bluuebunny/crossref_metadata_2025 huggingface dataset:
Intensity modulated radiotherapy (IMRT) and fractionated stereotactic radiotherapy (FSRT) for children with head-and-neck rhabdomyosarcoma
Authors: Combs S. E. , Behnisch W. , Kulozik A. , Muenter M. W. , Debus J. , Schulz-Ertner D.
Published: March 2020

9065

Background: To evaluate intensity-modulated radiotherapy (IMRT) and fractionated stereotactic radiotherapy (FSRT) for children with head-and-neck rhabdomyosarcoma (RMS) with special regard to radiation induced toxicity. Methods: From 1995 to 2005, we treated 19 children with head-and-neck RMS with FSRT (n=14) or IMRT (n=5). The median age at the time of RT was 62.5 months. All children received systemic chemotherapy according to the German Soft Tissue Sarcoma Study protocols (CWS). Patients were grouped classified according to the grouping system used in Intergroup Rhabdomyosarcoma Study Group (IRSG) trials. Patients were immobilized using an individual mask fixation system. For treatment planning contrast-enhanced MRI- and CT-scans were performed. Median size of PTV for RT was 93,4 ml. We applied a median total dose of 45 Gy (range 32 - 54 Gy) using a median fractionation of 5 × 1,8 Gy/week (range 1,6 - 1,8 Gy / week). Deep sedation or general anaesthesia was required for children < 5 years. Results: RT was well tolerated in all children and could be completed without interruptions > 4 days. Minor RT-induced side effects included skin erythema, alopecia, conjunctivitis, mucositis and nausea / vomiting, however no toxicities >CTC grade II developed. The median follow-up time after precision RT was 17 months. Until now, no secondary malignancies developed. After RT, the 3- and 5-year survival rate was 94%. The 3- and 5-year actuarial local control rate after RT was 89%. With respect to tumor localization, the 3- and 5-year local control rates were 100% for patients with RMS of the orbit and 91% for patients with parameningeal tumors. The actuarial freedom of distant metastases rate was 89% at 5 years. For patients with RMS of the orbit only, the actuarial distant progression-free survival rate was 100% at 5 years. The actuarial 3- and 5-year distant metastases-free survival rate was 91%, in children with parameningeal RMS. Conclusions: High precision RT techniques such as IMRT and FSRT offer good coverage of complex shaped target volumes in critical locations with the necessary RT dose while adhering to the tolerance doses of nearby critical normal tissue structures. Local and distant control rates are not reduced.

No significant financial relationships to disclose.
Updated results of a phase II trial of AP23573, a novel mTOR inhibitor, in patients (pts) with advanced soft tissue or bone sarcomas
Authors: Chawla S. P. , Tolcher A. W. , Staddon A. P. , Schuetze S. M. , D’Amato G. Z. , Blay J. Y. , Sankhala K. K. , Daly S. T. , Rivera V. M. , Demetri G. D.
Published: March 2020

9505

Background: AP23573 is an mTOR inhibitor that has shown anti-tumor activity in phase 1 clinical trials, particularly in patients with advanced sarcomas. Given this observation, this phase 2 trial was undertaken to assess further the efficacy and safety of AP23573 across various sarcoma subtypes. Methods: Advanced sarcoma pts, with no restrictions on prior therapies, were enrolled into 4 cohorts based on histologic subtype, in a phase 2 trial with Simon’s 2-stage design. AP23573 (12.5 mg, i.v.) is administered for 5 days every 2 wks. Efficacy is assessed using RECIST guidelines, with clinical benefit response (CBR) defined as complete or partial response (PR) or stable disease (SD) for at least 16 wks duration. For each cohort, treatment was defined as successful if the proportion of patients with CBR was ≥ 25%. Studies of potential predictive markers of response include 18FDG-PET imaging, analysis of mTOR pathway proteins in tumoral tissue, and measurement of plasma cytokines and angiogenic factors. Results: In total, 216 pts were enrolled as all cohorts met criteria to enter Stage 2 of the trial. Of these pts, 213 were treated (106 M/107 F) (age 17–79 yrs, median 50 yrs). Most frequent related adverse events included mucositis, rash, hyperlipidemia, fatigue, and thrombocytopenia. Preliminary response data for 193 evaluable pts are available: overall 54 (28%) had CBRs, including 5 PRs (3 pts with osteo, 1 with spindle cell of bone, and 1 with MFH). Twenty of 76 pts (26%) imaged with PET had rapid induction of partial metabolic responses following 3 to 5 days of study treatment. Conclusions: Initial assessments from this trial show that single-agent AP23573 is well tolerated and has efficacy in pts with advanced sarcomas that warrants evaluation in phase 3. Analysis of the potential utility of FDG-PET and a broad set of candidate biomarkers continues. Enrollment is complete, and pt treatment and follow-up are ongoing.

