bluuebunny/crossref_metadata_2025 huggingface dataset:
Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE): Position paper on diagnosis, prognosis, and treatment by theMNGIEInternational Network
Authors: Hirano Michio , Carelli Valerio , De Giorgio Roberto , Pironi Loris , Accarino Anna , Cenacchi Giovanna , D'Alessandro Roberto , Filosto Massimiliano , Martí Ramon , Nonino Francesco , Pinna Antonio Daniele , Baldin Elisa , Bax Bridget Elizabeth , Bolletta Alessio , Bolletta Riccardo , Boschetti Elisa , Cescon Matteo , D'Angelo Roberto , Dotti Maria Teresa , Giordano Carla , Gramegna Laura Ludovica , Levene Michelle , Lodi Raffaele , Mandel Hanna , Morelli Maria Cristina , Musumeci Olimpia , Pugliese Alessia , Scarpelli Mauro , Siniscalchi Antonio , Spinazzola Antonella , Tal Galit , Torres‐Torronteras Javier , Vignatelli Luca , Zaidman Irina , Zoller Heinz , Rinaldi Rita , Zeviani Massimo
Published: August 2020

Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare autosomal recessive disease caused byTYMPmutations and thymidine phosphorylase (TP) deficiency. Thymidine and deoxyuridine accumulate impairing the mitochondrial DNA maintenance and integrity. Clinically, patients show severe and progressive gastrointestinal and neurological manifestations. The onset typically occurs in the second decade of life and mean age at death is 37 years. Signs and symptoms of MNGIE are heterogeneous and confirmatory diagnostic tests are not routinely performed by most laboratories, accounting for common misdiagnosis. Factors predictive of progression and appropriate tests for monitoring are still undefined. Several treatment options showed promising results in restoring the biochemical imbalance of MNGIE. The lack of controlled studies with appropriate follow‐up accounts for the limited evidence informing diagnostic and therapeutic choices. The International Consensus Conference (ICC) on MNGIE, held in Bologna, Italy, on 30 March to 31 March 2019, aimed at an evidence‐based consensus on diagnosis, prognosis, and treatment of MNGIE among experts, patients, caregivers and other stakeholders involved in caring the condition. The conference was conducted according to the National Institute of Health Consensus Conference methodology. A consensus development panel formulated a set of statements and proposed a research agenda. Specifically, the ICC produced recommendations on: (a) diagnostic pathway; (b) prognosis and the main predictors of disease progression; (c) efficacy and safety of treatments; and (f) research priorities on diagnosis, prognosis, and treatment. The Bologna ICC on diagnosis, management and treatment of MNGIE provided evidence‐based guidance for clinicians incorporating patients' values and preferences.
Reflections of global warming in trends of temperature characteristics in the Czech Republic, 1961–2019
Authors: Zahradníček Pavel , Brázdil Rudolf , Štěpánek Petr , Trnka Miroslav
Published: August 2020

This paper presents a comprehensive trend analysis of spatiotemporal temperature change patterns over the territory of what is now the Czech Republic (CR) during the 1961–2019 period. Employing daily mean temperatures (TAVG), maximum (TMAX) and minimum (TMIN) temperatures and diurnal temperature range (DTR), supplied by 133 stations of the Czech Hydrometeorological Institute, daily, monthly, seasonal and annual series were calculated for four altitudinal groups and the entire CR, for which linear trends were calculated and further analysed. For the purposes of relative trend comparison, the linear trends were also calculated from standardized series (mean 0, SD 1, in 1961–1990). All seasonal and annual TAVG, TMAX and TMIN series exhibit statistically significant increasing trends, with the exceptions of only a few cases for winter (DJF) and autumn (SON). DTR trends increase significantly in spring (MAM) and summer (JJA), but decrease in DJF and SON. The highest increases in trends occur in JJA and from stations at lower altitudes for groups I (up to 300 m asl) and II (301–600 m asl). Trends in JJA and SON TMIN are relatively higher than in TMAX, while the opposite holds true of DJF and MAM. Comparing the three decades after 1990 with the 1961–1990 normal, each decade was generally warmer than the previous period, with particularly enhanced warming in 2011–2019. This is also reflected in prominent increases in cumulative temperature sums throughout the year. The results obtained are discussed in the context of other European papers and with respect to explaining existing differences.
Improved oncologic outcomes for minimally invasive left pancreatectomy: Propensity‐score matched analysis of the National Cancer Database
Authors: Watson Michael D. , Baimas‐George Maria R. , Thompson Kyle J. , Iannitti David A. , Ocuin Lee M. , Baker Erin H. , Martinie John B. , Vrochides Dionisios
Published: August 2020

Background and objectives

Minimally invasive (MIS) left pancreatectomy (LP) is increasingly used to treat pancreatic adenocarcinoma (PDAC). Despite improved short‐term outcomes, no studies have demonstrated long‐term benefits over open resection.

Methods

The National Cancer Database was queried between 2010 and 2016 for patients with PDAC, grouped by surgical approach (MIS vs open). Demographics, comorbidities, clinical staging, and pathologic staging were used for propensity‐score matching. Perioperative, short‐term oncologic, and survival outcomes were compared.

