bluuebunny/crossref_metadata_2025 huggingface dataset:
Arabic language validation of TANGO questionnaire for nocturia: A translation into the Arabian Peninsula dialect
Authors: Altaweel Waleed , Alrumayyan Majed , Seyam Raouf
Published: July 2020

Aims

Targeting the Aetiology of Nocturia to Guide Outcomes (TANGO) is a validated English language questionnaire to identify underlying factors leading to nocturia. We set out to provide a culturally correct Arabic version of the TANGO questionnaire in Saudi Arabia.

Methods

The English version underwent forwarded and backward translation. The final version was administered to native Arabic speaking hospital employees and patients. Test‐retest reliability and the clarity of questions were determined by Kappa and Cronbach's α statistics.

Results

The translation: The median Likert score for translated questions was ≥4 with a Cronbach's α .865. Test‐retest reliability: Thirty employees answered the questionnaire. The median, standard deviation (SD), and range were age 29.0 ± 11.0 years (20‐55), and nocturia 1.0 ± 0.96 episodes per night (0‐4). Three questions had identical constant answers and no Kappa values were computed. Based on prevalence‐adjusted bias‐adjusted Kappa (PABAK) values, 10 questions had a “very good” agreement, eight questions had a “good” agreement, and one item had a “moderate” agreement. The range of PABAK was 0.53 to 1, P < .01.

Clarity of questions: The employees had a median Likert score of 5.0 with a Cronbach's α .961. Thirty‐two patients answered the questionnaire. The median, SD, and range were age 40.0 ± 15.4 years (17‐79), and nocturia 1.0 ± 1.6 episodes per night (0‐6). The median item score on the Likert scale was 5.0, with a Cronbach's α .909. A total of 29 (90.6%) patients stated that the questions were clear or needed no help to fill in the questionnaire.

Conclusion

The Arabic language translation of TANGO questionnaire is a valid tool in the dialect of Saudi Arabia.
Outcomes of transurethral resection of the prostate in unobstructed patients with concomitant detrusor underactivity
Authors: Rubilotta Emanuele , Balzarro Matteo , Gubbiotti Marilena , Antonelli Alessandro
Published: July 2020

Aims

The aim of the study was to evaluate the transurethral resection of the prostate (TURP) outcomes of unobstructed patients with detrusor underactivity (DUA), comparing the surgical results between obstructed and unobstructed males with concomitant DUA, at midterm follow‐up.

Methods

This was an observational, prospective, comparative, nonrandomized study. Candidates to TURP underwent preoperative urodynamics (UD), with a diagnosis of DUA, were divided in two cohorts: Group A unobstructed men, group B males with bladder outlet obstruction (BOO). Males were evaluated yearly with uroflowmetry (UF), post‐void residual (PVR), and bladder voiding efficiency (BVE), International Prostate Symptom Score (IPSS) questionnaire, visual analogic scale (VAS) for subjective assessment of the quality of life. The degree of the variation of maximum flow rate (Qmax), PVR, BVE, IPSS, VAS between baseline and follow‐up (Δ) was evaluated.

Results

Patients in group A were 28 and in group B 23. Overall patient's mean ± SD age was 63.37 ± 12.41 years. Preoperative urodynamics characteristics: mean bladder contractility index (BCI) of 61.15 and 76.25 in group A and B, respectively; mean bladder outlet obstruction index (BOOI) of 17.25 and 50.15 in group A and group B, respectively. After surgery, overall patient group, group A, and group B showed a statistical improvement in IPSS score (P < .0001), Qmax (P < .0001), PVR (P < .0008), BVE (P < .03) and VAS (P < .0001).

Conclusions

BOO had an important impact on the degree of improvement of Qmax and PVR/BVE, while had a poor influence on lower urinary tract symptoms amelioration. The most relevant outcomes were found when BOO was associated with DUA, which was not a contraindication to surgery.
Impact of adhesive ingredients on adhesion between rubber and brass‐plated steel wire in tire
Authors: Chowdhury Soumya Ghosh , Chanda Jagannath , Ghosh Sreedip , Banerjee Koushik , Banerjee Shib Shankar , Das Amit , Ghosh Prasenjit , Bhattacharyya Sanjay Kr. , Mukhopadhyay Rabindra
Published: July 2020

Proficiency on underlying mechanism of rubber‐metal adhesion has been increased significantly in the last few decades. Researchers have investigated the effect of various ingredients, such as hexamethoxymethyl melamine, resorcinol, cobalt stearate, and silica, on rubber‐metal interface. The role of each ingredient on rubber‐metal interfacial adhesion is still a subject of scrutiny. In this article, a typical belt skim compound of truck radial tire is selected and the effect of each adhesive ingredient on adhesion strength is explored. Out of these ingredients, the effect of cobalt stearate is found noteworthy. It has improved adhesion strength by 12% (without aging) and by 11% (humid‐aged), respectively, over control compound. For detailed understanding of the effect of cobalt stearate on adhesion, scanning electron microscopy and energy dispersive spectroscopy are utilized to ascertain the rubber coverage and distribution of elements. X‐ray photoelectron spectroscopy results helped us to understand the impact of CuXS layer depth on rubber‐metal adhesion. The depth profile of the CuXS layer was found to be one of the dominant factors of rubber‐metal adhesion retention. Thus, this study has made an attempt to find the impact of different adhesive ingredients on the formation of CuXS layer depth at rubber‐metal interface and establish a correlation with adhesion strength simultaneously.
Electrical conductivity and electromagnetic interference shielding effectiveness of nano‐structured carbon assisted poly(methyl methacrylate) nanocomposites
Authors: Mondal Subhadip , Ravindren Revathy , Shin Beomsu , Kim Suhyun , Lee Hyunsang , Ganguly Sayan , Das Narayan Ch. , Nah Changwoon
Published: July 2020

