bluuebunny/crossref_metadata_2025 huggingface dataset:
Breast clinical target volume: HU-based glandular CTVs and ESTRO CTVs in modern and historical radiotherapy treatment planning
Authors: Duma Marciana Nona , Kulms Theresa , Knippen Stefan , Teichmann Tobias , Wittig Andrea
Published: September 2021

Purpose

The current study aimed to compare contouring of glandular tissue only (gCTV) with the clinical target volume (CTV) as defined according to European Society for Radiotherapy and Oncology (ESTRO) guidelines (eCTV) and historically treated volumes (marked by wire and determined by palpation and anatomic landmarks) in breast cancer radiotherapy.

Methods

A total of 56 consecutive breast cancer patients underwent treatment planning based solely on anatomic landmarks/wire markings (“wire based”). From these treatment plans, the 50% and 95% isodoses were transferred as structures and compared to the following CT-based volumes: eCTV; a Hounsfield unit (HU)-based automatic contouring of the gCTV; and standardized planning target volumes (PTVs) generated with 1‑cm safety margins (resulting in the ePTVs and gPTVs, respectively).

Results

The 95% isodose volume of the wire-based plan was larger than the eCTV by 352.39 ± 176.06 cm3 but smaller than the ePTV by 157.58 ± 189.32 cm3. The 95% isodose was larger than the gCTV by 921.20 ± 419.78 cm3 and larger than the gPTV by 190.91 ± 233.49 cm3. Patients with larger breasts had significantly less glandular tissue than those with small breasts. There was a trend toward a lower percentage of glandular tissue in older patients.

Conclusion

Historical wire and anatomic landmarks-based treatment planning sufficiently covers the glandular tissue and the theoretical gPTV generated for the glandular tissue. Modern CT-based CTV and PTV definition according to ESTRO results in a larger treated volume than the historical wire-based techniques. HU-standardized glandular tissue contouring results in a significantly smaller CTV and might be an option for reducing the treatment volume and improving reproducibility of contouring between institutions.
Primary immunosuppressive TNI-based conditioning regimens in pediatric patients treated with haploidentical hematopoietic cell transplantation
Authors: Wegener D. , Lang P. , Paulsen F. , Weidner N. , Zips D. , Ebinger M. , Holzer U. , Döring M. , Heinzelmann F.
Published: September 2021

Purpose

This retrospective analysis aims to address the toxicity and efficacy of a modified total nodal irradiation (TNI)-based conditioning regimen before haploidentical hematopoietic cell transplantation (HCT) in pediatric patients.

Materials and methods

Patient data including long-term follow-up were evaluated of 7 pediatric patients with malignant (n = 2) and non-malignant diseases (n = 5) who were treated by a primary TNI-based conditioning regimen. TNI was performed using anterior/posterior opposing fields. All patients received 7 Gy single-dose TNI combined with systemic agents followed by an infusion of peripheral blood stem cells (n = 7). All children had haploidentical family donors.

Results

Engraftment was reached in 6/7 children after a median time of 9.5 days; 1 child had primary graft failure but was successfully reconditioned shortly thereafter. After an average follow-up time of 103.5 months (range 8.8–138.5 months), event-free (EFS) and overall survival (OS) rates were 71.4% and 85.7%, respectively. One child with a non-malignant disease died 8.8 months after transplantation due to a relapse and a multiple organ failure. Follow-up data was available for 5/6 long-term survivors with a median follow-up (FU) of 106.2 months (range 54.5–138.5 months). Hypothyroidism and deficiency of sexual hormones was present in 3/5 patients each. Mean forced expiratory volume in 1 s (FEV1) after TNI was 71%; mean vital capacity (VC) was 78%. Growth failure (< 10th percentile) occurred in 2/5 patients (height) and 1/5 patient (weight). No secondary malignancies were reported.

Conclusion

In this group of patients, a primary single-dose 7 Gy TNI-based conditioning regimen before HCT in pediatric patients allowed sustained engraftment combined with a tolerable toxicity profile leading to long-term OS/EFS. Late toxicity after a median FU of over 9 years includes growth failure, manageable hormonal deficiencies, and acceptable decrease in lung function.
Endoskopische Vermessung von Nasenseptumdefekten
Authors: Rosenthal Jean-Claude , Wisotzky Eric L. , Matuschek Carsten , Hobl Melanie , Hilsmann Anna , Eisert Peter , Uecker Florian C.
Published: September 2021

Hintergrund

Die vielfältigen unangenehmen Symptome von Nasenseptumdefekten (NSD) führen zu einer deutlichen Einschränkung der Lebensqualität. NSD können mittels patientenspezifischer Implantate oder durch eine Op. verschlossen werden. Implantate werden dabei durch Silikonabformungen unter Vollnarkose, ggf. in lokaler Betäubung, oder anhand von 3D-Modellen aus computertomographischen (CT-)Daten erstellt. Nachteile für die Patientensicherheit sind ein erhöhtes Morbiditätsrisiko oder die Strahlenbelastung.

