bluuebunny/crossref_metadata_2025 huggingface dataset:
Reflectance Confocal Microscopy, Optical Coherence Tomography, and Multiphoton Microscopy in Inflammatory Skin Disease Diagnosis
Authors: Csuka Ella A. , Ward Suzanne C. , Ekelem Chloe , Csuka David A. , Ardigò Marco , Mesinkovska Natasha A.
Published: February 2021

Background and Objectives

Technological advances in medicine have brought about many novel skin imaging devices. This review aims to evaluate the scientific evidence supporting the use of noninvasive optical imaging techniques to aid in the diagnosis and prognosis of inflammatory skin diseases.

Study Design/Materials and Methods

PubMed and Scopus were searched in September 2020 according to PRISMA guidelines for articles using reflectance confocal microscopy (RCM), optical coherence tomography (OCT), and multiphoton microscopy (MPM) in inflammatory skin diseases, excluding studies monitoring treatment efficacy.

Results

At the time of the study, there were 66 articles that addressed the utilization of noninvasive imaging in interface, spongiotic, psoriasiform, vesiculobullous, and fibrosing/sclerosing inflammatory skin dermatoses: RCM was utilized in 46, OCT in 16, and MPM in 5 articles. RCM was most investigated in psoriasiform dermatoses, whereas OCT and MPM were both most investigated in spongiotic dermatoses, including atopic dermatitis and allergic contact dermatitis.

Conclusions

There is preliminary evidence to support the diagnostic potential of noninvasive optical imaging techniques in inflammatory skin diseases. Improvements in the devices and further correlation with histology will help broaden their utility. Additional studies are needed to determine the parameters for diagnostic features, disease differentiation, and staging of inflammatory skin conditions. Lasers Surg. Med. © 2021 Wiley Periodicals LLC
Eigencolor radiochromic film dosimetry
Authors: Bouchard Hugo , Billas Ilias , Subiel Anna , Duane Simon
Published: February 2021

Purpose

The goal of this work is to propose a new multichannel method correcting for systematic thickness disturbances and to evaluate its precision in relevant radiation dosimetry applications.

Methods

The eigencolor ratio technique is introduced and theoretically developed to provide a method correcting for thickness disturbances. The method is applied to EBT3 GafchromicTM film irradiated with cobalt‐60 and 6 MV photon beams and digitized with an Epson 10000XL photo scanner. Dose profiles and output factors of different field sizes are measured and analyzed. Variance analysis of the previous method of Bouchard et al. [“On the characterization and uncertainty analysis of radiochromic film dosimetry” Med Phys. 2009;36:1931‐1946] is adapted to the new approach. Uncertainties are predicted for relevant applications.

Results

Results show that systematic disturbances attributed to thickness variations are efficiently corrected. The method is shown efficient to identify and correct for dark spots which cause systematic errors in single‐channel distributions. Applications of the method in the context of relative dosimetry yields standard uncertainties ranging between 0.8% and 1.9%, depending on the region of interest (ROI) size and the film irradiation. Variance analysis predicts that uncertainty levels between 0.3% and 0.6% are achievable with repeated measurements. Uncertainties are found to vary with absorbed dose and ROI size.

Conclusions

The proposed multichannel method is efficient for accurate dosimetry, reaching uncertainty levels comparable to previous publications with EBT film. The method is also promising for applications beyond clinical QA, such as machine characterization and other advanced dosimetry applications.
Physiological Consequences of Different Fishing Tournament Culling Methods on Largemouth Bass
Authors: Chong Daniel R. , Abrams Alice E. I. , Zolderdo Aaron J. , Lawrence Michael J. , Reid Connor H. , Cooke Steven J.
Published: February 2021

In live-release angling tournaments, fish are captured and typically held within onboard live-well systems, where they are subsequently “culled” (i.e., released) as larger fish are captured. Anglers often mark individual fish to easily identify them based on weight and to reduce handling time. However, there is limited information about the physiological consequences of using different culling apparatus on fish. This study examined the physiological consequences associated with using four different types of culling apparatus (i.e., metal stringer through the jaw, pincher on the jaw, lasso around the caudal peduncle, and zippered mesh bag) on Largemouth Bass Micropterus salmoides relative to controls during a 2-h live-well retention period. Blood samples were taken afterwards and were analyzed for blood glucose, blood lactate, plasma cortisol, and osmolality. Compared to the baseline control (i.e., fish that were captured, subjected to blood sampling, and immediately released), blood parameters (except osmolality) were significantly elevated in all treatments. The pincher and lasso treatments tended to yield higher physiological disturbances than the other treatments, including fish that were held in the live well without any culling apparatus. Moreover, the lasso culling apparatus appeared to cause noticeable injury relative to the other culling devices. Our research provides valuable information to help guide the selection of culling gear that maintains the welfare status of retained fish during tournaments.
A Review of Factors Affecting PIT Tag Detection Using Mobile Arrays and Use of Mobile Antennas to Detect PIT-Tagged Suckers in a Wadeable Ozark Stream
Authors: Zentner Douglas L. , Wolf Skylar L. , Brewer Shannon K. , Shoup Daniel E.
Published: February 2021