[Table: see text]

[Table: see text]
Updated results from a phase III trial of sunitinib in GIST patients (pts) for whom imatinib (IM) therapy has failed due to resistance or intolerance
Authors: Casali P. G. , Garrett C. R. , Blackstein M. E. , Shah M. , Verweij J. , McArthur G. , Judson I. , Li J. , Baum C. M. , Demetri G. D.
Published: March 2020

9513

Background: Sunitinib malate (previously known as SU11248) is an oral multitargeted tyrosine kinase inhibitor with both antitumor and antiangiogenic effects due to blockade of KIT, PDGFRs, VEGFRs, FLT3, and RET. Initial results from this phase III trial showed sunitinib was associated with significantly longer TTP than placebo in IM-resistant GIST pts. Methods: This double-blind, placebo-controlled, phase III trial compared sunitinib 50 mg/day (N=207) to placebo (N=105) in IM-resistant or -intolerant GIST pts. Treatment was administered in 6-week cycles (4 weeks on, 2 weeks off treatment). The primary endpoint was TTP. Secondary endpoints included PFS, OS, ORR, and pain and health status (HS) measures. Pain relief response rate (PRRR) was defined as the proportion of pts who had ≥1 pain relief response event (based on weekly changes in present pain index of MPQ and analgesic consumption). HS was measured using the EQ-5D questionnaire. Results: A planned interim analysis showed significantly longer median TTP with sunitinib versus placebo (27.3 vs 6.4 weeks; HR, 0.33; P<0.001), which led to unblinding of the study and crossover of all placebo pts to open-label sunitinib. OS was also significantly longer with sunitinib (median OS will be presented). Sunitinib therapy induced PRs in 14 pts (6.8%) and durable SD (≥22 weeks) in 36 (17.4%) vs. 0% PR and SD ≥22 weeks in 2 (1.9%) pts on placebo. Four of 9 IM-intolerant pts achieved PR with sunitinib therapy versus 0 of 4 IM-intolerant pts treated with placebo. There was a trend for higher PRRR with sunitinib versus placebo in the ITT population (17.4% vs 9.5%, P=0.064) and in 174 pts who reported pain or analgesic use at baseline (31.0% vs 17.2%, P=0.052). The most common treatment-related AEs were fatigue, diarrhea, skin discoloration, and nausea, which were usually grade 1/2 and easily managed. Updated survival and tumor-control efficacy measures, tolerability, and HS results will be available for presentation. Conclusions: Sunitinib significantly prolonged TTP and OS in GIST pts for whom IM therapy had failed due to resistance or intolerance. This trial demonstrated major clinical benefit from a multitargeted tyrosine kinase inhibitor in pts resistant to a different kinase inhibitor.

[Table: see text]
Sunitinib for patients (pts) with advanced imatinib (IM)-refractory GIST: Early results from a “treatment-use” trial
Authors: Morgan J. A. , Garrett C. R. , Schutte H. J. , Hurwitz H. , Rosen L. S. , Ruka W. , Picus J. , Kaiser P. , Baum C. M. , Demetri G. D.
Published: March 2020

9540

Background: Pts with advanced or metastatic GIST are typically treated first with IM, but many GISTs develop resistance to IM over time or are initially resistant this agent, and a small fraction of GIST pts are intolerant of IM therapy. Sunitinib malate (previously known as SU11248) is an oral, multitargeted tyrosine kinase inhibitor of KIT, PDGFR, VEGFR, FLT3, and RET that has demonstrated efficacy in extensive prior trials involving IM-refractory GIST pts. Since GIST pts who were ineligible for participation in sunitinib clinical trials might derive significant benefit from this therapy, a treatment-use program was implemented for this purpose. Methods: This on-going, multicenter, open-label trial was designed to grant access to sunitinib for treatment use in pts who were ineligible for other sunitinib trials and who had advanced IM-resistant GIST or documented intolerance to IM. Pts on sunitinib are monitored closely to assess clinical benefit as judged by the investigator. Sunitinib is administered at a starting dose of 50 mg/day on a 4/2 schedule (4 consecutive weeks on, 2 weeks off treatment). Clinical endpoints include safety and tolerability, as well as disease control (TTP), response rates, and survival. Results: Of 268 GIST pts enrolled in this treatment-use trial at the time of this analysis, 247 had received at least one dose of sunitinib. The median number of cycles completed was 2 (range, 0–9), and the median number of days on treatment was 83 (range, 1–385). The most frequently reported treatment-related AEs were fatigue (36%), diarrhea (31%), nausea (27%), and hand-foot syndrome (15%), which were generally grade 1/2. At the time of analysis, preliminary efficacy data were available for 152 pts. Of these, 123 pts remain on therapy and have received a median of 3 (range, 2–7) cycles of sunitinib. Based on initial investigator assessments, one pt achieved a CR, 14% achieved PR and 63% have noted SD as best response. Conclusions: Sunitinib was associated with acceptable tolerability in this population of IM-refractory GIST pts enrolled in this treatment-use trial. Consistent with previous results, promising clinical activity was seen, and expanded tolerability and efficacy data will be presented.

[Table: see text]
reGISTry: An observational registry of gastrointestinal stromal tumor (GIST) patients (pts) in the USA
Authors: Trent J. C. , Blanke C. D. , Pisters P. W. , Von Mehren M. , Davis D. S. , Ruxer R. , McWhorter L. T. , Salvado A. J.
Published: March 2020

