bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of sight and hearing loss in patients with Norrie disease: advantages of Dual Sensory clinics in patient care
Authors: Sowden Jane C , Kros Corné J , Sirimanna Tony , Pagarkar Waheeda , Oluonye Ngozi , Henderson Robert H
Published: November 2020

Norrie disease (ND) is a rare, X-linked condition of visual and auditory impairment, often presenting with additional neurological features and developmental delays of varying severity. While all affected patients are born blind, or lose their vision in infancy, progressive sensorineural hearing loss develops in the majority of cases and is typically detected in the second decade of life. A range of additional symptoms of ND, such as seizure disorders, typically appear from a young age, but it is difficult to predict the range of symptoms ND patients will experience. After growing up without vision, hearing loss represents the greatest worry for many patients with ND, as they may lose the ability to participate in previously enjoyed activities or to communicate with others.

Dual sensory loss has a physical, psychosocial and financial impact on both patients with ND and their families. Routine monitoring of the condition is required in order to identify, treat and provide support for emerging health problems, leading to a large burden of medical appointments. Many patients need to travel long distances to meet with specialists, representing a further burden on time and finances. Additionally, the rare nature of dual sensory impairment in children means that few clinical environments are designed to meet their needs. Dual Sensory clinics are multidisciplinary environments designed for sensory-impaired children and have been suggested to alleviate the impact of diseases involving sensory loss such as ND.

Here, we discuss the diagnosis, monitoring and management of ND and the impact it has on paediatric patients and their caregivers. We describe the potential for dual sensory clinics to reduce disease burden through providing an appropriate clinical environment, access to multiple clinical experts in one visit, and ease of monitoring for patients with ND.
Amelioration of systemic inflammation in advanced chronic liver disease upon beta-blocker therapy translates into improved clinical outcomes
Authors: Jachs Mathias , Hartl Lukas , Schaufler Dunja , Desbalmes Christopher , Simbrunner Benedikt , Eigenbauer Ernst , Bauer David Josef Maria , Paternostro Rafael , Schwabl Philipp , Scheiner Bernhard , Bucsics Theresa , Stättermayer Albert Friedrich , Pinter Matthias , Trauner Michael , Mandorfer Mattias , Reiberger Thomas
Published: November 2020

Objective

Systemic inflammation promotes the development of clinical events in patients with advanced chronic liver disease (ACLD). We assessed whether (1) non-selective beta blocker (NSBB) treatment initiation impacts biomarkers of systemic inflammation and (2) whether these changes in systemic inflammation predict complications and mortality.

Design

Biomarkers of systemic inflammation, that is, white blood cell count (WBC), C reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT) were determined at sequential hepatic venous pressure gradient (HVPG) measurements without NSBB and under stable NSBB intake. The influence of NSBB-related changes in systemic inflammation on the risk of decompensation and liver-related death was analysed using competing risk regression.

Results

Our study comprised 307 stable patients with ACLD (Child-A: 77 (25.1%), Child-B: 161 (52.4%), Child-C: 69 (22.5%), median HVPG: 20 (IQR 17–24) mm Hg) including 231 (75.2%) with decompensated disease.

WBC significantly decreased upon NSBB therapy initiation (median: −2 (IQR −19;+13)%, p=0.011) in the overall cohort. NSBB-related reductions of WBC (Child-C: −16 (−30;+3)% vs Child-B: −2 (−16;+16)% vs Child-A: +3 (−7;+13)%, p<0.001) and of CRP (Child-C: −26 (−56,+8)% vs Child-B: −16 (−46;+13)% vs Child-A: ±0 (−33;+33)%, p<0.001) were more pronounced in advanced stages of cirrhosis. The NSBB-associated changes in WBC correlated with changes in CRP (Spearman’s ρ=0.228, p<0.001), PCT (ρ=0.470, p=0.002) and IL-6 (ρ=0.501, p=0.001), but not with changes in HVPG (ρ=0.097, p=0.088).

An NSBB-related decrease in systemic inflammation (ie, WBC reduction ≥15%) was achieved by n=91 (29.6%) patients and was found to be an independent protective factor of further decompensation (subdistribution HR, sHR: 0.694 (0.49–0.98), p=0.038) in decompensated patients and of liver-related mortality in the overall patient cohort (sHR: 0.561 (0.356–0.883), p=0.013).

Conclusion

NSBB therapy seems to exert systemic anti-inflammatory activity as evidenced by reductions of WBC and CRP levels. Interestingly, this effect was most pronounced in Child-C and independent of HVPG response. An NSBB-related WBC reduction by ≥15% was associated with a decreased risk of further decompensation and death.
Methodological considerations in MVC epidemiological research
Authors: Fridman Liraz , Rothman Linda , Howard Andrew William , Hagel Brent E , Macarthur Colin
Published: November 2020

Background

The global burden of MVC injuries and deaths among vulnerable road users, has led to the implementation of prevention programmes and policies at the local and national level. MVC epidemiological research is key to quantifying MVC burden, identifying risk factors and evaluating interventions. There are, however, several methodological considerations in MVC epidemiological research.

Methods

This manuscript collates and describes methodological considerations in MVC epidemiological research, using examples drawn from published studies, with a focus on the vulnerable road user population of children and adolescents.

