bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of treatment plans for hypofractionated high‐dose prostate cancer radiotherapy using the Varian Halcyon and the Elekta Synergy platforms
Authors: Tamihardja Jörg , Razinskas Gary , Exner Florian , Richter Anne , Kessler Patrick , Weick Stefan , Kraft Johannes , Mantel Frederick , Flentje Michael , Polat Bülent
Published: August 2021

Purpose

To compare radiotherapy plans between an O‐ring and a conventional C‐arm linac for hypofractionated high‐dose prostate radiotherapy in terms of plan quality, dose distribution, and quality assurance in a multi‐vendor environment.

Methods

Twenty prostate cancer treatment plans were irradiated on the O‐ring Varian Halcyon linac and were re‐optimized for the C‐arm Elekta Synergy Agility linac. Dose‐volume histogram metrics for target coverage and organ at risk dose, quality assurance, and monitor units were retrospectively compared. Patient‐specific quality assurance with ion chamber measurements, gamma index analysis, and portal dosimetry was performed using the Varian Portal Dosimetry system and the ArcCHECK® phantom (Sun Nuclear Corporation). Prostate‐only radiotherapy was delivered with simultaneous integrated boost (SIB) volumetric modulated arc therapy (VMAT) in 20 fractions of 2.5/3.0 Gy each.

Results

For both linacs, target coverage was excellent and plan quality comparable. Homogeneity in PTVBoost was high for Synergy as well as Halcyon with a mean homogeneity index of 0.07 ± 0.01 and 0.05 ± 0.01, respectively. Mean dose for the organs at risk rectum and bladder differed not significantly between the linacs but were higher for the femoral heads and penile bulb for Halcyon. Quality assurance showed no significant differences in terms of ArcCHECK gamma pass rates. Median pass rate for 3%/2 mm was 99.3% (96.7 to 99.8%) for Synergy and 99.8% (95.6 to 100%) for Halcyon. Agreement between calculated and measured dose was high with a median deviation of −0.6% (−1.7 to 0.8%) for Synergy and 0.2% (−0.6 to 2.3%) for Halcyon. Monitor units were higher for the Halcyon by approximately 20% (p < 0.001).

Conclusion

Hypofractionated high‐dose prostate cancer SIB VMAT on the Halcyon system is feasible with comparable plan quality in reference to a standard C‐arm Elekta Synergy linac.
A Continuous MgF2 Network Structure Encapsulated Mg Alloy Prepared by Selective Laser Melting for Enhanced Biodegradation Resistance
Authors: Gao Chengde , Zeng Zihao , Peng Shuping , Tan Wei , Shuai Cijun
Published: August 2021

Magnesium (Mg) alloys have been regarded as potential biodegradable metals but degrade too fast in the physiological environment. Herein, a continuous magnesium fluoride (MgF2) network structure is designed and induced into Mg alloy to improve the degradation resistance. For this purpose, Mg alloy particles are first treated by hydrofluoric acid (HF) and then used to prepare alloys via selective laser melting (SLM). The results show that an intact and tightly packed MgF2 layer generates on the surface of Mg alloy particles. After SLM, the alloy presents a continuous network structure, in which Mg alloy matrix is encapsulated in the network units constructed by MgF2. Owing to the high corrosion resistance and chemical inertness of MgF2, the continuous network structure resists the erosion of corrosion medium and decreases the degradation rate of Mg alloy by 21%. In addition, cell fluorescence and viability results show that the network structure encapsulated Mg alloy exhibits improved cell proliferation and adhesion ability, indicating better biocompatibility. These findings show that the airtight network structure might be a good way to improve the degradation resistance of Mg alloys for biomedical applications.
Strategies and Applications for Improving the Stability of Black Phosphorus in Physical Environment
Authors: Zhao Lin , Chao Xuan , Xu Na , Ling Guixia , Zhang Peng
Published: August 2021

As a new type of 2D material, black phosphorus (BP) has been gradually attracting attentions since it was rediscovered in 2014 because of its many excellent properties, such as strong anisotropic properties, optical‐response properties, layer‐dependent bandgap, and so on. 2D BP is becoming an excellent candidate in the fields of electronics, optics, and so on. However, the applications of 2D BP are greatly limited and challenged by many adverse factors, such as the low yield, poor stability, and high price of BP nanosheets (NSs). Among them, the poor stability of BP is an important factor, which is an urgent problem to be solved. The main reason for its poor stability is the instability of its environment. The degradation factors of 2D BP are studied, including photoinduced degradation and water‐catalyzed degradation. At present, some feasible methods are explored to improve the degradation, which include passivation, surface functionalization, and doping metal or nonmetal ions. This review not only clarifies the structure, properties, degradation mechanism, and methods to improve the BP stability, but also shows more strategic means for the design and application of stable BP‐based nanocomposite materials in the fields of electronics, optics, biomedicine, and fire safety.
Deformation Behavior of 2D Composite Cellular Lattices of Ceramic Building Blocks and Epoxy Resin
Authors: Eichhorn Franziska , Keppner Felix , Köllner David , Fey Tobias
Published: August 2021

2D lattice structures with ordered cell designs based on honeycombs are built from modular composites of ceramic building blocks and epoxy resin. The variation of structural parameters as slenderness t2 g−1 and piezoelectric active area q changes the cell design. finite element method (FEM) simulations based on algorithm‐generated models within a structural parameter range determine the effect of thermal expansion of different materials (αMaterial) on the mechanical behavior in plane strain mode representative of piezoelectric excitation. The stress distribution σyy and strain amplification ay as a function of deformation are analyzed for Al2O3−PZT and PZT−PZT building block composites. The aim herein is to increase ay by modifying structure design. Furthermore, zero deformation with simultaneously occurring stresses is investigated.
Resonant Dielectric Metagratings for Response Intensified Optical Sensing
Authors: Aoni Rifat Ahmmed , Manjunath Shridhar , Karawdeniya Buddini I. , Zangeneh Kamali Khosro , Xu Lei , Damry Adam M. , Jackson Colin J. , Tricoli Antonio , Miroshnichenko Andrey E. , Rahmani Mohsen , Neshev Dragomir N.
Published: August 2021

