bluuebunny/crossref_metadata_2025 huggingface dataset:
The comfort ability program for adolescents with sickle cell pain: Evaluating feasibility and acceptability of an inpatient group‐based clinical implementation
Authors: Sil Soumitri , Lee Jennifer L. , Klosky James , Vaz Angela , Mee Laura , Cochran Shavontia , Thompson Beth , Coakley Rachael
Published: March 2021

Background

Integration of nonpharmacological therapies, such as cognitive and behavioral pain management strategies, is recommended to support comprehensive disease and pain management among children and adolescents with sickle cell disease (SCD). The Comfort Ability Program for Sickle Cell Pain (CAP for SCP) introduces psychological and biobehavioral pain management strategies to children and adolescents with SCD. This study aimed to pilot the implementation of the CAP for SCP in a group setting to children and adolescents hospitalized for SCD pain examining feasibility, acceptability, and preliminary effectiveness on improving pain knowledge and coping efficacy.

Method

Adaptation of CAP for SCP into a three‐session group format was guided by four phases of the Dynamic Adaptation Process model: Exploration, Preparation, Implementation, and Sustainment. Youth with SCD (n = 57) hospitalized for pain participated in at least one session and completed self‐report of knowledge of pain management skills, pain coping efficacy, and treatment acceptance. Completion rates of sessions and qualitative feedback were gathered to evaluate feasibility and acceptability.

Results

Feasibility of conducting inpatient group sessions was suboptimal; however, patients and medical providers reported moderate to high levels of treatment acceptance. Patients also reported significant improvements in knowledge of pain management skills following session 1.

Conclusions

CAP for SCP is a patient‐centered first‐line psychoeducational intervention that can be integrated into clinical practice settings to introduce youth to cognitive and behavioral pain management strategies to support SCD pain management.
Integration of cancer registry and electronic health record data to construct a childhood cancer survivorship cohort, facilitate risk stratification for late effects, and assess appropriate follow‐up care
Authors: Noyd David H. , Neely Nigel B. , Schroeder Kristin M. , Lantos Paul M. , Power Steve , Kreissman Susan G. , Oeffinger Kevin C.
Published: March 2021

Background

This retrospective study harnessed an institutional cancer registry to construct a childhood cancer survivorship cohort, integrate electronic health record (EHR) and geospatial data to stratify survivors based on late‐effect risk, analyze follow‐up care patterns, and determine factors associated with suboptimal follow‐up care.

Procedure

The survivorship cohort included patients ≤18 years of age reported to the institutional cancer registry between January 1, 1994 and November 30, 2012. International Classification of Diseases for Oncology, third revision (ICD‐O‐3) coding and treatment exposures facilitated risk stratification of survivors. The EHR was linked to the cancer registry based on medical record number (MRN) to extract clinic visits.

Results

Five hundred and ninety pediatric hematology‐oncology (PHO) and 275 pediatric neuro‐oncology (PNO) survivors were included in the final analytic cohort. Two hundred and eight‐two survivors (32.6%) were not seen in any oncology‐related subspecialty clinic at Duke 5–7 years after initial diagnosis. Factors associated with follow‐up included age (p = .008), diagnosis (p < .001), race/ethnicity (p = .010), late‐effect risk strata (p = .001), distance to treatment center (p < .0001), and area deprivation index (ADI) (p = .011). Multivariable logistic modeling attenuated the association for high‐risk (OR 1.72; 95% CI 0.805, 3.66) and intermediate‐risk (OR 1.23, 95% CI 0.644, 2.36) survivors compared to survivors at low risk of late effects among the PHO cohort. PNO survivors at high risk for late effects were more likely to follow up (adjusted OR 3.66; 95% CI 1.76, 7.61).

Conclusions

Nearly a third of survivors received suboptimal follow‐up care. This study provides a reproducible model to integrate cancer registry and EHR data to construct risk‐stratified survivorship cohorts to assess follow‐up care.
Dielectric properties of polydimethylsiloxane composites filled with SrTiO3 nanoparticles
Authors: Bertasius Povilas , Schaefer Sebastien , Macutkevic Jan , Banys Juras , Selskis Algirdas , Fierro Vanessa , Celzard Alain
Published: March 2021

This article deals with the dielectric properties of polydimethylsiloxane (PDMS) nanocomposites filled with SrTiO3 nanoparticles. The investigations were performed over a very broad range of frequencies (20 Hz to 3 THz). Almost no dielectric dispersion was observed in all the composites at room temperature over the entire range of measurement frequencies, and the dielectric losses were also very low under these conditions (<1.9). The dielectric dispersion was observed at lower temperatures (below 280 K), due to relaxation at the PDMS/SrTiO3 interface and in the bulk polymer. The relaxation time for both cases followed the Vogel–Vulcher law, while the freezing temperature was substantially lower for relaxation at the PDMS/SrTiO3 interface.
Foaming parameter identification of polyurethane using FOAMAT® device
Authors: Raimbault Clément , Laure Patrice , François Guillaume , Boyer Séverine , Vincent Michel , Choquart François , Agassant Jean‐Francois
Published: March 2021