Results

Methodological considerations in MVC epidemiological research include the availability and quality of data to measure counts and calculate event rates and challenges in evaluation related to study design, measurement and statistical analysis. Recommendations include innovative data collection (eg, naturalistic design, stepped-wedge clinical trials), combining data sources for a more comprehensive representation of collision events, and the use of machine learning/artificial intelligence for large data sets.

Conclusions

MVC epidemiological research can be challenging at all levels: data capture and quality, study design, measurement and analysis. Addressing these challenges using innovative data collection and analysis methods is required.
Concomitant or delayed anti-TNF differentially impact on immune-related adverse events and antitumor efficacy after anti-CD40 therapy
Authors: Jacoberger-Foissac Celia , Blake Stephen J , Liu Jing , McDonald Elizabeth , Triscott Hannah , Nakamura Kyohei , Smyth Mark J , Teng Michele WL
Published: November 2020

Background

Concomitant tumor necrosis factor (TNF) neutralization in combination with immune checkpoint inhibitors (ICIs) reduces clinical immune-related adverse events (irAEs) and appears to improve antitumor efficacy in preclinical tumor models. Agonistic antibodies targeting costimulatory receptors such as CD40 represent an additional strategy to boost antitumor immune response and potentiate the activity of ICIs. However, the dose-limiting toxicities observed in anti-CD40-treated cancer patients have hindered its clinical development.

Methods

We previously described a mouse model to assess both antitumor activity and irAEs induced by various effective combination immunotherapies. Using the BALB/c and C57BL/6 strains of FoxP3-GFP-DTR (FoxP3DTR) mice, transient depletion of T regulatory cells (Tregs) prior to immunotherapy with additional immunomodulatory antibodies, lowered immune self-tolerance, resulting in the development of a spectrum of physical and biochemical irAEs similar to that reported clinically. In MC38 and 4T1.2 tumor models, following transient Treg depletion, we evaluated the impact of anti-CD40 on antitumor efficacy and the development of irAEs and the impact of concomitant or delayed TNF blockade on both these parameters. Physical irAEs were scored and biochemical irAEs were measured in the serum (ALT and cytokine levels). Histopathological liver and colon tissue analysis were performed to assess immune cell infiltration and tissue damage.

Results

Similar to early clinical trials of CD40 agonists, in our tumor models we observed liver toxicities and rapid release of proinflammatory cytokines (TNF, interleukin 6, interferon-γ). In the BALB/c strain, anti-CD40 induced severe physical and biochemical irAEs. Concomitant anti-TNF treatment abrogated weight loss, liver damage and colitis, which consequently resulted in an improved clinical score. However, concomitant anti-TNF impaired antitumor response in a proportion of anti-CD40-treated C57BL/6 FoxP3DTR mice. Delaying TNF blockade in these mice reduced biochemical but not physical irAEs while preserving antitumor efficacy.

Conclusions

Our results suggest concomitant rather than delayed anti-TNF is most effective in reducing biochemical and physical irAEs induced by anti-CD40, although it had the potential to negatively impact antitumor efficacy. Furthermore, our findings highlight the utility of our mouse model to assess the severity of irAEs induced by novel immunotherapeutic agents and evaluate whether their toxicity and antitumor efficacy can be uncoupled.
Your leadership style: why understanding yourself matters
Authors: Price-Dowd Clare Felicity Jane
Published: November 2020

Understanding of personal leadership style has been shown to be a key part of effective leadership practice. It has been a topic of interest for many decades as we have tried to understand, and replicate, what makes those considered to be ‘great leaders’ so successful. This article gives a brief introduction to different leadership ‘theories’, leadership ‘styles’ and the effect they have on the ‘climate’ in organisations. Having an understanding of the different approaches can help leaders be more effective through comprehending how and why they do what they do, as well as helping them identify where and when they need to adapt their style. By considering how our understanding of leadership has evolved, it is possible to show how effective leadership is not linked to one approach. It is a combination of knowledge, attitudes and behaviours with a focus on both the task in hand and concern for those undertaking that task. Furthermore this understanding supports impactful personal development, which creates positive climates in organisations where compassionate and inclusive leadership behaviours can, and do result in better outcomes for staff and patients.
Evidence-based medical leadership development: a systematic review
Authors: Lyons Oscar , George Robynne , Galante Joao R , Mafi Alexander , Fordwoh Thomas , Frich Jan , Geerts Jaason Matthew
Published: November 2020