Results

After matching, both cohorts included 805 patients. There were no differences in baseline characteristics, staging, or preoperative therapy between cohorts. The MIS cohort had a shorter length of stay (6.8 ± 5.5 vs 8.5 ± 7.3 days; P < .0001) with the trend toward improved time to chemotherapy (53.9 ± 26.1 vs 57.9 ± 29.9 days; P = .0511) and margin‐positive resection rate (15.3% vs 18.9%; P = .0605). Lymph node retrieval and receipt of chemotherapy were similar. The MIS cohort had higher median overall survival (28.0 vs 22.1 months; P = .0067). Subgroup analysis demonstrated the highest survival for robotic compared with laparoscopic and open LP (41.9 vs 26.6 vs 22.1 months; P < .0001).

Conclusions

This study demonstrates the safety of MIS LP and favorable long‐term oncologic outcomes. The improved survival after MIS LP warrants further study with prospective, randomized trials.
Surgical approach, management, and oncologic outcomes of primary leiomyosarcoma of the inferior vena cava: An institutional case series
Authors: Joung Hae Soo , Nooromid Michael J. , Eskandari Mark K. , Wayne Jeffrey D.
Published: August 2020

Background

Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor arising from the smooth muscle of vessel walls. Surgery is the only potential curative treatment. Given its rarity, optimal surgical, and oncologic management is not well described. We review our institutional series of primary leiomyosarcomas treated with resection and IVC reconstruction over the last decade.

Methods

Retrospective chart review of all patients who underwent surgical resection of primary leiomyosarcoma of the IVC from November 2009 to March 2020 at a single tertiary care center was performed.

Results

Among the eight patients treated, the majority were female (87.5%) with a median age of 52 years (range, 44‐63). Tumor was located in the infrarenal IVC in five patients (62.5%). IVC was reconstructed using a ring‐enforced PTFE graft in six patients (75%). All but one patient had an intermediate (grade 2) or high grade (grade 3) tumor, and all resections achieved grossly negative margins. The 1‐ and 3‐year disease‐free survival was 85.7% and 64.3%, respectively. There were no disease‐specific deaths during a median follow‐up of 36 months (interquartile range, 10‐51 months).

Conclusions

With a well‐coordinated multidisciplinary approach, primary leiomyosarcoma of the IVC can be safely resected with good long‐term survival.
QT interval prolongation noted in one percent of 2553 Asian patients with schizophrenia: Findings from the REAP‐AP survey
Authors: Park Seon‐Cheol , Lee Bong Ju , Park Jae Hong , Kawasaki Hiroaki , Avasthi Ajit , Grover Sandeep , Tanra Andi J. , Lin Shih‐Ku , Javed Afzal , Tan Chay Hoon , Sartorius Norman , Shinfuku Naotaka , Park Yong Chon
Published: August 2020

Although the association between antipsychotic use and corrected QT interval (QTc) prolongation has been repeatedly confirmed, the relationship has been rarely studied in a practical setting. Using data from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP‐AP) survey, our study aimed to investigate the prevalence and clinical correlates of QTc prolongation in 2553 Asian patients with schizophrenia. After adjusting for the potential effect of confounding factors, the baseline and clinical characteristics of the schizophrenia patients with and without QTc prolongation were compared using analyses of covariance and binary logistic analyses. In addition, a binary logistic analysis model with a forward selection method was used to identify the distinctive clinical correlates of QTc prolongation. QTc prolongation was noted in 1.1% of Asian patients with schizophrenia. Schizophrenia patients were characterized by lower proportions of disorganized speech and negative symptoms; higher use of amisulpride and clozapine; and higher proportions of rigidity, hypercholesterolemia, and sedation than those without QTc prolongation. Finally, a binary logistic mode showed that amisulpride, clozapine, rigidity, and hypercholesterolemia might be the distinctive clinical correlates of QTc prolongation in Asian patients with schizophrenia. These findings indicate the clinical implications that the uses of amisulpride and clozapine and the occurrences of rigidity and hypercholesterolemia may be potential risk factors for QTc prolongation of schizophrenia patients.
Estimating soil salinity with different fractional vegetation cover using remote sensing
Authors: Zhang Junrui , Zhang Zhitao , Chen Junying , Chen Haiying , Jin Jiming , Han Jia , Wang Xintao , Song Zhishuang , Wei Guangfei
Published: August 2020

Soil salinization is a serious restrictive factor affecting sustainable agricultural development. In order to explore the effect of Fractional Vegetation Cover (FVC), we monitored soil salinization in sites different vegetation coverage in Jiefangzha Irrigation District in Inner Mongolia using satellite remote sensing. From May to August 2018, we carried out field sampling at different depths in each month, and calculated FVC and spectral covariates using GF‐1 satellite images in the corresponding sampling period. Based on the FVC division criteria for Inner Mongolia, we took the following steps: (a) setting up a control treatment A (the full data with undivided FVC, TA) and experimental treatments B (bare land, TB), C (mid‐low FVC, TC), D (mid FVC, TD) and E (high FVC, TE); (b) conducting the Best Subset Selection (BSS) for all spectral covariates at different depths of each treatment; and (c) constructing the Soil Salt Content (SSC) inversion models using partial least square regression (PLSR), Cubist, and Extreme Learning Machine (ELM). The results indicated that (a) classifying FVC could improve the stability and predictive ability of the models; (b) the performance of the three modeling methods were different (Cubist was the best, ELM next and PLSR the poorest); (c) the optimal inversion models for TB, TC and TE were constructed by Cubist at 0–20, 0–40 and 0–20 cm, and for TD was constructed by ELM at 0–60 cm, respectively. The results can provide references for soil salinization prevention and agricultural production in Jiefangzha Irrigation District and other areas with the similar vegetation cover.
Self‐contained deep learning‐based boosting of 4D cone‐beam CT reconstruction
Authors: Madesta Frederic , Sentker Thilo , Gauer Tobias , Werner René
Published: August 2020

Purpose

Four‐dimensional cone‐beam computed tomography (4D CBCT) imaging has been suggested as a solution to account for interfraction motion variability of moving targets like lung and liver during radiotherapy (RT) of moving targets. However, due to severe sparse view sampling artifacts, current 4D CBCT data lack sufficient image quality for accurate motion quantification. In the present paper, we introduce a deep learning‐based framework for boosting the image quality of 4D CBCT image data that can be combined with any CBCT reconstruction approach and clinical 4D CBCT workflow.