Methodik

Für die Hals‑, Nasen- und Ohren-(HNO)-Chirurgie wird ein schonender Ansatz zur Behandlung von NSD mit einer neuen bildbasierten, kontakt- und strahlungsfreien Messmethode unter Nutzung eines Stereoendoskops vorgestellt. Das Verfahren beruht ausschließlich auf Bilddaten und nutzt echtzeitfähige Bildverarbeitungsalgorithmen zur Berechnung von 3D-Informationen. Es ist beliebig oft wiederholbar und wurde bereits erfolgreich in der robotergestützten Chirurgie und in der OP-Mikroskopie eingesetzt. Daher wurde diese Methode für die Nasenchirurgie erweitert, für die es zusätzliche anatomische und stereoskopische Herausforderungen gibt.

Ergebnisse

Nach Auswertung von 3 relevanten Messgrößen (NSD-Ausdehnung: axial, koronal und Umfang) von 6 Patienten und Vergleich der Ergebnisse von 2 Stereoendoskopen mit vorhandenen CT-Daten zeigte sich: Die bildbasierten Messergebnisse können vergleichbare Genauigkeiten wie CT-Daten erzielen. Bei einem Patienten wurden die Daten nur teilweise ausgewertet, da der NSD größer als das endoskopische Sichtfeld war.

Schlussfolgerung

Aufbauend auf den sehr guten Messwerten wird ein Therapieverfahren skizziert, welches die Herstellung von patientenspezifischen NSD-Implantaten auf Basis endoskopischer Daten ermöglicht.
Stenotic intercondylar notch is not a risk factor for posterior cruciate ligament rupture: a morphological analyses using magnetic resonance imaging
Authors: Liu Fei , Zhang Sheng , Xiao Yang , Feng Xiaoreng , Liang Zhenming , Leung Frankie , Chen Bin
Published: September 2021

Purpose

The present study aimed to examine the factors related to the morphological characteristics of the femoral condyle in posterior cruciate ligament rupture in female and male populations.

Methods

One hundred and three patients (41 females, 62 males) with posterior cruciate ligament rupture from 2010 to 2020 were included in this retrospective case–control study. The sex and age of the posterior cruciate ligament rupture group were matched to those of the control group (41 females, 62 males; age range 16–69 years). Magnetic resonance imaging was used to measure the intercondylar notch width, femoral condylar width, and intercondylar notch angle in both the axial and coronal images. The ‘α’ angle was also measured using magnetic resonance imaging. The notch width index is the ratio of the intercondylar notch width to the femoral condylar width. Three types of intercondylar notch shapes (types A, U, and W) were evaluated in the axial magnetic resonance imaging images.

Results

The difference in the mean coronal notch width index between the study groups was statistically significant in the female population. The difference in the mean coronal femoral condylar width between the study groups was statistically significant in the male population.

Conclusions

A larger coronal notch width index was the greatest risk factor for posterior cruciate ligament rupture in the female population. In the male population, decreased coronal condylar width was the greatest risk factor for posterior cruciate ligament rupture. The results did not indicate that patients with a PCL rupture have a stenotic intercondylar notch. Posterior cruciate ligament injury prevention strategies could be applied to females with a larger coronal notch width index and males with a decreased condylar width.

Levels of evidence

Level III.
Mass spectrometric characterization of cyclic dinucleotides (CDNs) in vivo
Authors: Annibal Andrea , Ripa Roberto , Ballhysa Eugen , Latza Christian , Hochhard Nadine , Antebi Adam
Published: September 2021

Cyclic dinucleotides (CDNs) are key secondary messenger molecules produced by cyclic dinucleotide synthases that trigger various cellular signaling cascades from bacteria to vertebrates. In mammals, cyclic GMP-AMP synthase (cGAS) has been shown to bind to intracellular DNA and catalyze the production of the dinucleotide 2′3′ cGAMP, which signals downstream effectors to regulate immune function, interferon signaling, and the antiviral response. Despite the importance of CDNs, sensitive and accurate methods to measure their levels in vivo are lacking. Here, we report a novel LC-MS/MS method to quantify CDNs in vivo. We characterized the mass spectrometric behavior of four different biologically relevant CDNs (c-di-AMP, c-di-GMP, 3′3′ cGAMP, 2′3′ cGAMP) and provided a means of visually representing fragmentation resulting from collision-induced dissociation at different energies using collision energy breakdown graphs. We then validated the method and quantified CDNs in two in vivo systems, the bacteria Escherichia coli OP50 and the killifish Nothobranchius furzeri. We found that optimization of LC-MS/MS parameters is crucial to sensitivity and accuracy. These technical advances should help illuminate physiological and pathological roles of these CDNs in in vivo settings.
Technical and clinical validation of commercial automated volumetric MRI tools for dementia diagnosis—a systematic review
Authors: Pemberton Hugh G. , Zaki Lara A. M. , Goodkin Olivia , Das Ravi K. , Steketee Rebecca M. E. , Barkhof Frederik , Vernooij Meike W.
Published: September 2021

