bluuebunny/crossref_metadata_2025 huggingface dataset:
Sand spit dynamics in a large tidal‐range environment: Insight from multiple LiDAR, UAV and hydrodynamic measurements on multiple spit hook development, breaching, reconstruction, and shoreline changes
Authors: Robin Nicolas , Levoy Franck , Anthony Edward J. , Monfort Olivier
Published: June 2020

Sand spits with distal hooks have been well documented from coasts with low to moderate tidal ranges, unlike high tidal‐range environments. Datasets from 15 LiDAR and 3 UAV surveys between 2009 and 2019 on the Agon spit in Normandy (France), a setting with one of the largest tidal ranges in the world (mean spring tidal range: 11 m), combined with in‐situ hydrodynamic records between 2013 and 2017, highlight a three‐stage pattern of spit hook evolution. Stage 1 (2009–2013) commenced with the onshore migration and attachment of a swash bar, followed by persistent spit accretion updrift of the bar and erosion downdrift because of the slow speed of bar migration in this large tidal‐range environment. In stage 2 (2013–2016), three overwash events and a 220 m‐wide breach culminating in the total destruction of the spit during winter 2015–2016 involved the landward mobilization of thousands of cubic metres of sand. These events occurred during short durations (a few hours) when spring high tides coincided with relatively energetic waves, underscoring the importance of storms in rapid spit morphological change. Strong spring tidal currents maintained the breach. Stage 3 (2016–2019) has involved new hook construction through welding of a swash bar and spit longshore extension, highlighting the resilience of the spit over the 10‐year period, and involving a positive sediment balance of 244 000 m3. The three stages bring out, by virtue of the temporal density of LiDAR and UAV data used, a high detail of spit evolution relative to earlier studies in this macrotidal setting. The large tidal range strongly modulates the role of waves and wave‐generated longshore currents, the main process drivers of spit evolution, by favouring long periods of inertia in the course of the spring–neap tidal cycle, but also brief episodes of significant morphological change when storm waves coincide with spring high tides. © 2020 John Wiley & Sons, Ltd.
The strange case of less C‐sections: Hospital ownership, market concentration, and DRG‐tariff regulation
Authors: Berta Paolo , Martini Gianmaria , Piacenza Massimiliano , Turati Gilberto
Published: June 2020

We evaluate the relationship between hospital ownership and responses to a policy providing large financial incentives for vaginal deliveries and financial disincentives for C‐sections. We compare for‐profit, nonprofit, and public hospitals operating in a public health care system organized according to the quasi‐market model. We first theoretically show that hospital ownership matters insofar different hospitals are characterized by different ethical preferences. We also show that competition makes ownership less important. We then consider the case study of Lombardy in Italy. We exploit spatial variation in hospital ownership and in market concentration at the local level to evaluate the relationship between ownership and the probability of C‐section. According to theory, empirical results strongly suggest that competitive pressures from alternative providers tend to homogenize behaviors. However, in local monopolies, in presence of a strong monetary incentive toward vaginal deliveries, we do observe less C‐section from private for‐profit hospitals than from public and private nonprofit hospitals, especially when C‐sections are medically appropriate.
An evaluation of the effect of tube potential on clinical image quality using direct digital detectors for pelvis and lumbar spine radiographs
Authors: Peacock Nicole E , Steward Adam L , Riley Peter J
Published: June 2020

Introduction

High kVp techniques, 15% or 10‐kVp rules, are well‐known dose reduction methods. Traditionally, the use of high tube potential (i.e. increased kVp) is associated with decreased radiographic contrast and overall image quality. Recent studies suggest contrast and image quality are not heavily reliant on kVp with digital systems. This study aims to assess the effects of the high tube potential technique on clinical radiographic image quality when using digital systems, to validate high kVp as a dose saving technique.

Methods

A selection of comparable pelvis and lumbar spine radiographs were collected from the hospital’s picture archiving and communication system (PACS), with technical factors recorded. All clinical radiographs were assessed by 5 senior radiographers using a 15‐point visual grading analysis (VGA) rubric.

Results

For 40 AP pelvis radiographs and 40 lateral lumbar spine radiographs, reduction in the dose area product (DAP) with higher kVp is seen. Average pelvis DAP at 75 kVp = 14.06 mGy.cm2; 85 kVp = 7.47 mGy.cm2. Average lumbar spine DAP at 80 kVp = 15.76 mGy.cm2; 90 kVp = 14.83 mGy.cm2. Image quality and contrast scores showed no statistically significant difference between the high and low kVp groups (z = 0.06 and 0.12, respectively). Average pelvis VGA score at 75 kVp = 11.26; 85 kVp = 12.55. Average lumbar spine VGA score at 80 kVp = 9.23; 90 kVp = 10.64.