The development of nanoscale optical sensors is desirable for a broad range of applications, including wearable medical‐diagnostics, biochemical detection, and environmental monitoring. Optical detection platforms based on resonant nanostructures are the golden standard for miniaturized footprint and high optical sensitivity. These sensors function by measuring a shift in resonance wavelength upon binding of analytes to their surface. However, such measurements are sensitive to intensity fluctuations of the illuminating source and its wavelength calibration, which limits their applicability. Here, a novel optical sensing concept based on diffraction measurements from resonant dielectric metagratings is proposed and experimentally demonstrated. It is shown that this approach enables the direct measurement of unknown analytes with enhanced sensitivity and without the need for intensity calibrations. The intensified sensitivity of this metagrating‐sensor is derived from combining the resonant phenomena of the nanostructures with the tailored diffraction from the metagrating, thereby providing the highest sensitivity demonstrated to date amongst grating‐based sensors. As a proof of concept, the metagrating‐sensor was validated using an antibody binding assay, achieving a femtomolar‐level limit of detection. Due to their high sensitivity and robust performance, the proposed metagrating sensors pave the way for novel miniaturized medical diagnostics and biosensing applications.
Polymer Nanosheet Interfaced Bioelectrode for Skin‐Inert sEMG Measurement
Authors: Ito Marimo , Horii Tatsuhiro , Fujie Toshinori
Published: August 2021

The interface between skin and electrodes plays a major role in the accuracy and efficiency of biopotential measurements. For reliable biosignal recording, stable and low‐impedance contact is required between electrodes and the target tissue. Conventional wet electrodes (Ag/AgCl) are composed of metal electrodes with skin‐adhesive hydrogel. However, for long‐term measurement, direct contact between the pre‐gel electrode and skin causes discomfort and skin irritation, especially for infants and people with sensitive skin because of the adhesiveness of the hydrogel. In this study, a low‐adhesive electrode is reported by exploiting a free‐standing polymeric ultra‐thin film (referred to as a “nanosheet”) as an intermediate layer at the backside of the electrode, which reduces the adhesiveness of the pre‐gel electrode while allowing for surface electromyogram (sEMG) measurement. Intermediate layer of the nanosheet made from polystyrene–polybutadiene–polystyrene triblock copolymer (SBS), polystyrene (PS) or polydimethylsiloxane (PDMS) is prepared using the roll‐to‐roll gravure coating method. The thickness of each nanosheet is varied from hundreds to thousands of nanometers, and the effect on the electrode performance is evaluated. The nanosheet‐modified electrodes with low adhesiveness are applied to human skin, which shows a good performance to detect sEMG signals of the forearm in a skin‐friendly manner.
Potential of Printed Electrodes for Electrochemical Impedance Spectroscopy (EIS): Toward Membrane Fouling Detection
Authors: Goh Guo Liang , Tay Ming Feng , Lee Jia Min , Ho Jia Shin , Sim Lee Nuang , Yeong Wai Yee , Chong Tzyy Haur
Published: August 2021

Electrochemical impedance spectroscopy (EIS), one of the techniques for electrochemical analysis, has been used for a wide range of applications especially chemical‐ and bio‐sensing. Besides, EIS is one of the few techniques that has been proven useful for membrane fouling detection. Electrodes are some of the most essential components for analytes detection applications with EIS. With the advances in printing technology, the fabrication of advanced printed electrode systems with miniature designs and improved sensitivity for electrochemical sensing is made possible. This review addresses recent advances in printed electrodes for electrochemical impedance spectroscopy with the emphasis placed on discussing the use of printed electrodes for membrane fouling detection. Common electrode designs and materials for electrochemical impedance spectroscopy are discussed, along with practical examples of these printed electrodes. The commonly used printing techniques for the fabrication of printed electrodes are also deliberated. The successful realization of printed electrodes for EIS requires careful design of electrodes, proper selection of electrode materials, as well as optimization of the printing process. It is expected that printed electrodes will be widely accepted for EIS sensing applications and will facilitate the creation of low‐cost high‐performance sensing devices.
Phosphorized CoNi2S4 Yolk‐Shell Spheres for Highly Efficient Hydrogen Production via Water and Urea Electrolysis
Authors: Lu Xue Feng , Zhang Song Lin , Sim Wei Lok , Gao Shuyan , Lou Xiong Wen (David)
Published: August 2021

Exploring earth‐abundant electrocatalysts with excellent activity, robust stability, and multiple functions is crucial for electrolytic hydrogen generation. Porous phosphorized CoNi2S4 yolk‐shell spheres (P‐CoNi2S4 YSSs) were rationally designed and synthesized by a combined hydrothermal sulfidation and gas‐phase phosphorization strategy. Benefiting from the strengthened Ni3+/Ni2+ couple, enhanced electronic conductivity, and hollow structure, the P‐CoNi2S4 YSSs exhibit excellent activity and durability towards hydrogen/oxygen evolution and urea oxidation reactions in alkaline solution, affording low potentials of −0.135 V, 1.512 V, and 1.306 V (versus reversible hydrogen electrode) at 10 mA cm−2, respectively. Remarkably, when used as the anode and cathode simultaneously, the P‐CoNi2S4 catalyst merely requires a cell voltage of 1.544 V in water splitting and 1.402 V in urea electrolysis to attain 10 mA cm−2 with excellent durability for 100 h, outperforming most of the reported nickel‐based sulfides and even noble‐metal‐based electrocatalysts. This work promotes the application of sulfides in electrochemical hydrogen production and provides a feasible approach for urea‐rich wastewater treatment.
Catalysis with Supramolecular Carbon‐Bonding Interactions
Authors: Wang Wei , Li Xinxin , Zhou Pan‐Pan , Wang Yao
Published: August 2021