A key problem in the modeling of polyurethane (PU) foaming is the determination of relevant physical parameters for the viscosity, the gas expansion, and the curing rate. Indeed, it is difficult to measure the chemical kinetics parameters as well as the viscosity of industrial PU formulations (polyol–isocyanate–water mixture) because the time scales of gas production and PU crosslinking are very short and hardly compatible with the installation of the sample in characterization devices such as differential scanning calorimetry and parallel plates rheometer. A FOAMAT® system has been developed to get these experimental data but the relationship between measurements and the rheo‐chemical parameters has not been clearly established. In this paper, an analytical model of the foaming process is developed in the cylindrical FOAMAT geometry, which allows identifying the parameters of the curing and gas production kinetics equations, as well as the viscosity. This analytical model is based on a set of simplifying hypotheses which validity is checked using the finite element computation software REM3D dedicated to foaming modeling and applicable for injection‐molding processing.
Broadband Efficient Polarization‐Pure Airy Beam Generation Based on Three‐Layer Metasurface
Authors: Wu Chao , Li Quan , Zhao Song , Zhang Zhihui , Liu Xuan , Wei Shijie , Li Hongqiang
Published: March 2021

Herein, a polarization‐pure Airy beam generation strategy based on twisted layer structures, which is broadband with efficiency approaching the theoretical limit, is proposed. As demonstration, an Airy beam generator operating in the microwave regime is built with stacked three‐layer identical complementary split ring resonators (CSRRs) as the unit cell. By spatially arranging the orientation angle of the middle layer in each unit cell, linearly polarized incident waves can be converted to an Airy beam in cross‐polarization, whereas the unmodulated copolarized component is strongly suppressed in the transmitted field. The proposed Airy beam generation strategy along with the transmission amplitude and phase modulation method can be implemented at terahertz and even infrared regimes using various other twisted multilayer structures.
Understanding Reproducibility of Sputter‐Deposited Metastable Ferroelectric Wurtzite Al0.6Sc0.4N Films Using In Situ Optical Emission Spectrometry
Authors: Drury Daniel , Yazawa Keisuke , Mis Allison , Talley Kevin , Zakutayev Andriy , Brennecka Geoff L.
Published: March 2021

High‐Sc Al1–xScxN thin films are of tremendous interest because of their attractive piezoelectric and ferroelectric properties, but overall film quality and reproducibility are widely reported to suffer as x increases. In this study, structural and electrical properties of metastable Al0.6Sc0.4N films are connected with plasma changes during film growth, identified via glow discharge optical emission spectroscopy (GD‐OES), and linked to the target mode changes. This in situ GD‐OES technique uses changes in the N2(I) intensity, correlated with DC bias hysteresis behavior of a Al0.6Sc0.4 target in metallic and poisoned modes, to identify films that subsequently exhibit unacceptable structural and electrical performance. Two representative samples deposited under identical conditions but possessing distinct properties related to phases present in the films are focused on. Films sputtered under a poisoned target mode produce pure wurtzite ferroelectric Al0.6Sc0.4N with a reversible 80 μC cm−1 polarization and 3.1 MV cm−1 coercive field. When identical chamber settings are used but the process starts in metallic mode, a mixed wurtzite/rocksalt film is deposited which exhibits nanometer‐scale changes to the film microstructure and a nonferroelectric response. These results illustrate the utility of optical emission spectroscopy for tracking target mode fluctuations when fabricating metastable materials such as high‐Sc Al1–xScxN films.
68.9% Efficient GaAs‐Based Photonic Power Conversion Enabled by Photon Recycling and Optical Resonance
Authors: Helmers Henning , Lopez Esther , Höhn Oliver , Lackner David , Schön Jonas , Schauerte Meike , Schachtner Michael , Dimroth Frank , Bett Andreas W.
Published: March 2021

For solar cells operating under the broad‐band solar spectrum, the photovoltaic conversion efficiency is fundamentally limited by transmission and thermalization losses. For monochromatic light, these losses can be minimized by matching the photon energy and the absorber material's bandgap energy. Furthermore, for high‐crystal‐quality direct semiconductors, radiative recombination dominates the minority carrier recombination. Light‐trapping schemes can leverage reabsorption of thereby internally generated photons. Such photon recycling increases the effective excess carrier concentration, which, in turn, increases photovoltage and consequently conversion efficiency. Herein, a back surface reflector underneath a GaAs/AlGaAs rear‐heterojunction structure leverages photon recycling to effectively reduce radiative recombination losses and therefore boost the photovoltage. At the same time, resonance in the created optical cavity is tailored to enhance near‐bandgap absorption and, thus, minimize thermalization loss. With a thin film process and a combined dielectric–metal reflector, an unprecedented photovoltaic conversion efficiency of 68.9 ± 2.8% under 858 nm monochromatic light at an irradiance of 11.4 W cm−2 is demonstrated.
Metabolic study of ginsenoside Rg3 and glimepiride in type 2 diabetic rats by liquid chromatography coupled with quadrupole‐Orbitrap mass spectrometry
Authors: Yang Di , Li Xue , Fu Yunhua , Tao Xingyu , Zheng Fei , Yu Jiangbo , Yue Hao , Dai Yulin
Published: March 2021

Rationale

Ginsenoside Rg3 and glimepiride have been applied to treat type 2 diabetes (T2DM) because of their good hypoglycemic effects. In this study, the effects of ginsenoside Rg3 acting synergistically with glimepiride were investigated in liver microsomes from rats with type 2 diabetes.

Methods

An in vitro incubation system with normal rat liver microsomes (RLM) and type 2 diabetic rat liver microsomes (TRLM) was developed. The system also included two experimental groups consisting of RLM and TRLM pretreated with ginsenoside Rg3 and glimepiride (named the RLMR and TRLMR groups, respectively). The metabolism in the different groups was analyzed by ultra‐performance liquid chromatography coupled with quadrupole‐orbitrap mass spectrometry (UPLC/Q‐Orbitrap MS).