Developments in neuroradiological MRI analysis offer promise in enhancing objectivity and consistency in dementia diagnosis through the use of quantitative volumetric reporting tools (QReports). Translation into clinical settings should follow a structured framework of development, including technical and clinical validation steps. However, published technical and clinical validation of the available commercial/proprietary tools is not always easy to find and pathways for successful integration into the clinical workflow are varied. The quantitative neuroradiology initiative (QNI) framework highlights six necessary steps for the development, validation and integration of quantitative tools in the clinic. In this paper, we reviewed the published evidence regarding regulatory-approved QReports for use in the memory clinic and to what extent this evidence fulfils the steps of the QNI framework. We summarize unbiased technical details of available products in order to increase the transparency of evidence and present the range of reporting tools on the market. Our intention is to assist neuroradiologists in making informed decisions regarding the adoption of these methods in the clinic. For the 17 products identified, 11 companies have published some form of technical validation on their methods, but only 4 have published clinical validation of their QReports in a dementia population. Upon systematically reviewing the published evidence for regulatory-approved QReports in dementia, we concluded that there is a significant evidence gap in the literature regarding clinical validation, workflow integration and in-use evaluation of these tools in dementia MRI diagnosis.
Prevalence of hypogammaglobulinemia and its management with subcutaneous immunoglobulin supplementation in patients after allogeneic hematopoietic stem cell transplantation—a single-center analysis
Authors: Karakulska-Prystupiuk Ewa , Dwilewicz-Trojaczek Jadwiga , Drozd-Sokołowska Joanna , Kmin Ewelina , Chlebus Marcin , Szczypińska Karolina , Boguradzki Piotr , Tomaszewska Agnieszka , Mądry Krzysztof , Biliński Jarosław , Basak Grzegorz Władysław , Jędrzejczak Wiesław Wiktor
Published: September 2021

Secondary immunodeficiencies are frequently observed after allo-HSCT. The efficacy of subcutaneous IgG preparations in this population is unknown. A retrospective single-institution study involved 126 adult patients transplanted in 2012–2019 for hematological malignancies. Patients were tested every 2–3 weeks for plasma IgG concentration during the 1st year after transplantation and supplemented with facilitated subcutaneous immunoglobulin when they either had IgG concentration < 500 mg/dl or between 500 and 700 mg/dl and recurrent infection. The IgG concentration < 500 mg/dL was diagnosed in 41 patients, while 500–700 mg/dL in 25 and altogether 53 patients received IgG supplementation. The median number of IgG administrations was 2. The median time to the first IgG administration after allo-HSCT was 4.1 months, while to the next administration (if more than one was required) 53 days (prophylactic group) and 32 days (group with infections). We did not observe any significant toxicity. Two situations were associated with increased probability of meeting criteria for IgG supplementation: diagnosis of either acute lymphoblastic leukemia (ALL) or chronic lymphocytic leukemia (CLL) (83.8% versus 39.3% for other diagnosis, p = 0.000) and the systemic use of corticosteroids (64.2% versus 31.5% for patients without systemic corticosteroids, p = 0.005). Over 40% of the adult recipients may require at least incidental immunoglobulin supplementation during the first year after allo-HSCT. Low IgG concentrations are associated with inferior outcomes. The subcutaneous route of IgG administration appeared to be safe and may allow for long persistence.
A Preliminary Survey of the Distribution of Segmented Filamentous Bacteria in the Porcine Gastrointestinal Tract
Authors: Grześkowiak Łukasz , Martínez-Vallespín Beatriz , Zentek Jürgen , Vahjen Wilfried
Published: September 2021

Segmented filamentous bacteria (SFB) are present in various animal species including pigs. The aim of this work was to analyze the occurrence of SFB in different parts of the gastrointestinal tract of piglets of different ages. A total of 377 DNA extracts from stomach, jejunum, ileum, cecum and colon digesta, and from feces collected on different time points, originating from 155 animals, were screened by qPCR method with primers specific for the SFB. SFB sequences were detected in 74 of 377 samples (19.6%) from 155 animals in total. SFB were most abundant in ileum (50.0%), cecum (45.0%), and colon (37.0%), followed by feces (14.6%). SFB prevalence in sows was 12.9% (13/101) and 75.9% (41/54) in individual piglets. Of the 41 SFB-positive piglets, only two samples were from pre-weaning animals, while the rest of samples originated from post-weaning piglets. SFB sequences are abundant in post-weaning piglets, but not in suckling or adult animals. They are most abundant in the ileum and cecum of pigs. Further studies are warranted to reveal the role of SFB in pigs.
Thermal effects of thulium: YAG laser treatment of the prostate—an in vitro study
Authors: Hein Simon , Petzold Ralf , Suarez-Ibarrola Rodrigo , Schoenthaler Martin , Gratzke Christian , Miernik Arkadiusz
Published: September 2021

Purpose

To objectively determine whether there is potential thermal tissue damage during Tm:YAG laser-based LUTS treatment.

Methods

Our experimental model was comprised of a prostatic resection trainer placed in a 37 °C water bath. In a hollowed-out central area simulating the urethral lumen, we placed a RigiFib 800 fibre, irrigation inflow regulated with a digital pump, and a type K thermocouple. A second thermocouple was inserted 0.5/1 cm adjacently and protected with an aluminum barrier to prevent it from urethral fluid. We investigated continuous and intermittent 120 W and 80 W laser application with various irrigation rates in eight measurement sessions lasting up to 14 min. Thermal measurements were recorded continuously and in real-time using MatLab. All experiments were repeated five times to balance out variations.

Results

Continuous laser application at 120 W and 125 ml/min caused a urethral ∆T of ~ 15 K and a parenchymal temperature increase of up to 7 K. With 50 ml/min irrigation, a urethral and parenchymal ∆T of 30 K and 15 K were reached, respectively. Subsequently and in absence of laser application, prostatic parenchyma needed over 16 min to reach baseline body temperature. At 80 W lower temperature increases were reached compared to similar irrigation but higher power.