Herein, we describe a new catalysis platform, supramolecular carbon‐bonding catalysis, which exploits the highly directional weak interactions between carbon centers of catalysts and electron donors to drive chemical reactions. To demonstrate this catalysis approach, we discovered a class of cyclopropane derivatives incorporated with carbonyl, ester and cyano groups as catalysts which showed general catalysis capability in different types of benchmark reactions. Among these typical examples, a challenging tail‐to‐head terpene cyclization can be achieved by supramolecular carbon‐bonding catalysis. The co‐crystal structures of catalyst and electron donors, comparison experiments, and titrations support a catalysis mode of carbon‐bonding activation of Lewis basic reactants.
Imaging of Cancer Cells and Dictated Cytotoxicity Using Aptamer‐Guided Hybridization Chain Reaction (HCR)‐Generated G‐Quadruplex Chains
Authors: Jou Amily Fang‐Ju , Chou Yi‐Te , Willner Itamar , Ho Ja‐an Annie
Published: August 2021

DNA nanotechnology provides powerful tools for developing cancer theranostics. Here we introduce the autonomous surface‐nucleolin‐guided HCR that leads to the polymerization of G‐quadruplex polymer chains, in which the ZnII‐protoporphyrin IX is intercalated. We demonstrate that MDA‐MB‐231 (Triple Negative Breast Cancer cells, TNBC) with overexpressed surface nucleolin were able to induce HCR leading to the formation of the ZnIIPPIX‐loaded G‐quadruplex polymer chains, while the M10 epithelial breast cells served as control. The ZnIIPPIX‐loaded nanowires allow the selective imaging of TNBC, and their permeation into the TNBC leads to selective cytotoxicity and guided photodynamic therapy toward the cancer cells due to structural perturbation of the membranes. The aptamer‐guided HCR‐generated G‐quadruplex polymer chains may serve as a versatile tool to target TNBC featuring poor prognosis and high pathological risk of recurrence, thus offering a promising theranostic platform.
Template Guiding for the Encapsulation of Uniformly Subnanometric Platinum Clusters in Beta‐Zeolites Enabling High Catalytic Activity and Stability
Authors: Tian Yajie , Duan Haonan , Zhang Bofeng , Gong Siyuan , Lu Zongjing , Dai Lei , Qiao Congzhen , Liu Guozhu , Zhao Yong
Published: August 2021

Subnanometric metal clusters have attracted extensive attention because of their unique properties as heterogeneous catalysts. However, it is challenging to obtain uniformly distributed metal clusters under synthesis and reaction conditions. Herein, we report a template‐guidance protocol to synthesize subnanometric metal clusters uniformly encapsulated in beta‐zeolite, with the metal ions anchored to the internal channels of the zeolite template via electrostatic interactions. Pt metal clusters with a narrow size range of 0.89 to 1.22 nm have been obtained on the intersectional sites of beta‐zeolite (Pt@beta) with a broad range of Si/Al molar ratios (15–200). The uniformly distributed Pt clusters in Pt@H‐beta are subject to strong electron withdrawal by the zeolite, which promotes transfer of active hydrogen, providing excellent activity and stability in hydrodeoxygenation reactions. A general strategy is thus proposed for the encapsulation of subnanometric metal clusters in zeolites with high thermal stability.
Reflections on school safety from a threat assessment perspective
Authors: Cornell Dewey
Published: August 2021

Behavioral threat assessment is a violence prevention strategy that can be adapted for use in schools. The Comprehensive School Threat Assessment Guidelines (CSTAG) is a form of behavioral threat assessment that is designed to recognize the developmental needs of youth and the mission of schools to help all students be successful. A multidisciplinary CSTAG team employing a five‐step decision‐tree will consider the student's intentions and the context of his/her behavior to distinguish transient threats that are not serious from the small proportion of substantive threats that require protective action to prevent violence. From a threat assessment perspective, schools are not as dangerous as the public perceives, but less obvious problems in the school climate such as bullying and harassment require attention. CSTAG teams are oriented to helping students with the conflicts that underlie their threatening behavior rather than responding with a punitive, zero tolerance approach. Six controlled studies have supported the safety and effectiveness of the CSTAG model.
Deacetylation of BmAda3 is required for cell apoptosis caused by Bombyx mori nucleopolyhedrovirus infection
Authors: Zhu Yajie , Hu Miao , Ngowo Jonas , Gao Xu , Chen Xi , Yan Huihui , Yu Wei
Published: August 2021