Conclusions

The high tube potential techniques allowed for reduced patient radiation doses whilst showing no degradation of diagnostic image quality in a clinical setting. This study successfully validates the high kVp technique as a useful tool for reducing patient radiation doses whilst maintaining high diagnostic image quality for digital pelvis and lumbar spine radiography.
Land degradation along a climatic gradient in Mali: Farmers' perceptions of causes and impacts
Authors: Touré Ibrahim , Larjavaara Markku , Savadogo Patrice , Bayala Jules , Yirdaw Eshetu , Diakite Adama
Published: June 2020

Land degradation (LD) in Mali is prevalent and leads to an enduring environmental and humanitarian crisis. Farmers' ecological knowledge has proven to be a valuable tool in addressing its challenges. How farmers perceive LD affects how they deal with induced risks, and their responses to these perceptions will shape restoration options and outcomes. Therefore, this study assessed farmers' perceptions of LD along a climatic gradient in three regions of Mali. We interviewed 270 farmers, and we analyzed their responses using descriptive statistics and Spearman rank‐order correlation. We found that the respondents were aware of LD and have identified its key indicators and its impacts on their livelihoods. Moreover, we found that farmers' perceptions are not influenced by gender, age, or education level, but rather by agricultural training, participation in agricultural labor, the practice of fallowing, shortage of firewood, livestock, household size, appearance of some plant species and famine. Additionally, farmers' perceptions of LD vary along the climatic gradient as they correlate to different variables in each agro‐ecological zone. LD's impacts, however, decrease in severity along the north–south gradient, although they are linked to the same variables. As LD is seen through a reduction of ecosystem services provisioning capacity because of the local communities' heavy dependence on natural resources, actions should be geared towards agronomic and vegetative land management options. Such actions should prioritize context‐specific soil and water conservation techniques and proven indigenous practices.
“It wasn't just for me”: Motivations and implications of genetic testing for women at a low risk of hereditary breast and ovarian cancer syndrome
Authors: Gill Gulvir , Beard Catherine , Storey Kirsty , Taylor Shelby , Sexton Adrienne
Published: June 2020

Objective

Genetic testing for hereditary breast and ovarian cancer (HBOC) due to pathogenic variants in BRCA1 or BRCA2 is why most women present to familial cancer centers. Despite being assessed as low risk for HBOC, many women proceed with genetic testing. This study explored the genetic testing experiences of unaffected women at low risk of HBOC to clarify what motivates these women to have testing, and what are the implications of the results.

Methods

A qualitative approach was taken. Participants included women who had genetic testing for HBOC from 2016‐2018 at the Parkville Familial Cancer Centre in Melbourne, Australia. In‐depth, semi‐structured interviews were conducted, and thematic analysis was undertaken on transcripts; transcripts were coded, codes were organized into a hierarchical system of categories/subcategories, and key themes were identified.

Results

Analysis of 19 transcripts identified five themes: family underpinned all motivators for HBOC genetic testing; health professionals were influential throughout the process; participants were planning for a positive result; results influenced screening‐anxiety and frequency; and negative results gave participants relief in many different ways. The three participants with positive results reported feeling shocked at the results and empowered giving this information to family members.

Conclusions

Women at low HBOC risk may be motivated to seek genetic testing, and access to this is increasingly offered through non‐genetic health professionals. Professionals can support clients through genetic testing by recognizing familial experiences, providing accurate information, addressing risk perceptions, and understanding cancer anxiety felt by many women.
Optimal design and seismic performance of Multi‐Tuned Mass Damper Inerter (MTMDI) applied to adjacent high‐rise buildings
Authors: De Domenico Dario , Qiao Haoshuai , Wang Qinhua , Zhu Zhiwen , Marano Giuseppe
Published: June 2020

The tuned mass damper inerter (TMDI) is an enhanced variant of the tuned mass damper (TMD) that benefits from the mass‐amplification effect of the inerter. Here, a multi‐TMDI (MTMDI) system (comprising more than one TMDI) linking two adjacent high‐rise buildings is presented as an unconventional seismic protection strategy. The relative acceleration response of the adjacent structures triggers large reaction forces of the inerter devices in the MTMDI, which in turn efficiently improve the seismic performance of the two buildings. By addressing a real project of two adjacent high‐rise buildings connected by two corridors equipped with the proposed MTMDI system, the displacement‐, interstory drift‐, and acceleration‐based parametric optimizations are separately performed by employing Nondominated Sorting Genetic Algorithm II (NSGA‐II) under 44 ground motions from the FEMA P695 far‐field record set. It is found that the frequency content of the seismic input has strong impact on the MTMDI mitigation performance. Adopting realistic mass ratio constraints, the optimally designed MTMDI outperforms both conventional MTMD and single TMDI in acceleration control, while it is not much effective in mitigating the displacement response due to the highly flexible nature of the high‐rise buildings, in contrast to other literature studies generally focused on low‐to‐medium rise buildings.
Self‐powered Biosensor Big Data Intelligent Information Processing System for Real‐time Motion Monitoring
Authors: Liu Bing , Shen Mailun , Mao Lipeng , Mao Yupeng , Ma Hongtao
Published: June 2020

A portable self‐powered biosensor big data information processing system has been designed to help coaches monitor athlete training performance in real‐time. The material system is composed of tetrapod‐shaped ZnO nanowires and common textiles. Based on the piezoelectric effect, the device can convert weak shape variables into electrical signals, and the output piezoelectric signal obviously depends on the shape variable, the surrounding humidity and temperature. After attaching the device to the athlete, it can monitor the speed, frequency, angle of an athlete, and surrounding humidity and temperature in real‐time without external power supply. API data collected by information processing end, server behavior simulated by Web service, turns the host of integrated web services into a data server, shares to other terminals via LAN to implement the visual charts summary for data‐driven views, summarize and analyze charts. This multidisciplinary research can point out the new development direction of sport science and may promote the development of flexible self‐powered multifunctional nano‐systems.
Gaugino mass term for D-branes and Generalized Complex Geometry
Authors: Graña Mariana , Kovensky Nicolás , Retolaza Ander
Published: June 2020