Nanostructured carbon‐based polymeric nanocomposites are gaining research interest because of their cost‐effectiveness, lightweight, and robust electromagnetic interference (EMI) shielding performance. Till now, it is a great challenge to design and fabricate highly scalable, cost‐effective nanocomposites with superior EMI shielding performance. Herein, highly scalable EMI shielding material with tunable absorbing behaviors comprising of low‐budget ketjen black (K‐CB) reinforced poly(methyl methacrylate) (PMMA) nanocomposites have been prepared using simple solvent assisted solution mixing technique followed by hot compression technique. The morphological investigation revealed the homogeneous distribution of K‐CB and strong interfacial interaction in PMMA matrix, which validated the strong reinforcement and other intriguing properties of the nanocomposites. The PMMA nanocomposites showed a low percolation threshold (2.79 wt%) and excellent electrical conductivity due to the formation of 3D conductive network like architecture within the polymer matrix. Specifically, the 10 wt% K‐CB nanocomposite possessed a superior EMI shielding performance of about 28 dB for X‐band frequency range. Further, a huge change in EMI shielding performance of PMMA nanocomposites is observed with varying thickness. The brand new K‐CB decorated PMMA nanocomposites are expected to open the door for next‐generation cost‐effective EMI shielding materials for academic and industrial applications.
Parental perceptions of gender differences in child technology use and cyberbullying
Authors: Bolenbaugh Mallory , Foley‐Nicpon Megan , Young Rachel , Tully Melissa , Grunewald Nikki , Ramirez Marizen
Published: July 2020

Cyberbullying is a major health concern for today's youth and a pervasive stressor for adolescents and their families. This study offers qualitative insights into how parents perceive their children's technology use and engagement in cyberbullying based on gender. Eight focus groups were conducted with 48 parents of adolescents ages 10–17. Findings indicated parents perceived their children overuse technology and lack awareness of what cyberbullying is. Specific to gender, parents suggested their daughters use technology for social connection, and parents were more concerned about their daughter's technology use than their son's, which they believed was related to specific interests. In response to cyberbullying scenarios, parents encouraged females but not males to socialize with peers. This is the first qualitative study to obtain an in‐depth understanding of the ways in which parents perceive and socialize their children in regard to technology use and cyberbullying scenarios. These results may help school systems, school psychologists, researchers, and parents gain awareness of the gender‐stereotypical socialization process that unfolds in parental monitoring of technology use and cyberbullying situations. We conclude by offering suggestions for how school systems and personnel might intervene.
Evidence of ionic film deposition from single‐filament dielectric barrier discharges in Ar–HMDSO mixtures
Authors: Bröcker Lars , Perlick Gesa S. , Klages Claus‐Peter
Published: July 2020

The short residence time of Ar–HMDSO (Ar–hexamethyldisiloxane) gas mixtures rapidly flowing across atmospheric‐pressure, glow‐type, single‐filament dielectric barrier discharges is utilized to accomplish thin‐film deposition via a purely ionic route. A comparison of thin‐film volumes obtained from profilometry, on the one hand, and from the transferred charge, on the other hand, enables to evaluate the mass of the ions contributing to the film growth. For HMDSO fractions at the lower end of the studied range of molar fractions, 50 ppm, pentamethyldisiloxanyl cations (Me3SiOSiMe2+, PMDS+), generated from the monomer via Penning ionization by Ar(1s) species, are mainly responsible for film formation. For HMDSO fractions growing beyond 1,000 ppm, ionic oligomerization processes by reactions of PMDS+ with HMDSO molecules result in a 2.5‐fold increase of the average deposited ion mass.
The association between asthma and anxiety in elementary school students in Japan
Authors: Kimura Manami , Ikeda Ai , Suzuki Yohei , Maruyama Koutatsu , Wada Hiroo , Tanigawa Takeshi
Published: July 2020

Background

Studies on the association between asthma and anxiety in Asian children are limited. Therefore, we aimed to evaluate the association between asthma and anxiety among Japanese elementary school students.

Methods

A cross‐sectional study of the association between asthma and anxiety in primary school children in Matsuyama City was conducted in 2014. The questionnaires included inquiries on asthma, anxiety, and other demographic variables. After excluding missing values, 17 752 (51.5% male) children were included in the analysis. The presence of asthma (yes/no) was answered by guardians. A score of four or more on the emotional symptom subscale of the strengths and difficulties questionnaire was considered as having anxiety. A Rohrer index score of 145 or more was considered as overweight. We estimated the prevalence ratio (PR) of having anxiety in relation to the presence of asthma based on the Poisson regression model.

Results

The multivariate PR (95% confidence interval) of having anxiety in asthmatic boys compared with non‐asthmatic boys was 1.56 (1.21‐1.99). The association was more evident in older than younger boys, where PR = 1.32 (0.93‐1.88) for younger versus 1.87(1.32‐2.64) for older boys (P for interaction = .08); and in non‐overweight boys than overweight, where PR = 1.64 (1.27‐2.13) and 0.94 (0.41‐2.19) (P for interaction = .22), respectively. Similar associations were not found for girls.

