bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical outcomes of pediatric patients with autism spectrum disorder and other neurodevelopmental disorders and intracranial germ cell tumors
Authors: Liu Kevin X. , Sethi Roshan V. , Pulsifer Margaret B. , D'Gama Alissa M. , LaVally Beverly , Ebb David H. , Tarbell Nancy J. , Yock Torunn I. , MacDonald Shannon M.
Published: March 2021

Introduction

Intracranial germ cell tumors (IGCTs) are rare tumors of the central nervous system with peak incidence around puberty. Given the developmental origins of IGCTs, we investigated the prevalence of neurodevelopmental disorders (NDDs) in patients with IGCTs and characterized outcomes for patients with NDD and IGCTs.

Methods

A retrospective review of medical records was conducted for 111 patients diagnosed with IGCTs between 1998 and 2018 and evaluated at the Massachusetts General Hospital. Kaplan–Meier method and log‐rank test was used for survival analyses. Cox regression analyses were performed for parameters associated with progression‐free survival (PFS).

Results

Median age at IGCT diagnosis was 12.8 years (range: 4.3–21.7) and median follow‐up was 6.5 years (range: 0.2–20.5). Eighteen patients were diagnosed with NDDs prior to IGCT diagnosis, including five patients with autism spectrum disorder (ASD). Of the 67 patients with pure germinomas, four (6.0 %) had prior ASD diagnoses. Patients with NDD had significantly inferior PFS in the nongerminomatous germ cell tumor (NGGCT) cohort. On univariate and multivariable analyses, craniospinal irradiation (CSI) was significantly associated with improved PFS in the NGGCT cohort.

Conclusions

Our study found an ASD prevalence in the pure germinoma cohort more than threefold greater than the national prevalence, suggesting an association between ASD and pure germinomas. Furthermore, patients with NDD and NGGCT had worse PFS, possibly due to fewer patients with NDD receiving CSI. Future prospective studies with larger cohorts are needed to examine associations between NDDs and IGCTs, and further characterize outcomes for patients with NDDs and IGCTs.
Safety of concomitant therapy with radium‐223 and abiraterone or enzalutamide in a real‐world population
Authors: Zhao Hanson , Howard Lauren E. , De Hoedt Amanda M. , Terris Martha K. , Amling Christopher L. , Kane Christopher J. , Cooperberg Matthew R. , Aronson William J. , Klaassen Zachary , Polascik Thomas J. , Vidal Adriana C. , Freedland Stephen J.
Published: March 2021

Background

Real‐world utilization and outcomes of combination therapy for men with metastatic castrate‐resistant prostate cancer (mCRPC) are largely unknown. We evaluated the overall survival (OS) and skeletal‐related events (SREs) among men who received radium‐223 with or without concomitant abiraterone or enzalutamide in the Veterans Affairs (VA) Health System.

Methods

We reviewed charts of all mCRPC patients who received radium‐223 in the VA from January 2013 to September 2017. We used Cox models to test the association between concomitant therapy versus radium‐223 alone on OS and SRE. Sensitivity analyses were performed for concomitant use of denosumab/bisphosphonates.

Results

Three hundred and eighteen patients treated with radium‐223 were identified; 116/318 (37%) received concomitant abiraterone/enzalutamide. Two hundred and seventy‐seven (87%) patients died during follow‐up. Patients who received concomitant therapy were younger at radium‐223 initiation (median age 68 vs. 70, p = .027) and had a longer follow‐up (median 29.5 vs. 17.9 months, p = .030). There was no OS benefit for those on concomitant therapy (hazard ratio [HR]: 0.87, 95% confidence interval [CI]: 0.67–1.12, p = .28). There was a trend for an increased SRE risk for patients on concomitant therapy (HR: 1.87, 95% CI: 0.96–3.61, p = .066), but this was not significant. When analyses were limited to men using bone heath agents, similar results were seen for OS (HR: 0.86, 95% CI 0.64–1.15, p = .30) and SRE (HR: 2.36, 95% CI: 0.94–5.94, p = .068).

Conclusions

Despite the common use of concomitant therapy in this real‐world study, there was no difference in OS among mCRPC patients. A nonsignificant increased SRE risk was observed. Further work needs to evaluate the optimal sequence, timing, and safety of combination therapies.
Maneuvering control of planar snake robot: An adaptive robust approach with artificial time delay
Authors: Mukherjee Joyjit , Roy Spandan , Kar Indra Narayan , Mukherjee Sudipto
Published: March 2021

