bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospective comparison of 18F-PSMA-1007 PET/CT, whole-body MRI and CT in primary nodal staging of unfavourable intermediate- and high-risk prostate cancer
Authors: Malaspina Simona , Anttinen Mikael , Taimen Pekka , Jambor Ivan , Sandell Minna , Rinta-Kiikka Irina , Kajander Sami , Schildt Jukka , Saukko Ekaterina , Noponen Tommi , Saunavaara Jani , Dean Peter B. , Sequeiros Roberto Blanco , Aronen Hannu J. , Kemppainen Jukka , Seppänen Marko , Boström Peter J. , Ettala Otto
Published: March 2021

Purpose

To prospectively compare 18F-prostate-specific membrane antigen (PSMA)-1007 positron emission tomography (PET)/CT, whole-body magnetic resonance imaging (WBMRI) including diffusion-weighted imaging (DWI) and standard computed tomography (CT), in primary nodal staging of prostate cancer (PCa).

Methods

Men with newly diagnosed unfavourable intermediate- or high-risk PCa prospectively underwent 18F-PSMA-1007 PET/CT, WBMRI with DWI and contrast-enhanced CT within a median of 8 days. Six readers (two for each modality) independently reported pelvic lymph nodes as malignant, equivocal or benign while blinded to the other imaging modalities. Sensitivity, specificity and accuracy were reported according to optimistic (equivocal lesions interpreted as benign) and pessimistic (equivocal lesions interpreted as malignant) analyses. The reference standard diagnosis was based on multidisciplinary consensus meetings where available histopathology, clinical and follow-up data were used.

Results

Seventy-nine patients completed all the imaging modalities, except for one case of interrupted WBMRI. Thirty-one (39%) patients had pelvic lymph node metastases, which were detected in 27/31 (87%), 14/31 (45%) and 8/31 (26%) patients by 18F-PSMA-1007 PET/CT, WBMRI with DWI and CT, respectively (optimistic analysis). In 8/31 (26%) patients, only 18F-PSMA-1007 PET/CT detected malignant lymph nodes, while the other two imaging modalities were reported as negative. At the patient level, sensitivity and specificity values for 18F-PSMA-1007 PET/CT, WBMRI with DWI and CT in optimistic analysis were 0.87 (95%CI 0.71–0.95) and 0.98 (95%CI 0.89–1.00), 0.37 (95%CI 0.22–0.55) and 0.98 (95%CI 0.89–1.00) and 0.26 (95%CI 0.14–0.43) and 1.00 (95%CI 0.93–1.00), respectively.

Conclusion

18F-PSMA-1007 PET/CT showed significantly greater sensitivity in nodal staging of primary PCa than did WBMRI with DWI or CT, while maintaining high specificity.

Clinical trial registration

Clinicaltrials.gov ID: NCT03537391
GCA: Better ✓check for third cranial nerve involvement!
Authors: Schwarz Daniel
Published: March 2021

Key Points

• The intriguing “Check Mark Sign” suggests 3rd cranial nerve involvement in GCA.
Ossification of the acetabular rim: a highly prevalent finding in asymptomatic non-osteoarthritic hips of all ages
Authors: Valente Catarina , Haefliger Laura , Favre Julien , Omoumi Patrick
Published: March 2021

Objective

To estimate the prevalence of acetabular rim ossifications in the adult population with asymptomatic, morphologically normal hips at CT and to determine whether the presence of these ossifications is associated with patient- or hip-related parameters.

Methods

We prospectively included all patients undergoing thoracoabdominal CT over a 3-month period. After exclusion of patients with a clinical history of hip pathology and/or with signs of osteoarthritis on CT, we included a total of 150 hips from 75 patients. We analyzed the presence and the size of ossifications around the acetabular rim. The relationships between the size of acetabular rim ossifications and patient-related (sex, age, BMI) or hip-related parameters (joint space width, and cam- and pincer-type femoroacetabular impingement morphology) were tested using multiple regression analysis.

Results

The prevalence of acetabular rim ossifications in this population of asymptomatic, non-osteoarthritic hips was 96% (95% CI = [80.1; 100.0]). The presence of ossifications and their size were correlated between the right and left hips (Spearman coefficient = 0.64 (95% CI = [0.46;0.79]), p < 0.05)). The size of acetabular rim ossifications was significantly associated with age (p < 0.0001) but not with BMI (p = 0.35), gender (p = 0.05), joint space width (p ≥ 0.53 for all locations), or any of the qualitative or quantitative parameters associated with femoroacetabular morphology (p ≥ 0.34).

Conclusion

Acetabular rim ossifications are highly prevalent in asymptomatic, non-osteoarthritic adult hips at all ages. Their size is not correlated with any patient- or hip-related parameters except for age. These findings suggest that ossifications at the acetabular rim, when present in isolation, should not be considered a sign of osteoarthritis or femoroacetabular impingement morphology.

Key Points

• Acetabular rim ossifications are extremely common in asymptomatic, non-osteoarthritic adult hips.

• Acetabular rim ossifications are present independently from other signs of osteoarthritis in adult hips at all ages and should not be interpreted as a pathological finding.