Advantages of PIT tags are their small size, longevity, and low cost compared to other tags. They are often used in fisheries to study movement patterns and survival or to estimate population size. However, PIT tags are limited by their short detection distance. Mobile PIT antennas may increase the utility of PIT tags in fisheries. In this study, we synthesized current detection efficiency literature for mobile PIT antennas, determined physical factors that decreased PIT tag detection probabilities for our antenna, determined factors that influenced the proportion of PIT-tagged suckers detected by our mobile antenna, and summarized techniques used to increase detections of PIT-tagged suckers using mobile antennas in a wadable stream. Our literature review indicated that tag size and orientation were the most important factors affecting detection probabilities. However, our manual testing suggested that the detection probability for our antenna was primarily influenced by water depth of the tag and distance from the antenna. Our sucker detection data showed that detection efficiency in our stream was most influenced by discharge, turbidity, and sample date. Tracking methods that include targeting key habitats (e.g., rootwads) and using natural features to congregate tagged fishes (e.g., riffles or pinch points) may increase detection efficiency in wadable streams. This is the first formal review of factors affecting mobile PIT antenna detection efficiency. The published literature, combined with our study results, indicates that several factors need to be considered prior to mobile PIT antenna tracking.
Radiotherapy Plus Procarbazine, Lomustine, and Vincristine Versus Radiotherapy Plus Temozolomide for IDH-Mutant Anaplastic Astrocytoma: A Retrospective Multicenter Analysis of the French POLA Cohort
Authors: Esteyrie Vincent , Dehais Caroline , Martin Elodie , Carpentier Catherine , Uro-Coste Emmanuelle , Figarella-Branger Dominique , Bronniman Charlotte , Pouessel Damien , Ciron Delphine Larrieu , Ducray François , Moyal Elizabeth Cohen-Jonathan , Network Pola
Published: February 2021

Background

IDH-mutant anaplastic astrocytomas (AAs) are chemosensitive tumors for which the best choice of adjuvant chemotherapy between procarbazine, lomustine, and vincristine (PCV) or temozolomide (TMZ) after radiotherapy (RT) remains unclear.

Methods

In a large cohort of patients with histologically proven 2016 World Health Organization classification AA with IDH1/2 mutations included in the French national POLA cohort (n = 355), the primary objective was to compare progression-free survival (PFS) between the two treatment regimens (n = 311). Secondary endpoints were overall survival (OS), progression type, pseudoprogression rate, and toxicity.

Results

The 4-year PFS in the RT + PCV arm was 70.8% versus 53.5% in the RT + TMZ arm, with a hazard ratio (HR) of 0.58 (95% confidence interval [CI], 0.38–0.87; p = .0074) in univariable analysis and 0.63 (95% CI, 0.41–0.97; p = .0348) in multivariable analysis. The 4-year OS in the RT + PCV arm was 84.3% versus 76.6% in the RT + TMZ arm, with an HR of 0.57 (95% CI, 0.30–1.05; p = .0675) in univariable analysis. Toxicity was significantly higher in the RT + PCV arm with more grade ≥3 toxicity (46.7% vs. 8.6%, p < .0001).

Conclusion

RT + PCV significantly improved PFS compared with RT + TMZ for IDH-mutant AA. However, RT + TMZ was better tolerated.

Implications for Practice

In the absence of fully conducted randomized trials comparing procarbazine, lomustine, and vincristine (PCV) with temozolomide (TMZ) in adjuvant treatment after radiotherapy (RT) for the management of IDH-mutant anaplastic astrocytoma (AA) and a similar level of evidence, these two chemotherapies are both equally recommended in international guidelines. This study in a national cohort of IDH-mutant AA defined according the 2016 World Health Organization (WHO) classification shows for the first time that the RT + PCV regimen significantly improves progression-free survival in comparison with the RT + TMZ regimen. Even if at the time of analysis the difference in overall survival was not significant, this result provides new evidence for the debate about the chemotherapy regimen to prescribe in adjuvant treatment to RT for WHO 2016 IDH-mutant AA.
Asymmetric pass‐through between oil and transport prices: Evidence from a nonlinear analysis
Authors: Waqar Shujaa , Qayyum Waqqas , Haq Mirajul , Amin Baber
Published: February 2021

The present study focuses on a widely discussed phenomenon, Asymmetric Price Transmission, which refers to the nonlinear behavior of prices when they are evaluated at their crests and troughs. The underlying study attempts to capture this behavior, giving special emphasis to the transportation sector of Pakistan. By employing monthly data of retail oil prices spanning between 1990 and 2016, we have tried to empirically investigate the existence of this phenomenon in a sector directly linked with oil price variations. This sector has been often overlooked in terms of its evaluation within the given context. Our study employs a recently developed nonlinear autoregressive distributed lag model (NARDL), to examine the pass‐through of oil prices into the fares of the transportation sector. This model allows us to capture short‐run and long‐run estimates simultaneously and also offers an opportunity to determine the magnitude of respective positive and negative oil price shocks. In addition, this study categorizes the transport sector into subsegments of LTVs and HTVs and finds differential patterns in the response of these two categories against oil price variations. The obtained results indicate that oil prices affect the fares of the transportation sector asymmetrically. The findings of the study are instrumental for identifying the pass‐through of oil prices to the subsegments of transport sectors. This identification about the differential impact/pass upon the various segments of the transport sector can be helpful for policymakers, especially if they are concerned about devising a trickle‐down policy in periods of oil price decline.
Emerging diseases of Cannabis sativa and sustainable management
Authors: Punja Zamir K
Published: February 2021