Conclusion

Asthma was significantly associated with anxiety in boys, particularly in older boys.
Sleep disordered breathing: Assessment and therapy in the age of emerging neuromuscular therapies
Authors: Gurbani Neepa , Pascoe John E. , Katz Sherri , Sawnani Hemant
Published: July 2020

The term neuromuscular disease (NMD) encompasses a large variety of disorders that result in abnormal muscle function. Although it may be conventional to relate the use of this term to the most common muscular diseases (Duchenne muscular dystrophy [DMD], spinal muscular atrophy [SMA], and amyotrophic lateral sclerosis, etc), it is important to extend the term to pathologies manifested by severe neurologic (brain and spinal cord) malformations and injuries. In many of these scenarios, there are common mechanisms that contribute to sleep disordered breathing (SDB) and respiratory insufficiency although comorbidities may be somewhat different. Advances in the understanding of these diseases and their natural history, and increasing availability of mechanical ventilation to these patients have improved survival. The development of novel genetic and molecular therapies (as in the cases of DMD, SMA, and X‐linked myotubular myopathy) provides an opportunity to use SDB as a reasonable outcome measure while also allowing the use of polysomnography as a validation tool in the assessments of effectiveness of therapies. We seek to provide an understanding of SDB in NMDs, and in the same light, would like to begin the conversation of thinking about weaning respiratory support when possible.
Highly Efficient Charge Transfer between Perovskite Nanocrystals and g‐C3N4 Nanosheets
Authors: Sheng Yuhang , Zhao Aiqing , Yu Liyan , Yuan Songyan , Di Yunsong , Liu Cihui , Dong Lifeng , Gan Zhixing
Published: July 2020

Benefiting from the bandgap engineering implemented on two different structures, heterostructures have significantly extended the applications of semiconductors. Thus, understanding the energy/charge transfer of heterostructures is very important for achieving high‐performance devices. Herein, heterostructures with potential applications in solar harvesting are constructed by CsPb(BrxI1−x)3 perovskite nanocrystals (PNCs) emitting at 640 nm and g‐C3N4 nanosheets (CN) with fluorescence covering from 450 to 550 nm. The fluorescence of CsPb(BrxI1−x)3 PNCs is substantially quenched by CN. Moreover, the photodegradation of CsPb(BrxI1−x)3 is remarkably hastened when interacting with the CN, indicating efficient charge transfer in the heterostructures, which is further verified by time‐resolved photoluminescence (PL) and temperature‐dependent PL results. The charge transfer lifetime is much shorter than the radiative recombination lifetime and defect trapping lifetime, ensuring quick charge transfer from PNCs to CN before radiative recombination and defect trapping, resulting in high charge transfer efficiency up to 98.16%. This work sheds light on heterostructures based on PNCs, which will facilitate their future application in photocatalysts, light‐emitting diodes, and photodetectors.
Point Defect‐Induced UV‐C Absorption in Aluminum Nitride Epitaxial Layers Grown on Sapphire Substrates by Metal‐Organic Chemical Vapor Deposition
Authors: Tillner Nadine , Frankerl Christian , Nippert Felix , Davies Matthew J. , Brandl Christian , Lösing Rainer , Mandl Martin , Lugauer Hans-Jürgen , Zeisel Roland , Hoffmann Axel , Waag Andreas , Hoffmann Marc Patrick
Published: July 2020

Herein, the optical properties of aluminum nitride (AlN) epitaxial layers grown on sapphire substrates by metal‐organic chemical vapor deposition (MOCVD) are reported. The structures investigated in this study are grown at highly different degrees of supersaturation in the MOCVD process. In addition, both pulsed and continuous growth conditions are employed and AlN is deposited on nucleation layers favoring different polarities. The samples are investigated by photoluminescence (PL), photoluminescence excitation (PLE), and absorption spectroscopy and are found to vary significantly in absorption and emission characteristics. Two distinct absorption bands in the UV‐C spectral range are observed and examined in greater detail, with either giving rise to a significant absorption coefficient of around 1000 cm−1. The corresponding defect transitions are identified by PL spectroscopy. Combined with secondary‐ion mass spectrometry (SIMS) measurements, these absorption bands are allocated to the incorporation of carbon and oxygen impurities, depending on the applied growth conditions. Furthermore, similarities with other epitaxial growth techniques serving as basis for UV‐C applications are highlighted. These results are highly relevant for a better understanding of absorption issues in AlN templates grown by various deposition techniques. In addition, consequences for the growth of efficient UV‐C devices by MOCVD on sapphire substrates are outlined.
Individualized robotic organ‐sparing surgery in a paediatric case of renal perivascular epithelioid cell tumour
Authors: Silveri Massimiliano , Natali Gian Luigi , Cobellis Giovanni , Roberti Agnese , Rossi Sabrina , Gregori Lorenzo , Torino Giovanni
Published: July 2020

Background

Perivascular epithelioid cell tumours (PEComas) represent a rare group of mesenchymal tumours with an unpredictable outcome. They are usually observed in middle‐aged women whilst they are very rare in children, with limited cases described. Due to the rare anatomical location in kidneys, a correct diagnosis and treatment is really challenging.

Methods

We observed and treated a case of kidney's PEComa in a 14‐year‐old boy.

Results

An individualized approach based on anatomical (3D CT‐reconstructions) and histopathological (US‐guided preliminary biopsy) features lead us to perform a successful robotic‐sparing surgery enabling the preservation of two‐thirds of the kidney involved.

