bluuebunny/crossref_metadata_2025 huggingface dataset:
Bladder preservation therapy for muscle invasive bladder cancer: the past, present and future
Authors: Kimura Tomokazu , Ishikawa Hitoshi , Kojima Takahiro , Kandori Shuya , Kawahara Takashi , Sekino Yuta , Sakurai Hideyuki , Nishiyama Hiroyuki
Published: August 2020

Radical cystectomy is the gold standard treatment for muscle invasive bladder cancer, but some patients have medically inoperable disease or refuse cystectomy to preserve their bladder function. Bladder preservation therapy with transurethral resection of the bladder tumor and concurrent chemoradiotherapy, known as trimodal treatment, is regarded to be a curative-intent alternative to radical cystectomy for patients with muscle invasive bladder cancer during the past decade. After the development of immune checkpoint inhibitors, a world-changing breakthrough occurred in the field of metastatic urothelial carcinoma and many clinical trials have been conducted against non-muscle invasive bladder cancer. Interestingly, preclinical and clinical studies against other malignancies have shown that immune checkpoint inhibitors interact with the radiation-induced immune reaction. As half of the patients with muscle invasive bladder cancer are elderly, and some have renal dysfunction, not only as comorbidity but also because of hydronephrosis caused by their tumors, immune checkpoint inhibitors are expected to become part of a new therapeutic approach for combination treatment with radiotherapy. Accordingly, clinical trials testing immune checkpoint inhibitors have been initiated to preserve bladder for muscle invasive bladder cancer patients using radiation and immune checkpoint inhibitors with/without chemotherapy. The objective of this review is to summarize the evidence of trimodal therapy for muscle invasive bladder cancer during the past decade and to discuss the future directions of bladder preservation therapy in immuno-oncology era.
Feasibility study of cryobiopsy for practical pathological diagnosis of primary lung cancer including immunohistochemical assessment
Authors: Nishida Tomoki , Matsumoto Yuji , Sasada Shinji , Tanaka Midori , Nakai Toshiyuki , Fukai Ryuta , Ohe Yuichiro , Watanabe Shun-ichi , Motoi Noriko
Published: August 2020

Background

Precision medicine in non-small cell lung cancer requires attainment of a sufficient amount of high-quality tumor tissue. Transbronchial cryobiopsy has emerged as a new diagnostic method for non-neoplastic lung disease with a better potential to assess morphology compared with conventional methods. However, the influence of cryobiopsy on specimen quality, particularly detection of protein expression, is unknown. We performed a comparative immunohistochemical study in specimens obtained by cryobiopsy versus conventional sampling to evaluate the feasibility of cryobiopsy for lung cancer diagnosis.

Methods

Pairs of artificial biopsy specimens, collected using a cryoprobe or conventional scalpel, were obtained from 43 surgically resected primary lung tumors. Formalin-fixed, paraffin-embedded blocks were prepared in an ISO15189-certified laboratory. Immunohistochemical staining of thyroid transcription factor-1, p40, Ki67 and programmed death-ligand 1 (22C3) was performed. The H-scores for thyroid transcription factor-1 and p40, labeling index for Ki67 and tumor proportion score for programmed death-ligand 1 were assessed. Pearson’s correlation coefficients between two sampling types were calculated.

Results

The thyroid transcription factor-1 and p40 H-scores showed perfect correlations between the cryobiopsy and conventional scalpel-obtained specimens (R2 = 0.977 and 0.996, respectively). Ki67 labeling index and PD-L1 tumor proportion score also showed strong correlations between the two sample types (R2 = 0.896 and 0.851, respectively). Five cases (11.6%) exhibited differences in tumor proportion score category between sample types, potentially because of intratumoral heterogeneity.

Conclusions

Immunohistochemical expression of certain tumor markers showed a high concordance between cryobiopsy and conventional scalpel sampling. Cryobiopsy is feasible for pathological diagnostics including PD-L1 evaluation.
Genome-Wide Association Study of Susceptibility Loci for TCF3-PBX1 Acute Lymphoblastic Leukemia in Children
Authors: Lee Shawn H. R , Qian Maoxiang , Yang Wentao , Diedrich Jonathan D , Raetz Elizabeth , Yang Wenjian , Dong Qian , Devidas Meenakshi , Pei Deqing , Yeoh Allen , Cheng Cheng , Pui Ching-Hon , Evans William E , Mullighan Charles G , Hunger Stephen P , Savic Daniel , Relling Mary V , Loh Mignon L , Yang Jun J
Published: August 2020

Acute lymphoblastic leukemia (ALL) is the most common cancer in children. TCF3-PBX1 fusion defines a common molecular subtype of ALL with unique clinical features, but the molecular basis of its inherited susceptibility is unknown. In a genome-wide association study of 1494 ALL cases and 2057 non-ALL controls, we identified a germline risk locus located in an intergenic region between BCL11A and PAPOLG: rs2665658, P = 1.88 × 10–8 for TCF3-PBX1 ALL vs non-ALL, and P = 1.70 × 10–8 for TCF3-PBX1 ALL vs other-ALL. The lead variant was validated in a replication cohort, and conditional analyses pointed to a single causal variant with subtype-specific effect. The risk variant is located in a regulatory DNA element uniquely activated in ALL cells with the TCF3-PBX1 fusion and may distally modulate the transcription of the adjacent gene REL. Our results expand the understanding of subtype-specific ALL susceptibility and highlight plausible interplay between germline variants and somatic genomic abnormalities in ALL pathogenesis.
“I Think It’s Been Met With a Shrug:” Oncologists’ Views Toward and Experiences With Right-to-Try
Authors: Smith Cambray , Stout Jeremiah , Adjei Alex A , Buckner Jan , Wentworth Mark , Tilburt Jon , Master Zubin
Published: August 2020

Background

The federal Right-to-Try (RTT) Act created an alternate regulatory pathway for preapproval access to investigational drugs. A few studies have examined the experiences of physicians with the Food and Drug Administration’s Expanded Access Programs, but to our knowledge, no study has yet to examine their attitudes and experiences toward RTT.