Methods

Boosting is achieved by learning the relationship between so‐called sparse view pseudo‐time‐average CBCT images obtained by a projection selection scheme introduced to mimic phase image sparse view artifact characteristics and corresponding time‐average CBCT images obtained by full view reconstruction. The employed convolutional neural network architecture is the residual dense network (RDN). The underlying hypothesis is that the RDN learns the appearance of the streaking artifacts that is typical for 4D CBCT phase images — and removes them without influencing the anatomical image information. After training the RDN, it can be applied to the 4D CBCT phase images to enhance the image quality without affecting the contained temporal and motion information. Different to existing approaches, no patient‐specific prior knowledge about anatomy or motion characteristics is needed, that is, the proposed approach is self‐contained.

Results

Application of the trained network to reconstructed phase images of an external (SPARE challenge) as well as in‐house 4D CBCT patient and motion phantom data set reduces the phase image streak artifacts consistently for all patients and state‐of‐the‐art reconstruction approaches. Using the SPARE data set, we show that the root mean squared error compared to ground truth data provided by the challenge is reduced by approximately 50% while normalized cross correlation of reconstruction and ground truth is improved up to 10%. Compared to direct deep learning‐based 4D CBCT to 4D CT mapping, our proposed method performs better because inappropriate prior knowledge about the patient anatomy and physiology is taken into account. Moreover, the image quality enhancement leads to more plausible motion fields estimated by deformable image registration (DIR) in the 4D CBCT image sequences.

Conclusions

The presented framework enables significantly boosting of 4D CBCT image quality as well as improved DIR and motion field consistency. Thus, the proposed method facilitates extraction of motion information from severely artifact‐affected images, which is one of the key challenges of integrating 4D CBCT imaging into RT workflows.
Feasibility study of patient‐specific dose verification in proton therapy utilizing positron emission tomography (PET) and generative adversarial network (GAN)
Authors: Ma Saiqun , Hu Zongsheng , Ye Kuangkuang , Zhang Xiaoke , Wang Yuenan , Peng Hao
Published: August 2020

Purpose

Online dose verification based on proton‐induced positron emitters is a promising strategy for quality assurance in proton therapy. Because of the nonlinear correlation between dose and the activity distributions, a machine learning‐based approach was developed to establish their relationship.

Methods

Simulations were carried out using a pencil beam scanning system and a computed tomography (CT) image‐based phantom. A DiscoGAN model was developed to perform dose verification for both central and off‐center lines. Besides the activity as input, HU information from CT images and stopping power (SP) prior were incorporated as auxiliary features for the model. The performance was quantitatively studied in terms of mean absolute error (MAE) and mean relative error (MRE), under different signal‐to‐noise ratios (SNRs). In addition to a dataset comprising monoenergetic beams, two additional datasets were generated to evaluate the model’s generalization capability: five reconstructed PET images based on an in‐beam PET system and a dataset comprising spread‐out Bragg peaks (SOBPs).

Results

The feasibility of dose verification was successfully demonstrated for all three datasets. For the monoenergetic case (i.e., raw activity of positron emitters), the MRE is found to be <1% for the central lines and 5% for the off‐center lines, respectively. The range uncertainty is found to be less than 1 mm. The prediction based on five PET images, which take into account the detection of 511‐keV photons and image reconstruction, yields slightly inferior performance. For the SOBP case, the MRE of the center lines is found to be <3% and the range uncertainty is <1 mm. The inclusion of anatomical information (HU and SP) improves both accuracy and generalization of the DiscoGAN model.

Conclusion

The combination of proton‐induced positron emitters, in‐beam PET, and machine learning may become a useful tool allowing for patient‐specific online dose verification in proton therapy.
Estimating Migratory Behavior and Age for Anadromous Coastal Cutthroat Trout in South Puget Sound: Evaluation of Approaches Based on Fish Scales versus Otoliths
Authors: Claiborne Andrew M. , Losee James P. , Miller Jessica A.
Published: August 2020