Health systems invest significant resources in leadership development for physicians and other health professionals. Competent leadership is considered vital for maintaining and improving quality and patient safety. We carried out this systematic review to synthesise new empirical evidence regarding medical leadership development programme factors which are associated with outcomes at the clinical and organisational levels. Using Ovid MEDLINE, we conducted a database search using both free text and Medical Subject Headings. We then conducted an extensive hand-search of references and of citations in known healthcare leadership development reviews. We applied the Medical Education Research Study Quality Indicator (MERSQI) and the Joanna Briggs Institute (JBI) Critical Appraisal Tool to determine study reliability, and synthesised results using a meta-aggregation approach. 117 studies were included in this systematic review. 28 studies met criteria for higher reliability studies. The median critical appraisal score according to the MERSQI was 8.5/18 and the median critical appraisal score according to the JBI was 3/10. There were recurring causes of low study quality scores related to study design, data analysis and reporting. There was considerable heterogeneity in intervention design and evaluation design. Programmes with internal or mixed faculty were significantly more likely to report organisational outcomes than programmes with external faculty only (p=0.049). Project work and mentoring increased the likelihood of organisational outcomes. No leadership development content area was particularly associated with organisational outcomes. In leadership development programmes in healthcare, external faculty should be used to supplement in-house faculty and not be a replacement for in-house expertise. To facilitate organisational outcomes, interventions should include project work and mentoring. Educational methods appear to be more important for organisational outcomes than specific curriculum content. Improving evaluation design will allow educators and evaluators to more effectively understand factors which are reliably associated with organisational outcomes of leadership development.
The dying patient: taboo, controversy and missing terms of reference for designers—an architectural perspective
Authors: Bellamy Annie , Clark Sam , Anstey Sally
Published: November 2020

Contemporary society has grown seemingly detached from the realities of growing old and subsequently, dying. A consequence, perhaps, of death becoming increasingly overmedicalised, nearly one in two UK nationals die institutional deaths. In this article we, two architectural scholars engaged in teaching, research and practice and a nurse and healthcare scholar with a focus on end-of-life care and peoples’ experiences, wish to draw attention to a controversy resulting from a paucity in current literature on the terms of reference of the dying ‘patient’ as we navigate the future implications of the COVID-19 pandemic. This contributes to a relative lack of touchstones for architects to refer to when designing person-centred palliative care environments. Unlike common building types, architects are extremely unlikely to have lived experience of palliative care environments as patients; and therefore, require the help of healthcare professionals to imagine and empathise with the requirements of a person dying away from home. This paper includes a review of ageing and dying literature to understand, and distil from an architectural perspective,who, design professionals, are designing for and to remember the nuanced characteristics of those we hold a duty of care toward. We ask readers to heed the importance of accurate terms of reference, especially when commissioning and/or designing environments of palliative care. Furthermore, we put forward an appeal for interdisciplinary collaboration to develop a framework for codesigning positive experiences of person-centred careandenvironments at the end of life.
Creating a market for IQOS: analysis of Philip Morris’ strategy to introduce heated tobacco products to the Australian consumer market
Authors: Watts Christina , Burton Suzan , Freeman Becky
Published: November 2020

Background

Philip Morris International has made efforts to expand the sale of its heated tobacco product, IQOS, into new domestic markets globally. In Australia, where heated tobacco products are prohibited, the company recently attempted to overturn Australian legislation in order to permit their sale. In light of this recent move, this study presents a case study of the company’s strategies to legalise and distribute IQOS in the Australian market.

Methods

To assess Philip Morris’ lobbying activities and corporate strategies, a case study approach was used by triangulating data from three sources: interviews with former Philip Morris employees, news articles reporting Philip Morris’ lobbying activities or plans for IQOS in Australia, and submissions to relevant government inquiries and reviews from 2015 to 2020.

Results

Philip Morris has actively lobbied Australian policy-makers to overturn bans on nicotine-containing products. Information obtained from key informants and Philip Morris’ government submissions indicates that the company’s goal is for heated tobacco products in Australia to be regulated in a new product category, exempt from tobacco control laws. Informants revealed that Philip Morris was also working to establish a network of upmarket pubs, clubs and bars where they could sell IQOS once legalisation was achieved.

Conclusions

Philip Morris has strongly lobbied the Australian government to legalise heated tobacco products, while simultaneously making plans to sell IQOS at young adult-friendly premises such as bars, clubs and pubs if its proposed legislative changes are made. This case study provides valuable insights for other countries where Philip Morris may be replicating similar strategies to weaken tobacco control legislation.
Extraluminal oesophageal stricture following traumatic diaphragmatic hernia repair in a cat
Authors: Maskell Kirsty Ann , Corzo‐Menendez Nuria , Henderson Elisabeth
Published: November 2020

A one‐year six‐month‐old male neutered domestic shorthaired cat was presented for regurgitation of increasing severity, 10 days following surgical repair of a suspected traumatic diaphragmatic hernia. Diaphragmatic hernia repair had been carried out between the aortic and oesophageal hiatuses. Abdominal ultrasound and video fluoroscopy were performed, revealing an extraluminal oesophageal obstruction. Exploratory laparotomy performed at the referral centre revealed a large multifilament knot and associated adhesions causing a stricture of the oesophagus. Removal of previously placed suture material and revised hernia closure was performed. Closure involved using a simple interrupted suture pattern, ensuring no excessive tension was placed on the tissue. In addition, a left sided gastropexy was carried out. No further regurgitation was noted following revision surgery. Stricture of the oesophagus was not previously a recognised complication of diaphragmatic hernia repair and this case highlights the importance of suture material selection and placement.
Clearing up cloudy waters: a review of sediment impacts to unionid freshwater mussels
Authors: Goldsmith Amanda M. , Jaber Fouad H. , Ahmari Habib , Randklev Charles R.
Published: November 2020