Conclusions

A meticulous preoperative planning in selected patients can lead to a minimally invasive approach even in some paediatric kidney's neoplasms.
An overview of the immune mechanisms of viral myocarditis
Authors: Lasrado Ninaad , Reddy Jay
Published: July 2020

Viral myocarditis has been identified as a major cause of dilated cardiomyopathy (DCM) that can lead to heart failure. Historically, Coxsackieviruses and adenoviruses have been commonly suspected in myocarditis/DCM patients in North America and Europe. However, this notion is changing as other viruses such as Parvovirus B19 and human herpesvirus‐6 are increasingly reported as causes of myocarditis in the United States, with the most recent example being the severe acute respiratory syndrome coronavirus 2, causing the Coronavirus Disease‐19. The mouse model of Coxsackievirus B3 (CVB3)‐induced myocarditis, which may involve mediation of autoimmunity, is routinely used in the study of immune pathogenesis of viral infections as triggers of DCM. In this review, we discuss the immune mechanisms underlying the development of viral myocarditis with an emphasis on autoimmunity in the development of post‐infectious myocarditis induced with CVB3.
Classification ofhigh‐dimensionalelectroencephalography data with location selection using structuredspike‐and‐slabprior
Authors: Mohammed Shariq , Dey Dipak K. , Zhang Yuping
Published: July 2020

With the advent of modern technologies, it is increasingly common to deal with data of large dimensions in various scientific fields of study. In this paper, we develop a Bayesian approach for the classification of multi‐subject high‐dimensional electroencephalography (EEG) data. In this EEG data, we have a matrix of covariates corresponding to each subject from either the alcoholic or control group. The matrix covariates have a natural spatial correlation based on the locations of the brain, and temporal correlation as the measurements are taken over time. We employ a divide and conquer strategy by building multiple local Bayesian models at each time point separately. We incorporate the spatial structure through the structured spike‐and‐slab prior, which has inherent variable selection properties. The temporal structure is incorporated within the prior by learning from the local model from the previous time point. We pool the information from the local models and use a weighted average to design a prediction method. We perform simulation studies to show the efficiency of our approach and demonstrate the local Bayesian modeling with a case study on EEG data.
Hot Deformation Behavior of V–Ti Microalloy Steels
Authors: Xiong Wenming , Song Renbo , Yu Ping , Liu Zhijun , Qin Shuai , Zhang Yingchao , Quan Shuyi , Huo Weifeng , Zhao Zhiyang , Su Shengrui , Wei Chen
Published: July 2020

Hot deformation behavior of V–Ti microalloyed steel is carried out using Gleeble1500. The results show that the flow stress curve is mainly characterized by work hardening and high‐temperature deformation softening mechanisms. Herein, the combination of strain hardening rate–stress curve and stress–strain–temperature dynamic recrystallization 3D model can be used to determine the temperature and strain corresponding to the beginning and end of dynamic recrystallization. The recrystallization activation energy and hot deformation constitutive equation are calculated by austenite recrystallization kinetic regression. Comparing three constitutive equation models with different fitting accuracies, the hyperbolic sine equation with fitting accuracy of 0.99178 is obtained, and the thermal deformation activation energy is determined to be 286.897 kJ mol−1. It is close to the self‐diffusion activation energy of austenite 281 kJ mol−1, so the rate control mechanism under this deformation condition is the dislocation climbing of diffusion control. The combination of the 3D model of dynamic recrystallization and the constitutive equation can not only obtain the flow stress curve under a certain deformation condition, but also obtain the structure evolution information. The mutual verification of the two makes it possible to study the hot deformation behavior under different deformation conditions more comprehensively.
Complex influences of mechanistic knowledge, worldview, and quantitative reasoning on climate change discourse: Evidence for ideologically motivated reasoning among youth
Authors: Zummo Lynne , Donovan Brian , Busch K. C.
Published: July 2020

Anthropogenic climate change remains divisive in the United States, where skepticism of the scientific consensus is associated with conservative worldviews, resulting in political polarization. This study considers three hypotheses regarding U.S. polarization over climate change that have emerged from social psychology research and applies them to science education by showing how these hypotheses could relate to adolescents' science learning. We then test each hypothesis within an experimental educational intervention designed to study the influence of worldview, mechanistic knowledge, and quantitative reasoning on students' written arguments about climate change. We used mixed methods to analyze the results of this individually randomized trial with clustering involving 357 participants in grades 9–11 from 5 U.S. sites. Findings show that: (a) exposure to mechanistic knowledge about climate change increased odds of receptivity toward climate change; (b) increasingly conservative worldviews were associated with decreased odds of receptivity; (c) worldview and quantitative reasoning interacted, resulting in an amplified effect of worldview for students with greater quantitative reasoning. Results also suggest that the influence of worldview and mechanistic knowledge on receptivity work independently from one another in our dataset. This study demonstrates the value of teaching mechanistic understandings of climate change, yet also demonstrates the influence of worldview on receptivity to climate change for adolescents, as well as complex interactions between quantitative reasoning (something school science aims to develop) and worldview. It shows that moving the U.S. public toward the scientific consensus is complex and involves confronting ideologically motivated reasoning within science education.
Industry 4.0 in Retrospect and in Context
Authors: Michelsen Karl-Erik
Published: July 2020

The concept of an industrial revolution is not a simple one and it seems that typically the start and the end of an industrial revolution is assigned only retrospectively. The concept of industry 4.0 and the Fourth Industrial Revolution that it represents are an anomaly in this respect and it seems that Industry 4.0 is a holistic roadmap for the future rather than a backward looking statement about what has taken place. The original German vision that is Industry 4.0 is indeed holistic and encompasses also issues beyond technology, this is an important observation, as there is a certain aura of technological determinism that drives the talk about the future in the industry. This preface goes through the history of industrial revolutions, the background of the concept of Industry 4.0, and finally positions this book.
Gravitational Wilson lines in 3D de Sitter
Authors: Castro Alejandra , Sabella-Garnier Philippe , Zukowski Claire
Published: July 2020

