bluuebunny/crossref_metadata_2025 huggingface dataset:
Global rheophytes data set: angiosperms and gymnosperms
Authors: Costa Laís Mara Santana , Goetze Márcia , Rodrigues Arthur Vinícius , Seger Guilherme Dubal dos Santos , Bered Fernanda
Published: April 2020

The term rheophyte describes a biological group of flood‐tolerant plants that are confined to the beds of swift‐running streams and rivers in nature and grow up to flood level, but not beyond the reach of regularly occurring flash floods. Although over 35 yr have passed since the first global census of rheophytes, no updates have been recorded regarding the number of taxa in this biological group in seed plants. Therefore, the present work aimed to (1) review the main topics associated with rheophytism (e.g., morphological characteristics, genetic studies, geographic distribution, conservation, and evolutionary aspects); (2) provide an updated checklist of rheophytes distributed around the world considering the two main groups in seed plants (gymnosperms and angiosperms); (3) demonstrate the distribution of rheophytism in the angiosperm phylogeny; and (4) estimate the geographical distribution and richness of selected taxa on the world map for the first time. All data compiled for the present study originated from a search of peer‐reviewed articles, secondary literature (theses, dissertations, reports, books, and floras), and electronic facilities. We compiled a data set composed of four taxa in gymnosperms (Podocarpaceae family) and 1,368 taxa (including obligate, facultative, and unclassified rheophytes) distributed in 114 families and 508 genera in angiosperms. Most of the studied taxa belong to eudicotyledons (72.81%), while 1.46% belong to magnoliids, and 25.73% belong to monocotyledons. The families with the highest number of taxa in descending order are Podostemaceae, Araceae, Myrtaceae, Rubiaceae, Asteraceae, Apocynaceae, Arecaceae, Fabaceae, Phyllanthaceae, and Poaceae. Of the 114 families plotted in angiosperm phylogeny, at least 80 harbor obligate rheophytes. The geographical distribution of rheophytes in angiosperms, as expected based on the first census of this biological group, is mainly in the tropical and subtropical regions. The high richness of rheophytic taxa was mostly found in southern Mexico, southern China, Borneo, and northern and eastern Australia. In contrast, the geographical distribution of rheophytes in gymnosperms is restricted to New Caledonia and Tasmania. The present study will help to advance knowledge regarding the diversity of rheophytes in angiosperms and gymnosperms while drawing attention to this biological group, which has often been overlooked. There are no copyright restrictions. Please cite this data paper when the data are used in publications and teaching events.
Behavioral niche partitioning reexamined: Do behavioral differences predict dietary differences in warblers?
Authors: Kent Cody M. , Sherry Thomas W.
Published: April 2020

Behavioral niche partitioning is an important and widely assumed mechanism for the coexistence of ecologically similar species. Here we assessed this mechanism by testing its core assumption, that evolved differences in foraging behavior correspond with differences in resources consumed. We combined data on foraging behavior, available prey, and observed diets of five coexisting species of New World wood warblers (Parulidae), a system that has been foundational to our understanding of behavioral niche partitioning. Consistent with past work, we found that the five species differed markedly in their foraging behavior, enough that some species pairs hardly overlapped at all in foraging microhabitat. In contrast, the birds overlapped highly in diet, while exhibiting small, interpretable differences in resource use. The high overlap resulted mostly from all five species consuming numerous ants, a prey source that moves between microhabitats. To test the prediction that the large differences in foraging behavior explain the small dietary differences, we generated expected diets based on available prey and foraging microhabitat use. Consistent with niche partitioning as a coexistence mechanism, we found that the small dietary differences were explained by a combination of foraging microhabitat and available prey, but this pattern was driven by only a small number of prey taxa. Thus, we found mixed support for behavioral niche partitioning. Our results indicate that foraging behavior among these bird species helps explain subtle variation in diet, potentially facilitating coexistence. However, our results also revealed a weak relationship between foraging behavior and resource partitioning. Consequently, studies that rely solely on foraging behavior may greatly overestimate the degree of niche differentiation leading to erroneous conclusions. Overall, this study calls into question how and why these differences in foraging behavior evolved, and what role if any they play in facilitating coexistence.
Use of sacubitril/valsartan in non‐compaction cardiomyopathy: a case report
Authors: Bonatto Marcely Gimenes , Albanez Rodrigo , Salemi Vera Maria Cury , Moura Lídia Zytynski
Published: April 2020

The use of sacubitril/valsartan significantly reduces death or hospitalization in patients with ejection fraction < 40%. There is no study evaluating this drug effects in non‐compaction cardiomyopathy (NCCM) individuals.

The aim of this article is to report a case of a patient with NCCM initially refractory to gold standard treatment and afterwards treated with sacubitril/valsartan and its improvements. This is a case report of a 48‐year‐old woman, presenting with NCCM heart failure, who had received standard guideline‐directed medical therapy for 18 months without any improvement in clinical and echocardiographic parameters. After that period, sacubitril/valsartan was initiated. After 18 months of refractory usage of guideline‐directed medical therapy, sacubitril/valsartan was started, and significant change in functional class (III to I) and important ventricular remodelling were achieved with an improvement of 29% in the ejection fraction, reduction of 7 mm in ventricular diastolic diameter, and mild to none mitral valve functional regurgitation.