Conclusions

We showed that potentially harming temperatures can be reached, especially during high laser power and low irrigation. The heat generation can also be conveyed to the prostate parenchyma and deeper structures, potentially affecting the neurovascular bundles. Further clinical studies with intracorporal temperature measurement are necessary to further investigate this potentially harming surgical adverse effect.
Association between SARS-CoV-2 infection and disease severity among prostate cancer patients on androgen deprivation therapy: a systematic review and meta-analysis
Authors: Sari Motlagh Reza , Abufaraj Mohammad , Karakiewicz Pierre I. , Rajwa Pawel , Mori Keiichiro , Mun Dong-Ho , Shariat Shahrokh F.
Published: September 2021

Purpose

Androgen-regulated enzymes such as the angiotensin-converting enzyme 2 (ACE2) and the transmembrane serine protease 2 (TMPRSS2) are involved in the SARS-CoV-2 infection process. The expression of TMPRSS2 and its fusion gene, which are increased in the epithelium of the human prostate gland during prostate carcinogenesis, are regulated by androgens. Our goal was to assess the risk of the SARS-CoV-2 infection and the severity of the disease in PCa patients treated with androgen deprivation therapy (ADT).

Methods

We conducted a systematic review and meta-analysis according to PRISMA guidelines. We queried PubMed and Web of Science databases on 1 July 2021. We used random- and/or fixed-effects meta-analytic models in the presence or absence of heterogeneity according to Cochrane’s Q test and I2 statistic, respectively.

Results

Six retrospective studies (n = 50,220 patients) were selected after considering inclusion and exclusion criteria for qualitative evidence synthesis. Four retrospective studies were included to assess the SARS-CoV-2 infection risk in PCa patients under ADT vs. no ADT and the summarized risk ratio (RR) was 0.8 (95% confidence intervals (CI) 0.44–1.47). Five retrospective studies were included to assess the severity of coronavirus disease 2019 (COVID-19) in PCa patients under ADT versus no ADT and the summarized RR was 1.23 (95% CI 0.9–1.68).

Conclusion

We found a non-significant association between the risk of SARS-CoV-2 infection and COVID-19 severity in PCa patients treated with ADT. However, our results suggest that during the COVID-19 pandemic PCa patients can safely undergo ADT as a cancer therapy without worsening COVID-19 risk and trajectory.
Experimental ex-vivo performance study comparing a novel, pulsed thulium solid-state laser, chopped thulium fibre laser, low and high-power holmium:YAG laser for endoscopic enucleation of the prostate
Authors: Yilmaz Mehmet , Esser Julia , Kraft Lea , Petzold Ralf , Sigle August , Gratzke Christian , Suarez-Ibarrola Rodrigo , Miernik Arkadiusz
Published: September 2021

Purpose

The aim of this study was to compare the enucleation performances of four different types of laser devices in an ex-vivo experiment: a novel, pulsed Tm:YAG solid-state laser evaluation model (p-Tm:YAG), chopped thulium fibre laser (TFL), low-power Ho:YAG laser (LP-Ho:YAG), and a high-power Ho:YAG laser (HP-Ho:YAG).

Methods

Our primary aim was to endoscopically separate the fascial layers of a porcine belly using laser fibres within a time period of 60 s. The size of a “tissue pocket” was assessed numerically. The enucleation characteristics reflecting the surgeon’s experience were evaluated via the NASA Task Load Index (TLX) questionnaire and a questionnaire based on Likert scale.

Results

HP-Ho:YAG achieved with the available laser settings the largest overall “tissue pocket” (31.5 cm2) followed by p-Tm:YAG (15 cm2), TFL (12 cm2), and LP-Ho:YAG (6 cm2). The coagulation performances of p-Tm:YAG and TFL were rated the best. In the performance evaluation by the Likert questionnaire, HP-Ho:YAG (average score of 4.06) was rated highest, followed by p-Tm:YAG (3.94), TFL (3.38), and LP-Ho:YAG (3.25). The evaluation of the NASA-TLX performance questionnaire revealed average scores for HP-Ho:YAG, LP-Ho:YAG, TFL and p-Tm:YAG of 4.38, 4.09, 3.92 and 3.90, respectively.

Conclusion

We are the first to compare different laser devices and settings in an ex-vivo study. We found that the surgeons were most satisfied with the HP-Ho:YAG laser device, followed by the p-Tm:YAG. These findings could be highly relevant for future research and for the practical utilisation of laser systems in endourology.
Comparing Boosting and Bagging for Decision Trees of Rankings
Authors: Plaia Antonella , Buscemi Simona , Fürnkranz Johannes , Mencía Eneldo Loza
Published: September 2021