Methods

This study explored the views of 21 oncologists at a major cancer center with 3 main sites across the United States using semi-structured interviews and qualitative analysis. Participants were selected to have experience with Expanded Access Programs.

Results

Most oncologists had limited familiarity with RTT, and several reported confusion about the legislation, including whether patients have a right to investigational drugs and an obligation for companies to provide them. Although oncologists were interested in decreased regulatory burdens, 3 areas of concern were articulated: lack of safety and oversight, unclear structure and no provision for data collection, and potential heightening of patient expectations. Only 4 oncologists had experience discussing RTT, and none formally attempted to obtain the drug through this mechanism. Participants questioned the practicality of RTT legislation and suggested alternative ways to improve access.

Conclusions

The study provides foundational empirical data underlying challenging ambiguities by experienced oncologists familiar with off-trial use of investigational therapeutics and reaffirms the role of physicians and regulatory bodies in mitigating the risks of investigational drugs. Our findings highlight the need for medical centers to inform oncologists about RTT and other preapproval pathways so that they are able to address questions from patients interested in nontrial investigational drugs.
Health, Integration and Agency: Sport Participation Experiences of Asylum Seekers
Authors: Ley Clemens , Karus Felix , Wiesbauer Lisa , Rato Barrio María , Spaaij Ramon
Published: August 2020

Politicians, scholars, and practitioners have drawn attention to social and health benefits of sport participation in the context of forced migration and refugee settlement. This study aims to progress conceptual and practical understandings of how asylum seekers’ past and present experiences shape their sport participation. We present an instrumental case study drawn from the Movi Kune programme to discuss the experiences of an asylum seeker holistically, in a particular context in time and space. The findings illustrate how pre-migration, migratory, and present experiences of living in prolonged uncertainty and liminality all strongly affect sport participation and its health and integration outcomes. The results further show that sport participation was an opportunity to perform agency, experience mastery, coping, and social recognition, promoting positive self-efficacy beliefs, health and social connection over time. Our findings extend the literature by indicating that sport practices can enhance human agency to cope with health issues and distressing past and present experiences during the asylum-seeking process.
The synchrotron polarization in decaying magnetic field in gamma-ray bursts
Authors: Cheng K F , Zhao X H , Bai J M
Published: August 2020

Polarization can serve as a probe of the radiation mechanism and magnetic field (MF) configuration in gamma-ray bursts (GRBs). In the case of constant MF, the synchrotron polarization in the prompt phase of GRBs has been widely studied. In this paper, we consider the case of the decaying MF. We calculate the time-averaged and instantaneous synchrotron polarizations in a pulse for different viewing angles and for the large-scale decaying MF model, which can explain the so-called Band spectrum. We find that the on-axis time-averaged polarization degree (PD) in the energy band of 50–500 keV for the decaying large-scale MF model (∼0.6 for typical parameters) is higher than that in the constant MF model (∼0.5). An interesting result is the instantaneous PD in the off-axis case will experience a turnover, i.e. the PD will evolve from a positive value to a negative one. This suggests the polarization angle (PA) change by an angle of 90°. Such a result is roughly consistent with the discovery of the PA evolution within a pulse in some bursts, such as GRB 170114A and GRB 160821A. Our result implies at least a part of bursts (off-axis bursts) should have the PA evolution in a pulse.
The observational impact of dust trapping in self-gravitating discs
Authors: Cadman James , Hall Cassandra , Rice Ken , Harries Tim J , Klaassen Pamela D
Published: August 2020

We present a 3D semi-analytical model of self-gravitating discs, and include a prescription for dust trapping in the disc spiral arms. Using Monte Carlo radiative transfer, we produce synthetic ALMA (Atacama Large Millimeter/submillimeter Array) observations of these discs. In doing so, we demonstrate that our model is capable of producing observational predictions, and able to model real image data of potentially self-gravitating discs. For a disc to generate spiral structure that would be observable with ALMA requires that the disc’s dust mass budget is dominated by millimetre- and centimetre-sized grains. Discs in which grains have grown to the grain fragmentation threshold may satisfy this criterion; thus, we predict that signatures of gravitational instability may be detectable in discs of lower mass than has previously been suggested. For example, we find that discs with disc-to-star mass ratios as low as 0.10 are capable of driving observable spiral arms. Substructure becomes challenging to detect in discs where no grain growth has occurred or in which grain growth has proceeded well beyond the grain fragmentation threshold. We demonstrate how we can use our model to retrieve information about dust trapping and grain growth through multiwavelength observations of discs, and using estimates of the opacity spectral index. Applying our disc model to the Elias 27, WaOph 6, and IM Lup systems, we find gravitational instability to be a plausible explanation for the observed substructure in all three discs, if sufficient grain growth has indeed occurred.
Opening reionization: quantitative morphology of the epoch of reionization and its connection to the cosmic density field
Authors: Busch Philipp , Eide Marius B , Ciardi Benedetta , Kakiichi Koki
Published: August 2020