In this case report, sacubitril/valsartan use was associated with improvement of echocardiographic and clinical parameters in a patient with NCCM.
Using seasonal temperature difference in underground surrounding rocks to cooling ventilation airflow: A conceptual model and simulation study
Authors: Zhu Shuai , Cheng Jianwei , Song Wanting , Borowski Marek , Zhang Yongjun , Yu Baohai , Wang Yue , Qi Chang , Tukkaraja Purushotham , Hua Gang , Xu Yonggang , Ghosh Apurna , Wang Chao , Peng Yun
Published: April 2020

With the gradual development of deep mining, heat hazard has become an increasingly prominent problem, which poses a great threat to the coal mine production. In order to reduce the heat hazard effectively, it is necessary to investigate the temperature distribution characteristics and regulation of the surrounding rock of the mine tunnels. Based on field measurement data from a Chinese coal mine, the present study probes into the dynamic law of periodic variation of the heat regulation circle (HRC) in surrounding rocks, which is featured by the serious heat hazard, and further reveals the evolution characteristics of the physical range of HRC and the temperature field distribution. By analyzing field data, it can be concluded that a total of five typical distribution models of HRC of surrounding rocks are summarized. Influencing factors concerning thermophysical properties, thermal environment conditions of the stratum, and boundary conditions play important roles and affect the formation of such five models. A mathematical model of heat regulation and energy storage of surrounding rocks in a mine tunnel is proposed. Calculations of air temperature–regulating capability of HRC and evaluating its cooling storage capacity are also demonstrated. Using the HRC in rocks for cooling underground ventilation may be a good and green engineering practice for coal mines.
Unanswered Questions: Hereditary breast and gynecological cancer risk assessment in transgender adolescents and young adults
Authors: Sutherland Nykole , Espinel Whitney , Grotzke Marissa , Colonna Sarah
Published: April 2020

Transgender (TG) individuals have higher rates of mortality associated with cancer diagnoses, in part due to avoidance of gender‐assigned cancer screenings resulting in later stages at diagnosis. Knowledge about the risks of breast or gynecological cancer in TG and nonbinary (NB) persons receiving gender‐affirming hormone therapy is limited. Even less information exists regarding the subset of individuals with genetic predisposition for these malignancies. We performed a retrospective literature review of studies from the last 15 years on breast cancer rates and identified risks in TG persons. An accumulating body of data on breast cancer incidence in TG persons suggests higher than previously believed rates of breast cancer in TG women compared with cisgender men and risk correlating with duration of hormone use. Few studies have examined other cancer risks in TG populations. To date, only three publications address the association withBRCA1/2mutation presence and breast cancer incidence in TG persons. Meanwhile, there is growing awareness and social acceptance of TG/NB identities coupled with recognition of gender dysphoria at increasingly earlier ages. No information directly addressing cancer risk counseling in TG/NB adolescents and young adults with a family history of cancer or hereditary cancer syndrome exists. Whether the presence of a known genetic predisposition or strong family cancer history may affect cancer risk in these populations is unknown, leading to significant gaps in clinicians’ ability to accurately and appropriately estimate cancer risks and counsel those with genetic predisposition on the risks/benefits associated with surgical options and the initiation, duration, and dosing of gender‐affirming hormone therapies. A series of three cases illustrates the utility of cancer risk assessment and genetic testing in TG/NB adolescents and young adults, and the unique challenges and unanswered questions that are encountered in the process.
Prediction of outcome of treatment of acute severe ulcerative colitis using principal component analysis and artificial intelligence
Authors: Ghoshal Uday C , Rai Sushmita , Kulkarni Akshay , Gupta Ankur
Published: April 2020

Background and Aim

About 15% patients with acute severe ulcerative colitis (UC) fail to respond to medical treatment and may require colectomy. An early prediction of response may help the treating team and the patients and their family to prepare for alternative treatment options.

Methods

Data of 263 patients (mean age 37.0 ± 14.0‐years, 176, 77% male) with acute severe UC admitted during a 12‐year period were used to study predictors of response using univariate analysis, multivariate linear principal component analysis (PCA), and nonlinear artificial neural network (ANN).

Results

Of 263 patients, 231 (87.8%) responded to the initial medical treatment that included oral prednisolone (n = 14, 5.3%), intravenous (IV) hydrocortisone (n = 238, 90.5%), IV cyclosporine (n = 9, 3.4%), and inflixmab (n = 2, 0.7%), and 28 (10.6%) did not respond and the remaining 4 (1.5%) died, all of whom did were also nonresponders. Nonresponding patients had to stay longer in the hospital and died more often. On univariate analysis, the presence of complications, the need for use of cyclosporin, lower Hb, platelets, albumin, serum potassium, and higher C‐reactive protein were predictors of nonresponse. Hb and albumin were strong predictive factors on both PCA and ANN. Though the nonlinear modeling using ANN had a good predictive accuracy for the response, its accuracy for predicting nonresponse was lower.

Conclusion

It is possible to predict the response to medical treatment in patients with UC using linear and nonlinear modeling technique. Serum albumin and Hb are strong predictive factors.
Automated Detection of Vestibular Schwannoma Growth Using a Two‐Dimensional U‐Net Convolutional Neural Network
Authors: George‐Jones Nicholas A. , Wang Kai , Wang Jing , Hunter Jacob B.
Published: April 2020

Objectives/Hypothesis

To determine if an automated vestibular schwannoma (VS) segmentation model has comparable performance to using the greatest linear dimension to detect growth.