Silkworm is not only an ideal insect model with a biological significance, but it is also crucially important in sericulture and bioreactors. Bombyx mori nucleopolyhedrovirus (BmNPV) is a principal pathogen of silkworm. However, the molecular mechanism underlying BmNPV invasion is still unclear. Based on our previous acetylome research findings of B. mori after BmNPV infection, here, we focused on silkworm alteration/deficiency in activation‐3 (BmAda3). The acetylation of K124 and K128 were significantly reduced (0.66‐fold) upon the virus challenge. Due to the interaction between Ada3 and P53, acetylation‐mimic K124Q/K128Q and deacetylation‐mimic K124R/K128R mutants of BmAda3 were constructed to explore the roles exerted by the acetylation modification of BmAda3 on P53. Yeast two‐hybrid and IP results revealed that both BmAda3 and its deacetylation mutants (K124R/K128R) interacted with P53. Interestingly, we found that the deacetylation mutants (K124R/K128R) of BmAda3 significantly promoted the stability of P53. Since P53 is a proapoptotic factor, cell apoptosis was detected. We established that the deacetylation of BmAda3 at K124/K128 facilitated cellular apoptosis during BmNPV infection. Finally, viral proliferation was analyzed, and the results indicated that virus generation was reduced by K124/K128 deacetylation. Our report, based on the deacetylation of two lysine sites 124/128 of BmAda3, shows possible regulatory pathways of BmNPV proliferation and provides novel insights into the development of antiviral agents.
Using a massive high‐resolution ensemble climate data set to examine dynamic and thermodynamic aspects of heavy precipitation change
Authors: Yamada Tomohito J. , Hoshino Tsuyoshi , Suzuki Akihiro
Published: August 2021

This study investigated the relationship between extreme precipitation and near‐surface temperature (precipitation–temperature relation) from two different perspectives, the rate of change of precipitation with temperature and dynamic (i.e., effect of the change in atmospheric motion) and thermodynamic (i.e., effect of the change in atmospheric moisture content) aspects, using a 5‐km dynamical downscaled hundreds‐year data set for past climate condition (PAST; from 1951 to 2010) and future climate condition (FUTURE; 4°C warmer than the preindustrial condition). Initially, using the observation and the PAST and FUTURE data sets, it was found that the 99th and 99.9th percentile hourly precipitation for each temperature bin (P99 and P99.9, respectively) paralleled the slope of the Clausius–Clapeyron (C–C) relation for a certain temperature range over the Tokachi River basin in Hokkaido, the northern island of Japan; however, both P99 and P99.9 decreased in the high‐temperature range. Next, we examined the cause of the P99 and P99.9 differences between PAST and FUTURE for each temperature bin by classifying dynamic and thermodynamic factors. The result showed that the thermodynamic effect dominates the differences in P99 and P99.9 between PAST and FUTURE, which means that the thermodynamic effect is the main component of the precipitation–temperature relation. Similar analyses were applied to the whole river basin, including the mountainous area. The results showed that the differences in P99 and P99.9 between PAST and FUTURE are mainly due to the thermodynamic contribution, regardless of plain or mountain area. Using such large model data sets, we could make a robust assessment of the precipitation–temperature relation and the dynamic and thermodynamic contributions to precipitation changes. Moreover, using the 5‐km resolution hundreds‐year data set enabled us to quantify the spatial distribution of such precipitation characteristics over a thousands of square kilometer catchment.
Brandschutztechnisches Verhalten von raumabschließenden Holzrahmenkonstruktionen
Authors: Scheidel Sabine , Dienst Sebastian , Götz Tobias , Kornadt Oliver
Published: August 2021

Raumabschließende Bauteile in einer Holzrahmen‐/Holztafelbaukonstruktion werden derzeit über das additive Berechnungsverfahren nach DIN EN 1995‐1‐2 Anhang E geregelt. Dieses Berechnungsverfahren gilt in der Praxis jedoch häufig als zu konservativ, was zu einer Überdimensionierung der entsprechenden Bauteile führt. Daher wurde an der ETH in Zürich die Component Additive Method (CAM) auf Basis der DIN EN 1995‐1‐2 Anhang E entwickelt, die das bisherige Verfahren durch eine genauere Berechnungsmöglichkeit verbessern soll. Im Rahmen einer Versuchsreihe wurden das additive Berechnungsverfahren mit der Component Additive Method verglichen. Die Component Additive Method bildet die Grundlage für das im Technical Guideline „Fire Safety in Timber Buildings” beschriebene Berechnungsverfahren. Durch Brandversuche und FEM‐Simulationen wurde die Genauigkeit der beiden Berechnungsverfahren untersucht. Die sich ergebenen Bereiche guter Übereinstimmung bzw. teilweise deutlicher Abweichung werden analysiert und insbesondere auf die anzunehmende Funktionsdauer raumabschließender Holzrahmen‐/Holztafelbauwände bezogen.
Wärmebrückenberechnung für Bauelemente – Entwicklung vereinfachter universeller Ersatzsysteme
Authors: Schild Kai , Schild Bianca
Published: August 2021

Die Berücksichtigung von Wärmebrücken im Rahmen der Gesamtenergieeffizienz‐Bewertung von Gebäuden erfordert häufig eine detaillierte Betrachtung im Sinne von durchzuführenden Wärmebrückenberechnungen. Für Bauelemente wie Fensterrahmen und andere kann hierbei bislang auf die Referenz‐Elemente gemäß DIN 4108 Beiblatt 2, Anhang F zurückgegriffen werden. Diese führen jedoch zu einem recht hohen Arbeitsaufwand bei der praktischen Anwendung. Ziel der hier vorgestellten Untersuchungen war es, vereinfachte Ersatzmodelle für Bauelemente zu entwickeln, die anstelle der aufwendigen Referenz‐Elemente genutzt werden können. Auf Initiative des Verbandes für Dämmsysteme, Putz und Mörtel e. V. (VDPM) wurden im Rahmen eines Forschungsprojektes [6| Ersatzmodelle entwickelt, die hinsichtlich des Wärmeverlustes (ausgedrückt durch den ψ‐ Wert) und der niedrigsten Oberflächentemperatur θsi,min zu Berechnungsergebnissen führen, die mit denen der Referenzmodelle vergleichbar sind.
Flankenübertragung von Hochlochziegelmauerwerk mit Leichtbau‐Trennwänden
Authors: Schneider Martin , Naumann Kai , Zeitler Berndt
Published: August 2021

Die flankierende Schallübertragung wird bei massiven Bauteilen durch ihre Direktdämmung und die Stoßstellendämmung bestimmt. Bei flankierenden Massivwänden in Verbindung mit einer mehrschaligen Trennwand ist das Stoßstellendämm‐Maß bei durchlaufenden Massivwänden deutlich vermindert. Im Flankenprüfstand der Hochschule für Technik Stuttgart wurde die Stoßstellendämmung auf dem Übertragungsweg Außenwand – Außenwand an einem T‐Stoß aus Hochlochziegel‐Mauerwerk und einer Leichtbau‐Trennwand untersucht. Durch bauliche Maßnahmen konnten unterschiedliche Stoßstellenvarianten realisiert und deren Einfluss auf das Stoßstellendämm‐Maß ermittelt werden.