We introduce a versatile and spatially resolved morphological characterization of binary fields, rooted in the opening transform of mathematical morphology. We subsequently apply it to the thresholded ionization field in simulations of cosmic reionization and study the morphology of ionized regions. We find that an ionized volume element typically resides in an ionized region with radius ∼8 h−1 cMpc at the midpoint of reionization (z ≈ 7.5) and follow the bubble size distribution even beyond the overlap phase. We find that percolation of the fully ionized component sets in when 25 per cent of the universe is ionized and that the resulting infinite cluster incorporates all ionized regions above ∼8 h−1 cMpc. We also quantify the clustering of ionized regions of varying radius with respect to matter and on small scales detect the formation of superbubbles in the overlap phase. On large scales, we quantify the bias values of the centres of ionized and neutral regions of different sizes and not only show that the largest ones at the high-point of reionization can reach b ≈ 30, but also that early small ionized regions are positively correlated with matter and large neutral regions and late small ionized regions are heavily antibiased with respect to matter, down to b ≲ −20.
Observability of dusty debris discs around M-stars
Authors: Luppe Patricia , Krivov Alexander V , Booth Mark , Lestrade Jean-François
Published: August 2020

Debris discs are second-generation dusty discs formed by collisions of planetesimals. Many debris discs have been found and resolved around hot and solar-type stars. However, only a handful have been discovered around M-stars, and the reasons for their paucity remain unclear. Here, we check whether the sensitivity and wavelength coverage of present-day telescopes are simply unfavourable for detection of these discs or if they are truly rare. We approach this question by looking at the Herschel/DEBRIS survey that has searched for debris discs including M-type stars. Assuming that these cool-star discs are ‘similar’ to those of the hotter stars in some sense (i.e. in terms of dust location, temperature, fractional luminosity, or mass), we check whether this survey should have found them. With our procedure we can reproduce the $2.1^{+4.5}_{-1.7}$ per cent detection rate of M-star debris discs of the DEBRIS survey, which implies that these discs can indeed be similar to discs around hotter stars and just avoid detection. We then apply this procedure to IRAM NIKA-2 and ALMA bands 3, 6, and 7 to predict possible detection rates and give recommendations for future observations. We do not favour observing with IRAM, since it leads to detection rates lower than for the DEBRIS survey, with 0.6–4.5 per cent for a 15 min observation. ALMA observations, with detection rates 0.9–7.2 per cent, do not offer a significant improvement either, and so we conclude that more sensitive far-infrared and single dish sub-millimetre telescopes are necessary to discover the missing population of M-star debris discs.
State-to-state inelastic rate coefficients of phosphine in collision with He at low to moderate temperature
Authors: Badri Ayda , Najar Faouzi , Bop Cheikh T , Jaidane Nejm-Eddine , Hochlaf Majdi
Published: August 2020

Several phosphorus-bearing molecules, such as the phosphine of interest here, have been detected in astrophysical media. With the aim of satisfying the precision required by the astrophysical community, we report the rate coefficients of PH3 in collision with helium from low to moderate temperature. To this end, we constructed the first three-dimensional potential energy surface (3D-PES) of the PH3–He van der Waals complex, which governs the nuclear motions. The 3D-PES was worked out by means of the standard coupled cluster with single, double and non-iterative triple excitation approach, in conjunction with the aug-cc-pVQZ basis set and complemented by mid-bond functions. This 3D-PES presents a well of 34.92 cm−1 at {R, θ, Φ}  = {5.76 a0, 90°, 60°}. Afterwards, we incorporated this 3D-PES into time-independent close-coupling quantum dynamical computations to derive the inelastic cross-sections of rotational excitation of (ortho-) para-PH3 after collision with He up to (1000) 500 cm−1. Subsequently, we evaluated the rate coefficients for temperatures up to (100 K) 50 K populating the (41) 42 low-lying rotational levels of (ortho-) para-PH3. These data were derived by averaging the cross-sections thermally over the Maxwell–Boltzmann velocity distribution. No general propensity rules are found. We also performed a comparison with the rates for NH3–He. Differences are observed that invalidate the use of NH3 rates for deducing accurate abundances of phosphine in cold astrophysical media. Our results should be of great help in determining accurate PH3 abundances and, more generally, constraining the interstellar PH3 chemistry better.
SN 2014ab: an aspherical Type IIn supernova with low polarization
Authors: Bilinski Christopher , Smith Nathan , Williams G Grant , Smith Paul , Andrews Jennifer , Clubb Kelsey I , Zheng WeiKang , Filippenko Alexei V , Fox Ori D , Hosseinzadeh Griffin , Howell D Andrew , Kelly Patrick L , Milne Peter , Sand D J , Hoffman Jennifer L , Leonard Douglas C , Cargill Samantha , Casper Chadwick , Halevy Goni , Kim Haejung , Kumar Sahana , Pina Kenia , Yuk Heechan
Published: August 2020

