bluuebunny/crossref_metadata_2025 huggingface dataset:
Retzius‐sparing versus standard robot‐assisted laparoscopic prostatectomy: A two‐year patient‐reported and oncological assessment
Authors: Diamand Romain , Bernard Pierre‐Loup , Mjaess Georges , Benijts Jan , Assenmacher Christophe , Assenmacher Grégoire
Published: October 2024

Purpose

To evaluate the two‐year functional and oncological outcomes of Retzius‐sparing robot‐assisted laparoscopic prostatectomy (rsRALP) and standard approach (sRALP).

Methods

A total of 200 consecutive patients who underwent either sRALP (n = 100) or rsRALP (n = 100) for clinically localized PCa at a single referral European center between 2015 and 2020 were identified from a prospectively cohort, as part of the Belgian Cancer Registry. Primary outcomes included functional outcomes and quality of life (QoL) using validated patient‐reported outcome measures (PROMs) assessed at 1‐, 3‐, 12‐, and 24‐months post‐surgery. Secondary outcomes comprised oncological outcomes reported as positive surgical margins (PSM) and 5‐year biochemical recurrence (BCR). Kaplan‐Meier analysis with log‐rank test and multivariable Cox regression were used.

Results

The median follow‐up was 60 months. No significant differences were observed between the surgical approaches in terms of patient and tumor characteristics. Urinary function and QoL were significantly better at each follow‐up period (all p ≤ 0.01) with rsRALP, while sexual function was not significantly different 12 months after surgery. No significant difference in positive surgical margins rate was observed between surgical approaches (31% vs 32%, p = 0.9). Retzius‐sparing RALP was associated with longer PSM lengths (5 mm vs 2.5 mm, p = 0.02), a higher multifocality rate (34% vs. 13%, p < 0.001), more occurrences in organ‐confined disease (59% vs. 39%, p < 0.001) and at anterior locations (37% vs. 16%, p = 0.05). Five‐year BCR‐free survival was not significantly different, and surgical approach was not a predictor of BCR.

Conclusions

The rsRALP approach significantly improves both early and short‐term urinary function and QoL compared to sRALP. Despite being associated with worse PSM characteristics, no significant decrease in BCR‐free survival was observed with rsRALP.
Exocrine Pancreatic Insufficiency in Heart Failure: Clinical Features and Association With Cardiac Cachexia
Authors: Vijver Marlene A. T. , Dams Olivier C. , Gorter Thomas M. , van Veldhuisen Charlotte L. , Verdonk Robert C. , van Veldhuisen Dirk J.
Published: October 2024

Background

Cardiac cachexia is a complex syndrome, and the underlying mechanisms are not completely understood. Exocrine pancreatic insufficiency (EPI) causes malabsorption, malnutrition and sarcopenia; and might contribute to cardiac cachexia. The prevalence of EPI and its clinical profile in patients with heart failure (HF) remain unknown. The objective of this study is to prospectively examine the prevalence and clinical characteristics of EPI in a wide spectrum of patients with HF and to relate these findings to malnutrition and cardiac cachexia.

Methods

Exocrine pancreatic function was examined in patients with HF using faecal elastase 1 (FE‐1) measurements. A FE‐1 level of ≤206 μg/g (<200 ± 3%) supported the diagnosis of EPI. All patients were well characterized (including echocardiography and biomarkers); in 36 patients, invasive hemodynamics were measured. Cardiac cachexia was defined as non‐edematous weight loss >5% in at least six months. Malnutrition was assessed by the Simplified Nutritional Appetite Questionnaire (SNAQ). Comparisons were made between patients with and without EPI.

Results

We enrolled 60 consecutive patients; mean age was 60 ± 10 years, 25 (42%) were women, mean left ventricular ejection fraction (LVEF) was 29 ± 14% and median N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) was 3926 [2126–6645] pg/mL. Six patients (10%) had EPI. They had a lower body weight (61.7 versus 83.0 kg; p = 0.003) and lower BMI (22.3 ± 3.3 versus 26.9 ± 4.5 kg/m2, p = 0.02), but functional class, LVEF and NT‐proBNP were similar (p = 0.53, p = 0.78 and p = 0.97, respectively). Patients with EPI had a higher SNAQ‐score, indicating (more symptoms of) malnutrition (1 [0–3] versus 3 [2–4], p = 0.045). Cardiac cachexia was present in three (50%) of the patients with EPI (versus 26% in patients without EPI, p = 0.35). Patients with EPI exhibited lower serum lipase than patients without EPI (23 [14–25] U/L versus 39 [26–71] U/L, p = 0.003). The aetiology of HF was different between groups (p = 0.016); patients with congenital heart disease appeared to be more often affected by EPI (p = 0.07).