9543

Background: The management of pts with GIST dramatically changed after the discovery of the biologic role of dysregulated KIT and PDGFR receptor tyrosine kinases. However, published data on the epidemiology and patterns of diagnosis and management of GIST are limited. To fill this gap, the reGISTry, an observational, internet-based database designed to understand evolving patterns of care for pts with GIST, overall and by pt and provider characteristics, was established. Methods: Up to 200 physicians are expected to participate; recruitment of centers is stratified by geographic area and institution size/type. The reGISTry will be active for at least 4 years with expected accrual of 1800 pts. Pts must have a diagnosis of GIST and give written informed consent. Collected data include pt demographics, clinical characteristics, clinical/economic outcomes and medical care provided to treat GIST. Data analyses are performed every 6 months. Results: The first pt was enrolled in Jan 2005. As of Nov 2005 there were 108 pts enrolled from 39 centers. Eighty five pts (79%) were from community-based practices and 23 (21%) from university/academic centers. Fifty-five pts (51%) were male. Median age was 62 years (range 37–85). At diagnosis, 84 pts (78%) had a primary tumor and 24 (22%) metastatic disease. At diagnosis, 101 pts (94%) had immunohistochemical KIT testing, 95% with positive results. Only 2% of pts had genotyping performed. Surgery was the most common first-line treatment (85 pts, 79%). Eighty-nine percent of those with primary disease and 42% of those with metastatic disease underwent surgical resection as their initial therapy. Fifty percent of pts with metastatic disease and 7% of pts with primary disease underwent systemic therapy as their initial treatment. Forty-seven pts (44%) had imatinib mesylate therapy with 400 mg daily the most commonly prescribed dose. Therapeutic efficacy was more commonly assessed by CT size with radiodensity (55.6%) than positron-emission tomography (0%). Conclusions: The reGISTry is a useful tool for determining evolving practice patterns in the management of GIST. Iterative data analyses over the next 4 years will allow for comparison of management patterns as advances in the understanding of GIST evolve.

[Table: see text]
Angiosarcoma of the breast
Authors: Sher T. , Hennessy B. T. , Valero V. , Trent J. , Broglio K. , Woodward W. A. , Hunt K. K. , Hortobagyi G. N. , Gonzalez-Angulo A. M.
Published: March 2020

9554

Background: The purpose of this analysis is to describe the characteristics and clinical outcomes of female patients with primary breast angiosarcoma. Methods: The M. D. Anderson Cancer Center Breast Medical Oncology database was searched to identify breast angiosarcoma patients between 1965–2002. Survival outcomes were estimated by the Kaplan-Meier method. The log-rank statistic was used to compare groups. Cox proportional hazards models were used for multivariate analysis. Results: The 69 patients had a median follow up of 40 months (range, 0–413 months). Median age at diagnosis was 46. Median tumor size was 5.5 cm. Thirteen patients had received prior chest radiation (18.8%) for invasive breast carcinoma and were older than other patients (p<0.0001). Most patients underwent a simple mastectomy with (41%) or without (45%) axillary dissection. Regional metastasis to axillary lymph nodes was rare (2/28 patients). Fifteen patients (22%) received neoadjuvant chemotherapy, of whom two had a complete clinical response and 3 a partial response to doxorubicin/ifosfamide (AI); 44% received adjuvant chemotherapy, one patient received neoadjuvant and 31% adjuvant radiotherapy. There have been 38 recurrences [locoregional (20), distant (16), or combined (2)] and 27 deaths. The 5-year overall and recurrence-free survival (RFS) rates were 61% (95% CI 49–76%) and 44% (95% CI 33–58%) with estimated medians of 100 and 37 months, respectively. Survival and RFS were significantly associated with T stage (p=0.03) but not with patient age or prior radiation. Survival was also significantly worse in patients who received neoadjuvant chemotherapy administration (p=0.01) likely due to more advanced disease when this approach was used. In Cox proportional hazards models, only age at diagnosis was associated with RFS. Of 29 patients treated with chemotherapy at relapse, there were 4 complete and 10 partial responses (48% responses) with AI or a gemcitabine-taxane combination. Conclusion: Breast angiosarcoma is frequently advanced at diagnosis with a tendency for locoregional recurrence. In light of this and its observed chemosensitivity, a multidisciplinary therapeutic approach with chemo- radiotherapy and surgical resection should be considered. Initial chemotherapy for neoadjuvant and metastatic disease is effective.

No significant financial relationships to disclose.
ABV (doxorubicin [Adriamycin], bleomicin and vincristine) polychemotherapy regimen in HIV Kaposi’s Sarcoma: Uruguaian 10-year experience
Authors: Krygier G. , Sosa A. , Blanco A. , Lombardo K. , Castillo C. , Dutra A. , Cabrera S. , Savio E. , Muse I. , Sabini G.
Published: March 2020

9559

Background: Kaposi’s sarcoma is the most common malignancy among HIV patients and is considered to be one of the AIDS defining conditions. This abstract illustrates our 10 year experience with the treatment of 32 Kaposi’s sarcoma HIV patients with the same therapeutic approach. Methods: Between 04/95 and 03/05 we recruited 32 previously untreated patients that were diagnosed with Kaposi’s sarcoma and treated at the Servicio de Oncologia Clinica (Universitary Clinicas Hospital) in Montevideo. All of them received the same iv polychemotherapy plan (Adriamycin 10mg/m2, Bleomycin 10 U/m2 and Vincristine 1.4 mg/m2, every two weeks until tumor progression or severe toxicity). Results: 21 of the patients were good risk ones and the remaining 11 were poor risk patients (AIDS Clinical Trials Group staging classification). CD4 levels varied from 6 to 780/ml and the viral load ranges were 240 to 89000 copies. The patients received an average of 10.2 (4–21) polychemotherapy cycles. Grade 3–4 myelotoxicity was reported in 5 patients delaying the onset of the subsequent cycles. Grade 2 neurotoxicity was seen in 7 patients after 4, 5, 6, 8, 10, 11 and 13 cycles of ABV, changing vincristine for vinblastine (4mg/m2 every two weeks) in these patients. All the patients achieved a partial response with improvements in CD4 levels and viral load. 13/32 patients experienced a relapse (3–29 months after last chemotherapy cycle). 3 patients were retreated with paclitaxel 135 mg/m2 with 2/3 new partial responses of shorter duration. 5 patients received 4 additional ABV cycles achieving a new partial response. 5 patients refused further treatment dying due to progressive disease. One relapsed patient developed a second malignancy (High grade Non Hodgkin lymphoma) dying three months later. Conclusions: These data suggest that ABV regimen is still an effective treatment option for HIV-Kaposi’s sarcoma, specially in the undeveloped countries in which the cost of other better internationally approved options (liposomal doxorubicin and daunorubicin) makes them unaccesible for the majority of the population.