Die Pegeldifferenz bleibt durch einen bauüblichen Anschluss der mehrschaligen Leichtbau‐Trennwand an die Hochlochziegel‐Außenwand konstant und das Stoßstellendämm‐Maß auf diesem Übertragungsweg wird für eine durchlaufende Außenwand durch den Mindestwert des Stoßstellendämm‐MaßesKij,minbeschrieben. Durch konstruktive Maßnahmen an der Außenwand im Bereich der Stoßstelle (Trennfuge, Beton‐ oder Mauerwerksstütze) werden die Schnellepegeldifferenzen und damit die Stoßstellendämm‐Maße erhöht. Ein Verkürzen der Außenwandlänge im Prüfstand auf bauübliche Längen zeigt, dass die Norm‐Flankenschallpegeldifferenz bei den kleinen Außenwandlängen deutlich größer wird. Mit diesen verkürzten Stößen ist die Messung des Stoßstellendämm‐Maßes zwar nicht mehr normgerecht, liefert aber konservative Werte.
Empowering children to speak up and act on social justice issues: The use of folktales and collaborative storytelling as tools of social imagination
Authors: Hajisoteriou Christina , Panaou Petros , Angelides Panayiotis
Published: August 2021

Over the last decade, various organisations, scholars and educators across the globe have been arguing for the need to foster dialogue between and with children regarding the world they want to have, in terms of both justice and sustainability. Research has shown that stories and storytelling have a world‐making and world‐changing character that may trigger children’s social imagination on social justice issues and help them play a participatory role in society. In this context, the study presented here aimed to empower children to speak up for their beliefs and to become active agents of change in relation to social justice issues. To meet our research goals, we developed workshops around traditional folktales, which we implemented in four schools in Cyprus. During these workshops, we promoted critical dialogue for social justice issues through pertinent collaborative storytelling activities. Collaborative storytelling is a method that can involve participants in critical dialogue, enabling them to produce innovative and creative counter‐stories. This can potentially deepen their perceptions about social justice, while also allowing them to communicate the knowledge they have built in engaging and accessible ways. Data collection included observations during workshops, as well as post‐implementation interviews with a purposive sample of child participants. Our findings suggest that the children deployed either a ‘we are all different’ or a ‘we are all the same’ discourse to define social justice. Nonetheless, as the project progressed, they seemed to gradually turn to a ‘we need to see injustice to be able to act against it’ discourse. This project aims to contribute to academic discussions on promoting dialogue with children on social justice issues, and cultivating children’s metacognitive skills about societal injustices.
A simple test‐based frailty index to predict survival among cancer patients with an unplanned hospitalization: An observational cohort study
Authors: Hembree Timothy , Theou Olga , Thirlwell Sarah , Reich Richard R. , Cao Biwei , Sehovic Marina , Syed Misbahuddin , Verma Neha , Nguyen Thu‐Cuc , Keerty Dinesh , Wesolow Jaqueline , Koverzhenko Viktoriya , Extermann Martine , Huang Jessica , Ramsakal Asha
Published: August 2021

Background

Frailty is a state of increased vulnerability to stressors, and predicts risk of adverse outcomes, such as mortality. Frailty can be defined by a frailty index (FI) using an accumulation of deficits approach. An FI comprised of 20 items derived from our previously studied test‐based frailty index (TBFI) and an additional 33 survey‐based elements sourced from the standard CGA was developed to evaluate if predictive validity of survival was improved.

Methods

One hundred eighty‐nine cancer patients during acute hospitalization were consented between September 2018 and May 2019. Frailty scores were calculated, and patients were categorized into four groups: non‐frail (0–0.2), mildly frail (0.2–0.3), moderately frail (0.3–0.4), and severely frail (>0.4). Patients were followed for 1‐year to assess FI and TBFI prediction of survival. Area under the curve (AUC) statistics from ROC analyses were compared for the FI versus TBFI.

Results

Increasing frailty was similarly associated with increased risk of mortality (HR, 4.5 [95% CI, 2.519–8.075] and HR, 4.1 [95%CI, 1.692–9.942]) and the likelihood of death at 6 months was about 11‐fold (odds ratio, 10.9 [95% CI, 3.97–33.24]) and 9.73‐fold (95% CI, 2.85–38.50) higher for severely frail patients compared to non‐frail patients for FI and TBFI, respectively. This association was independent of age and type of cancer. The FI and TBFI were predictive of survival for older and younger cancer patients with no significant differences between models in discriminating survival (FI AUC, 0.747 [95% CI, 0.6772–0.8157] and TBFI AUC, 0.724 [95% CI, 0.6513–0.7957]).

