suggested for the other frequently occurring oncogenic G12 mutants. Here we summarize the latest advances of this field, provide perspectives for novel approaches, and highlight the special properties of KRAS, which might issue some new challenges.
Impact of Repeated Exposure and Cleaning on Protective Properties of Structural Firefighting Turnout Gear
Authors: Horn Gavin P. , Kerber Steve , Andrews Jessica , Kesler Richard M. , Newman Hannah , Stewart Jacob W. , Fent Kenneth W. , Smith Denise L.
Published: July 2020

The US fire service has become acutely aware of the need to clean PPE after fires. However, there is concern that damage from repeated cleaning may impact critical protection from fireground risk. Using a protocol that included repeated simulated fireground exposures (between 0 cycles and 40 cycles) and/or repeated cleaning with techniques common in the fire service, we found that several important protective properties of NFPA 1971 compliant turnout gear are significantly changed. Outer shell and thermal liner tear strength showed a statistically significant reduction when laundered as compared to wet or dry decontamination. Larger changes in outer shell tear strength resulted when the coat closure incorporated hook & dee clasps as compared with garments using zippered closures. Total Heat Loss was reduced for all samples that underwent any form of cleaning while Thermal Protective Performance was only increased in the gear that was laundered. These results suggest that some important protective properties of bunker gear can be decreased after repeated exposure/cleaning cycles relative to their levels when tested in a new condition. For the specific materials tested, outer shell trap tear strength in the fill direction and seam strength dropped below NFPA 1971 requirements after 40 laundering cycles. The findings for this study may have utility for setting preconditions for the measurement of certain performance properties in future editions of NFPA 1971.
A review of the physiology behind letrozole applications in infertility: are current protocols optimal?
Authors: Rose Bruce I. , Brown Samuel E.
Published: July 2020

Letrozole is a targeted aromatase inhibitor which has primarily been used in post-menopausal women with breast cancer. Recently, it has been utilized in infertile pre-menopausal women because of its ability to enhance FSH production for ovulation induction. However, the ovarian follicle’s response to FSH is only a part of the endocrine events occurring in a developing follicle. The health of the small antral follicles is driven primarily by androgens, which contribute to granulosa cell mitosis, sensitivity to FSH, and resistance to atresia. In contrast, elevated androgens in the late antral to pre-ovulatory follicle have a negative impact on follicle health and lead to atresia and cystic follicle formation. This ovarian physiologic data suggests that current applications of letrozole to infertility may be squandering some of the primary benefits available in using letrozole to promote follicle development. Four applications of letrozole to infertility that have appeared in the medical literature are reviewed. Androgen-related benefits are reviewed and various questions put forward about how letrozole could be more effectively used to help patients in these settings.
Phytoextraction from Chromium-Contaminated Soil Using Moso Bamboo in Mediterranean Conditions
Authors: Ranieri Ezio , Tursi Angelo , Giuliano Silvia , Spagnolo Vincenzo , Ranieri Ada Cristina , Petrella Andrea
Published: July 2020

An experimentation has been carried out in simulated Mediterranean and tropical laboratory conditions aimed to show the Moso bamboo capability of phytoextraction chromium from contaminated soil. Electronic microscopy supported the analyses performed on soil and on the different plant tissues. A preliminary test on the bamboo has been carried out in laboratory evaluating his growth with irrigation in Mediterranean conditions (600 mm/year) and tropical conditions (1.800 mm/year). A test of the bamboo tolerance of was also carried out by measuring his growth with irrigation with a solution of 100 mg Cr/l, reporting not significant damages to the plant tissues. Subsequently chromium phytoextraction was tested highlighting that bamboo removes Cr from soil with a percentage ranging from 43% (600 mm/year) to 47.4% (1.800 mm/year) of the total content in soil. Lastly, the distribution of chromium in the different fragments of the bamboo plants has been performed. It has been shown that approx. 69% of chromium, in Mediterranean conditions, was in the rhizomes and approx. 68% in tropical conditions. A slightly higher tendency to chromium translocation to leaves has been shown in tropical conditions than in Mediterranean conditions.
Living with leg lymphedema: developing a novel model of quality lymphedema care for cancer survivors
Authors: Bowman Catharine , Oberoi Devesh , Radke Lori , Francis George J. , Carlson Linda E.
Published: July 2020

Purpose

Lower-extremity lymphedema (LEL) is a lifelong consequence of cancer therapy and can lead to serious physical and psychosocial complications for many cancer survivors. However, clinical knowledge and treatment of LEL remain minimal. The purpose of this study was to integrate perspectives of lymphedema patients and healthcare providers (HCPs) on LEL to develop a novel model for quality lymphedema care.