No significant financial relationships to disclose.
Sequential epirubicin-docetaxel-CMF as adjuvant therapy of early breast cancer: Results of the Taxit216 multicenter phase III trial
Authors: Bianco A. R. , De Matteis A. , Manzione L. , Boni C. , Palazzo S. , Di Palma M. , Iacono C. , De Placido S. , Papaldo P. , Cognetti F.
Published: March 2020

LBA520

Background: Docetaxel is among the most active drugs for advanced breast cancer and it has recently shown efficacy in the adjuvant setting too. This trial is aimed at comparing the efficacy and tolerability of a sequential approach of a chemotherapy combination regimen containing docetaxel to a standard anthracycline-based regimen as adjuvant therapy in node-positive (N+) early breast cancer. Methods: Between July 1998 and July 2002, 972 N+ early breast cancer patients were randomized to either arm A (E→CMF): Epirubicin (E) 120 mg/m2 iv d1 q21 × 4 cycles followed by Cyclophosphamide 600 mg/m2 iv, Methotrexate 40 mg/m2 iv and Fluorouracil 600 mg/m2 iv (CMF) d1,8 q28 × 4 cycles; or armB (E→T→CMF) in which Docetaxel 100 mg/m2 iv (T) d1 q21 × 4 cycles was administered after the 4th cycle of E and before the 1st cycle of CMF. Treatment allocation was performed by a computer program using a dynamic balancing algorithm. Balancing factors were: center, lymph node involvement (1 to 3, 4 to 9, >10), estrogen receptor status (negative/positive/unknown), menopausal status (pre/post). During chemotherapy pts were subjected to physical examination and blood chemistry tests every 3 wks, hematology was repeated weekly. At the completion of treatment pts were followed up every 3 months for the first 2 years, every 6 months for years 3–5 and every 12 months for years 6–10. Primary endpoint was disease free survival (DFS) and secondary endpoints were tolerability and overall survival (OS). The study was designed to detect a hazard ratio of 0.70, assuming an α of 0.05 (two sided), a power of 0.80 and an expected DFS in Arm A of 0.65 at 5 years. This required 480 pts per Arm and 250 events. Results: As of March 27th 2006, 486 pts were enrolled in arm A and 486 in arm B, 252 primary events were recorded and the median follow up was 53 months. DFS at 5 years was 0.67 in arm A vs 0.74 in arm B with an estimated Hazard Ratio (HR) of 0.80 (95% CI: 0.62–1.03, p = 0.079). After adjustement by predefined balancing factors (ER, Nodal and menopausal status) the HR was 0.78 (95% CIs: 0.61–1.00; p = 0.05). As for OS, 117 deaths were observed with HR of 0.74 (95% CIs: 0.51–1.07, p = 0.10). Conclusions: Sequential E→T→CMF yields a borderline significant improvement of DFS. Follow up update is still ongoing.

[Table: see text]
The Virtuosity of Langston Hughes: Persona, Rhetoric, and Iconography inThe Weary Blues
Authors: Skansgaard Michael
Published: March 2020

Previous historical studies of The Weary Blues have focused on the racial symbolism of Langston Hughes’s technique, which (as the consensus goes) authenticates the voice of the persona through its deliberate simplicity. This orthodox view is wrongheaded from the outset. The essay uses a new system of rhetorically driven scansion to identify elaborate rhetorical symmetries and polyrhythms that shape the cognition of Hughes’s persona and the recognition of his readers in ways that prose language cannot. Hughes employs rhetoric and iconography as alternative modes of historical narration. This recuperation of his persona intervenes in an ongoing dispute in the field of historical poetics about the value of formalism and cognitivism. The essay aims to show that the concept of thinking in verse is valuable where it has been least applied: in reclaiming the value of traditionally marginalized literatures such as those of the African American vernacular tradition.
Great potential of ultrasound elastography for the assessment of the masseter muscle in patients with temporomandibular disorders. A systematic review
Authors: Olchowy Anna , Wieckiewicz Mieszko , Winocur Efraim , Dominiak Marzena , Dekkers Ilona , Łasecki Mateusz , Olchowy Cyprian
Published: March 2020

Objective:

To summarize the available evidence on the use of elastography in the assessment of the masseter muscle in healthy individuals and patients with masseter muscle disorders.

Methods:

Systematic literature review has been performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

Results:

16 of 142 studies identified were analyzed. Elastography was used in seven studies. Heterogeneity was observed in terms of study protocols, devices, patients, units of measure, and results. Elasticity values showed a correlation between the left and right masseter muscle side in healthy people, but not in patients with temporomandibular disorders (TMDs). Elasticity values increased in TMD and were correlated with the severity of TMD symptoms. Phantom studies proved the high reliability of elastography.