Study Design

Case‐control Study.

Methods

Patients were selected from an internal database who had an initial gadolinium‐enhanced T1‐weighted magnetic resonance imaging scan and a follow‐up scan captured at least 5 months later. Two observers manually segmented the VS to compute volumes, and one observer's segmentations were used to train a convolutional neural network model to automatically segment the VS and determine the volume. The results of automatic segmentation were compared to the observer whose measurements were not used in model development to measure agreement. We then examined the sensitivity, specificity, and area under the receiver‐operating characteristic curve (AUC) to compare automated volumetric growth detection versus using the greatest linear dimension. Growth detection determined by the external observer's measurements served as the gold standard.

Results

A total of 65 patients and 130 scans were studied. The automated method of segmentation demonstrated excellent agreement with the observer whose measurements were not used for model development for the initial scan (interclass correlational coefficient [ICC] = 0.995; 95% confidence interval [CI]: 0.991‐0.997) and follow‐up scan (ICC = 0.960; 95% CI: 0.935–0.975). The automated method of segmentation demonstrated increased sensitivity (72.2% vs. 63.9%), specificity (79.3% vs. 69.0%), and AUC (0.822 vs. 0.701) compared to using the greatest linear dimension for growth detection.

Conclusions

In detecting VS growth, a convolutional neural network model outperformed using the greatest linear dimension, demonstrating a potential application of artificial intelligence methods to VS surveillance.

Level of Evidence

4 Laryngoscope, 131:E619–E624, 2021
Detailed analysis of the impact of surgeon and hospital volume in microsurgical breast reconstruction
Authors: Reid Chris M. , Parmeshwar Nisha , Brandel Michael G. , Crisera Christopher A. , Herrera Fernando A. , Suliman Ahmed S.
Published: April 2020

Background

Prior investigations of microsurgical breast reconstruction have not distinguished the effects of surgeon versus hospital volume and failed to address the effect of patient clustering. Our data‐driven analysis aims to determine the impacts of surgeon and hospital volume on outcomes of microsurgical breast reconstruction.

Methods

Nationwide Inpatient Sample (NIS) data from 2008 to 2011 was analyzed for patients who underwent microsurgical breast reconstruction. Volume‐outcome relationships were analyzed with restricted cubic spline analysis. A multivariable mixed‐effects logistic regression was used to account for patient clustering effect.

Results

A total of 5,404 NIS patients met inclusion criteria. High‐volume (HV) surgeons had a 59% decrease in the risk of inpatient complications, which became non‐significant after clustering correction. For HV hospitals, there was a 47% decrease in the risk of inpatient complications (odds ratio = 0.53; 95% confidence intervals 0.30, 0.91; p = 0.021) that was statistically significant with the clustering adjustment. Neither the volume‐cost relationship for surgeons nor hospitals remained statistically significant after accounting for clustering.

Conclusions

Hospital volume plays a significant impact on outcomes in microsurgical breast reconstruction, while surgeon volume has comparatively not shown to be similarly impactful. The complexity of care related to microsurgical breast reconstruction warrants equally complex and engineered health systems.
The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures
Authors: Shetty Kanaka D. , Robbins Michael , Aragaki Dixie , Basu Aashna , Conlon Craig , Dworsky Michael , Benner Douglas , Seelam Rachana , Nuckols Teryl K.
Published: April 2020

Introduction

The quality of electrodiagnostic tests may influence treatment decisions, particularly regarding surgery, affecting health outcomes and health‐care expenditures.

Methods

We evaluated test quality among 338 adults with workers’ compensation claims for carpal tunnel syndrome. Using simulations, we examined how it influences the appropriateness of surgery. Using regression, we evaluated associations with symptoms and functional limitations (Boston Carpal Tunnel Questionnaire), overall health (12‐item Short Form Health Survey version 2), actual receipt of surgery, and expenditures.

Results

In simulations, suboptimal quality tests rendered surgery inappropriate for 99 of 309 patients (+32 percentage points). In regression analyses, patients with the highest quality tests had larger declines in symptoms (−0.50 point; 95% confidence interval [CI], −0.89 to −0.12) and functional impairment (−0.42 point; 95% CI, −0.78 to −0.06) than patients with the lowest quality tests. Test quality was not associated with overall health, actual receipt of surgery, or expenditures.

Discussion

Test quality is pivotal to determining surgical appropriateness and associated with meaningful differences in symptoms and function.
Histone acetyltransferase inhibition rescues differentiation of emerin‐deficient myogenic progenitors
Authors: Bossone Katherine A. , Ellis Joseph A. , Holaska James M.
Published: April 2020

Introduction

Emery‐Dreifuss muscular dystrophy (EDMD) is a disease characterized by skeletal muscle wasting, major tendon contractures, and cardiac conduction defects. Mutations in the gene encoding emerin cause EDMD1. Our previous studies suggested that emerin activation of histone deacetylase 3 (HDAC3) to reduce histone 4‐lysine 5 (H4K5) acetylation (ac) is important for myogenic differentiation.