Abstract

We construct local probes in the static patch of Euclidean dS3 gravity. These probes are Wilson line operators, designed by exploiting the Chern-Simons formulation of 3D gravity. Our prescription uses non-unitary representations of so (4) ≃ su (2)L× su(2)R, and we evaluate the Wilson line for states satisfying a singlet condition. We discuss how to reproduce the Green’s functions of massive scalar fields in dS3, the construction of bulk fields, and the quasinormal mode spectrum. We also discuss the interpretation of our construction in Lorentzian signature in the inflationary patch, via SL(2, ℂ) Chern-Simons theory.
Polysialic acid and Siglec-E orchestrate negative feedback regulation of microglia activation
Authors: Thiesler Hauke , Beimdiek Julia , Hildebrandt Herbert
Published: July 2020

Polysialic acid (polySia) emerges as a novel regulator of microglia activity. We recently identified polysialylated proteins in the Golgi compartment of murine microglia that are released in response to inflammatory stimulation. Since exogenously added polySia is able to attenuate the inflammatory response, we proposed that the release of polysialylated proteins constitutes a mechanism for negative feedback regulation of microglia activation. Here, we demonstrate that translocation of polySia from the Golgi to the cell surface can be induced by calcium depletion of the Golgi compartment and that polysialylated proteins are continuously released for at least 24 h after the onset of inflammatory stimulation. The latter was unexpected, because polySia signals detected by immunocytochemistry are rapidly depleted. However, it indicates that the amount of released polySia is much higher than anticipated based on immunostaining. This may be crucial for microglial responses during traumatic brain injury (TBI), as we detected polySia signals in activated microglia around a stab wound in the adult mouse brain. In BV2 microglia, the putative polySia receptor Siglec-E is internalized during lipopolysaccharide (LPS)-induced activation and in response to polySia exposure, indicating interaction. Correspondingly, CRISPR/Cas9-mediated Siglec-E knockout prevents inhibition of pro inflammatory activation by exogenously added polySia and leads to a strong increase of the LPS response. A comparable increase of LPS-induced activation has been observed in microglia with abolished polySia synthesis. Together, these results indicate that the release of the microglia-intrinsic polySia pool, as implicated in TBI, inhibits the inflammatory response by acting as a trans-activating ligand of Siglec-E.
Stratified $${{\mathcal {C}}}^p$$-semialgebraic triviality
Authors: Valette Anna
Published: July 2020

We show that a stratified submersion between stratified semialgebraic sets is locally $${{\mathcal {C}}}^p$$

C

p

-semialgebraically trivial outside the set of stratified generalized critical values.
10-Year Paclitaxel Dose-Related Outcomes of Drug-Eluting Stents Treated Below the Knee in Patients with Chronic Limb-Threatening Ischemia (The PADI Trial)
Authors: Konijn Louise C. D. , Wakkie Thijs , Spreen Marlon I. , de Jong Pim A. , van Dijk Lukas C. , Wever Jan J. , Veger Hugo T. C. , Statius van Eps Randolph G. , Mali Willem P. Th. M. , van Overhagen Hendrik
Published: July 2020

Purpose

Recently, two meta-analyses concluded that there appears to be an increased risk of long-term mortality of paclitaxel-coated balloons and stents in the superficial femoral and popliteal artery, and paclitaxel-coated balloons below the knee. In this post hoc study of the PADI Trial, we investigated the long-term safety of first-generation paclitaxel-coated drug-eluting stents (DES) below the knee and the dose–mortality relationships of paclitaxel in patients with chronic limb-threatening ischemia (CLI).

Materials and Methods

The PADI Trial compared paclitaxel-coated DES with percutaneous transluminal angioplasty with bail-out bare-metal stents (PTA ± BMS) in patients with CLI treated below the knee. Follow-up was extended to 10 years after the first inclusion, and survival analyses were performed. In addition, dose-related mortality and dose per patient weight-related mortality relations were examined.

Results

A total of 140 limbs in 137 patients were included in the PADI Trial. Ten years after the first inclusion, 109/137 (79.6%) patients had died. There was no significant difference between mortality in the DES group compared with the PTA ± BMS group (Log-rank p value = 0.12). No specific dose-related mortality (HR 1.00, 95% CI 0.99–1.00, p = 0.99) or dose per weight mortality (HR 1.05, 95% CI 0.93–1.18, p = 0.46) relationships were identified in the Cox-proportional Hazard models or by Kaplan–Meier survival analyses.

Conclusions

There is a poor 10-year survival in both paclitaxel-coated DES and PTA ± BMS in patients with CLI treated below the knee. No dose-related adverse effects of paclitaxel-coated DES were observed in our study of patients with CLI treated below the knee.

Level of Evidence

The PADI Trial: level 1, randomized clinical trial
Forensic age estimation in living adolescents with CT imaging of the clavicula—impact of low-dose scanning on readers’ confidence
Authors: Gassenmaier Sebastian , Schaefer Juergen F. , Nikolaou Konstantin , Esser Michael , Tsiflikas Ilias
Published: July 2020

Objectives

Computed tomography (CT) imaging of the clavicula displays the reference standard for forensic bone age diagnostics in adolescents and young adults. Consequently, highest efforts on radiation reduction are warranted. Therefore, the aim of this study was to investigate the feasibility of low-dose (LD) CT imaging of the clavicula for age estimation in living adolescents.