Conclusions

The TBFI was predictive of survival, and the addition of an in‐person assessment (FI) did not greatly improve predictive validity. Increasing frailty, as measured by a TBFI, resulted in a meaningfully increased risk of mortality and may be well‐suited for screening of hospitalized cancer patients.
Optimal surgical timing and radiotherapy dose for trimodality therapy in locally advanced non‐small cell lung cancer
Authors: Han James E. , Hasan Shaakir , Choi J. Isabelle , Press Robert H. , Simone Charles B.
Published: August 2021

Purpose/Objectives

Data are conflicting on the effects of time interval from neoadjuvant chemoradiation (NCRT) to surgery for locally advanced non‐small‐cell lung cancer (LA‐NSCLC). This study investigated the impact of surgical timing after NCRT and radiation dose on postoperative mortality and overall survival (OS).

Materials and Methods

Using the National Cancer Database, we identified 3489 LA‐NSCLC patients treated with NCRT and surgery. Multivariate Cox proportional hazards analysis (MVA) was used to examine the effects of surgery >7 weeks from NCRT completion on OS. Propensity score (PS)‐matched survival analysis for surgery ≤7 and >7 weeks was performed. Postoperative mortality was assessed.

Results

Median OS for surgery ≤7 weeks and >7 weeks after NCRT were 56.9 versus 45.6 months (hazard ratio, HR 1.18 [1.07–1.30];p < 0.001). Surgery >7 weeks correlated with decreased OS on MVA (HR 1.15 [1.04–1.27];p = 0.009) and PS matching (HR 1.16 [1.049–1.29];p = 0.004). Time as a continuous variable correlated with OS on MVA (HR 1.003 [1.001–1.006];p = 0.0056) and PS matching (HR 1.004 [1.001–1.006];p = 0.004). Among 2902 lobectomy patients, the mortality rate for surgery ≤66 days was 5.2% versus 8.1% for >66 days (MVA HR 1.59 [1.02–2.49];p = 0.04). Higher neoadjuvant radiotherapy dose correlated with surgery >7 weeks and lobectomy >66 days on MVA.

Conclusions

Increased interval >7 weeks from NCRT to surgery for LA‐NSCLC is correlated with worse OS and lobectomy ≤66 days correlated with improved OS. Surgery ≤7weeks may improve tumor control, whereas higher mortality for surgery >66 days may relate to late NCRT manifestations. Neoadjuvant doses of 44–50.4 Gy may minimize risks of radiation‐induced lung injury and surgical complications and facilitate surgery within the optimal 7‐week interval.
Acute granulomatous interstitial nephritis in a patient with metastatic melanoma on targeted therapy with dabrafenib and trametinib—A case report
Authors: Krelle Anna , Mathai Vinod Kalapurackal , Kirkland Geoff , Nott Louise , Jose Matthew D. , Whale Karen
Published: August 2021

Background

Combination molecular targeted therapy with dabrafenib plus trametinib has been shown to improve progression‐free survival and overall survival in patients with BRAF V600 mutated unresectable or metastatic melanoma. In general, these agents are well tolerated. Kidney related adverse events are uncommon with only three case reports of acute interstitial nephritis and one case of a serious acute kidney injury. We report another case of interstitial nephritis related to these drugs.

Case

A 37‐year‐old man diagnosed with metastatic melanoma (BRAF V600E mutation) who developed acute interstitial nephritis 5 years into his treatment with combination dabrafenib plus trametinib therapy. He presented with an asymptomatic acute kidney injury on routine surveillance pathology with a creatinine of 174 μmol/L (from baseline 80 μmol/L) and a corresponding estimated glomerular filtration rate (eGFR) of 42 ml/min/1.73 m2 (from a baseline >90 ml/min/1.73 m2) and microalbuminuria (albumin creatinine ratio [ACR] 8.5 mg/mmol). Renal biopsy revealed a granulomatous interstitial nephritis likely drug related. He was treated with prednisolone 1 mg/kg and ceased his targeted therapy with improvement in his renal function.

Conclusion

Although rare, recognition of acute interstitial nephritis, a possible serious adverse outcome due to dabrafenib and trametinib is important and needs to be incorporated into current Australian cancer therapy guidelines.
Polygenic score modifies risk for Alzheimer's disease in APOE ε4 homozygotes at phenotypic extremes
Authors: Huq Aamira J. , Fulton‐Howard Brian , Riaz Moeen , Laws Simon , Sebra Robert , Ryan Joanne ,   Alzheimer's Disease Genetics Consortium, Renton Alan E. , Goate Alison M. , Masters Colin L. , Storey Elsdon , Shah Raj C. , Murray Anne , McNeil John , Winship Ingrid , James Paul A. , Lacaze Paul
Published: August 2021

Introduction

Diversity in cognition among apolipoprotein E (APOE) ε4 homozygotes can range from early‐onset Alzheimer's disease (AD) to a lifetime with no symptoms.

Methods

We evaluated a phenotypic extreme polygenic risk score (PRS) for AD between cognitively healthy APOE ε4 homozygotes aged ≥75 years (n = 213) and early‐onset APOE ε4 homozygote AD cases aged ≤65 years (n = 223) as an explanation for this diversity.

Results

The PRS for AD was significantly higher in APOE ε4 homozygote AD cases compared to older cognitively healthy APOE ε4/ε4 controls (odds ratio [OR] 8.39; confidence interval [CI] 2.0–35.2; P = .003). The difference in the same PRS between APOE ε3/ε3 extremes was not as significant (OR 3.13; CI 0.98–9.92; P = .053) despite similar numbers and power. There was no statistical difference in an educational attainment PRS between these age extreme case‐controls.