• The diagnosis of osteoarthritis or femoroacetabular impingement morphology should not be made based on the sole presence of ossifications at the acetabular rim.
Threshold-dependent iodine imaging and spectral separation in a whole-body photon-counting CT system
Authors: Sawall S. , Klein L. , Wehrse E. , Rotkopf L. T. , Amato C. , Maier J. , Schlemmer H.-P. , Ziener C. H. , Heinze S. , Kachelrieß M.
Published: March 2021

Objective

To evaluate the dual-energy (DE) performance and spectral separation with respect to iodine imaging in a photon-counting CT (PCCT) and compare it to dual-source CT (DSCT) DE imaging.

Methods

A semi-anthropomorphic phantom extendable with fat rings equipped with iodine vials is measured in an experimental PCCT. The system comprises a PC detector with two energy bins (20 keV, T) and (T, eU) with threshold T and tube voltage U. Measurements using the PCCT are performed at all available tube voltages (80 to 140 kV) and threshold settings (50–90 keV). Further measurements are performed using a conventional energy-integrating DSCT. Spectral separation is quantified as the relative contrast media ratio R between the energy bins and low/high images. Image noise and dose-normalized contrast-to-noise ratio (CNRD) are evaluated in resulting iodine images. All results are validated in a post-mortem angiography study.

Results

R of the PC detector varies between 1.2 and 2.6 and increases with higher thresholds and higher tube voltage. Reference R of the EI DSCT is found as 2.20 on average overall phantoms. Maximum CNRD in iodine images is found for T = 60/65/70/70 keV for 80/100/120/140 kV. The highest CNRD of the PCCT is obtained using 140 kV and is decreasing with decreasing tube voltage. All results could be confirmed in the post-mortem angiography study.

Conclusion

Intrinsically acquired DE data are able to provide iodine images similar to conventional DSCT. However, PCCT thresholds should be chosen with respect to tube voltage to maximize image quality in retrospectively derived image sets.

Key Points

• Photon-counting CT allows for the computation of iodine images with similar quality compared to conventional dual-source dual-energy CT.

• Thresholds should be chosen as a function of the tube voltage to maximize iodine contrast-to-noise ratio in derived image sets.

• Image quality of retrospectively computed image sets can be maximized using optimized threshold settings.
A novel knockout mouse for the small EDRK-rich factor 2 (Serf2) showing developmental and other deficits
Authors: Cleverley Karen , Lee Weaverly Colleen , Mumford Paige , Collins Toby , Rickman Matthew , Cunningham Thomas J. , Cleak James , Mianne Joffrey , Szoke-Kovacs Zsombor , Stewart Michelle , Teboul Lydia , Maduro Cheryl , Wells Sara , Wiseman Frances K. , Fisher Elizabeth M. C.
Published: March 2021

The small EDRK-rich factor 2 (SERF2) is a highly conserved protein that modifies amyloid fibre assembly in vitro and promotes protein misfolding. However, the role of SERF2 in regulating age-related proteotoxicity remains largely unexplored due to a lack of in vivo models. Here, we report the generation of Serf2 knockout mice using an ES cell targeting approach, with Serf2 knockout alleles being bred onto different defined genetic backgrounds. We highlight phenotyping data from heterozygous Serf2+/− mice, including unexpected male-specific phenotypes in startle response and pre-pulse inhibition. We report embryonic lethality in Serf2−/− null animals when bred onto a C57BL/6 N background. However, homozygous null animals were viable on a mixed genetic background and, remarkably, developed without obvious abnormalities. The Serf2 knockout mice provide a powerful tool to further investigate the role of SERF2 protein in previously unexplored pathophysiological pathways in the context of a whole organism.
Independent Domination Subdivision in Graphs
Authors: Babikir Ammar , Dettlaff Magda , Henning Michael A. , Lemańska Magdalena
Published: March 2021

A set S of vertices in a graph G is a dominating set if every vertex not in S is ad jacent to a vertex in S. If, in addition, S is an independent set, then S is an independent dominating set. The independent domination number i(G) of G is the minimum cardinality of an independent dominating set in G. The independent domination subdivision number $$ \hbox {sd}_{\mathrm{i}}(G)$$

sd
i

(
G
)

is the minimum number of edges that must be subdivided (each edge in G can be subdivided at most once) in order to increase the independent domination number. We show that for every connected graph G on at least three vertices, the parameter $$ \hbox {sd}_{\mathrm{i}}(G)$$

sd
i

(
G
)

is well defined and differs significantly from the well-studied domination subdivision number $$\mathrm{sd_\gamma }(G)$$

sd
γ

(
G
)

. For example, if G is a block graph, then $$\mathrm{sd_\gamma }(G) \le 3$$

sd
γ

(
G
)

≤
3

, while $$ \hbox {sd}_{\mathrm{i}}(G)$$

sd
i

(
G
)

can be arbitrary large. Further we show that there exist connected graph G with arbitrarily large maximum degree $$\Delta (G)$$

Δ
(
G
)

such that $$ \hbox {sd}_{\mathrm{i}}(G) \ge 3 \Delta (G) - 2$$

sd
i

(
G
)

≥
3
Δ

(
G
)

-
2

, in contrast to the known result that $$\mathrm{sd_\gamma }(G) \le 2 \Delta (G) - 1$$

sd
γ

(
G
)

≤
2
Δ

(
G
)

-
1

always holds. Among other results, we present a simple characterization of trees T with $$ \hbox {sd}_{\mathrm{i}}(T) = 1$$

sd
i

(
T
)

=
1

.
Sympathetic and sensory nerve fiber function in multiple system atrophy and idiopathic Parkinson’s disease
Authors: Krämer Heidrun H. , Rebhorn Cora , Geber Christian , Birklein Frank
Published: March 2021

Objective

To explore small fiber somatosensory and sympathetic function in PD and MSA.

