bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival of Young Versus Old Patients With Oral Cavity Squamous Cell Carcinoma: A Meta‐Analysis
Authors: Lee David S. , Ramirez Ricardo J. , Lee Jake J. , Valenzuela Carla V. , Zevallos Jose P. , Mazul Angela L. , Puram Sidharth V. , Doering Michelle M. , Pipkorn Patrik , Jackson Ryan S.
Published: December 2020

Objective/Hypothesis

To assess whether young patients with oral cavity squamous cell carcinoma (OCSCC) demonstrate worse oncologic outcomes than older patients after definitive therapy.

Study Design

Systematic review and meta‐analysis.

Methods

A medical librarian composed a search strategy to identify relevant studies in Medline, Embase, Scopus, and other major databases (Prospero registration number CRD42019127974). Inclusion criteria were adults with histologically diagnosed OCSCC that underwent treatment, comparator groups with an age cutoff of 40 years old, and reported survival outcomes. Articles were excluded if they contained patients with oropharyngeal squamous cell carcinoma or patients treated for palliative intent. Overall survival hazard ratios were analyzed with a meta‐analysis.

Results

There were 23,382 patients with OCSCC that were treated with definitive therapy from 22 included studies. The pooled cohort contained 2,238 (10%) patients ≤40 years of age. Oral tongue was the most common subsite in both the younger (n = 1,961, 91%) and older (n = 18,047, 88%) cohorts. The majority of OCSCCs were either T1 or T2, representing 859 (80%) malignancies in younger patients and 8,126 (77%) malignancies in older patients. A meta‐analysis of nine studies demonstrated that younger patients did not experience worse survival outcomes than older patients (hazard ratio = 0.97, 95% confidence interval = 0.66–1.41).

Conclusions

Young adults with OCSCC experienced similar oncologic outcomes as older patients with OCSCC after definitive treatment. Until compelling evidence demonstrates clinically relevant differences between these two cohorts, their approach to management should be similar. Future studies should consider comorbidities and using age 40 as a standard age cutoff to provide more uniform data moving forward. Laryngoscope, 131:1310–1319, 2021
Dual‐polarized beam‐switching Yagi–Uda patch antenna with large tilted angle
Authors: Liu Chuzhao , Cao Yunfei , Yang Deqiang , Yang Xin , Chen Yongpin
Published: December 2020

A compact dual‐polarized beam‐switching patch antenna with large tilted angle is presented in this paper. The antenna is a Yagi–Uda patch antenna, which consists of one driven patch and two parasitic elements. Two PIN diodes are placed across the slots of the complementary split‐ring resonator to switch the function of the corresponding parasitic element between director and reflector. By properly controlling the PIN diodes, either one of the two parasitic elements will act as a director or a reflector. In doing this, reconfigurable patterns with large tilted angle of the main lobe, and hence a wide scanning angle can be achieved for both ports. Simulated and measured results of the S‐parameters and radiation patterns are presented. It is shown that within 4.7–5.0 GHz, the beam direction of the proposed antenna can be switched among 0°, −27° and 27° to cover a wide scanning angle, where the peak realized gain is higher than 7.0 dBi.
Cultural adaptation and validation of the Survivor Unmet Needs Survey Short‐Form among cancer patients in China
Authors: Yan Tingting , Zheng Wei , Wang Dandan , Zhang Wei
Published: December 2020

Aim

Cancer patients have long been found to have multiple types of unmet needs during their survivorship. Composite psychological instruments are essential for measuring the unmet needs of cancer patients. The objective of this study was to evaluate the psychometric properties of the Short‐Form Survivor Unmet Needs Survey (SF‐SUNS)‐Chinese version.

Design

A cross‐sectional survey.

Methods

The Chinese version was developed using the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology and 428 Chinese cancer patients participated in the survey between 2016‐2017. Inter‐rater reliability, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were calculated.

Results

Confirmatory factor analysis supported the four‐factor structure with good model fit. Cronbach's alpha of 0.894 for the overall scale and intra‐class correlation coefficients (0.869–0.884) indicated that reliability was satisfactory. The EFA extracted four factors with eigenvalues greater than 1 and these factors explained 50.68% of the total variance. The Chinese version of SF‐SUNS was confirmed to have the potential to become a useful and valid instrument. It could contribute to the assessment of unmet needs among Chinese cancer patients with accuracy and with respect to Chinese culture and context. This measurement of unmet needs may help promote cancer management and nursing quality. Clinical nurses and researchers could use the simple assessment tool to target the individual needs of Chinese cancer patients and then provide more personalized care efficiently.
Evaluating the Soft Tissue Sarcoma Paradigm for the Local Management of Extraskeletal Ewing Sarcoma
Authors: Boyce-Fappiano David , Guadagnolo B. Ashleigh , Ratan Ravin , Wang Wei-Lien , Wagner Michael J. , Patel Shreyaskumar , Livingston John A. , Lin Patrick P. , Diao Kevin , Mitra Devarati , Farooqi Ahsan , Lazar Alexander J. , Roland Christina L. , Bishop Andrew J.
Published: December 2020

Objectives

We reviewed our experience treating patients with localized extraskeletal Ewing sarcoma (EES) to determine optimal local management strategies for this rare disease.

Methods

Sixty patients with localized EES treated at our institution between 1994 and 2018 were reviewed. The Kaplan-Meier method was used to estimates disease outcomes.