We present photometry, spectra, and spectropolarimetry of supernova (SN) 2014ab, obtained through ∼200 d after peak brightness. SN 2014ab was a luminous Type IIn SN (MV < −19.14 mag) discovered after peak brightness near the nucleus of its host galaxy, VV 306c. Pre-discovery upper limits constrain the time of explosion to within 200 d prior to discovery. While SN 2014ab declined by ∼1 mag over the course of our observations, the observed spectrum remained remarkably unchanged. Spectra exhibit an asymmetric emission-line profile with a consistently stronger blueshifted component, suggesting the presence of dust or a lack of symmetry between the far side and near side of the SN. The Pa β emission line shows a profile very similar to that of H α, implying that this stronger blueshifted component is caused either through obscuration by large dust grains, occultation by optically thick material, or a lack of symmetry between the far side and near side of the interaction region. Despite these asymmetric line profiles, our spectropolarimetric data show that SN 2014ab has little detected polarization after accounting for the interstellar polarization. We are likely seeing emission from a photosphere that has only small deviation from circular symmetry in the plane normal to our line of sight, but with either large-grain dust or significant asymmetry in the density of circumstellar material or SN ejecta along our line of sight. We suggest that SN 2014ab and SN 2010jl (as well as other SNe IIn) may be events with similar geometry viewed from different directions.
Galaxy And Mass Assembly (GAMA): a forensic SED reconstruction of the cosmic star formation history and metallicity evolution by galaxy type
Authors: Bellstedt Sabine , Robotham Aaron S G , Driver Simon P , Thorne Jessica E , Davies Luke J M , Lagos Claudia del P , Stevens Adam R H , Taylor Edward N , Baldry Ivan K , Moffett Amanda J , Hopkins Andrew M , Phillipps Steven
Published: August 2020

We apply the spectral energy distribution (SED) fitting code ProSpect to multiwavelength imaging for ∼7000 galaxies from the GAMA survey at z < 0.06, in order to extract their star formation histories. We combine a parametric description of the star formation history with a closed-box evolution of metallicity where the present-day gas-phase metallicity of the galaxy is a free parameter. We show with this approach that we are able to recover the observationally determined cosmic star formation history (CSFH), an indication that stars are being formed in the correct epoch of the Universe, on average, for the manner in which we are conducting SED fitting. We also show the contribution to the CSFH of galaxies of different present-day visual morphologies and stellar masses. Our analysis suggests that half of the mass in present-day elliptical galaxies was in place 11 Gyr ago. In other morphological types, the stellar mass formed later, up to 6 Gyr ago for present-day irregular galaxies. Similarly, the most massive galaxies in our sample were shown to have formed half their stellar mass by 11 Gyr ago, whereas the least massive galaxies reached this stage as late as 4 Gyr ago (the well-known effect of ‘galaxy downsizing’). Finally, our metallicity approach allows us to follow the average evolution in gas-phase metallicity for populations of galaxies and extract the evolution of the cosmic metal mass density in stars and in gas, producing results in broad agreement with independent, higher redshift observations of metal densities in the Universe.
A minimum dilution scenario for supernovae and consequences for extremely metal-poor stars
Authors: Magg Mattis , Nordlander Thomas , Glover Simon C O , Hansen Camilla J , Ishigaki Miho , Heger Alexander , Klessen Ralf S , Kobayashi Chiaki , Nomoto Ken’ichi
Published: August 2020

To date no metal-free stars have been identified by direct observations. The most common method of constraining their properties is searching the spectra of the most metal-poor stars for the chemical elements created in the first stars and their supernova (SN). In this approach, modelled SN yields are compared to the observed abundance patterns in extremely metal-poor stars. The method typically only uses the abundance ratios, i.e. the yields are diluted to the observed level. Following the usual assumption of spherical symmetry we compute a simple lower limit of the mass an SN can mix with and find that it is consistent with all published simulations of early chemical enrichment in the interstellar medium. For three different cases, we demonstrate that this dilution limit can change the conclusions from the abundance fitting. There is a large discrepancy between the dilution found in simulations of SN explosions in minihaloes and the dilution assumed in many abundance fits. Limiting the dilution can significantly alter the likelihood of which supernovae are possible progenitors of observed CEMP-no stars. In particular, some of the faint, very low yield SNe, which have been suggested as models for the abundance pattern of SMSS0313−6708, cannot explain the measured metal abundances, as their predicted metal yields are too small by two orders of magnitude. Altogether, the new dilution model presented here emphasizes the need to better understand the mixing and dilution behaviour of aspherical SNe.
Host galaxy properties of changing-look AGNs revealed in the MaNGA survey
Authors: Yu Xiaoling , Shi Yong , Chen Yanmei , Chen Jianhang , Li Songlin , Bing Longji , Ge Junqiang , Riffel Rogemar A , Riffel Rogério
Published: August 2020

Changing-look active galactic nuclei (CL-AGNs) are a subset of AGNs in which the broad Balmer emission lines appear or disappear within a few years. We use the Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) survey to identify five CL-AGNs. The 2D photometric and kinematic maps reveal common features as well as some unusual properties of CL-AGN hosts as compared to the AGN hosts in general. All MaNGA CL-AGNs reside in the star-forming main sequence, similar to MaNGA non-changing-look AGNs (NCL-AGNs). The $80 \pm 16{{\ \rm per\ cent}}$ of our CL-AGNs do possess pseudo-bulge features, and follow the overall NCL-AGN MBH–σ* relationship. The kinematic measurements indicate that they have similar distributions in the plane of angular momentum versus galaxy ellipticity. MaNGA CL-AGNs, however, show a higher, but not statistically significant ($20 \pm 16{{\ \rm per\ cent}}$) fraction of counter-rotating features compared to that ($1.84 \pm 0.61{{\ \rm per\ cent}}$) in general star formation population. In addition, MaNGA CL-AGNs favour more face-on (axial ratio > 0.7) than that of type I NCL-AGNs. These results suggest that host galaxies could play a role in the CL-AGN phenomenon.
Rotating neutron stars in F(R) gravity with axions
Authors: Astashenok Artyom V , Odintsov Sergey D
Published: August 2020