Conclusions

EPI is present in a significant proportion of patients with HF but is not associated with conventional HF parameters. Patients with HF and EPI are characterized by lower body weight and BMI, malnutrition and lower plasma lipase. Since EPI is treatable, these findings may have clinical and therapeutic consequences in patients with HF.
The role of individual differences in environmental sensitivity in teachers' stress and burnout at work
Authors: Sperati A. , Persico M. E. , Palumbo R. , Fasolo M. , Spinelli M. , Pluess M. , D’Urso G. , Lionetti F.
Published: October 2024

School teachers are among workers most exposed to stress and burnout—a relevant occupational phenomenon leading to psychological and economic costs. The Environmental Sensitivity individual trait—as captured by the psychological marker of sensory processing sensitivity (SPS)—has been found to have a relevant role in stress and emotional exhaustion at work. Yet, little is still known about heightened SPS in the educational field and on underlying mechanisms occurring in the relationship between SPS, stress and burnout. The current work aimed to explore the association between SPS and burnout among teachers as well as the moderating role of perceived stress and school climate in this association. One hundred and ninety eight teachers (44.3 years; SD = 9.7, 94% F) reported on their levels of SPS, occupational burnout, perceived stress and school climate quality. In line with a vulnerability effect, we found heightened SPS largely associated with burnout. This was particularly evident in a context of high‐perceived stress, suggesting that teachers high on SPS may experience more challenges in the face of elevated stress with the need of more support. When exposed to positive and supportive school climate, highly sensitive teachers showed a decrease in burnout, suggesting high SPS as a valuable strength for benefiting from positive experiences. Findings have the potential to inform the customisation of support programs, assisting both schools and work agencies in increasing their awareness of the role of individual differences in responding to both work‐demand‐related stress and to positive work environments.
Revealing Local Grain Boundary Chemistry and Correlating it with Local Mass Transport in Mixed‐Conducting Perovskite Electrodes
Authors: Sha Zijie , Douglas James O. , Yedra Lluís , Seymour Ieuan D. , Estradé Sònia , Peiró Francesca , Skinner Stephen J. , Kilner John A.
Published: October 2024

Grain boundary (GB) mass transport, and chemistry exert a pronounced influence on both the performance and stability of electrodes for solid oxide electrochemical cells. Lanthanum strontium cobalt ferrite (LSCF6428) is applied as a model mixed ionic and electronic conducting (MIEC) perovskite oxide. The cation‐vacancy distribution at the GBs is studied at both single and multi‐grain scales using high‐resolution characterization techniques and computational approaches. The accumulation of oxygen vacancies () in the GB region, rather than necessarily at the GB core, results in an enhancement of the oxygen diffusivity by 3 – 4 orders of magnitude along the GBs (Dgb). At 350 °C, the oxygen tracer diffusion coefficient (D*) is measured as 2.5 × 10−14 cm2 s−1. The Dgb is determined to be 2.8 × 10−10 cm2 s−1 assuming a crystallographic GB width (δcrystal) of 1 nm, and 2.5 × 10−11 cm2 s−1 using a chemically measured δchem of 11.10 nm by atom probe tomography (APT). The origin of the concomitant changes in the cation composition is also investigate. In addition to the host cations, strong Na segregation is detected at all the GBs examined. Despite the low (ppm) level of this impurity, its presence can affect the space charge potential (Φ0). This, in turn, will influence the evolution of GB chemistry.
Breaking the Pt Electron Symmetry and OH Spillover towards PtIr Active Center for Performance Modulation in Direct Ammonia Fuel Cell
Authors: Barik Sidharth , Kharabe Geeta Pandurang , Samal Pragnya Paramita , Urkude Rajashri R. , Kumar Sachin , Yoyakki Athira , Vinod C. P. , Krishnamurty Sailaja , Kurungot Sreekumar
Published: October 2024

The growing interest in low‐temperature direct ammonia fuel cells (DAFCs) arises from the utilization of a carbon‐neutral ammonia source; however, DAFCs encounter significant electrode overpotentials due to the substantial energy barrier of the *NH2 to *NH dehydrogenation, compounded by the facile deactivation by *N on the Pt surface. In this work, a unique catalyst, Pt4Ir@AlOOH/NGr i.e., Pt4Ir/ANGr, is introduced composed of PtIr alloy nanoparticles controllably decorated on the pseudo‐boehmite phase of AlOOH‐supported nitrogen‐doped reduced graphene (AlOOH/NGr) composite, synthesized via the polyol reduction method. The detailed studies on the structural and electronic properties of the catalyst by XAS and VB‐XPS reveal the possible electronic modulations. The optimized Pt4Ir/ANGr composition exhibits a significantly improved onset potential and mass activity for AOR. The DFT study confirms the OHad species spillover by AlOOH and Pt4Ir (100) facilitates the conversion of the *NH2 to *NH with minimal energy barriers. Finally, testing of DAFC at the system level using a membrane electrode assembly (MEA) with Pt4Ir/ANGr as the anode catalyst, demonstrating the suitability of the catalyst for its practical applications. This study thus uncovers the potential of the Pt4Ir catalyst in synergy with ANGr, largely addressing the challenges in hydrogen transportation, storage, and safety within DAFCs.
Effect of Carbide Precipitation on Hardness and Wear Resistance of H13 Steel
Authors: Yu Xingfu , Ma He , Su Yong , Wei Yinghua , Sun Yufeng , Yang Shuai , Zheng Dongyue
Published: October 2024

The carbide precipitation of H13 steel and its effect on hardness and friction and wear resistance are investigated by microstructure observation, phase analysis, and mechanical property test. Results show that the tempering hardness is mainly related to the content of secondary carbides. After solution treatment in the temperature range of 1040–1070 °C, quenching and tempering, with the increase of the solution temperature, the content of secondary carbides and hardness of H13 steel in the tempering microstructure increase first and then decrease, and both reach the maximum value when the solution temperature is 1060 °C. The change of hardness is consistent with that of the content of secondary carbides. When the solution temperature is 1040 °C, the wear mass loss of the tempered H13 steel is the least, which is 4.63 mg, indicating that its wear resistance is the best, and this is caused by the presence of more undissolved carbides in the tempering microstructure. With the increase of the solution temperature, the wear mass loss increases gradually, and the wear resistance decreases, which is mainly related to the content decrease of undissolved and secondary carbides and the content increase of residual austenite.
Effects of Pressure on Nitrogen Content and Solidification Structure during Pressurized Electroslag Remelting Process with Composite Electrode
Authors: Suo Haoyang , Liu Fubin , Kang Cong‐Peng , Li Huabing , Jiang Zhouhua , Geng Xin
Published: October 2024