Methods

Pharmacological inhibitors (Nu9056, L002) of histone acetyltransferases targeting acetylated H4K5 were used to test whether increased acetylated H4K5 was responsible for the impaired differentiation seen in emerin‐deficient myogenic progenitors.

Results

Nu9056 and L002 rescued impaired differentiation in emerin deficiency. SRT1720, which inhibits the nicotinamide adenine dinucleotide (NAD)+‐dependent deacetylase sirtuin 1 (SIRT1), failed to rescue myotube formation.

Discussion

We conclude that emerin regulation of HDAC3 activity to affect H4K5 acetylation dynamics is important for myogenic differentiation. Targeting H4K5ac dynamics represents a potential new strategy for ameliorating the skeletal muscle wasting seen in EDMD1.
Impact of Traumatic Brain Injury on Clinical Institute Withdrawal Assessment Use in Trauma Patients: A Descriptive Study
Authors: Carter William , Truong Phong , Sima Adam P , Hupe Jessica , Newman James , Ebadi Ali
Published: April 2020

Background

Alcohol withdrawal syndrome (AWS) and traumatic brain injury (TBI) present with similar signs and symptoms, yet their treatment strategies differ greatly. AWS treatment includes the Clinical Institute Withdrawal Assessment (CIWA) protocol, which grades withdrawal signs and symptoms. A major purpose of CIWA is to guide the addition and titration of central nervous system (CNS) depressants, most commonly benzodiazepines. Conversely, best practice is to avoid these same CNS depressants in the setting of TBI. Thus, patients with TBI presenting with AWS risk may receive undesirable interventions that could worsen outcome.

Objective

To describe the relationship of TBI diagnosis with CIWA protocol scores and intervention implementation.

Design

Retrospective cohort observational study.

Setting

Single university‐based, level one trauma center.

Patients

Three hundred seventy‐five patients with head trauma or AWS classification, identified through the trauma center's trauma registry.

Interventions

CIWA protocol and related medication use.

Main Outcome Measures

Frequency of elevated CIWA score, length of CIWA administration, and medication administration incidence were abstracted from patients' medical records.

Results

The percentage of elevated CIWA scores increased significantly with TBI severity, from 4.5%(0‐60) in the No TBI group, up to 12.5% (0‐36) in the Mild TBI group, 27.1% (0‐57) in the Moderate TBI group, and 50.0% (14‐77) in the Severe TBI group. Nominally, lorazepam use showed a similar pattern of escalation with TBI severity, but it did not reach statistical significance. Haloperidol use did significantly escalate with higher TBI severity. No group differences were observed for total lorazepam equivalents or length on the CIWA protocol.

Conclusions

TBI diagnosis and higher TBI severity level correlate with higher CIWA scores, but neither increased nor decreased benzodiazepine usage was observed. Antipsychotic use did escalate with TBI diagnosis and severity. The risks versus benefits of minimizing benzodiazepines in patients with TBI who are at risk for AWS warrant future study.
Generic Construction of the Standard Model Gauge Group and Matter Representations in F‐theory
Authors: Taylor Washington , Turner Andrew P.
Published: April 2020

We describe general classes of 6D and 4D F‐theory models with gauge group . We prove that this set of constructions gives all possible consistent 6D supergravity theories with no tensor multiplets having this gauge group and the corresponding generic matter representations, which include those of the MSSM. We expect, though do not prove, that these models are similarly generic for 6D theories with tensor multiplets and for 4D supergravity theories. The largest class of these constructions come from deforming an underlying geometry with gauge symmetry .
Comparative Study of Blue Phosphorus–MoTe2/WTe2 van der Waals Heterostructures on Electronic Structures and Band Realignment
Authors: Li Honglin , Li Dongmei , Luo Haijun
Published: April 2020

Herein, blue phosphorus (BP) and monolayer MoTe2/WTe2 are blended to obtain type‐II band alignment heterostructures based on the density functional theory (DFT). The first‐principles calculations are performed to explore the interlayer coupling effects and the bands realignment of BP–MoTe2/WTe2 when the external strain is imposed. It is proved that the bandgap variation of BP–MoTe2/WTe2 heterostructures exhibits interesting responses to the applied external strain compared with freestanding structures, and an obvious promoted light adsorption in solar spectrum range is observed in BP–MoTe2. The band structures reveal that the photoinduced electrons/holes are transferred to the conduction/valence band of BP from the valence/conduction band of MoTe2/WTe2, respectively. The calculations also confirm that BP–MoTe2 is more suitable for solar energy utilization in comparison with BP–WTe2, because it can realize a better response to solar energy and a prominent carriers’ separation. In brief, a convictive theoretical approach is presented to reveal the evolution of water splitting activity achieved by BP–MoTe2/WTe2 heterostructures.
Deep Subwavelength Light Confinement in Disordered Bismuth Nanorods as a Linearly Thermal‐Tunable Metamaterial
Authors: Soydan Mahmut Can , Ghobadi Amir , Yildirim Deniz Umut , Erturk Vakur Behcet , Ozbay Ekmel
Published: April 2020