Conclusion:

Elastography is a promising tool for the assessment of the masseter muscle elasticity, but the evidence is insufficient. Studies on larger groups are needed to determine the accuracy of elastography to characterize masticatory muscle disorders.
Clinical manifestation of norovirus infection in children aged less than five years old admitted with acute diarrhea in Surabaya, Indonesia: a cross-sectional study
Authors: Fardah Athiyyah Alpha , Shigemura Katsumi , Kitagawa Koichi , Agustina Nazara , Darma Andy , Ranuh Reza , Raharjo Dadik , Shirakawa Toshiro , Fujisawa Masato , Marto Sudarmo Subijanto
Published: March 2020

Background: The objective of this study was to investigate the clinical manifestation of norovirus infection between norovirus genogroup and severity of acute diarrhea in pediatric patients at the Dr. Soetomo Hospital, Surabaya, Indonesia.

Methods: This cross-sectional study involved 31 participants aged 1-60 months admitted to the hospital with acute diarrhea from April 2012 to March 2013. Norovirus genogroups (GI and II) were identified from patient stool using reverse transcription polymerase chain reaction (RT-PCR). Severity was measured using the Ruuska and Vesikari scoring system.

Results: In total, 94 stool samples were obtained, of which 31 (19%) were norovirus positive. Norovirus GI was found in one sample with mild diarrhea. Norovirus GII was found in 30 samples (96.8%); one sample with mild diarrhea (3.3%), 20 samples with moderate diarrhea (66.7%), and nine samples with severe diarrhea (30%).

Conclusion: Norovirus GII was the most prevalent cause of acute diarrhea and 30% of the cases manifested as severe diarrhea.
Estimating the power to detect a change caused by a vaccine from time series data
Authors: Weinberger Daniel M. , Warren Joshua L.
Published: March 2020

When evaluating the effects of vaccination programs, it is common to estimate changes in rates of disease before and after vaccine introduction. There are a number of related approaches that attempt to adjust for trends unrelated to the vaccine and to detect changes that coincide with introduction. However, characteristics of the data can influence the ability to estimate such a change. These include, but are not limited to, the number of years of available data prior to vaccine introduction, the expected strength of the effect of the intervention, the strength of underlying secular trends, and the amount of unexplained variability in the data. Sources of unexplained variability include model misspecification, epidemics due to unidentified pathogens, and changes in ascertainment or coding practice among others. In this study, we present a simple simulation framework for estimating the power to detect a decline and the precision of these estimates. We use real-world data from a pre-vaccine period to generate simulated time series where the vaccine effect is specified a priori. We present an interactive web-based tool to implement this approach. We also demonstrate the use of this approach using observed data on pneumonia hospitalization from the states in Brazil from a period prior to introduction of pneumococcal vaccines to generate the simulated time series. We relate the power of the hypothesis tests to the number of cases per year and the amount of unexplained variability in the data and demonstrate how fewer years of data influence the results.
Renminbi Internationalization: Domestic Challenges and External Implications
Authors: Lopes Marra de Sousa Ana Tereza
Published: March 2020

En este trabajo se investiga el proceso de inserción de la moneda china, el renminbi (rmb), en el Sistema Monetario Internacional (smi). Al analizar el histórico de internacionalización del rmb y los instrumentos que el gobierno chino ha utilizado para esto, se observó que China impulsa su moneda por medio de acciones que in­tentan evitar una sobreexposición de la cuenta capital y financiera, y, por lo tanto, el impacto negativo que los mercados, dominados por los agentes de Wall Street, pueden producir sobre su economía. De este modo, el proceso de internacionalización del rmb es diferente del de todas las monedas que pasaron por internacionalización durante la égida del Dollar Wall Street Regime (dwsr), pues no puede ser sustancialmente controlado por los mercados internacionales. Se interpreta así que esa inserción mo­netaria puede ser vista como una forma de contestación a los mercados financieros globales, al papel del dólar y al ejercicio del poder de Estados Unidos en el sistema financiero y monetario.
Organisational empowerment and speaking up against unsafe practice: the case for newly qualified nurses in Saudi Arabia
Authors: Mansour Mansour , Al-Madani Maha , Al-Anati Abdelrahman , Jamama Aysar
Published: March 2020

Background/aims

Nurses' sense of empowerment and ability to speak up against unsafe clinical practice are crucial to patient safety and staff wellbeing. However, research examining these attitudes among newly qualified nurses is lacking. This study aimed to investigate perceptions of organisational empowerment and willingness to speak up against perceived unsafe practice among newly qualified nurses in Saudi Arabia.

Methods

A questionnaire was completed by a convenient sample of 83 newly qualified nurses in the Eastern Province of Saudi Arabia. Descriptive statistics and Spearman's correlation coefficient (rho) were used for data analysis.

Findings

The nurses reported moderate levels of both empowerment and willingness to speak up against unsafe practice. There was a statistically significant correlation between the participants' total structured empowerment score and their speaking up score. Willingness to speak up against potentially unsafe practice was also correlated with participants' perceived access to support at work.

Conclusions

These findings highlight the need to support newly qualified nurses to develop their level of empowerment and assertive communication skills. Nurse managers, educators and peers must therefore consider practical strategies to help build and sustain newly qualified nurses' sense of work empowerment and assertiveness.
Organisational intelligence and successful change in NHS organisations
Authors: Beattie Alastair , Bartoli Birju
Published: March 2020

Change or transformation projects within the NHS can range from an extensive organisational change, such as a new clinical model, to altered clinical processes or even the development and implementation of a new IT system. However, it is common for such projects to fail. The authors of this article used both experience and multidisciplinary group reflection to produce a Venn diagram showing the interactions between three ‘intelligences’ – intellectual, emotional and organisational – and why the use of all three together is essential to successful change projects. Organisational intelligence is not easy to define; it is something that successful systems-thinking people ‘just get’ after they have worked in their organisation for a while. This article describes what is meant by this term, provides a checklist which others may find helpful and outlines an example involving the implementation of an electronic system for triage and observations in a large emergency department.
Leading NHS organisations into a land of systems
Authors: Anandaciva Siva
Published: March 2020