The nitrogen content and solidification structure of the 1Mn18Cr18N ingots produced by the customized laboratory‐scale vacuum induction melting furnace and the pressure electroslag remelting furnace (PESR) with novel composite electrode under different pressure and the same power consumption are compared and studied. The results show that there are perfectly uniform radial chromium and nitrogen profiles during the PESR process. The nitrogen uptake reaction in the PESR process with composite electrode takes place on the liquid metal film on the electrode. Nitrogen uptake could be improved by increasing the nitrogen partial pressure. In addition, the basin depth at a pressure of 0.1 and 1.22 MPa is about 41 and 38 mm, the angle of the grains with respect to the vertical axis is 35° and 31°, respectively. The flat metal basin profile resulted from the thermal resistance at the slag–mold interface decreasing with increasing pressure. Primary and secondary dendritic arm spacing (PDAS and SDAS) variations exhibit an increasing and subsequently decreasing the trend as they move further away from the center in a horizontal direction. Both PDAS and SDAS decrease with increasing pressure from 0.1 to 1.22 MPa.
Perineal hernia in a pregnant Angus heifer (Bos taurus)
Authors: Van den Branden Emma , Van Oevelen Heleen , Kemel Celien , Pas Mathilde Laetitia , Meesters Maya
Published: October 2024

This case report details a perineal hernia in a 3‐year‐old Angus heifer in late gestation. The heifer had a gradually increasing swelling of the perineal region since 2 weeks. Upon palpation, the swelling was painless, hard and non‐reducible. Ultrasonographic examination revealed a hernial sac enclosing the non‐pregnant horn of the uterus, filled with homogenous hypoechoic fluid. Based on the anamnesis and clinical examination, a tentative diagnosis of perineal herniation was made. Considering the deteriorating clinical condition of the cow and the possible risk of dystocia, the viable calf was delivered by Caesarean section. The cow recovered with a reducible hernial sac, which was decided not to correct surgically due to its large size. After 7 days, the cow showed no further complications and was discharged. In conclusion, although rare, a perineal hernia involving the uterus should be considered in the differential diagnosis of perineal swellings in pregnant cows.
Effective range of auditory frightening devices based on hearing capabilities and antipredator responses of nuisance blackbirds
Authors: Duttenhefner Jessica L. , Klug Page E.
Published: October 2024

A variety of acoustic strategies have been implemented to disperse wildlife from areas of human‐wildlife conflict. Propane cannons are a popular tool; however, their efficacy based on avian behavior has yet to be fully explored. We collected sound attenuation data for a propane cannon, compared to a rifle and shotgun, with reference to hearing capabilities in birds. We evaluated the behavioral responses of red‐winged blackbirds (Agelaius phoeniceus, RWBL) and brown‐headed cowbirds (Molothrus ater, BHCO) to detonations of a cannon. We placed birds in individual enclosures, void of visual stimuli, at 15–495 m from a cannon and evaluated responses (i.e., relaxed, vigilant, startled) to cannon blasts using 2 approaches: 1) incremental, where individual birds were exposed to a series of detonations at decreasing distances and 2) random assignment, where individual birds were randomly assigned distances and exposed to 2 series of 4 cannon blasts. We found behavioral responses of birds significantly decreased at greater distances (χ2(1) = 127, P < 0.001), regardless of species (χ2(1) = 0.74, P = 0.389), when incrementally approached. The probability of startling (i.e., flinch, wing flap, feather compression, or flight) was greater than vigilance (i.e., increased head turning, sudden head‐up, or neck extension) within 64 m for BHCO and 136 m for RWBL. We found a significant effect of distance (χ2(1) = 97.8, P < 0.001), between species (χ2(1) = 19.6, P < 0.001), and blast number (χ2(3) = 17.6, P < 0.001) when birds were randomly assigned a distance from the cannon. With the first cannon blast, the probability of startling was greater than vigilance or relaxed within 334 m for BHCO and 153 m for RWBL. With subsequent blasts the probability of startling was greater than vigilance and relaxed within 204–221 m of the cannon for BHCO, but startling was never greater than vigilance for RWBL. We note that the estimated range of the cannon is conservative given birds are contained with limited flight ability. Nevertheless, information on effective range and avian responses to repeated blasts informs managers on the potential interstimulus timing and distribution of propane cannons to protect resources from birds.
Numerical exploration of micropolar fluid stratified flow over curved stretching sheet under buoyancy effect
Authors: Vidhya K. G. , Nagaraja B. , Almeida F. , Kumar Pradeep
Published: October 2024