Results

The results showed that the concentration of glimepiride increased in RLM and TRLM after treatment with ginsenoside Rg3. Five metabolites (M1–M5) of glimepiride were found, and they were named 3N‐hydroxyglimepiride, hydroxyglimepiride, 1,2‐epoxy ether‐3‐hydroxyglimepiride, 1N‐hydroxyglimepiride and 1N,2C,S,O,O‐epoxy ether‐3‐hydroxyglimepiride. The metabolite of ginsenoside Rg3 was ginsenoside Rh2.

Conclusions

An in vitro incubation system with RLM and TRLM was developed. The system revealed pathways that produce glimepiride metabolites. Ginsenoside Rg3 may inhibit the activity of cytochrome P450 enzymes in vitro. The present study showed that ginsenoside Rg3 and glimepiride may be combined for the treatment of T2DM.
Follicular development during hormone replacement therapy in patients with premature ovarian insufficiency
Authors: Sato Takuma , Kusuhara Atsuko , Kasahara Yuta , Haino Takayuki , Kishi Hiroshi , Okamoto Aikou
Published: March 2021

Purpose

To provide information about the relationship between follow‐up period and follicular development in patients with infertility due to premature ovarian insufficiency (POI) who are undergoing hormone replacement therapy (HRT). It is necessary to detect follicle development for artificial insemination or in vitro fertilization.

Methods

This retrospective cohort study was conducted at a university hospital in Tokyo, Japan, from April 2014 to February 2019 in 20 patients [follicular development group, 11 women (55%); non‐follicular development group, 9 women (45%)] with POI; their follicular development was followed up weekly. Background characteristics, including age, follicle‐stimulating hormone (FSH) and anti‐Mullerian hormone levels (AMH), the period from the last spontaneous menstruation to hormone replacement therapy initiation, and follow‐up period during HRT were investigated. The period without follicular development was tabulated, and the subsequent cumulative follicular development detection rate was calculated.

Results

At least 1‐year follow‐up, the cumulative follicular development rate was 70%; follicular development was observed with a probability of 49.1% at 3 months, 33.4% at 6 months, and 8.3% at 12 months in the follow‐up period.

Conclusions

The results show that the longer the non‐follicle development period, the lower the probability of subsequent follicular development in patients with POI during HRT.
Asymptotic normality of consecutive patterns in permutations encoded by generating trees with one‐dimensional labels
Authors: Borga Jacopo
Published: March 2021

We consider uniform random permutations drawn from a family enumerated through generating trees. We develop a new general technique to establish a central limit theorem for the number of consecutive occurrences of a fixed pattern in such permutations. We propose a technique to sample uniform permutations in such families as conditioned random colored walks. Building on that, we derive the behavior of the consecutive patterns in random permutations studying properties of the consecutive increments in the corresponding random walks. The method applies to families of permutations with a one‐dimensional‐labeled generating tree (together with some technical assumptions) and implies local convergence for random permutations in such families. We exhibit ten different families of permutations, most of them being permutation classes, that satisfy our assumptions. To the best of our knowledge, this is the first work where generating trees—which were introduced to enumerate combinatorial objects—have been used to establish probabilistic results.
Linking water vapor sorption to water repellency in soils with high organic carbon contents
Authors: Hermansen Cecilie , Norgaard Trine , de Jonge Lis Wollesen , Weber Peter L. , Moldrup Per , Greve Mogens H. , Tuller Markus , Arthur Emmanuel
Published: March 2021

Water repellency (WR) significantly affects the hydraulic behavior of soils. Although WR often is regarded as a phenomenon with implications for dry soils, it is prevalent at water contents (w) exceeding the wilting point water content. Because the measurement of the WR–w relationship is laborious, alternative more time‐efficient methods are desirable to estimate parameters of the WR‐w curve. Using 32 high organic carbon (OC) soils from Denmark and South Greenland, we characterized the water vapor sorption isotherms (WSIs), investigated the interrelated effects of OC and clay contents on WSIs and the WR–w relationship, and further evaluated if parameters of the WR‐w curve may be derived directly from WSIs. The samples exhibited OC and clay contents ranging from 0.014 to 0.369 kg kg–1 and from 0.02 to 0.16 kg kg–1, respectively. The WSIs measured for relative humidity (RH) values between 3 and 93%, were strongly hysteretic, were OC dependent, and could be accurately characterized with the Guggenheim, Anderson, and de Boer model. Further, the WRarea and wnon parameters, derived from WR measured for several w, were well estimated with linear regressions based on OC content and multiple linear regressions based on OC and clay contents. Estimations for WRarea and wnon based on the WSI parameter wm‐a were superior to OC and clay content. Finally, we established mathematical expressions that estimate WRarea or wnon from any air‐dry w obtained from either the desorption or adsorption isotherms between 10 and 90% RH.
Corrosion resistance of Cu‐bearing 316L stainless steel tuned by various passivation potentials
Authors: Zhang Hongzhen , Zhao Jinlong , Yang Chunguang , Shen Minggang , Zhang Xinrui , Xi Tong , Yin Lu , Zhao Hanyu , Liu Xiaofang , Liu Lichu , Yang Ke
Published: March 2021