Results

The median follow-up time was 74 months (interquartile range [IQR], 17–121). Half the patients (n = 30) received combined-modality local therapy (CMT) with both surgery and radiation therapy (RT), whereas the other half received single-modality local therapy (SMT) with either surgery or RT. All patients received chemotherapy. The 5-year overall survival was 76%. Twenty-two patients (37%) developed recurrence at a median time of 15 months (IQR, 5–56 months) resulting in 3-year progression-free survival (PFS) of 65%. On univariate analysis, the use of both neoadjuvant and adjuvant chemotherapy was associated with improved 5-year PFS (71% vs. 50%, p = .04) compared with those who received one or the other. Furthermore, 11 patients (18%) developed local recurrences at a median time of 14 months (IQR, 2–19 months), resulting in a 5-year local control (LC) rate of 77%. Use of CMT was not associated with improved LC (83% vs. 72% SMT, p = .41). Also, use of CMT was the only factor associated with poorer disease-specific survival (vs. SMT; hazard ratio, 3.4; p = .047; 95% confidence interval, 1.01–11.4).

Conclusion

For patients with EES, CMT was not associated with a decreased rate of local relapse. These data suggest that SMT alone may be sufficient for LC in select patients. A multi-institutional collaborative effort should be considered to validate these findings.

Implications for Practice

Extraskeletal Ewing sarcoma is a rare chemosensitive sarcoma whose clinical course more closely follows Ewing sarcoma of bone rather than that of other soft tissue sarcomas. Based on this study, combined-modality local therapy did not confer a local control advantage compared with single-modality local therapy. Therefore, single-modality local therapy is likely adequate in select patients with favorable disease features, which has the advantage of ensuring prompt administration of systemic therapy. A multi-institutional collaborative effort is warranted to determine which patients may benefit from de-escalated local therapy.
High-Flow Nasal Cannula Therapy for Exertional Dyspnea in Patients with Cancer: A Pilot Randomized Clinical Trial
Authors: Hui David , Mahler Donald A. , Larsson Liliana , Wu Jimin , Thomas Saji , Harrison Carol A. , Hess Kenneth , Lopez-Mattei Juan , Thompson Kara , Gomez Daniel , Jeter Melenda , Lin Steven , Basen-Engquist Karen , Bruera Eduardo
Published: December 2020

Background

Exertional dyspnea is common in patients with cancer and limits their function. The impact of high-flow nasal cannula on exertional dyspnea in nonhypoxemic patients is unclear. In this double-blind, parallel-group, randomized trial, we assessed the effect of flow rate (high vs. low) and gas (oxygen vs. air) on exertional dyspnea in nonhypoxemic patients with cancer.

Patients and Methods

Patients with cancer with oxygen saturation >90% at rest and exertion completed incremental and constant work (80% maximal) cycle ergometry while breathing low-flow air at 2 L/minute. They were then randomized to receive high-flow oxygen, high-flow air, low-flow oxygen, or low-flow air while performing symptom-limited endurance cycle ergometry at 80% maximal. The primary outcome was modified 0–10 Borg dyspnea intensity scale at isotime. Secondary outcomes included dyspnea unpleasantness, exercise time, and adverse events.

Results

Seventy-four patients were enrolled, and 44 completed the study (mean age 63; 41% female). Compared with low-flow air at baseline, dyspnea intensity was significantly lower at isotime with high-flow oxygen (mean change, −1.1; 95% confidence interval [CI], −2.1, −0.12) and low-flow oxygen (−1.83; 95% CI, −2.7, −0.9), but not high-flow air (−0.2; 95% CI, −0.97, 0.6) or low-flow air (−0.5; 95% CI, −1.3, 0.4). Compared with low-flow air, high-flow oxygen also resulted in significantly longer exercise time (difference + 2.5 minutes, p = .009), but not low-flow oxygen (+0.39 minutes, p = .65) or high-flow air (+0.63 minutes, p = .48). The interventions were well tolerated without significant adverse effects.

Conclusion

Our preliminary findings support that high-flow oxygen improved both exertional dyspnea and exercise duration in nonhypoxemic patients with cancer. (ClinicalTrials.gov ID: NCT02357134).

Implications for Practice

In this four-arm, double-blind, randomized clinical trial examining the role of high-flow nasal cannula on exertional dyspnea in patients with cancer without hypoxemia, high-flow oxygen, but not high-flow air, resulted in significantly lower dyspnea scores and longer exercise time. High-flow oxygen delivered by high-flow nasal cannula devices may improve clinically relevant outcomes even in patients without hypoxemia.
Novel BN‐epoxy/anhydride composites with enhanced thermal conductivity
Authors: Isarn Isaac , Ferrando Francesc , Serra Àngels , Urbina Cristina
Published: December 2020

A new series of high thermal boron nitride (BN) composites are prepared and characterized by several techniques. They are formed by an epoxy‐anhydride matrix and different BN contents, ranging from 30 to 80 wt%, of 120 μm agglomerates. For high BN ratio (≥60 wt%), epoxy mixtures were compressed (75 MPa) during 1 minute before curing, eliminating voids due to the high increase of viscosity, improving the compactness of the material and enhancing the thermal conductivity (TC). The curing process evolution was studied by calorimetric measurements to see if there was an influence of the filler on the curing rate. Rheological tests were performed to obtain the percolation threshold. It was observed that BN filler did not affect negatively the thermomechanical properties of the materials and allowed to enhance the TC from 0.17 W/m K in the case of the neat epoxy, to 3.06 W/m K when 80 wt% of BN agglomerates were added, which represents an improvement of 1700%.
Confidence intervals for difference in proportions for matched pairs compatible with exact McNemar's or sign tests
Authors: Fay Michael P. , Lumbard Keith
Published: December 2020