This article focuses on the effect of buoyancy on the bioconvective micropolar fluid flow over a curved stretching surface under the slip boundary condition. Mass and heat transfer analysis has been analysed using double stratification, linear heat source, chemical reaction and Joule dissipation. The calculation of entropy formation in a fluid flow is also illustrated. Using similarity transformations, the system of partial differential equations is transformed into a set of ordinary differential equations through reduction in the flow equations and then solved using the numerical methodology of the Runge‐Kutta‐Fehlberg 4th‐5th order method. The mathematical data obtained for velocity, temperature, concentration, and bio‐convection profiles with different parameters are presented on graphs. The velocity profile exhibits consistent behaviour near the buoyancy parameter, with a decrease at the boundary followed by an increase. Notably, the velocity profile experiences a decrease under first‐order slip conditions but grows when subjected to second‐order slip. Micro‐rotation intensifies as the material parameter increases. Conversely, temperature and concentration has declined as the stratification parameter rises. Additionally, the concentration of motile microorganisms reduces with increasing Lewis number and Peclet number. As the material parameter rises, entropy decreases while the Bejan number increases.
BRST covariant phase space and holographic Ward identities
Authors: Baulieu Laurent , Wetzstein Tom
Published: October 2024

Abstract

This paper develops an enlarged BRST framework to treat the large gauge transformations of a given quantum field theory. It determines the associated infinitely many Noether charges stemming from a gauge fixed and BRST invariant Lagrangian, a result that cannot be obtained from Noether’s second theorem. The geometrical significance of this result is highlighted by the construction of a trigraded BRST covariant phase space, allowing a BRST invariant gauge fixing procedure. This provides an appropriate framework for determining the conserved BRST Noether current of the global BRST symmetry and the associated global Noether charges. The latter are found to be equivalent with the usual classical corner charges of large gauge transformations. It allows one to prove the gauge independence of their physical effects at the perturbative quantum level. In particular, the underlying BRST fundamental canonical relation provides the same graded symplectic brackets as in the classical covariant phase space. A unified Lagrangian Ward identity for small and large gauge transformations is built. It consistently decouples into a bulk part for small gauge transformations, which is the standard BRST-BV quantum master equation, and a boundary part for large gauge transformations. The boundary part provides a perturbation theory origin for the invariance of the Hamiltonian physical -matrix under asymptotic symmetries. Holographic anomalies for the boundary Ward identity are studied and found to be solutions of a codimension one Wess-Zumino consistency condition. Such solutions are studied in the context of extended BMS symmetry. Their existence clarifies the status of the 1-loop correction to the subleading soft graviton theorem.
Quantum complexity of $$ T\overline{T} $$-deformation and its implications
Authors: Astaneh Amin Faraji
Published: October 2024

Abstract

We employ holography to calculate the quantum complexity of $$ T\overline{T} $$
T

T
¯

-deformation, utilizing the complexity equals volume (CV) and the complexity equals action (CA) proposals within the bulk spacetime with a finite radius cutoff. We find that the complexity of the deformed theory differs from the renormalized complexity of the original theory by a geometric functional: the bending (Willmore) energy of the time-constant slice of the base manifold. We use this result to propose an unambiguous scheme for calculating holographic quantum complexity through the CA proposal.
Bounds on $$ T\overline{T} $$ deformation from entanglement
Authors: Banerjee Avik , Roy Pratik
Published: October 2024

Abstract

Motivated by the existence of complex spectrum in $$ T\overline{T} $$
T

T
¯

-deformed CFTs, in this paper we revisit the broadly studied topic of (holographic) entanglement entropy in the deformed theory to investigate its complex behaviour. As a concrete example, we show that in case of a 1+1 dimensional holographic CFT at finite temperature β−1 and chemical potential Ω, the holographic entanglement entropy in the deformed theory remains to be real only within the range $$ -\frac{\beta^2}{8{\pi}^2}\frac{{\left(1-{\Omega}^2\right)}^2}{\Omega^2}<\mu <\frac{\beta^2}{8{\pi}^2}\left(1-{\Omega}^2\right) $$
−

β
2

8

π
2

1
−

Ω
2

2

Ω
2

<
μ
<

β
2

8

π
2

1
−

Ω
2

of the deformation parameter. While the upper bound overlaps with the familiar Hagedorn bound in the deformed theory, the novel lower bound on the negative values of the deformation parameter does not show up in thermodynamic quantities. However, from a holographic perspective we show that this intriguing lower bound is related to a spacelike to null transition of the associated Ryu-Takayanagi surface in the deformed geometry. We also investigate the Quantum Null Energy Condition in the deformed theory, within its regime of validity.
A twist at infinite distance in the CHL string
Authors: Collazuol Veronica , Melnikov Ilarion V.
Published: October 2024

Abstract

We analyze a space-time algebra of BPS states that emerges in the infinite distance limit in the moduli space of the nine-dimensional CHL string as the theory decompactifies to the ten-dimensional E8 × E8 heterotic string. We find an affine algebra as expected from the heterotic case, but in a twisted version.
Two-phase flows through porous media described by a Cahn–Hilliard–Brinkman model with dynamic boundary conditions
Authors: Colli Pierluigi , Knopf Patrik , Schimperna Giulio , Signori Andrea
Published: October 2024

We investigate a new diffuse-interface model that describes creeping two-phase flows (i.e., flows exhibiting a low Reynolds number), especially flows that permeate a porous medium. The system of equations consists of a Brinkman equation for the volume averaged velocity field and a convective Cahn–Hilliard equation with dynamic boundary conditions for the phase field, which describes the location of the two fluids within the domain. The dynamic boundary conditions are incorporated to model the interaction of the fluids with the wall of the container more precisely. In particular, they allow for a dynamic evolution of the contact angle between the interface separating the fluids and the boundary, and for a convection-induced motion of the corresponding contact line. For our model, we first prove the existence of global-in-time weak solutions in the case where regular potentials are used in the Cahn–Hilliard subsystem. In this case, we can further show the uniqueness of the weak solution under suitable additional assumptions. We further prove the existence of weak solutions in the case of singular potentials. Therefore, we regularize such singular potentials by a Moreau–Yosida approximation, such that the results for regular potentials can be applied, and eventually pass to the limit in this approximation scheme.
On the torsion part in the K-theory of imaginary quadratic fields
Authors: Emery Vincent
Published: October 2024