Abstract

We compute the four-dimensional gaugino mass for a Dp-brane extended in spacetime and wrapping a cycle on the internal geometry in a warped compactification with fluxes. Motivated by the backreaction of gaugino bilinear VEVs, we use Generalized Complex Geometry to characterize the internal geometry as well as the cycle wrapped by the brane. We find that the RR fluxes and the non-closure of the generalized complex structures combine in the gaugino mass terms in the same form as they do in the bulk superpotential, while for the NSNS fluxes there is a crucial minus sign in the component normal to the brane. Our expression extends the known result for D3 and D7-branes in Calabi-Yau manifolds, where the gaugino masses are induced respectively by the imaginary anti-self dual and imaginary self-dual components of the complex 3-form flux G
3.
$$ T\overline{T} $$ deformations, massive gravity and non-critical strings
Authors: Tolley Andrew J.
Published: June 2020

Abstract

The

$$ T\overline{T} $$

T

T
¯

deformation of a 2 dimensional field theory living on a curved space- time is equivalent to coupling the undeformed field theory to 2 dimensional ‘ghost-free’ massive gravity. We derive the equivalence classically, and using a path integral formulation of the random geometries proposal, which mirrors the holographic bulk cutoff picture. We emphasize the role of the massive gravity Stückelberg fields which describe the diffeomorphism between the two metrics. For a general field theory, the dynamics of the Stückelberg fields is non-trivial, however for a CFT it trivializes and becomes equivalent to an additional pair of target space dimensions with associated curved target space geometry and dynamical worldsheet metric. That is, the

$$ T\overline{T} $$

T

T
¯

deformation of a CFT on curved spacetime is equivalent to a non-critical string theory in Polyakov form, with a non-zero B-field. We give a direct proof of the equivalence classically without relying on gauge fixing, and determine the explicit form for the classical Hamiltonian of the

$$ T\overline{T} $$

T

T
¯

deformation of an arbitrary CFT on a curved spacetime. When the QFT action is a sum of a CFT plus an operator of fixed scaling dimension, as for example in the sine-Gordon model, the equivalence to a non-critical theory string holds with a modified target space metric and modified B-field. Finally we give a stochastic path integral formulation for the general

$$ T\overline{T}+J\overline{T}+T\overline{J} $$

T

T
¯

+
J

T
¯

+
T

J
¯

deformation of a general QFT, and show that it reproduces a recent path integral proposal in the literature.
Relaxation regimes of the holographic electrons at charge neutrality after a local quench of chemical potential
Authors: Krikun Alexander
Published: June 2020

Abstract

In this work we study the relaxation of the system of strongly correlated electrons, at charge neutrality, when the chemical potential undergoes a local change. This setup is a model for the X-ray absorbtion edge study in the half-filled graphene. We use holographic duality to describe the system as a classical Schwarzschild black hole in curved 4-dimensional AdS spacetime. Assuming the amplitude of the quench is small, we neglect the backreaction on the geometry. We numerically study the two relaxation regimes: the adiabatic relaxation when the quench is slow and the relaxation governed by the quasinormal modes of the system, when the quench is fast. We confirm the expectation that the scale of separation between the slow and fast regimes is set by the characteristic frequency of the quasinormal modes.
Topological sectors for heterotic M5-brane charges under Hypothesis H
Authors: Roberts David Michael
Published: June 2020

Abstract

Assuming Fiorenza-Sati-Schreiber’s Hypothesis H, on the charge quantization of M-theory’s C -field, the topological sectors of the resulting String
c2 (4)-valued higher gauge theory on a heterotic M5-brane are classified by homotopy classes of maps from the worldvolume Σ
M5 to BString
c2 (4). This note calculates the sectors in a number of examples of M5-brane topology, including examples considered in the 3d-3d correspondence, the emergence of skyrmions from higher-dimensional instantons and Witten’s analysis of the S-duality of 4d Yang-Mills theory.
How CD40L reverse signaling regulates axon and dendrite growth
Authors: Carriba Paulina , Davies Alun M.
Published: June 2020

CD40-activated CD40L reverse signaling is a major physiological regulator of axon and dendrite growth from developing hippocampal pyramidal neurons. Here we have studied how CD40L-mediated reverse signaling promotes the growth of these processes. Cultures of hippocampal pyramidal neurons were established from Cd40−/− mouse embryos to eliminate endogenous CD40/CD40L signaling, and CD40L reverse signaling was stimulated by a CD40-Fc chimera. CD40L reverse signaling increased phosphorylation and hence activation of proteins in the PKC, ERK, and JNK signaling pathways. Pharmacological activators and inhibitors of these pathways revealed that whereas activation of JNK inhibited growth, activation of PKC and ERK1/ERK2 enhanced growth. Experiments using combinations of pharmacological reagents revealed that these signaling pathways regulate growth by functioning as an interconnected and interdependent network rather than acting in a simple linear sequence. Immunoprecipitation studies suggested that stimulation of CD40L reverse signaling generated a receptor complex comprising CD40L, PKCβ, and the Syk tyrosine kinase. Our studies have begun to elucidate the molecular network and interactions that promote axon and dendrite growth from developing hippocampal neurons following activation of CD40L reverse signaling.
A comprehensive overview of substrate specificity of glycoside hydrolases and transporters in the small intestine
Authors: Elferink Hidde , Bruekers Jeroen P. J. , Veeneman Gerrit H. , Boltje Thomas J.
Published: June 2020