Discussion

A PRS for AD contributes to modified cognitive expression of the APOE ε4/ε4 genotype at phenotypic extremes of risk.
Chrysin modulates protein kinase IKKε/TBK1, insulin sensitivity and hepatic fatty infiltration in diet‐induced obese mice
Authors: Amir Siddiqui Mohammad , Badruddeen  , Akhtar Juber , Uddin Shahab , Chandrashekharan Sidda Madappa , Ahmad Mohammad , Khan Mohammad Irfan , Khalid Mohammad
Published: August 2021

Nuclear factor kappa B cells (NF‐κB) activation causes induction of the noncanonical IκB kinases (I‐kappa‐B kinase epsilon (IKKε) and TANK‐binding kinase 1 (TBK1) in liver and fat after high fat diet which followed activating of cascade of counter‐inflammation that conserves energy storage. Chrysin (5,7‐dihydroxyflavone), a natural flavonoid, present in many plants, honey and propolis, used conventionally to treat numerous ailments. The present study was aimed to identify the protective role of chrysin on the glucose lowering and insulin sensitivity in diet induced obese (DIO) mice by regulating IKKε/TBK1. Chrysin administered therapeutically (60, 100, 200 mg/kg body weight) and preventive mode (200 mg/kg body weight) for 4 and 10 weeks respectively to DIO mice. At last fasting blood glucose, oral glucose tolerance test, serum lipid profile, as well as the expression level of IKKε/TBK1 and triglyceride in the liver tissue were assessed. DIO mice showed impaired glucose tolerance, reduced weight gain, elevated hepatic IKKε/TBK1 expression, fatty acid infiltration triglyceride and increased in plasma insulin and glucose. Chrysin in both therapeutic and preventive mode normalized the altered levels of the same. Overall chrysin improves glycemic control and insulin sensitivity through regulating expression of IKKε/TBK1 in liver of DIO mice.
Help students with disabilities develop a positive identity
Authors: Hope Joan
Published: August 2021

Most discussions higher education professionals have about disability focus on accommodations and what legal requirements must be met, said Michelle Heinig Resnick, Director of Disability Accommodations and Support Services at California State University, Channel Islands. Only recently, the discussions have begun to more often include disability rights as civil rights and disability as part of identity, she added.
Mouse models of patent ductus arteriosus (PDA) and their relevance for human PDA
Authors: Yarboro Michael T. , Gopal Srirupa H. , Su Rachel L. , Morgan Thomas M. , Reese Jeff
Published: August 2021

The ductus arteriosus (DA) is a unique fetal vascular shunt, which allows blood to bypass the developing lungs in utero. After birth, changes in complex signaling pathways lead to constriction and permanent closure of the DA. The persistent patency of the DA (PDA) is a common disorder in preterm infants, yet the underlying causes of PDA are not fully defined. Although limits on the availability of human DA tissues prevent comprehensive studies on the mechanisms of DA function, mouse models have been developed that reveal critical pathways in DA regulation. Over 20 different transgenic models of PDA in mice have been described, with implications for human DA biology. Similarly, we enumerate 224 human single‐gene syndromes that are associated with PDA, including a small subset that consistently feature PDA as a prominent phenotype. Comparison and functional analyses of these genes provide insight into DA development and identify key regulatory pathways that may serve as potential therapeutic targets for the management of PDA.
Successful treatment of COVID‐19 infection with convalescent plasma in B‐cell‐depleted patients may promote cellular immunity
Authors: Kremer Andreas E. , Kremer Anita N. , Willam Carsten , Völkl Simon , Verhagen Johan , Achenbach Susanne , van der Meijden Edith D. , Lang Vanessa , Aigner Michael , Maier Clara , Tenbusch Matthias , Korn Klaus , Lutzny‐Geier Gloria , Spoerl Silvia , Strauß Richard , Vetter Marcel , Überla Klaus , Neurath Markus F. , Mackensen Andreas , Schiffer Mario , Hackstein Holger
Published: August 2021

Treatment with convalescent plasma has been shown to be safe in coronavirus disease in 2019 (COVID‐19) infection, although efficacy reported in immunocompetent patients varies. Nevertheless, neutralizing antibodies are a key requisite in the fight against viral infections. Patients depleted of antibody‐producing B cells, such as those treated with rituximab (anti‐CD20) for hematological malignancies, lack a fundamental part of their adaptive immunity. Treatment with convalescent plasma appears to be of general benefit in this particularly vulnerable cohort. We analyzed clinical course and inflammation markers of three B‐cell‐depleted patients suffering from COVID‐19 who were treated with convalescent plasma. In addition, we measured serum antibody levels as well as peripheral blood CD38/HLA‐DR‐positive T‐cells ex vivo and CD137‐positive T‐cells after in vitro stimulation with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)‐derived peptides in these patients. We observed that therapy with convalescent plasma was effective in all three patients and analysis of CD137‐positive T‐cells after stimulation with SARS‐CoV‐2 peptides showed an increase in peptide‐specific T‐cells after application of convalescent plasma.

In conclusion, we here demonstrate efficacy of convalescent plasma therapy in three B‐cell‐depleted patients and present data that suggest that while application of convalescent plasma elevates systemic antibody levels only transiently, it may also boost specific T‐cell responses.
Experimental study on multi‐fuel combustion of lean coal and by‐product gas in a 75t/h tangentially‐fired boiler
Authors: Yi Zhengming , Hu Xuman , Zhou Zheng
Published: August 2021