Important variability exists in life history attributes among localized populations of Coastal Cutthroat Trout Oncorhynchus clarkii clarkii in relation to geographic and environmental factors. Describing the life history of locally adapted populations is critical to successful fishery management and conservation. The number of annuli and distance between circuli in scales (i.e., scale analysis) are often used to describe migratory behavior and age of Coastal Cutthroat Trout, but the accuracy of these estimates is largely unknown. In this study, we compared estimates of age (based on analyses of scale and otolith structure) and migratory patterns (based on scale structure and otolith structure and chemistry) for anadromous Coastal Cutthroat Trout in South Puget Sound, Washington State. We compared 48 paired scale and otolith samples (age range = 1–5 years), and age estimates agreed 79% of the time (average percent error [APE] = 5%; CV = 6%), supporting historical age estimates that were generated using scales. However, the number of migrations between freshwater and marine environments estimated using scales and otoliths agreed 44% of the time (n = 50; APE = 25%; CV = 35%). Comparisons of scales and otoliths indicated that more individuals overwinter in marine waters than previously thought based on scale analysis. The majority of fish in this study (68%) were the progeny of females that matured in marine waters and may be vulnerable to fisheries in the marine environment. Current management actions that prohibit the harvest of Coastal Cutthroat Trout in marine waters may be important for the conservation of small localized populations in South Puget Sound.
In Utero Exposure to Maternal Overweight or Obesity is Associated with Altered Offspring Brain Function in Middle Childhood
Authors: Shapiro Allison L. B. , Moore Brianna F. , Sutton Brianne , Wilkening Greta , Stence Nicholas , Dabelea Dana , Tregellas Jason R.
Published: August 2020

Objective

The impact of in utero exposure to maternal overweight and obesity on offspring metabolic health is well documented. Neurodevelopmental outcomes among these children are, however, less well studied. To address this gap, the current study investigated brain function among 4‐ to 6‐year‐old children exposed to maternal overweight or obesity during gestation compared with that of children born to mothers with healthy BMI in pregnancy.

Methods

Resting‐state functional magnetic resonance imaging was used to study neuronal activity and connectivity during a passive viewing task (movie) among 101 typically developing children enrolled in the Healthy Start study, a longitudinal prebirth cohort in Colorado.

Results

Forty‐nine children (48%) were exposed to maternal overweight or obesity in utero (mean age = 5 years, SD = 0.9). Children born to mothers with overweight or obesity demonstrated hyperactivity in the left posterior cingulate cortex and hypoactivity in the dorsal anterior cingulate and the supplementary motor area (P < 0.05 for all). Children born to mothers with overweight or obesity also showed ubiquitously weaker brain connectivity (P < 0.05 for all).

Conclusions

These novel results suggest altered brain function among children exposed to maternal overweight and obesity in utero.
Diversified exploitation of aerolysin nanopore in single‐molecule sensing and protein sequencing
Authors: Lu Si‐Min , Wu Xue‐Yuan , Li Meng‐Yin , Ying Yi‐Lun , Long Yi‐Tao
Published: August 2020

Nanopore electrochemistry has emerged as a promising technology to achieve the real‐time investigation of nanoscale processes at the single‐molecule level in a label‐free manner. To further extend the single‐molecule sensing versatility of nanopore single‐biomolecule interface, mutant aerolysin nanopore is developed followed by exploring the sensing mechanism. The exquisite design enables the site‐directed controlling of every amino acid along the aerolysin single‐biomolecule interface with the precision of chemical group. Owing to diversified pore‐analyte weak interactions between chemical groups (e.g., electrostatic interactions, hydrogen bond, van der Waals’ force) and steric confined effect, the mutant aerolysin displays extraordinarily high sensitivity and selectivity toward individual analytes in the stochastic sensing process. These well‐designed nanopores open more opportunities for biophysical, diagnostic applications, and even emerge as promising candidates for single‐molecule protein sequencing.
Tumor therapy based on self‐assembling peptides nanotechnology
Authors: Ma Xiaoyan , Xing Ruirui , Yuan Chengqian , Ogino Kenji , Yan Xuehai
Published: August 2020

Self‐assembling peptides display great potential in biological and medical applications, especially tumor therapy with noninvasive ways. The rapid expansion of self‐assembling peptides is almost on account of their favorable biocompatibility, tumor microenvironment responsiveness, multivalency, and structural versatility. With taking full advantage of self‐assembling peptide peculiarities, peptide‐based nanomaterials are applied for delivery carriers, chemotherapy, immunotherapy, and noninvasive tumor treatments including photothermal therapy (PTT), photodynamic therapy (PDT), and sonodynamic therapy (SDT). In addition, immunogenic cell death of tumor cells originating from PDT and SDT, and the necrosis of tumor cells due to PTT can elicit some degree of immune responses. Therefore, synergistic therapy has served as a more effective and powerful strategy for tumor therapy. Importantly, self‐assembling peptides are capable of subtly making combination of various treatments. This review outlines biomedical applications of nanomaterials based on self‐assembling peptides with emphasizing variegated treatment methods.
Distribution of intestinal parasites of baboons (Papio anubis) and warthogs (Phacochoerus aethiopicus) at the Mole National Park, Ghana
Authors: Larbi John A. , Akyeampong Stephen , Addo Seth Offei , Dakwa Kwaku Brako , Boampong Kwadwo , Opoku‐Nketiah Bright
Published: August 2020

The identification of intestinal parasite of baboons (Papio anubis) and warthogs (Phacochoerus aethiopicus) was undertaken at the Mole National Park, Ghana. The main objective of the study was to determine the types and prevalence of intestinal parasites in baboons and warthogs in the Mole National Park. A total of nineteen (19) and twenty‐three (23) samples were collected from the baboons and warthogs, respectively, and examined using the direct saline smear and formol‐ether concentration technique for the identification of cysts, eggs and larvae of parasites. The survey showed that 94.74% of the baboon samples examined was infected with at least one parasite, whereas that of the warthogs showed 95.65% prevalence. A total of seven (7) and eight (8) different parasites were identified in baboon and warthog faecal samples, respectively. Strongyloides sp. had the highest prevalence in baboons (84.21%) and warthogs (78.26%). The second prevalent parasite identified was Ascaris sp. in the baboons (31.58%) and warthogs (30.43%). The results showed a high level of multiparasitism in these wild animals and an increased risk of zoonotic transmission which may result from interaction with inhabitants of the park community.
COVID‐19 and Morbid Obesity: Associations and Consequences for Policy and Practice
Authors: Curtin Kevin M. , Pawloski Lisa R. , Mitchell Penelope , Dunbar Jillian
Published: August 2020