Methods

A total of 207 non-contrast chest CT of 144 patients born between 1988 and 2012, performed in 2018 due to various clinical indications, were included in this retrospective study. The mean patient age was 16.9 ± 6.6 years. Patients were divided into a LD (n = 146) and standard-dose (SD; n = 61) group. Image quality, confidence levels, and ossification stages (using the 5-stage classification including the subgroups 2a–3c) were assessed by two radiologists independently. Radiation dose was determined via dosimetry software.

Results

Dose simulation with z-axis reduction to depict the clavicula only resulted in a median exposure of 0.1 mSv (IQR: 0.0) in LD compared with 0.9 mSv (IQR: 0.6) in SD (p < 0.001). The median image quality was rated by both readers significantly worse in LD compared with SD on a Likert scale ranging from 1 to 4 with a median of 3 (IQR: 1) versus 4 (IQR: 0; p < 0.001 for both readers). There was an almost perfect agreement for the ossification stages between both readers with a Cohen’s kappa of 0.83 (p < 0.001). Median confidence levels of both readers were not significantly different between LD and SD in the decisive subgroups 2a–3c.

Conclusions

Low-dose CT imaging of the clavicula for age estimation in living adolescents is possible without loss of readers’ confidence.

Key Points

• Radiological bone age diagnostics in young delinquents with unknown exact chronological age is important as the judicial systems differentiate between youths and adults.

• Low-dose computed tomography scanning of the medial clavicular joint for forensic age estimation is feasible in living adolescents without loss of readers’ confidence.

• Sufficient image quality of the medial clavicular joint for forensic bone age diagnostics in living adolescents is achievable using a median dose of 0.1 mSv.
Tibiopedal and distal femoral retrograde vascular access for challenging chronic total occlusions: predictors for technical success, and complication rates in a large single-center cohort
Authors: Grözinger Gerd , Hallecker Jan , Grosse Ulrich , Syha Roland , Ketelsen Dominik , Brechtel Klaus , Lescan Mario , Nikolaou Konstantin , Artzner Christoph
Published: July 2020

Objective

To evaluate the safety and effectiveness of tibiopedal and distal femoral access for retrograde crossing of chronic total occlusion (CTO) in Rutherford stage III to VI peripheral arterial occlusive disease, and to determine factors that correlate with technical success.

Material and methods

One hundred seventy-one consecutive patients were included in this retrospective study. Rutherford stages were III, IV, and V/VI in 24%, 8%, and 67% of patients. Inclusion criteria were CTO at the superficial femoral (SFA), popliteal (PA), and/or below-the-knee (BTK) level, and a failed antegrade treatment followed by a distal retrograde approach. The numbers of occluded vascular levels (OVL), lesion length, degree of calcification, technical success rate, complications, and clinical outcome were noted.

Results

OVL were 1 in 72%, 2 in 20%, and 3 in 8% of patients. CTOs were longer than 20 cm in 45.6% of cases and showed severe calcifications in 50.3%. Target vessels for distal access were the distal SFA/PA in 17% and BTK in 83%. The overall technical success rate was 82%. Severe calcification decreased technical success (p = 0.01) despite lesion length and Rutherford stage. Clinical outcome improved in 123/152 patients with a significant increase of the median ABI (N = 158) from 0.53 (interquartile range 0.39 to 0.61) to 0.85 (0.59 to 1.03; p < 0.001). Complications were reported in 7.6% cases with 2.3% related to the distal vascular access.

Conclusion

The tibiopedal and distal femoral retrograde access presents a safe and effective treatment option of CTOs at the thigh and/or BTK after a failed antegrade attempt improving clinical outcome. Technical success decreased with lesion’s degree of calcification.

Key Points

• Safety and effectiveness of the tibiopedal and distal femoral access for retrograde crossing of chronic total occlusion.

• Target lesion’s degree of calcification decreases technical success.

• Complications related to the distal vascular access were rare.
Efficient image dataset classification difficulty estimation for predicting deep-learning accuracy
Authors: Scheidegger Florian , Istrate Roxana , Mariani Giovanni , Benini Luca , Bekas Costas , Malossi Cristiano
Published: July 2020

In the deep-learning community, new algorithms are published at a very fast pace. Therefore, solving an image classification problem for new datasets becomes a challenging task, as it requires to re-evaluate published algorithms and their different configurations in order to find a close to optimal classifier. To facilitate this process, before biasing our decision toward a class of neural networks or running an expensive search over the network space, we propose to estimate the classification difficulty of the dataset. Our method computes a single number that characterizes the dataset difficulty$$97\times $$97×faster than training state-of-the-art networks. The proposed method can be used in combination with network topology and hyper-parameter search optimizers to efficiently drive the search toward promising neural network configurations.
The influence of fish consumption on serum n-3 polyunsaturated fatty acid (PUFA) concentrations in women of childbearing age: a randomised controlled trial (the iFish Study)
Authors: Conway Marie C. , McSorley Emeir M. , Mulhern Maria S. , Spence Toni , Wijngaarden Edwin van , Watson Gene E. , Wahlberg Karin , Pineda Daniela , Broberg Karin , Hyland Barry W. , Cobice Diego F. , Strain J. J. , Yeates Alison J.
Published: July 2020

Purpose

Long-chain polyunsaturated fatty acids (LCPUFA) can be synthesised endogenously from linoleic acid (LA) and α-linolenic acid (ALA) in a pathway involving the fatty acid desaturase (FADS) genes. Endogenous synthesis is inefficient; therefore, dietary intake of preformed LCPUFA from their richest source of fish is preferred. This study investigated the effect of fish consumption on PUFA concentrations in women of childbearing age while stratifying by FADS genotype. The influence of fish consumption on lipid profile, and markers of inflammation and oxidative stress was also examined.