Methods

A mixed-methods approach was implemented. Standardized questionnaires and semi-structured interviews were used to assess psychosocial well-being and experiences of LEL patients. Interviews were also used to evaluate the clinical experiences of HCPs working within tumour groups associated with cancer-related LEL. Thematic analysis was used to analyse qualitative data.

Results

Twenty-two patients and eleven HCPs participated in this study. Patient QOL, generalized anxiety and depressive symptom scores revealed a complex interplay between psychosocial well-being and supportive LEL care after cancer. Three themes emerged from interviews with patients (n = 19) and HCPs (n = 11): level of lymphedema knowledge, effectiveness of rehabilitation oncology services and barriers to care.

Implications for Cancer Survivors

We developed a novel model for quality lymphedema care that emphasizes the importance of continued physical and psychosocial support for LEL patients, while illustrating the importance of HCPs in facilitating a smooth transition for patients to LEL care after cancer treatment.
Separation of diffracted waves via SVD filter
Authors: Shen Hong-Yan , Li Qin , Yan Yue-Ying , Li Xin-Xin , Zhao Jing
Published: July 2020

Diffracted seismic waves may be used to help identify and track geologically heterogeneous bodies or zones. However, the energy of diffracted waves is weaker than that of reflections. Therefore, the extraction of diffracted waves is the basis for the effective utilization of diffracted waves. Based on the difference in travel times between diffracted and reflected waves, we developed a method for separating the diffracted waves via singular value decomposition filters and presented an effective processing flowchart for diffracted wave separation and imaging. The research results show that the horizontally coherent difference between the reflected and diffracted waves can be further improved using normal move-out (NMO) correction. Then, a band-rank or high-rank approximation is used to suppress the reflected waves with better transverse coherence. Following, separation of reflected and diffracted waves is achieved after the filtered data are transformed into the original data domain by inverse NMO. Synthetic and field examples show that our proposed method has the advantages of fewer constraints, fast processing speed and complete extraction of diffracted waves. And the diffracted wave imaging results can effectively improve the identification accuracy of geological heterogeneous bodies or zones.
Prospective observational study of bevacizumab combined with paclitaxel as first- or second-line chemotherapy for locally advanced or metastatic breast cancer: the JBCRG-C05 (B-SHARE) study
Authors: Yamamoto Yutaka , Yamashiro Hiroyasu , Toh Uhi , Kondo Naoto , Nakamura Rikiya , Kashiwaba Masahiro , Takahashi Masato , Tsugawa Koichiro , Ishikawa Takashi , Nakayama Takahiro , Ohtani Shoichiro , Takano Toshimi , Fujisawa Tomomi , Toyama Tatsuya , Kawaguchi Hidetoshi , Mashino Kojiro , Tanino Yuichi , Morita Satoshi , Toi Masakazu , Ohno Shinji
Published: July 2020

Purpose

To investigate the effectiveness and safety of bevacizumab–paclitaxel combination therapy as first- or second-line chemotherapy for HER2-negative locally advanced or metastatic breast cancer in daily clinical practice.

Methods

In this prospective multicenter observational study, bevacizumab–paclitaxel was administered at the discretion of attending physicians. Cohorts A and B had hormone receptor-positive and triple-negative breast cancer (TNBC), respectively. Primary endpoint was overall survival (OS). Multivariate analyses were conducted to identify prognostic factors.

Results

Between November 2012 and October 2014, 767 patients were enrolled from 155 institutions across Japan. Effectiveness was analyzed in 754 eligible patients (cohort A, 539; cohort B, 215) and safety in 750 treated patients (median observation period, 19.7 months). Median OS (95% CI) was 21.7 (19.8–23.6) months in eligible patients; 25.2 (22.4–27.4) months and 13.2 (11.3–16.6) months in cohorts A and B, respectively; and 24.4 (21.9–27.2) months and 17.6 (15.2–20.0) months in patients receiving first- and second-line therapy, respectively. Factors affecting OS (hazard ratio 95% CI) were TNBC (1.75, 1.44–2.14), second-line therapy (1.35, 1.13–1.63), ECOG performance status ≥ 1 (1.28, 1.04–1.57), taxane-based chemotherapy (0.65, 0.49–0.86), cancer-related symptoms (0.56, 0.46–0.68), and visceral metastasis (0.52, 0.40–0.66). Incidences of grade ≥ 3 AEs hypertension, neutropenia, peripheral neuropathy, proteinuria, and bleeding were 35.7%, 27.2%, 7.2%, 3.7%, and 0.3%, respectively.