For testing with paired data (eg, twins randomized between two treatments), a simple test is the sign test, where we test if the distribution of the sign of the differences in responses between the two treatments within pairs is more often positive (favoring one treatment) or negative (favoring the other). When the responses are binary, this reduces to a McNemar‐type test, and the calculations are the same. Although it is easy to calculate an exactP‐value by conditioning on the total number of discordant pairs, the accompanying confidence interval on a parameter of interest (proportion positive minus proportion negative) is not straightforward. Effect estimates and confidence intervals are important for interpretation because it is possible that the treatment helps a very small proportion of the population yet gives a highly significant effect. We construct a confidence interval that is compatible with an exact sign test, meaning the 100 interval excludes the null hypothesis of equality of proportions if and only if the associated exact sign test rejects at level . We conjecture that the proposed confidence intervals guarantee nominal coverage, and we support that conjecture with extensive numerical calculations, but we have no mathematical proof to show guaranteed coverage. We have written and made available the functionmcnemarExactDPin theexact2x2R package and the functionsignTestin theashtR package to perform the methods described in this article.
Advanced control‐flow and concurrency in C∀
Authors: Delisle Thierry , Buhr Peter A.
Published: December 2020

C∀ is a polymorphic, nonobject‐oriented, concurrent, backwards compatible extension of the C programming language. This paper discusses the design philosophy and implementation of its advanced control‐flow and concurrent/parallel features, along with the supporting runtime written in C∀. These features are created from scratch as ISO C has only low‐level and/or unimplemented concurrency, so C programmers continue to rely on library approaches like pthreads. C∀ introduces modern language‐level control‐flow mechanisms, like generators, coroutines, user‐level threading, and monitors for mutual exclusion and synchronization. The runtime provides significant programmer simplification and safety by eliminating spurious wakeup and monitor barging. The runtime also ensures multiple monitors can be safely acquired in a deadlock‐free way, and this feature is fully integrated with all monitor synchronization mechanisms. All control‐flow features integrate with the C∀ polymorphic type‐system and exception handling, while respecting the expectations and style of C programmers. Experimental results show comparable performance of the new features with similar mechanisms in other concurrent programming languages.
Self‐Assembled Structures from Solid Cadmium(II) Acetate in Thiol/Ethanol Solutions: A Novel Type of Organic Chemical Garden
Authors: Bernini Fabrizio , Castellini Elena , Sebastianelli Lorenzo , Bighi Beatrice , Sainz‐Díaz Claro Ignacio , Mucci Adele , Malferrari Daniele , Ranieri Antonio , Brigatti Maria Franca , Borsari Marco
Published: December 2020

Cadmium(II) acetate in tablet form, immersed in ethanol solutions with a high concentration of heptanethiol (30–80 mM), was able to develop self‐assembled sail‐shaped structures. The solution in which the self‐assembled structure is formed is totally organic (both solute and solvent), thus representing a unique case among organic Chemical Gardens. The constituting material for this new Chemical Garden (CG) is made of a single phase, namely a cadmium heptanethiolate with a microcrystalline structure consisting of a central cluster [CdnSn]. The morphological and structural features were studied using different techniques (SEM‐EDS, elemental analysis, ATR‐FTIR, 113Cd MAS NMR, XRPD). A crystalline cell for the Cd(II) heptanethiolate cluster was obtained that completely differs from that of the solid phase precipitated by mixing an ethanol solution of Cd(II) acetate with heptanethiol. It follows that the conditions under which the formation of Cd(II) heptanethiolate occurs (slowly from solid, quickly from solution) play a critical role in determining the nature and structure of the precipitating phase.
Ein modulares Modell zur Qualitätssicherung im Medizin- und Ernährungsjournalismus
Authors: Anhäuser Marcus , Wormer Holger , Viciano Astrid , Rögener Wiebke
Published: December 2020

Hintergrund und Ziele

Die Qualität medizinjournalistischer Beiträge spielt bei informierten Entscheidungen von Patienten, von politischen, wirtschaftlichen und gesellschaftlichen Akteuren sowie für die allgemeine Gesundheitskompetenz (Health Literacy) eine zentrale Rolle. Daher erscheinen Qualitätsstandards notwendig, die wissenschaftlicheundjournalistische Prinzipien berücksichtigen, aber auch flexibel auf Besonderheiten spezieller gesundheitsrelevanter Themenfelder (Medizin, Ernährung, Umwelt) skalierbar sind.

Methoden

Im Rahmen des Medien-Doktor-Projekts wurden, ausgehend von einem internationalen Katalog, Kriterien für guten Medizinjournalismus analysiert, auf Basis theoretischer Konzepte und praktischer Anwendbarkeit neu klassifiziert und ergänzt. Parallel wurde ein Kriterienkatalog für guten Ernährungsjournalismus abgeleitet.