Decision tree learning is among the most popular and most traditional families of machine learning algorithms. While these techniques excel in being quite intuitive and interpretable, they also suffer from instability: small perturbations in the training data may result in big changes in the predictions. The so-called ensemble methods combine the output of multiple trees, which makes the decision more reliable and stable. They have been primarily applied to numeric prediction problems and to classification tasks. In the last years, some attempts to extend the ensemble methods to ordinal data can be found in the literature, but no concrete methodology has been provided for preference data. In this paper, we extend decision trees, and in the following also ensemble methods to ranking data. In particular, we propose a theoretical and computational definition of bagging and boosting, two of the best known ensemble methods. In an experimental study using simulated data and real-world datasets, our results confirm that known results from classification, such as that boosting outperforms bagging, could be successfully carried over to the ranking case.
Trace element fractionation between biotite, allanite, and granitic melt
Authors: Were Patrick , Keppler Hans
Published: September 2021

The partitioning of a large suite of trace elements between biotite and water-saturated granitic melt was measured at 2 kbar and 700—800 ˚C. To reach equilibrium and to grow biotite crystals large enough for analysis, runs usually lasted from 30 to 45 days. In every charge, a few trace elements were initially doped at the 0.1—0.5 wt. % level and analyzed by electron microprobe after the run. First-row transition metal ions are highly compatible in biotite with Dbiotite/melt of 17 for Ti, 35 for V, 47 for Co, 174 for Ni, and 5.8 for Zn. A very notable exception is Cu with Dbiotite/melt < 0.9. This is likely one of the reasons why Cu is enriched together with Mo (Dbiotite/melt = 0.29) in porphyry deposits associated with intermediate to felsic plutons, while the other transition metals are not. Both Nb and Ta are mildly compatible in biotite with Dbiotite/melt being larger for Nb (3.69) than for Ta (1.89). Moderate (15—30%) biotite fractionation would be sufficient to reduce the Nb/Ta ratio from the chondritic value to the range observed in the continental crust. Moreover, the strong partitioning of Ti into biotite implies that already modest biotite fractionation suppresses the saturation of Ti-oxide phases and thereby indirectly facilitates the enrichment of Ta over Nb in the residual melt. The heavy alkalis, alkaline earths, and Pb are only mildly fractionated between biotite and melt (Dbiotite/melt = 3.8 for Rb, 0.6 for Cs, 0.6 for Sr, 1.8 for Ba, 0.7 for Pb). The rare earth elements are generally incompatible in biotite, with a minimum for Dbiotite/melt of 0.03–0.06 at Gd, Tb, and Dy, while both the light and heavy rare earths are less incompatible (e.g. Dbiotite/melt = 0.6 for La and 0.3 for Yb). This behavior probably reflects a partitioning into two sites, the K site for the light rare earths and the octahedral Mg site for the heavy rare earths. There is no obvious dependence of the rare earth partition coefficients on tetrahedral Al in the biotite, presumably because charge balancing by cation vacancies is possible. Allanite was found as run product in some experiments. For the light rare earths, Dallanite/melt is very high (e.g. 385 to 963 for Ce and Nd) and appears to increase with decreasing temperatures. However, the rather high solubility of allanite in the melts implies that it likely only crystallizes during the last stages of cooling of most magmas, except if the source magma is unusually enriched in rare earths.
The role of PMCT for the assessment of the cause of death in natural disaster (landslide and flood): a Sicilian experience
Authors: Mondello Cristina , Baldino Gennaro , Bottari Antonio , Sapienza Daniela , Perri Fabrizio , Argo Antonina , Asmundo Alessio , Ventura Spagnolo Elvira
Published: September 2021

In this report, the authors provide a contribution of PMCT in assessing the cause of death due to natural disasters. Here, the PMCT findings of 43 subjects who died during both landslide and flood were described. The post-mortem imaging revealed, clearly, traumatic injuries and/or the presence of foreign material in airways allowing to assess the cause of death of each subject, together with external inspection and the collected circumstantial data. Particularly, the PMCT has been helpful for characterization and localization of the clogging substance in airways providing findings on bronchial branches involvement. Moreover, the investigation offered detailed data on skeletal injuries in all anatomic districts and put in evidence both the precise fracturing site and the characteristics of fracture stubs for each bone fracture. This report supports the recommendation of the virtual autopsy in a case with several victims, as in natural disasters, and its role as an alternative diagnostic investigation when the standard autopsy is not feasible.
Child suicides in Sweden, 2000–2018
Authors: Junuzovic Mensura , Lind Kaja Maria Toporska , Jakobsson Ulf
Published: September 2021

Although child mortality is decreasing in Sweden, an increase in suicide rates has been previously observed among children and adolescents collectively. To increase knowledge about trends, demographics, and means in child suicides, data including all child (< 18 years) suicides in Sweden in 2000 through 2018 were retrieved from the Swedish National Board of Forensic Medicine. In all, a total of 416 child suicides were found in a 19-year period, accounting for an annual suicide rate of 1.1/100,000 child population. The number of suicides increased with 2.2% by each successive year during the study period (p < 0.001). The mean age in both sexes was 16 years; boys accounted for 55% and girls for 45% of all study cases. The majority of the children who died by suicide (96%) were teenagers (13–17 years old) and suicides in children younger than 10 years were uncommon. Suicide methods were 59% hanging, 20% lying/jumping in front of a moving object, 8% jumping from a height, 7% firearm injury, 4% poisoning, and 2% other methods. Sex differences were significant (p < 0.001) only for firearms being preferably used by boys. The vast majority of firearms used were licensed long-barreled weapons.