The human body is able to process and transport a complex variety of carbohydrates, unlocking their nutritional value as energy source or as important building block. The endogenous glycosyl hydrolases (glycosidases) and glycosyl transporter proteins located in the enterocytes of the small intestine play a crucial role in this process and digest and/or transport nutritional sugars based on their structural features. It is for these reasons that glycosidases and glycosyl transporters are interesting therapeutic targets to combat sugar related diseases (such as diabetes) or to improve drug delivery. In this review we provide a detailed overview focused on the molecular structure of the substrates involved as a solid base to start from and to fuel research in the area of therapeutics and diagnostics.
Well-Posedness and Stability Results for Some Periodic Muskat Problems
Authors: Matioc Bogdan-Vasile
Published: June 2020

We study the two-dimensional Muskat problem in a horizontally periodic setting and for fluids with arbitrary densities and viscosities. We show that in the presence of surface tension effects the Muskat problem is a quasilinear parabolic problem which is well-posed in the Sobolev space$$H^r({\mathbb {S}})$$Hr(S)for each$$r\in (2,3)$$r∈(2,3). When neglecting surface tension effects, the Muskat problem is a fully nonlinear evolution equation and of parabolic type in the regime where the Rayleigh–Taylor condition is satisfied. We then establish the well-posedness of the Muskat problem in the open subset of$$H^2({\mathbb {S}})$$H2(S)defined by the Rayleigh–Taylor condition. Besides, we identify all equilibrium solutions and study the stability properties of trivial and of small finger-shaped equilibria. Also other qualitative properties of solutions such as parabolic smoothing, blow-up behavior, and criteria for global existence are outlined.
Well-Posedness of Strong Solutions to the Anelastic Equations of Stratified Viscous Flows
Authors: Liu Xin , Titi Edriss S.
Published: June 2020

We establish the local and global well-posedness of strong solutions to the two- and three-dimensional anelastic equations of stratified viscous flows. In this model, the interaction of the density profile with the velocity field is taken into account, and the density background profile is permitted to have physical vacuum singularity. The existing time of the solutions is infinite in two dimensions, with general initial data, and in three dimensions with small initial data.
Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands
Authors: Peek Jesse , Beks Reinier B. , Hietbrink Falco , De Jong Mirjam B. , Heng Marilyn , Beeres Frank J. P. , IJpma Frank F. A. , Leenen Loek P. H. , Groenwold Rolf H. H. , Houwert Roderick M.
Published: June 2020

Purpose

Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups.

Methods

A nationwide retrospective cohort study was performed with the use of the Dutch Trauma Registry which covers 99% of the acutely admitted Dutch trauma population. All patients aged 18 years and older admitted to the hospital between January 2015 and December 2017 with one or more rib fractures were included. Incidence rates were calculated using demographic data from the Dutch Population Register. Subgroup analyses were performed for flail chest, polytrauma, primary thoracic trauma, and elderly patients.

Results

A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. Of these, 573 (3.9%) patients had a flail chest, 4438 (29.9%) were polytrauma patients, 9273 (63.4%) were patients with primary thoracic trauma, and 6663 (44.9%) were elderly patients. The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n = 1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). The median hospital length of stay was 6 days (IQR, 3–11) and 37.3% were admitted to the intensive care unit (ICU).

Conclusions

Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.
Arginine derivatives in atrial fibrillation progression phenotypes
Authors: Büttner Petra , Bahls Martin , Böger Rainer H. , Hindricks Gerhard , Thiele Holger , Schwedhelm Edzard , Kornej Jelena
Published: June 2020

Arginine, homoarginine (hArg), asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) affect nitric oxide metabolism and altered concentrations are associated with cardiovascular morbidity and mortality. We analyzed these metabolites using liquid chromatography–tandem mass spectrometry in patients with atrial fibrillation (AF) (n = 241) with a focus on heart rhythm at blood withdrawal, AF progression phenotypes, and successful sinus rhythm (SR) restoration (n = 22). AF progression phenotypes were defined as paroxysmal AF with/without low voltage areas (LVA) and persistent AF with/without LVA. While arginine, ADMA, and hArg were within reference limits for healthy controls, SDMA was higher in the AF cohort (0.57 ± 0.12 vs. 0.53 μmol/L (97.5th percentile in reference cohort)). SR restoration in AF patients resulted in normalization of SDMA concentrations (0.465 ± 0.082 vs. 0.570 ± 0.134 μmol/L at baseline, p < 0.001). Patients with AF at the time of blood sampling had significantly lower hArg (1.65 ± 0.51 vs. 1.85 ± 0.60 μmol/L, p = 0.006) and higher ADMA concentrations (0.526 ± 0.08 vs. 0.477 ± 0.08 μmol/L, p < 0.001) compared with AF patients in SR. hArg concentrations were lower in patients with advanced AF progression phenotypes (persistent AF with LVA (p = 0.046)) independent of heart rhythm at blood sampling. Summarizing, arginine metabolism imbalance is associated with AF in general and AF progression and may contribute to associated risk.

Key messages

• Heart rhythm at blood withdrawal affects ADMA and hArg level in AF patients.

• SDMA is higher in AF patients.

• SDMA levels normalize after sinus rhythm restoration.