Ergebnisse

Es konnte ein Konsens über einen Kriterienkatalog erzielt werden, der in allgemeinjournalistische, allgemeinwissenschaftsjournalistische und spezifisch medizinjournalistische Aspekte modularisiert ist. Dieser wird hier erstmals in einem Fachbeitrag vorgestellt. Medizinjournalistische Qualitätskriterien ließen sich mit wenigen Ausnahmen gut auf Ernährungsthemen anpassen. Auf Basis der beiden Kataloge werden seitdem regelmäßig weitere Medienbeiträge bewertet.

Diskussion

Die stärkere Modularisierung der Kriterienkataloge erleichtert deren Anwendbarkeit und eventuell auch Ausweitung auf weitere Fachdisziplinen sowie die Nutzung durch Ärzte ebenso wie Laien. Während sich der Medizinjournalismus stark an wissenschaftlichen Evidenzkriterien orientiert, sollte für den Ernährungsjournalismus weiter untersucht werden, welche Rolle Studien und Experten im Vergleich zu anekdotischer Evidenz spielen.
The human coronaviruses (HCoVs) and the molecular mechanisms of SARS-CoV-2 infection
Authors: Santacroce Luigi , Charitos Ioannis A. , Carretta Domenico M. , De Nitto Emanuele , Lovero Roberto
Published: December 2020

In humans, coronaviruses can cause infections of the respiratory system, with damage of varying severity depending on the virus examined: ranging from mild-to-moderate upper respiratory tract diseases, such as the common cold, pneumonia, severe acute respiratory syndrome, kidney failure, and even death. Human coronaviruses known to date, common throughout the world, are seven. The most common—and least harmful—ones were discovered in the 1960s and cause a common cold. Others, more dangerous, identified in the early 2000s and cause more severe respiratory tract infections. Among these the SARS-CoV, isolated in 2003 and responsible for the severe acute respiratory syndrome (the so-called SARS), which appeared in China in November 2002, the coronavirus 2012 (2012-nCoV) cause of the Middle Eastern respiratory syndrome (MERS) from coronavirus, which exploded in June 2012 in Saudi Arabia, and actually SARS-CoV-2. On December 31, 2019, a new coronavirus strain was reported in Wuhan, China, identified as a new coronavirus beta strain ß-CoV from group 2B, with a genetic similarity of approximately 70% to SARS-CoV, the virus responsible of SARS. In the first half of February, the International Committee on Taxonomy of Viruses (ICTV), in charge of the designation and naming of the viruses (i.e., species, genus, family, etc.), thus definitively named the new coronavirus as SARS-CoV-2. This article highlights the main knowledge we have about the biomolecular and pathophysiologic mechanisms of SARS-CoV-2.
Early predictors for late hospitalizations up to 14 years after first episode psychosis
Authors: Strålin Pontus , Skott Maria , Cullberg Johan
Published: December 2020

Purpose

New hospitalizations after first episode psychosis (FEP) may be viewed as an indicator of instability in a psychotic disorder. In the current study we wanted to analyse long term risk for psychosis hospitalizations after FEP. We also wanted to analyse predictors for late hospitalizations, with focus on early antipsychotic medication.

Methods

First episode psychosis cases were recruited to the Swedish Parachute project in 1996–1997. The program offered highly available and continuous psychosocial support and a cautious use of antipsychotic medication for 5 years from inclusion. Longitudinal data from population registers on psychiatric hospitalizations up to 14 years after inclusion were analysed. One hundred and sixty-one cases were included of the original 175 in the project. Associations with possible early predictive factors from the original project data were analysed with COX regression.

Results

A majority of the cases (67%) had hospitalizations in the first year after inclusion in the study. The cohort then diverged into a group (46%) with new hospitalizations for psychosis after the first year, most of them multiple times, and another group (54%) without new hospitalizations for psychosis, many without any late antipsychotic medication. Forty-two percentage of the cases had antipsychotic medication by month 12, and it was significantly associated with later psychosis hospitalizations (HR = 2.5, p value < 0.001).

Conclusions

The study demonstrates that a large part of FEP cases have a good outcome as measured by absence of new hospitalizations for psychosis, and that many cases may terminate antipsychotic medication within a year of FEP onset without later relapses needing hospitalizations.
Human neuronal signaling and communication assays to assess functional neurotoxicity
Authors: Loser Dominik , Schaefer Jasmin , Danker Timm , Möller Clemens , Brüll Markus , Suciu Ilinca , Ückert Anna-Katharina , Klima Stefanie , Leist Marcel , Kraushaar Udo
Published: December 2020

Prediction of drug toxicity on the human nervous system still relies mainly on animal experiments. Here, we developed an alternative system allowing assessment of complex signaling in both individual human neurons and on the network level. The LUHMES cultures used for our approach can be cultured in 384-well plates with high reproducibility. We established here high-throughput quantification of free intracellular Ca2+concentrations [Ca2+]ias broadly applicable surrogate of neuronal activity and verified the main processes by patch clamp recordings. Initially, we characterized the expression pattern of many neuronal signaling components and selected the purinergic receptors to demonstrate the applicability of the [Ca2+]isignals for quantitative characterization of agonist and antagonist responses on classical ionotropic neurotransmitter receptors. This included receptor sub-typing and the characterization of the anti-parasitic drug suramin as modulator of the cellular response to ATP. To exemplify potential studies on ion channels, we characterized voltage-gated sodium channels and their inhibition by tetrodotoxin, saxitoxin and lidocaine, as well as their opening by the plant alkaloid veratridine and the food-relevant marine biotoxin ciguatoxin. Even broader applicability of [Ca2+]iquantification as an end point was demonstrated by measurements of dopamine transporter activity based on the membrane potential-changing activity of this neurotransmitter carrier. The substrates dopamine or amphetamine triggered [Ca2+]ioscillations that were synchronized over the entire culture dish. We identified compounds that modified these oscillations by interfering with various ion channels. Thus, this new test system allows multiple types of neuronal signaling, within and between cells, to be assessed, quantified and characterized for their potential disturbance.
Random Spanning Forests and Hyperbolic Symmetry
Authors: Bauerschmidt Roland , Crawford Nicholas , Helmuth Tyler , Swan Andrew
Published: December 2020