Freshwater unionid mussels are among the most imperiled fauna in North America, and their decline has been partially attributed to sediment from anthropogenic activities. However, there remains a debate regarding the role played by sediment in mussel declines due to a lack of field and laboratory evidence. If sediment is responsible for mussel declines, then a lack of information will likely impede efforts to mitigate species declines and protect remaining habitat. However, if the impacts of sediment are overstated, time and resources may be wasted on a threat that has little bearing on mussel declines or habitat loss. Given this knowledge gap, the purpose of this paper is to review the literature focused on the potential impact of suspended sediment and sedimentation on freshwater mussels. We focused our search on suspended sediment, expressed either as suspended sediment concentration (SSC) or total suspended solids (TSS), and sediment deposition and scour. We found increases in suspended solids could impact mussels by decreasing food availability, physically interfering with filter feeding and respiration, and impeding various aspects of the mussel–host relationship. We also found mussel–sediment thresholds, wherein certain concentrations of sediment caused significant declines in population performance, which could serve as reference points for ecological research and management. Specifically, we found clearance rates (a measure of feeding) were negatively impacted by TSS concentrations >8 mg/L, and respiratory stress occurred at ∼600 mg/L. Declines in fertilization success and glochidial (i.e., mussel larvae) development were observed at TSS values of 15 mg/L, and reproductive failure occurred at 20 mg/L. Impacts on host fish attachment and glochidial encystment occurred at TSS concentrations of 1250–5000 mg/L. Impacts on fish varied depending on the biological endpoint but typically occurred at TSS values ranging from 20 to 5000 mg/L. We also found mussels were sensitive to smothering and mortality occurred at depths as low as 0.6–2.5 cm of substrate. Finally, we found relative shear stress (RSS) values >1, which is a measure of substrate stability in response to scour and entrainment, resulted in significant declines in mussel biodiversity.
Chapter 6 Jubaila–Arab–Hith sequences
Authors: Wilson A. O.
Published: November 2020

During deposition of the Jubaila-Arab-Hith sequences, the most important Arab-D reservoir, the Arab-C to A reservoirs and the Arab and Hith anhydrite seals were formed. The Kimmeridgian Jubaila-Arab-D transgression (MFS J70) restored and expanded the intrashelf basin geometry. The restored basin was filled by deeper subtidal Jubaila facies, which graded upwards to the Arab-D reservoir facies. In the late stages the Arab-D facies included both basin rim shoal facies and at least one large isolated shoal surrounded by ‘lagoonal’ intrashelf basin remnants interconnected by accessway channels. This differentiation was facilitated by local structural growth of a few metres. The Arab-D reservoir is overlain by the Arab-D anhydrite, deposited initially as gypsum in broad salinas, which blanketed the intrashelf basin region, forming the first major seal. By the end of Arab-D anhydrite deposition, the entire intrashelf basin area had been ﬁlled and transformed into a broad evaporite platform. Atop this platform, the Arab-C to -A (MFS J80-100) alternating shallow water carbonate and anhydrite (initially gypsum) intervals were deposited, ending regionally with the thick Hith Anhydrite Formation. The depositional setting for each of the main Jubaila-Arab-Hith sequences is reviewed and illustrated. The evolution of Jubaila-Arab-D reservoir models is discussed. Different interpretations of Jubaila-Arab-D-Hith sequences are compared, including the issue of whether the Arab carbonate-evaporite depositional sequence boundaries should be taken at the top of the carbonate intervals or the top of the anhydrites. Examples are included which illustrate how easterly palaeowind directions were an important factor controlling Arab-D facies variation. A scenario is presented to show how the Late Jurassic Tethys shelf uplift and low angle unconformity coupled with westward structural tilt were important. An alternating balance developed between the evolving land barrier and eustatic sea-level change during deposition of the Arab carbonate–evaporites and the Hith Anhydrite. Carbonates were deposited when the barrier was inundated and evaporites when the barrier was exposed and the area restricted and hypersaline. A major late Tithonian ﬂooding event (MFS J110) formed the top-Hith Manifa carbonate reservoir and brought open marine carbonate mud-rich deposition to the area, continuing without hiatus into the Early Cretaceous.
Chapter 8 Summary and conclusions
Authors: Wilson A. O.
Published: November 2020

This chapter summarizes the main conclusions in this Memoir. Included is a comparison of the Arabian Intrashelf Basin events to the Haq (2017) revision of the Jurassic sea level curve. One conclusion is that the Mid- to Late Jurassic Arabian Intrashelf Basin, with its stable tectonic setting during deposition, extensive present-day outcrops and subsurface well and seismic control, may be an ideal place to evaluate global changes during its time span. The last part of this chapter lists and discusses topics and questions raised within this Memoir which warrant further evaluation.
Genetic Variation and Hybridization in Evolutionary Radiations of Cichlid Fishes
Authors: Svardal Hannes , Salzburger Walter , Malinsky Milan
Published: November 2020

Evolutionary radiations are responsible for much of the variation in biodiversity across taxa. Cichlid fishes are well known for spectacular evolutionary radiations, as they have repeatedly evolved into large and phenotypically diverse arrays of species. Cichlid genomes carry signatures of past events and, at the same time, are the substrate for ongoing evolution. We survey genome-wide data and the available literature covering 438 cichlid populations (412 species) across multiple radiations to synthesize information about patterns and sharing of genetic variation. Nucleotide diversity within species is low in cichlids, with 92% of surveyed populations having less diversity than the median value found in other vertebrates. Divergence within radiations is also low, and a large proportion of variation is shared among species due to incomplete lineage sorting and widespread hybridization. Population genetics therefore provides a suitable conceptual framework for evolutionary genomic studies of cichlid radiations. We focus in detail on the roles of hybridization in shaping the patterns of genetic variation and in promoting cichlid diversification.
Perspectives on Policing: Cynthia Lum
Authors: Lum Cynthia
Published: November 2020

The Editorial Committee of the Annual Review of Criminology has launched a new section within the journal in which we invite one or more authors to write a more personal and yet scholarly article that puts forth their perspective on an important and timely topic. For Volume 4, we asked Dr. Cynthia Lum and Dr. Phillip Atiba Goff to provide their perspectives on policing.