Methods

Healthy women (n = 49) provided a buccal swab which was analysed for FADS2 genotype (rs3834458; T/deletion). Participants were stratified according to genotype and randomised to an intervention group to receive either no fish (n = 18), 1 portion (n = 14) or 2 portions (n = 17) (140 g per portion) of fish per week for a period of 8 weeks. Serum PUFA was analysed at baseline and post-intervention. Lipid profile, and markers of inflammation and oxidative stress were also analysed.

Results

Participants consuming 2 portions of fish per week had significantly higher concentrations of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and total n-3 PUFA, and a lower n-6:n-3 ratio compared to those in the no fish or 1 portion per week group (all p < 0.05). Fish consumption did not have a significant effect on biomarkers of oxidative stress, inflammation and lipid profile in the current study.

Conclusion

Consumption of 2 portions of fish per week has beneficial effects on biological n-3 PUFA concentrations in women of childbearing age; however, no effects on oxidative stress, inflammation or lipid profile were observed. This trial was registered at www.clinicaltrials.gov (NCT03765580), registered December 2018.
Psychological consequences of COVID-19 pandemic in Italian MS patients: signs of resilience?
Authors: Capuano Rocco , Altieri Manuela , Bisecco Alvino , d’Ambrosio Alessandro , Docimo Renato , Buonanno Daniela , Matrone Federica , Giuliano Federica , Tedeschi Gioacchino , Santangelo Gabriella , Gallo Antonio
Published: July 2020

Background

Anxiety, depression and reduction of quality of life (QoL) are common in people with multiple sclerosis (pwMS). Fear of getting sick from COVID-19, government’s lockdown and the imposed social distancing might have had an impact on psychological distress and QoL.

Objectives

The aim of our study was to investigate anxiety, depression and QoL changes in pwMS during SARS-CoV-2 outbreak and lockdown in Italy.

Methods

67 pwMS with a previous (less than 6 months) neuropsychological evaluation before SARS-CoV-2 outbreak (T0) were re-evaluated at the time of the outbreak and lockdown in Italy (T1). They underwent a clinical and neurological evaluation and completed the State-Trait Anxiety Inventory (STAI-Y1), the Beck Depression Inventory second edition (BDI-II), and Multiple Sclerosis Quality of Life-54 (MsQoL-54) at T0 and T1. Benjamini–Hochberg procedure was applied to control the false discovery rate.

Results

BDI-II and STAI-Y1 scores did not change between T0 and T1. At T1, MsQoL-54 scores were higher on the satisfaction with sexual life and the social function subscales, and lower on the limitation due to emotional problems subscale.

Conclusions

This is the first study that evaluated mood and QoL levels before and during the lockdown due to COVID-19 pandemic in pwMS. No worsening of anxiety and depression levels was found. Contrariwise some improvements were noted on QoL, the most reliable regarding the sexual satisfaction and the social function.
Transepithelial corneal cross-linking assisted by two continuous cycles of iontophoresis for progressive keratoconus in adults: retrospective 5-year analysis
Authors: Wu Huping , Luo Shunrong , Fang Xie , Shang Xumin , Xie Zhiwen , Xiao Xianwen , Lin Zhirong , Liu Zuguo
Published: July 2020

Purpose

The aim of this study is to compare the long-term effects of transepithelial corneal crosslinking with two continuous cycles of iontophoresis (EI-CXL) and conventional corneal crosslinking (C-CXL) in adults with progressive keratoconus.

Methods

A retrospective analysis was conducted in adults who underwent C-CXL or EI-CXL between 2013 and 2015. Visual acuity, corneal tomography, anterior segment optical coherence tomography, in vivo corneal confocal microscopy (IVCM), and endothelial cell count (ECC) were performed preoperatively and 5 years postoperatively.

Results

Sixty-eight patients with a mean age of (24.3 ± 3.8) years were included, 34 for each group. After CXL, UCVA or BCVA remained stable, while the spherical diopter, cylinder diopter, spherical equivalent, and Kmax significantly decreased at 1, 2, and 3 years in both groups than baseline (P < 0.05). No significant differences were found in any refractive or tomographic parameters as well as the minimal corneal thickness between groups during follow-up. At 5 years, Kmax was slightly higher in EI-CXL group (58.16 ± 6.28) than that of C-CXL group (57.46 ± 4.98). At 3 and 5 years, the minimal corneal thickness in C-CXL group was still significantly lower than baseline (P < 0.05). IVCM demonstrated the demarcation zone at a mean depth of (302.0 ± 41.7) μm after C-CXL, and at (251.2 ± 28.1) μm after EI-CXL (P < 0.001). Keratocyte repopulation was detectable at all follow-up timepoint in both groups. Postoperative complications including progression were recorded in 6 patients (11.7%) after C-CXL and 3 patients (8.8%) after EI-CXL. ECC remained stable in both groups.