We study (unrooted) random forests on a graph where the probability of a forest is multiplicatively weighted by a parameter $$\beta >0$$

β
>
0

per edge. This is called the arboreal gas model, and the special case when $$\beta =1$$

β
=
1

is the uniform forest model. The arboreal gas can equivalently be defined to be Bernoulli bond percolation with parameter $$p=\beta /(1+\beta )$$

p
=
β
/
(
1
+
β
)

conditioned to be acyclic, or as the limit $$q\rightarrow 0$$

q
→
0

with $$p=\beta q$$

p
=
β
q

of the random cluster model. It is known that on the complete graph $$K_{N}$$

K
N

with $$\beta =\alpha /N$$

β
=
α
/
N

there is a phase transition similar to that of the Erdős–Rényi random graph: a giant tree percolates for $$\alpha > 1$$

α
>
1

and all trees have bounded size for $$\alpha <1$$

α
<
1

. In contrast to this, by exploiting an exact relationship between the arboreal gas and a supersymmetric sigma model with hyperbolic target space, we show that the forest constraint is significant in two dimensions: trees do not percolate on $${\mathbb {Z}}^2$$

Z

2

for any finite $$\beta >0$$

β
>
0

. This result is a consequence of a Mermin–Wagner theorem associated to the hyperbolic symmetry of the sigma model. Our proof makes use of two main ingredients: techniques previously developed for hyperbolic sigma models related to linearly reinforced random walks and a version of the principle of dimensional reduction.
A Review of Parathyroid Surgery for Primary Hyperparathyroidism from the United Kingdom Registry of Endocrine and Thyroid Surgery (UKRETS)
Authors: Ishii H. , Stechman M. J. , Watkinson J. C. , Aspinall S. , Kim D. S.
Published: December 2020

Background

The United Kingdom Registry of Endocrine and Thyroid Surgeons is a national database holding details on > 28,000 parathyroidectomies.

Methods

An extract (2004–2017) of the database was analysed to investigate the reported efficacy, safety and use of intra‐operative surgical adjuncts in targeted parathyroidectomy (tPTx) and bilateral neck exploration (BNE) for adult, first‐time primary hyperparathyroidism (PHPT).

Results

50.9% of 21,738 cases underwent tPTx. Excellent short‐term (median follow‐up 35 days) post‐operative normocalcaemia rates were reported overall (tPTx 96.6%, BNE 94.5%, p < 0.05) and in image‐positive cases (tPTx 96.7%, BNE 96%, p < 0.05). Intra‐operative PTH improved overall normocalcaemia rates (tPTx 97.8% vs 96.3%, BNE 95% vs 94.4%: both p < 0.05). Intra‐operative nerve monitoring reduced vocal cord (VC) dysfunction in image‐positive tPTx, but not in BNE (97.8% vs 93.2%, p < 0.05). Complications were higher following BNE (7.4% vs 3.8%, p < 0.05), especially hypocalcaemia (5.3% vs 2%, p < 0.05). There was no difference in rates of subjective dysphonia following tPTx or BNE (2.4% vs 2.3%, p > 0.05), nor any difference in VC dysfunction when formally examined (4.9% vs 4.1%, p > 0.05).

Conclusions

In image‐positive, first time, adult PHPT cases, tPTx is as safe and effective as BNE, with both achieving excellent short‐term results with minimal complications.
Oral high-dose sucrosomial iron vs intravenous iron in sideropenic anemia patients intolerant/refractory to iron sulfate: a multicentric randomized study
Authors: Giordano Giulio , Napolitano Mariasanta , Di Battista Valeria , Lucchesi Alessandro
Published: December 2020

Iron deficiency anemia is among the most frequent causes of disability. Intravenous iron is the quickest way to correct iron deficiency, bypassing the bottleneck of iron intestinal absorption, the only true mechanism of iron balance regulation in human body. Intravenous iron administration is suggested in patients who are refractory/intolerant to oral iron sulfate. However, the intravenous way of iron administration requires several precautions; as the in-hospital administration requires a resuscitation service, as imposed in Europe by the European Medicine Agency, it is very expensive and negatively affects patient’s perceived quality of life. A new oral iron formulation, Sucrosomial iron, bypassing the normal way of absorption, seems to be cost-effective in correcting iron deficiency anemia at doses higher than those usually effective with other oral iron formulations. In this multicentric randomized study, we analyze the cost-effectiveness of intravenous sodium ferrigluconate vs oral Sucrosomial iron in patients with iron deficiency anemia refractory/intolerant to oral iron sulfate without other interfering factors on iron absorption.
Visual discrimination and resolution in freshwater stingrays (Potamotrygon motoro)
Authors: Daniel Martha M. M. , Alvermann Laura , Böök Imke , Schluessel Vera
Published: December 2020