Three incremental passivation potentials (0.2, 0.5, and 0.8 VSCE) were selected to passivate the 316L‐Cu stainless steel (SS) and the 316L SS in 0.5 M H2SO4 solution, with the aim to investigate the corrosion resistance differences of two SSs in 0.9 wt.% NaCl solution. Various electrochemical tests including potentiodynamic polarization, electrochemical impedance spectroscopy (EIS), and Mott–Schottky analytical method assisted with X‐ray photoelectron spectroscopy (XPS) were employed. The results indicated that 316L‐Cu SS after passivation in 0.5 M H2SO4 solution showed no influence on the double‐layer structure of passive films. Besides, increased passivation potential augmented the electron donor concentration (ND) and the hole accepter concentration (NA) of the passive film on the 316L‐Cu SS, hinting a gradually declined compactness of the passive film. EIS results further affirmed that the passive film stability of 316L‐Cu SS followed the same tendency with increased passivation potential. XPS results hinted that the oxidation reaction of Cu element switching into Cu2+ and Cu+ ions promoted the dissolution of Cu ions and weakened the passive film stability of 316L‐Cu SS.
Enhancing Interfacial Contact in Solid‐State Batteries with a Gradient Composite Solid Electrolyte
Authors: Deng Chenglong , Chen Nan , Hou Chuanyu , Liu Hanxiao , Zhou Zhiming , Chen Renjie
Published: March 2021

Solid‐state batteries promise to meet the challenges of high energy density and high safety for future energy storage. However, poor interfacial contact and complex manufacturing processes limit their practical applications. Herein, a simple strategy is proposed to enhance interfacial contact by introducing a gradient composite polymer solid electrolyte (GCPE), which is prepared by a facile UV‐curing polymerization technique. The high‐Li6.4La3Zr1.4Ta0.6O12 (LLZTO)‐content side of the electrolyte exhibits high oxidation resistance (5.4 V versus Li+/Li), making it compatible with a high‐voltage cathode material, whereas the LLZTO‐deficient side achieves excellent interfacial contact with the Li metal anode, facilitating uniform Li deposition. Benefiting from the elaborate composition and structure of GCPE films, the symmetric Li//Li cell exhibits a low‐voltage hysteresis potential of 42 mV and a long cycle life of >1900 h without short‐circuiting. The Li//LiFePO4 solid‐state batteries deliver a capacity of 161.0 mA h g−1 at 60 °C and 0.1 C (82.4% capacity is retained after 200 cycles). Even at 80 °C, the cell still shows an outstanding capacity of 132.9 mAh g−1 at 0.2 C after 100 cycles. The design principle of gradient electrolytes provides a new path for achieving enhanced interfacial contact in high‐performance solid‐state batteries.
Application of Carbon Materials in Aqueous Zinc Ion Energy Storage Devices
Authors: Wang Ziting , Zhang Maoqin , Ma Weiting , Zhu Junbo , Song Weixing
Published: March 2021

Zinc‐ion storage is a promising electrochemical energy field due to loads of its advantages like easy preparation, environmental friendliness, high safety performance, and high capacity. Carbon materials have been widely studied for zinc‐ion storage due to their extraordinary properties such as earth‐abundancy, low‐cost, good electrical conductivity, various structures, and good stability. This article reviews some widely used carbon materials in zinc ion storage devices, including hollow carbon spheres, activated carbon, N‐doped porous carbon, graphene, and carbon nanotubes. The unique roles and advantages of these carbon materials in both zinc ion supercapacitors and zinc ion batteries are emphasized. Characteristics and functionalizations of different carbon materials are also comparatively discussed in view of zinc‐ion energy storage devices. Finally, some challenges and perspectives of carbon materials in zinc‐ion energy storage are outlined.
Automated generation of terminological dictionary from textual business rules
Authors: Haj Abdellatif , Balouki Youssef , Gadi Taoufiq
Published: March 2021

To support decision making, organizations tend to operate according to Business Rules, which are usually represented in a natural language format easily understood by all intervenors. According to the business rules manifesto by the Business Rules Group (OMG), rules build on facts, and facts build on concepts as expressed by terms. To avoid ambiguity and misunderstanding, the standardization of the terminology used at the business level becomes a persistent need. However, doing so manually is error prone and time consuming, especially that the Business Rules are the subject of continuous updating. In this paper, we present an automated approach to generate the Business Vocabulary from textual statements of Business Rules. Our approach is distinguished from existing works in that it extracts the Terminological Dictionary as described by the Semantic of Business Vocabulary and Rules (SBVR) standard to provide a more comprehensive meaning for each concept. Accordingly, an in‐depth Natural Language Processing (NLP) is used to extract not only flat list of terms and relations, but also extra specifications and implicit knowledge. With a satisfactory result, our approach has proved its capability to automatically generate the SBVR Terminological Dictionary from large number of natural language business rules statements.
Simultaneous determination of 34 chemical pesticides in red chili using gas chromatography‐tandem mass spectrometer
Authors: R Harischandra Naik , K Pavankumar , S Pallavi M , M Bheemanna , R Udaykumar Nidoni
Published: March 2021

A multi‐residue analytical method for analysis of 34 pesticides was standardized and validated using gas chromatography‐tandem mass spectrometry. The calibration curve constructed for each pesticide was linear over the concentration of 10 to 100 μg/L and the correlation coefficient ranged between 0.998 and 0.999. The limit of quantification and detection were in the range of 1.6 to 3.5 and 4.9 to 10.5 μg/kg, respectively. The sample preparation technique involving solid‐phase extraction using primary secondary amine and magnesium sulfate with acetonitrile provided acceptable recoveries in the range of 70.60 to 119.56% for 10 μg/kg, 70.12 to 115.58% for 50 μg/kg, and 71.51 to 118.11 for 100 μg/kg spiking levels with acceptable relative standard deviation. The field‐collected red chili samples were screened and the pesticide residues were quantified by using gas chromatography with tandem mass spectrometry. The mean residues of red chili samples assessed for the potential risk to consumers showed no risk.
Recent progress on lanthanide scintillators for soft X‐ray‐triggered bioimaging and deep‐tissue theranostics
Authors: Jiang Mingyang , Deng Zhiming , Zeng Songjun , Hao Jianhua
Published: March 2021