While the impact of obesity on chronic disease has been widely examined, there has been less research regarding the influence of obesity on infectious diseases, particularly respiratory diseases. This exploratory research uses the currently available data on COVID‐19 cases and mortality, along with estimates of the morbidly obese populations in the United States by county, to examine the association between morbid obesity and deaths from COVID‐19 and to identify potential coincident spatial clusters of morbid obesity and COVID‐19 deaths. Results indicate a statistically significant positive correlation between population‐adjusted COVID‐19 deaths and cases and the estimated population with a body mass index ≥ 40. Clustering analyses show there is a predominant similarity in the distribution of COVID‐19 deaths and obesity. Our findings suggest it is critical to include an awareness of obesity when developing infectious disease control measures and point to a greater need to focus resources toward obesity education and policy initiatives.
Coronavirus, Refugees, and Government Policy: The State of U.S. Refugee Resettlement during the Coronavirus Pandemic
Authors: Grant Aubrey
Published: August 2020

The novel coronavirus pandemic poses unique challenges to forcibly displaced populations around the world. Months into the pandemic, countries are still scrambling to enact policies that mitigate the outbreak and minimize the strain on their health‐care infrastructures and economies. The United Nations High Commissioner for Refugees continues to work with member states to provide guidance and assistance to those populations protected under their mandate. However, there is great concern regarding the ability to appropriately provide for displaced populations, as they tend to be hosted in areas that lack access to health care and proper hygiene materials. The situation has been exacerbated by the temporary suspension of refugee resettlement across the globe. In the United States, the Trump Administration has responded to the crisis by further eroding refugee and asylum resettlement programs and failing to properly protect the asylum seekers currently being detained. At the local level, resettled refugees and asylees have responded to the unique challenges posed by coronavirus by using their skillsets to provide assistance and services to community members in need. The coronavirus, and the Trump Administration's response, are likely to have long‐term negative impacts on refugee resettlement and asylum programs.
Vertical greenery systems: from plants to trees with self-growing interconnections
Authors: Wang Xiuli , Gard Wolfgang , Borska Helena , Ursem Bob , van de Kuilen J. W. G.
Published: August 2020

The integration of buildings into vegetation has become a necessity in many metropolitan areas of the world today. It expands the potential of vertical and horizontal, exterior and interior, exposed and enclosed spaces in a building that can be used to accommodate plants. Green infrastructures have benefits both on urban and building scales. They can be categorized into green roofs and vertical greenery systems that can be divided further into green façade, green wall, green terraces, elevated forest and vertical forest. There are many design and planting considerations for architects, structural engineers and botanists when using living architectures to mimic natural systems, such as plant characteristics and environmental conditions. Plants used for vertical greenery are more likely to be hardwood species to adjust solar radiation during cooling and heating periods, as well as for aesthetic pleasure. Take Bosco Verticale, which is located in Milan, as an example to look into engineering methods when trees grow on balconies of high-rise buildings. It can be concluded that planting restraint safety systems and regular maintenance are necessary for the tree growth in the sky. However, the change in growing conditions causes various problems such as stability and irregular growth of trees. Instead of using steel cables and cages to prevent trees from falling off in the sky, the concept of self-growing connections is proposed to act as natural bracings and provide the stability for vertical forests. This paper is meant to generate awareness of the possibilities of the vertical integration of trees into buildings, show application considerations, and inspire future developments.
Motivic Tambara functors
Authors: Bachmann Tom
Published: August 2020

Let k be a field and denote by $$\mathcal {SH}(k)$$

SH
(
k
)

the motivic stable homotopy category. Recall its full subcategory $$\mathcal {SH}(k)^{{\text {eff}}\heartsuit }$$

SH

(
k
)

eff
♡

(Bachmann in J Topol 10(4):1124–1144. arXiv:1610.01346, 2017). Write $$\mathrm {NAlg}(\mathcal {SH}(k))$$

NAlg
(
SH
(
k
)
)

for the category of $${\mathrm {S}\mathrm {m}}$$

S
m

-normed spectra (Bachmann-Hoyois in arXiv:1711.03061, 2017); recall that there is a forgetful functor $$U: \mathrm {NAlg}(\mathcal {SH}(k)) \rightarrow \mathcal {SH}(k)$$

U
:
NAlg
(
SH
(
k
)
)
→
SH
(
k
)

. Let $$\mathrm {NAlg}(\mathcal {SH}(k)^{{\text {eff}}\heartsuit }) \subset \mathrm {NAlg}(\mathcal {SH}(k))$$

NAlg

(
SH

(
k
)

eff
♡

)

⊂
NAlg

(
SH

(
k
)

)

denote the full subcategory on normed spectra E such that $$UE \in \mathcal {SH}(k)^{{\text {eff}}\heartsuit }$$

U
E
∈
SH

(
k
)

eff
♡

. In this article we provide an explicit description of $$\mathrm {NAlg}(\mathcal {SH}(k)^{{\text {eff}}\heartsuit })$$