Conclusions

In Japanese clinical practice, combined bevacizumab–paclitaxel was as effective as in previous studies. Factors that independently predicted poor prognosis in the present study are consistent with those identified previously.

Trial registration

Trial no. UMIN000009086.
First Report of the Co-occurrence of Cylindrospermopsin, Nodularin and Microcystins in the Freshwaters of Lake Victoria, Tanzania
Authors: Mchau Geofrey J. , Machunda Revocatus , Kimanya Martin , Makule Edna , Gong Yun Yun , Mpolya Emmanuel , Meneely Julie P. , Elliott Christopher T. , Greer Brett
Published: July 2020

There is a global concern regarding the increase of cyanotoxins in freshwater and their potential effects on human health. The existence of multiple toxins in freshwater can result in an increased risk of their bioaccumulation in humans from their ingestion through contaminated drinking water or recreational activities. This study, the first of its kind, was conducted to determine the occurrence of thirteen cyanotoxins namely; microcystins (-LA, -LF, -LR, -LY, -LW, -RR, -YR, -WR, dm MC-RR and dm MC-LR), anatoxin-a, nodularin and cylindrospermopsin in the freshwaters of Lake Victoria in Tanzania. A total of 23 sites were selected for water sampling. Samples were randomly collected from lakeshores (n = 54), wells (n = 66) and piped water (n = 18) in two phases, February (dry season) and December (rainy season) 2018. Samples (n = 138) were analysed using liquid chromatography mass spectrometry (UPLC-MS/MS). Cylindrospermopsin was the most abundant cyanotoxin detected in the lakeshores, with eight of the nine collection sites (89%) reporting cylindrospermopsin in phase I, compared to three out of nine (33%) in phase II. Microcystin congeners -RR, -LR and -YR were detected in phase I, with microcystins -RR and -LR detected in phase II. MC concentrations ranged from 0.003 to 0.007 μg/L for MC-RR, 0.01–0.013 μg/L for MC-LR and 0.004 to 0.01 μg/L for cylindrospermopsin, with nodularin reported once at a concentration of 0.01 μg/L. No cyanotoxins were detected in wells or in treated pipe water samples. The existence of multiple toxins in different collection sites may lead to synergistic effects and increase the toxicological risk to humans. This is the first study to report the presence of cylindrospermopsin and nodularin in the freshwaters of Lake Victoria.
Stationary water waves on rotational flows of two vortical layers
Authors: Shōji Mayumi , Okamoto Hisashi
Published: July 2020

Stationary waves of constant shape and constant propagation speed on rotational flows of two layers are computed numerically. Two layers are assumed to be of distinct constant vorticity distributions. Three different kinds of waves of finite depth are considered: pure capillary, capillary-gravity, and gravity waves. The problem is formulated as a bifurcation problem, which involves many parameters and produces a complicated structure of solutions. We adopted a numerical method by which waves with stagnation points can be computed, and obtained variety of new solutions. It is also reported that the locations of the stagnation points vary curiously with the prescribed parameters and that they offer an interesting problem.
HIV transmission by human bite: a case report and review of the literature—implications for post-exposure prophylaxis
Authors: Schürmann Dirk , Hoffmann Christian , Stegemann Miriam S. , Ruwwe-Glösenkamp Christoph , Gürtler Lutz
Published: July 2020

We report a case of a probable HIV-1 transmission by human bite. The analyzed data from ten previously reported  suspected or allegedly confirmed HIV transmissions revealed a deep bleeding bite wound as the primary risk factor. A high HIV plasma viral load and bleeding oral lesions are present most of the time during HIV transmission by bite. HIV post-exposure prophylaxis (PEP) should be recommended in case of a bleeding wound resulting from a bite of an HIV-infected person. PEP was missed in this presented case.
On the irreducibility of cones of 3-secant planes
Authors: Ciliberto Ciro
Published: July 2020

In this paper we prove that if $$X\subset {\mathbb P}^r$$

X
⊂

P

r

is a 2-smooth, irreducible, projective non-degenerate variety of dimension n such that $${\text {Sec}}_2(X)={\mathbb P}^r$$