Conclusion: The number of child suicides in Sweden is relatively low but increasing. Most of the children used a violent and highly lethal method. Prevention of premature mortality is an urgent concern with an emphasis on resolutely reducing the availability of suicide means.What is Known:• Suicide is a significant cause of death globally among children, bringing tragic consequences for young individuals, their family, and the entire society.• Suicide rates and distribution of suicide methods in children differ between countries and settings, but studies of time trends are scarce.What is New:• Increasing number of minors’ suicides and the predominance of violent methods emphasize the importance of prevention strategies tailored for a child population.• Even in a setting of very restrictive firearm laws, firearm suicides in children must not be overlooked.
Subretinal fibrosis in neovascular age-related macular degeneration: current concepts, therapeutic avenues, and future perspectives
Authors: Tenbrock Louis , Wolf Julian , Boneva Stefaniya , Schlecht Anja , Agostini Hansjürgen , Wieghofer Peter , Schlunck Günther , Lange Clemens
Published: September 2021

Age-related macular degeneration (AMD) is a progressive, degenerative disease of the human retina which in its most aggressive form is associated with the formation of macular neovascularization (MNV) and subretinal fibrosis leading to irreversible blindness. MNVs contain blood vessels as well as infiltrating immune cells, myofibroblasts, and excessive amounts of extracellular matrix proteins such as collagens, fibronectin, and laminin which disrupts retinal function and triggers neurodegeneration. In the mammalian retina, damaged neurons cannot be replaced by tissue regeneration, and subretinal MNV and fibrosis persist and thus fuel degeneration and visual loss. This review provides an overview of subretinal fibrosis in neovascular AMD, by summarizing its clinical manifestations, exploring the current understanding of the underlying cellular and molecular mechanisms and discussing potential therapeutic approaches to inhibit subretinal fibrosis in the future.
The relationship between core temperature and perioperative shivering during caesarean section under intrathecal anesthesia with bupivacaine and ropivacaine: a randomized controlled study
Authors: Feng Guangju , Wang Yu , Feng Jiehua , Luo Xiaomin , Li Chaoyang , Yao Shanglong
Published: September 2021

Purpose

To assess the incidence rate of perioperative shivering for cesarean section and explore the associations between the occurrence of shivering and hypothermia, core temperature change, local anesthetic.

Methods

This is a prospective, randomized, controlled, double-blinded study of 100 patients consenting for caesarean section under intrathecal anesthesia. Parturients with ASA I or II accepted elective caesarean section with combined spinal-epidural anesthesia (SA). 2–2.5 ml of 0.5% bupivacaine or 0.5% ropivacaine was intrathecally injected in group B and group R, respectively.

Results

The intraoperative shivering incidence in group B was significantly higher than that in group R (66.7 vs. 20.5%, Pvalue < 0.001), and shivering intensity in group B was significantly greater than group R (score: 1.4 vs. 0.3, Pvalue < 0.001). The core temperature in both groups gradually decreased with the time after SA. Hypothermia (core temperature < 36.0 ℃) 5–30 min after SA was not associated with shivering. However, changes of temperature at 25 and 30 min after SA, and bupivacaine were statistically associated with shivering, with the odds of 10.77 (95% CI: 1.36–85.21, P value = 0.02), 8.88 (95% CI: 1.29–60.97, P value = 0.03), and 7.78 (95% CI: 2.94–20.59, P value < 0.01), respectively.

Conclusions

In our study, for cesarean section, the occurrence of shivering was associated with the local anesthetics and the change of core temperature after SA, while not the hypothermia.
Heat waves: a hot topic in climate change research
Authors: Marx Werner , Haunschild Robin , Bornmann Lutz
Published: September 2021

Research on heat waves (periods of excessively hot weather, which may be accompanied by high humidity) is a newly emerging research topic within the field of climate change research with high relevance for the whole of society. In this study, we analyzed the rapidly growing scientific literature dealing with heat waves. No summarizing overview has been published on this literature hitherto. We developed a suitable search query to retrieve the relevant literature covered by the Web of Science (WoS) as complete as possible and to exclude irrelevant literature (n = 8,011 papers). The time evolution of the publications shows that research dealing with heat waves is a highly dynamic research topic, doubling within about 5 years. An analysis of the thematic content reveals the most severe heat wave events within the recent decades (1995 and 2003), the cities and countries/regions affected (USA, Europe, and Australia), and the ecological and medical impacts (drought, urban heat islands, excess hospital admissions, and mortality). An alarming finding is that the limit for survivability may be reached at the end of the twenty-first century in many regions of the world due to the fatal combination of rising temperatures and humidity levels measured as “wet-bulb temperature” (WBT). Risk estimation and future strategies for adaptation to hot weather are major political issues. We identified 104 citation classics, which include fundamental early works of research on heat waves and more recent works (which are characterized by a relatively strong connection to climate change).
Scenario-based risk evaluation
Authors: Wang Ruodu , Ziegel Johanna F.
Published: September 2021

Risk measures such as expected shortfall (ES) and value-at-risk (VaR) have been prominent in banking regulation and financial risk management. Motivated by practical considerations in the assessment and management of risks, including tractability, scenario relevance and robustness, we consider theoretical properties of scenario-based risk evaluation. We establish axiomatic characterisations of scenario-based risk measures that are comonotonic-additive or coherent, and we obtain a novel ES-based representation result. We propose several novel scenario-based risk measures, including various versions of Max-ES and Max-VaR, and study their properties. The theory is illustrated with financial data examples.
Additive logistic processes in option pricing
Authors: Carr Peter , Torricelli Lorenzo
Published: September 2021

