bluuebunny/crossref_metadata_2025 huggingface dataset:
Killer immunoglobulin‐like receptor genotypes and chronic myeloid leukemia outcomes after imatinib cessation for treatment‐free remission
Authors: Dumas Pierre‐Yves , Bérard Emilie , Bréal Claire , Dulucq Stéphanie , Réa Delphine , Nicolini Franck , Forcade Edouard , Dufossée Melody , Pasquet Jean‐Max , Turcq Béatrice , Bidet Audrey , Milpied Noel , Déchanet‐Merville Julie , Lafarge Xavier , Etienne Gabriel , Mahon François‐Xavier ,   French Intergroup in Chronic Myeloid Leukemia
Published: July 2019

Background

Natural Killer (NK) cells are innate lymphoid cells that can be cytotoxic toward a large panel of solid tumors and hematological malignancies including chronic myeloid leukemia (CML). Such a cytotoxicity depends on various receptors. Killer immunoglobulin‐like receptors (KIR) belong to these receptors and are involved in maturation process, then in the activation abilities of NK cells. Methods: We investigated the prognostic impact of the KIR2DL5B genotype in 240 CML patients included in two clinical trials investigating tyrosine kinase inhibitors (TKI) discontinuation: STIM and STIM2. Results: After adjustment for standard risk factors in CML, we found that the inhibitory receptor KIR2DL5B‐positive genotype was independently related to a delayed second deep molecular remission (HR 0.54, 95% CI [0.32‐0.91], P = 0.02) after TKI rechallenge but not to time to first deep molecular remission or treatment‐free remission rates. Conclusion: These results suggest that KIR2DL5B could carry a role in lymphocyte‐mediated control of leukemic residual disease control in patient with CML relapse.
Colitis after checkpoint blockade: A retrospective cohort study of melanoma patients requiring admission for symptom control
Authors: Hughes Michael S. , Zheng Hui , Zubiri Leyre , Molina Gabriel E. , Chen Steven T. , Mooradian Meghan J. , Allen Ian M. , Reynolds Kerry L. , Dougan Michael
Published: July 2019

Background

Immune checkpoint inhibitors (CPIs) have revolutionized oncologic therapy but can lead to immune‐related adverse events (irAEs). Corticosteroids are first‐line treatment with escalation to biologic immunosuppression in refractory cases. CPI‐related gastroenterocolitis (GEC) affects 20%‐50% of patients receiving CPIs and can carry significant morbidity and mortality. Severe CPI‐related GEC is not well‐described. We present the clinical characterization of all CPI‐related GEC requiring admission at a single institution.

Methods

Clinical, laboratory, radiographic, and endoscopic data were extracted from charts of all melanoma patients ≥18 years of age admitted to one institution for CPI‐related GEC, from February 5, 2011 to December 13, 2016. Patients were followed until December 31, 2017 for further admissions. Survival, outcomes, and pharmaceutical‐use analyses were performed.

Results

Median time‐to‐admission from initial CPI exposure was 73.5 days. Median length of stay was 4.5 days. About 50.0% required second‐line immunosuppression. Readmission for recrudescence occurred in 33.3%. Common Terminology Criteria for Adverse Events (CTCAE) grade was not significantly associated with outcomes. Hypoalbuminemia (P = 0.005), relative lymphopenia (P = 0.027), and decreased lactate dehydrogenase (P = 0.026) were associated with second‐line immunosuppression. There was no difference in progression‐free survival (PFS) or OS (P = 0.367, 0.400) for second‐line immunosuppression. Subgroup analysis showed that early corticosteroid administration (P = 0.045) was associated with decreased PFS.

Conclusions

Severe CPI‐related GEC typically manifests within 3 months of immunotherapy exposure. Rates of second‐line immunosuppression and readmission for recrudescence were high. CTCAE grade did not capture the degree of severity in our cohort. Second‐line immunosuppression was not associated with poorer oncologic outcomes; however, early corticosteroid exposure was associated with decreased PFS. Further investigation is warranted.
Tatarinan T, an α‐asarone‐derived lignin, attenuates osteoclastogenesis induced by RANKL via the inhibition of NFATc1/c‐Fos expression
Authors: Zhang Yuxin , Wang Zhi , Xie Xiaona , Wang Shaoming , Wang Yingjian , Quan Guihua , Wang Hongbing , Sun Wan‐chun
Published: July 2019

We have previously reported that the lignin‐like compounds,Tatarinan O(TO) andTatarinan N(TN), extracted from the roots ofAcorus tatarinowii Schott, inhibit receptor activator of nuclear factor‐κB ligand (RANKL)‐induced osteoclastogenesis. In the present study, the potential function of the α‐asarone‐derived lignins,Tatarinan T(TT) andTatarinan A(TA), to regulate RANKL‐induced osteoclastogenesis was investigated, and it was found that only early treatment with TT may inhibit RANKL‐triggered formation of osteoclasts and resorption. The results revealed repressed expression levels of several osteoclast marker genes, including ATPase H+‐transporting V0 subunit d2 (Atp6v0d2),αvβ3integrin, and osteoclast‐associated receptor (OSCAR), following TT treatment during osteoclastogenesis. Moreover, TT reduced the expression levels of the core transcription elements, nuclear factor of activated T‐cells cytoplasmic 1 (NFATc1) andc‐Fos. However, western blotting analysis showed that TT treatment did not alter nuclear factor‐κΒ (NF‐κB) activation or mitogen‐activated protein kinase (MAPK) or Syk/Btk/phospholipase Cγ2 (PLCγ2) phosphorylation. Taken together, these results suggest the potential of TT in the treatment of diseases of increased bone resorption.
Metal–Helix Frameworks Formed by μ3‐NO3− with Different Orientations and Connected to a Heterometallic CuII10DyIII2 Folded Cluster
Authors: Wang Hai‐Ling , Zhu Zhong‐Hong , Ma Xiong‐Feng , Zou Hua‐Hong , Liang Fu‐Pei
Published: July 2019