We investigate equilibrium configurations of uniformly rotating neutron stars in R2 gravity with axion scalar field for GM1 equation of state (EoS) for nuclear matter. The mass–radius diagram, mass–central energy density are presented for some frequencies in comparison with static stars. We also compute equatorial and polar radii and moment of inertia for stars. For axion field ϕ, the coupling in the form ∼R2ϕ is assumed. Several interesting results follow from our consideration. Maximal possible star mass with given EoS increases due to the contribution of coupling term. We discovered the possibility to increase maximal frequency of the rotation in comparison with General Relativity. As a consequence, the lower bound on mass of the fast rotating stars decreases. For frequency f = 700 Hz, neutron stars with masses ∼M⊙ can exist for some choice of parameters (in General Relativity for same EoS, this limit is around 1.2 M⊙). Another feature of our solutions is relatively small increase of stars' radii for high frequencies in comparison with static case. Thus, eventually, the new class of neutron stars in R2 gravity with axions is discovered namely fast rotating compact stars with intermediate masses.
Survival Trends After Surgery for Spinal Metastatic Tumors: 20-Year Cancer Center Experience
Authors: Rothrock Robert J , Barzilai Ori , Reiner Anne S , Lis Eric , Schmitt Adam M , Higginson Daniel S , Yamada Yoshiya , Bilsky Mark H , Laufer Ilya
Published: August 2020

BACKGROUND

Over the last 2 decades, advances in systemic therapy have increased the expected overall survival for patients with cancer. It is unclear whether the same survival benefit has been conferred to patients requiring surgery for metastatic spinal disease.

OBJECTIVE

To examine trends in postoperative survival over a 20-yr period for patients surgically treated for spinal metastatic disease.

METHODS

Data were obtained for 1515 patients who underwent surgery for metastatic epidural spinal cord compression or tumor-related mechanical instability. Postoperative overall survival was calculated for all included patients using Kaplan-Meier methodology from date of surgery until death or last follow-up for those who were censored. Trends were analyzed using Cox proportional hazards modeling.

RESULTS

Patients with renal, breast, lung, and colon cancers experienced a statistically significant improvement in survival over time based on the year of surgery (40%-100% improvement over the study period), whereas the overall survival trend for the entire cohort did not reach statistical significance (P = .12, median survival 0.71 yr, 95% CI 0.63-0.78). Patients presenting with synchronous metastatic disease had better survival compared to those presenting with metachronous disease (median overall survival: 0.94 vs 0.63 yr, respectively; log-rank P-value = .00001).

CONCLUSION

The postoperative survival among patients with spinal metastases has improved over the past 20 yr, particularly in patients with kidney, breast, lung, and colon tumors metastatic to the spine. The observed survival improvement emphasizes the need for long-term outcome consideration in treatment decisions for patients undergoing surgery for spinal metastatic tumors.
Mild and Severe Obesity Reduce the Effectiveness of Lumbar Fusions: 1-Year Patient-Reported Outcomes in 8171 Patients
Authors: Mulvaney Graham , Rice Olivia M , Rossi Vincent , Peters David , Smith Mark , Patt Joshua , Pfortmiller Deborah , Asher Anthony L , Kim Paul , Bernard Joe , McGirt Matthew
Published: August 2020

BACKGROUND

Elevated body mass index (BMI) is a well-known risk factor for surgical complications in lumbar surgery. However, its effect on surgical effectiveness independent of surgical complications is unclear.

OBJECTIVE

To determine increasing BMI’s effect on functional outcomes following lumbar fusion surgery, independent of surgical complications.

METHODS

We retrospectively analyzed a prospectively built, patient-reported, quality of life registry representing 75 hospital systems. We evaluated 1- to 3-level elective lumbar fusions. Patients who experienced surgical complications were excluded. A stepwise multivariate regression model assessed factors independently associated with 1-yr Oswestry Disability Index (ODI), preop to 1-yr ODI change, and achievement of minimal clinically important difference (MCID).

RESULTS

A total of 8171 patients met inclusion criteria: 2435 with class I obesity (BMI 30-35 kg/m2), 1328 with class II (35-40 kg/m2), and 760 with class III (≥40 kg/m2). Increasing BMI was independently associated with worse 12-mo ODI (t = 8.005, P < .001) and decreased likelihood of achieving MCID (odds ratio [OR] = 0.977, P < .001). One year after surgery, mean ODI, ODI change, and percentage achieving MCID worsened with class I, class II, and class III vs nonobese cohorts (P < .001) in stepwise fashion.