Cultivation of cannabis plants (Cannabis sativa L., marijuana) has taken place worldwide for centuries. In Canada, legalization of cannabis in October 2018 for the medicinal and recreational markets has spurned interest in large‐scale growing. This increased production has seen a rise in the incidence and severity of plant pathogens, causing a range of previously unreported diseases. The objective of this review is to highlight the important diseases currently affecting the cannabis and hemp industries in North America and to discuss various mitigation strategies. Progress in molecular diagnostics for pathogen identification and determining inoculum sources and methods of pathogen spread have provided useful insights. Sustainable disease management approaches include establishing clean planting stock, modifying environmental conditions to reduce pathogen development, implementing sanitation measures, and applying fungal and bacterial biological control agents. Fungicides are not currently registered for use and hence there are no published data on their efficacy. The greatest challenge remains in reducing microbial loads (colony‐forming units) on harvested inflorescences (buds). Contaminating microbes may be introduced during the cultivation and postharvest phases, or constitute resident endophytes. Failure to achieve a minimum threshold of microbes deemed to be safe for utilization of cannabis products can arise from conventional and organic cultivation methods, or following applications of beneficial biocontrol agents. The current regulatory process for approval of cannabis products presents a challenge to producers utilizing biological control agents for disease management. © 2021 The Author. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
A high‐order WENO‐limited finite‐volume algorithm for atmospheric flow using the ADER‐differential transform time discretization
Authors: Norman Matthew R.
Published: February 2021

A high‐order‐accurate weighted essentially non‐oscillatory (WENO) limited upwind finite‐volume scheme is detailed for the compressible, nonhydrostatic, inviscid Euler equations using an arbitrary derivatives (ADER) time‐stepping scheme based on differential transforms (DTs). A second‐order‐accurate alternating Strang dimensional splitting is compared against multidimensional simulation with 2D transport using solid body rotation of various data. The two were found to give nearly identical accuracy in orthogonal, Cartesian coordinates. Orders of convergence are demonstrated at up to ninth‐order accuracy with 2D transport. 1D transport is used to confirm that error decreases monotonically with increasing order of accuracy with WENO limiting even for discontinuous data. Further, WENO limiting always decreased the error compared with simulation without limiting in the L1 norm. A series of standard 2D compressible nonhydrostatic Euler equation test cases were validated against previous results from literature. Finally, it was demonstrated that increasing the order of accuracy led to better resolved features and increased power for kinetic energy at small wavelengths.
Interval stability and interval stabilization of linear stochastic systems with time‐varying delay
Authors: Zhang Huasheng , Xia Jianwei , Park Ju H. , Sun Wei , Zhuang Guangming
Published: February 2021

This article first investigates the criterion of interval stability for linear stochastic systems with time‐varying delay via equivalent systems and Lyapunov–Krasovskii (L‐K) functionals. Different from existing stability conditions, the criterion of interval stability can be used to make a more accurate judgment of the stability for linear time‐delay systems. In other words, the new criterion can judge not only the stability of the system but also the speed of its convergence. Meanwhile, based on the criterion of the interval stability, the condition of interval stabilization is derived, which cannot only ensure the stability of the linear time‐delay systems, but also adjust the convergence rate of the states to the ideal level. A numerical instance is presented to illustrate the advantages of the resulting interval stabilization criterion.
The energy‐extractives nexus and the just transition
Authors: Bainton Nicholas , Kemp Deanna , Lèbre Eleonore , Owen John R. , Marston Greg
Published: January 2021

The concept of a ‘just transition’ to a low‐carbon economy is firmly embedded in mainstream global discourses about mitigating climate change. Drawing on Karl Polanyi's political economy elaborated inThe Great Transformation, we interrogate the idea of a just transition and place it within its historical context. We address a major contradiction at the core of global energy transition debates: the rapid shift to low‐carbon energy‐systems will require increased extraction of minerals and metals. In doing so, we argue that extractive industries are energy and carbon‐intensive, and will enlarge and intensify social and ecological injustice. Our findings reveal the importance of understanding how the idea of a just transition is used, and by who, and the type of justice that underpins this concept. We demonstrate the need to ground just transition policies and programmes in a notion of justice as fairness.
Electron Backscatter Diffraction Investigation of Heat Deformation Behavior of 2205 Duplex Stainless Steel
Authors: Song Yaohui , Li Yugui , Zhao Guanghui , Liu Haitao , Li Huaying , Li Juan , Liu Erqiang
Published: February 2021

Herein, the thermal compression of 2205 duplex stainless steel is simulated using a thermal simulation testing machine at 850–1100 °/0.01 s−1 and 850–1100 °/10 s−1, and the large deformation zone (LDZ) and free deformation zone (FDZ) of the structure are characterized by electron backscatter diffraction (EBSD). The study results show that the stress–strain curve with a strain rate of 10 s−1 hardens continuously. In addition, ferrite undergoes deformation mostly when the strain is less than 0.33, and strain hardening occurs in austenite after the strain reaches 0.33. As a result, the curve ascends and steepens, and secondary hardening occurs. Continuous dynamic recrystallization (CDRX) is distinctly observed in original ferrite grains, whereas the austenite grains are recrystallized discontinuously due to the bulging high‐angle grain boundaries (HAGBs). Meanwhile, the recrystallization fraction in the large deformation region of both ferrite and austenite is significantly higher than that in the free deformation zone. The orientation distribution function (ODF) diagram analysis reveals that ferrite is mainly composed of the rotation cube {001}<111> texture, and austenite mainly consists of the rolled α‐fiber texture, including brass {011}<211>, Gauss {011}<100>, and {011}<111>.
Factors Associated with Detection and Distribution of Native Brook Trout and Introduced Brown Trout in the Driftless Area of Iowa
Authors: Kelly Brett , Siepker Michael J. , Weber Michael J.
Published: February 2021