Materials with a tunable optical response that can be controllably tailored using external stimuli excitation have undergone considerable research effort for the development of active optical devices, such as thermo‐optical modulators. Although bismuth (Bi) nanodots, embedded into glass matrices, have been proven to have a thermo‐optical response, the recyclability of the structure in solid–liquid phase transitions is a major challenge. Herein, a facile and lithography‐free fabrication method is proposed to realize densely packed stand‐alone Bi nanorods (NRs), with deep subwavelength gaps and a resonance at the midinfrared range (λ ≅ 4.462 μm). Owing to these ultrasmall gaps that support lossy Mie‐like resonances, strong field confinement is achieved, and the resonance wavelength exhibits great sensitivity to temperature, as the thermal sensitivity reaches as high as 1.0316 nm °C−1. This operation is conducted in the moderate temperature interval of 25–85 °C, which is far from the melting point of Bi. Overall, our simple, robust, and high‐performance device is highly promising for realizing optical switches, thermo‐optic modulators, and infrared camouflage.
Patient‐specific titanium onlay eminoplasty: A novel protocol for treatment of recurrent temporomandibular joint dislocation
Authors: Ihab Rania , Mounir Ragia , Mounir Mohamed
Published: April 2020

Purpose

The present study aimed to introduce an accurate, less morbid and less time‐consuming approach that secures the stability of the condylar movement's range for treating recurrent TMJ dislocations.

Methods

Five patients were treated by surgical implantation of bilateral patient‐specific titanium onlay eminoplasties; each implant was virtually designed using specific software and milled from grade V titanium blocks. Intraoperatively, each implant was fixed with three mini‐screws along the lateral aspect of the zygomatic arch.

Results

The follow‐up period ranged from 6 months to 1 year, which targeted the assessment of the maximal incisal mouth opening (MIO). The mean preoperative maximal incisal mouth opening figured (47.8 mm) vs (33.2 mm) for that recorded postoperatively. One patient reported postoperative slight unilateral pain that was gradually diminished through the first postoperative month.

Conclusion

The innovated patient‐specific titanium eminoplasty represents an accurate alternative for treatment of chronic recurrent TMJ dislocation.
A pre-investigational new drug study of lung spheroid cell therapy for treating pulmonary fibrosis
Authors: Cores Jhon , Dinh Phuong-Uyen C. , Hensley Taylor , Adler Kenneth B. , Lobo Leonard J. , Cheng Ke
Published: April 2020

Idiopathic pulmonary fibrosis is a lethal interstitial lung disease with unknown etiology, no cure, and few treatment options. Herein, a therapy option is presented that makes use of a heterogeneous population of lung cells, including progenitor cells and supporting cells lines, cultured in adherent and suspension conditions, the latter of which induces spontaneous spheroid formation. Within these spheroids, progenitor marker expression is augmented. The cells, called lung spheroid cells, are isolated from fibrotic lungs, expanded, and delivered in single cell suspensions into rat models of pulmonary fibrosis via tail-vein injections. Two bleomycin-induced fibrotic rat models are used; a syngeneic Wistar-Kyoto rat model, treated with syngeneic cells, and a xenogeneic nude rat model, treated with human cells. The first objective was to study the differences in fibrotic progression in the two rat models after bleomycin injury. Nude rat fibrosis formed quickly and extended for 30 days with no self-resolution. Wistar-Kyoto rat fibrosis was more gradual and began to decrease in severity between days 14 and 30. The second goal was to find the minimum effective dose of cells that demonstrated safe and effective therapeutic value. The resultant minimum effective therapeutic dose, acquired from the nude rat model, was 3 × 106 human cells. Histological analysis revealed no evidence of tumorigenicity, increased local immunological activity in the lungs, or an increase in liver enzyme production. These data demonstrate the safety and efficacy of lung spheroid cells in their application as therapeutic agents for pulmonary fibrosis, as well as their potential for clinical translation.

Significance statement This study helps set the stage for the transition of this cellular therapy paradigm from rodent models to clinical trials in a number of ways. The transbronchial acquisition of the lung spheroid cells is a minimally invasive strategy suitable for the clinic and preferable to thoracoscopic alternatives; the doses used in this study are scalable, manufacturable, and comparable to currently existing clinical trial efforts targeting other lung diseases; and the intravenous route of administration used is applicable to clinical trials, as it presents an easy, quick, and patient-friendly way to administer the treatment.
Esophageal atresia and tracheoesophageal fistula: prenatal sonographic manifestation from early to late pregnancy
Authors: Kassif E. , Weissbach T. , Kushnir A. , Shust‐Barequet S. , Elkan‐Miller T. , Mazkereth R. , Weissmann‐Brenner A. , Achiron R. , Weisz B.
Published: April 2020

Objective

Esophageal atresia and/or tracheoesophageal fistula (EA/TEF) remains one of the most frequently missed congenital anomalies prenatally. The aim of our study was to elucidate the sonographic manifestation of EA/TEF throughout pregnancy.

Methods

This was a retrospective study of data obtained from a tertiary center over a 12‐year period. The prenatal ultrasound scans of fetuses with EA/TEF were assessed to determine the presence and timing of detection of three principal signs: small/absent stomach and worsening polyhydramnios, both of which were considered as ‘suspected’ EA/TEF, and esophageal pouch, which was considered as ‘detected’ EA/TEF. We assessed the yield of the early (14–16 weeks' gestation), routine mid‐trimester (19–26 weeks) and third‐trimester (≥ 27 weeks) anomaly scans in the prenatal diagnosis of EA/TEF.