Metal nanoclusters have a certain rigidity due to their specific coordination patterns and shapes; thus, they face extreme difficulty in folding into a specific direction to form a double‐helix structure and in further interconnecting to form metal–helix frameworks (MHFs). To date, no MHFs have been produced by the formation of heterometallic clusters. Selecting the appropriate “bonding molecules” to bond metal nanoclusters in a specific multiple direction is one of the most effective strategies for designing synthetic MHFs. In this study, we realized for the first time the control of different orientations of μ3‐NO3− to join heterometallic clusters (Cu10Dy2) and subsequently form a left‐handed double helix chain, which further joins to form MHFs. In the structure of the MHFs, four different directions of bridging μ3‐NO3− exist, three of which are involved in the linkage of the double‐helix chain. Each μ3‐NO3− is connected to three adjacent Cu10Dy2. Herein, we extend a new method for designing synthetic double‐helix structures and MHFs, thereby further laying the foundation for the development of similar DNA double‐helix structures and nucleic acid secondary structures in vitro.
Suicides and deaths linked to risky health behavior in childhood cancer patients: A Nordic population‐based register study
Authors: Korhonen Liisa M. , Taskinen Mervi , Rantanen Matti , Erdmann Friederike , Winther Jeanette Falck , Bautz Andrea , Feychting Maria , Mogensen Hanna , Talbäck Mats , Malila Nea , Ryynänen Heidi , Madanat‐Harjuoja Laura
Published: July 2019

Background

Childhood cancer survivors have been reported to be vulnerable to psychiatric morbidities and risky health behavior. Suicides, substance abuse, accidents, and violence as causes of death can be regarded as an extreme manifestation of risky health behavior. In the current study, the authors studied the risk of suicide and other risky health behavior–related deaths among childhood cancer patients in Denmark, Finland, and Sweden.

Methods

Using linkage between national cancer, population, and cause‐of‐death registries, the authors investigated the causes of death in 29,285 patients diagnosed with cancer before age 20 years between 1971 and 2009 compared with a cohort of 146,282 age‐matched, sex‐matched, and country‐matched population comparisons. Rate ratios (RRs) with 95% CIs were estimated using Poisson regression models, adjusting for demographic factors.

Results

The overall risk of dying of a risky health behavior was found to be increased among childhood cancer patients (RR, 1.25; 95% CI, 1.06‐1.47) when compared with population comparisons. The elevated risk was statistically significant among patients with central nervous system tumors (RR, 1.49; 95% CI, 1.08‐2.05) and patients diagnosed at ages 5 to 9 years and 15 to 19 years (RR, 1.50 [95% CI, 1.01‐2.24] and RR, 1.31 [95% CI, 1.03‐1.67], respectively). The overall risk of suicide was found to be increased (RR, 1.37; 95% CI, 1.02‐1.83), and statistically significantly so when patients were diagnosed between ages 15 and 19 years (RR, 1.61; 95% CI, 1.09‐2.39).

Conclusions

Childhood cancer patients appear to have an increased risk of risky health behavior–related causes of death compared with the general population. The results of the current study suggest the importance of integrating psychosocial support into the follow‐up care of these individuals.
Providing health care for patients with childhood cancer and survivors: A survey of pediatric primary care providers
Authors: Wadhwa Aman , Chen Yanjun , Bhatia Smita , Landier Wendy
Published: July 2019

Background

The current study was conducted to assess self‐reported comfort levels of pediatric primary care providers (PCPs) in providing acute medical care to patients with childhood cancer who currently were receiving therapy (on‐therapy patients) and health maintenance care to childhood cancer survivors, independently and in conjunction with pediatric oncologists, along with confidence levels regarding knowledge about immunizations for survivors. All levels were measured using 7‐point Likert scales.

Methods

A cross‐sectional, 23‐item survey mailed to practicing PCPs affiliated with a tertiary children's hospital was analyzed.

Results

The response rate was 64.4% (259 of 402 eligible PCPs). The mean PCP comfort level was higher when collaborating with a pediatric oncologist to provide acute medical care for on‐therapy patients and health maintenance care for childhood cancer survivors (mean ratings of 6.0 ± 1.5 and 6.4 ± 1.3, respectively) compared with independently providing such care (mean ratings of 4.6 ± 1.8 and 5.0 ± 1.7, respectively; P < .0001). Only approximately 30% of PCPs were confident in their knowledge regarding immunizations for survivors. Certain factors were found to be associated with PCP comfort in providing care in conjunction with a pediatric oncologist. For acute care, these factors were rural location compared with urban location (odds ratio [OR], 5.0; 95% CI, 1.9‐13.1 [P = .03]) and having cared for ≥6 on‐therapy patients within the past year versus none (OR, 3.8; 95% CI, 1.9‐7.5 [P = .0001]). For survivor health maintenance care, practice location <50 miles from pediatric oncology specialty care versus ≥50 miles was the only factor found to be associated with PCP comfort (OR, 2.8; 95% CI, 1.3‐6.1 [P = .009]).