Methods

We recruited 20 PD patients (7 women, median age 65.5 years; IQR 54.75–70.0), 10 MSA patients (4 women; median age 68 years; IQR 66.25–74.0), and 10 healthy subjects (HC; 4 women, median age 68; IQR 59.0–71.0 years). Autonomic testing included forehead cooling, intradermal microdialysis of norepinephrine (NE; 10–5; 10–6; 10–7; and 10–8), and orthostatic hypotension (OH); somatosensory testing included quantitative sensory testing (QST) according to the protocol of the German Research Network on Neuropathic Pain (DFNS).

Results

OH occurred more frequently in PD (p = 0.018) and MSA (p = 0.002) compared to HC. Vasoconstriction responses were stronger in PD compared to MSA during forehead cooling (p = 0.044) and microdialysis of physiologically concentrated NE solutions (10–7; 10–8; p = 0.017). PD and MSA had impaired cold (PD: p < 0.01; MSA: p < 0.05) and warm detection thresholds (PD and MSA, both p < 0.05). The mechanical detection threshold was higher in PD (p < 0.01). Conversely, mechanical pain thresholds were decreased in PD and MSA (both p < 0.001), indicating mechanical hyperalgesia.

Conclusion

In contrast to MSA, we found evidence of peripheral adrenoreceptor hypersensitivity in PD, probably caused by peripheral sympathetic denervation. Sensory testing revealed peripheral neuropathy and central pain sensitization in PD and MSA. Jointly, our data demonstrate autonomic and somatosensory dysfunction in PD and MSA.
An exploratory study to investigate the association between age, physical activity, femoral trochlear cartilage thickness and biomarkers of tissue metabolism in adult males
Authors: Roberts Harry M. , Griffith-McGeever Claire L. , Owen Julian A. , Angell Lewis , Moore Jonathan P. , Thom Jeanette M.
Published: March 2021

Purpose

To investigate the association between age, physical activity, femoral trochlear cartilage thickness and biomarkers of tissue metabolism in a cross-sectional sample of adult males. This study utilizes several emerging biomarkers that have been associated with early joint degenerative changes; serum COMP (cartilage oligomeric matrix protein), HA (hyaluronan) and lubricin.

Methods

Eighty-one males (age: mean (range): 43(18–70) years; body mass index: 25.2 (21.0–30.6) kg/m2) volunteered. Resting serum COMP, HA and lubricin concentrations were determined via commercially available enzyme-linked immunosorbent assay (ELISA) and femoral trochlear cartilage thickness via supra-patellar ultrasound imaging. Physical activity levels were assessed using questionnaires. Statistical analyses were performed using correlation and regression analyses.

Results

Age was correlated with lateral trochlear cartilage thickness (r = − 0.372; p < 0.01) and serum COMP (r = 0.342; p < 0.01). 7-day physical activity was correlated with serum COMP (r = 0.357, p < 0.01), and 12-month physical activity with both lateral trochlear cartilage thickness (r = 0.340, p = 0.01) and serum HA (r = 0.296, p < 0.05). Regression analyses revealed that age significantly accounted for the variability in lateral cartilage thickness and serum COMP, following the adjustment for potential cofounders. However, the association between age and lateral trochlear cartilage thickness was not moderated by physical activity levels (all p > 0.05).

Conclusion

This study indicates that older age may be associated with thinner lateral trochlear cartilage and higher cartilage turnover. Being physically active may also be positive for lateral trochlear cartilage thickness. However, overall, both age and physical activity level only account for a small amount of the variability in cartilage thickness and serum biomarkers.
Decreased exercise capacity in young athletes using self-adapted mouthguards
Authors: Lässing Johannes , Falz Roberto , Schulze Antina , Pökel Christoph , Vondran Maximilian , Schröter Thomas , Borger Michael A. , Busse Martin
Published: March 2021

Purpose

There is evidence of both the preventive effects and poor acceptance of mouthguards. There are various effects on performance depending on the type of mouthguard model. Hemodynamic responses to wearing a mouthguard have not been described. The aim of this study was to investigate the effects of self-adapted mouthguards with breathing channels (SAMGvent).

Methods

In this randomized crossover study, 17 healthy, active subjects (age 25.12 ± 2.19 years) underwent body plethysmography and performed two incremental exertion tests wearing a (SAMGvent) and not wearing (CON) a mouthguard. Blood lactate, spirometrics, and thoracic impedance were measured during these maximum exercise tests.

Results

The mean values using a SAMGventrevealed significantly greater airway resistance compared to CON (0.53 ± 0.16 kPa·L−1vs. 0.35 ± 0.10 kPa·L−1, respectively;p = < 0.01). At maximum load, ventilation with SAMGventwas less than CON (118.4 ± 28.17 L min−1vs. 128.2 ± 32.16 L min−1, respectively;p = < 0.01). At submaximal loads, blood lactate responses with SAMGventwere higher than CON (8.68 ± 2.20 mmol·L−1vs. 7.89 ± 1.65 mmol·L−1, respectively;p < 0.01). Maximum performance with a SAMGventwas 265.9 ± 59.9 W, and without a mouthguard was 272.9 ± 60.8 W (p < 0.01). Maximum stroke volume was higher using a SAMGventthan without using a mouthguard (138.4 ± 29.9 mL vs. 130.2 ± 21.2 mL, respectively;p < 0.01).