Siva Anandaciva analyses the challenges faced by NHS leaders in the transition to integrated care systems and discusses his experience of systems which have successfully adapted to the new approach.
Single-/dual-pulse repetition rate variable supercontinuum light source with peak wavelength around 1.7  µm using a modulated pump
Authors: Li Xiaoyan , Zhang Peng , Wu Di , Han Kexuan , Tong Shoufeng , Jiang Huilin
Published: March 2020

A single-/dual-pulse repetition rate variable supercontinuum (SC) light source (SLS) with a peak wavelength of around 1.7 µm (SLS around 1.7 µm) is proposed and experimentally demonstrated. In our scheme, a 1.5 µm modulated pump source included a laser and an intensity modulator (IM). The pump source can generate pulse trains with different repetitions and pulse durations. A 1 km high nonlinear fiber (HNLF) was used as the nonlinear gain medium. A picosecond-pulsed SC signal was obtained by pumping the HNLF, and a wavelength division multiplexer was used for filtering residual pump. Additionally, a Sagnac loop was applied to create a multiwavelength pulse SC light source. The generated SC source covered from 1.59 to 1.96 µm, and its peak wavelength was around 1.7 µm. The single-/dual-pulse train can be produced and switched by adjusting the direct current bias and radio frequency driving voltages of the input signal to the IM. When the repetition rate of the generated pulse train was between 170 MHz and 2 GHz, the pulse duration of the dual-pulse train was between 60 ps and 180 ps. Additionally, the duty cycle of the dual-pulse operation was 40%. The single pulse SLS, around 1.7 µm, can be a choice to improve optical coherence tomography (OCT) performance, and the dual-pulse source will be a reference for laser drilling applications.
Effective Fresnel diffraction field extension of diffractive optical elements with plane wave incidence
Authors: Kong Zhe , Xu Ning , Xiao Huan , Tan Qiaofeng
Published: March 2020

Diffractive optical elements (DOEs) are widely used to realize special diffraction fields today, but the size of the effective Fresnel diffraction field of the DOEs with plane wave incidence is limited by the wavelength of the incident beam, sampling interval of the DOE, and distance between the DOE and the output plane. In this paper, a method is proposed to extend the size of the effective Fresnel diffraction field with an introduced intermediate plane and two-step diffraction calculation. Zero padding is used on the DOE plane, the sampling interval on the intermediate plane is correspondingly decreased, and the size of the Fresnel diffraction field on the output plane is finally extended. The accompanying aliasing is eliminated by placing a low-pass filter on the intermediate plane. Both numerical simulations and experimental results show the validity of the proposed method to extend the size of the effective Fresnel diffraction field of the DOEs with plane wave incidence.
Transverse mode instability
Authors: Jauregui Cesar , Stihler Christoph , Limpert Jens
Published: March 2020

This work presents a review on the effect of transverse mode instability in high-power fiber laser systems and the corresponding investigations led worldwide over the past decade. This paper includes a description of the experimental observations and the physical origin of this effect, as well as some of the proposed mitigation strategies.
Carrier lifetime of GeSn measured by spectrally resolved picosecond photoluminescence spectroscopy
Authors: Julsgaard Brian , von den Driesch Nils , Tidemand-Lichtenberg Peter , Pedersen Christian , Ikonic Zoran , Buca Dan
Published: March 2020

We present an experimental setup capable of time-resolved photoluminescence spectroscopy for photon energies in the range of 0.51 to 0.56 eV with an instrument time response of 75 ps. The detection system is based on optical parametric three-wave mixing, operates at room temperature, has spectral resolving power, and is shown to be well suited for investigating dynamical processes in germanium-tin alloys. In particular, the carrier lifetime of a direct-bandgap

Ge

1
−
x

Sn
x

film with concentration

x
=
12.5
%

and biaxial strain

−
0.55
%

is determined to be

217
±
15
  
ps

at a temperature of 20 K. A room-temperature investigation indicates that the variation in this lifetime with temperature is very modest. The characteristics of the photoluminescence as a function of pump fluence are discussed.
Excellent light-capture capability of trilobal SiNW for ultra-high JSC in single-nanowire solar cells
Authors: Gao Zhongliang , Lin Guilu , Zheng Yupeng , Sang Na , Li Yingfeng , Chen Lei , Li Meicheng
Published: March 2020

Single-nanowire solar cells with a unique light-concentration property are expected to exceed the Shockley–Queisser limit. The architecture of single nanowire is an important factor to regulate its optical performance. We designed a trilobal silicon nanowire (SiNW) with two equivalent scales that possesses superior light-absorption efficiency in the whole wavelength range and shows good tolerance for incident angle. The electric field distribution in this geometry is concentrated in the blade with small equivalent scale and pivot with large equivalent scale, respectively, in the short wavelength range and long wavelength range. Corresponding good light absorption of trilobal SiNW in the two wavelength ranges leads to stronger total light-absorption capacity than that of cylindrical SiNW. Trilobal single-nanowire solar cells can obtain a short-circuit current density (

J

SC

) of

647
  
mA
·

cm

−
2

, which provides a new choice for designing single nanowire with excellent light-capture capability.
Cross-cumulant enhanced radiality nanoscopy for multicolor superresolution subcellular imaging
Authors: Zeng Zhiping , Ma Jing , Xu Canhua
Published: March 2020