We obtain upper bounds for the torsion in the K-groups of the ring of integers of imaginary quadratic number fields, in terms of their discriminants.
Impact of blood parasites on the behaviour of two congeneric wall lizards (genus Podarcis)
Authors: Faria J. Filipe , Megía-Palma Rodrigo , Harris D. James
Published: October 2024

Modern studies have shown how parasites add extra complexity to ecosystems through their potential effects on hosts. Blood parasites are common in lizards and various studies have suggested varying degrees of negative effects on these hosts. In this study, we investigate effects of infection by blood parasites on the boldness and aggressiveness of male lizards of two sympatric species living in North Portugal: Podarcis bocagei and Podarcis lusitanicus, known to host blood parasites of two protozoan orders: Adeleorina and Eimeriorina (Apicomplexa). We used a mirror to quantify behavioural interactions of the lizards with their specular images, which did not identify any influence of parasite infection on either species. Boldness was evaluated through exploratory tests, with an identified trend for parasitized P. lusitanicus towards higher exploratory activity and exposure time. This was independent of the intensity of infection. No such effect was found for P. bocagei. The behavioural changes for infected P. lusitanicus appear to be in the direction of increasing light exposure by spending more time directly under the light source, thus suggesting a link with thermoregulation, although further experiments to clarify this hypothesis are required. These results highlight the importance of understanding individual parasite-host relationships, as they show that the same parasites can have different effects across even closely related species.

Significance statement

Parasites can affect their host in a variety of ways. We used mirror-interaction and exploratory tests to assess the effects of blood parasites in the aggressiveness and boldness behavioural traits of two sympatric lizard species: Podarcis bocagei and Podarcis lusitanicus. No effect of blood parasite infection in these two behavioural traits was identified on Podarcis bocagei. Podarcis lusitanicus tended to demonstrate a response to infection by Adeleorina with an increase in boldness and willingness to increase exposure times, despite low intensity of infection. Our results show how the same parasites can differently affect closely related host taxa from the same system, and how their effects can be significant even when intensities of infection are low.
Developing a Clinical Service in Interventional Radiology: Results from the 2024 CIRSE Clinical Practice Survey
Authors: Ryan A. G. , Slijepčević B. , Cannavale A. , Krokidis M. , Chun J. Y. , de Baere T. , Dezman R. , Duvnjak S. , Ruffino M. A. , Urbano J. , Mahnken A. H.
Published: October 2024

Purpose

Engaging in clinical service development is a prerequisite for Interventional Radiology (IR) to prosper as a full clinical discipline. The CIRSE Clinical Services in IR Task Force conducted a survey of CIRSE members worldwide to assess the current status of their clinical practice and to identify areas of practice requiring further support.

Materials and Methods

An online questionnaire with 63 structured items was sent to 7,501 CIRSE members in November 2023. The survey was closed in January 2024 and a statistical data analysis was performed.

Results

A total of 520 complete responses were collected. 49.6% of respondents have an IR outpatient clinic, 34.5% have a dedicated IR day-case ward and 19.8% have dedicated inpatient beds. While 62% of respondents treat patients as the primary consultant responsible for their patients’ care, 40.3% of respondents currently without their own beds have admitting rights to the hospital. Clinical practice activities are itemised in the work schedule of 41.3% of respondents and 45% routinely perform ward rounds. A total of 40% feel very positive with their personal clinical practice competency.

Conclusion

With half of responding IRs having primary patient access and clinical services in place, the results are encouraging; however further engagement by those who are not yet involved is required. The authors advocate a step-wise approach towards clinical services starting with ward rounds, and subsequently taking increasing responsibility for each step in the IR patient pathway.

Graphical Abstract
Preoperative multidisciplinary team meeting improves the incidence of positive margins in pathological T2 prostate cancer
Authors: Kobatake Kohei , Goto Keisuke , Honda Yukiko , Naito Miki , Takemoto Kenshiro , Miyamoto Shunsuke , Sekino Yohei , Kitano Hiroyuki , Ikeda Kenichiro , Hieda Keisuke , Goriki Akihiro , Hinata Nobuyuki
Published: October 2024

Purpose

Positive surgical margins (PSM) after robot-assisted radical prostatectomy (RARP) for prostate cancer (PCa) can increase the risk of biochemical recurrence and PCa-specific mortality. We aimed to evaluate the impact of multidisciplinary team meetings (MDTM) on reducing the incidence of PSM following RARP.

Methods

We retrospectively collected the clinical data of consecutive patients undergoing RARP at Hiroshima University between February 2017 and October 2023. The MDTM, comprising a radiologist, uropathologist, and urologist, reviewed the preoperative magnetic resonance imaging (MRI) and prostate biopsy results of each patient before RARP and considered the areas requiring attention during RARP. Surgeons were categorized as experienced or non-experienced based on the number of RARP procedures performed.