NAlg
(
SH

(
k
)

eff
♡

)

as the category of effective homotopy modules with étale norms, at least if $$char(k) = 0$$

c
h
a
r
(
k
)
=
0

. A weaker statement is available if k is perfect of characteristic $$> 2$$

>
2

.
Which Functional Classification Scale is Optimal for Children with Pulmonary Hypertension (PAH)?
Authors: Migdał Anna , Żuk Małgorzata , Jagiełłowicz-Kowalska Dorota , Powichrowska Zuzanna , Brzezińska-Rajszys Grażyna
Published: August 2020

Functional status assessed by the WHO-FC scale derived from adults is a known prognostic factor for pulmonary hypertension. Data on the usefulness of the Panama-FC scale in assessing children with pulmonary hypertension are limited. The study was performed to compare functional status results (WHO-FC and Panama-FC) and to assess the usefulness of these scales in various clinical situations. The reliability of the Panama-FC questionnaire method for facilitating patient evaluation was also examined. 26 functional status assessments (7 in disease progression/after treatment intensification) in both scales were analyzed in 19 patients with PAH confirmed in RHC. WHO-FC, Panama-FC scales, and questionnaire-based on Panama-FC were conducted independently by three different physicians. Results of assessments were compared with each other and with 6MWD, NTproBNP level, and echo parameters (TAPSE, RV/LV ratio). The Panama-FC scale results obtained using the medical interview method and questionnaire did not differ. Both WHO-FC and Panama-FC classes well-reflected disease advancement confirmed by non-invasive parameters (NTproBNP, 6MWD, TAPSE, RV/LV ratio). Differences between grading the class in both scales were observed: 5pts were classified to II (Panama-FC) vs I (WHO-FC), 2pts were in lower risk group in WHO-FC (II) vs Panama (IIIa). Worsening or improvement after treatment intensification in functional status in both scales was connected with the significant change of NTproBNP level. The 6-min walking distance did not change. TAPSE, RV/LV ratio changed significantly in 3pts with IPAH, accordingly to change in WHO-FC and Panama-FC. WHO-FC and Panama-FC well reflect the disease advancement. The questionnaire method simplified the use of the Panama-FC scale. The Panama-FC scale appears to be better for assessing functional status during long-term follow-up, while the WHO-FC scale was more useful in short-term treatment monitoring.
New computed tomographic predictors of complicated perioperative course of 17.5F mini-percutaneous nephrolithotomy (mini-PNL)
Authors: Ozimek Tomasz , Laturnus Jan M. , Gohlke Carolin , Wiessmeyer Judith R. , Struck Julian P. , Hupe Marie C. , Merseburger Axel S. , Kramer Mario W.
Published: August 2020

Purpose

Radiological parameters predicting a postoperative stone-free status (SFS) or a complicated perioperative course of mini-PNL, are scarce. Our aim was to identify such factors for prone 17.5F mini-PNL.

Methods

A monocentric cohort of 103 cases was retrospectively analysed for factors predicting SFS and relevant complications, i.e. Clavien–Dindo (CD) ≥ 2. Parameters measured on preoperative supine CT included maximal stone diameter, skin-to-stone distance (SSD), ideal tract length (ITL), access angle, minimal T12—Lower Kidney Pole distance (T12LP) and minimal Iliac Crest—Lower Kidney Pole distance (ICLP). Infundibulopelvic angle (IPA) was measured on intraoperative pyelography.

Results

The median maximal stone diameter was lower in cases with postoperative SFS [16 mm (Min. 10; Max. 35) vs. 20 mm (Min. 6; Max. 85), p = 0.0052]. CD ≥ 2 was more frequent in cases with a bigger stone burden [19 mm (Min. 13; Max. 85) vs. 16 mm (Min. 6; Max. 49), p = 0.0056] and with the ribs in the access angle [7/23 (30.43%) vs. 8/76 (10.53%); p = 0.0454]. T12LP significantly differed in cases with and without CD ≥ 2 [80.48 mm (± 21.31) vs. 90.43 mm (± 19.42), p = 0.0397]; however, it had no influence on SFS (p > 0.05). SSD, ITL, IPA and ICLP were significant regarding neither SFS nor CD ≥ 2 prevalence (p > 0.05). Using multivariate logistic regression, T12LP was confirmed as an independent predictor on CD ≥ 2 prevalence.

Conclusions

Preoperative computed tomographic factors indicating elevated kidney position influence perioperative course of mini-PNL. T12LP and the presence of ribs in the access angle are, apart from stone diameter, the most useful indicators for cases at risk of CD ≥ 2.
Effect of Mach number on droplet aerobreakup in shear stripping regime
Authors: Wang Zhaoguang , Hopfes Thomas , Giglmaier Marcus , Adams Nikolaus A.
Published: August 2020

The present experimental study investigates the shear stripping breakup of single droplets in subsonic and supersonic gaseous flows. In contrast to most research that places emphasis on the Weber number (We), we focus on the individual effects exerted by flow Mach (M∞) and Reynolds numbers (Re). Millimeter-sized droplets made of either ethylene glycol or water are exposed to shock-induced flows. Shadowgraph and schlieren images of the breakup process are recorded by an ultra-high-speed camera. The experimental We is constrained at 1100, while M∞ is varied from 0.3 to 1.19 and Re from 2600 to 24,000. A systematic analysis of the experiment series reveals that the breakup pattern alters with M∞ although a constant We is maintained. The classical stripping behavior with fine mist shed from the peripheral sheet changes to rupture of multiple bags along the periphery at M∞ = 0.63, and further to stretching of ligament structures from the leeward surface at M∞ = 1.19. The corresponding breakup initiation is delayed and the resultant fragments are sized less uniformly and distributed over a narrower spread. In terms of the early-stage deformation, droplets experience less intense flattening and slower sheet growth at higher M∞. The change of Re introduces additional variations, but only to a minor extent.