Conclusions

The findings of the current study underscore the need for collaboration between pediatric oncologists and PCPs when caring for children with cancer across the spectrum of care.
Design of efficient fractional operator for ECG signal detection in implantable cardiac pacemaker systems
Authors: Kumar Ashish , Komaragiri Rama , Kumar Manjeet
Published: July 2019

A low power and high‐performance digital electrocardiogram (ECG) detector has become a basic requirement in modern implantable cardiac pacemakers. A fractional operator‐based digital ECG detector for modern pacemaker systems is proposed in this work. Instead of conventional thresholding, an adaptive slope prediction threshold is utilized for the detection of ECG peaks. A stochastic search‐based algorithm, namely, cuckoo search algorithm, is used to design an optimal fractional operator that is used for ECG denoising. It has been found that the proposed adaptive slope prediction threshold increases the QRS complex detection performance. A low detection error rate (DER) ranges from 0.01% to 0.56%, positive predictivity (P+) ranges from 99.32% to 99.98%, sensitivity (Se) ranges from 99.45% to 99.98%, and a detection accuracy (Acc) ranges from 99.43% to 99.96% for different databases are achieved for the proposed ECG detector, which is better compared with the existing ECG detectors. The proposed design of fractional order operator based on the lattice wave digital filter (LWDF) requires a minimum number of the multipliers for its structural realization.
Retrospective analysis into differences in heart failure patients with and without iron deficiency or anaemia
Authors: Jacob Christian , Altevers Julia , Barck Isabella , Hardt Thomas , Braun Sebastian , Greiner Wolfgang
Published: July 2019

Aims

The aim of this study was to assess the burden of heart failure (HF) patients with/without iron deficiency/iron deficiency anaemia (ID/A) from the health insurance perspective.

Methods and results

We conducted a retrospective claims database analysis using the Institut für angewandte Gesundheitsforschung Berlin research database. The study period spanned from 1 January 2012 to 31 December 2014. HF patients were identified by International Statistical Classification of Diseases and Related Health Problems, 10th revision, German Modification codes (I50.‐, I50.0‐, I50.00, I50.01, I50.1‐, I50.11, I50.12, I50.13, I50.14, I50.19, and I50.9). HF patients were stratified into HF patients without ID/A and HF patients with ID/A (D50.‐, D50.0, D50.8, D50.9, and E61.1). HF patients with ID/A were stratified into three subgroups: no iron treatment, oral iron treatment, and intravenous iron treatment. A matching approach was applied to compare outcomes for HF patients without ID/A vs. HF patient with untreated incident ID/A without iron treatment and for HF patients receiving no iron treatment vs. oral iron treatment vs. intravenous iron treatment. Matching parameters included exact age, sex, and New York Heart Association functional class. An optimization algorithm was used to balance total health care costs in the baseline period for the potential matched pairs without sample size reduction. In total, 172 394 (4537.4 per 100 000) HF patients were identified in the Institut für angewandte Gesundheitsforschung Berlin research database in 2013. Of these, 11.1% (19 070; 501.9 per 100 000) were diagnosed with ID/A and/or had a prescription for iron medication in 2013. The mean age of HF patients was 77.0 years (±12.0 years). Women were more frequently diagnosed with HF (54.6%). HF patients with untreated incident ID/A (1.77%) had a significantly higher all‐cause mortality than HF patients without ID/A (33.1% vs. 24.1%, P < 0.01). The analysis of health care utilization revealed significant differences in the rate of all‐cause hospitalization (72.9% vs. 50.5%, P < 0.01). The annual health care costs for HF patients with untreated incident ID/A amounted to €17 347 with incremental costs of €849 (P < 0.01) attributed to ID/A.

Conclusions

Heart failure is associated with a major burden for patients and the health care system in terms of health care resource utilization, costs, and mortality. Our findings suggest that there is an unmet need for treating more HF patients with ID/A with iron medication.
Synthesis of Arsenopyrite‐Type Rhodium Pernitride RhN2 from a Single‐Source Azide Precursor
Authors: Bykov Maxim , Yusenko Kirill V. , Bykova Elena , Pakhomova Anna , Kraus Werner , Dubrovinskaia Natalia , Dubrovinsky Leonid
Published: July 2019

Nitrogen‐rich noble metal nitrides possess unique mechanical and catalytic properties, therefore their synthesis and characterization is of interest for fundamental solid state chemistry and materials science. In this study we have synthesized a novel single‐source precursor [Rh(NH3)6]3(N3)5Cl4 (Rh/N ratio 1:11). Its controlled decomposition in a laser‐heated diamond anvil cell at 39 GPa resulted in a formation of rhodium pernitride RhN2. According to the results of single‐crystal X‐ray diffraction RhN2 has arsenopyrite structure type previously unknown for this compound [P21/c (no. 14), a = 4.694(3), b = 4.7100(6), c = 4.7198(7) Å, β =109.83(3) ° at 39 GPa].
Evolution of diet across the animal tree of life
Authors: Román-Palacios Cristian , Scholl Joshua P. , Wiens John J.
Published: July 2019

What an animal eats is a fundamental aspect of its biology, but the evolution of diet has not been studied across animal phylogeny. Here, we performed a large-scale phylogenetic analysis to address three unresolved questions about the evolution of animal diets. (i) Are diets conserved across animal phylogeny? (ii) Does diet influence rates of species proliferation (diversification) among animal phyla? (iii) What was the ancestral diet of animals and major animal clades? We analyzed diet data for 1087 taxa, proportionally sampled among animal phyla based on the relative species richness of phyla. Our survey suggests that across animals, carnivory is most common (∼63%), herbivory less common (∼32%), and omnivory relatively rare (∼3%). Despite considerable controversy over whether ecological traits are conserved or labile, we found strong conservatism in diet over extraordinarily deep timescales. We found that diet is unrelated to rates of species diversification across animal phyla, contrasting with previous studies showing that herbivory increased diversification within some important groups (e.g., crustaceans, insects, and mammals). Finally, we estimated that the ancestor of all animals was most likely carnivorous, as were many major phyla (e.g., arthropods, molluscs, and chordates). Remarkably, our results suggest that many carnivorous species living today may have maintained this diet through a continuous series of carnivorous ancestors for >800 million years.
From intention to action: A mixed methods study of clients’ experiences of goal‐oriented practices
Authors: Di Malta Gina , Oddli Hanne W. , Cooper Mick
Published: July 2019

Objectives

Goal‐oriented practices are central to many contemporary psychotherapies. The aim of this study was to explore clients’ experiences of this work.