Fish populations at the fringe of their geographic range often inhabit marginal habitats and are vulnerable to ecological disturbances, such as species invasion, land cover conversion, and climate change. The Driftless Area of northeastern Iowa, USA represents the southwestern edge of the native range of Brook Trout Salvelinus fontinalis, where endemic populations have been greatly reduced due to habitat degradation and introduced Brown Trout Salmo trutta. Therefore, documenting Brook Trout occurrence patterns at the southern tip of their range may prove useful for the conservation of peripheral populations. We fitted single‐species occupancy models at multiple spatial scales to estimate the relative effects of biotic (e.g., Brown Trout density) and habitat (instream, riparian, and watershed) variables on Brook and Brown Trout occupancy to predict their current distribution in the Iowa Driftless Area. Species occurrence and physical habitat data were collected at 138 stream segments of the Upper Iowa, Yellow, and Little Maquoketa River watersheds (8‐digit hydrologic unit codes) during May–September in 2018 and 2019. Brook Trout occupancy was low (19 of 138 sites) and affected by local (instream and riparian) habitat covariates, particularly August–September stream temperatures, but no adverse effects of Brown Trout density were detected. Brown Trout occupied 54% of streams (74 of 138 sites), and occupancy was influenced by a combination of local‐scale (mean stream velocity, percentage of run macrohabitat, and August–September stream temperatures) and catchment‐scale (percent forested land cover and upstream catchment area) habitat variables. Our results provide evidence that instream thermal conditions are a critical determinant of Brook Trout distribution, while Brown Trout exhibit plasticity in habitat suitability and increased colonization in areas where they are introduced. Given the dependence of Brook Trout on cold stream temperatures, the projected loss of thermally suitable habitats due to climate change may facilitate their replacement by naturalized Brown Trout at the southwestern extent of their range.
“It is impossible to teach English in English”: Preservice teachers’ struggles to facilitate L2 comprehensibility in English
Authors: Barahona Malba , Delaporte‐Raurich Catalina , Ibaceta‐Quijanes Ximena
Published: February 2021

Teachers’ use of the target language for instruction in the context of foreign language teaching has been identified as a key factor for learning. However, it has also been observed that teachers do not use the target language for reasons such as lack of proficiency in the second language (L2), lack of pedagogical content knowledge or confidence in that knowledge, doubt that their students will understand, and specific cultural practices. This article reports on a study that investigated the implementation of a university‐based classroom intervention centered on a practice‐based approach in an initial English language teacher education program in Chile. This intervention aimed at understanding how a group of preservice teachers learned how to enact strategies to facilitate L2 comprehensibility in English. Findings demonstrate that a practice‐based approach can provide effective opportunities for preservice teachers to develop pedagogical content knowledge and become more confident in using English more effectively in their lessons. Findings also reveal that preservice teachers struggled in this process; however, they tended to develop higher levels of reflection as they learned how to facilitate L2. The article concludes with a discussion about key reasons preservice teachers claimed for using the first language in English lessons.
Obstetric and neonatal literature is complex and should be merged to understand perinatal SARS‐CoV‐2 infection
Authors: Vivanti A. J. , De Luca D. , Raschetti R. , Benachi A.
Published: February 2021

Linked article: This Correspondence comments on Faure‐Bardon et al. Click here to view the article.
Entanglement and confinement in coupled quantum systems
Authors: Alet Fabien , Hanada Masanori , Jevicki Antal , Peng Cheng
Published: February 2021

Abstract

We study some general properties of coupled quantum systems. We consider simple interactions between two copies of identical Hamiltonians such as the SYK model, Pauli spin chains with random magnetic field and harmonic oscillators. Such couplings make the ground states close to the thermofield double states of the uncoupled Hamiltonians. For the coupled SYK model, we push the numerical computation further towards the thermodynamic limit so that an extrapolation in the size of the system is possible. We find good agreement between the extrapolated numerical result and the analytic result in the large-qlimit. We also consider the coupled gauged matrix model and vector model, and argue that the deconfinement is associated with the loss of the entanglement, similarly to the previous observation for the coupled SYK model. The understanding of the microscopic mechanism of the confinement/deconfinement transition enables us to estimate the quantum entanglement precisely, and backs up the dual gravity interpretation which relates the deconfinement to the disappearance of the wormhole. Our results demonstrate the importance of the entanglement between the color degrees of freedom in the emergence of the bulk geometry from quantum field theory via holography.
An overview of grid-edge control with the digital transformation
Authors: Mai Tam T. , Nguyen Phuong H. , Tran Quoc-Tuan , Cagnano Alessia , De Carne Giovanni , Amirat Yassine , Le Anh-Tuan , De Tuglie Enrico
Published: February 2021