Results

In the pT2 population, the PSM rate was significantly lower in cases evaluated using the MDTM than in those not (11.1% vs. 24.0%; p = 0.0067). Cox regression analysis identified that a PSA level > 7 ng/mL (hazard ratio 2.2799) and nerve-sparing procedures (hazard ratio 2.2619) were independent predictors of increased PSM risk while conducting an MDTM (hazard ratio 0.4773) was an independent predictor of reduced PSM risk in the pT2 population. In the pathological T3 population, there was no significant difference in PSM rates between cases evaluated and not evaluated at an MDTM. In cases evaluated at an MDTM, similar PSM rates were observed regardless of surgeon experience (10.4% for non-experienced and 11.9% for experienced surgeons; p = 0.9999).

Conclusions

An MDTM can improve the PSM rate of pT2 PCa following RARP.
Anti-inflammatory effects of proprotein convertase subtilisin/kexin 9 inhibitor therapy in the early phase of acute myocardial infarction
Authors: Shimizu Tomohiro , Morishita Tetsuji , Uzui Hiroyasu , Sato Yusuke , Kataoka Tatsuhiro , Miyoshi Machiko , Yamaguchi Junya , Shiomi Yuichiro , Ikeda Hiroyuki , Tama Naoto , Hasegawa Kanae , Ishida Kentaro , Tada Hiroshi
Published: October 2024

This study examined the anti-inflammatory and endothelial function-enhancing effects of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitor therapy in the early phase after acute myocardial infarction (AMI) by assessing changes in tumor necrosis factor-α (TNF-α) levels and the l-arginine/asymmetric-dimethylarginine (ADMA) ratio. This retrospective, single-center cohort study included patients who underwent successful timely primary percutaneous coronary intervention (PCI) for first-onset AMI between September 2017 and March 2018. The PCSK9 inhibitor group comprised patients who received 75 mg alirocumab up to 7 days after AMI, while the standard therapy group comprised patients who did not. We evaluated the change in TNF-α levels and the l-arginine/ADMA ratio at the time of hospital admission and prior to discharge. PCSK9 inhibitor therapy in the early phase after AMI suppressed TNF-α levels (standard therapy group, 1.64 ± 2.14 pg/mL vs. PCSK9 inhibitor group, 0.26 ± 0.33 pg/mL; p = 0.033) and increased the L-arginine/ADMA ratio (standard therapy group, − 13.0 ± 39.7 vs. PCSK9 inhibitor group, 23.2 ± 39.7; p = 0.042). Upon multiple regression analysis adjusted for sex, age, and peak creatine kinase levels, PCSK9 inhibitor therapy was associated with TNF-α suppression (p = 0.025; β = − 0.235, 95% confidence interval [CI], − 0.436 to − 0.033). The L-arginine/ADMA ratio was also analyzed using multiple regression, adjusted for sex, age, peak creatine kinase levels, and smoking, showing a significant improvement in the ratio (p = 0.018; β = 41.913, 95% CI, 10.337−73.491). Moreover, a weak negative correlation was suggested between the change in TNF-α levels and the change in l-arginine/ADMA ratio (r = − 0.393, p = 0.058). PCSK9 inhibitor therapy in the early phase after AMI suppresses TNF-α levels and improves the l-arginine/ADMA ratio, potentially indicating anti-inflammatory and endothelial function-enhancing effects.
Changes in bone density and microarchitecture in adolescents undergoing a first kidney transplantation: a prospective study
Authors: De Mul Aurélie , Leclerc Anne-Laure Sellier , Ginhoux Tiphanie , Levi Charlène , Confavreux Cyrille , Aurelle Manon , Portefaix Aurélie , Bacchetta Justine
Published: October 2024

Purpose

Mineral bone disorder associated with chronic kidney disease (CKD-MBD) frequently persists after kidney transplantation (KTx), being due to pre-existing CKD-MBD, immunosuppressive therapies, and post-KTx hypophosphatemia. This study aimed to evaluate bone biomarkers and microarchitecture using high resolution peripheral quantitative computed tomography (HR-pQCT) at the time of KTx and 6 months thereafter and to compare these results with those of matched healthy controls (HC).

Methods

This study presented the single-center subgroup of patients aged between 10 and 18 years included in the prospective “Bone Microarchitecture in the Transplant Patient” study (TRANSOS-NCT02729142). Patients undergoing a first KTx were matched (1:2) with HC from the “Vitamin D, Bones, Nutritional and Cardiovascular Status” cohort (VITADOS) on sex, pubertal stage, and age.

Results

At a median (interquartile range, IQR) age of 15 [13; 16] years, 19 patients (6 girls, 7 pre-emptive KTx, 7 steroid-sparing immunosuppressive strategies) underwent a first KTx, with a median [IQR] parathyroid hormone level of 1.9 [1.4; 2.9] the upper limit of normal (ULN). Higher total and trabecular bone densities, along with superior trabecular microarchitecture, were observed at KTx compared to HC. Six months post-KTx, patients had significantly impaired trabecular parameters at the radius, while results were not significantly different at the weight-bearing tibia, neither cortical parameters at both sites. Six months post-KTx, 6 (32%) patients still present with metabolic acidosis, 10 (53%) persistent hyperparathyroidism (always < 2 ULN), and 5 (26%) elevated FGF23 levels; 11 (58%) received phosphate supplementation.

Conclusions: Bone density and microarchitecture at the time of KTx were superior compared to HC, but radial trabecular bone microarchitecture impairment observed 6 months post-KTx may reflect subtle albeit present post-KTx CKD-MBD.

What is Known?• Mineral bone disorder associated with chronic kidney disease (CKD-MBD) frequently persists after kidney transplantation (KTx) and is associated with morbidity. However, biochemical parameters and dual X-ray absorptiometry (DXA) are poor predictors of the underlying bone disease.