Design

Mixed methods, with a main qualitative part and a smaller quantitative component. Participants were 22 clients in integrative psychotherapy (15 females, 6 males, 1 other). Semi‐structured interviews after session 4 and at endpoint were analyzed thematically. On the basis of the identified themes, “goal attitude” scores were developed and their correlations with outcomes investigated.

Results

Goal‐oriented practices could help clients move from intention to action through increased awareness and focus, setting manageable tasks, and progress monitoring. However, they had the potential to hinder clients’ awareness of their intentions, feel irrelevant, disorientating, or demotivating. Effectiveness hinged on client's management of their expectations, flexible working, and time. Positive attitudes toward goal‐oriented practices were associated with improvement.

Conclusions

Goal‐oriented practices can enhance psychotherapeutic work but need to be individually tailored and implemented collaboratively.
Retracted: MicroRNA‐204‐3p represses colon cancer cells proliferation, migration, and invasion by targeting HMGA2
Authors: Xi Xiangpeng , Teng Mujian , Zhang Liang , Xia Lijian , Chen Jingbo , Cui Zhonghui
Published: July 2019

Colon cancer is a detrimental neoplasm of the digestive tract. MicroRNAs (miRNAs) as central regulators have been discovered in colon cancer. Nonetheless, the impact of miR‐204‐3p on colon cancer remains indistinct. The research attempted to uncover the impacts of miR‐204‐3p on colon cancer cells growth, migration, and invasion. miR‐204‐3p expression level in colon cancer tissues and diverse colon cancer cell lines were testified by the quantitative real‐time polymerase chain reaction. Exploration of the impacts of miR‐204‐3p on cell growth, migration, invasion, and their associated factors through assessment of CCK‐8, flow cytometry, Transwell, and western blot, respectively. High mobility group AT‐hook 2 (HMGA2) expression was then detected in Caco‐2 cells after miR‐204‐3p mimic and inhibitor transfection, additionally dual‐luciferase activity was implemented to further uncover the correlation between HMGA2 and miR‐204‐3p. The impact of HMGA2 on Caco‐2 cell growth, migration, and invasion was finally assessed. We found that repression of miR‐204‐3p was discovered in colon cancer tissues and HCT116, SW480, Caco‐2, HT29 and SW620 cell lines. MiR‐204‐3p overexpression mitigated Coca‐2 cell viability, facilitated apoptosis, simultaneously adjusted CyclinD1 and cleaved caspase‐3 expression. Cell migration, invasion, and the associated factors were all suppressed by miR‐204‐3p overexpression. Reduction of HMGA2 was presented in Caco‐2 cells with miR‐204‐3p mimic transfection, and HMGA2 was predicated to be a target gene of miR‐204‐3p. Besides, HMGA2 silence showed the inhibitory effect on Caco‐2 cells growth, migration, and invasion. In conclusion, miR‐204‐3p repressed colon cancer cell growth, migration, and invasion through targeting HMGA2.
Population Pharmacokinetic Modeling of Gentamicin in Pediatrics
Authors: Wang Hechuan , Sherwin Catherine , Gobburu Jogarao V.S. , Ivaturi Vijay
Published: July 2019

The primary objective of this work was to characterize the pharmacokinetics (PK) of gentamicin across the whole pediatric age spectrum from premature neonates to young adults with a single model by identifying significant clinical predictors. A nonlinear mixed‐effect population PK model was developed with retrospective therapeutic drug‐monitoring data. A total of 6459 drug concentration measurements from 3370 hospitalized patients were collected for model building (n = 2357) and evaluation (n = 1013). In agreement with previously reported models, a 2‐compartment model with first‐order elimination best described the drug PK. Patient‐specific factors significantly impacting gentamicin clearance included fat‐free mass, postmenstrual age, and serum creatinine (SCr). Based on our model, the deviation of the individual SCr from the age‐dependent expected mean SCr value (SCrM) can result in a 40% lower clearance in a patient with renal impairment than that in a patient with normal kidney function, with SCrM:SCr ratios between 0.16 and 3.2 in this study. Consistent with the known age‐dependent changes of the proportion of extracellular water in body weight, the inclusion of the impact of extracellular water maturation on the central volume of distribution was found to improve the model fitting significantly. In comparison with other published models, model evaluation suggested the developed model was the least biased and physiologically most representative. These results will be used to inform individualized initial dosing strategies and serve as a prior PK model for Bayesian updating and forecasting as individual clinical observations become available.
An Efficient Method for the Synthesis of N‐uracil‐4‐oxo‐thiazolidines without Catalyst
Authors: Mohamed Asmaa H. , Shaker Raafat M.
Published: July 2019