Conclusion

Use of a self-adapted mouthguard led to increased metabolic effort and a significant reduction in ventilation parameters. Unchanged oxygen uptake may be the result of cardiopulmonary compensation and increased breathing efforts, which slightly affects performance. These results and the obvious preventive effects of mouthguards support their use in sports.
Brachial and central blood pressure and arterial stiffness in adult elite athletes
Authors: Tomschi Fabian , Ottmann Hannah , Bloch Wilhelm , Grau Marijke , Predel Hans-Georg
Published: March 2021

Purpose

Measures of arterial stiffness (AS) and central blood pressure (BP) are indicators for cardiovascular health and possess a high prognostic value in the prediction of cardiovascular events. The effects of physical training are widely unexplored in the context of competitive, high-performance sports. Therefore, we aimed to present possible reference values of brachial and central BP and of AS of adult elite athletes compared to a control group.

Methods

A total of 189 subjects participated in this cross-sectional study. Of these were 139 adult elite athletes (70 male, 69 female) performing on top-national and international level, and 50 control subjects (26 male, 24 female). Resting brachial and central BP and aortic pulse wave velocity (PWV) were measured and were compared in terms of sex, sport category, and age of the athletes.

Results

Results show no difference between athletes and controls in any parameter. Women exhibit lower brachial and central BP and AS values compared to men. PWV is positively correlated with age. Evaluation of the parameters according to the different sport categories showed that endurance athletes exhibit lower BP and PWV compared to other athletes.

Conclusions

This study presents brachial and central BP and PWV values of athletes, suggesting that high-performance sport does not negatively impact AS. The proposed reference values might support a more detailed evaluation of elite athlete’s cardiovascular and hemodynamic system and a better assignment to possible risk groups.
The bead process for beta ensembles
Authors: Najnudel Joseph , Virág Bálint
Published: March 2021

The bead process introduced by Boutillier is a countable interlacing of the $${\text {Sine}}_2$$

Sine
2

point processes. We construct the bead process for general $${\text {Sine}}_{\beta }$$

Sine
β

processes as an infinite dimensional Markov chain whose transition mechanism is explicitly described. We show that this process is the microscopic scaling limit in the bulk of the Hermite $$\beta $$
β
corner process introduced by Gorin and Shkolnikov, generalizing the process of the minors of the Gaussian Unitary and Orthogonal Ensembles. In order to prove our results, we use bounds on the variance of the point counting of the circular and the Gaussian beta ensembles, proven in a companion paper (Najnudel and Virág in Some estimates on the point counting of the Circular and the Gaussian Beta Ensemble, 2019).
Hardware implementation of radial-basis neural networks with Gaussian activation functions on FPGA
Authors: Shymkovych Volodymyr , Telenyk Sergii , Kravets Petro
Published: March 2021

This article introduces a method for realizing the Gaussian activation function of radial-basis (RBF) neural networks with their hardware implementation on field-programmable gaits area (FPGAs). The results of modeling of the Gaussian function on FPGA chips of different families have been presented. RBF neural networks of various topologies have been synthesized and investigated. The hardware component implemented by this algorithm is an RBF neural network with four neurons of the latent layer and one neuron with a sigmoid activation function on an FPGA using 16-bit numbers with a fixed point, which took 1193 logic matrix gate (LUTs—LookUpTable). Each hidden layer neuron of the RBF network is designed on an FPGA as a separate computing unit. The speed as a total delay of the combination scheme of the block RBF network was 101.579 ns. The implementation of the Gaussian activation functions of the hidden layer of the RBF network occupies 106 LUTs, and the speed of the Gaussian activation functions is 29.33 ns. The absolute error is ± 0.005. The Spartan 3 family of chips for modeling has been used to get these results. Modeling on chips of other series has been also introduced in the article. RBF neural networks of various topologies have been synthesized and investigated. Hardware implementation of RBF neural networks with such speed allows them to be used in real-time control systems for high-speed objects.
Origin of andradite in the Quaternary volcanic Andahua Group, Central Volcanic Zone, Peruvian Andes
Authors: Gałaś Andrzej , Majka Jarosław , Włodek Adam
Published: March 2021

Euhedral andradite crystals were found in trachyandesitic (latitic) lavas of the volcanic Andahua Group (AG) in the Central Andes. The AG comprises around 150 volcanic centers, most of wich are monogenetic. The studied andradite is complexly zoned (enriched in Ca and Al in its core and mantle, and in Fe in this compositionally homogenous rim). The core-mantle regions contain inclusions of anhydrite, halite, S- and Cl-bearing silicate glass, quartz, anorthite, wollastonite magnetite and clinopyroxene. The chemical compositions of the garnet and its inclusions suggest their contact metamorphic to pyrometamorphic origin. The observed zoning pattern and changes in the type and abundance of inclusions are indicative of an abrupt change in temperature and subsequent devolatilization of sulfates and halides during the garnet growth. This process is interpreted to have taken place entirely within a captured xenolith of evaporite-bearing wall rock in the host trachyandesitic magma. The devolitilization of sediments, especially sulfur-bearing phases, may have resulted in occasional but voluminous emissions of gases and may be regarded as a potential hazard associated with the AG volcanism.
Critical evaluation of a crystal structure of nitrogenase with bound N2 ligands
Authors: Bergmann Justin , Oksanen Esko , Ryde Ulf
Published: March 2021