Graphical abstract
TREM2 activation on microglia promotes myelin debris clearance and remyelination in a model of multiple sclerosis
Authors: Cignarella Francesca , Filipello Fabia , Bollman Bryan , Cantoni Claudia , Locca Alberto , Mikesell Robert , Manis Melissa , Ibrahim Adiljan , Deng Li , Benitez Bruno A. , Cruchaga Carlos , Licastro Danilo , Mihindukulasuriya Kathie , Harari Oscar , Buckland Michael , Holtzman David M. , Rosenthal Arnon , Schwabe Tina , Tassi Ilaria , Piccio Laura
Published: August 2020

Multiple sclerosis (MS) is an inflammatory, demyelinating, and neurodegenerative disease of the central nervous system (CNS) triggered by autoimmune mechanisms. Microglia are critical for the clearance of myelin debris in areas of demyelination, a key step to allow remyelination. TREM2 is expressed by microglia and promotes microglial survival, proliferation, and phagocytic activity. Herein we demonstrate that TREM2 was highly expressed on myelin-laden phagocytes in active demyelinating lesions in the CNS of subjects with MS. In gene expression studies, macrophages from subjects with TREM2 genetic deficiency displayed a defect in phagocytic pathways. Treatment with a new TREM2 agonistic antibody promoted the clearance of myelin debris in the cuprizone model of CNS demyelination. Effects included enhancement of myelin uptake and degradation, resulting in accelerated myelin debris removal by microglia. Most importantly, antibody-dependent TREM2 activation on microglia increased density of oligodendrocyte precursors in areas of demyelination, as well as the formation of mature oligodendrocytes thus enhancing remyelination and axonal integrity. These results are relevant as they propose TREM2 on microglia as a potential new target to promote remyelination.
Premalignant lesions, basal cell carcinoma and melanoma in patients with cutaneous squamous cell carcinoma
Authors: Korhonen Niina , Ylitalo Leea , Luukkaala Tiina , Itkonen Julius , Häihälä Henni , Jernman Juha , Snellman Erna , Palve Johanna
Published: August 2020

The incidence of keratinocyte carcinomas is increasing worldwide and currently there is no standardised strategy for the follow-up of patients with multiple tumours. The objective of this study was to assess the prevalence of premalignant lesions, i.e., actinic keratosis and Bowen’s disease, as well as basal cell carcinoma (BCC) and cutaneous melanoma (CM) among patients with cutaneous squamous cell carcinoma (cSCC). Pathology database search was performed to identify all cSCC patients diagnosed in the Pirkanmaa region of Finland in 2006–2015. Details of the patients and tumours were obtained through medical record review. The cohort consisted of 774 patients with 1131 cSCC tumours. Overall 559 patients (72%) had premalignant lesions. A total of 316 patients (41%) had BCC and 52% of these (n = 164) had more than one BCC tumour. 50 patients (6%) had CM. Overall 180 cSCC patients (23%) had no premalignant changes, BCC or CM. The median age of these patients was 6 years less than that of the patients with premalignant lesions (p < 0.001) or BCC (p < 0.001). The invasion depth of the tumours was deeper in the patients with only cSCC (median 3 mm, interquartile range 2–6) than in those with premalignant lesions or BCC (median 2 mm, interquartile range 1–3), p < 0.001. CSCC patients have a high risk of developing multiple skin cancers and need long-term follow-up.
What guides decision-making on intravenous thrombolysis in acute vestibular syndrome and suspected ischemic stroke in the posterior circulation?
Authors: Machner Björn , Choi Jin Hee , Neumann Alexander , Trillenberg Peter , Helmchen Christoph
Published: August 2020

Intravenous thrombolysis (IVT) is rarely performed in dizzy patients with acute vestibular syndrome (AVS) or acute imbalance (AIS) even if posterior circulation stroke (PCS) is suspected. Decision-making may be affected by uncertainties in discriminating central from peripheral vestibulopathy or concerns of IVT-related harm, particularly intracerebral hemorrhage (ICH), but related studies are missing. Using an in-house register of dizzy patients coming to the emergency room, we identified 29 AVS/AIS patients who presented within 4.5 h after onset, revealed clinical signs indicative of PCS (central oculomotor signs, mild focal abnormalities), and had non-contrast computed tomography (NCCT). Patients treated with IVT (n = 15) were compared to NoIVT patients (n = 14) with regard to clinical and imaging (including perfusion computed tomography, CTP) parameters, occurrence of ICH and short-term clinical outcome (NIHSS improvement; ability to walk independently). IVT and NoIVT patients did not differ in baseline characteristics, central oculomotor signs, or clinical outcome. IVT patients more often exhibited disabling vestibular symptoms (severe dizziness/vertigo, inability to stand unsupported) and focal abnormalities than NoIVT patients. There was no ICH in either group. CTP was performed in 0% of NoIVT versus 80% of IVT patients, seven of twelve revealing posterior circulation hypoperfusion. Comparison of initial hypoperfusion (CTP) and final stroke (NCCT) revealed IVT-related benefit (smaller lesion) in three of seven IVT patients. In AVS/AIS patients with suspected PCS, disabling vestibular symptoms, focal neurological deficits, and hypoperfusion on CTP seem to direct decision-making pro IVT. In our small cohort, there were no significant IVT-related clinical benefits, no IVT-related ICHs, and salvage of brain tissue in some patients.
Improved outcomes in metastatic germ cell cancer: results from a large cohort study
Authors: Hentrich Marcus , Debole Jessica , Jurinovic Vindi , Gerl Arthur
Published: August 2020

Purpose

Treatment of metastatic germ cell cancer (GCC) is based on the International Germ Cell Cancer Collaborative Group (IGCCCG) prognostic classification published in 1997. 5-year survival rates were reported to be 91%, 79%, and 48% for patients with good, intermediate and poor prognosis, respectively. However, treatment results may have improved over time due to cumulative experience, improved supportive care and modern-type chemotherapy.