In option pricing, it is customary to first specify a stochastic underlying model and then extract valuation equations from it. However, it is possible to reverse this paradigm: starting from an arbitrage-free option valuation formula, one could derive a family of risk-neutral probabilities and a corresponding risk-neutral underlying asset process. In this paper, we start from two simple arbitrage-free valuation equations, inspired by the log-sum-exponential function and an $\ell ^{p}$

ℓ
p

vector norm. Such expressions lead respectively to logistic and Dagum (or “log-skew-logistic”) risk-neutral distributions for the underlying security price. We proceed to exhibit supporting martingale processes of additive type for underlying securities having as time marginals two such distributions. By construction, these processes produce closed-form valuation equations which are even simpler than those of the Bachelier and Samuelson–Black–Scholes models. Additive logistic processes provide parsimonious and simple option pricing models capturing various important stylised facts at the minimum price of a single market observable input.
Quantitative evaluation of visual guidance effects for 360-degree directions
Authors: Harada Yuki , Ohyama Junji
Published: September 2021

A head-mounted display cannot cover an angle of visual field as wide as that of natural view (out-of-view problem). To enhance the visual cognition of an immersive environment, previous studies have developed various guidance designs that visualize the location or direction of items presented in the users’ surroundings. However, two issues regarding the guidance effects remain unresolved: How are the guidance effects different with each guided direction? How much is the cognitive load required by the guidance? To investigate the two issues, we performed a visual search task in an immersive environment and measured the search time of a target and time spent to recognize a guidance design. In this task, participants searched for a target presented on a head-mounted display and reported the target color while using a guidance design. The guidance designs (a moving window, 3D arrow, radiation, spherical gradation, and 3D radar) and target directions were manipulated. The search times showed an interaction effect between guidance designs and guided directions, e.g., the 3D arrow and radar shorten the search time for targets presented at the back of users. The recognition times showed that the participants required short times to recognize the details of the moving window and radiation but long times for the 3D arrow, spherical gradation, and 3D radar. These results suggest that the moving window and radiation are effective with respect to cognitive load, but the 3D arrow and radar are effective for guiding users’ attention to necessary items presented at the out-of-view.
DEM Analysis of Single-Particle Crushing Considering the Inhomogeneity of Material Properties
Authors: Zhang Tao , Huang Wenxiong
Published: September 2021

Crushing characteristics of single particles are the basis of granular material simulation with discrete element method (DEM). To improve the universality and precision of crushable DEM model, inhomogeneous stiffness and strength properties are introduced into the bonded particle method, with which the Weibull distribution and size effect of particle strength can be reproduced without deleting elementary balls. The issues of particle strength and carrying capacity under complex contact conditions are investigated in this work by symmetric loading tests, asymmetric loading tests, and ball–ball loading tests. Results of numerical experiments indicate that particle carrying capacity is significantly influenced by coordination numbers, the symmetry of contact points, as well as the relative size of its neighbors. Contact conditions also show impact on single-particle crushing categories and the origin position of inner particle cracks. The existing stress indexes and assumptions of particle crushing criterion are proved to be inappropriate for general loading cases. Both the inherent inhomogeneity and contact conditions of particles should be taken into consideration in the simulation of granular materials.
Analysis of a Helmholtz preconditioning problem motivated by uncertainty quantification
Authors: Graham I. G. , Pembery O. R. , Spence E. A.
Published: September 2021

This paper analyses the following question: let Aj, j = 1,2, be the Galerkin matrices corresponding to finite-element discretisations of the exterior Dirichlet problem for the heterogeneous Helmholtz equations ∇⋅ (Aj∇uj) + k2njuj = −f. How small must $\|A_{1} -A_{2}\|_{L^{q}}$
∥

A

1

−

A

2

∥

L

q

and $\|{n_{1}} - {n_{2}}\|_{L^{q}}$
∥

n

1

−

n

2

∥

L

q

be (in terms of k-dependence) for GMRES applied to either $(\mathbf {A}_1)^{-1}\mathbf {A}_2$

(

A

1

)

−
1

A

2

or A2(A1)− 1 to converge in a k-independent number of iterations for arbitrarily large k? (In other words, for A1 to be a good left or right preconditioner for A2?) We prove results answering this question, give theoretical evidence for their sharpness, and give numerical experiments supporting the estimates. Our motivation for tackling this question comes from calculating quantities of interest for the Helmholtz equation with random coefficients A and n. Such a calculation may require the solution of many deterministic Helmholtz problems, each with different A and n, and the answer to the question above dictates to what extent a previously calculated inverse of one of the Galerkin matrices can be used as a preconditioner for other Galerkin matrices.
Adsorption kinetics and equilibria of two methanol samples with different water content on activated carbon
Authors: Rösler Meret , Wedler Carsten
Published: September 2021