Lanthanide scintillators capable of converting the absorbed X‐ray photon energy to ultraviolet (UV) or visible light, are emerged as promising nanoprobes for multifunctional diagnosis and deep‐tissue antitumor therapy such as X‐ray‐excited fluorescence (XEF) imaging, X‐ray‐triggered photodynamic therapy (X‐PDT), and soft X‐ray‐activated NO gas therapy. Such biomedical tools have the potential to overcome the major challenge of the depth barrier suffered by traditional optics. Recently, various lanthanide scintillators have been designed for diagnosis and therapy of deep‐seated tumors. This minireview presents an overview of recent progress on the lanthanide‐based scintillators and illustration of the potential challenges and future development.
Synthesis, structures, photoluminescence and magnetic properties of three dinuclear lanthanide(III) complexes derived from 4‐fluorophenylselenoacetic acid
Authors: Zhang Fan , Zhang Ru‐Fen , Ru Jing , Wang Jing , Li Qian‐Li , Ma Chun‐Lin
Published: March 2021

Three novel dinuclear lanthanide(III) complexes [Ln2L6(phen)2] (Ln=EuIII (1), TbIII (2), Dy III (3)), derived from 4‐fluorophenylselenoacetic acid and 1,10‐phenanthroline, have been synthesized and characterized by elemental analysis, IR, TGA, powder X‐ray diffraction and single‐crystal X‐ray diffraction analysis. Single crystal X‐ray diffraction reveal they are isostructural and crystallize in the monoclinic crystal system, space group P2(1)/c. The investigations on luminescent properties of Eu(III) complex 1 and Tb(III) complex 2 exhibit the characteristic emissions of EuIII (5D0→7F0‐4) and TbIII (5D4→7F6‐3), and the corresponding luminescent lifetimes are 1.52 and 1.10 ms, respectively. Temperature‐dependent photoluminescence studies show the emission intensities and lifetimes for both complexes decrease upon increasing temperature, which indicates complexes 1 and 2 have the potential for sensing temperature. The magnetic studies reveal that Dy(III) complex 3 exhibits weak antiferromagnetic interactions and slow magnetic relaxation behavior.
Non‐local stress and electric displacement solution of a 3D semi‐permeable rectangular crack in infinite orthotropic piezoelectric materials
Authors: Liu Hai‐Tao , Wang Peng‐Hui , Qie Yan‐Hui
Published: March 2021

The paper presents the non‐local stress and electric displacement solution of a 3D semi‐permeable rectangular crack in infinite orthotropic piezoelectric materials (OPMs). With the help of the generalized Almansi's theorem and 2D Fourier transform, the boundary problem is formulated by three pairs of dual integral equations, and the displacement jumps across the crack surfaces are defined. The Schmidt method is used to solve the dual integral equations. The non‐local stress field (NSF) and the non‐local electric displacement field (NEDF) along the crack edges are deduced. Numerical results are reported to explain the influence of the size of the rectangular crack, the lattice parameter and the electric permittivity of the air inside the crack on the NSF and the NEDF at the crack edges in OPMs in detail. The present non‐local solutions exhibit no stress and electric displacement singularities along the crack edges, and may be benefit future works.
Affine Subspaces of Curvature Functions from Closed Planar Curves
Authors: Alese Leonardo
Published: March 2021

Given a pair of real functions (k, f), we study the conditions they must satisfy for $$k+\lambda f$$

k
+
λ
f

to be the curvature in the arc-length of a closed planar curve for all real $$\lambda $$
λ
. Several equivalent conditions are pointed out, certain periodic behaviours are shown as essential and a family of such pairs is explicitely constructed. The discrete counterpart of the problem is also studied.
The topological nilpotence degree of a Noetherian unstable algebra
Authors: Heard Drew
Published: March 2021

We investigate the topological nilpotence degree, in the sense of Henn–Lannes–Schwartz, of a connected Noetherian unstable algebraR. WhenRis the modpcohomology ring of a compact Lie group, Kuhn showed how this invariant is controlled by centralizers of elementary abelianp-subgroups. By replacing centralizers of elementary abelianp-subgroups with components of Lannes’T-functor, and utilizing the techniques of unstable algebras over the Steenrod algebra, we are able to generalize Kuhn’s result to a large class of connected Noetherian unstable algebras. We show how this generalizes Kuhn’s result to more general classes of groups, such as groups of finite virtual cohomological dimension, profinite groups, and Kac–Moody groups. In fact, our results apply much more generally, for example, we establish results forp-local compact groups in the sense of Broto–Levi–Oliver, for connectedH-spaces with Noetherian modpcohomology, and for the Borel equivariant cohomology of a compact Lie group acting on a manifold. Along the way we establish several results of independent interest. For example, we formulate and prove a version of Carlson’s depth conjecture in the case of a Noetherian unstable algebra of minimal depth.
Anabolic-androgenic steroid administration increases self-reported aggression in healthy males: a systematic review and meta-analysis of experimental studies
Authors: Chegeni Razieh , Pallesen Ståle , McVeigh Jim , Sagoe Dominic
Published: March 2021

Rationale

Aggression and irritability are notable psychiatric side effects of anabolic-androgenic steroid (AAS) use. However, no previous study has systematically reviewed and quantitatively synthesized effects reported by experimental studies on this topic.