Recently, a 1.83 Å crystallographic structure of nitrogenase was suggested to show N2-derived ligands at three sites in the catalytic FeMo cluster, replacing the three $$\mu_{2}$$

μ
2

bridging sulfide ligands (two in one subunit and the third in the other subunit) (Kang et al. in Science 368: 1381–1385, 2020). Naturally, such a structure is sensational, having strong bearings on the reaction mechanism of the enzyme. Therefore, it is highly important to ensure that the interpretation of the structure is correct. Here, we use standard crystallographic refinement and quantum refinement to evaluate the structure. We show that the original crystallographic raw data are strongly anisotropic, with a much lower resolution in certain directions than others. This, together with the questionable use of anisotropic B factors, give atoms an elongated shape, which may look like diatomic atoms. In terms of standard electron-density maps and real-space Z scores, a resting-state structure with no dissociated sulfide ligands fits the raw data better than the interpretation suggested by the crystallographers. The anomalous electron density at 7100 eV is weaker for the putative N2 ligands, but not lower than for several of the $${\mu }_{3}$$

μ
3

bridging sulfide ions and not lower than what can be expected from a statistical analysis of the densities. Therefore, we find no convincing evidence for any N2 binding to the FeMo cluster. Instead, a standard resting state without any dissociated ligands seems to be the most likely interpretation of the structure. Likewise, we find no support that the homocitrate ligand should show monodentate binding.

Graphic abstract
Evaluation of the Ventral Hernia Working Group classification for long-term outcome using English Hospital Episode Statistics: a population study
Authors: Hodgkinson J. D. , Worley G. , Warusavitarne J. , Hanna G. B. , Vaizey C. J. , Faiz O. D.
Published: March 2021

Purpose

The Ventral Hernia Working Group (VHWG) classification of ventral/incisional hernia (IH) was developed by expert consensus in 2010. Subsequently, Kanters et al. have demonstrated the validity of a modified version of the system for predicting short-term outcomes. This study aims to evaluate the modified system for predicting hernia recurrence.

Methods

Patients undergoing IH surgery (defined by OPCS codes) in the England Hospital Episode Statistics (HES) database, from 1997 to 2012, were identified. Baseline demographics at index hernia operation and episodes of further hernia surgery (FHS) were recorded. Risk factors for FHS were identified using cox regression and evaluated against the modified-VHWG grade using receiver-operating characteristics (ROC).

Results

The final analysis included 214,082 index IH operations. Of these, 52.6% were female and mean age was 56.59 (SD15.9). An admission for FHS was found in 8.3% cases (17,714 patients).

Multi-variate cox regression revealed contaminated hernia (p < 0.0001), pre-existing IBD (p < 0.0001) and hernia comorbidity (p = 0.05) to be significantly related to long-term FHS. Classifying patients using these factors, according to the modified-VHWG classification, revealed that compared to Grade 1, the hazard ratio (HR) of FHS increased in Grade 2 (HR 1.19; p < 0.0001) and further increased in Grade 3 (HR 1.79; p < 0.0001). ROC analysis revealed the area under the curve to be 0.73 (95% CI 0.73–0.74).

Conclusion

This analysis demonstrates the broad validity of the modified-VHWG classification in discriminating risk for FHS. Inclusion of pre-existing IBD as a factor defining Grade 2 patients would be recommended. This analysis is limited by the absence of certain factors within the HES database, such as BMI.
Trans-hiatal herniation following esophagectomy or gastrectomy: retrospective single-center experiences with a potential surgical emergency
Authors: Oppelt P. U. , Askevold I. , Hörbelt R. , Roller F. C. , Padberg W. , Hecker A. , Reichert M.
Published: March 2021

Purpose

Trans-hiatal herniation after esophago-gastric surgery is a potentially severe complication due to the risk of bowel incarceration and cardiac or respiratory complaints. However, measures for prevention and treatment options are based on a single surgeon´s experiences and small case series in the literature.

Methods

Retrospective single-center analysis on patients who underwent surgical repair of trans-hiatal hernia following gastrectomy or esophagectomy from 01/2003 to 07/2020 regarding clinical symptoms, hernia characteristics, pre-operative imaging, hernia repair technique and perioperative outcome.

Results

Trans-hiatal hernia repair was performed in 9 patients following abdomino-thoracic esophagectomy (40.9%), in 8 patients following trans-hiatal esophagectomy (36.4%) and in 5 patients following conventional gastrectomy (22.7%). Gastrointestinal symptoms with bowel obstruction and pain were mostly prevalent (63.6 and 59.1%, respectively), two patients were asymptomatic. Transverse colon (54.5%) and small intestine (77.3%) most frequently prolapsed into the left chest after esophagectomy (88.2%) and into the dorsal mediastinum after gastrectomy (60.0%). Half of the patients had signs of incarceration in pre-operative imaging, 10 patients underwent emergency surgery. However, bowel resection was only necessary in one patient. Hernia repair was performed by suture cruroplasty without (n = 12) or with mesh reinforcement (n = 5) or tension-free mesh interposition (n = 5). Postoperative pleural complications were most frequently observed, especially in patients who underwent any kind of mesh repair. Three patients developed recurrency, of whom two underwent again surgical repair.