CONCLUSION

Increasing BMI is associated with decreased effectiveness of 1- to 3-level elective lumbar fusion, despite absence of surgical complications. BMI ≥ 30 kg/m2 is, therefore, a risk factor for both surgical complication and reduced benefit from lumbar fusion.
Diatom-inspired multiscale mineralization of patterned protein–polysaccharide complex structures
Authors: Li Ke , Li Yingfeng , Wang Xinyu , Cui Mengkui , An Bolin , Pu Jiahua , Liu Jintao , Zhang Boyang , Ma Guijun , Zhong Chao
Published: August 2020

Marine diatoms construct their hierarchically ordered, three-dimensional (3D) external structures called frustules through precise biomineralization processes. Recapitulating the remarkable architectures and functions of diatom frustules in artificial materials is a major challenge that has important technological implications for hierarchically ordered composites. Here, we report the construction of highly ordered, mineralized composites based on fabrication of complex self-supporting porous structures—made of genetically engineered amyloid fusion proteins and the natural polysaccharide chitin—and performing in situ multiscale protein-mediated mineralization with diverse inorganic materials, including SiO2, TiO2 and Ga2O3. Subsequently, using sugar cubes as templates, we demonstrate that 3D fabricated porous structures can become colonized by engineered bacteria and can be functionalized with highly photoreactive minerals, thereby enabling co-localization of the photocatalytic units with a bacteria-based hydrogenase reaction for a successful semi-solid artificial photosynthesis system for hydrogen evolution. Our study thus highlights the power of coupling genetically engineered proteins and polysaccharides with biofabrication techniques to generate hierarchically organized mineralized porous structures inspired by nature.
Ultra-small hollow ternary alloy nanoparticles for efficient hydrogen evolution reaction
Authors: Li Zhenxing , Yu Chengcheng , Kang Yikun , Zhang Xin , Wen Yangyang , Wang Zhao-Kui , Ma Chang , Wang Cong , Wang Kaiwen , Qu Xianlin , He Miao , Zhang Ya-Wen , Song Weiyu
Published: August 2020

Hollow nanoparticles with large specific surface area and high atom utilization are promising catalysts for the hydrogen evolution reaction (HER). We describe herein the design and synthesis of a series of ultra-small hollow ternary alloy nanostructures using a simple one-pot strategy. The same technique was demonstrated for hollow PtNiCu nanoparticles, hollow PtCoCu nanoparticles and hollow CuNiCo nanoparticles. During synthesis, the displacement reaction and oxidative etching played important roles in the formation of hollow structures. Moreover, our hollow PtNiCu and PtCoCu nanoparticles were single crystalline, with an average diameter of 5 nm. Impressively, ultra-small hollow PtNiCu nanoparticles, containing only 10% Pt, exhibited greater electrocatalytic HER activity and stability than a commercial Pt/C catalyst. The overpotential of hollow PtNiCu nanoparticles at 10 mA cm−2 was 28 mV versus reversible hydrogen electrode (RHE). The mass activity was 4.54 A mgPt−1 at −70 mV versus RHE, which is 5.62-fold greater than that of a commercial Pt/C system (0.81 A mgPt−1). Through analyses of bonding and antibonding orbital filling, density functional theory calculations demonstrated that the bonding strength of different metals to the hydrogen intermediate (H*) was in the order of Pt > Co > Ni > Cu. The excellent HER performance of our hollow PtNiCu nanoparticles derives from moderately synergistic interactions between the three metals and H*. This work demonstrates a new strategy for the design of low-cost and high-activity HER catalysts.
Graphdiyne-based metal atomic catalysts for synthesizing ammonia
Authors: Yu Huidi , Xue Yurui , Hui Lan , Zhang Chao , Fang Yan , Liu Yuxin , Chen Xi , Zhang Danyan , Huang Bolong , Li Yuliang
Published: August 2020

Development of novel catalysts for nitrogen reduction at ambient pressures and temperatures with ultrahigh ammonia (NH3) yield and selectivity is challenging. In this work, an atomic catalyst with separated Pd atoms on graphdiyne (Pd-GDY) was synthesized, which shows fascinating electrocatalytic properties for nitrogen reduction. The catalyst has the highest average NH3 yield of 4.45 ± 0.30 mgNH3 mgPd−1 h−1, almost tens of orders larger than for previously reported catalysts, and 100% reaction selectivity in neutral media. Pd-GDY exhibits almost no decreases in NH3 yield and Faradaic efficiency. Density functional theory calculations show that the reaction pathway prefers to perform at the (Pd, C1, C2) active area because of the strongly coupled (Pd, C1, C2), which elevates the selectivity via enhanced electron transfer. By adjusting the p–d coupling accurately, reduction of self-activated nitrogen is promoted by anchoring atom selection, and side effects are minimized.
A Care Ethical Theory of Right Action
Authors: Steyl Steven
Published: August 2020

One of the most striking and underexplored points of difference between care ethics and other normative theories is its reluctance to offer a theory of right action. Unlike other normative ethical frameworks, care ethicists typically either neglect right action or explicitly refuse to provide a theory thereof. This paper disputes that stance. It begins with an examination of right action in care ethics, offering reasons for care ethicists not to oppose the development of a care ethical theory thereof. It then considers some potential formulations of a first premise of a theory of right action, both demonstrating the diversity of possible first premises and arguing for a monistic subset of these. It subsequently presents some potential second premises, arguing that a care ethical theory of right action ought to adopt a eudaimonistic approach to care. The paper thereby makes several inroads into a care ethical account of moral evaluation.
Anakinra treatment in patients with familial Mediterranean fever: a single-centre experience
Authors: Ugurlu Serdal , Ergezen Bilgesu , Egeli Bugra Han , Selvi Oguzhan , Ozdogan Huri
Published: August 2020

Objectives

Anakinra is proven to be effective in controlled trials in terms of attack frequency and subclinical inflammation in colchicine-resistant patients. The objective of this study was to review the patients followed in our single centre with FMF who received anakinra because of insufficient colchicine response.