Potamotrygon motoro has been shown to use vision to orient in a laboratory setting and has been successfully trained in cognitive behavioral studies using visual stimuli. This study explores P. motoro’s visual discrimination abilities in the context of two-alternative forced-choice experiments, with a focus on shape and contrast, stimulus orientation, and visual resolution. Results support that stingrays are able to discriminate stimulus-presence and -absence, overall stimulus contrasts, two forms, horizontal from vertical stimulus orientations, and different colors that also vary in brightness. Stingrays tested in visual resolution experiments demonstrated a range of visual acuities from < 0.13 to 0.23 cpd under the given experimental conditions. Additionally, this report includes the first evidence for memory retention in this species.
A multistate first-order Markov model for modeling time distribution of extreme rainfall events
Authors: Rohith A. N. , Gitau Margaret W. , Chaubey I. , Sudheer K. P.
Published: December 2020

The time distribution of extreme rainfall events is a significant property that governs the design of urban stormwater management structures. Accuracy in characterizing this behavior can significantly influence the design of hydraulic structures. Current methods used for this purpose either tend to be generic and hence sacrifice on accuracy or need a lot of model parameters and input data. In this study, a computationally efficient multistate first-order Markov model is proposed for use in characterizing the inherently stochastic nature of the dimensionless time distribution of extreme rainfall. The model was applied to bivariate extremes at 10 stations in India and 205 stations in the United States (US). A comprehensive performance evaluation was carried out with one-hundred stochastically generated extremes for each historically observed extreme rainfall event. The comparisons included: 1-h (15-min); 2-h (30-min); and, 3-h (45-min) peak rainfall intensities for India and (US) stations, respectively; number of first, second, third, and fourth-quartile storms; the dependence of peak rainfall intensity on total depth and duration; and, return levels and return periods of peak discharge when these extremes were applied on a hypothetical urban catchment. Results show that the model efficiently characterizes the time distribution of extremes with: Nash–Sutcliffe-Efficiency > 0.85 for peak rainfall intensity and peak discharge; < 20% error in reproducing different quartile storms; and, < 0.15 error in correlation analysis at all study locations. Hence the model can be used to effectively reproduce the time distribution of extreme rainfall events, thus increasing the confidence of design of urban stormwater management structures.
Cognitive task performance under (combined) conditions of a metabolic and sensory stressor
Authors: Bottenheft Charelle , Brouwer Anne-Marie , Stuldreher Ivo , Groen Eric , van Erp Jan
Published: December 2020

Effects of stressors on cognitive task performance have primarily been studied in isolation, and little is known about the combined effects of two or more stressors. This study examined how a metabolic stressor (skipping breakfast) and a sensory stressor (noise) affect cognitive task performance in isolation and combined. In addition to performance, we collected physiological and subjective data to get insight in the underlying mechanisms. Twenty participants came to the lab twice, once after skipping breakfast, and once after a standardized breakfast. They performed runs of the 2-back task and the International Shopping List Task, which were alternately presented with and without noise. During the 2-back task, electrocardiography (ECG), electrodermal activity (EDA), and electroencephalography (EEG) were recorded. Subjective ratings on effort and stress were also collected. No interaction effects between the two stressors on cognitive performance were found. Skipping breakfast did not cause hypoglycemia, but resulted in subjective discomfort and a lower state of arousal (as indicated by lower heart rate and EDA). These may underly the trend for more missed responses on the 2-back task after breakfast skipping. Noise appeared to generate arousal and increased attention (reflected in higher EDA and P300) in accordance with higher experienced load and stress. This is consistent with less missed 2-back responses in noise conditions. The results indicate that individuals spent extra effort to maintain task performance in the presence of noise. We propose to use a model that, besides additional effort, takes the effect of stressors on performance into account.
Views of Catholic Priests Regarding Causes, Treatments and Psychosocial Consequences of Schizophrenia and Depression: A Comparative Study in Italy
Authors: Magliano Lorenza , Citarelli Giulia , Affuso Gaetana
Published: December 2020

This study explored views of Catholic priests about schizophrenia and depression in Italy. Participants completed a questionnaire on their views about either schizophrenia (N = 282) or depression (N = 277). The depression group was surer than the schizophrenia group that: the disorder was due to psychosocial causes; curable; non-requiring long-term pharmacotherapy; the persons with depression could participate in religious activities. The older priests were more convinced than the younger priests that: the prayer and long-term pharmacotherapy are useful; the persons with mental disorders had affective difficulties, are recognizable and kept at distance. Priests should receive education on stigma in mental disorders, particularly schizophrenia.
How the love of muscle can break a heart: Impact of anabolic androgenic steroids on skeletal muscle hypertrophy, metabolic and cardiovascular health
Authors: McCullough Deaglan , Webb Richard , Enright Kevin J. , Lane Katie E. , McVeigh Jim , Stewart Claire E. , Davies Ian G.
Published: December 2020