By‐product gas is used as an alternative energy for steel mills to relieve the pressure of the fossil fuel crisis. In order to study the influence of blending by‐product gas on boiler operation, the multi‐fuel combustion experiments on the mixture of coke oven gas (COG), blast furnace gas (BFG), and lean coal were carried out in a 75t/h multi‐fuel combustion boiler so as to determine the most balanced fuel formula. The results indicated that the mixed combustion of COG and lean coal could improve the boiler efficiency. However, the balance of by‐product gas utilization in steel mills was destroyed for not using BFG. Although mixed combustion of BFG and COG improved the boiler efficiency, the boiler could only be operated under low load because of lower furnace temperature. After applying the most balanced flue ratio of BFG, COG, and lean coal, with heat value rations of 35%, 35%, and 30%, respectively, the efficiency of the boiler became 77.21%. The flue gas temperature lowered 4.5°C and the carbon content of fly ash and boiler slag were reduced by 1.06% and 1.09%, respectively. As a result, the stand coal consumption of the boiler decreased by 226.1 kg/h with the ratio of coal saving being 3.3%.
Effect of saffron supplementation on oxidative stress parameters: A systematic review and meta‐analysis of randomized placebo‐controlled trials
Authors: Morvaridzadeh Mojgan , Agah Shahram , Dulce Estêvão M. , Hosseini Ava Sadat , Heydari Hafez , Toupchian Omid , Abdollahi Shima , Persad Emma , Abu‐Zaid Ahmed , Rezamand Gholamreza , Heshmati Javad
Published: August 2021

Oxidative stress (OS), the absence of equilibrium between prooxidants and antioxidants in the body, has been shown to play a pivotal role in the initiation and progression of many diseases. Saffron has been noted for its antioxidant capacity and can be used to improve OS parameters in unhealthy patients. Our aim was to evaluate the efficacy of saffron supplementation on OS parameters in unhealthy patients in randomized controlled trials (RCTs). We searched Medline, EMBASE, Cochrane CENTRAL, Scopus, and Web of Science without language restrictions for RCTs up until April 2021. Studies were included if they compared any form of saffron supplementation to placebo or no supplementation on OS parameters in unhealthy patients. Using a random‐effects model with calculated standardized mean difference (SMD) and 95% confidence intervals (CI), we quantitatively synthesized the data. Heterogeneity was assessed using Cochrane's I2 values. Ten randomized controlled trials were eligible for this review. Seven were included in the meta‐analysis and indicated an association between saffron intake and a statistically significant decrease in malondialdehyde (MDA) levels (SMD: −0.40; 95% CI: −0.63, −0.17; I2 = 32.6%) and a significant increase in total antioxidant capacity (TAC, SMD: 0.24; 95% CI: 0.05, 0.42; I2 = 00.0%). Saffron intake was shown to significantly impact MDA and TAC, indicating its beneficial properties in improving OS in unhealthy patients. However, additional RCTs are required to evaluate the effect on other OS parameters.
Genomic Testing, Unexpected Consanguinity, and Adolescent Parents
Authors: McGowan Michelle , Brown Teneille , Biller Aimee B. , deSante‐Bertkau Jennifer
Published: August 2021

This case study about an infant with epidermolysis bullosa and his fourteen‐year‐old mother involves pediatric genomic testing and concerns about the adolescent parent's decision‐making capacity. Four commentaries explore ethics issues in the case, including the following challenges: The current ethics guidelines regarding informed decision‐making for genomic testing and return of results have been relatively silent on how to involve parents who are minors in decision‐making on behalf of their children. This lack of guidance can be particularly difficult for physicians when genetic test results revealing consanguinity raise concerns about sexual abuse of a minor, provoking questions about mandatory reporting requirements. Finally, medical teams may find themselves having to evaluate an adolescent parent's capacity in making medical decisions for her child while questioning the role and relationship of her support person.
Putting the local back into planning‐experiences and perceptions of state and district health functionaries of seven aspirational districts in India on an innovative planning capacity building approach
Authors: Sarin Enisha , Bisht Nitin , Mohanty Jaya Swarup , Chandra Joshi Naresh , Kumar Arvind , Dey Surajit , Kumar Harish
Published: August 2021

District functionaries have ostensibly a major responsibility to develop evidence based plans. However, this responsibility is not commensurate with skills and expertise among functionaries in many Indian states. Vriddhi project‐technical partner of the government, developed a planning tool for maternal and neonatal health programmes, called RMNCH + A Action Agenda using Strategic Approach (RAASTA), which was introduced in a workshop format in two states and attended by program officers. Qualitative feedback was obtained from selected participants to understand their experience of the workshop and of the planning tool. It emerged that previous planning process had little application of local evidence based solutions. Participants appreciated the alternative approach as RAASTA equipped them to use local evidence. Several action plans derived at the workshop were included in the state plan. At the same time, apprehension was expressed by participants about translating their learnings to practical application as planning was not a central priority in their scheme of duties and tasks. Enhanced support from states in refreshing district planners' skills would be an important step. One state government has scaled up the RAASTA tool while an electronic version is being developed for future use as it demonstrates great potential to equip and aid district officials in developing evidence based plans.
Impact of focused cardiac ultrasound in vascular surgery patients: A prospective observational study
Authors: Mensel Camilla , Eldrup Nikolaj , Guldbrand Vibeke , Juhl‐Olsen Peter
Published: August 2021

Purpose

We aimed to evaluate the diagnostic and logistical consequences of routine preoperative focused cardiac ultrasound (FOCUS) in patients scheduled for elective vascular surgery.

Methods

In a prospective, observational study, FOCUS was performed in all patients seen in the vascular surgery outpatient clinic from January 14 to May1, 2019, unless a full echocardiography had been conducted in the preceding 12 months or the patient was already referred to an echocardiography by the vascular surgeons. FOCUS followed a stringent protocol and referrals for a full echocardiography followed predefined criteria.

Results

Preoperative FOCUS was performed in 55 (60%) patients. Of these, 12 patients (22%) revealed cardiac pathology and were referred to a full echocardiography. Coronary angiography was subsequently performed in one of these patients but was without a further consequence. All patients underwent surgery.

Conclusion

FOCUS disclosed cardiac pathology in the outpatient clinic but with little clinical consequence. This study does not support routine FOCUS as a part of the preoperative patient cardiovascular assessment before vascular surgery. However, larger studies are warranted to further evaluate the relevance of preoperative FOCUS in a larger sample size.