Methods

The study was conducted at a tertiary rheumatology centre experienced in autoinflammatory diseases. The patients were treated for at least 1 month with anakinra. Patients with amyloidosis and pregnancy were not included. Attack frequency, patient global assessment scales of disease severity and acute phase reactants were recorded before and throughout anakinra treatment. Criteria of treatment termination were side effects, disease remission, inadequate response, pregnancy plan and non-compliance.

Results

One hundred and six patients diagnosed with FMF were treated with anakinra; 45.92% of the patients had a homozygous M694V mutation; 83 of the 98 patients tested for MEFV carried at least one copy of M694V. Attack frequency decreased while on anakinra treatment; in fact, no attacks were observed in 75 patients. Visual analogue scale score decreased from 7.49 (2.03) to 3.08 (2.82) (P = 0.001). Currently, 71 patients are still on anakinra treatment. Treatment of 34 patients was discontinued (32%). Insufficient response and side effects were the most common reasons for treatment discontinuation. All of the side effects observed were reversible and the patients alleviated after treatment cessation. In four patients, leukopenia was observed.

Conclusion

In patients who were refractory to colchicine, anti-IL-1 agent anakinra was shown to be effective and safe. The effectiveness of anakinra stems from preventing attacks and increasing the quality of life.
Tofacitinib as a possible treatment for skin thickening in diffuse cutaneous systemic sclerosis
Authors: You Hanxiao , Xu Dong , Hou Yong , Zhou Jiaxin , Wang Qian , Li Mengtao , Zeng Xiaofeng
Published: August 2020

Objectives

To analyse the effectiveness of tofacitinib for the treatment of refractory skin thickening in dcSSc.

Methods

Data from 10 patients with dcSSc treated with tofacitinib (5 mg twice daily) were analysed. A total of 12 dcSSc patients treated with intensive conventional immunosuppressants were selected as the historical comparator group. A clinically relevant response was defined as a decrease in the modified Rodnan skin score (mRSS) of >5 points and ≥25% from baseline. Clinical indicators were compared between the two groups to evaluate the effect of tofacitinib.

Results

The mRSS significantly improved the first month after tofacitinib treatment, with a mean change in the mRSS of −3.7 (95% CI −5.52, −1.88; P = 0.001) and greater than the comparators at 6 months [−10.0 (95% CI −14.74, −5.26) vs −4.1 (95% CI −7.49, −0.73), P = 0.026]. Tofacitinib-treated patients had a significantly shorter response time than the comparators (P = 0.015 by log-rank test), with overall response rates of 20% (2/10) vs 0% (0/12) and 60% (6/10) vs 16.7% (2/12) at 1 and 3 months, respectively.

Conclusion

Our results indicate that tofacitinib may be as effective as or even better than intensive conventional immunosuppressants, with a quicker and higher response rate in refractory dcSSc patients with progressive skin thickness.
Communal Intimacy: Formalization, Egalitarianism, and Exchangeability in Collective Housing
Authors: Törnqvist Maria
Published: August 2020

This article uses collective housing, a voluntary form of shared living positioned in between the conventional intimacy sphere and public life, to explore the relation between the organized and the intimate. Combining multisited observations and interviews, the study reveals collective housing to represent fairly depersonalized homes characterized by residential transition and formalization. Rather than addressing the dwellings in terms of detachment, however, the article demonstrates that they are exchange(st)able structures with existential bearing. It is through, not despite, the partially organized framework of daily chores and routines that closeness emerges. Grounded in these findings, the article calls for a reframing of intimacy outside of its traditional contexts and proposes the term “communal intimacy” to conceptualize a sociality of closeness that is bound not to exclusive dyads but to an inclusive relational infrastructure characterized by the strength of many weak ties.
Effects of increasing dietary L-glutamine to replace antibiotics on pig health and performance following weaning and transport
Authors: Duttlinger Alan W , Kpodo Kouassi R , Schinckel Allan P , Richert Brian T , Johnson Jay S
Published: August 2020