We have developed highly efficient, one‐pot three component reaction of 5‐amino‐uracil and aromatic aldehydes with thioglycolic acid for the synthesis of N‐uracil‐thiazolidinones in excellent yields. The same products were also prepared by the reaction of Schiff bases of 5‐amino‐uracil with thioglycolic acid. In addition, benzylation of thiazolidinone derivatives and Schiff bases by using benzyl chloride was investigated. The results obtained from elemental microanalysis and different spectral data are in agreement with the assigned structures.
Effect of zinc‐biofortified seeds on grain yield of wheat, rice, and common bean grown in six countries
Authors: Rashid Abdul , Ram Hari , Zou Chun-Qin , Rerkasem Benjavan , Duarte Aildson P. , Simunji Simunji , Yazici Atilla , Guo Shiwei , Rizwan Muhammad , Bal Rajinder S. , Wang Zhaohui , Malik Sudeep S. , Phattarakul Nattinee , Soares de Freitas Rogerio , Lungu Obed , Barros Vera L. N. P. , Cakmak Ismail
Published: July 2019

Seeds enriched with zinc (Zn) are ususally associated with better germination, more vigorous seedlings and higher yields. However, agronomic benefits of high‐Zn seeds were not studied under diverse agro‐climatic field conditions. This study investigated effects of low‐Zn and high‐Zn seeds (biofortified by foliar Zn fertilization of maternal plants under field conditions) of wheat (Tritcum aestivum L.), rice (Oryza sativa L.), and common bean (Phaseolus vulgaris L.) on seedling density, grain yield and grain Zn concentration in 31 field locations over two years in six countries. Experimental treatments were: (1) low‐Zn seeds and no soil Zn fertilization (control treatment), (2) low‐Zn seeds + soil Zn fertilization, and (3) Zn‐biofortified seeds and no soil Zn fertilization. The wheat experiments were established in China, India, Pakistan, and Zambia, the rice experiments in China, India and Thailand, and the common bean experiment in Brazil. When compared to the control treatment, soil Zn fertilization increased wheat grain yield in all six locations in India, two locations in Pakistan and one location in China. Zinc‐biofortified seeds also increased wheat grain yield in all four locations in Pakistan and four locations in India compared to the control treatment. Across all countries over 2 years, Zn‐biofortified wheat seeds increased plant population by 26.8% and grain yield by 5.37%. In rice, soil Zn fertilization increased paddy yield in all four locations in India and one location in Thailand. Across all countries, paddy yield increase was 8.2% by soil Zn fertilization and 5.3% by Zn‐biofortified seeds when compared to the control treatment. In common bean, soil Zn application as well as Zn‐biofortified seed increased grain yield in one location in Brazil. Effects of soil Zn fertilization and high‐Zn seed on grain Zn density were generally low. This study, at 31 field locations in six countries over two years, revealed that the seeds biofortfied with Zn enhanced crop productivity at many locations with different soil and environmental conditions. As high‐Zn grains are a by‐product of Zn biofortification, use of Zn‐enriched grains as seed in the next cropping season can contribute to enhance crop productivity in a cost‐effective manner.
Local recurrence of Ewing sarcoma: Is wide excision an acceptable treatment?
Authors: Xue Ruifeng , Lewis Valerae O. , Moon Bryan S. , Lin Patrick P.
Published: July 2019

Background and Objectives

Local recurrence in Ewing sarcoma (ES) is associated with poor prognosis. The purpose of the study is to determine what factors affect overall survival after local recurrence and whether wide excision constitutes appropriate treatment.

Methods

From 1992 to 2017, 26 patients were treated for local recurrence of ES. Sixteen patients presented with local recurrence only while 10 had metastasis. The median follow‐up was 23 months (range, 3‐255 months). Overall survival was assessed with Kaplan–Meier analysis.

Results

At the last follow‐up, seven of 26 (27%) patients were alive. Overall survival after local recurrence was 28% at 5 years. Later onset of local recurrence (P = .041), surgical treatment (P < .001), and complete eradication of all recurrent disease (P < .001) predicted better survival. Metastasis was associated with worse survival (P = .014). All three patients who survived more than 10 years were treated with wide local excision. A second local recurrence developed in seven patients (28%) but did not predict worse overall survival.

Conclusions

Overall survival after local recurrence is better for patients with nonmetastatic disease treated surgically. Wide excision can be compatible with long survival. We do not advocate amputation on a routine basis for local recurrence. Complete eradication of all diseases is associated with better survival.
An experimental study on the effects of grass root density on gully headcut erosion in the gully region of China's Loess Plateau
Authors: Guo Mingming , Wang Wenlong , Shi Qianhua , Chen Tongde , Kang Hongliang , Li Jianming
Published: July 2019

Vegetation plays an important role in gully headcut erosion in China's Loess Plateau, but little is known about the effects of root density on gully headcut erosion. This study attempted to investigate the effects of grass root density on gully headcut erosion and morphological development of the gully head using plots with different grass root densities (with bare land as the control). The experiment was performed on plots with different grass root densities, and the rainfall intensity and inflow discharge increased throughout the experiment. The results showed that headcut migration in bare land was mainly activated by upstream flow incision, headwall erosion, and plunge pool erosion, whereas headcut migration in grassland was driven by soil‐root matrix collapse at the headcut, headwall erosion, and plunge pool erosion. The soil loss rate (SLR), gully headcut retreat distance (GRD), gully area (GA), and upstream soil loss volume (SLVU) in grassland plots with different root densities were 45.64–68.45%, 66.97–85.38%, 69.26–78.18%, and 67.89–87.02% less than those in the bare land plots, respectively. However, as root density increased, the gully depth in the grassland plots increased from 19% to 59%, and the proportion of gully head soil loss volume (SLVGH) to the total soil loss volume increased from 63.37% to 88.37%. The SLR, GRD, GA, and SLVGH showed decreasing trends as the root density increased, as described by a Hill curve. Moreover, roots with diameters of 0–0.5 mm had greater effects on soil loss and morphological evolution than roots with larger diameters. Our results provide a reference for the reasonable selection of grass root density for controlling gully headcut erosion in China's Loess Plateau.
Bulk Acyclic Diene Metathesis Polycondensation
Authors: Bell Michael , Hester Holley Grace , Gallman Alec Nicholas , Gomez Valentina , Pribyl Julia , Rojas Giovanni , Riegger Andreas , Weil Tanja , Watanabe Hiro , Chujo Yoshiki , Wagener Kenneth B.
Published: July 2019