• hArg levels decrease in advanced AF progression phenotypes.
Optimizing the numerical algorithm in Fast Constant Engagement Offsetting Method for generating 2.5D milling tool paths
Authors: Jacso Adam , Szalay Tibor
Published: June 2020

In the case of 2.5D rough milling operations, machining efficiency can significantly be increased by providing a uniform tool load. This is underpinned by the fact that uniform load has a positive effect on both tool life and machining time. Unfortunately, conventional contour-parallel tool paths are unable to guarantee uniform tool loads. However, nowadays there are some advanced path generation methods which can offer a constant tool load by controlling the cutter engagement angle. Yet, the spread of these non-equidistant offsetting methods is hindered by their dependence on complex calculations. As a solution to this problem, the Fast Constant Engagement Offsetting Method (FACEOM), developed in the scope of our previous study, is seen to be taking a step towards reducing computational needs. In this paper, suggestions for further improvements of FACEOM are presented. Decreasing the number of path points to be calculated is made possible by implementing adaptive step size and spline interpolation. Through simulation tests, it was also analysed which of the numerical methods utilized for solving boundary value problems can be applied to obtain the shortest calculation time during tool path generation. The practical applicability of the algorithm has been proved by cutting experiments. With respect to research results, this paper also describes how a tool path created by the algorithm can be adapted to controllers of CNC machine tools. Solutions presented in this paper can promote a wider application of a modern path generation method that ensures constant tool loads.
On Zipf’s law and the bias of Zipf regressions
Authors: Schluter Christian
Published: June 2020

City size distributions are not strictly Pareto, but upper tails are rather Pareto like (i.e. tails are regularly varying). We examine the properties of the tail exponent estimator obtained from ordinary least squares (OLS) rank size regressions (Zipf regressions for short), the most popular empirical strategy among urban economists. The estimator is then biased towards Zipf’s law in the leading class of distributions. The Pareto quantile–quantile plot is shown to offer a simple diagnostic device to detect such distortions and should be used in conjunction with the regression residuals to select the anchor point of the OLS regression in a data-dependent manner. Applying these updated methods to some well-known data sets for the largest cities, Zipf’s law is now rejected in several cases.
Organophosphorus compounds and oximes: a critical review
Authors: Worek Franz , Thiermann Horst , Wille Timo
Published: June 2020

Organophosphorus (OP) pesticides and nerve agents still pose a threat to the population. Treatment of OP poisoning is an ongoing challenge and burden for medical services. Standard drug treatment consists of atropine and an oxime as reactivator of OP-inhibited acetylcholinesterase and is virtually unchanged since more than six decades. Established oximes, i.e. pralidoxime, obidoxime, TMB-4, HI-6 and MMB-4, are of insufficient effectiveness in some poisonings and often cover only a limited spectrum of the different nerve agents and pesticides. Moreover, the value of oximes in human OP pesticide poisoning is still disputed. Long-lasting research efforts resulted in the preparation of countless experimental oximes, and more recently non-oxime reactivators, intended to replace or supplement the established and licensed oximes. The progress of this development is slow and none of the novel compounds appears to be suitable for transfer into advanced development or into clinical use. This situation calls for a critical analysis of the value of oximes as mainstay of treatment as well as the potential and limitations of established and novel reactivators. Requirements for a straightforward identification of superior reactivators and their development to licensed drugs need to be addressed as well as options for interim solutions as a chance to improve the therapy of OP poisoning in a foreseeable time frame.
Leibniz Gauge Theories and Infinity Structures
Authors: Bonezzi Roberto , Hohm Olaf
Published: June 2020

We formulate gauge theories based on Leibniz(-Loday) algebras and uncover their underlying mathematical structure. Various special cases have been developed in the context of gauged supergravity and exceptional field theory. These are based on ‘tensor hierarchies’, which describe towers of p-form gauge fields transforming under non-abelian gauge symmetries and which have been constructed up to low levels. Here we define ‘infinity-enhanced Leibniz algebras’ that guarantee the existence of consistent tensor hierarchies to arbitrary level. We contrast these algebras with strongly homotopy Lie algebras ($$L_{\infty }$$

L
∞

algebras), which can be used to define topological field theories for which all curvatures vanish. Any infinity-enhanced Leibniz algebra carries an associated $$L_{\infty }$$

L
∞

algebra, which we discuss.
Comparison of Postoperative Quality of Life among Three Different Reconstruction Methods After Proximal Gastrectomy: Insights From the PGSAS Study
Authors: Yabusaki Hiroshi , Kodera Yasuhiro , Fukushima Norimasa , Hiki Naoki , Kinami Shinichi , Yoshida Masashi , Aoyagi Keishiro , Ota Shuichi , Hata Hiroaki , Noro Hiroshi , Oshio Atsushi , Nakada Koji
Published: June 2020

Background

Proximal gastrectomy (PG) has become an increasingly preferred procedure for early cancer in the upper third of the stomach, owing to reportedly superior quality of life (QOL) after PG when compared with total gastrectomy. However, various methods of reconstruction have currently been proposed. We compared the postoperative QOL among the three different reconstruction methods after PG using the Postgastrectomy Syndrome Assessment Scale‐45 (PGSAS‐45) questionnaire.