Distribution networks are evolving to become more responsive with increasing integration of distributed energy resources (DERs) and digital transformation at the grid edges. This evolution imposes many challenges to the operation of the network, which then calls for new control and operation paradigms. Among others, a so-called grid-edge control is emerging to harmonise the coexistence of the grid control system and DER’s autonomous control. This paper provides a comprehensive overview of the grid-edge control with various control architectures, layers, and strategies. The challenges and opportunities for such an approach at the grid edge with the integration of DERs and digital transformation are summarised. The potential solutions to support the network operation by using the inherent controllability of DER and the availability of the digital transformation at the grid edges are discussed.
Metabolic reprogramming of T regulatory cells in the hypoxic tumor microenvironment
Authors: Sasidharan Nair Varun , Saleh Reem , Toor Salman M. , Cyprian Farhan S. , Elkord Eyad
Published: February 2021

Metabolic dysregulation in the hypoxic tumor microenvironment (TME) is considered as a hallmark of solid tumors, leading to changes in biosynthetic pathways favoring onset, survival and proliferation of malignant cells. Within the TME, hypoxic milieu favors metabolic reprogramming of tumor cells, which subsequently affects biological properties of tumor-infiltrating immune cells. T regulatory cells (Tregs), including both circulating and tissue-resident cells, are particularly susceptible to hypoxic metabolic signaling that can reprogram their biological and physicochemical properties. Furthermore, metabolic reprogramming modifies Tregs to utilize alternative substrates and undergo a plethora of metabolic events to meet their energy demands. Major impact of this metabolic reprogramming can result in differentiation, survival, excessive secretion of immunosuppressive cytokines and proliferation of Tregs within the TME, which in turn dampen anti-tumor immune responses. Studies on fine-tuning of Treg metabolism are challenging due to heterogenicity of tissue-resident Tregs and their dynamic functions. In this review, we highlight tumor intrinsic and extrinsic factors, which can influence Treg metabolism in the hypoxic TME. Moreover, we focus on metabolic reprogramming of Tregs that could unveil potential regulatory networks favoring tumorigenesis/progression, and provide novel insights, including inhibitors against acetyl-coA carboxylase 1 and transforming growth factor beta into targeting Treg metabolism for therapeutic benefits.
Neurosurgical experience of managing optic pathway gliomas
Authors: Hill Ciaran Scott , Khan Mehdi , Phipps Kim , Green Katherine , Hargrave Darren , Aquilina Kristian
Published: February 2021

Background

Optic pathway gliomas (OPGs), also known as visual pathway gliomas, are debilitating tumors that account for 3–5% of all pediatric brain tumors. They are most commonly WHO grade 1 pilocytic astrocytomas and frequently occur in patients with neurofibromatosis type 1. The location of these tumors results in visual loss and blindness, endocrine and hypothalamic dysfunction, hydrocephalus, and premature death. Their involvement of the visual pathways and proximity to other eloquent brain structures typically precludes complete resection or optimal radiation dosing without incurring significant neurological injury. There are various surgical interventions that can be performed in relation to these lesions including biopsy, cerebrospinal fluid diversion, and partial or radical resection, but their role is a source of debate. This study catalogues our surgical experience and patient outcomes in order to support decision-making in this challenging pathology.

Methods

A retrospective review of all cases of OPGs treated in a single center from July 1990 to July 2020. Data was collected on patient demographics, radiographic findings, pathology, and management including surgical interventions. Outcome data included survival, visual function, endocrine, and hypothalamic dysfunction.

Results

One hundred twenty-one patients with OPG were identified, and 50 of these patients underwent a total of 104 surgical procedures. These included biopsy (31), subtotal or gross total resection (20 operations in 17 patients), cyst drainage (17), Ommaya reservoir insertion (9), or cerebrospinal fluid diversion (27). During the study period, there was 6% overall mortality, 18% hypothalamic dysfunction, 20% endocrine dysfunction, and 42% had some cognitive dysfunction. At diagnosis 75% of patients had good or moderate visual function in at least one eye, and overall, this improved to 83% at the end of the study period. In comparison the worst eye had good or moderate visual function in 56%, and this reduced to 53%. Baseline and final visual function were poorer in patients who had a surgical resection, but improvements in vision were still found—particularly in the best eye.

Discussion/conclusion

OPG are debilitating childhood tumor that have lifelong consequences in terms of visual function and endocrinopathies/hypothalamic dysfunction; this can result in substantial patient morbidity. Decisions regarding management and the role of surgery in this condition are challenging and include cerebrospinal fluid diversion, biopsy, and in highly select cases cystic decompression or surgical resection. In this paper, we review our own experience, outcomes, and surgical philosophy.
Heterotopic ossification in primary total hip arthroplasty using the posterolateral compared to the direct lateral approach
Authors: van Erp J. H. J. , Massier J. R. A. , Truijen S. , Bekkers J. E. J. , Snijders T. E. , de Gast A.
Published: February 2021

Purpose

Total hip arthroplasty (THA) is a successful procedure. However, in time, heterotopic ossification (HO) can form due to, amongst others, soft tissue damage. This can lead to pain and impairment. This study compares the formations of HO between patients who underwent either THA with the posterolateral approach (PA) or with the direct lateral approach (DLA). Our hypothesis is that patients who underwent THA with a PA form less HO compared to THA patients who underwent DLA.

Methods

In this prospective cohort study, 296 consecutive patients were included who underwent THA. A total of 127 patients underwent THA with the PA and 169 with the DLA. This was dependent on the surgeon’s preference and experience. More than 95% of patients had primary osteoarthritis as the primary diagnosis. Clinical outcomes were scored using the Numeric Rating Scale (NRS) and Harris Hip Score (HHS), radiological HO were scored using the Brooker classification. Follow-up was performed at 1 and 6 years postoperatively.