Bulk acyclic diene metathesis (ADMET) polymerization performed in the melt at temperatures up to 175 °C is completed using a cyclic (alkyl)(amino) carbene (CAAC) ruthenium‐based Grubbs catalyst. High temperature stability is investigated at temperatures well above conventional ADMET chemistry, leading to the highest weight‐average molecular weights ever achieved for any ADMET polymer. A study of isomerization tendency (double bond migration) is done via self‐metathesis of a small molecule model compound using CAAC catalysts. Minimal olefin isomerization is observed using appropriate catalyst ratios and temperatures.
Semi‐automated infarct segmentation from follow‐up noncontrast CT scans in patients with acute ischemic stroke
Authors: Kuang Hulin , Menon Bijoy K. , Qiu Wu
Published: July 2019

Purpose

Cerebral infarct volume observed in follow‐up noncontrast computed tomography (NCCT) scans of acute ischemic stroke (AIS) patients is as an important radiologic outcome measure of the effectiveness of endovascular therapy (EVT). In this paper, our aim is to propose a semiautomated segmentation approach that can accurately measure ischemic infarct volume from NCCT images of AIS patients.

Methods

A novel cascaded random forest (RF) learning is first employed to classify each voxel into normal or ischemic voxel, leading to an infarct probability map. Four types of features: intensity, statistical information in local region, symmetric difference compared to the contralateral side, and spatial probability of infarct occurrence generated by the STAPLE method, are extracted. These features are input into RF to train a first‐stage classifier. The coarse segmentation results generated by the first‐stage classifier are then used to train a fine second‐stage classifier with fivefold cross validation. The RF estimated infarct probability map obtained in the second‐stage testing as well as user input high‐level knowledge are then incorporated into a convex optimization function to obtain final segmentation. One hundred AIS patients were collected in this study, of which 70 patient images were used for evaluation while the remaining 30 patient images were used for RF training.

Results

Quantitative results show that the proposed approach is capable of yielding a dice coefficient (DC) of 79.42%, significantly outperforming some state‐of‐the‐art automated segmentation methods, such as the RF‐based methods and convolutional neural network (CNN)‐based segmentation method, U‐net. The infarct volume obtained by the proposed method is strongly correlated with the manually segmented volume. In addition, interobserver variability analysis initialized by two observers suggests low user dependency.

Conclusions

Our proposed semiautomated segmentation method can accurately segment infarct from NCCT of AIS patients.
The evolution of Ag nanoparticles inside a gas aggregation cluster source
Authors: Nikitin Daniil , Hanuš Jan , Ali‐Ogly Suren , Polonskyi Oleksandr , Drewes Jonas , Faupel Franz , Biederman Hynek , Choukourov Andrei
Published: July 2019

In‐situ UV–Vis spectroscopy was used for investigating the evolution of silver nanoparticles (NPs) inside the gas aggregation cluster source (GAS). The light beam probed the interior of the GAS at different distances from the magnetron. Plasmon resonance was detected at 365 nm, with the highest intensity found close to the magnetron due to the NP trapping. Time‐resolved measurements revealed that after the discharge switch off the majority of trapped NPs fly out of the GAS. Part of them is redeposited onto the center of the target due to the electrostatic force. NPs collected at the distance of 20 mm and further from the magnetron demonstrate gradual decrease of the size, pointing to the loss of bigger NPs on the walls.
Effect of randomization of nasal high flow rate in preterm infants
Authors: Hough Judith L. , Shearman Andrew D. , Jardine Luke , Caldararo Deborah , Schibler Andreas
Published: July 2019

Objective

To assess the effect of nasal high flow (NHF) cannula on end‐expiratory level (EEL), continuous distending pressure (CDP) and regional ventilation distribution in preterm infants.

Design

A prospective observational clinical study with randomly applied NHF rates.

Patients and Setting

Preterm infants requiring continuous positive airway pressure (CPAP) respiratory support in a Neonatal Intensive Care Unit.

Interventions

Infants were measured on randomly applied flow rates at 2, 4, and 6 L/min of NHF and compared with bubble CPAP.

Measurements and Results

Regional ventilation distribution and EEL were measured using electrical impedance tomography (EIT) and respiratory inductance plethysmography (RIP) in 24 preterm infants (31.19 ± 1.17 weeks corrected age). Changes in CDP were measured from the esophagus via the nasogastric tube. Physiological variables were also recorded. There were no differences in ventilation distribution, EEL or CDP between CPAP and NHF (P > .05). However, the physiological variables of FiO2 (P = .01) and SpO2/FiO2 (P < .01) were improved on CPAP compared with NHF.

Conclusion

NHF applied in random order with flow rates between 2 to 6 L/min was equally as good as CPAP in maintaining EEL and ventilation distribution in stable preterm infants. Overall oxygenation was better on CPAP compared to NHF.
Metered‐dose inhaler therapy with spacers: Are newborns capable of using this system correctly?
Authors: Herbes Carolina , Gonçalves Amanda Machado , Motta Gabriela Cantori , Ventura Danielle Aparecida dos Santos , Colvero Maurício , Amantéa Sérgio Luis
Published: July 2019

Introduction: Aerosol therapy using a metered‐dose inhaler (MDI) coupled to a spacer chamber is the most widely used long‐term treatment modality for chronic lung disease of prematurity. However, its use in neonates is based on data obtained from other age groups. Proper use of maintenance treatment is essential for the long‐term stability of these patients.