Methods

Post Gastrectomy Syndrome Assessment Study (PGSAS), a nationwide multi‐institutional survey, was conducted to evaluate QOL using the PGSAS‐45 among various types of gastrectomy. Of the 2,368 eligible data from the PGSAS survey, data from 193 patients who underwent PG were retrieved and used in the current study. The PGSAS‐45 consists of 45 items including 22 original gastrectomy specific items in addition to the SF‐8 and GSRS. These were consolidated into 19 main outcome measures pertaining postgastrectomy symptoms, amount of food ingested, quality of ingestion, work, and level of satisfaction for daily work, and the three reconstruction methods (n = 193; 115 esophago‐gastrostomy [PGEG], 34 jejunal interposition [PGJI], and 44 jejunal pouch interposition [PGJPI]) were compared using PGSAS‐45.

Results

Size of the remnant stomach was significantly larger in PGEG, and significantly smaller in PGJI and PGJPI (P < 0.05). There was no difference in other patient background factors among the groups. EGJPI tended to be superior to PGEG in several of the 19 main outcome with marginal significance (P = 0.047–0.076).

Conclusion

PGJPI appears to be the most favorable of the three reconstruction methods after PG especially when the size of remnant stomach is rather small.

Trial registration number

UMIN‐CTR #000002116 entitled as “A study to observe correlation between resection and reconstruction procedures employed for gastric neoplasms and development of postgastrectomy syndrome”
Surgical management of peripheral nerve sheath tumours in children, with special consideration of neurofibromatoses
Authors: Zipfel Julian , Al-Hariri Meizer , Gugel Isabel , Haas-Lude Karin , Grimm Alexander , Warmann Steven , Krimmel Michael , Mautner Victor-Felix , Tatagiba Marcos , Schuhmann Martin U.
Published: June 2020

Introduction

Peripheral nerve sheath tumours in children are a rare and heterogeneous group, consisting mostly of benign tumours as well as malignant neoplasms. Especially in the paediatric population, diagnostics and indication for therapy pose relevant challenges for neurosurgeons and paediatric neurologists alike. Most paediatric cases that need surgical intervention are associated to neurofibromatosis type 1 (NF1).

Methods

We retrospectively reviewed all paediatric cases treated at the Department of Neurosurgery in Tübingen between 2006 and 2017 for peripheral nerve sheath tumours. We analysed clinical signs, symptoms, histology, association to an underlying phacomatosis and sensory/motor function.

Results

Of the 82 identified patients, the majority had NF1 (76.8%). Nine children bore a sporadic tumour without underlying phacomatosis (11%), 8 had NF2 (9.8%) and 2 schwannomatosis (2.4%), A total of 168 surgical interventions were performed, and 206 tumours were removed. Indication for surgery was in most instances significant tumour growth (45.2%) followed by pain (33.9%). New deficits led to surgery in 12.5% of interventions; malignancy was suspected in 8.3%. Histopathology revealed mostly neurofibromas (82.5%), divided into cutaneous neurofibromas (10.7%), infiltrating plexiform neurofibromas (25.7%) and peripheral nerve-born neurofibromas (46.1%). 12.1% of tumours were schwannomas, 2.9% MPNST, 1.5% ganglioneuroma (n = 3) and 1 hybrid-neurofibroma and perineurinoma each. Leading symptoms, such as pain and motor and sensory deficits, improved after 125/166 interventions (74.4%), remained unchanged following 39 interventions (23.2%) and worsened in 4 occasions (2.4%).

Conclusion

Surgery is safe and effective for (neurofibromatosis associated) peripheral nerve sheath tumours in the paediatric population; however, management needs a multidisciplinary setting. We propose early surgical resection in paediatric patients with peripheral nerve sheath tumours with significant growth, or pain, or motor deficit, or suspected malignancy.
Pre- and postoperative need for pituitary hormone replacement in non-adenomatous sellar and parasellar lesions: importance of the sellar encroachment score
Authors: Waqar Mueez , Rampersad Shiva , Bennett David , Kearney Tara , Gnanalingham Kanna K.
Published: June 2020

Background

Pre-/postoperative pituitary endocrine deficiencies in patients with sellar/parasellar non-adenomatous lesions are poorly described and studies have not considered the effect of sellar invasion on endocrine outcome. The aim of this study was to relate the need for pituitary hormone replacement pre-/postoperatively, with sellar invasion, in non-adenomatous sellar/parasellar lesions.

Methods

Single-centre review of adults with histologically confirmed non-adenomatous sellar/parasellar lesion and follow-up ≥ 3 months or until postop radiotherapy. Pituitary dysfunction was defined by hormone replacement. The sellar encroachment score (0–6) was calculated as the sum of the thirds of radiological encroachment into the sellar region in the coronal and sagittal planes. Multivariate analysis with binary logistic regression was used to determine factors associated with pituitary hormone replacement.

Results

One hundred and seventeen patients were included with a median age of 49 years (range 16–84 years) and median follow-up of 13 months. Surgery was trans-sphenoidal (53%), trans-cranial (36%) or a combination (11%). The commonest histology types were meningioma (n = 33, 28%) and craniopharyngioma (n = 20, 17%). The median sellar encroachment score was 6 (range 0–6). Most (n = 86, 74%) did not require pituitary hormone replacement preoperatively. The need for pituitary hormones increased after surgery in 41 (35%) patients. In multivariate analysis, the sellar encroachment score was the only factor predictive of pre- (OR = 2.6, 95% CI = 1.2–5.5; p = 0.01) and postoperative risk of new pituitary hormone replacement (OR = 4.1, 95% CI = 1.7–10.1, p = 0.002).