Conclusion

Trans-hiatal herniation after esophago-gastric surgery is rare but relevant. The role of surgical repair in asymptomatic patients is disputed. However, early hernia repair prevents patients from severe complications. Measures for prevention and adequate closure techniques are not yet defined.
Prevention of incisional hernia at the site of stoma closure with different reinforcing mesh types: a systematic review and meta-analysis
Authors: Peltrini Roberto , Imperatore Nicola , Altieri Gaia , Castiglioni Simone , Di Nuzzo Maria Michela , Grimaldi Luciano , D’Ambra Michele , Lionetti Ruggero , Bracale Umberto , Corcione Francesco
Published: March 2021

Purpose

To evaluate safety and efficacy of a mesh reinforcement following stoma reversal to prevent stoma site incisional hernia (SSIH) and differences across the prostheses used.

Methods

A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Cochrane databases was conducted to identify comparative studies until September 2020. A meta-analysis of postoperative outcomes and a network meta-analysis for a multiple comparison of the prostheses with each other were performed.

Results

Seven studies were included in the analysis (78.4% ileostomy and 21.6% colostomy) with a total of 1716 patients with (n = 684) or without (n = 1032) mesh. Mesh placement was associated with lower risk of SSIH (7.8%vs18.1%, OR0.266,95% CI 0.123–0.577, p < 0.001) than no mesh procedures but also with a longer operative time (SMD 0.941, 95% CI 0.462–1.421, p < 0.001). There was no statistically significant difference in terms of Surgical Site infection (11.5% vs 11.1%, OR 1.074, 95% CI 0.78–1.48, p = 0.66), seroma formation (4.4% vs 7.1%, OR 1.052, 95% CI 0.64–1.73, p = 0.84), anastomotic leakage (3.7% vs 2.7%, OR 1.598, 95% CI 0.846–3.019, p = 0.149) and length of stay (SMD − 0.579,95% CI − 1.261 to 0.102, p = 0.096) between mesh and no mesh groups. Use of prosthesis was associated with a significant lower need for a reoperation than no mesh group (8.1% vs 12.1%, OR 0.332, 95% CI 0.119–0.930, p = 0.036). Incidence of seroma is lower with biologic than polypropylene meshes but they showed a trend towards poor results compared with polypropylene or biosynthetic meshes.

Conclusion

Despite longer operative time, mesh prophylactic reinforcement at the site of stoma seems a safe and effective procedure with lower incidence of SSIH, need for reoperation and comparable short-term outcomes than standard closure technique. A significant superiority of a specific mesh type was not identified.
Combination of vegetable soup and glucan demonstrates synergistic effects on macrophage-mediated immune responses
Authors: Lee Ha-Nul , Choi Joo-Hee , Park Ji-Yeon , Ahn Jae-Hun , Jang Da Eun , Shim Jae Gun , Park Jong-Hwan , Kim Young-Min
Published: March 2021

Vegetable soup (VS), a plant-based functional food, has been used as a traditional folk medicine and is attracting attention for its ability to enhance the immune response. β-Glucan, a well-established and effective immunomodulator, has synergistic effects when used in combination with some bioactive compounds. In the present study, we aimed to evaluate the synergistic immunomodulatory effects of the combination of VS and β-glucan on macrophage-mediated immune responses. β-Glucan was demonstrated to synergistically enhance the VS-stimulated immune response, including the production of interleukin-6, tumor necrosis factor-α, and nitric oxide, mainly through the mitogen-activated protein kinase pathway in macrophages. In addition, this combination has the potential for further development in functional foods with immune-enhancing activity.
If horses had toes: demonstrating mirror self recognition at group level in Equus caballus
Authors: Baragli Paolo , Scopa Chiara , Maglieri Veronica , Palagi Elisabetta
Published: March 2021

Mirror self-recognition (MSR), investigated in primates and recently in non-primate species, is considered a measure of self-awareness. Nowadays, the only reliable test for investigating MSR potential skills consists in the untrained response to a visual body mark detected using a reflective surface. Here, we report the first evidence of MSR at group level in horses, by facing the weaknesses of methodology present in a previous pilot study. Fourteen horses were used in a 4-phases mirror test (covered mirror, open mirror, invisible mark, visible colored mark). After engaging in a series of contingency behaviors (looking behind the mirror, peek-a-boo, head and tongue movements), our horses used the mirror surface to guide their movements towards their colored cheeks, thus showing that they can recognize themselves in a mirror. The analysis at the group level, which ‘marks’ a turning point in the analytical technique of MSR exploration in non-primate species, showed that horses spent a longer time in scratching their faces when marked with the visible mark compared to the non-visible mark. This finding indicates that horses did not see the non-visible mark and that they did not touch their own face guided by the tactile sensation, suggesting the presence of MSR in horses. Although a heated debate on the binaryversusgradualist model in the MSR interpretation exists, recent empirical pieces of evidence, including ours, indicate that MSR is not an all-or-nothing phenomenon that appeared once in phylogeny and that a convergent evolution mechanism can be at the basis of its presence in phylogenetically distant taxa.
A unified approach for a 1D generalized total variation problem
Authors: Lu Cheng , Hochbaum Dorit S.
Published: March 2021