This article proposes an adaptive‐robust maneuvering control framework for a planar snake robot under the influence of parameter uncertainties. The entire control objective of maneuvering control can be viewed as the simultaneous establishments of two goals: one to maintain a time‐varying body shape of the snake robot for consistent motion (called the outer layer) and the other dealing with the velocity and head‐angle tracking of the same (called the inner layer). Unknown variations in the ground friction coefficients have been considered to be the primary source of time‐varying uncertainties which affects the control performance in both the layers. Accordingly, an artificial time delay‐based adaptive‐robust control (ARC) framework, dual adaptive‐robust time‐delayed control (ARTDC), is proposed. The term dual signifies simultaneous application of ARTDC for the outer as well as the inner layer. ARTDC comprises of two segments: an artificial time delay‐based time‐delayed estimation (TDE) part and an ARC part. While TDE approximates the completely unknown friction forces, the ARC tackles the approximation error arising from the TDE. More importantly, compared with the existing ARC methodologies, the proposed ARTDC neither presumes the overall uncertainty to be upper bounded by a constant nor requires any prior knowledge of the bound of uncertainty to implement the controller. A Lyapunov function‐based method has been adopted for analyzing the stability of the closed‐loop system. Simulation studies affirm the improved performance of the ARTDC in contrast to the classical artificial delay‐based methodology.
Janus Vitrification of Droplet via Cold Leidenfrost Phenomenon
Authors: Shi Meng , Qiu Jinbin , Feng Shangsheng , Zhang Lei , Zhao Yimin , Lu Tian Jian , Xu Feng
Published: March 2021

Janus particles with asymmetric crystals show great importance in optoelectronics and photocatalysis, but their synthesis usually requires complicated procedures. Here, an unexpected Janus vitrification phenomenon is observed in a droplet caused by the Leidenfrost effect at a cryogenic temperature, which is commonly regarded as symmetric. The Leidenfrost phenomenon levitates the droplet when it comes in contact with liquid nitrogen causing different cooling conditions on the droplet's top and bottom surfaces. It induces asymmetric crystallization in the droplet, forming a Janus vitrified particle with an asymmetric crystallization borderline after cooling, as further evidenced by cryotransmission electron microscopy (cryo‐TEM) experiments. Theoretical analysis and experimental study indicate that the position of the asymmetric crystallization borderline is determined by the droplet radius and density, and the observation window of asymmetric crystallization borderline is determined by the chemical concentration. The finding reveals the asymmetric crystallization phenomenon in droplet vitrification for the first time, and provides a new insight for creating Janus particles through the Leidenfrost phenomenon.
Composite likelihood ratio testing under nonstandard conditions using tangent cones
Authors: Azadbakhsh Mahdis , Gao Xin , Jankowski Hanna
Published: March 2021

When the null hypothesis constrains parameters to the boundary of the parameter space, the asymptotic null distribution of the composite likelihood ratio statistic is often a mixture of weighted chi‐squared distributions. The mixing weights depend on the true unknown parameter and can be very difficult to calculate, except in a few special cases. We propose a Monte Carlo algorithm to estimate the mixing weights through a projection method. We then show how this algorithm facilitates composite likelihood ratio testing under nonstandard conditions.
Translational remodeling by RNA‐binding proteins and noncoding RNAs
Authors: Ho J. J. David , Man Jeffrey H. S. , Schatz Jonathan H. , Marsden Philip A.
Published: March 2021

Responsible for generating the proteome that controls phenotype, translation is the ultimate convergence point for myriad upstream signals that influence gene expression. System‐wide adaptive translational reprogramming has recently emerged as a pillar of cellular adaptation. As classic regulators of mRNA stability and translation efficiency, foundational studies established the concept of collaboration and competition between RNA‐binding proteins (RBPs) and noncoding RNAs (ncRNAs) on individual mRNAs. Fresh conceptual innovations now highlight stress‐activated, evolutionarily conserved RBP networks and ncRNAs that increase the translation efficiency of populations of transcripts encoding proteins that participate in a common cellular process. The discovery of post‐transcriptional functions for long noncoding RNAs (lncRNAs) was particularly intriguing given their cell‐type‐specificity and historical definition as nuclear‐functioning epigenetic regulators. The convergence of RBPs, lncRNAs, and microRNAs on functionally related mRNAs to enable adaptive protein synthesis is a newer biological paradigm that highlights their role as “translatome (protein output) remodelers” and reinvigorates the paradigm of “RNA operons.” Together, these concepts modernize our understanding of cellular stress adaptation and strategies for therapeutic development.

This article is categorized under:

RNA Interactions with Proteins and Other Molecules > Protein‐RNA Interactions: Functional Implications

Translation > Translation Regulation

Regulatory RNAs/RNAi/Riboswitches > Regulatory RNAs
Artificial Intelligence and Machine Learning: An Instructor’s Exoskeleton in the Future of Education
Authors: August Stephanie E. , Tsaima Audrey
Published: March 2021

The role of artificial intelligence in US education is expanding. As education moves toward providing customized learning paths, the use of artificial intelligence (AI) and machine learning (ML) algorithms in learning systems increases. This can be viewed as growing metaphorical exoskeletons for instructors, enabling them to provide a higher level of guidance, feedback, and autonomy to learners. In turn, the instructor gains time to sense student needs and support authentic learning experiences that go beyond what AI and ML can provide. Applications of AI-based education technology support learning through automated tutoring, personalizing learning, assessing student knowledge, and automating tasks normally performed by the instructor. This technology raises questions about how it is best used, what data provides evidence of the impact of AI and ML on learning, and future directions in interactive learning systems. Exploration of the use of AI and ML for both co-curricular and independent learnings in content presentation and instruction; interactions, communications, and discussions; learner activities; assessment and evaluation; and co-curricular opportunities provide guidance for future research.
Academic Literacy Development: What Does It Entail for Multilingual Scholars?
Authors: Muresan Laura-Mihaela , Orna-Montesinos Concepción
Published: March 2021