Objective: To ascertain whether newborns are capable of generating negative pressure during the use of a spacer with face mask for aerosol therapy.

Patients and methods: Total of 117 low‐risk newborns (age 12‐48 hours), with no congenital malformations or any detectable clinical symptoms, were included. Inspiratory pressure was measured with a respiratory pressure meter, at each respiratory cycle, during a 10‐second period, for three sequential measurements. The meter was connected to the inner chamber of the spacer through a noncollapsible silicone tube. Suitably sized masks were used.

Results: Only 43 participants (36.8%) generated a negative pressure capable of opening the spacer valve, as verified by the respiratory pressure meter. In 25 patients, all three measurements were within the expected range. Weight, gestational age, and mode of delivery were in no way associated with the ability to generate a detectable negative pressure.

Conclusion: In neonates, the MDI therapy with a spacer chamber and face mask is susceptible to failure due to the inability of most patients in this age range to generate a negative inspiratory pressure sufficient to open the spacer valve.
Cost‐effectiveness of combination therapy (Mechanical Diagnosis and Treatment and Transforaminal Epidural Steroid Injections) among patients with an indication for a Lumbar Herniated Disc surgery: Protocol of a randomized controlled trial
Authors: Mutubuki Elizabeth N. , van Helvoirt Hans , van Dongen Johanna M. , Vleggeert‐Lankamp Carmen L.A. , Huygen Frank J.P.M. , van Tulder Maurits W. , Klopper‐Kes Hanneke A.H.J. , Ostelo Raymond W.J.G.
Published: July 2019

Objectives

The general consensus is that surgical treatment is advised when conservative methods fail in patients with lumbosacral radicular syndrome (LRS). Preliminary evidence from our pilot study indicates that combination therapy (mechanical diagnosis therapy and transforaminal epidural injections) can prevent surgical treatment in patients on the waiting list for surgery. The pilot study lacked a control group, and therefore, firm conclusions pertaining to effects could not be made. This study aims to determine if combination therapy, performed while being on the waiting list for lumbar herniated disc surgery, is effective and cost‐effective compared with usual care (i.e., no intervention while being on the waiting list) among patients with a magnetic resonance imaging (MRI)‐confirmed indication for a lumbar herniated disc surgery.

Methods

A randomized controlled trial will be conducted with an economic evaluation. Patients aged 18 and above with incapacitating LRS, with leg pain and an MRI confirmed indication for lumbar disc hernia surgery, will be recruited from seven Dutch hospitals. While being on the waiting list for lumbar herniated disc surgery, patients will be randomized to either the combination therapy or usual care group. The primary outcome measure is the number of patients undergoing lumbar disc surgery during 12‐month follow‐up. Secondary outcomes include back and leg pain intensity (numeric pain rating scale), physical functioning (Roland Morris Disability Questionnaires‐23), self‐perceived recovery (global perceived effect), and health‐related quality of life (EuroQol Five Dimensions Health Questionnaire (EQ‐5D‐5L) and 12‐Item Short Form Health Survey (SF‐12)). For the economic evaluation, societal and health care costs will be measured. Measurements moments are baseline, 1, 2, 4, 6, 9, and 12 months. Data will be analysed according to the intention‐to‐treat principle.

Conclusion

No randomized controlled trials have evaluated the effectiveness and cost‐effectiveness of combination therapy compared with usual care in patients with an indication for lumbar herniated disc surgery, which emphasizes the importance of this study.
Spasticity, gait, and balance in patients with multiple sclerosis: A cross‐sectional study
Authors: Norbye Anja Davis , Midgard Rune , Thrane Gyrd
Published: July 2019

Objective

More than 80% of people with multiple sclerosis (MS) are affected by spasticity. Spasticity is known to reduce quality of life and contribute to additional symptoms, such as pain and reduced mobility, but the association between spasticity, balance, and mobility has not yet been established. Our aim was to examine whether a relationship exists between spasticity in the lower limbs, balance, and gait, as well as to explore the involvement of different muscle groups.

Methods

This study employed a cross‐sectional design. Thirty patients with MS were included. The Modified Ashworth Scale (MAS) was used to examine spasticity in the ankle plantar flexors, knee extensors, and hip adductors. Balance was measured using the Mini‐Balance Evaluation Systems Test, and gait with the 2‐Minute Walk Test. The participants were tested once with no additional follow‐up. Spearman's correlation, recursive partitioning, and linear regression analyses were used to explore the association.

Results

A significant correlation between gait distance and spasticity in the ankle plantar flexors (ρ = −.69, p < .001) and knee extensors (ρ = −.45, p = .012) was observed. Balance significantly correlated with spasticity in ankle plantar flexors (ρ = −.69, p < .001), knee extensors (ρ = −.52, p = .003), and hip adductors (ρ = −.5, p = .005). The relationship between spasticity in ankle plantar flexors and hip adductors was significant, even from low levels of spasticity, whereas MAS score ≥ 2 was clinically correlated with a decrease in gait and balance function. Adjustments for sex, age, or years since diagnosis had only minor impact on the results.