Supplementing nursery diets with 0.20% L-glutamine (GLN) may provide similar growth and health benefits as dietary antibiotics, but it was unknown if greater inclusion levels may provide additional benefits. Therefore, the study objective was to evaluate the impact of replacing dietary antibiotics with increasing GLN levels on growth performance, therapeutic antibiotic treatment rates, welfare measures, and production costs in pigs after weaning and transport. We hypothesized that withholding dietary antibiotics may negatively impact performance and increase therapeutic treatment rate, and that diet supplementation with 0.20% to 1.00% GLN may incrementally improve productivity and reduce therapeutic antibiotic treatment rates compared with dietary antibiotics. Mixed sex pigs (N = 308; 5.64 ± 0.06 kg body weight [BW]) were weaned (19.1 ± 0.2 d of age) and transported in central Indiana in 2017. Pigs were blocked by BW and allotted to one of seven dietary treatments (n = 8 pens/dietary treatment): dietary antibiotics (positive control [PC]; chlortetracycline [441 mg/kg] + tiamulin [38.6 mg/kg]), no antibiotics or added GLN (negative control [NC]), 0.20% GLN, 0.40% GLN, 0.60% GLN, 0.80% GLN, or 1.00% GLN fed for 14 d. From d 14 to 35, pigs were provided nonantibiotic common diets in two phases. Overall, average daily gain (ADG) was reduced (P = 0.01; 17.7%) from d 0 to 14 in NC, 0.20% GLN, 0.60% GLN, 0.80% GLN, and 1.00% GLN pigs compared with PC pigs, but no ADG differences were detected between 0.40% GLN pigs and PC pigs. Increasing GLN in the diet tended to increase ADG (linear; P = 0.10). Overall, d 35 BW was greater (P = 0.01) in 0.80% GLN and PC pigs compared with NC, 0.20% GLN, and 0.60% GLN pigs, and was greater for 0.40% GLN and 1.00% GLN pigs vs. 0.20% GLN pigs. However, no d 35 BW differences were detected (P > 0.05) between PC, 0.40% GLN, 0.80% GLN, and 1.00% GLN pigs. Increasing GLN in the diet tended to increase (linear; P = 0.08) d 35 BW. Overall, income over feed and therapeutic injectable antibiotics cost (IOFAC) for enteric and unthrifty challenges were greater (P = 0.02) in 0.80% GLN pigs compared with NC, 0.20% GLN, and 0.60% GLN pigs, but no IOFACs for enteric and unthrifty challenges differences were detected between 0.80% GLN pigs and 0.40% GLN, 1.00% GLN, and PC pigs. In conclusion, GLN supplemented pigs had improved performance after weaning and transport compared with the NC pigs with 0.40% GLN being the most effective level.
Effects of increasing doses of trenbolone acetate and estradiol on finishing phase growth performance, carcass trait responses, and serum metabolites in beef steers following implantation
Authors: Smerchek Dathan T , Smith Zachary K
Published: August 2020

Yearling Simmental × Angus crossbred beef steers (n = 240; allotment BW = 365 ± 22.5 kg) from a South Dakota auction facility were transported 117 km to Brookings, SD and used in a randomized complete block design feedlot study to evaluate the effects of implants (both from Zoetis, Parsippany, NJ) containing increasing doses of trenbolone acetate (TBA) and estradiol benzoate (EB) administered 124 d prior to harvest have on finishing phase growth performance, carcass characteristics, and serum concentrations of urea-N (SUN) and insulin-like growth factor I (IGF-I). Thirty pens (10 pens/treatment) were assigned to 1 of 3 treatments: 1) negative control given no implant (NI); 2) a steroidal implant containing 100 mg TBA and 14 mg EB administered subcutaneously in the center one-third of the ear on day 1 (Synovex Choice, Zoetis, Parsippany, NJ; CH); 3) a steroidal implant containing 200 mg TBA and 28 mg EB administered subcutaneously in the center one-third of the ear on day 1 (Synovex Plus, Zoetis; PL). Cattle were fed for 124 d post-implantation. Steers were fed a common diet throughout the study. Treatment effects were evaluated by the use of orthogonal polynomials. Pen was the experimental unit for all analyses; an α of 0.05 determined significance. There was a quadratic effect (P = 0.01) on carcass-adjusted final BW. Increasing doses of TBA and EB resulted in a linear increase for both average daily gain (P = 0.01) and dry matter intake (P = 0.02). A quadratic effect on gain-to-feed ratio was observed (P = 0.01). No quadratic (P ≥ 0.40) or linear (P ≥ 0.14) effects were observed for dressing percentage, rib fat (RF), calculated yield grade, or marbling scores. A quadratic increase (P = 0.01) in hot carcass weight (HCW) and a linear increase (P = 0.01) in ribeye area (REA) were detected. No significant implant × day interaction (P ≥ 0.09) was noted for serum concentrations of urea-N or IGF-I. Implants decreased (P = 0.01) SUN compared with NI. Serum concentration of IGF-I was increased (P = 0.04) in implanted steers compared with NI steers. In yearling crossbred beef steers, the use of steroidal implants containing a combination of 100 mg TBA + 14 mg EB or 200 mg TBA + 28 mg EB increases growth performance, HCW, and REA at equal RF accumulation without detriment to marbling score compared with nonimplanted steers.
A Case Study of Dual Infection of Dengue and COVID-19: Presenting as Multiorgan Dysfunction in an Infant
Authors: Kazi Maha Ashraf , Ghosh Sanajit , Roychowdhury Satyabrata , Giri Prabhas Prasun , Sarkar Mihir
Published: August 2020

Dengue is a major health concern in South Asian countries transmitted by bite of day breeder mosquitoes Aedes aegypti and Aedes albopictus. Severity of plasma leak, shock, bleeding tendency and other organ dysfunction can be more pronounced in infants. The management becomes further complicated in the presence of a co-existing COVID-19 infection. Although COVID-19 infection is usually asymptomatic or has mild manifestations in children, however in presence of serious co-infection like dengue it can modify the course of the illness and lead to drastic consequences. Here, we present one such case of a 9-month-old female child who tested positive for dengue as well as COVID-19 during the ongoing corona pandemic and went on to develop shock, encephalopathy with deranged liver enzymes but managed to overcome all odds and recover from the disease by day 14 of illness.