Objective

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effect of AAS administration on self-reported and observer-reported aggression.

Methods

Twelve RCTs comprising a total of 562 healthy males were identified through systematic searches of MEDLINE, PsycInfo, ISI Web of Science, ProQuest, Google Scholar, and the Cochrane Library.

Results

After excluding one outlier, AAS administration was associated with an increase in self-reported aggression under a random-effects model, albeit small (Hedges’g= 0.171, 95% CI: 0.029–0.312,k= 11,p= .018), and when restricting the analysis to the effect of acute AAS administration on self-reported aggression under a fixed-effect model (g= 0.291, 95% CI: 0.014–0.524,p= .014). However, the above effects were neither replicated in the analysis of observer-reported aggression nor after restricting the analysis to the effects of the administration of higher (over 500 mg) and long-term (3 days to 14 weeks) doses.

Conclusions

The present meta-analysis provides evidence of an increase, although small, in self-reported aggression in healthy males following AAS administration in RCTs. Ecologically rational RCTs are warranted to better explore the effect of AAS administration on aggression in humans.
Histology and computed tomography of incidental calcifications in the human basal ganglia
Authors: de Brouwer Esther J. M. , de Jong Pim A. , De Jonghe Annemarieke , Emmelot-Vonk Marielle H. , Koek Huiberdina L. , Dankbaar Jan-Willem , Mohamed Hoesein Firdaus A. A. , Van Hecke Wim
Published: March 2021

Incidental basal ganglia calcifications are a common finding on computed tomography (CT). We investigated the histological characteristics of these calcifications and their association with CT findings, using post-mortem basal ganglia tissue from 22 patients. Eight patients had basal ganglia calcifications on histology, and six patients had calcifications on CT, varying from mild to severe. Four patients had calcifications identified by both histology and CT, and two patients had calcifications detected by CT but not by histology, possibly because of insufficient tissue available. Calcifications were found mainly in the tunica media of arterioles located in the globus pallidus, which suggests that incidental CT calcifications are vascular in nature. However, tunica media calcifications, and thereby incidental basal ganglia calcifications, are probably not related to atherosclerosis.
An A.I. classifier derived from 4D radiomics of dynamic contrast-enhanced breast MRI data: potential to avoid unnecessary breast biopsies
Authors: Pötsch Nina , Dietzel Matthias , Kapetas Panagiotis , Clauser Paola , Pinker Katja , Ellmann Stephan , Uder Michael , Helbich Thomas , Baltzer Pascal A. T.
Published: March 2021

Objectives

Due to its high sensitivity, DCE MRI of the breast (bMRI) is increasingly used for both screening and assessment purposes. The high number of detected lesions poses a significant logistic challenge in clinical practice. The aim was to evaluate a temporally and spatially resolved (4D) radiomics approach to distinguish benign from malignant enhancing breast lesions and thereby avoid unnecessary biopsies.

Methods

This retrospective study included consecutive patients with MRI-suspicious findings (BI-RADS 4/5). Two blinded readers analyzed DCE images using a commercially available software, automatically extracting BI-RADS curve types and pharmacokinetic enhancement features. After principal component analysis (PCA), a neural network–derived A.I. classifier to discriminate benign from malignant lesions was constructed and tested using a random split simple approach. The rate of avoidable biopsies was evaluated at exploratory cutoffs (C1, 100%, and C2, ≥ 95% sensitivity).

Results

Four hundred seventy (295 malignant) lesions in 329 female patients (mean age 55.1 years, range 18–85 years) were examined. Eighty-six DCE features were extracted based on automated volumetric lesion analysis. Five independent component features were extracted using PCA. The A.I. classifier achieved a significant (p < .001) accuracy to distinguish benign from malignant lesion within the test sample (AUC: 83.5%; 95% CI: 76.8–89.0%). Applying identified cutoffs on testing data not included in training dataset showed the potential to lower the number of unnecessary biopsies of benign lesions by 14.5% (C1) and 36.2% (C2).

Conclusion

The investigated automated 4D radiomics approach resulted in an accurate A.I. classifier able to distinguish between benign and malignant lesions. Its application could have avoided unnecessary biopsies.

Key Points

• Principal component analysis of the extracted volumetric and temporally resolved (4D) DCE markers favored pharmacokinetic modeling derived features.

• An A.I. classifier based on 86 extracted DCE features achieved a good to excellent diagnostic performance as measured by the area under the ROC curve with 80.6% (training dataset) and 83.5% (testing dataset).

• Testing the resulting A.I. classifier showed the potential to lower the number of unnecessary biopsies of benign breast lesions by up to 36.2%, p < .001 at the cost of up to 4.5% (n = 4) false negative low-risk cancers.
Pathological reporting of cystectomy lymph nodes: a retrospective analysis of experience in Paris
Authors: Oszwald André , Wasinger Gabriel , Larnaudie Laura , Varinot Justine , Sebe Philippe , Cussenot Olivier , Compérat Eva
Published: March 2021

Purpose

Pathological evaluation of pelvic lymph node (LN) dissection (PLND) is important for management of cystectomy patients. However, challenges such as unclear interobserver variability of LN counting remain. Here, we assess interobserver variability of LN measures and their clinical utility, with a focus on variant histology.

Methods

We retrieved radical cystectomy cases with PLND between 2010 and 2016 and reevaluated pathological parameters; number of total and metastatic LN, LN density (LND), length of metastatic LN and metastases, extranodal extension (ENE).