Sec
2

(
X
)

=

P

r

, if $$n > \frac{4}{7}(r-2)$$

n
>

4
7

(
r
-
2
)

and if $$X'$$

X
′

is the projection of X to $${\mathbb P}^{r-1}$$

P

r
-
1

from a general point, then the set of length 3 subschemes of $$X'$$

X
′

which lie on a line form an irreducible variety.
Body Image, Orgasmic Response, and Sexual Relationship Satisfaction: Understanding Relationships and Establishing Typologies Based on Body Image Satisfaction
Authors: Horvath Zsolt , Smith Betina Hodt , Sal Dorottya , Hevesi Krisztina , Rowland David L.
Published: July 2020

Introduction

This study explored the role of body image dissatisfaction on orgasmic response during partnered sex and masturbation and on sexual relationship satisfaction. The study also described typologies of women having different levels of body image satisfaction.

Methods

A sample of 257 Norwegian women responded to an online survey assessing body image dissatisfaction, problems with orgasm, and sexual relationship satisfaction. Using structural equation modeling and factor mixture modeling, the relationship between body image dissatisfaction and orgasmic response was assessed, and clusters of sexual response characteristics associated with varying levels of body image dissatisfaction were identified.

Main Outcome Measure

Orgasmic function during partnered sex and masturbation, along with sexual relationship satisfaction, were assessed as a function of body image.

Results

Body image dissatisfaction, along with a number of covariates, predicted higher levels of “problems with orgasm” during both partnered sex and masturbation, with no significant difference in the association depending on the type of sexual activity. Varying levels of body image dissatisfaction/satisfaction were associated with differences in orgasmic incidence, difficulty, and pleasure during partnered sex; with one orgasmic parameter during masturbation; and with sexual relationship satisfaction.

Conclusion

Body image dissatisfaction and likely concomitant psychological distress are related to impaired orgasmic response during both partnered sex and masturbation and may diminish sexual relationship satisfaction. Women with high body image dissatisfaction can be characterized by specific sexual response patterns.
Chemsex in Italy: Experiences of Men Who Have Sex with Men Consuming Illicit Drugs to Enhance and Prolong Their Sexual Activity
Authors: Nimbi Filippo Maria , Rosati Fausta , Esposito Rita Maria , Stuart David , Simonelli Chiara , Tambelli Renata
Published: July 2020

Background

Chemsex is a novel phenomenon referring to the consumption of illicit drugs to facilitate, enhance, and prolong the sexual experience in men who have sex with men (MSM).

Aim

The present study aims to investigate contexts, patterns of substance use, first chemsex experience, and harm reduction in a group of MSM practicing chemsex in Italy.

Methods

Thirty MSM involved in chemsex activities were interviewed between February and July 2019.

Outcomes

The interviews were conducted using an ad hoc grid exploring general characteristics of Italian chemsex, patterns of substance use, first chemsex experience, and harm reduction opinions.

Results

Chemsex in Italy showed important peculiarities and patterns because of sociocultural background. Chemsex was mainly reported in private venues within couple and group sexual activities. Most participants attended chemsex sessions about 1-2 times per month often concurring with men-only club events. Freebase cocaine emerged among the most relevant substances consumed together with gamma-hydroxybutyrate/gamma-butyrolactone, crystal methamphetamine, and mephedrone. A rare use of injected substances compared with other European Union countries was shown. Given the high prevalence of erectile problems, a large use of phosphodiesterase type 5 inhibitors was reported, and noncoital sexual activities were usually preferred (eg, oral sex, fist fucking). The first chemsex experiences were usually accessed by geolocation-based dating apps and sexual partners and were generally described as positive experiences, with some negative consequences at the end of the session (dysphoric mental states, guilt, craving). Taking part in international gay events seems to favor the first experience of chemsex for some participants. Moreover, some MSM practiced chemsex only abroad or in other cities in Italy so as not to be recognized as chem users in their daily environment.

Clinical Translation

Implications for ad hoc harm reduction programs are discussed.

Strengths & Limitations

Despite the methodological limitations due to participants’ number and the absence of interviews audio recording, results highlighted some relevant characteristics of chemsex in Italy, such as freebase cocaine use, attitudes regarding slamming, geographical movements, and secrecy.

Conclusion

The results revealed a need for greater scientific and public attention on chemsex to act with the most specific and effective prevention and harm reduction tools.