Results

Seventy‐five cases of EA/TEF with available ultrasound images were included in the study. A small/absent stomach was detected on the early anomaly scan in 3.6% of fetuses scanned, without a definitive diagnosis. On the mid‐trimester scan, 19.4% of scanned cases were suspected and 4.3% were detected. On the third‐trimester anomaly scan, 43.9% of scanned cases were suspected and 33.9% were detected. An additional case with an esophageal pouch was detected on magnetic resonance imaging (MRI) in the mid‐trimester and a further two were detected on MRI in the third trimester. In total, 44.0% of cases of EA/TEF in our cohort were suspected, 33.3% were detected and 10.7% were suspected but, eventually, not detected prenatally.

Conclusions

Prenatal diagnosis of EA/TEF on ultrasound is not feasible before the late second trimester. A small/absent stomach may be visualized as early as 15 weeks' gestation. Polyhydramnios does not develop before the mid‐trimester. An esophageal pouch can be detected as early as 22 weeks on a targeted scan in suspected cases. The detection rates of all three signs increase with advancing pregnancy, peaking in the third trimester. The early and mid‐trimester anomaly scans perform poorly as a screening and diagnostic test for EA/TEF. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
Generalized ’t Hooft anomalies on non-spin manifolds
Authors: Anber Mohamed M. , Poppitz Erich
Published: April 2020

Abstract

We study the mixed anomaly between the discrete chiral symmetry and general baryon-color-flavor (BCF) backgrounds in SU(N

c
) gauge theories with N

f
flavors of Dirac fermions in representations ℛ
c
of N -ality n

c
, formulated on non-spin manifolds. We show how to study these theories on ℂℙ2 by turning on general BCF fluxes consistent with the fermion transition functions. We consider several examples in detail and argue that matching the anomaly on non-spin manifolds places stronger constraints on the infrared physics, compared to the ones on spin manifolds (e.g. 𝕋4). We also show how to consistently formulate various chiral gauge theories on non-spin manifolds.
Scattering amplitudes in $$ \mathcal{N} $$ = 3 supersymmetric SU(N) Chern-Simons-matter theory at large N
Authors: Inbasekar Karthik , Janagal Lavneet , Shukla Ashish
Published: April 2020

Abstract

We study

$$ \mathcal{N} $$

N

= 3 supersymmetric Chern-Simons-matter theory coupled to matter in the fundamental representation of SU(N). In the ’t Hooft large N limit, we compute the exact 2 → 2 scattering amplitudes of the fundamental scalar superfields to all orders in the ’t Hooft coupling λ. Our computations are presented in

$$ \mathcal{N} $$

N

= 1 superspace and make significant use of the residual SO(2)
R
symmetry in order to solve for the exact four-point correlator of the scalar superfields. By taking the on-shell limit, we are able to extract the exact 2 → 2 scattering amplitudes of bosons/fermions in the symmetric, anti-symmetric and adjoint channels of scattering. We find that the scattering amplitude of the

$$ \mathcal{N} $$

N

= 3 theory in the planar limit is tree-level exact to all orders in the ’t Hooft coupling λ. The result is consistent with the conjectured bosonization duality and is expected to have enhanced symmetry structures such as dual superconformal symmetry and Yangian symmetry.
Transverse collective modes in interacting holographic plasmas
Authors: Baggioli Matteo , Gran Ulf , Tornsö Marcus
Published: April 2020

Abstract

We study in detail the transverse collective modes of simple holographic models in presence of electromagnetic Coulomb interactions. We render the Maxwell gauge field dynamical via mixed boundary conditions, corresponding to a double trace deformation in the boundary field theory. We consider three different situations: (i) a holographic plasma with conserved momentum, (ii) a holographic (dirty) plasma with finite momentum relaxation and (iii) a holographic viscoelastic plasma with propagating transverse phonons. We observe two interesting new features induced by the Coulomb interactions: a mode repulsion between the shear mode and the photon mode at finite momentum relaxation, and a propagation-to-diffusion crossover of the transverse collective modes induced by the finite electromagnetic interactions. Finally, at large charge density, our results are in agreement with the transverse collective mode spectrum of a charged Fermi liquid for strong interaction between quasi-particles, but with an important difference: the gapped photon mode is damped even at zero momentum. This property, usually referred to as anomalous attenuation, is produced by the interaction with a quantum critical continuum of states and might be experimentally observable in strongly correlated materials close to quantum criticality, e.g. in strange metals.
Resummed predictions for jet-resolution scales in multijet production in e+e− annihilation
Authors: Baberuxki Nick , Preuss Christian T , Reichelt Daniel , Schumann Steffen
Published: April 2020

Abstract

We present for the first time resummed predictions at NLO + NLL′ accuracy for the Durham jet-resolution scales y

n,n+1 in multijet production in e
+
e

−
collisions. Results are obtained using an implementation of the well known Caesar formalism within the Sherpa framework. For the 4-, 5- and 6-jet resolutions we discuss in particular the impact of subleading colour contributions and compare to matrix-element plus parton-shower predictions from Sherpa and Vincia.
War trauma in Homer’s Iliad: a trauma registry perspective
Authors: Chicco Maria , Tebala Giovanni D.
Published: April 2020

Purpose

Homer’s Iliad reports detailed descriptions of war traumas, with precise anatomical references, so that the Iliad can be considered the first trauma registry. We aimed to analyse the Iliad from the perspective of a modern trauma registry: that is, to find historical and local prognostic factors through the epidemiological study of the reported traumas.