Conclusions

This study indicates that spasticity in the lower limbs is clinically significantly associated with mobility in people with MS.
Analogue spectra for impact ionization mass spectra of water ice grains obtained at different impact speeds in space
Authors: Klenner Fabian , Postberg Frank , Hillier Jon , Khawaja Nozair , Reviol René , Srama Ralf , Abel Bernd , Stolz Ferdinand , Kempf Sascha
Published: July 2019

Rationale

Detecting ice grains with impact ionization mass spectrometers in space provides information about the compositions of ice grains and their sources. Depending on the impact speeds of the ice grains onto the metal target of a mass spectrometer, ionization conditions can vary substantially, resulting in changes to the appearance of the resulting mass spectra.

Methods

Here we accurately reproduce mass spectra of water ice grains, recorded with the Cosmic Dust Analyzer (CDA) on board the Cassini spacecraft at typical impact speeds ranging between 4 km/s to 21 km/s, with a laboratory analogue experiment. In this Laser‐Induced Liquid Beam Ion Desorption (LILBID) approach, a μm‐sized liquid water beam is irradiated with a pulsed infrared laser, desorbing charged analyte and solvent aggregates and isolated ions, which are subsequently analyzed in a time‐of‐flight (TOF) mass spectrometer.

Results

We show that our analogue experiment can reproduce impact ionization mass spectra of ice grains obtained over a wide range of impact speeds, aiding the quantitative analyses of mass spectra from space.

Conclusions

Spectra libraries created with the LILBID experiment will be a vital tool for inferring the composition of ice grains from mass spectra recorded by both past and future impact ionization mass spectrometers (e.g. the SUrface Dust Analyzer (SUDA) onboard NASA's Europa Clipper Mission or detectors on a future Enceladus Mission).
Adaptive neural network control for a nonlinear Euler‐Bernoulli beam in three‐dimensional space with unknown control direction
Authors: Ji Ning , Liu Jinkun
Published: July 2019

In this paper, an adaptive neural network control system is developed for a nonlinear three‐dimensional Euler‐Bernoulli beam with unknown control direction. The Euler‐Bernoulli beam is modeled as a combination of partial differential equations (PDEs) and ordinary differential equations (ODEs). Adaptive radial basis function–based neural network control laws are designed to determine approximation of disturbances. A projection mapping operator is adopted to realize bounded approximation of disturbances. A Nussbaum function is introduced to compensate for the unknown control direction. The goal of this study is to suppress the vibrations of the Euler‐Bernoulli beam in three‐dimensional space. In addition, unknown control direction problem and bounded disturbances are considered to guarantee that the signals of the system are uniformly bounded. Numerical simulations demonstrate the effectiveness of the proposed method.
Growth response of Abies spectabilis to climate along an elevation gradient of the Manang valley in the central Himalayas
Authors: Rai Samresh , Dawadi Binod , Wang Yafeng , Lu Xiaoming , Ru Huang , Sigdel Shalik Ram
Published: July 2019

The Himalayas are characterized by a broad gradient of bioclimatic zones along their elevation. However, less is known how forest growth responds to climatic change along elevation. In this study, four standard tree-ring width chronologies of Himalayan fir (Abiesspectabilis) were developed, spanning 142–649 years along an elevation gradient of 3076–3900 m a.s.l. Principal component analysis classified the four chronologies into two groups; the ones at lower elevations (M1 and M2) and higher elevations (M3 and M4) show two distinct growth trends. Radial growth is limited by summer (June–August) precipitation at M3, and by precipitation during spring (March–May) and summer at M4. It is limited by spring temperatures and winter precipitation (December–February) at M1. Tree-ring width chronologies also significantly correlate with winter and spring Palmer Drought Severity Index (PDSI) at M1, and with summer PDSI at M3 and M4. Thus, Himalayan fir growth at high elevations is mainly limited by moisture stress rather than by low temperatures. Furthermore, the occurrence of missing rings coincides with dry periods, providing additional evidence for moisture limitation of Himalayan fir growth.
Building capacity in the healthcare sector: A strengths-based approach for increasing employees' well-being and organisational resilience
Authors: Brunetto Yvonne , Dick Tom , Xerri Matthew , Cully Ashley
Published: July 2019

This study uses Appreciative Inquiry (AI) as a lens for informing the process for building on employees' existing wellbeing within one Australian organisation, using the ‘discovery, dreaming, designing, and achieving destiny’ process. Using POSH as a theoretical framework, we worked with a large Not-For-Profit healthcare organisation as part of the ‘discovery’ phase to identify elements of what was positive, flourishing, and life-giving in the practices of their employees. During the ‘dreaming’ process, employees' wellbeing was identified as a strength. During the ‘designing’ phase, a training program was co-designed to build on employees' existing levels of wellbeing. This paper reports outcomes as part of the ‘achieving destiny component’ of the AI process. In particular, the outcomes show that employees' knowledge of, and ability to use positive emotions increased, which is a positive first step for increasing employees' wellbeing and organisational resilience.
PERMUTATION POLYNOMIALS OF DEGREE 8 OVER FINITE FIELDS OF ODD CHARACTERISTIC
Authors: FAN XIANG
Published: July 2019

We give an algorithmic generalisation of Dickson’s method of classifying permutation polynomials (PPs) of a given degree $d$ over finite fields. Dickson’s idea is to formulate from Hermite’s criterion several polynomial equations satisfied by the coefficients of an arbitrary PP of degree $d$. Previous classifications of PPs of degree at most 6 were essentially deduced from manual analysis of these polynomial equations, but this approach is no longer viable for $d>6$. Our idea is to calculate some radicals of ideals generated by the polynomials, implemented by a computer algebra system. Our algorithms running in SageMath 8.6 on a personal computer work very fast to determine all PPs of degree 8 over an arbitrary finite field of odd order $q>8$. Such PPs exist if and only if $q\in \{11,13,19,23,27,29,31\}$ and are explicitly listed in normalised form.