Conclusion

A significant proportion of these patients present with need for pituitary hormone replacement that may worsen postoperatively. The degree of sellar encroachment is predictive of pituitary hormone replacement status pre-/postoperatively.
The effect of lipoxin A4 on E. coli LPS-induced osteoclastogenesis
Authors: Ali Muhanad , Kucko Nathan , Jansen John A. , Yang Fang , Walboomers X. Frank
Published: June 2020

Objectives

The objective of the present study was to investigate the effect of lipoxin-type A4 (LXA4) on bacterial-induced osteoclastogenesis.

Material and methods

Human periodontal ligament cells (PDLCs) in coculture with osteoclast precursors (RAW264.7 cells) were exposed to bacterial stimulation with lipopolysaccharide (LPS) to induce inflammation. After 24 h, cells were treated to 100 ng/ml of LXA4 and 50 ng/ml of forymul peptide receptor 2 (FPR2/ALX) receptor antagonist (Boc-2). After 5 days, osteoclastic resorptive activity was assessed on calcium phosphate (CaP) synthetic bone substitute. Additionally, osteoclastic differentiation was evaluated using tartrate-resistant acid phosphatase (TRAP) staining, TRAP enzymatic activity assay, and on the expression of osteoclast-specific genes.

Results

We found that stimulation of in the osteoclasts with LPS-stimulated PDLCs induced a significant increase in tartrate-resistant acid phosphatase (TRAP) positive cells, higher resorptive activity, and enhanced expression of specific genes. Meanwhile, LXA4-treatment exhibited strong anti-inflammatory activity, and was able to reverse these inflammatory effects.

Conclusions

We conclude that (1) PDLCs are a potential target for treating bacterial-induced bone resorption in patients with periodontal disease, and (2) LXA4 is a suitable candidate for such therapy.

Clinical relevance

The results prove that lipoxins have a protective role in bacterial-induced periodontal inflammation and alveolar bone resorption, which can be translated into a clinical beneficial alterative treatment.
Predicting ADHD symptoms and diagnosis at age 14 from objective activity levels at age 7 in a large UK cohort
Authors: Brandt Valerie , Patalay Praveetha , Kerner auch Koerner Julia
Published: June 2020

Hyperactivity is one of the three core symptoms in children with attention deficit hyperactivity disorder (ADHD). Diagnosing ADHD typically involves self-report, third party report and observations. Objective activity data can make a valuable contribution to the diagnostic process. Small actigraphy studies in clinical samples have shown that children with ADHD move more than children without ADHD. However, differences in physical activity between children with and without ADHD have not been assessed in large community samples or longitudinally. This study used data from the Millennium Cohort Study to test whether symptoms of ADHD (parent-rating Strengths and Difficulties Questionnaire) and ADHD diagnosis at age 14 (reported by parents) could be predicted from objective activity data (measured with actigraphs) at age 7 in N = 6675 children (final N = 5251). Regressions showed that less sedentary behavior at age 7 predicted more ADHD symptoms at age 14 (β =  − 0.002, CI  − 0.004 to  − 0.001). The result remained significant when controlled for ADHD symptoms at age 7, sex, BMI, month of birth, SES and ethnicity (β  =  − 0.001, CI  − 0.003 to  − 0.0003). ADHD diagnosis at age 14 was also significantly predicted by less sedentary behavior at age 7 (β  =  − 0.008). Our findings show that symptoms of ADHD can be predicted by objective activity data 5 years in advance and suggest that actigraphy could be a useful instrument aiding an ADHD diagnosis. Interestingly, the results indicate that the key difference between children with and without ADHD lies in reduced sedentary activity, i.e., times of rest.
Finding and verifying the nucleolus of cooperative games
Authors: Benedek Márton , Fliege Jörg , Nguyen Tri-Dung
Published: June 2020

The nucleolus offers a desirable payoff-sharing solution in cooperative games, thanks to its attractive properties—it always exists and lies in the core (if the core is non-empty), and it is unique. The nucleolus is considered as the most ‘stable’ solution in the sense that it lexicographically minimizes the dissatisfactions among all coalitions. Although computing the nucleolus is very challenging, the Kohlberg criterion offers a powerful method for verifying whether a solution is the nucleolus in relatively small games (i.e. with the number of players $$n \le 15$$

n
≤
15

). This approach, however, becomes more challenging for larger games because of the need to form and check a criterion involving possibly exponentially large collections of coalitions, with each collection potentially of an exponentially large size. The aim of this work is twofold. First, we develop an improved version of the Kohlberg criterion that involves checking the ‘balancedness’ of at most $$(n-1)$$

(
n
-
1
)

sets of coalitions. Second, we exploit these results and introduce a novel descent-based constructive algorithm to find the nucleolus efficiently. We demonstrate the performance of the new algorithms by comparing them with existing methods over different types of games. Our contribution also includes the first open-source code for computing the nucleolus for games of moderately large sizes.
Management of pineal region tumors in a pediatric case series
Authors: Schulz Matthias , Afshar-Bakshloo Melissa , Koch Arend , Capper David , Driever Pablo Hernáiz , Tietze Anna , Grün Arne , Thomale Ulrich-Wilhelm
Published: June 2020