Results

Two hundred and fifty-eight patients (87%) completed the 6-year follow-up. HO formation occurred more in patients who underwent DLA, compared to PA (43(30%) vs. 21(18%), p = 0.024) after 6 years. However, the presence of severe HO (Brooker 3–4) was equal between the DLA and PA (7 vs. 5,p = 0.551). After 6 years the HHS and NRS for patient satisfaction were statistically significant higher after the PA (95.2 and 8.9, respectively) compared to the DLA (91.6 and 8.5, respectively) (p < 0.001 and p = 0.003, respectively). The NRS for load pain was statistically significant lower in the PA group (0.5) compared to the DLA group (1.2) (p = 0.004). The NRS for rest pain was equal: 0.3 in the PA group and 0.5 in the DLA group.

Conclusion

THA with the PA causes less HO formation than the DLA.

Trial registration

Registrated as HipVit trial, NL 32832.100.10, R-10.17D/HIPVIT 1. Central Commission Human-Related research (CCMO) Registry.
Chromosome X aneusomy and androgen receptor gene copy number aberrations in apocrine carcinoma of the breast
Authors: Cremonini Anna , Saragoni Luca , Morandi Luca , Corradini Angelo G. , Ravaioli Caterina , Di Oto Enrico , Limarzi Francesco , Sanchez Alejandro M. , Cucchi Maria C. , Masetti Riccardo , Quinn Cecily , Foschini Maria P.
Published: February 2021

Carcinomas with apocrine differentiation (CAD) of the breast are rare tumours typically presenting high immunohistochemical expression of androgen receptor (AR) which is a target molecule for personalised therapy. To date, no studies have evaluated the genetic changes that are associated with AR immunohistochemical expression in CADs. The present work aims to characterise AR status in CADs. Twenty CAD tumours were studied with immunohistochemistry, in situ fluorescence hybridization and DNA methylation analysis, to evaluate AR expression and its regulator status. All tumours demonstrated high AR immunohistochemical expression, with over 95% of the neoplastic cells showing AR positivity in 19/20 cases. CADs showed AR gene copy loss in a percentage of neoplastic cells ranging from 5 to 84% (mean 48.93%). AR regulator genes, including the MAGE family, UXT and FLNA, presented variable methylation levels, but were mainly hypomethylated and therefore all transcriptionally active. The results of this study indicate that CADs present AR monosomy, paralleled by higher transcriptional activity of the gene with potential to influence response to AR deprivation therapy.
Practice variations in the management of childhood nephrotic syndrome in the Netherlands
Authors: Schijvens Anne M. , van der Weerd Lucie , van Wijk Joanna A. E. , Bouts Antonia H. M. , Keijzer-Veen Mandy G. , Dorresteijn Eiske M. , Schreuder Michiel F.
Published: February 2021

Nephrotic syndrome in childhood is a common entity in the field of pediatric nephrology. The optimal treatment of children with nephrotic syndrome is often debated. Previously conducted studies have shown significant variability in nephrotic syndrome management, especially in the choice of steroid-sparing drugs. In the Netherlands, a practice guideline on the management of childhood nephrotic syndrome has been available since 2010. The aim of this study was to identify practice variations and opportunities to improve clinical practice of childhood nephrotic syndrome in the Netherlands. A digital structured survey among Dutch pediatricians and pediatric nephrologists was performed, including questions regarding the initial treatment, relapse treatment, kidney biopsy, additional immunosuppressive treatment, and supportive care. Among the 51 responses, uniformity was seen in the management of a first presentation and first relapse. Wide variation was found in the tapering of steroids after alternate day dosing. Most pediatricians and pediatric nephrologists (83%) would perform a kidney biopsy in case of steroid-resistant nephrotic syndrome, whereas for frequent relapsing and steroid-dependent nephrotic syndrome this was 22% and 41%, respectively. Variation was reported in the steroid-sparing treatment. Finally, significant differences were present in the supportive treatment of nephrotic syndrome.

Conclusion: Substantial variation was present in the management of nephrotic syndrome in the Netherlands. Differences were identified in steroid tapering, use of steroid coverage during stress, choice of steroid-sparing agents, and biopsy practice. To promote guideline adherence and reduce practice variation, factors driving this variation should be assessed and resolved.

What is Known:• National and international guidelines are available to guide the management of childhood nephrotic syndrome.• Several aspects of the management of childhood nephrotic syndrome, including the choice of steroid-sparing drugs and biopsy practice, are controversial and often debated among physicians.What is New:• Significant practice variation is present in the management of childhood nephrotic syndrome in the Netherlands, especially in the treatment of FRNS, SDNS, and SRNS.• The recommendation on the steroid treatment of a first episode of nephrotic syndrome in the KDIGO guideline leaves room for interpretation and is likely the cause of substantial differences in steroid-tapering practices among Dutch pediatricians and pediatric nephrologists.
Quality of life among advanced cancer patients in Vietnam: a multicenter cross-sectional study
Authors: Huyen Bui Thanh , Van Anh Pham Thi , Duong Le Dai , The Than Ha Ngoc , Guo Ping , Van Thuc Pham , Khue Luong Ngoc , Krakauer Eric L. , Harding Richard
Published: February 2021

Purpose

Cancer is a leading cause of death in Vietnam. To maximize quality of life (QOL) at the end of life, valid and clinically useful instruments are needed to assess palliative care needs and the effectiveness of palliative care interventions.