Fluorescence fluctuation-based superresolution techniques can achieve fast superresolution imaging on a cost-effective wide-field platform at a low light level with reduced phototoxicity. However, the current methods exhibit certain imaging deficiencies that misinterpret nanoscale features reconstructed from fluctuating image sequences, thus degrading the superresolution imaging quality and performance. Here we propose cross-cumulant enhanced radiality nanoscopy (CERN), which employs cross-cumulant analysis in tandem with radiality processing. We demonstrated that CERN can significantly improve the spatial resolution at a low light level while eliminating the misinterpretations of nanoscale features of the existing fluctuation-based superresolution methods. In the experiment, we further verified the superior performance of CERN over the current methods through performing multicolor superresolution imaging of subcellular microtubule networks and clathrin-coated pits as well as the high-precision reconstruction of densely packed RNA transcripts.
Identification and expression analysis of zebrafish testis-specific gene 10 (tsga10)
Authors: Asghari-Givehchi Shohreh , Hossein-Modarressi Mohammad
Published: March 2020

Several clinical studies suggest that testis-specific gene antigen 10 (TSGA10) is a cancer-testis antigen with a discernible expression pattern in the testis. Recent studies have highlighted that TSGA10 overexpression in HeLa cells impairs the transcriptional activity of hypoxia-inducible factor alpha (HIF-1α) and inhibits angiogenesis. In this study, we used the zebrafish as a powerful model organism to identify and characterize the orthologue of TSGA10. We analyzed the gene expression pattern by RT-PCR and whole mount in situ hybridization and overexpressed the tsga10 protein by mRNA microinjection. Our results revealed that during early development, tsga10 expression is enriched, but gradually subsides between 0 and 72 hours post fertilization (hpf). There was no detectable transcript at the larval stages. In adult fish, we found high expression levels of tsga10 in the testis and unfertilized egg and low levels of gene expression in the brain, eyes and muscle. Overexpression of tsga10, using tsga10 mRNA microinjection into one-cell stage embryos, resulted in angiogenic and morphological defects at 24 and 48 hpf. This study clarified the expression pattern of tsga10 in different developmental stages and adult tissues, suggesting that tsga10 may have a related biological role in different cell types and tissues. Our results indicate that tsga10 mRNA at embryonic stages is maternally deposited, indicating a transient functional role during embryogenesis. Our findings suggest that tsga10 is a human orthologous gene relevant for future studies to elucidate its mechanism of action in angiogenesis.
Hedgehog signaling dynamics in mouse embryos determined by a bioluminiscent reporter
Authors: Hernández-García David , Fuentes-Jiménez Daniel , Rojo-León Verónica , Wood Christopher , García Celina , Covarrubias Luis
Published: March 2020

Determination of cellular signaling in live embryos is key to understand the molecular processes that drive development. Here, we show that a transgenic mouse line carrying a luciferase-based gene reporter of Gli-mediated transcriptional activation (Gli-Luc) displays sonic hedgehog (Shh) signaling in discrete developmental processes during short-term cultures of whole embryos or embryo explants. The bioluminescence in E9.5 embryos was detected in regions in which Shh activity has been demonstrated. Later, in E10.5 embryos, bioluminescence intensity markedly increased, mostly corresponding to the high Shh activity of the developing midbrain and limb. Notably, the dynamic range of the Gli-Luc reporter in the developing limb revealed the progressive emergence of bioluminescence in the zone of polarizing activity, where reporter activity locally increased and spatially spread in agreement with the signaling gradient expected for Shh. In the midbrain of E9.5 mouse embryos, bioluminescence was not detected along the ventral region as expected but, instead, Shh-dependent anterior and posterior bioluminescence foci emerged by E10.5 indicating that the Gli-Luc reporter can only respond transcriptionally to relatively high levels of GliA and/or without the interaction with other transcription factors. The present work supports the use of bioluminescence to identify and study the dynamics of centers of morphogen signaling during mouse embryogenesis.
Asociación entre los factores demográficos y socioeconómicos con el estado nutricional en niños menores de 5 años en poblaciones rurales de Colima, México
Authors: Bernabeu Justes Mirella , Sánchez-Ramírez Carmen Alicia
Published: March 2020

Introducción: La prevalencia de desnutrición en México se ha mantenido superior en la población rural nacional con respecto a las zonas urbanas. El patrón de crecimiento publicado por la OMS en 2006 confirma que los niños ≤5 años tienen el mismo potencial de crecimiento si las condiciones de vida son óptimas, existiendo diversos factores que pueden afectar el estado nutricional. El objetivo del estudio fue determinar si existe asociación entre los factores demográficos-socioeconómicos con el estado nutricional en poblaciones rurales de Colima.Material y métodos: Diseño: transversal analítico. Se incluyeron 72 niños ≤5 años (34 género masculino; 38 femenino) de las poblaciones de Suchitlán, Cofradía de Suchitlán y Zacualpan, (2015 abril-junio). Se realizaron mediciones de peso y talla y se calcularon los indicadores de peso/edad, talla/edad, peso/talla e índice de masa corporal/edad. Se aplicó un cuestionario de factores demográficos y socioeconómicos y se realizó el análisis estadístico usando x2 o exacta de Fisher para buscar asociaciones entre el estado nutricional y los factores socioeconómicos o demográficos. Resultados: La prevalencia de desnutrición crónica fue 25%, desnutrición aguda 2,8% y sobrepeso/obesidad 11,2%. Se asoció el ser hijo único  con el sobrepeso/obesidad (p=0,016) y el recibir lactancia materna con la desnutrición crónica (p=0,014).Conclusiones: Se identificó el ser hijo único como factor de riesgo para el desarrollo de sobrepeso/obesidad y la lactancia materna con la presencia de desnutrición crónica.
Sleep disorders and anthropometric measures in Chilean university students
Authors: Durán-Agüero Samuel , Sepulveda Ricardo , Guerrero-Wyss Marion
Published: March 2020