We study a 1-dimensional discrete signal denoising problem that consists of minimizing a sum of separable convex fidelity terms and convex regularization terms, the latter penalize the differences of adjacent signal values. This problem generalizes the total variation regularization problem. We provide here a unified approach to solve the problem for general convex fidelity and regularization functions that is based on the Karush–Kuhn–Tucker optimality conditions. This approach is shown here to lead to a fast algorithm for the problem with general convex fidelity and regularization functions, and a faster algorithm if, in addition, the fidelity functions are differentiable and the regularization functions are strictly convex. Both algorithms achieve the best theoretical worst case complexity over existing algorithms for the classes of objective functions studied here. Also in practice, our C++ implementation of the method is considerably faster than popular C++ nonlinear optimization solvers for the problem.
Trifluridine/tipiracil in patients with metastatic gastroesophageal junction cancer: a subgroup analysis from the phase 3 TAGS study
Authors: Mansoor Wasat , Arkenau Hendrik-Tobias , Alsina Maria , Shitara Kohei , Thuss-Patience Peter , Cuffe Sinead , Dvorkin Mikhail , Park David , Ando Takayuki , Van Den Eynde Marc , Beretta Giordano D. , Zaniboni Alberto , Doi Toshihiko , Tabernero Josep , Ilson David H. , Makris Lukas , Benhadji Karim A. , Van Cutsem Eric
Published: March 2021

Background

Patients with advanced gastroesophageal junction cancer (GEJC) have poor survival outcomes, and GEJC-specific data from trials evaluating agents in gastric cancers (GCs) as a whole are lacking. Trifluridine/tipiracil (FTD/TPI) was approved for previously treated metastatic GC or GEJC (mGC/mGEJC) based on results of the phase 3 TAGS trial. Subgroup analyses by primary tumor type (GC or GEJC) in TAGS are reported here.

Methods

Pa
tients with mGC/mGEJC treated with  ≥ 2 prior chemotherapy regimens were randomized (2:1) to receive FTD/TPI or placebo, plus best supportive care. A pre-planned sub-analysis was performed to evaluate efficacy and safety outcomes by primary tumor type (GEJC or GC).

Results

Of 507 randomized patients, 145 (29%) had GEJC and 360 (71%) had GC as the primary disease site. Baseline characteristics were generally similar between the GEJC and GC subgroups, except that more patients in the GEJC subgroup had received  ≥ 3 prior regimens (72 vs. 59% in the GC subgroup). Survival benefit with FTD/TPI was observed in both subgroups. The overall survival hazard ratio for FTD/TPI vs placebo was 0.75 (95% CI 0.50–1.11) and 0.67 (95% CI 0.52–0.87) in the GEJC and GC subgroups, respectively. Grade ≥ 3 adverse events of any cause were reported in 75 (77%) and 192 (81%) FTD/TPI-treated patients in the GEJC and GC subgroups, respectively. No new safety concerns were noted with FTD/TPI.

Conclusion

As in patients with GC, FTD/TPI showed an efficacy benefit in patients with GEJC in the TAGS trial, along with demonstrating a manageable safety profile.
Betting on bitcoin: a profitable trading between directional and shielding strategies
Authors: De Angelis Paolo , De Marchis Roberto , Marino Mario , Martire Antonio Luciano , Oliva Immacolata
Published: March 2021

In this paper, we come up with an original trading strategy on Bitcoins. The methodology we propose is profit-oriented, and it is based on buying or selling the so-called Contracts for Difference, so that the investor’s gain, assessed at a given future time t, is obtained as the difference between the predicted Bitcoin price and an apt threshold. Starting from some empirical findings, and passing through the specification of a suitable theoretical model for the Bitcoin price process, we are able to provide possible investment scenarios, thanks to the use of a Recurrent Neural Network with a Long Short-Term Memory for predicting purposes.
Is dealing with errors in the classroom specific for school subjects? A study of the error climate in mathematics, German, and English
Authors: Steuer Gabriele , Tulis Maria , Dresel Markus
Published: March 2021

A frequent observation in the school context is that opportunities to learn from errors are often missed. However, a positive error climate may support learning from errors. For the school subject of mathematics, some findings about characteristics of the error climate already exist. But, a comparison of the error climate between different school subjects is still pending. In the present study, it is analyzed whether the error climate differs in different school subjects and whether the same interrelations between the ways in which individuals deal with errors can be found in these different school subjects. In a study with 937 students from 48 classrooms from grades 5 to 7, in different secondary schools in Germany and Austria, we assessed the error climate and individual reactions following errors in mathematics, German, and English. Small mean differences between mathematics and the two language subjects were yielded. In addition, we found medium-sized correlations between the error climate measures in the three school subjects. However, the same pattern of interrelations between error climate and the way individuals deal with errors for all three school subjects could be shown. The results suggest that the perception of the error climate is rather similar in different school subjects. This has implications, for instance, for interventions that aim at fostering the error climate.
Win – and stay, but not too long: cavity selection by Boreal Owls to minimize nest predation by Pine Marten
Authors: Sonerud Geir A.
Published: March 2021

Site fidelity after successful nesting and site shift after nest predation (win–stay, lose–shift) is a well-documented adaptation to spatially heterogeneous and temporally auto-correlated predation risk. However, site shift even after a successful nesting (win–shift) may become a better tactic than site fidelity (win–stay), if a successful nest site becomes more risky until the next nesting opportunity, and if new low-risk nest sites regularly appear. Correspondingly, selecting a new non-used nest site may become a better tactic than selecting one previously used successfully by a conspecific. I studied this dynamic by focusing on nest cavities that may be available for many years, and using nest boxes to allow an experimental design. At localities where Boreal Owls (Aegolius funereus) had nested successfully, a dyad of nest boxes was made available each year, one box in the original nest tree and one in a new tree for the season, each containing either old nest material from the successful nesting or new wood shavings. Boreal owls were more likely to select the box in the new tree when more years had elapsed since the successful nesting and since a box was installed in the original nest tree, independent of box content. The pattern of selection differed between young and old individuals for males, but not females. Young males based their selection of nest tree mainly on box content, while old males based it on time elapsed since the successful nesting in the original nest tree and how long a box had been present there. The probability of depredation of Boreal Owl nests by Pine Marten (Martes martes) has previously been found to increase with cavity age and number of nesting seasons elapsed since the previous successful nesting. This pattern of nest predation thus predicted the pattern of nest site selection found.
Release mechanisms of major DAMPs
Authors: Murao Atsushi , Aziz Monowar , Wang Haichao , Brenner Max , Wang Ping
Published: March 2021