Pineal region tumors commonly present with non-communicating hydrocephalus. These heterogeneous histological entities require different therapeutic regimens. We evaluated our surgical experience concerning procurance of a histological diagnosis, management of hydrocephalus, and choice of antitumoral treatment. We analyzed the efficacy of neuroendoscopic biopsy and endoscopic third ventriculocisternostomy (ETV) in patients with pineal region tumors between 2006 and 2019 in a single-center retrospective cross-sectional study with regard to diagnostic yield, hydrocephalus treatment, as well as impact on further antitumoral management. Out of 28 identified patients, 23 patients presented with untreated hydrocephalus and 25 without histological diagnosis. One patient underwent open biopsy, and 24 received a neuroendoscopic biopsy with concomitant hydrocephalus treatment if necessary. Eighteen primary ETVs, 2 secondary ETVs, and 2 ventriculoperitoneal shunts (VPSs) were performed. Endoscopic biopsy had a diagnostic yield of 95.8% (23/24) and complication rates of 12.5% (transient) and 4.2% (permanent), respectively. ETV for hydrocephalus management was successful in 89.5% (17/19) with a median follow-up of more than 3 years. Following histological diagnosis, 8 patients (28.6%) underwent primary resection of their tumor. Another 9 patients underwent later-stage resection after either adjuvant treatment (n = 5) or for progressive disease during observation (n = 4). Eventually, 20 patients received adjuvant treatment and 7 were observed after primary management. One patient was lost to follow-up. Heterogeneity of pineal region tumor requires histological confirmation. Primary biopsy of pineal lesions should precede surgical resection since less than a third of patients needed primary surgical resection according to the German pediatric brain tumor protocols. Interdisciplinary decision making upfront any treatment is warranted in order to adequately guide treatment.
Preoperative meloxicam versus postoperative meloxicam for pain control, patients’ satisfaction and function recovery in hip osteoarthritis patients who receive total hip arthroplasty: a randomized, controlled study
Authors: Ren Lingyun , Meng Li , Yan Hong , Sun Wei , Yao Dan
Published: June 2020

This study aimed to compare the analgesic effect, patients’ satisfaction, tolerance and hip-joint function recovery by preoperative meloxicam versus postoperative meloxicam in treating hip osteoarthritis (OA) patients receiving total hip arthroplasty (THA). 132 hip OA patients who underwent THA surgery were allocated into postoperative analgesia (POST) and preoperative analgesia (PRE) groups at a 1:1 ratio. In the PRE group, patients took meloxicam 15 mg at 24 h pre-operation, 7.5 mg at 4 h, 24 h, 48 h and 72 h post-operation; in the POST group, patients received meloxicam 15 mg at 4 h post-operation, then 7.5 mg at 24 h, 48 h and 72 h post-operation. Furthermore, postoperative pain, consumption of patient-controlled analgesia (PCA), overall satisfaction and adverse events were evaluated within 96 h post-operation; meanwhile, Harris hip score was assessed within 6 months post-operation. Pain VAS at rest at 6 h, 12 h, 24 h, and pain VAS at passive movement at 6 h, 12 h were decreased in PRE group compared to POST group. In addition, additional consumption of PCA and the total consumption of PCA were both reduced in PRE group compared to POST group. Additionally, overall satisfaction in PRE group was higher at 24 h, 48 h and 72 h compared to POST group. While Harris hip score was of no difference between POST group and PRE group at M3 or M6. Besides, no difference in adverse events incidence was found between the two groups. In conclusion, preoperative meloxicam achieves better efficacy and similar tolerance compared to postoperative meloxicam in hip OA patients post THA.
Evaluation of “SIBS”, An Intervention for Siblings and Parents of Children with Chronic Disorders
Authors: Haukeland Yngvild Bjartveit , Czajkowski Nikolai Olavi , Fjermestad Krister Westlye , Silverman Wendy K. , Mossige Svein , Vatne Torun Marie
Published: June 2020

Siblings of children with chronic disorders are at increased risk of experiencing family communication problems and poorer mental health. We assessed initial feasibility, acceptability, and outcomes of SIBS; a manual-based group intervention for siblings and parents of children with chronic disorders, aiming to improve parent-sibling communication and sibling mental health. Ninety-nine siblings aged 8–16 years (M = 11.5 years,SD = 2.0; 54.5% girls) and parents (63.6% mothers) of children with chronic disorders participated in three separate group sessions for siblings and parents and two joint sessions with integrated sibling-parent dialogues. We assessed participant satisfaction post-intervention and checked for group leader manual adherence. We measured the following outcomes at baseline, three, and six months post-intervention in an open trial: (1) parent-sibling communication quality; (2) sibling emotional and behavioral problems; (3) sibling adaptation to the disorder; and (4) sibling disorder knowledge. Using growth curve modeling, we found significant improvement in parent-sibling communication quality (p = 0.001), emotional and behavioral problems (p = 0.009), adaptation to the disorder (p = 0.003), and disorder knowledge (p = 0.000) from baseline to follow-up (effect sizesd = 0.22 to 0.64). Improvement in sibling-reported emotional and behavioral problems and adaptation to the disorder was partly explained by communication quality. User satisfaction was high and manual adherence was good. Our evaluation yields support for the SIBS intervention, with initial evidence of acceptability, feasibility, and beneficial outcomes. Our study suggests targeting parent-sibling communication may be a beneficial way of improving siblings’ mental health.