Methods

We aimed to (i) determine psychometric properties of the Vietnamese version of the WHO abbreviated quality of life scale (WHOQOL-BREFVN) among advanced cancer patients, (ii) measure HR-QOL, and (iii) identify predictors of HR-QOL. We collected demographic, clinical, and HR-QOL data from stage III/IV adult cancer patients at two major Vietnamese cancer centers. We determined the internal consistency (Cronbach’s alpha), construct validity (confirmatory factor analysis (CFA)), and discriminant validity (known-groups comparison) of the Vietnamese instrument. HR-QOL was analyzed descriptively. Multinomial logistic regressions identified predictors of HR-QOL.

Results

A total of 825 patients participated. Missing data were completely at random (MCAR) (chi-square = 14.270, df = 14, p = 0.430). Cronbach’s alpha for all items was 0.904. CFA loadings of physical, psychological, social relationship, and environment domains onto HR-QOL were 0.81, 0.82, 0.34, and 0.75, respectively. Prediction of scores differed significantly by functional status (Wilks’ lambda = 0.784, chi-square = 197.546, df = 4, p < 0.01, correct prediction = 74.6%). HR-QOL was reported as very bad/bad by n = 188 patients (22.8%) and general health as very bad/bad by n = 430 (52.1%). Multinomial logistic regression (likelihood ratio test: chi-square = 35.494, df = 24, p = 0.061, correct prediction = 62.2%) and the Pearson correlations revealed worse HR-QOL was associated with inpatient status, high ECOG score, and having dependent children.

Conclusion

The Vietnamese version of the WHOQOL-BREF has excellent internal consistency reliability and sound construct and discriminant validity in advanced cancer patients. Advanced cancer inpatients, those with dependent children, and those with poorer physical function appear to have the greatest palliative care needs.
Mycoplasma pneumoniae may cause dyspnoea and hospitalisations in young healthy adults
Authors: Metsälä Riku , Ala-Korpi Solja , Rannikko Juha , Helminen Merja , Renko Marjo
Published: February 2021

Polymerase chain reaction (PCR)-based diagnostics for Mycoplasma pneumoniae (M. pneumoniae) from the respiratory tract has become widely available, but the interpretation of the results remains unclear. M. pneumoniae has been suggested to cause mainly mild and self-limiting infections or asymptomatic carriage. However, systematic analyses of the association between PCR results and clinical findings are scarce. This study aimed to clarify the clinical features of PCR-positive M. pneumoniae infections in a hospital setting. We reviewed 103 PCR-positive patients cared for in a university hospital during a 3-year period. Data on age, sex, health condition, acute symptoms, other pathogens found, laboratory and X-ray results and treatments were collected. Over 85% of the patients had a triad of typical symptoms: fever, cough and shortness of breath. Symptoms in the upper respiratory tract were rare. In 91% of the cases, M. pneumoniae was the only pathogen found. The highest incidence was found in the age group of 30–40 years, and 68% of the patients did not have any underlying diseases. Most patients were initially empirically treated with beta-lactam antibiotics and needed 2–4 changes in their treatment. Only 6% were discharged without an antibiotic effective against M. pneumoniae. This study shows that M. pneumoniae often led to hospitalisation and that patients needed appropriate antimicrobial treatment to recover. Mixed infections were rare, and situations that could be interpreted as carriage did not occur.
Impact of combined use of intraoperative MRI and awake microsurgical resection on patients with gliomas: a systematic review and meta-analysis
Authors: Tuleasca Constantin , Leroy Henri-Arthur , Peciu-Florianu Iulia , Strachowski Ondine , Derre Benoit , Levivier Marc , Schulder Michael , Reyns Nicolas
Published: February 2021

Microsurgical resection of primary brain tumors located within or near eloquent areas is challenging. Primary aim is to preserve neurological function, while maximizing the extent of resection (EOR), to optimize long-term neurooncological outcomes and quality of life. Here, we review the combined integration of awake craniotomy and intraoperative MRI (IoMRI) for primary brain tumors, due to their multiple challenges. A systematic review of the literature was performed, in accordance with the Prisma guidelines. Were included 13 series and a total number of 527 patients, who underwent 541 surgeries. We paid particular attention to operative time, rate of intraoperative seizures, rate of initial complete resection at the time of first IoMRI, the final complete gross total resection (GTR, complete radiological resection rates), and the immediate and definitive postoperative neurological complications. The mean duration of surgery was 6.3 h (median 7.05, range 3.8–7.9). The intraoperative seizure rate was 3.7% (range 1.4–6; I^2 = 0%, P heterogeneity = 0.569, standard error = 0.012, p = 0.002). The intraoperative complete resection rate at the time of first IoMRI was 35.2% (range 25.7–44.7; I^2 = 66.73%, P heterogeneity = 0.004, standard error = 0.048, p < 0.001). The rate of patients who underwent supplementary resection after one or several IoMRI was 46% (range 39.8–52.2; I^2 = 8.49%, P heterogeneity = 0.364, standard error = 0.032, p < 0.001). The GTR rate at discharge was 56.3% (range 47.5–65.1; I^2 = 60.19%, P heterogeneity = 0.01, standard error = 0.045, p < 0.001). The rate of immediate postoperative complications was 27.4% (range 15.2–39.6; I^2 = 92.62%, P heterogeneity < 0.001, standard error = 0.062, p < 0.001). The rate of permanent postoperative complications was 4.1% (range 1.3–6.9; I^2 = 38.52%, P heterogeneity = 0.123, standard error = 0.014, p = 0.004). Combined use of awake craniotomy and IoMRI can help in maximizing brain tumor resection in selected patients. The technical obstacles to doing so are not severe and can be managed by experienced neurosurgery and anesthesiology teams. The benefits of bringing these technologies to bear on patients with brain tumors in or near language areas are obvious. The lack of equipoise on this topic by experienced practitioners will make it difficult to do a prospective, randomized, clinical trial. In the opinion of the authors, such a trial would be unnecessary and would deprive some patients of the benefits of the best available methods for their tumor resections.
Understanding the Reasons for Deferring ART Among Patients Diagnosed Under the Same-Day-ART Policy in Johannesburg, South Africa
Authors: Onoya Dorina , Sineke Tembeka , Mokhele Idah , Bor Jacob , Fox Matthew P. , Miot Jacqui
Published: February 2021