We hope our readers enjoy this new and exciting series of “Perspectives.”
Evaluating the High-Voltage Stability of Conductive Carbon and Ethylene Carbonate with Various Lithium Salts
Authors: Metzger Michael , Walke Patrick , Solchenbach Sophie , Salitra Gregory , Aurbach Doron , Gasteiger Hubert A.
Published: November 2020

The anodic stability of conductive carbon and alkyl carbonate-based electrolyte solvents is a crucial requirement for the success of high-voltage lithium-ion cells, particularly at elevated temperatures. In order to quantify the oxidative stability of ethylene carbonate (EC), a critical component of lithium-ion battery electrolytes, and conductive carbons, we have evaluated the stability of a 13C-labeled conductive carbon and an EC-based electrolyte up to 5.5 V vs Li+/Li. We examined the behavior between 25 °C and 60 °C for four different lithium salts (LiClO4, LiPF6, LiTFSI, and LiBF4). This is done by means of On-line Electrochemical Mass Spectrometry (OEMS), whereby the isotopically labeled carbon is used to differentiate between the CO and CO2 evolution from the oxidation of the conductive carbon (13CO/13CO2) and of the electrolyte (12CO/12CO2). Our analysis reveals that conductive carbon is stable with LiPF6, however, pronounced electrolyte oxidation and gaseous byproducts like HF, PF5 and POF3 are observed. LiBF4 provides an excellent carbon and electrolyte stability even at 50 °C, rendering it as a better salt than LiPF6 for the cathode side in high-voltage lithium-ion cells.
Regulation of direct adipose tissue free fatty acid storage during mixed meal ingestion and high free fatty acid concentration conditions
Authors: Zhang Lili , Hames Kazanna C. , Jensen Michael D.
Published: November 2020

We found that direct free fatty acid (FFA) storage (fatty acid cycling back into adipose tissue) in leg vs. abdominal subcutaneous fat is related to regional differences in adipose tissue diacylglycerol acyltransferase (DGAT) activity under high-FFA conditions and to differences in adipose tissue acyl-CoA synthetase (ACS)activity under meal ingestion conditions. We also found that direct FFA storage rates in leg fat were significantly less in physically active than sedentary adults. Direct FFA storage into adipocytes relates to body fat distribution. Adipose tissue CD36, ACS, and DGAT may account for some of the between-depot and interindividual variability in FFA storage. These studies were to test whether CD36, ACS, or DGAT might be important for direct palmitate storage under meal ingestion or high-FFA conditions. We measured upper (UBSQ) and lower body subcutaneous (LBSQ) adipose tissue FFA storage rates by infusing palmitate tracers intravenously and performing adipose biopsies under hypoinsulinemic (high-FFA) and mixed-meal conditions. We recruited five postmenopausal women, physically active males (5) and females (5), and sedentary males (5) and females (5). We found that 1) the ratio of UBSQ to LBSQ DGAT activity predicted the ratio of palmitate storage [adjusted R = 0.25, F = 8.0, P = 0.01, 95% CI (0.07, 0.48)] under high-FFA conditions; 2) the ratio of UBSQ to LBSQ ACS activity predicted the ratio of palmitate storage under meal conditions [adjusted R = 0.18, F = 6.3, P = 0.02, 95% CI (0.12, 1.28)]; 3) LBSQ direct palmitate storage rates were significantly less in physically active than sedentary and 4) adipose tissue CD36 protein content, ACS, or DGAT activities did not independently predict palmitate storage rates. We conclude that physically active adults have lesser fatty acid cycling back into adipose tissue and that adipose ACS and DGAT may affect competition between UBSQ and LBSQ adipose for direct palmitate storage.
The Change of Systemic Immune-Inflammation Index Independently Predicts Survival of Colorectal Cancer Patients after Curative Resection
Authors: Chen Qingqing , Wu Haohao , Guo Xinwei , Gu Ke , Wang Wenjie , Chen Xiaochen , Ji Shengjun , Yang Hui , Zhu Jiahao
Published: November 2020