In the introductory chapter, Muresan and Orna-Montesinos provide an overview of the multiple dimensions of academic literacy development, with a focus on its relevance for plurilingual scholars engaged in academic research writing and publishing processes. They situate the ethnographic and pedagogical studies presented in the subsequent chapters within a cognitive/socio-cultural theoretical framework, providing insights into higher education and academic literacy in glocal contexts.
Health Promotion Among Long-Term ICU Patients and Their Families
Authors: Haugdahl Hege Selnes , Alexandersen Ingeborg , Haugan Gørill
Published: March 2021

Few patients are as helpless and totally dependent on nursing as long-term intensive care (ICU) patients. How the ICU nurse relates to the patient is crucial, both concerning the patients’ mental and physical health and well-being. Even if nurses provide evidence-based care in the form of minimum sedation, early mobilization, and attempts at spontaneous breathing during weaning, the patient may not have the strength, courage, and willpower to comply. Interestingly, several elements of human connectedness have shown a positive influence on patient outcomes. Thus, a shift from technical nursing toward an increased focus on patient understanding and greater patient and family involvement in ICU treatment and care is suggested. Accordingly, a holistic view including the lived experiences of ICU care from the perspectives of patients, family members, and ICU nurses is required in ICU care as well as research.

Considerable research has been devoted to long-term ICU patients’ experiences from their ICU stays. However, less attention has been paid to salutogenic resources which are essential in supporting long-term ICU patients’ inner strength and existential will to keep on living. A theory of salutogenic ICU nursing is highly welcome. Therefore, this chapter draws on empirical data from three large qualitative studies in the development of a tentative theory of salutogenic ICU nursing care. From the perspective of former long-term ICU patients, their family members, and ICU nurses, this chapter provides insights into how salutogenic ICU nursing care can support and facilitate ICU patients’ existential will to keep on living, and thus promoting their health, survival, and well-being. In a salutogenic perspective on health, the ICU patient pathway along the ease/dis-ease continuum reveals three stages; (1) The breaking point, (2) In between, and (3) Never in my mind to give up. The tentative theory of salutogenic long-term ICU nursing care includes five main concepts: (1) the long-term ICU patient pathway (along the salutogenic health continuum), (2) the patient’s inner strength and willpower, (3) salutogenic ICU nursing care (4), family care, and (5) pull and push. The salutogenic concepts of inner strength, meaning, connectedness, hope, willpower, and coping are of vital importance and form the essence of salutogenic long-term ICU nursing care.
Dignity: An Essential Foundation for Promoting Health and Well-Being
Authors: Sæteren Berit , Nåden Dagfinn
Published: March 2021

The purpose of this chapter is to illuminate different understandings of the concept of dignity and to discuss how we can make use of this knowledge to enhance human health. Dignity is viewed as a universal concept in health sciences and a feature necessary to promote health and alleviate suffering related to sickness and impending death. The ideas presented in this chapter are founded in a caring science paradigm where the human being is considered as a unique entity consisting of body, soul, and spirit. Caring science as referred to in this chapter has its scientific foundation in Gadamer’s ontological hermeneutics.

Dignity is described in a historical perspective, and different meanings of dignity are clarified. Since health and dignity relate to one other, we have clarified the concept of health employing the texts of the Finnish theoretician Katie Eriksson. In order to illuminate the perspective of health promotion, we have also briefly described health in a salutogenic perspective according to the medical sociologist Aron Antonovsky. In clarifying dignity, the texts of well-known researchers from the Nordic countries and UK were employed. In reflecting on how we can make use of the knowledge of dignity and indignity to promote health, we have considered this matter in light of results of a major Scandinavian study. The main purpose of this study was to explore dignity and indignity of patients in nursing homes from the perspective of patients, family caregivers, and health personnel. The testimonies presented in this section are further interpreted employing mainly caring science and philosophical literature. Lastly, a short summary of some public policy efforts with the aim to preserve human dignity is offered.
Modellgestützte Wirkungsanalysen ausgewählter Maßnahmen und Strategien
Authors: Baum Sarah , Conradt Tobias , Dechow René , Elsasser Peter , Englert Hermann , Ermisch Nils , Gömann Horst , Goetzke Roland , Gottschalk Pia , Gutsch Martin , Henseler Martin , Hoymann Jana , Köthke Margret , Kreins Peter , Lasch-Born Petra , Suckow Felicitas , Wechsung Frank
Published: March 2021

Im Dialog mit Akteuren der Landnutzung wurden die Leitmotive Klimaschutz, Bioenergieerzeugung, Umwelt- und Naturschutz und Klimaanpassung herausgearbeitet und anschließend in Landnutzungsstrategien untersucht sowie die möglichen Beiträge dieser Landnutzungsstrategien zu gesellschaftlichen Zielen geprüft. Die Szenarienstudie CC-LandStraD fokussiert auf Vermeidungsstrategien des Klimawandels. Betrachtete Klimaszenarien illustrieren die Unsicherheit zukünftiger Entwicklungen. Die Wirkungen ausgewählter Maßnahmen und Landnutzungsstrategien wurden mit Hilfe eines interdisziplinären Modellverbundes im Rahmen eines komparativ-statischen Vergleichs untersucht, und zwar für die Landnutzungssektoren Siedlung und Verkehr sowie Land- und Forstwirtschaft. Anschließend wurden Maßnahmen gebündelt und zu Strategien zusammengefasst und die Wirkungen regional differenziert im Hinblick auf Änderungen der Flächennutzung, land- und forstwirtschaftlicher Produktion und Einkommen sowie Simulation von Waldbeständen sowie Stoffflüssen ausgewertet.
Personelle Indikatoren
Authors: Kladroba Andreas , Buchmann Tobias , Friz Katharina , Lange Marcel , Wolf Patrick
Published: March 2021