Methods

Two different editions of Homer’s Iliad—one in English and one in Italian—were thoroughly studied and epidemiological data were statistically analysed.

Results

148 reports of human traumas were analysed. The majority of traumas (73.6%) involved Trojan warriors, with spears being the most frequent wounding agent (71%). Overall mortality was 84.5% and was higher in the Trojan field (90.8% vs 61.5%). Despite the high mortality, median New Injury Severity Score (NISS) was low, probably due to high prevalence of penetrating mono-systemic trauma. Median NISS was higher in the Trojan group. Compared to the Achaeans, the Trojans had more torso injuries, whereas Achaeans had more injuries to limbs and superficial tissues. However, in both fields, head and neck were more frequently injured.

Conclusions

Homer’s Iliad gives us an interesting insight into war traumas during the siege of Troy. The reported higher mortality within the Trojan army can be explained not only by poetic reasons but also by different military skills.
Characterising the prognostic potential of HLA-DR during colorectal cancer development
Authors: Dunne Margaret R. , Phelan James J. , Michielsen Adriana J. , Maguire Aoife A. , Dunne Cara , Martin Petra , Noonan Sinead , Tosetto Miriam , Geraghty Robert , Fennelly David , Sheahan Kieran , Ryan Elizabeth J. , O’Sullivan Jacintha
Published: April 2020

HLA-DR, an MHC class II molecule that mediates antigen presentation, is a favourable prognostic indicator in colorectal cancer (CRC). However, the dynamics and location of HLA-DR expression during CRC development are unclear. We aimed to define HLA-DR expression by immunohistochemistry in colorectal epithelium and stromal tissue at different stages of cancer development, assessing non-neoplastic colorectal adenocarcinoma–adjacent tissue, adenomas and carcinoma tissues, and to associate HLA-DR levels with clinical outcomes. Patients with higher than median HLA-DR expression survived at least twice as long as patients with lower expression. This association was significant for HLA-DR staining in the colorectal carcinoma epithelium (n = 152, p = 0.011, HR 1.9, 95% CI 1.15–3.15) and adjacent non-neoplastic epithelium (n = 152, p < 0.001, HR 2.7, 95% CI 1.59–4.66), but not stroma. In stage II cases, however, the prognostic value of HLA-DR expression was significant only in adjacent non-neoplastic tissues, for both epithelium (n = 63, p = 0.015, HR 3.6, 95% CI 1.279–10.25) and stroma (n = 63, p = 0.018, HR 5.07, 95% CI 1.32–19.49). HLA-DR was lower in carcinoma tissue compared to matched adenomas (n = 35), in epithelium (p < 0.01) and stroma (p < 0.001). HLA-DR was further reduced in late-stage carcinoma (n = 101) compared to early stage (n = 105), in epithelium (p < 0.001) and stroma (p < 0.01). HLA-DR expression was lower (p < 0.05) in the adjacent non-neoplastic epithelium of patients with cancer recurrence. We demonstrate a progressive loss of HLA-DR in epithelial and stromal tissue compartments during CRC development and show prognostic ability in carcinoma–adjacent non-neoplastic tissues, highlighting the importance of this molecule in the anti-cancer immune response. These findings may have wider implications for immunotherapeutic interventions.
Atmospheric River Signatures in Radiosonde Profiles and Reanalyses at the Dronning Maud Land Coast, East Antarctica
Authors: Gorodetskaya Irina V. , Silva Tiago , Schmithüsen Holger , Hirasawa Naohiko
Published: April 2020

Atmospheric rivers (ARs) are an important component of the hydrological cycle linking moisture sources in lower latitudes to the Antarctic surface mass balance. We investigate AR signatures in the atmospheric vertical profiles at the Dronning Maud Land coast, East Antarctica, using regular and extra radiosonde measurements conducted during the Year of Polar Prediction Special Observing Period November 2018 to February 2019. Prominent AR events affecting the locations of Neumayer and Syowa cause a strong increase in specific humidity extending through the mid-troposphere and a strong low-level jet (LLJ). At Neumayer, the peak in the moisture inversion (up to 4 g kg−1) is observed between 800 and 900 hPa, while the LLJ (up to 32 m s−1) is concentrated below 900 hPa. At Syowa the increase in humidity is less pronounced and peaks near the surface, while there is a substantial increase in wind speed (up to 40 m s−1) between 825 and 925 hPa. Moisture transport (MT) within the vertical profile during the ARs attains a maximum of 100 g kg−1 m s−1 at both locations, and is captured by both ERA-Interim and ERA5 reanalysis data at Neumayer, but is strongly underestimated at Syowa. Composites of the enhanced MT events during 2009-19 show that these events represent an extreme state of the lower-tropospheric profile compared to its median values with respect to temperature, humidity, wind speed and, consequently, MT. High temporal- and vertical-resolution radiosonde observations are important for understanding the contribution of these rare events to the total MT towards Antarctica and improving their representation in models.
Partitioning uncertainty components of mean climate and climate change in a large ensemble of European regional climate model projections
Authors: Christensen Ole B. , Kjellström Erik
Published: April 2020