Background. The systemic immune-inflammation index (SII) has an important role in predicting survival in some solid tumors. However, little information is available concerning the change of the SII (∆SII) in colorectal cancer (CRC) after curative resection. This study was designed to evaluate the role of ∆SII in CRC patients who received surgery. Methods. A total 206 patients were enrolled in this study. Clinicopathologic characteristics and survival were assessed. The relationships between overall survival (OS), disease-free survival (DFS), and ∆SII were analyzed with both univariate Kaplan-Meier and multivariate Cox regression methods. Results. Based on the patient data, the receiver operating characteristic (ROC) optimal cutoff value of ∆SII was 127.7 for OS prediction. The 3-year and 5-year OS rates, respectively, were 60.4% and 36.7% in the high-∆SII group (>127.7) and 87.6% and 79.8% in the low-∆SII group (≤127.7). The 3-year and 5-year DFS rates, respectively, were 54.1% and 34.1% in the high-∆SII group and 80.3% and 78.5% in the low-∆SII group. In the univariate analysis, smoking, pathological stages III-IV, high-middle degree of differentiation, lymphatic invasion, vascular invasion, and the high-ΔSII group were associated with poor OS. Adjuvant therapy, pathological stages III-IV, vascular invasion, and ΔSII were able to predict DFS. Multivariate analysis revealed that pathological stages III-IV (

HR
=
0.442

, 95%

CI
=
0.236

-0.827,

p
=
0.011

), vascular invasion (

HR
=
2.182

, 95%

CI
=
1.243

-3.829,

p
=
0.007

), and the high-ΔSII group (

HR
=
4.301

, 95%

CI
=
2.517

-7.350,

p
<
0.001

) were independent predictors for OS. Adjuvant therapy (

HR
=
0.415

, 95%

CI
=
0.250

-0.687,

p
=
0.001

), vascular invasion (

HR
=
3.305

, 95%

CI
=
1.944

-5.620,

p
<
0.001

), and the high-ΔSII group (

HR
=
4.924

, 95%

CI
=
2.992

-8.102,

p
<
0.001

) were significant prognostic factors for DFS. Conclusions. The present study demonstrated that ∆SII was associated with the clinical outcome in CRC patients undergoing curative resection, supporting the role of ∆SII as a prognostic biomarker.
A Novel Multiway Splits Decision Tree for Multiple Types of Data
Authors: Liu Zhenyu , Wen Tao , Sun Wei , Zhang Qilong
Published: November 2020

Classical decision trees such as C4.5 and CART partition the feature space using axis-parallel splits. Oblique decision trees use the oblique splits based on linear combinations of features to potentially simplify the boundary structure. Although oblique decision trees have higher generalization accuracy, most oblique split methods are not directly conducive to the categorical data and are computationally expensive. In this paper, we propose a multiway splits decision tree (MSDT) algorithm, which adopts feature weighting and clustering. This method can combine multiple numerical features, multiple categorical features, or multiple mixed features. Experimental results show that MSDT has excellent performance for multiple types of data.
Vertical Transmission of COVID-19 to the Neonate
Authors: Moreno Sindy C. , To Justin , Chun Hajoon , Ngai Ivan M.
Published: November 2020

Objective. To estimate the incidence rate of vertical transmission of coronavirus disease 2019 (COVID-19) to the neonate during the third trimester. Study Design. We conducted a retrospective observational study of pregnant women diagnosed with COVID-19 during the third trimester, who delivered at Flushing Hospital Medical Centre (FHMC) or Jamaica Hospital Medical Centre (JHMC) between March 20, 2020, and April 30, 2020. The study participants were symptomatic pregnant women diagnosed with COVID-19 via positive SARS-CoV-2 RNA, real-time reverse transcription-polymerase chain reaction (SARS-CoV-2 rRT-PCR) test. Evidence of vertical transmission was assessed in the neonate via a SARS-CoV-2 rRT-PCR test, with nasopharyngeal swab samples collected on the neonates after 24 hours of birth. The exclusion criteria for this study were maternal or neonate records without SARS-CoV-2 rRT-PCR test results, neonates not delivered at FHMC or JHMC, and foetuses with suspected foetal anomalies or incomplete medical records. Results. We identified 19 symptomatic pregnant women diagnosed with COVID-19, including two women with twin pregnancies. Seven patients (36.8%) were delivered via cesarean. 12 patients (63.1%) presented in spontaneous labour, and 8 (38.1%) had preterm delivery. No maternal intensive care unit admission, maternal sepsis, or maternal mortality was observed. Twenty-one neonates were evaluated for COVID-19 after birth. SARS-CoV-2 rRT-PCR test results were negative in 100% of the neonates. Thirteen neonates (61.9%) were admitted to the neonatal intensive care unit. Prematurity was the most common cause of NICU admission 6 (46.1%), with a length of stay of

5.5
±
6.4

days. No invasive mechanical ventilation, neonatal sepsis, or neonatal mortality was observed. Conclusion. In our cohort, symptomatic COVID-19 during the third trimester of pregnancy was not associated with vertical transmission to the neonate.
Three-Dimensional Finite Element Numerical Simulation and Analysis of Solid-State Processing of Metal Material
Authors: Su Guang , Zhang Aimin
Published: November 2020