Dieses Kapitel behandelt FuE-Personal als Indikator der FuE-Statistik und beschreibt die Vorteile gegenüber den FuE-Aufwendungen. In Form von Steckbriefen werden die wichtigsten Eigenschaften und Anwendungsgebiete der Indikatoren beschrieben.
The see-saw portal at future Higgs Factories
Authors: Barducci Daniele , Bertuzzo Enrico , Caputo Andrea , Hernandez Pilar , Mele Barbara
Published: March 2021

Abstract

We consider an extension of the Standard Model with two right-handed singlet fermions with mass at the electroweak scale that induce neutrino masses, plus a generic new physics sector at a higher scale Λ. We focus on the effective operators of lowest dimension d = 5, which induce new production and decay modes for the singlet fermions. We assess the sensitivity of future Higgs Factories, such as FCC-ee, CLIC-380, ILC and CEPC, to the coefficients of these operators for various center of mass energies. We show that future lepton colliders can test the cut-off of the theory up to Λ ≃ 500–1000 TeV, surpassing the reach of future indirect measurements of the Higgs and Z boson widths. We also comment on the possibility of determining the underlying model flavor structure should a New Physics signal be observed, and on the impact of higher dimensional d = 6 operators on the experimental signatures.
On functions of bounded variation on convex domains in Hilbert spaces
Authors: Angiuli Luciana , Ferrari Simone , Pallara Diego
Published: March 2021

We study functions of bounded variation (and sets of finite perimeter) on a convex open set$${\varOmega }\subseteq X$$Ω⊆X,Xbeing an infinite-dimensional separable real Hilbert space. We relate the total variation of such functions, defined through an integration by parts formula, to the short-time behaviour of the semigroup associated with a perturbation of the Ornstein–Uhlenbeck operator.
Post-exercise pulsatility index indicates treatment effects in peripheral arterial occlusive disease (PAOD)
Authors: Udelnow Andrej , Hawemann Maria , Buschmann Ivo , Meyer Frank , Halloul Zuhir
Published: March 2021

Background

Hypothesis: Post-exercise measurements better discriminate PAOD-patients from healthy persons and they more sensitively detect hemodynamic improvements after treatment procedures than resting measurements.

Methods

A total of 19 healthy volunteers and 23 consecutive PAOD-patients underwent measurements of peak systolic velocity (PSV), end-diastolic velocity (EDV), minimal diastolic velocity (MDV), time-averaged maximum velocities (TAMAX), resistance index (RI) and pulsatility index (PI) before and after a standard exercise test (at 1, 2, 3, 4 and 5 min) before and after treatment (incl. epidemiological data, PAOD risk factors and comorbidities).

Results

In resting values, healthy persons and PAOD-patients did not differ significantly in any of the hemodynamic parameters. PSV increased after treatment in PAOD-patients by 5 cm/s (paired t‑test, p: 0.025); however, when the amplitude of autoregulatory changes related to the resting values were calculated, PAOD-patients showed clearly less hemodynamic changes after exercise than healthy persons (p: 0.04; 0.002; <0.001 for PSV, TAMAX and PI, resp.). The time course after exercise was compared by repeated measures of ANOVA. Healthy persons differed significantly in PI, RI and PSV from PAOD patients before and after treatment (p<0.001 each). The PAOD-patients revealed a significantly improved PI after treatment (p: 0.042). The only factor contributing significantly to PI independently from grouping was direct arterial vascularization as compared to discontinuous effects by an obstructed arterial tree.

Conclusion

Healthy persons cannot be well differentiated from PAOD-patients solely by hemodynamics at rest but by characteristic changes after standard exercise. Treatment effects are reflected by higher PI-values after exercise.
Usefulness of an artificial neural network for a beginner to achieve similar interpretations to an expert when examining myocardial perfusion images
Authors: Chiba A. , Kudo T. , Ideguchi R. , Altay M. , Koga S. , Yonekura T. , Tsuneto A. , Morikawa M. , Ikeda S. , Kawano H. , Koide Y. , Uetani M. , Maemura K.
Published: March 2021