A study of seasonal mean temperature, precipitation, and wind speed has been performed for a set of 19 global climate model (GCM) driven high-resolution regional climate model (RCM) simulations forming a complete 5 × 4 GCM × RCM matrix with only one missing simulation. Differences between single simulations and between groups of simulations forced by a specific GCM or a specific RCM are identified. With the help of an analysis of variance (ANOVA) we split the ensemble variance into linear GCM and RCM contributions and cross terms for both mean climate and climate change for the end of the current century according to the RCP8.5 emission scenario. The results document that the choice of GCM generally has a larger influence on the climate change signal than the choice of RCM, having a significant influence for roughly twice as many points in the area for the fields investigated (temperature, precipitation and wind speed). It is also clear that the RCM influence is generally concentrated close to the eastern and northern boundaries and in mountainous areas, i.e., in areas where the added surface detail of e.g. orography, snow and ice seen by the RCM is expected to have considerable influence on the climate, and in areas where the air in general has spent the most time within the regional domain. The analysis results in estimates of areas where the specific identity of either GCM or RCM is formally significant, hence obtaining an indication about regions, seasons, and fields where linear superpositions of GCM and RCM effects are good approximations to an actual simulation for both the mean fields analysed and their changes. In cases where linear superposition works well, the frequently encountered sparse GCM–RCM matrices may be filled with emulated results, leading to the possibility of giving more fair relative weight between model simulations than simple averaging of existing simulations. An important result of the present study is that properties of the specific GCM–RCM combination are generally important for the mean climate, but negligible for climate change for the seasonal-mean surface fields investigated here.
Cancer risks of firefighters: a systematic review and meta-analysis of secular trends and region-specific differences
Authors: Casjens Swaantje , Brüning Thomas , Taeger Dirk
Published: April 2020

Purpose

The objective of this study was to conduct a systematic review and meta-analysis to evaluate the cancer risks among firefighters in the time course and from different geographical areas.

Method

A PubMed search was performed to identify cohort studies about cancer risk and firefighting presented with standardized incidence ratios (SIRs) or standardized mortality ratios (SMRs). Using random-effect models, meta-relative risk estimates (mSIRs, mSMRs) and 95% confidence intervals (CI) were assessed. Cohort studies with employment starting before 1950 were classified as “old”, studies starting between 1950 and 1970 as “medium”, and later studies as “new”.

Results

The general cancer risk of firefighters was similar to the general population, but mSMR decreased over time (new studies: mSMR = 0.81, 95% CI 0.70–0.92). We observed an increase of mSIR for melanoma of the skin and prostate cancer as well as a decrease of mSIR for stomach cancer with later employment onset. For those cancer sites, we did not observe a secular trend of mSMRs. Regional differences between relative cancer risks were particularly observed for bladder cancer.

Conclusions

Among other things, innovative firefighting techniques and better personal protective equipment have provided a safer and healthier working environment for firefighters over time leading to a reduction of overall cancer incidence and mortality ratios. Increased general preventive medical checkups and possible additional screenings for firefighters might have led to more findings of malignant melanoma of the skin and prostate cancer in the recent past.
Treatment discontinuation and re-initiation of anti-PD-(L)1 agents in metastatic cancers
Authors: Tikkanen Antti , Iivanainen Sanna , Koivunen Jussi P.
Published: April 2020

Introduction

Immune checkpoint inhibitors (ICIs) are approved in multiple indications for cancer care. Most of the clinical trials have not questioned shorter than until disease progression approaches. In this study, we present results from a cohort of multiple advanced cancers treated with restricted anti-PD-(L)1 therapy.

Methods

All patients with advanced cancers treated with anti-PD-(L)1 therapy outside clinical trials at Oulu University Hospital 2014–19 were retrospectively identified from pharmacy records. Clinical variables, treatment history and survival were collected.

Results

106 patients with median age of 66 years with lung cancer (n = 45, 42.5%), melanoma (n = 30, 28.3%), renal and bladder cancers (GU cancers) (n = 26, 24.5%), head and neck (H&N) cancer (n = 4, 3.8%), and colorectal cancer (n = 1, 0.9%) were included in the study. The median (m) OS for the whole population was 14 months (CI 9.7–18.3), 9 months (CI 6.3–11.7) for patients with no IO-free period (n = 64, 62.1%), and 27.0 months (CI 20.6–33.4, p = 0.000001) for patients (n = 39) with IO-free period. The mIO-free survival was 10.0 months (CI 7.1–12.9) for the whole cohort, 8.0 months (CI 1.7–14.3) for lung cancer, 23.0 months (CI 2.6–43.4) for melanoma, and 14.0 months (CI 0.0–20.4) for GU cancer. From the IO-free cohort, 19 patients needed re-treatment during follow-up, of which 8 were re-challenged with anti-PD-(L)1 therapy. The clinical benefit rate of anti-PD-(L)1 re-challenge was 37.5%.

Conclusions

Our study shows that long IO-free periods can be achieved with limited duration of anti-PD-(L)1 therapy with excellent survival outcomes, and that anti-PD-(L)1 re-challenge is feasible in clinical practice.