Damage-associated molecular patterns (DAMPs) are endogenous molecules which foment inflammation and are associated with disorders in sepsis and cancer. Thus, therapeutically targeting DAMPs has potential to provide novel and effective treatments. When establishing anti-DAMP strategies, it is important not only to focus on the DAMPs as inflammatory mediators but also to take into account the underlying mechanisms of their release from cells and tissues. DAMPs can be released passively by membrane rupture due to necrosis/necroptosis, although the mechanisms of release appear to differ between the DAMPs. Other types of cell death, such as apoptosis, pyroptosis, ferroptosis and NETosis, can also contribute to DAMP release. In addition, some DAMPs can be exported actively from live cells by exocytosis of secretory lysosomes or exosomes, ectosomes, and activation of cell membrane channel pores. Here we review the shared and DAMP-specific mechanisms reported in the literature for high mobility group box 1, ATP, extracellular cold-inducible RNA-binding protein, histones, heat shock proteins, extracellular RNAs and cell-free DNA.
A novel approach to quantifying trophic interaction strengths and impact of invasive species in food webs
Authors: Calizza Edoardo , Rossi Loreto , Careddu Giulio , Sporta Caputi Simona , Costantini Maria Letizia
Published: March 2021

Measuring ecological and economic impacts of invasive species is necessary for managing invaded food webs. Based on abundance, biomass and diet data of autochthonous and allochthonous fish species, we proposed a novel approach to quantifying trophic interaction strengths in terms of number of individuals and biomass that each species subtract to the others in the food web. This allowed to estimate the economic loss associated to the impact of an invasive species on commercial fish stocks, as well as the resilience of invaded food webs to further perturbations. As case study, we measured the impact of the invasive bassMicropterus salmoidesin two lake communities differing in food web complexity and species richness, as well as the biotic resistance of autochthonous and allochthonous fish species against the invader. Resistance to the invader was higher, while its ecological and economic impact was lower, in the more complex and species-rich food web. The percidPerca fluviatilisand the whitefishCoregonus lavaretuswere the two species that most limited the invader, representing meaningful targets for conservation biological control strategies. In both food webs, the limiting effect of allochthonous species againstM. salmoideswas higher than the effect of autochthonous ones. Simulations predicted that the eradication of the invader would increase food web resilience, while that an increase in fish diversity would preserve resilience also at high abundances ofM. salmoides. Our results support the conservation of biodiverse food webs as a way to mitigate the impact of bass invasion in lake ecosystems. Notably, the proposed approach could be applied to any habitat and animal species whenever biomass and diet data can be obtained.
Repeat breast-conserving treatment of ipsilateral breast cancer recurrence: a nationwide survey amongst breast surgeons and radiation oncologists in the Netherlands
Authors: Walstra Coco J. E. F. , Schipper Robert-Jan , van Riet Yvonne E. , van der Toorn Peter-Paul G. , Smidt Marjolein L. , Sangen Maurice J. C. vd , Voogd Adri C. , Nieuwenhuijzen Grard A. P.
Published: March 2021

Background

In line with the paradigm to minimize surgical morbidity in patients with primary breast cancer, there is increasing evidence for the safety of a repeat breast-conserving treatment (BCT) of an ipsilateral breast tumour recurrence (IBTR) in selected patients. The conditions for the feasibility of a repeat BCT vary widely in literature. In clinical practice, many physicians have ongoing concerns about the oncological safety and possible toxicity of repeat BCT.

Aim

To investigate the attitude of Dutch breast surgeons and radiation oncologists towards repeat BCT and to report on their experiences with, objections against and perceived requirements to consider a repeat BCT in case of IBTR.

Patients and methods

An online survey consisting of a maximum of 26 open and multiple-choice questions about repeat BCT for IBTR was distributed amongst Dutch breast surgeons and radiation oncologists.

Results

Forty-nine surgeons representing 49% of Dutch hospitals and 20 radiation oncologists representing 70% of Dutch radiation oncology centres responded. A repeat BCT was considered feasible in selected cases by 28.7% of breast surgeons and 55% of radiation oncologists. The most important factors to consider a repeat BCT for both groups were the patient’s preference to preserve the breast and surgical feasibility of a second lumpectomy. Arguments against a repeat BCT were based on the perceived unacceptable toxicity and cosmesis of a second course of radiotherapy. The technique of preference for re-irradiation would be partial breast irradiation (PBI) according to all radiation oncologists. Differentiating between new primary tumours (NPT) and true recurrences (TR) was reported to be done by 57.1% of breast surgeons and 60% of radiation oncologists. The most important reason to differentiate between NPT and TR was to establish prognosis and to consider whether a repeat BCT would be feasible.

Conclusion

An increasing number of Dutch breast cancer specialists is considering a repeat BCT feasible in selected cases, at the patient’s preference and with partial breast re-irradiation.