Methods

Patients with metastatic GCC who received cisplatin-based chemotherapy at two institutions in Munich between 2000 and 2013 were retrospectively studied. Clinical characteristics, treatment and outcomes were analyzed with respect to the IGCCG prognostic classification.

Results

Of 225 patients (median age 35 years), 72 (32%) had seminoma (S) and 153 (68%) nonseminoma. 175 (78%), 30 (13%) and 20 patients (9%) had good, intermediate and poor prognosis according to the IGCCCG classification. The 2-year-progression free survival of patients with good, intermediate and poor prognosis was 91%, 83% and 37%, and the 5-year-overall survival (OS) was 98%, 96%, and 66%, respectively. There was no significant difference in the OS between patients in the good and intermediate prognosis group.

Conclusion

Compared to data from the original IGCCCG classification system, the outcome of patients with metastatic GCC has considerably improved over time. While the prognosis of intermediate-risk patients is excellent, treatment in the poor-prognosis group remains to be improved.
Modelling and quantifying tree biometric properties of dry Afromontane forests of south-central Ethiopia
Authors: Asrat Zerihun , Eid Tron , Gobakken Terje , Negash Mesele
Published: August 2020

Key message

Models for quantifying tree biometric properties, imperative for forest management decision-making, including height, diameter, bark thickness and volume were developed, and wood basic density was documented for dry Afromontane forests of south-central Ethiopia.

Tree biometric properties such as height (ht), diameter at breast height (dbh), bark thickness (bt), volume and wood basic density (wbd) are imperative for forest management decision-making. For dry Afromontane forests in south-central Ethiopia, models for quantifying such tree properties are totally lacking. This study, therefore, aimed at developing models for ht based on dbh, for dbh based on stump height diameter (dsh), for bt based on dbh, for volume based on dbh, ht and crown width (crw), as well as documenting wbd data. Comprehensive and representative datasets were collected from Degaga–Gambo and Wondo Genet forests. The ht, dbh and bt modelling were based on 1345 sampled trees during forest inventories, while the volume modelling and wbd documentation were based on 63 destructively sampled trees from 30 species covering 87% of the total basal area in the study sites. Weighted least squares regression was applied for modelling and leave one out cross-validation was used for evaluation. The ht–dbh and dbh–dsh models performed well (pseudo-R2 = 0.72 and 0.98), while bt–dbh performed poorer (pseudo-R2 = 0.42). Models for the total tree, merchantable stem and branches volume were developed with different options for independent variables, where pseudo-R2 varied from 0.74 to 0.98, with smallest values for the branches models The models may be applied to forests outside the present study sites provided that the growing conditions are carefully evaluated. The species-wise wbd was ranging from 0.426 to 0.979 g cm−3, with the overall mean of 0.588 g cm−3. The wbd data will be useful for building up a national wbd database and may also be included in the Global Wood Density database. The study represents a significant step towards sustainable forest management including REDD + MRV practices in the dry Afromontane forests of south-central Ethiopia.
Exploring the dietary choices of Chinese women living with breast cancer in Vancouver, Canada
Authors: Ng Brenda , Chapman Gwen E. , Levy-Milne Ryna , Balneaves Lynda G.
Published: August 2020

Purpose

To explore how Chinese Canadian patients with breast cancer make dietary choices and to understand their nutritional information needs in order to inform oncology healthcare providers about provision of optimal supportive care for this population.

Methods

Using interpretive description methodology, semi-structured interviews were conducted with first- and second-generation Chinese Canadian women aged 41–73 years living in Vancouver, Canada, who were diagnosed with breast cancer within the last 5 years. A follow-up focus group was held to validate emergent themes.

Results

Nineteen women were interviewed; 6 participated in the focus group. Their accounts of dietary experiences following diagnosis focused on three areas: dietary change (including desired and implemented changes that participants believed would benefit their health), facilitators and barriers to dietary change, and information and resource needs. Dietary changes reported included avoiding or consuming greater amounts of certain foods, and taking traditional Chinese medicine (TCM) and natural health products. Barriers to desired dietary change included the interplay between food preferences and family and social life, work-life balance, and cost and availability of specialty foods. Support from family members, however, facilitated participants’ consumption of more whole and natural foods after their cancer diagnosis. Participants obtained food and nutrition information from a variety of sources but had difficulty determining the reliability and accuracy of information. They requested timely, credible, culturally-relevant, and easily accessible dietary information.

Conclusions

Oncology healthcare providers would benefit from increased understanding of the dietary practices, including TCM, of Chinese women living with breast cancer. To facilitate communication and improve quality of care, healthcare professionals should provide credible and culturally relevant diet-related information in a variety of forms.