This study examined whether using an artificial neural network (ANN) helps beginners in diagnostic cardiac imaging to achieve similar results to experts when interpreting stress myocardial perfusion imaging (MPI). One hundred and thirty-eight patients underwent stress MPI with Tc-labeled agents. An expert and a beginner interpreted stress/rest MPI with or without the ANN and the results were compared. The myocardium was divided into 5 regions (the apex; septum; anterior; lateral, and inferior regions), and the defect score of myocardial blood flow was evaluated from 0 to 4, and SSS, SRS, and SDS were calculated. The ANN effect, defined as the difference in each of these scores between with and without the ANN, was calculated to investigate the influence of ANN on the interpreters' performance. We classified 2 groups (insignificant perfusion group and significant perfusion group) and compared them. In the same way, classified 2 groups (insignificant ischemia group and significant ischemia group) and compared them. Besides, we classified 2 groups (normal vessels group and multi-vessels group) and compared them. The ANN effect was smaller for the expert than for the beginner. Besides, the ANN effect for insignificant perfusion group, insignificant ischemia group and multi-vessels group were smaller for the expert than for the beginner. On the other hand, the ANN effect for significant perfusion group, significant ischemia group and normal vessels group were no significant. When interpreting MPI, beginners may achieve similar results to experts by using an ANN. Thus, interpreting MPI with ANN may be useful for beginners. Furthermore, when beginners interpret insignificant perfusion group, insignificant ischemia group and multi-vessel group, beginners may achieve similar results to experts by using an ANN.
Efficacy and safety of lurbinectedin and doxorubicin in relapsed small cell lung cancer. Results from an expansion cohort of a phase I study
Authors: Olmedo María Eugenia , Forster Martin , Moreno Victor , López-Criado María Pilar , Braña Irene , Flynn Michael , Doger Bernard , de Miguel María , López-Vilariño José Antonio , Núñez Rafael , Kahatt Carmen , Cullell-Young Martin , Zeaiter Ali , Calvo Emiliano
Published: March 2021

Background A phase I study found remarkable activity and manageable toxicity for doxorubicin (bolus) plus lurbinectedin (1-h intravenous [i.v.] infusion) on Day 1 every three weeks (q3wk) as second-line therapy in relapsed small cell lung cancer (SCLC). An expansion cohort further evaluated this combination. Patients and methods Twenty-eight patients with relapsed SCLC after no more than one line of cytotoxic-containing chemotherapy were treated: 18 (64%) with sensitive disease (chemotherapy-free interval [CTFI] ≥90 days) and ten (36%) with resistant disease (CTFI <90 days; including six with refractory disease [CTFI ≤30 days]). Results Ten patients showed confirmed response (overall response rate [ORR] = 36%); median progression-free survival (PFS) = 3.3 months; median overall survival (OS) = 7.9 months. ORR was 50% in sensitive disease (median PFS = 5.7 months; median OS = 11.5 months) and 10% in resistant disease (median PFS = 1.3 months; median OS = 4.6 months). The main toxicity was transient and reversible myelosuppression. Treatment-related non-hematological events (fatigue, nausea, decreased appetite, vomiting, alopecia) were mostly mild or moderate. Conclusion Doxorubicin 40 mg/m2 and lurbinectedin 2.0 mg/m2 on Day 1 q3wk has shown noteworthy activity in relapsed SCLC and a manageable safety profile. The combination is being evaluated as second-line therapy for SCLC in an ongoing, randomized phase III trial. Clinical trial registrationwww.ClinicalTrials.gov code: NCT01970540. Date of registration: 22 October, 2013.
Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study
Authors: Bergman Jonathan , Ballin Marcel , Nordström Anna , Nordström Peter
Published: March 2021

We conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.
Determining the optimal piecewise constant approximation for the nonhomogeneous Poisson process rate of Emergency Department patient arrivals
Authors: De Santis Alberto , Giovannelli Tommaso , Lucidi Stefano , Messedaglia Mauro , Roma Massimo
Published: March 2021

Modeling the arrival process to an Emergency Department (ED) is the first step of all studies dealing with the patient flow within the ED. Many of them focus on the increasing phenomenon of ED overcrowding, which is afflicting hospitals all over the world. Since Discrete Event Simulation models are often adopted to assess solutions for reducing the impact of this problem, proper nonstationary processes are taken into account to reproduce time–dependent arrivals. Accordingly, an accurate estimation of the unknown arrival rate is required to guarantee the reliability of results. In this work, an integer nonlinear black–box optimization problem is solved to determine the best piecewise constant approximation of the time-varying arrival rate function, by finding the optimal partition of the 24 h into a suitable number of not equally spaced intervals. The black-box constraints of the optimization problem make the feasible solutions satisfy proper statistical hypotheses; these ensure the validity of the nonhomogeneous Poisson assumption about the arrival process, commonly adopted in the literature, and prevent mixing overdispersed data for model estimation. The cost function of the optimization problem includes a fit error term for the solution accuracy and a penalty term to select an adequate degree of regularity of the optimal solution. To show the effectiveness of this methodology, real data from one of the largest Italian hospital EDs are used.
The Ribaucour families of discrete R-congruences
Authors: Rörig Thilo , Szewieczek Gudrun
Published: March 2021