It is estimated 6.4% of males and 1.6% of females globally use anabolic-androgenic steroids (AAS), mostly for appearance and performance enhancing reasons. In combination with resistance exercise, AAS use increases muscle protein synthesis resulting in skeletal muscle hypertrophy and increased performance. Primarily through binding to the androgen receptor, AAS exert their hypertrophic effects via genomic, non-genomic and anti-catabolic mechanisms. However, chronic AAS use also has a detrimental effect on metabolism ultimately increasing the risk of cardiovascular disease (CVD). Much research has focused on AAS effects on blood lipids and lipoproteins, with abnormal concentrations of these associated with insulin resistance, hypertension and increased visceral adipose tissue (VAT). This clustering of interconnected abnormalities is often referred as metabolic syndrome (MetS). Therefore, the aim of this review is to explore the impact of AAS use on mechanisms of muscle hypertrophy and markers of MetS. AAS use markedly decreases high-density lipoprotein cholesterol (HDL-C) and increases low-density lipoprotein cholesterol (LDL-C). Chronic AAS use also appears to cause higher fasting insulin levels and impaired glucose tolerance and possibly higher levels of VAT; however, research is currently lacking on the effects of AAS use on glucose metabolism. While cessation of AAS use can restore normal lipid levels, it may lead to withdrawal symptoms such as depression and hypogonadism that can increase CVD risk. Research is currently lacking on effective treatments for withdrawal symptoms and further long-term research is warranted on the effects of AAS use on metabolic health in males and females.
Experimental and Modelling Study of Gravity Drainage in a Three-Block System
Authors: Erfani Hamidreza , Karimi Malekabadi Abtin , Ghazanfari Mohammad Hossein , Rostami Behzad
Published: December 2020

Gravity drainage is known as the controlling mechanism of oil recovery in naturally fractured reservoirs. The efficiency of this mechanism is controlled by block-to-block interactions through capillary continuity and/or reinfiltration processes. In this study, at first, several free-fall gravity drainage experiments were conducted on a well-designed three-block apparatus and the role of tilt angle, spacers’ permeability, wettability and effective contact area (representing a different status of the block-to-block interactions between matrix blocks) on the recovery efficiency were investigated. Then, an experimental-based numerical model of free-fall gravity drainage process was developed, validated and used for monitoring the saturation profiles along with the matrix blocks. Results showed that gas wetting condition of horizontal fracture weakens the capillary continuity and in consequence decreases the recovery factor in comparison with the original liquid wetting condition. Moreover, higher spacers’ permeability increases oil recovery at early times, while it decreases the ultimate recovery factor. Tilt angle from the vertical axis decreases recovery factor, due to greater connectivity of matrix blocks to vertical fracture and consequent channelling. Decreasing horizontal fracture aperture decreases recovery at early times but increases the ultimate recovery due to a greater extent of capillary continuity between the adjacent blocks. Well match observed between the numerical model results and the experimental data of oil recovery makes the COMSOL multiphysics model attractive for application in multi-blocks fractured systems considering block-to-block interactions. The findings of this research improve our understanding of the role of different fracture properties on the block-to-block interactions and how they change the ultimate recovery of a multi-block system.
Effects of nasal high flow on nocturnal hypercapnia, sleep, and sympathovagal balance in patients with neuromuscular disorders
Authors: Meyer Anna Christina , Spiesshoefer Jens , Siebers Nina Christina , Heidbreder Anna , Thiedemann Christian , Schneider Hartmut , Braun Andrew T. , Randerath Winfried , Young Peter , Dreher Michael , Boentert Matthias
Published: December 2020

Purpose

In neuromuscular disorders (NMD), inspiratory muscle weakness may cause sleep-related hypoventilation requiring non-invasive ventilation (NIV). Alternatively, nasal high flow therapy (NHF) may ameliorate mild nocturnal hypercapnia (NH) through washout of anatomical dead space and generation of positive airway pressure. Ventilatory support by NIV or NHF might have favourable short-term effects on sympathovagal balance (SVB). This study comparatively investigated the effects of NHF and NIV on sleep-related breathing and SVB in NMD patients with evolving NH.

Methods

Transcutaneous CO2 (ptcCO2), peripheral oxygen saturation (SpO2), sleep outcomes and SVB (spectral analysis of heart rate, diastolic blood pressure variability) along with haemodynamic measures (cardiac index, total peripheral resistance index) were evaluated overnight in 17 patients. Polysomnographies (PSG) were randomly split into equal parts with no treatment, NIV and NHF at different flow rates (20 l/min vs. 50 l/min). In-depth analysis of SVB and haemodynamics was performed on 10-min segments of stable N2 sleep taken from each intervention.

Results

Compared with no treatment, NHF20 and NHF50 did not significantly change ptcCO2, SpO2 or the apnea hypopnea index (AHI). NHF50 was poorly tolerated. In contrast, NIV significantly improved both gas exchange and AHI without adversely affecting sleep. During daytime, NHF20 and NHF50 had neutral effects on ventilation and oxygenation whereas NIV improved ptcCO2 and SpO2. Effects of NIV and NHF on SVB and haemodynamics were neutral during both night and daytime.