Solid-state processing of metal material is a very complex physical and chemical process, which is coupled by a series of variations including heat transfer, momentum transfer, mass transfer, and phase change. Applying three-dimensional (3D) finite element numerical method to the simulation of solid-state processing can perform analysis of metal material’s forging processes before production trial production, can obtain their relevant information such as material flow law, temperature field, and strain field under the minimum physical test conditions, thereby predicting metal material’s forming defects and improving their forging quality. On the basis of summarizing and analyzing previous research works, this paper expounded the current status and significance of solid-state processing of metal materials, elaborated the development background, current status, and future challenges of 3D finite element numerical simulation, introduced the discrimination method and free surface solution method of numerical simulation calculation, conducted finite element model’s geometric assumptions, material selection, element division, model establishment, parameter selection, and initial and boundary condition determination, and simulated and analyzed rheological casting, remelting heating, thixoforming, and rotary piercing processes of metal materials. The results show that the 3D finite element numerical method can not only simulate various processes of flow field, temperature field, stress field, and microstructure in solid-state processing but also can provide a reliable basis for effectively obtaining a reasonable description and finding a more optimized design plan for metal material processing in a short time, which plays an important role in understanding and analyzing solid metal forming process, controlling and optimizing process parameters, guiding and mastering rheological casting, and secondary heating and rotary piercing of metal materials.
Discrete-Time Predator-Prey Model with Bifurcations and Chaos
Authors: Al-Basyouni K. S. , Khan A. Q.
Published: November 2020

In this paper, local dynamics, bifurcations and chaos control in a discrete-time predator-prey model have been explored in

ℝ
+
2

. It is proved that the model has a trivial fixed point for all parametric values and the unique positive fixed point under definite parametric conditions. By the existing linear stability theory, we studied the topological classifications at fixed points. It is explored that at trivial fixed point model does not undergo the flip bifurcation, but flip bifurcation occurs at the unique positive fixed point, and no other bifurcations occur at this point. Numerical simulations are performed not only to demonstrate obtained theoretical results but also to tell the complex behaviors in orbits of period-4, period-6, period-8, period-12, period-17, and period-18. We have computed the Maximum Lyapunov exponents as well as fractal dimension numerically to demonstrate the appearance of chaotic behaviors in the considered model. Further feedback control method is employed to stabilize chaos existing in the model. Finally, existence of periodic points at fixed points for the model is also explored.
Unusual Bladder Metastasis from a Primary Gastric Carcinoma: Two Case Reports and Review of Literature
Authors: Nouioui Mohamed Ali , Saadi Ahmed , Chakroun Marouene , Oueslati Amine , Ksentini Meriem , Bouzouita Abderrazak , Derouiche Amine , Slama Mohamed Riadh Ben , Rammeh Soumaya , Ayed Haroun , Chebil Mohamed
Published: November 2020

Primary bladder cancer is a frequent malignancy in the urology field, whereas secondary bladder neoplasms from a distant organ are extremely rare. This paper aims to report two rare cases of a secondary tumor of the urinary bladder from a primary gastric tumor and to perform a literature review of similar reported cases in order to better characterize its clinicopathological features and diagnosis in effort to shed light on this rare condition. The final diagnosis of secondary adenocarcinoma was made histologically after transurethral biopsy or resection of the bladder lesion. In one case, the bladder metastasis was a synchronous metastasis, and in the second case, it occurred under chemotherapy five months after initial diagnosis with gastric adenocarcinoma. Secondary adenocarcinoma of the bladder is extremely rare but should be considered when evaluating a bladder lesion in a patient treated for gastric cancer or presenting with gastric symptoms.
Paradox of Enrichment in a Stochastic Predator-Prey Model
Authors: Alebraheem Jawdat
Published: November 2020

We propose a stochastic predator-prey model to study a novel idea that involves investigating random noises effects on the enrichment paradox phenomenon. Existence and stochastic boundedness of a unique positive solution with positive initial conditions are proved. The global asymptotic stability is studied to determine the occurrence of the enrichment paradox phenomenon. We show theoretically that intensive noises play an important role in the occurrence of the phenomenon, where increasing intensive noises lead to occurrence of the paradox of enrichment. We perform numerical simulations to verify and demonstrate the theoretical results. The new results in this study may contribute to increasing attention to study the random noise effects on some ecological and biological phenomena as the paradox of enrichment.
Research on Low-Frequency Swaying Mechanism of Metro Vehicles Based on Wheel-Rail Relationship
Authors: Shi Yixuan , Dai Huanyun , Wang Qunsheng , Wei Lai , Shi Huailong
Published: November 2020

For the worn state of the wheel, metro vehicles often suffer a serious carbody swaying issue, which causes the lateral stability of the vehicle to exceed the limit and affects the ride comfort. An experimental test was carried out on this investigation to study the carbody swaying of the metro vehicle. The field results show that the vehicle system vibrates at around 2.5 Hz in the lateral direction, which leads to the low-frequency swaying on the carbody. In order to explore the formation mechanism of the carbody low-frequency swaying and its relationship with the geometry matching of wheel-rail contact, measured rail and wheel profiles are employed to present a comparative analysis with respect to the initial contact geometry. A multibody dynamic railway vehicle system is established further. Time-domain simulations state that the 2.5 Hz vibration on the carbody belongs to the natural frequency of the vehicle, and the amplitude is larger for the measured wheels than that of the standard wheel profiles. By using the root-locus method, it can be determined that the 2.5 Hz vibration corresponds to the upper swaying mode of the carbody. With the increase in the wheel-rail equivalent conicity, the hunting frequency of bogie increases gradually, which converts frequency with the upper swaying frequency of carbody and leads to carbody low-frequency swaying.
Neonatal Hypernatremic Dehydration Associated with Lactation Failure
Authors: Ogbe Zemichael , Andegiorgish Amanuel Kidane , Zeray Aradom Habteab , Zeng Lingxia
Published: November 2020