Introduction: To compare sleep habits, insomnia and daytime sleepiness in university students according to anthropometrics measures.Material and methods: A cross-sectional study was carried out on university students using the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index and Insomnia severity index. In addition, anthropometric variables were determined; weight, height and waist circumference.Results: We evaluated 1275 university students (74% female). Students on average slept at midnight and slept on average 6.4 hours, 77.9% sleep less than recommended, 34.2% had daytime somnolence and 68.5% had insomnia. Regarding insomnia, it was observed that the low weight group presented the highest insomnia score that significantly contrasted with the normal weight group (p=0.04). In the case of daytime sleepiness when comparing by nutritional status, it was observed that obese students are the ones with the greatest daytime somnolence (p <0.05). Finally, there is an association between fewer sleep hours with higher BMI (OR: 1.12 (95% CI 1.01-1.991)) and presence of insomnia (OR: 2.734 (95% CI: 1.324-5.645).Conclusion: University students sleep less than recommended, have a high prevalence of insomnia and excessive daytime sleepiness, in addition, it is obese women who present this alteration more frequently and the highest insomnia score is identified in underweight students. Both a high BMI and insomnia are associated with short-term sleep.
Hábitos alimentarios de niños entre 10 y 12 años según el origen étnico de los progenitores en la zona metropolitana de Alicante y Elche (España)
Authors: Ruiz-Callado Raúl , Giménez-Soria Sergio , Martínez-Martínez Gerardo , Sancho-Arranz Rebeca , Navalón-Mira Alba
Published: March 2020

Introducción: El objetivo de este estudio es conocer la prevalencia de hábitos alimentarios inadecuados en niñas y niños escolarizados en el tercer ciclo de educación primaria de distinto origen étnico. Material y Métodos: Para ello se llevó a cabo un estudio descriptivo. La muestra estuvo compuesta por 241 niños y niñas matriculados en 5º y 6º de primaria en centros educativos de Alicante y Elche (España). Los datos se obtuvieron a través de un formulario que recogía trece preguntas sobre datos sociodemográficos de los alumnos y sus familiares y una segunda parte, el cuestionario Krece-Plus. Resultados: Los resultados muestran que un 18,3% posee un nivel nutricional bajo, de los cuales el 11,4% pertenecen a la etnia gitana. El 68,5% de los niños y niñas afirman consumir dulces y golosinas. Además, el 27% acude más de una vez por semana a un fast-food, mostrando diferencias significativas entre los niños y niñas de origen autóctono y de etnia gitana. Conclusiones: Los hábitos alimentarios inadecuados de los niños no están determinados por el origen étnico de los progenitores.
Determinants of Climbing Performance: When Finger Flexor Strength and Endurance Count
Authors: Marcolin Giuseppe , Faggian Sara , Muschietti Massimiliano , Matteraglia Luca , Paoli Antonio
Published: March 2020

Marcolin, G, Faggian, S, Muschietti, M, Matteraglia, L, and Paoli, A. Determinants of climbing performance: when finger flexor strength and endurance count. J Strength Cond Res 36(4): 1099–1104, 2022—Aim of the study was: (a) to compare finger flexor strength and endurance among climbers and nonclimbers; (b) to predict climbers' level of ability using climbing-specific strength tests and prolonged fatigue protocols. 17 advanced climbers (ADV), 17 intermediate climbers (INT), and 15 nonclimbers (NOCLIMB) performed a maximal finger grip test on a climbing-specific device, a maximal handgrip test, 20 intermittent isometric maximal contractions (E1), a suspension test on a bar till exhaustion, and again 20 intermittent isometric maximal contractions (E2). Strength values were normalized to body weight (%BW). The handgrip test failed to discriminate ADV from INT. Maximal finger flexor strength differed among ADV (59.90 ± 9.42 %BW), INT (46.75 ± 8.40 %BW) and NOCLIMB (36.40 ± 6.51 %BW) (p < 0.0001;

: 0.586). ADV showed the best suspension time (58.55 ± 14.87 seconds) followed by INT (32.55 ± 16.87 seconds) and NOCLIMB (17.20 ± 14.30 seconds) (p < 0.0001;

: 0.563). ADV showed the best endurance performance in both E1 and E2. The highest correlations with climbers' ability scores were obtained with sport-specific tests (maximal finger strength, r = 0.60, p < 0.0001; bar suspension, r = 0.69, p < 0.0001) and at the highest level of fatigue (E2, r = 0.74, p < 0.0001). Strength and endurance gain more importance in determining climbers' ability if assessed with finger specific tests and after prolonged fatigue.
Developing Powerful Athletes Part 2: Practical Applications
Authors: Turner Anthony N. , Comfort Paul , McMahon John , Bishop Chris , Chavda Shyam , Read Paul , Mundy Peter , Lake Jason
Published: March 2020

In part 1 of this two-part review, we addressed the recent criticisms of the use of terms such as power, rate of force development, and explosiveness, over impulse. These terms were distinguished mechanically and conceptually for the benefit of the scientist and coach. In part 2, we use the key mechanical parameters underpinning power development and its relationship with the force–time characteristics and force–velocity profile of sporting movements, to evidence the planning of training drills and assist the strength and conditioning coach in devising periodized training programs.