Conclusions

NHF does not correct sleep-disordered breathing in NMD patients with NH. Both NHF and NIV exert no immediate effects on SVB.
Impaired benthic macrofauna function 4 years after sediment capping with activated carbon in the Grenland fjords, Norway
Authors: Raymond Caroline , Samuelsson Göran S , Agrenius Stefan , Schaanning Morten T , Gunnarsson Jonas S
Published: December 2020

The sediments in the Grenland fjords in southern Norway are heavily contaminated by large emissions of dioxins and mercury from historic industrial activities. As a possible in situ remediation option, thin-layer sediment surface capping with powdered activated carbon (AC) mixed with clay was applied at two large test sites (10,000 and 40,000 m2) at 30-m and 95-m depths, respectively, in 2009. This paper describes the long-term biological effects of the AC treatment on marine benthic communities up to 4 years after treatment. Our results show that the capping with AC strongly reduced the benthic species diversity, abundance, and biomass by up to 90%. Vital functions in the benthic ecosystem such as particle reworking and bioirrigation of the sediment were also reduced, analyzed by using novel bioturbation and bioirrigation indices (BPc, BIPc, and IPc). Much of the initial effects observed after 1 and 14 months were still present after 49 months, indicating that the effects are long-lasting. These long-lasting negative ecological effects should be carefully considered before decisions are made on sediment remediation with powdered AC, especially in large areas, since important ecosystem functions can be impaired.
Design and experimental study of a passive power-source-free stiffness-self-adjustable mechanism
Authors: Liu Yuwang , Wang Dongqi , Yang Shangkui , Liu Jinguo , Hao Guangbo
Published: December 2020

Passive variable stiffness joints have unique advantages over active variable stiffness joints and are currently eliciting increased attention. Existing passive variable stiffness joints rely mainly on sensors and special control algorithms, resulting in a bandwidth-limited response speed of the joint. We propose a new passive power-source-free stiffness-self-adjustable mechanism that can be used as the elbow joint of a robot arm. The new mechanism does not require special stiffness regulating motors or sensors and can realize large-range self-adaptive adjustment of stiffness in a purely mechanical manner. The variable stiffness mechanism can automatically adjust joint stiffness in accordance with the magnitude of the payload, and this adjustment is a successful imitation of the stiffness adjustment characteristics of the human elbow. The response speed is high because sensors and control algorithms are not needed. The variable stiffness principle is explained, and the design of the variable stiffness mechanism is analyzed. A prototype is fabricated, and the associated hardware is set up to validate the analytical stiffness model and design experimentally.
Computational models for contact current dosimetry at frequencies below 1 MHz
Authors: Schneeweiss Pia , Panescu Dorin , Stunder Dominik , Kroll Mark W. , Andrews Christopher J. , Theiler Tobias
Published: December 2020

Electric contact currents (CC) can cause muscle contractions, burns, or ventricular fibrillation which may result in life-threatening situations. In vivo studies with CC are rare due to potentially hazardous effects for participants. Cadaver studies are limited to the range of tissue’s electrical properties and the utilized probes’ size, relative position, and sensitivity. Thus, the general safety standards for protection against CC depend on a limited scientific basis. The aim of this study was therefore to develop an extendable and adaptable validated numerical body model for computational CC dosimetry for frequencies between DC and 1 MHz. Applying the developed model for calculations of the IEC heart current factors (HCF) revealed that in the case of transversal CCs, HCFs are frequency dependent, while for longitudinal CCs, the HCFs seem to be unaffected by frequency. HCFs for current paths from chest or back to hand appear to be underestimated by the International Electrotechnical Commission (IEC 60479-1). Unlike the HCFs provided in IEC 60479-1 for longitudinal current paths, our work predicts the HCFs equal 1.0, possibly due to a previously unappreciated current flow through the blood vessels. However, our results must be investigated by further research in order to make a definitive statement. Contact currents of frequencies from DC up to 100 kHz were conducted through the numerical body model Duke by seven contact electrodes on longitudinal and transversal paths. The resulting induced electric field and current enable the evaluation of the body impedance and the heart current factors for each frequency and current path.
Microstructure and Residual Stress Evolution of Laser Powder Bed Fused Inconel 718 under Heat Treatments
Authors: Marchese Giulio , Atzeni Eleonora , Salmi Alessandro , Biamino Sara
Published: December 2020

The current work aimed to study the influence of various heat treatments on the microstructure, hardness, and residual stresses of Inconel 718 processed by laser powder bed fusion process. The reduction in residual stresses is crucial to avoid the deformation of the component during its removal from the building platform. Among the different heat treatments, 800 °C kept almost unaltered the original microstructure, reducing the residual stresses. Heat treatments at 900, 980, and 1065 °C gradually triggered the melt pool and dendritic structures dissolution, drastically reducing the residual stresses. Heat treatments at 900 and 980 °C involved the formation of δ phases, whereas 1065 °C generated carbides. These heat treatments were also performed on components with narrow internal channels revealing that heat treatments up to 900 °C did not trigger sintering mechanisms allowing to remove the powder from the inner channels.
Innate immune responses in RNA viral infection
Authors: Xu Qian , Tang Yuting , Huang Gang
Published: December 2020

RNA viruses cause a multitude of human diseases, including several pandemic events in the past century. Upon viral invasion, the innate immune system responds rapidly and plays a key role in activating the adaptive immune system. In the innate immune system, the interactions between pathogen-associated molecular patterns and host pattern recognition receptors activate multiple signaling pathways in immune cells and induce the production of pro-inflammatory cytokines and interferons to elicit antiviral responses. Macrophages, dendritic cells, and natural killer cells are the principal innate immune components that exert antiviral activities. In this review, the current understanding of innate immunity contributing to the restriction of RNA viral infections was briefly summarized. Besides the main role of immune cells in combating viral infection, the intercellular transfer of pathogen and host-derived materials and their epigenetic and metabolic interactions associated with innate immunity was discussed. This knowledge provides an enhanced understanding of the innate immune response to RNA viral infections in general and aids in the preparation for the existing and next emerging viral infections.