Hypernatremic dehydration secondary to lactation failure remains a potentially life-threatening condition in countries where advanced laboratory investigations are scarce. An 11-day term baby with excessive weight loss (33.6%), reduced urine output, fever, jaundice, doughy skin, opisthotonus posturing, and tachycardia with poor perfusion was presented to our neonatal care. The baby was diagnosed with shock with hypernatremic dehydration. An initial bolus of 20 ml/kg of N/S was repeated 3 times (each over 20 minutes), i.e., a total of 204 ml was given over 1 hr, until the vital signs were normalized to PR-145, RR-45, T-37.2°C, SPO2-100%, and CRT < 3 seconds, and the baby began to void urine. Free water deficit and sodium excess was managed by gradual and slow correction over 72 hours to prevent cerebral oedema and neurologic sequelae. The baby required reconstituted solutions of 5% D/W + 1/2 N/S at a rate of 27 ml/hr for 72 hrs. Sepsis and hyperbilirubinemia were treated with antibiotics and phototherapy. Management of symptomatic hypernatremic dehydration must be considered in settings with inadequate laboratory facilities.
A Stochastic Programming Approach for Scheduling Extra Metro Trains to Serve Passengers from Uncertain Delayed High-Speed Railway Trains
Authors: Long Sihui , Meng Lingyun , Luan Xiaojie , Trivella Alessio , Miao Jianrui , Corman Francesco
Published: November 2020

The metro system is an important component of the urban transportation system due to the large volume of transported passengers. Hub stations connecting metro and high-speed railway (HSR) networks are particularly critical in this system. When HSR trains are delayed due to a disruption on the HSR network, passengers of these trains arriving at the hub station at night may fail to get their last metro connection. The metro operator can thus decide to schedule extra metro trains at night to serve passengers from delayed HSR trains. In this paper, we consider the extra metro train scheduling problem in which the metro operator decides how many extra metro trains to dispatch and their schedules. The problem is complex because (i) the arrival of delayed HSR trains is usually uncertain, and (ii) the operator has to minimize operating costs (i.e., number of additional trains and operation-ending time) but maximize the number of served passengers, which are two conflicting objectives. In other words, the problem we consider is stochastic and biobjective. We formulate this problem as a two-stage stochastic program with recourse and use an epsilon-constrained method to find a set of nondominated solutions. We perform extensive numerical experiments using realistic instances based on the Beijing metro network and two HSR lines connected to this network. We find that our stochastic model outperforms out-of-sample a deterministic model that relies on forecasts of the delay by a range of 3–5%. Moreover, we show that our solutions are nearly optimal by computing a perfect information dual bound and obtaining average optimality gaps below 1%.
Impact of Body Mass Index on Presence of ctDNA and Disease Recurrence after Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: Analysis from BRE12-158
Authors: Ballinger Tarah J. , Jiang Guanglong , Kassem Nawal , Radovich Milan , Schneider Bryan P.
Published: November 2020

Purpose:

This retrospective analysis aimed to determine the relationship between body mass index (BMI) and circulating tumor DNA (ctDNA) in triple-negative breast cancer (TNBC), and to evaluate the impact of BMI on disease recurrence and survival in the homogeneous, high-risk population of patients with residual TNBC after neoadjuvant chemotherapy.

Experimental Design:

BRE12-158 was a phase II trial of genomically directed therapy versus physician’s choice in residual TNBC after chemotherapy. ctDNA was isolated from plasma samples, and categorized as positive or negative. BMI (kg/m2) after surgery was analyzed as both a continuous and categorical variable: normal weight, <25; overweight, 25–30; and obese, ≥30. We compared ctDNA category and BMI, and estimated probability of disease-free survival (DFS), distant DFS (DDFS), and overall survival (OS) by BMI.

Results:

Of 177 patients in BRE12-158, 172 had BMI and 140 had ctDNA data. There was no difference in mean BMI between those with ctDNA positivity versus negativity (P = 0.48). There was no relationship between BMI category and presence of ctDNA (P = 0.31). In multivariate analysis, continuous BMI was not prognostic of DDFS (P = 0.996), DFS (P = 0.41), or OS (P = 0.98). There was no association between BMI categories and survival (P = 0.92, 0.74, and 0.97 for DDFS, DFS, and OS, respectively).

Conclusions:

In patients with residual TNBC after neoadjuvant chemotherapy, BMI was not prognostic of DDFS, DFS, or OS. There was no signal of a relationship between BMI and presence of ctDNA. This suggests inherent aggressive tumor biology, in which host phenotype may have less influence and impact of weight loss interventions may be diminished.
CDK12 Deficiency and the Immune Microenvironment in Prostate Cancer
Authors: Lotan Tamara L. , Antonarakis Emmanuel S.
Published: November 2020

CDK12 inactivation in prostate cancer is associated with tandem genomic duplications that may generate fusion-associated neoantigens and elicit immune responses amenable to checkpoint blockade. In the first study to comprehensively characterize the T-cell immune microenvironment of CDK12-deficient prostate cancers, subsets of immunosuppressive CD4+FOXP3− T cells were increased compared with CDK12-proficient controls.

See related article by Rescigno et al., p. 566