What is new?• The present study on 19 adolescent KTx recipients with adequate CKD-MBD control at the time of KTx reveals no significant bone disease compared to matched healthy controls. Microarchitecture impairment observes 6 months post-KTx may reflect subtle, albeit present, post-KTx CKD-MBD.
Contributions to the stereochemistry of zirconium oxysalts—part VI: syntheses and crystal structures of K2Zr(SO4)3∙2.5H2O, K2Zr(SeO4)3, K2Zr2O(SeO4)4, and Zr(OH)2(SeO4)·H2O
Authors: Wildner Manfred , Giester Gerald
Published: October 2024

The compounds K2Zr(SO4)3·2.5H2O, K2Zr(SeO4)3, and K2Zr2O(SeO4)4 were synthesized at 200 °C by reaction of Zr2O2(CO3)(OH)2 and KHCO3 with the respective acids H2SeO4/H2SO4 and minor H2O. Zr(OH)2(SeO4)·H2O originates from an analogous experiment at 215 °C without KHCO3. All four phases form colorless crystals up to several tenths of a mm and were investigated by single crystal X-ray diffraction. K2Zr(SO4)3·2.5H2O is monoclinic, space group P21/c (No. 14), with a = 7.295(2) Å, b = 13.925(3) Å, c = 12.579(3) Å, β = 95.32(3)°, V = 1272.3(4) Å3, Z = 4, R1 = 0.025. K2Zr(SeO4)3 and K2Zr2O(SeO4)4 are both triclinic, space group $$P\overline{1}$$

P

1
¯

(No. 2), with a = 7.570(1) Å, b = 10.500(1) Å, c = 14.400(1) Å, α = 85.55(1)°, β = 88.04(1)°, γ = 87.82(1)°, V = 1139.7(2) Å3, Z = 4, R1 = 0.049, and a = 5.400(1) Å, b = 7.328(1) Å, c = 9.642(1) Å, α = 95.81(1)°, β = 95.20(1)°, γ = 94.27(1)°, V = 376.74(4) Å3, Z = 1, R1 = 0.020, respectively. Zr(OH)2(SeO4)·H2O crystallizes in the monoclinic space group C2/c (No. 15), with a = 6.684(1) Å, b = 12.998(2) Å, c = 6.792(1) Å, β = 97.37(1)°, V = 585.14(6) Å3, Z = 2, R1 = 0.013.

Graphical abstract
ParaVerse: co-design of a parachute rehearsal and training virtual-reality enhanced simulator for the Australian Defence Force: combining a generative co-design framework and an agile approach to development
Authors: Mills Brennen , Masek Martin , Boston Julie , de Souza Wyatt , Snell Jake , Bender Stuart , Thompson Matthew , Sung Billy , Hansen Sara
Published: October 2024

While co-design methods are crucial for developing digital educational interventions that are user-centred, contextually relevant, inclusive, and effective in meeting the diverse needs of learners and educators, little attention has been paid to the potential value of co-design processes for digital application development in the Defence context. This research gauged the efficacy of combining a generative co-design framework making use of agile and iterative co-design principles in an applied research and development project. The project produced an immersive virtual reality based digital solution in collaboration with the Australian Defence Force Special Operations Command (SOCOMD) Army. Specifically, the ParaVerse project sought to develop a solution considering the advanced Tactics, Techniques and Procedures (TTPs) relevant to special operations soldiers for advanced parachute training. A Defence advisory group consisting of a series of subject matter experts was formulated to consult with the research and development team over the course of the co-design process. End-user testing with 35 SOCOMD personnel demonstrated the value of the ParaVerse application for SOCOMD personnel, speaking to the success of the leveraged generative co-design model. End-users rated ParaVerse as having greater capacity to influence education and training practices for SOCOMD and Defence generally in comparison to a pre-existing virtual parachute simulator. ParaVerse was also rated higher for satisfaction and useability and was associated with fewer instances of motion sickness. The Generative Co-Design Framework leveraged for this research provides one roadmap on how to integrate end-users in innovation design, particularly for projects working across the nexus of Defence and academia.
First-line pembrolizumab with or without chemotherapy for recurrent or metastatic head and neck squamous cell carcinoma: 5-year follow-up of the Japanese population of KEYNOTE‑048
Authors: Oridate Nobuhiko , Takahashi Shunji , Tanaka Kaoru , Shimizu Yasushi , Fujimoto Yasushi , Matsumoto Koji , Yokota Tomoya , Yamazaki Tomoko , Takahashi Masanobu , Ueda Tsutomu , Hanai Nobuhiro , Yamaguchi Hironori , Hara Hiroki , Yoshizaki Tomokazu , Yasumatsu Ryuji , Nakayama Masahiro , Shiga Kiyoto , Fujii Takashi , Mitsugi Kenji , Takahashi Kenichi , Nohata Nijiro , Gumuscu Burak , Lerman Nati , Tahara Makoto
Published: October 2024

Background

Previously reported results from phase III KEYNOTE-048 demonstrated similar or improved overall survival (OS) with pembrolizumab or pembrolizumab-chemotherapy versus cetuximab-chemotherapy (EXTREME) in Japanese patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). We report results in Japanese patients from KEYNOTE-048 after 5 years of follow-up.

Methods

Patients with R/M HNSCC of the oropharynx, oral cavity, hypopharynx, or larynx were randomly assigned 1:1:1 to pembrolizumab, pembrolizumab-chemotherapy, or EXTREME. Primary endpoints were OS and progression-free survival. Efficacy was evaluated in the programmed cell death ligand 1 (PD-L1) combined positive score (CPS) ≥ 20, PD-L1 CPS ≥ 1, and total Japanese populations.