To investigate the influence of fluid purity on the adsorption properties, adsorption kinetics and adsorption equilibria of two methanol samples with different water content on an activated carbon were studied. The purity of the methanol samples was 98.5% and 99.9%. Measurements were conducted at 298 K and 318 K using a magnetic suspension balance and cover a wide p/p0 range. To determine effective diffusion time constants and mass transfer coefficients, adsorption kinetics were evaluated using an isothermal and a nonisothermal Fickian diffusion model, and the linear driving force model. The pressure dependence of the kinetic parameters was studied and discussed. A small influence of sample purity on the adsorption equilibria was observed, as the purer methanol sample showed slightly higher equilibrium loadings than the less pure sample. However, significantly faster adsorption kinetics were observed for the purer sample at all temperature and pressure conditions. Compared to the less pure sample, the determined effective diffusion time constants and the mass transfer coefficients were up to 98% and 35% higher, respectively.
Role of TGFβ1 and WNT6 in FGF2 and BMP4-driven endothelial differentiation of murine embryonic stem cells
Authors: Gualandris Anna , Noghero Alessio , Cora’ Davide , Astanina Elena , Arese Marco , Bussolino Federico
Published: September 2021

Embryonic stem cells (ES) are a valuable source of endothelial cells. By co-culturing ES cells with the stromal PA6 cells, the endothelial commitment can be achieved by adding exogenous FGF2 or BMP4. In this work, the molecular pathways that direct the differentiation of ES cells toward endothelium in response to FGF2 are evaluated and compared to those activated by BMP4. To this purpose the genes expression profiles of both ES/PA6 co-cultures and of pure cultures of PA6 cells were obtained by microarray technique at different time points. The bioinformatics processing of the data indicated TGFβ1 as the most represented upstream regulator in FGF2-induced endothelial commitment while WNT pathway as the most represented in BMP4-activated endothelial differentiation. Loss of function experiments were performed to validate the importance of TGFβ1 and WNT6 respectively in FGF2 and BMP4-induced endothelial differentiation. The loss of TGFβ1 expression significantly impaired the accomplishment of the endothelial commitment unless exogenous recombinant TGFβ1 was added to the culture medium. Similarly, silencing WNT6 expression partially affected the endothelial differentiation of the ES cells upon BMP4 stimulation. Such dysfunction was recovered by the addition of recombinant WNT6 to the culture medium. The ES/PA6 co-culture system recreates an in vitro complete microenvironment in which endothelial commitment is accomplished in response to alternative signals through different mechanisms. Given the importance of WNT and TGFβ1 in mediating the crosstalk between tumor and stromal cells this work adds new insights in the mechanism of tumor angiogenesis and of its possible inhibition.
Neurophenomenology and Intersubjectivity: An Interdisciplinary Approach
Authors: Di Bernardo Mirko
Published: September 2021

The article aims to provide the main conceptual coordinates in order to fully understand the state of the art of the most recent research in the field of neurobiology of interpersonal experience. The main purpose of this work is to analyze, at an anthropological, phenomenological and epistemological level, how the fundamental characteristics of the recognition of otherness and intercorporeity among human beings contribute to changing the image of nature in the light of a possible new relationship between living bodies, neurophysiological systems and empathy. From this point of view, the hypothesis to investigate is that neurophenomenology, understood as a new evolutionary, multidimensional and autopoietic approach, is capable of probing the preconditions of the possible delineation of a phenomenology of intersubjectivity shaped by the neuroscientific turning point, represented by the discovery of mirror neurons. At this level, the neuroscientific data are interpreted according to a specific interdisciplinary perspective, thus trying to offer a possible unitary and integrated theoretical framework.
The effect of insecticide application by dropleg sprayers on pollen beetle parasitism in oilseed rape
Authors: Hausmann Johannes , Heimbach Udo , Rostás Michael , Brandes Meike
Published: September 2021

Dropleg sprayers apply pesticides below the flower horizon of oilseed rape plants and thus reduce unwanted side effects on pollinating insects. Whether this technique benefits parasitoids of seed and pollen feeding insect pests has not been studied earlier. To answer this question, we first assessed the vertical distribution of pests and parasitoids using a portable aspirator. In addition, parasitism rates of pollen beetle, Brassicogethes aeneus Fabricius (Coleoptera: Nitidulidae), by the larval parasitoid Tersilochus heterocerus Thomson (Hymenoptera: Ichneumonidae) were compared in conventional and dropleg sprayed fields over four years (2016–2019), using the neonicotinoids thiacloprid and acetamiprid. Our results show that seed and pollen feeders were mainly found in the flowering canopy, while the predominant location of parasitoids was species-specific. Among pollen beetle parasitoids, Phradis interstitialis Thomson (Hymenoptera: Ichneumonidae) was more abundant below flowering canopy (63% of total catch), whereas T. heterocerus was mainly caught in the flowering canopy (84% of total catch). In the spraying experiments, average parasitism rates of pollen beetles by T. heterocerus ranged between 55 and 82% in the untreated controls. In the dropleg spray treatments, parasitism rates did not differ significantly from control levels, with the exception of thiacloprid application in 2019. In contrast, conventional spray applications resulted in a reduction of parasitism rates by up to 37% compared to the control for at least one of the insecticides in three out of four years. The impact of conventional application differed between years, which may be explained by the temporal coincidence between spray application and the immigration of parasitoids into the crop. We conclude that dropleg spraying exerts lower non-target effects on the main biological control agent of pollen beetle.