Results

We report 96 patients: median age of 71a, 34 cases pN+, 36 cases with any extent of variant histology, median follow-up 10 months. Perivesical LN were only rarely identified, but frequently metastatic (4/9). Variant histology (34 cases) frequently exhibited LN metastasis (53% of pN+ cases). Interobserver variance was poor for total LN (kappa = 0.167), excellent for positive LN (0.85) and pN staging (0.96), and mediocre for LND (0.53). ROC analysis suggests that both LND and the sum of LN metastasis length may predict outcome (AUC 0.83 and 0.75, respectively).

Conclusion

Our study confirms the notion of LND as a prognostic measure, but cautions due to strong interobserver variance of LN counts. The sum length of LN metastases could be a measure that is independent of LN counts. We find that microscopically identified perivesical LN merit particular attention. In summary, our study highlights current challenges in pathological reporting of PLND, confirms previous observations and forms a basis for further studies.
Interhospital referral of colorectal cancer patients: a Dutch population-based study
Authors: Warps A. K. , de Neree tot Babberich M. P. M. , Dekker E. , Wouters M. W. J. M. , Dekker J. W. T. , Tollenaar R. A. E. M. , Tanis P. J. ,   On behalf of the Dutch ColoRectal Audit
Published: March 2021

Purpose

Interhospital referral is a consequence of centralization of complex oncological care but might negatively impact waiting time, a quality indicator in the Netherlands. This study aims to evaluate characteristics and waiting times of patients with primary colorectal cancer who are referred between hospitals.

Methods

Data were extracted from the Dutch ColoRectal Audit (2015-2019). Waiting time between first tumor-positive biopsy until first treatment was compared between subgroups stratified for referral status, disease stage, and type of hospital.

Results

In total, 46,561 patients were included. Patients treated for colon or rectal cancer in secondary care hospitals were referred in 12.2% and 14.7%, respectively. In tertiary care hospitals, corresponding referral rates were 43.8% and 66.4%. Referred patients in tertiary care hospitals were younger, but had a more advanced disease stage, and underwent more often multivisceral resection and simultaneous metastasectomy than non-referred patients in secondary care hospitals (p<0.001). Referred patients were more often treated within national quality standards for waiting time compared to non-referred patients (p<0.001). For referred patients, longer waiting times prior to MDT were observed compared to non-referred patients within each hospital type, although most time was spent post-MDT.

Conclusion

A large proportion of colorectal cancer patients that are treated in tertiary care hospitals are referred from another hospital but mostly treated within standards for waiting time. These patients are younger but often have a more advanced disease. This suggests that these patients are willing to travel more but also reflects successful centralization of complex oncological patients in the Netherlands.
Retained placenta and postpartum hemorrhage: time is not everything
Authors: Franke Denise , Zepf Julia , Burkhardt Tilo , Stein Philipp , Zimmermann Roland , Haslinger Christian
Published: March 2021

Purpose

Postpartum hemorrhage is the major cause of maternal mortality worldwide. Retained placenta accounts for nearly 20% of severe cases. We investigated the influence of the time factor and retained placenta etiology on postpartum hemorrhage dynamics.

Methods

Our retrospective study analyzed a single-center cohort of 296 women with retained placenta. Blood loss was measured using a validated and accurate technique based on calibrated blood collection bags, backed by the post- vs pre-partum decrease in hemoglobin. We evaluated the relationship between these two blood loss parameters and the duration of the third stage of labor using Spearman rank correlation, followed by subgroup analysis stratified by third stage duration and retained placenta etiology.

Results

Correlation analysis revealed no association between third stage duration and measured blood loss or decrease in hemoglobin. A shorter third stage (< 60 min) was associated with significantly increased uterine atony (p = 0.001) and need for blood transfusion (p = 0.006). Uterine atony was significantly associated with greater decrease in hemoglobin (p < 0.001), higher measured blood loss (p < 0.001), postpartum hemorrhage (p = 0.048), and need for blood transfusion (p < 0.001).

Conclusion

Postpartum blood loss does not correlate with third stage duration in women with retained placenta. Our results suggest that there is neither a safe time window preceding postpartum hemorrhage, nor justification for an early cut-off for manual removal of the placenta. The prompt detection of uterine atony and immediate prerequisites for manual removal of the placenta are key factors in the management of postpartum hemorrhage.
The cerebellar cognitive affective syndrome scale reveals early neuropsychological deficits in SCA3 patients
Authors: Maas Roderick P. P. W. M. , Killaars Sven , van de Warrenburg Bart P. C. , Schutter Dennis J. L. G.
Published: March 2021

Background

The cerebellar cognitive affective syndrome scale (CCAS-S) was recently developed to detect specific neuropsychological deficits in patients with cerebellar diseases in an expedited manner.

Objectives

To evaluate the discriminative ability of the CCAS-S in an etiologically homogeneous cohort of spinocerebellar ataxia type 3 (SCA3) patients and to examine relationships between cognitive deficits and motor symptom severity.

Methods

The CCAS-S was administered to twenty mildly to moderately affected SCA3 patients and eighteen healthy controls matched for age, sex, and educational level. Disease severity was measured by the Scale for the Assessment and Rating of Ataxia (SARA), Inventory of Non-Ataxia Signs (INAS), 8 m walk test, nine-hole peg test (9HPT), and Patient Health Questionnaire-9 (PHQ-9).