Results

In Japan, 67 patients were enrolled (pembrolizumab, n = 23; pembrolizumab-chemotherapy, n = 25; EXTREME, n = 19). Median follow-up was 71.0 months (range, 61.2–81.5); data cutoff, February 21, 2022. 5-year OS rates with pembrolizumab versus EXTREME were 35.7% versus 12.5% (hazard ratio [HR] 0.38; 95% CI 0.13–1.05), 23.8% versus 12.5% (HR 0.70; 95% CI 0.34–1.45), and 30.4% versus 10.5% (HR 0.54; 95% CI 0.27–1.07) in the PD-L1 CPS ≥ 20, CPS ≥ 1, and total Japanese populations, respectively. 5-year OS rates with pembrolizumab-chemotherapy versus EXTREME were 20.0% versus 14.3% (HR 0.79; 95% CI 0.27–2.33), 10.5% versus 14.3% (HR 1.18; 95% CI 0.56–2.48), and 8.0% versus 12.5% (HR 1.11; 95% CI 0.57–2.16) in the PD-L1 CPS ≥ 20, CPS ≥ 1, and total Japanese populations, respectively.

Conclusion

After 5 years of follow-up, pembrolizumab and pembrolizumab-chemotherapy showed long-term clinical benefits; results further support these treatments as first-line options for Japanese patients with R/M HNSCC.

Clinical trial registration

NCT02358031.
Impacts of washing and deodorization treatment on packaging-sourced post-consumer polypropylene
Authors: Bichler Lorenz P. , Pinter Elisabeth , Jones Mitchell P. , Koch Thomas , Krempl Nina , Archodoulaki Vasiliki-Maria
Published: October 2024

Emerging legal requirements will likely considerably heighten demand for high-quality recycled raw materials for e.g., packaging and automotive applications; key EU legislation mandates recycling as the future end-of-life option for municipal solid plastic waste. Yet recycled plastic use remains low due to safety concerns, undesirable aesthetic, olfactory, and mechanical properties, mainly attributable to contaminants present in recyclates. Advanced treatment options for recovered polypropylene (PP) packaging and the impact of such treatments on the polymer are currently poorly documented. We investigated the effectiveness of hot/cold washing and hot air devolatilization treatments in removing volatile substances from residential post-consumer PP plastic waste to improve its scope of application and value and to assess possible side effects on mechanical and processing parameters. Cold- and hot-washed recyclates exhibited similar contaminant levels and most substances were removed within 7 h. The recycling procedure had no adverse effects on mechanical or processing parameters although reprocessing caused polymer degradation, indicated by decreasing viscosity, elongation at break, and tensile strength. Washing and hot air devolatilization treatment of plastic wastes improve their scope of application and value by enhancing mechanical properties and considerably reducing the amounts of odorous substances, but is often not suited to high-quality applications, such as packaging. The dominance of packaging waste and strict legislation on food-grade recyclate applications will make widespread recyclate use challenging since it represents the primary use of plastic. Recyclate must consequently be extensively utilized in non-food contact applications until advances in waste sorting, washing, and devolatilization yield less contaminated recyclates with improved properties.
Unpacking “the surprise chain”: the governance of food security during the COVID-19 pandemic in Melbourne, Australia
Authors: Carey Rachel , Murphy Maureen
Published: October 2024

Food systems are being affected by multiple shocks related to climate change, the COVID-19 pandemic and geopolitical events. Food prices and food insecurity are rising globally as a result, raising questions about the effective governance of food security during shocks. This paper critically examines the governance of food security in Melbourne, Australia during a major food system shock, the COVID-19 pandemic. It draws on document analysis and 34 stakeholder interviews with 41 participants from government, industry and civil society between May 2020 and March 2021. The paper examines the role of these actors in governance mechanisms for two important aspects of food system governance during the COVID-19 pandemic, continuity of food supply and delivery of emergency food relief. Clark et al.’s (2021) “governance engagement continuum” is used to show how civil society groups were excluded from these formal governance mechanisms, instead establishing their own spaces of “self-governance”. The resilience aims associated with these governance mechanisms are also analyzed using Zurek et al.’s (2022) “three R’s” (robustness, recovery and reorientation) framework. Our study highlights the significant role of food industry actors in the continuity of food supply and delivery of emergency food relief, and it shows the vulnerabilities of emergency food relief that depends on industry food “surpluses” as a model for addressing food insecurity during food system shocks. We conclude that greater government leadership is needed in the governance of food security during food system shocks, and in implementation of legislative and policy approaches that are grounded in the human right to food.
Mitigating the risk of tanking in multi-stage tournaments
Authors: Csató László
Published: October 2024

Multi-stage tournaments consisting of a round-robin group stage followed by a knockout phase are ubiquitous in sports. However, this format is incentive incompatible if at least 2 teams from a group advance to the knockout stage where the brackets are predetermined. A model is developed to quantify the risk of tanking in these contests. The suggested approach is applied to the 2022 FIFA World Cup to uncover how its design could have been improved by changing group labelling (a reform that has received no attention before) and the schedule of group matches. Scheduling is found to be a surprisingly weak intervention compared to previous results on the risk of collusion in a group. The probability of tanking, which is disturbingly high around 25%, cannot be reduced by more than 3 percentage points via these policies. Tournament organisers need to consider more fundamental changes against tanking.