While a generic smooth Ribaucour sphere congruence admits exactly two envelopes, a discrete R-congruence gives rise to a 2-parameter family of discrete enveloping surfaces. The main purpose of this paper is to gain geometric insights into this ambiguity. In particular, discrete R-congruences that are enveloped by discrete channel surfaces and discrete Legendre maps with one family of spherical curvature lines are discussed.
Trajectories of Symptom Severity in Children with Autism: Variability and Turning Points through the Transition to School
Authors: Georgiades Stelios , Tait Peter A. , McNicholas Paul D. , Duku Eric , Zwaigenbaum Lonnie , Smith Isabel M. , Bennett Teresa , Elsabbagh Mayada , Kerns Connor M. , Mirenda Pat , Ungar Wendy J. , Vaillancourt Tracy , Volden Joanne , Waddell Charlotte , Zaidman-Zait Anat , Gentles Stephen , Szatmari Peter
Published: March 2021

This study examined the trajectories of autistic symptom severity in an inception cohort of 187 children with ASD assessed across four time points from diagnosis to age 10. Trajectory groups were derived using multivariate cluster analysis. A two trajectory/cluster solution was selected. Change in trajectory slopes revealed a turning point marked by plateauing in symptom reduction during the period of transition to school (age 6) for one of the two trajectories. Trajectories were labelled: Continuously Improving (27%) and Improving then Plateauing (73% of sample). Children in the two trajectories differed in levels of symptom severity, language, cognitive, and adaptive functioning skills. Study findings can inform the development of more personalized services for children with ASD transitioning into the school system.
The Influence of Antisocial Behavior and Callous-Unemotional Traits on Trajectories of School Engagement and Achievement in South-Korean Children
Authors: Hwang Suhlim , Waller Rebecca , Hawes David J. , Allen Jennifer L.
Published: March 2021

Poor educational outcomes are common among children with antisocial behavior problems, including among a subgroup of antisocial children with callous-unemotional traits, who show deficits in empathy, guilt, and prosociality. However, few studies have explored the unique contributions of antisocial behavior and callous-unemotional traits to school outcomes and most prior studies have been conducted in Western countries. The current study thus tested associations between callous-unemotional traits, antisocial behavior, and trajectories of school outcomes among South Korean children. Participants aged 10-12 years (N = 218; 52% boys) completed questionnaires assessing antisocial behavior, callous-unemotional traits, verbal ability, and school engagement, and teachers provided children’s Math and Korean grades at three time points during a single academic year. Prospective associations were explored in conditional latent growth curve models. Both antisocial behavior and callous-unemotional traits were related to lower school engagement at the start of the academic year, but the magnitude of the associations was greater for callous-unemotional traits, suggesting a greater adverse effect of callous-unemotional traits on engagement than antisocial behavior. Moreover, children with high levels of callous-unemotional traits showed stable and low levels of school engagement. There were no significant predictive associations between antisocial behavior or callous-unemotional traits and trajectories of academic grades. The findings suggest that interventions aimed at improving educational outcomes among antisocial children should be tailored according to the presence of callous-unemotional traits to target the specific needs of individual students, particularly at the start of the school year.
Production of no-carrier-added 89Zr at an 18 MeV cyclotron, its purification and use in investigations in solvent extraction
Authors: Mansel Alexander , Franke Karsten
Published: March 2021

The chemical separation of zirconium from lanthanides by liquid–liquid extraction is challenging but critical for medical and technological applications. Using the example of 89Zr, we optimize the liquid–liquid-extraction process by means of the radiotracer technique. We produced 89Zr by proton irradiation of a metallic yttrium target at a cyclotron. The purification of the radionuclide was performed by a UTEVA resin. 89Zr was separated in no-carrier-added form in a sulfuric acid solution. 89Zr was successfully used in solvent extraction tests with calixarenes for the separation of zirconium from lanthanides. This reaction is suitable for the efficient extraction and purification of lanthanides.
A multifaceted clinical decision support intervention to improve adherence to thromboprophylaxis guidelines
Authors: Jaspers Tessa , Duisenberg-van Essenberg Marjolijn , Maat Barbara , Durian Marc , van den Berg Roy , van den Bemt Patricia
Published: March 2021

Background Venous thromboembolism is a potentially fatal complication of hospitalisation, affecting approximately 3% of non-surgical patients. Administration of low molecular weight heparins to the appropriate patients adequately decreases venous thromboembolism incidence, but guideline adherence is notoriously low. Objective To determine the effect of a multifaceted intervention on thromboprophylaxis guideline adherence. The secondary objective was to study the effect on guideline adherence specifically in patients with a high venous thromboembolism risk. As an exploratory objective, we determined how many venous thromboembolisms may be prevented. Setting A Dutch general teaching hospital. Method A prospective study with a pre- and post-intervention measurement was conducted. A multifaceted intervention, consisting of Clinical Decision Support software, a mobile phone application, monitoring of duplicate anticoagulants and training, was implemented. Guideline adherence was assessed by calculating the Padua prediction and Improve bleeding score for each patient. The number of preventable venous thromboembolisms was calculated using the incidences of venous thromboembolism in patients with and without adequate thromboprophylaxis and extrapolated to the annual number of admitted patients. Main outcome measure Adherence to thromboprophylaxis guidelines in pre- and post-intervention measurements. Results 170 patients were included: 85 in both control and intervention group. The intervention significantly increased guideline adherence from 49.4 to 82.4% (OR 4.78; 95%CI 2.37–9.63). Guideline adherence in the patient group with a high venous thromboembolism risk also increased significantly from 54.5 to 84.3% (OR 2.46; 95%CI 1.31–4.62), resulting in the potential prevention of ± 261 venous thromboembolisms per year. Conclusions Our multifaceted intervention significantly increased thromboprophylaxis guideline adherence.
Agricultural mulching and fungicides—impacts on fungal biomass, mycotoxin occurrence, and soil organic matter decomposition
Authors: Meyer Maximilian , Diehl Dörte , Schaumann Gabriele Ellen , Muñoz Katherine
Published: March 2021