Conclusion

EI-CXL showed approximate efficacy with C-CXL in stabilizing progressive keratoconus in adults. EI-CXL has the potential to be a preferable transepithelial protocol.
Elevation of phosphate levels impairs skeletal myoblast differentiation
Authors: Raimann Adalbert , Dangl Alexander , Javanmardi Alireza , Greber-Platzer Susanne , Egerbacher Monika , Pietschmann Peter , Haeusler Gabriele
Published: July 2020

Hyperphosphatemic conditions such as chronic kidney disease are associated with severe muscle wasting and impaired life quality. While regeneration of muscle tissue is known to be reliant on recruitment of myogenic progenitor cells, the effects of elevated phosphate loads on this process have not been investigated in detail so far. This study aims to clarify the direct effects of hyperphosphatemic conditions on skeletal myoblast differentiation in a murine in vitro model. C2C12 murine muscle progenitor cells were supplemented with phosphate concentrations resembling moderate to severe hyperphosphatemia (1.4–2.9 mmol/l). Phosphate-induced effects were quantified by RT-PCR and immunoblotting. Immunohistochemistry was performed to count nuclear positive cells under treatment. Cell viability and metabolic activity were assessed by XTT and BrdU incorporation assays. Inorganic phosphate directly induced ERK-phosphorylation in pre-differentiated C2C12 myoblast cells. While phosphate concentrations resembling the upper normal range significantly reduced Myogenin expression (− 22.5%, p = 0.015), severe hyperphosphatemic conditions further impaired differentiation (Myogenin − 61.0%, p < 0.0001; MyoD − 51.0%; p < 0.0001). Analogue effects were found on the protein level (Myogenin − 42.0%, p = 0.004; MyoD − 25.7%, p = 0.002). ERK inhibition strongly attenuated phosphate-induced effects on Myogenin expression (p = 0.002). Metabolic activity was unaffected by the treatments. Our data point to a phosphate-induced inhibition of myoblast differentiation without effects on cell viability. Serum phosphate levels as low as the upper normal serum range significantly impaired marker gene expression in vitro. Investigation of cellular effects of hyperphosphatemia may help to better define serum cutoffs and modify existing treatment approaches of phosphate binders, especially in patients at risk of sarcopenia.
Lower semicontinuity and relaxation of nonlocal $$L^\infty $$-functionals
Authors: Kreisbeck Carolin , Zappale Elvira
Published: July 2020

We study variational problems involving nonlocal supremal functionals$$\begin{aligned} L^\infty (\Omega ;{\mathbb {R}}^m) \ni u\mapsto \mathrm{ess sup}_{(x,y)\in \Omega \times \Omega } W(u(x), u(y)), \end{aligned}$$L∞(Ω;Rm)∋u↦esssup(x,y)∈Ω×ΩW(u(x),u(y)),where$$\Omega \subset \mathbb {R}^n$$Ω⊂Rnis a bounded, open set and$$W:\mathbb {R}^m\times \mathbb {R}^m\rightarrow \mathbb {R}$$W:Rm×Rm→Ris a suitable function. Motivated by existence theory via the direct method, we identify a necessary and sufficient condition for$$L^\infty $$L∞-weak$$^*$$∗lower semicontinuity of these functionals, namely, separate level convexity of a symmetrized and suitably diagonalized version of the supremands. More generally, we show that the supremal structure of the functionals is preserved during the process of relaxation. The analogous statement in the related context of double-integral functionals was recently shown to be false. Our proof relies substantially on the connection between supremal and indicator functionals. This allows us to recast the relaxation problem into characterizing weak$$^*$$∗closures of a class of nonlocal inclusions, which is of independent interest. To illustrate the theory, we determine explicit relaxation formulas for examples of functionals with different multi-well supremands.
An andesitic sill complex in the Southern Permian Basin: volcanogenetic model and stratigraphic implications
Authors: Luthardt Ludwig , Breitkreuz Christoph , Schneider Joerg W. , Gaitzsch Birgit , Brink Judith , Stanek Klaus Peter , Linnemann Ulf , Hofmann Mandy , Ehling Bodo-Carlo
Published: July 2020

Subvolcanic intrusions are highly variable in shape and structure, and occur in nearly all parts of the upper crust, as a result of extensive volcanic activity. Processes of subvolcanics interacting with the host rock are insufficiently understood, as they are rarely exposed. In the southernmost part of the Flechtingen-Altmark Subprovince, (sub)volcanic rocks of the Flechtingen Volcanic Complex (FVC) are exposed in several quarries. It is built up of silicic tuffs, ignimbrites and lava flows, but also of intermediate lavas and extended sill sheets. Additionally, major granitic intrusions exposed by drillings are associated with the FVC. In the Mammendorf quarry, a sill intruded in between lithified turbiditic series of early Carboniferous (Visean–Serphukovian) age at the base, and widely consolidated volcanoclastic deposits of late Carboniferous (late Pennsylvanian) age at the top. Various magma-host rock interactions were found indicating brittle and ductile deformation patterns occurring at the basal contact, and secondary fluidal mixing predominantly occurring at the top contact, most probably caused by fluids accompanying the intruding magma. We present an extended volcanogenetic model for the FVC. Volcanic activity initiated at 302 ± 3 Ma with fallout deposits represented by mostly re-deposited silicic ashfall deposits of the Flechtingen Formation, and cumulated in depositing major ignimbrite series, most likely forming a caldera. Later, the sills intruded at the rheological boundary of the lithified Mississippian turbiditic series and the partly consolidated volcanoclastic series. Finally, major granitic intrusions emplaced in the basement rocks at around 298 ± 4 Ma. The study contributes to clarify stratigraphic constraints of late Carboniferous to early Permian continental deposits and sheds light on stratigraphy of significant late Paleozoic volcanic deposits of the Flechtingen-Altmark Subprovince in the Southern Permian Basin.
European Pandemic Recovery: An Opportunity to Reboot
Authors: Bénassy-Quéré Agnès , di Mauro Beatrice Weder
Published: July 2020

Europe’s failure to manage a bold, common response would further increase divergence, strengthen anti-European forces and fuel populism.