Results

SCA3 patients had a lower total CCAS-S score (p < 0.001) and higher number of failed tests (p = 0.006) than healthy controls. Patients displayed impairments in semantic fluency, phonemic fluency, category switching, cube drawing, and affect regulation. Total CCAS-S score showed high discriminative ability (area under the curve [AUC]: 0.96) and was associated with disease duration, SARA score, walking speed, and dominant hand 9HPT performance. No correlations were observed with INAS count, repeat length, and PHQ-9 score. Discriminative capacity of the number of failed tests was moderate (AUC: 0.76).

Conclusion

Essentially all SCA3 patients exhibited some form of cognitive impairment. The CCAS-S differentiates SCA3 patients from healthy controls, detects neuropsychological deficits early in the disease course, and correlates with relevant ataxia severity measures.
Blood neurofilament light concentration at admittance: a potential prognostic marker in COVID-19
Authors: Aamodt Anne Hege , Høgestøl Einar August , Popperud Trine Haug , Holter Jan Cato , Dyrhol-Riise Anne Ma , Tonby Kristian , Stiksrud Birgitte , Quist-Paulsen Else , Berge Tone , Barratt-Due Andreas , Aukrust Pål , Heggelund Lars , Blennow Kaj , Zetterberg Henrik , Harbo Hanne Flinstad
Published: March 2021

Objective

To test the hypotheses that blood biomarkers for nervous system injury, serum concentrations of neurofilament light chain protein (NfL) and glial fibrillary acidic protein (GFAp) can serve as biomarkers for disease severity in COVID-19 patients.

Methods

Forty-seven inpatients with confirmed COVID-19 had blood samples drawn on admission for assessing serum biomarkers of CNS injury by Single molecule array (Simoa), NfL and GFAp. Concentrations of NfL and GFAp were analyzed in relation to symptoms, clinical signs, inflammatory biomarkers and clinical outcomes. We used multivariate linear models to test for differences in biomarker concentrations in the subgroups, accounting for confounding effects.

Results

In total, 21% (n = 10) of the patients were admitted to an intensive care unit, and the overall mortality rate was 13% (n = 6). Non-survivors had higher serum concentrations of NfL (p < 0.001) upon admission than patients who were discharged alive both in adjusted analyses (p = 2.6 × 10–7) and unadjusted analyses (p = 0.001). The concentrations of NfL in non-survivors increased over repeated measurements; whereas, the concentrations in survivors were stable. The GFAp concentration was also significantly higher in non-survivors than survivors (p = 0.02).

Conclusion

Increased concentrations of NfL and GFAp in COVID-19 patients on admission may indicate increased mortality risk. Measurement of blood biomarkers for nervous system injury can be useful to detect and monitor CNS injury in COVID-19.
Phase II study of metronomic treatment with daily oral vinorelbine as first-line chemotherapy in patients with advanced/metastatic HR+/HER2− breast cancer resistant to endocrine therapy: VinoMetro—AGO-B-046
Authors: Krajnak Slavomir , Decker Thomas , Schollenberger Lukas , Rosé Christian , Ruckes Christian , Fehm Tanja , Thomssen Christoph , Harbeck Nadia , Schmidt Marcus
Published: March 2021

Purpose

Metronomic chemotherapy (MCT) is an increasingly used treatment option in hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) advanced/metastatic breast cancer (MBC) after failure of endocrine-based therapies.

Methods

VinoMetro was a multicentre, open-label, single-arm, phase II study of metronomic oral vinorelbine (VRL; 30 mg/day) as a first-line chemotherapy (CT) in patients with HR+/HER2− MBC after endocrine failure. The primary endpoint was the clinical benefit rate (CBR) at 24 weeks.

Results

Between January 2017 and April 2019, nine patients were enrolled. The CBR was 22.2% (90% confidence interval [CI] 4.1–55.0), p = 0.211. The median progression-free survival (PFS) was 12.0 weeks (95% CI 11.3–12.7). Grade 3–4 adverse events (AEs) occurred in 22.2% of patients. One patient died of febrile neutropenia.

Conclusion

VinoMetro (AGO-B-046) was closed early after nine patients and occurrence of one grade 5 toxicity in agreement with the lead institutional review board (IRB). Metronomic dosing of oral VRL in HR+/HER2− MBC as first-line CT after failure of endocrine therapies showed only limited benefit in this population.

Trial registration number and date of registration

ClinicalTrials.gov Identifier: NCT03007992; December 15, 2016.
On the maximal displacement of near-critical branching random walks
Authors: Neuman Eyal , Zheng Xinghua
Published: March 2021

We consider a branching random walk on $$\mathbb {Z}$$
Z
started by n particles at the origin, where each particle disperses according to a mean-zero random walk with bounded support and reproduces with mean number of offspring $$1+\theta /n$$

1
+
θ
/
n

. For $$t\ge 0$$

t
≥
0

, we study $$M_{nt}$$

M

nt

, the rightmost position reached by the branching random walk up to generation [nt]. Under certain moment assumptions on the branching law, we prove that $$M_{nt}/\sqrt{n}$$

M

nt

/

n

converges weakly to the rightmost support point of the local time of the limiting super-Brownian motion. The convergence result establishes a sharp exponential decay of the tail distribution of $$M_{nt}$$

M

nt

. We also confirm that when $$\theta >0$$

θ
>
0

, the support of the branching random walk grows in a linear speed that is identical to that of the limiting super-Brownian motion which was studied by Pinsky (Ann Probab 23(4):1748–1754, 1995). The rightmost position over all generations, $$M:=\sup _t M_{nt}$$

M
:
=

sup
t

M

nt

, is also shown to converge weakly to that of the limiting super-Brownian motion, whose tail is found to decay like a Gumbel distribution when $$\theta <0$$

θ
<
0

.