We aimed to examine the correlates of antiretroviral therapy (ART) deferral to inform ART demand creation and retention interventions for patients diagnosed with HIV during the Universal Test and Treat (UTT) policy in South Africa. We conducted a cohort study enrolling newly diagnosed HIV-positive adults (≥ 18 years), at four primary healthcare clinics in Johannesburg between October 2017 and August 2018. Patients were interviewed immediately after HIV diagnosis, and ART initiation was determined through medical record review up to six-months post-test. ART deferral was defined as not starting ART six months after HIV diagnosis. Participants who were not on ART six-months post-test were traced and interviewed telephonically to determine reasons for ART deferral. Modified Poisson regression was used to evaluate correlates of six-months ART deferral. We adjusted for baseline demographic and clinical factors. We present crude and adjusted risk ratios (aRR) associated with ART deferral. Overall, 99/652 (15.2%) had deferred ART by six months, 20.5% men and 12.2% women. Baseline predictors of ART deferral were older age at diagnosis (adjusted risk ratio (aRR) 1.5 for 30–39.9 vs 18–29.9 years, 95% confidence intervals (CI): 1.0–2.2), disclosure of intentions to test for HIV (aRR 2.2 non-disclosure vs disclosure to a partner/spouse, 95% CI: 1.4–3.6) and HIV testing history (aRR 1.7 for  > 12 months vs < 12 months/no prior test, 95% CI: 1.0–2.8). Additionally, having a primary house in another country (aRR 2.1 vs current house, 95% CI: 1.4–3.1) and testing alone (RR 4.6 vs partner/spouse support, 95% CI: 1.2–18.3) predicted ART deferral among men. Among the 43/99 six-months interviews, women (71.4%) were more likely to self-report ART initiation than men (RR 0.4, 95% CI: 0.2–0.8) and participants who relocated within SA (RR 2.1 vs not relocated, 95% CI: 1.2–3.5) were more likely to still not be on ART. Under the treat-all ART policy, nearly 15.2% of study participants deferred ART initiation up to six months after the HIV diagnosis. Our analysis highlighted the need to pay particular attention to patients who show little social preparation for HIV testing and mobile populations.
Current recommendations for clinical surveillance and genetic testing in rhabdoid tumor predisposition: a report from the SIOPE Host Genome Working Group
Authors: Frühwald M. C. , Nemes K. , Boztug H. , Cornips M. C. A. , Evans D. G. , Farah R. , Glentis S. , Jorgensen M. , Katsibardi K. , Hirsch S. , Jahnukainen K. , Kventsel I. , Kerl K. , Kratz C. P. , Pajtler K. W. , Kordes U. , Ridola V. , Stutz E. , Bourdeaut F.
Published: February 2021

The rhabdoid tumor (RT) predisposition syndromes 1 and 2 (RTPS1 and 2) are rare genetic conditions rendering young children vulnerable to an increased risk of RT, malignant neoplasms affecting the kidney, miscellaneous soft-part tissues, the liver and the central nervous system (Atypical Teratoid Rhabdoid Tumors, ATRT). Both, RTPS1&2 are due to pathogenic variants (PV) in genes encoding constituents of the BAF chromatin remodeling complex, i.e. SMARCB1 (RTPS1) and SMARCA4 (RTPS2). In contrast to other genetic disorders related to PVs in SMARCB1 and SMARCA4 such as Coffin-Siris Syndrome, RTPS1&2 are characterized by a predominance of truncating PVs, terminating transcription thus explaining a specific cancer risk. The penetrance of RTPS1 early in life is high and associated with a poor survival. However, few unaffected carriers may be encountered. Beyond RT, the tumor spectrum may be larger than initially suspected, and cancer surveillance offered to unaffected carriers (siblings or parents) and long-term survivors of RT is still a matter of discussion. RTPS2 exposes female carriers to an ill-defined risk of small cell carcinoma of the ovaries, hypercalcemic type (SCCOHT), which may appear in prepubertal females. RT surveillance protocols for these rare families have not been established. To address unresolved issues in the care of individuals with RTPS and to propose appropriate surveillance guidelines in childhood, the SIOPe Host Genome working group invited pediatric oncologists and geneticists to contribute to an expert meeting. The current manuscript summarizes conclusions of the panel discussion, including consented statements as well as non-evidence-based proposals for validation in the future.