Plastic and straw coverage (PC and SC) are often combined with fungicide application but their influence on fungicide entry into soil and the resulting consequences for soil quality are still unknown. The objective of this study was to investigate the impact of PC and SC, combined with fungicide application, on soil residual concentrations of fungicides (fenhexamid, cyprodinil, and fludioxonil), soil fungal biomass, mycotoxin occurrence, and soil organic matter (SOM) decomposition, depending on soil depth (0–10, 10–30, 30–60 cm) and time (1 month prior to fungicide application and respectively 1 week, 5 weeks, and 4 months afterwards). Soil analyses comprised fungicides, fusarium mycotoxins (deoxynivalenol, 15-acetyldeoxynivalenol, nivalenol, and zearalenone), ergosterol, soil microbial carbon and nitrogen, soil organic carbon, dissolved organic carbon, and pH. Fludioxonil and cyprodinil concentrations were higher under SC than under PC 1 week and 5 weeks after fungicide application (up to three times in the topsoil) but no differences were observed anymore after 4 months. Fenhexamid was not detected, presumably because of its fast dissipation in soil. The higher fludioxonil and cyprodinil concentrations under SC strongly reduced the fungal biomass and shifted microbial community towards larger bacterial fraction in the topsoil and enhanced the abundance and concentration of deoxynivalenol and 15-acetyldeoxynivalenol 5 weeks after fungicide application. Independent from the different fungicide concentrations, the decomposition of SOM was temporarily reduced after fungicide application under both coverage types. However, although PC and SC caused different concentrations of fungicide residues in soil, their impact on the investigated soil parameters was minor and transient (< 4 months) and hence not critical for soil quality.
Self-optimizing process planning of multi-step polishing processes
Authors: Denkena Berend , Dittrich Marc-André , Nguyen Hai Nam , Bild Konrad
Published: March 2021

Self-optimizing process planning is an essential approach for finding optimum process parameters and reducing ramp-up times in machining processes. For this purpose, polishing is presented as an application example. In conventional polishing processes, the process parameters are selected according to the operator’s expertise in order to achieve a high-quality surface in the final production step. By implementing machine learning (ML) models in process planning, a correlation between process parameter and measured surface quality is generated. The application of this knowledge automates the selection of optimal process parameters in computer-aided manufacturing (CAM) and enables a continuous adaptation of the NC-code to changing process conditions. Applying the presented ML-model, the prediction accuracy of 83% will adapt the process parameters to achieve the target roughness of 0.2 μm. The sample efficiency is shown by the decrease in root mean square error from 0.1–0.28 to 0.02–0.07 μm with additional polishing iterations.
Rhizosphere effect on removal and bioavailability of PAHs in contaminated agricultural soil
Authors: Li Na , Możdżeń Katarzyna , Zhang Zhiguo , Liu Chong , Zandi Peiman , Sardar Muhammad Fahad , Zhu Changxiong
Published: March 2021

The rhizosphere effect of ryegrass (Lolium perenne L.) on polycyclic aromatic hydrocarbons (PAHs) dissipation, bioavailability and the structure change of microbial community was investigated using a compartmented device-rhizobox. The PAHs removal efficiency, bioavailability and the change in structure of the microbial community were ascertained using HPLC, Tenax-TA extraction and PCR-DGGE, respectively. The results showed that in the root area (R1) and bulk soil (CK), the removal of 3-ring PAHs were 97.72 ± 0.34% and 95.51 ± 0.75%, 4-ring PAHs were 89.01 ± 1.61% and 78.65 ± 0.47%, 5-ring PAHs were 77.64 ± 4.05% and 48.63 ± 3.19%, 6-ring PAHs were 68.69 ± 3.68% and 36.09 ± 1.78%, respectively. The average removal efficiency of the total PAHs after 80 days followed the order: R1M (91.1%) > CKM (84.9%) > CK (77.6%), indicating that planted soil with inoculation of Mycobacterium sp. as well as non-planted soil inoculated with Mycobacterium sp. could both significantly accelerate the removal of PAHs compared to control soil. The bioavailability ratio of PAHs with 3 and 4 rings tended to decrease (from 59.9% to 14.8% for 3-ring and 7.61% to 5.08% for 4-ring, respectively in R1) while those with 5 rings increased significantly (from 2.41% to 33.78% in R1) during the last 40 days, indicating that bioavailability alteration varies with the number of rings in the PAHs. In addition, PAH bioavailability generally did not show a significant difference between treated soil and control soil. These results suggest that ryegrass rhizosphere effect as well as inoculation of Mycobacterium sp. can accelerate PAH removal in polluted soil. The bacteria community structure demonstrated a complex interplay of soil, bacteria and ryegrass root, and potential PAH degraders were present in abundance. This study provides the exploring data of rhizosphere and bioaugmentation effect on PAH dissipation in agricultural soil, as well as the change of bioavailability and microbial composition thereof.
Optimized formulation of thermoresponsive nanoemulsion-based gel for enhanced oil recovery (EOR) application
Authors: Dalibera Natália Cristina , Zanin Maria Helena Ambrosio , Guimaraes Kleber Lanigra , de Oliveira Leonardo Alencar , de Oliveira Adriano Marim
Published: March 2021

