bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Low Energy Beta Emissions on the Measurement Technique and Exposition
Authors: Filss Martin F. , Hummel Lothar , Zech Johann B. 
Published: April 2020

Abstract
We examined the suitability of taking smear tests (DIN ISO 7503.1) to evaluate surface activity. Special respect was given to mixtures of nuclides typical for the nuclear industry. We analysed the nuclides of samples of different fuel pools to evaluate the smear test measurement technique. Special calculations were carried out to examine the amount of nuclides that are difficult to measure due to their low maximum decay energy of less then 0.15 MeV (e. g. 55Fe, 63Ni). The response characteristic, detection sensitivity and the influence of the nuclide used for calibration were examined in detail on the basis of the nuclide vectors of fuel pool samples. We learned that especially the isotope standard used for calibration has a major influence for the suitability of the measurements. Calculation of the amount of these nuclides in relation to the effective dose (inhalation, ingestion) and the skin dose showed that they contribute little to the complete exposition.
Sacrificial Layer Composition Optimization for Immobilization of Radioactive Waste in Nuclear Reactor External Catcher
Authors: Vlassov Anatoly S. , Akopov Felix A. , Lukin Evgeny S. , Mineev Vladimir N. , Traktuev Oleg M. 
Published: April 2020

Abstract
Results of the analysis of influence sacrificial layer (SL) composition on the base of titanate ceramics on the processes in external core catcher are submitted.
It was being supposed that SL not only have to mitigate action of corium on refractory layer but then immobilize high level radioactive wastes (HLW). Titanate ceramics was selected as a SL material for this purpose. This ceramics is formed during interaction zirconium and zirconia from corium with refractory concrete of SL on the base of calcium aluminate and barium aluminate with filler from TiO2. The composition of indurated melt represents such well-known compounds as rutile TiO2, perovskite CaTiO3, zirconolite CaZrTi2O7 and phase hollandite type BaTi6Al2O16 which produce Synroc.
Minimization quantity material SL for their total deployment in under reactor space was made leaded. For immobilization of uranium there may be used zirconia from corium (55,5 t) and SL (21,5 t) and zirconolite as uranium yields a continuous range of solid solutions with these substances.
Crystallization processes of the model compositions without uranium oxide were studied. It was determined that perovskite, zirconolite, hollandite and after that crystallization eutectic systems were formed depending on melt crystallization velocity.
Development of Testing Laboratory for Checking Radioactive Waste Packages in the Czech Republic
Authors: Svoboda K. , Vokál A. 
Published: April 2020

Abstract
In the Czech Republic, radioactive wastes have been accumulated since the twenties of the past century without any consideration for the possible impact of generated wastes on the health of man and the environment. Since the sixties the radioactive wastes have been emplaced in abandoned mines Richard and Bratrství, with some of them only stored there for the future disposal in a planned Deep Geological Repository. Only in seventies more detailed rules for institutional waste management were issued by the decree of the Ministry of Health No. 59/1972, which were in 1997 replaced by Atomic Act No. 18/1997.
The contemporary state of checking waste packages coming to the repositories for their disposal or storage has been based mainly on the measurements of dose rates, surface contamination and, first of all, checking of documents prepared by waste producers.
The main objective of the development of a testing laboratory for checking radioactive waste packages in the Czech Republic is to establish a facility that will make possible to check independently the data provided by radioactive waste producers and to characterize the content of waste packages already stored or disposed of in disposal facilities in sixties, when so strict regulation requirements were not applied.
The main aim of this paper is to describe the state of the development of main methodologies leading to the establishment of the laboratory.
It is possible to divide into 3 main groups the essential methodologies now being developed in the laboratory: radiological, short-term properties and long-term durability properties. The emphasis is given, however, on the following non-destructive methods:
• Segmented gamma scanning - already developed with the support of IAEA;
• Digital radiography - under development;
• Passive and active neutron assay - in prospective plan.
The establishing of such a laboratory does not mean only to purchase very expensive equipment, enabling to determine the quality of waste packages, but also to establish Quality Control on all developed methodologies. While buying the equipment may be the matter of a rather short time, the development of methodologies, testing procedures and all quality assurance (QA) system documents may take years. A planned QA system of the laboratory is described in the last part of the article.
Historical Waste Products Refurbished in Belgium for Disposal in Germany
Authors: Kohlgarth Elke.-D. 
Published: April 2020