A thermoresponsive system of a nanoemulsion-based gel with favorable characteristics to enhanced oil recovery (EOR) application is presented. A full factorial design study with different formulations of thermosensitive nanoemulsion-based gels was performed to assess the influence of the oil chain length, concentration of polyethylene glycol (PEG 400) and concentration of oil on the rheological behavior of the system. A formulation with low viscosity at room temperature and high viscosity at the temperature of the oil extraction well was presented. Hexane (6-carbon chain), capric acid (10-carbon chain) and isopropyl myristate (17-carbon chain) were used in concentrations of 5%, 10%, 15% and 20% wt%, also varying the concentration of PEG 400 in 0%, 3%, 6% and 9% wt%. The thermosensitive polymer used was a mixture of Pluronic® F-127 and Pluronic® F-68 6:1 wt% at 4.7% concentration. The surfactants used were Tween 80 and Span 80 (HLB = 13) at 20%. The formulation containing 20% isopropyl myristate (IPM) without the addition of PEG 400 showed a better response, with an increase in viscosity of more than 38 times in relation to its viscosity at 25 °C, and the maximum viscosity was reached at 53 °C. This is a promising formulation for EOR technology.
Students’ agency, creative reasoning, and collaboration in mathematical problem solving
Authors: Hansen Ellen Kristine Solbrekke
Published: March 2021

This paper aims to give detailed insights of interactional aspects of students’ agency, reasoning, and collaboration, in their attempt to solve a linear function problem together. Four student pairs from a Norwegian upper secondary school suggested and explained ideas, tested it out, and evaluated their solution methods. The student–student interactions were studied by characterizing students’ individual mathematical reasoning, collaborative processes, and exercised agency. In the analysis, two interaction patterns emerged from the roles in how a student engaged or refrained from engaging in the collaborative work. Students’ engagement reveals aspects of how collaborative processes and mathematical reasoning co-exist with their agencies, through two ways of interacting: bi-directional interaction and one-directional interaction. Four student pairs illuminate how different roles in their collaboration are connected to shared agency or individual agency for merging knowledge together in shared understanding. In one-directional interactions, students engaged with different agencies as a primary agent, leading the conversation, making suggestions and explanations sometimes anchored in mathematical properties, or, as a secondary agent, listening and attempting to understand ideas are expressed by a peer. A secondary agent rarely reasoned mathematically. Both students attempted to collaborate, but rarely or never disagreed. The interactional pattern in bi-directional interactions highlights a mutual attempt to collaborate where both students were the driving forces of the problem-solving process. Students acted with similar roles where both were exercising a shared agency, building the final argument together by suggesting, accepting, listening, and negotiating mathematical properties. A critical variable for such a successful interaction was the collaborative process of repairing their shared understanding and reasoning anchored in mathematical properties of linear functions.
Paraganglioma of the Bladder: a Case Report
Authors: van Doorn Tess , Albers Leonore F. , van der Laan Jaap , Roshani Hossain
Published: March 2021

A paraganglioma of the bladder is a rare condition. Paraganglioma may case general symptoms of illness like sweating or headache. When performing a transurethral resection of the bladder of the paraganglioma, an antiadrenergic intervention is advised since the resection can trigger a hypertensive crisis. A 65-year-old female was under surveillance after a radical nephroureterectomy because of pTaG2 urothelial carcinoma of the renal pelvis. A year later, she had a recurrence in the bladder (pathology: TaG1 urothelial carcinoma). During follow-up, another suspicious lesion at the bladder wall was seen and resected by transurethral resection of the bladder. The pathology showed a paraganglioma. No other paragangliomas elsewhere in the body were detected. In retrospect, the patient reported to suffer from intermittent palpations and headaches, which are related to a paraganglioma. Paragangliomas are neuro-endocrine tumours and can occur at any age. Paragangliomas of the bladder are accountable for 0.05% of the tumours of the bladder. Eighty-three percent of the paragangliomas of the bladder are symptomatic due to production of catecholamines. Clinical symptoms include sweating, palpitations and hypertension during micturition and haematuria. Cystoscopy and resection of a hormone-producing can be dangerous in patients with symptomatic paragangliomas because of possible provocation of hypertensive crisis. Differentiating between malignant and benign tumours is difficult due to lack of histological criteria. Therefore, life-long monitoring is warranted.
A Comment on Affine Invariance and Ancillarity in Testing Multivariate Normality
Authors: Szkutnik Zbigniew
Published: March 2021

With the aim to clarify some confusion apparently still present in part of the literature on testing for multivariate normality, we collect and discuss some facts on invariance and ancillarity of various variants of, so-called, configuration of a multivariate normal sample. In particular, we show how the choice of the rotation matrix, used in the definition of the configuration, influences its invariance, distribution and ancillarity.