Abstract
Before 1988 the German service company Transnuklear (TN) had a licence to treat radioactive waste products for interim storage facilities. For this purpose a large amount of radioactive waste was transported to Mol, Belgium. Due to mismanagement at TN all the German waste remained in Belgium until the Belgian and the German government agreed to transfer it back to Germany. By appointment of the licensing and surveillance authorities TÜV Hannover/Sachsen-Anhalt e.V. had been monitoring the quality assurance measures for waste products bound for disposal in a final repository or for interim storage facilities in Germany. Due to insufficient documentation, the characterisation of the different waste types took a long time. Sampling plans were worked out. A stepwise procedure was established to qualify the waste for transportation to Germany. Different techniques have been developed for inspection and sampling of the waste to ensure the fulfilment of the acceptance criteria of the final storage or interim storage facilities. The first waste was transported in 1991. The last waste packages left Belgium in January, 2001.
How should we manage hip fracture patients on direct oral anticoagulants?
Authors: Aziz Sheweidin , Almeida Krishan , Taylor Grahame 
Published: April 2020

Objective
Currently, there are no national protocols in place for managing hip fracture patients on direct oral anticoagulants (DOACs). Hence, various local management protocols exist. We compared three different local protocols and a control group to assess blood loss and time delay to theatre.

Methods
Sequential data were collected for 120 hip fracture patients in four groups; wait 24 hours from last dose, wait 48 hours, perform DOAC levels and control.

Results
DOAC use in our hip fracture patients was 14%. Median haemoglobin (Hb) drop between the three protocol groups showed no significant difference (13.5, 21.5 and 16.0 g/L) (Kruskal-Wallis, p=0.9). Median Hb drop in the control group was 16.0 g/L versus 17.5 g/L in the protocol groups combined (Mann Whitney-U, p=0.7). Average Hb drop in the control group was 19.2 g/L and in the protocol groups was 22.1 g/L; a 15% greater blood loss with DOACs. The frequency distribution of blood loss was different between the control and protocol groups, but not between the protocol groups. The highest Hb drop in the control group was 3.4 g/L, while in the protocol groups, it was 7.8 g/L. Median Hb on arrival to hospital was higher in the control group (124 g/L) compared with the three protocol groups (87 g/L) (t-test p<0.0001). Transfusion rates of up to 40% were observed within the DOAC groups compared with zero in the control group.
Median time to theatre between the three protocol groups was significantly different at 17.5, 53.3 and 22.5 hours, respectively (Kruskal-Wallis, p<0.0001).

Conclusion
DOACs caused increased bleeding and delays to theatre in hip fracture patients, however the largest Hb difference was already apparent on arrival. Subsequent blood loss was minimal on average; a few patients bled heavily. Prolonged waiting made no significant difference to blood loss, but caused delay to theatre leading to financial losses from best practice tariff.
Caesarean delivery is associated with higher risk of overweight in the offspring: within-family analysis in the SUN cohort
Authors: Martín-Calvo Nerea , Martínez-González Miguel Ángel , Segura Gloria , Chavarro Jorge E , Carlos Silvia , Gea Alfredo 
Published: April 2020

BackgroundMost studies assessing the association between caesarean delivery (CD) and childhood overweight/obesity have failed to account for important confounders, such as maternal prepregnancy body mass index (BMI) or the indication of the CD. Furthermore, within-family analyses have reported contradictory results. We aimed at evaluating the association between CD and offspring’s risk of overweight/obesity while adjusting for important confounders and accounting for correlations between siblings.MethodsWomen in the ‘Seguimiento Universidad de Navarra’ cohort provided structured information regarding their pregnancy history and their children’s health through online cross-sectional questionnaires. We calculated adjusted differences in BMI z-score and risk ratios (RR) for offspring’s overweight/obesity associated with CD, with hierarchical models to account for correlations between siblings. We also performed a within-family analysis in 341 siblings who were discordant in delivery mode, using conditional multivariable logistic regression.ResultsAmong the 2791 children analysed, those born by CD had higher average BMI z-scores (difference: 0.17; 95% CI 0.07 to 0.27) and higher risk of overweight/obesity (RR: 1.32, 95% CI 1.05 to 1.65) than children born vaginally. The association did not differ by maternal characteristics or offspring’s age strata, and the results were consistent in sensitivity analyses. Furthermore, within-family analysis showed that children born by CD had 2.67-fold higher risk of overweight/obesity (95% CI 1.10 to 5.12) than their peers born vaginally.ConclusionChildren born by CD have higher average BMI z-scores and higher risk of overweight/obesity than children born vaginally. The consistency of these findings across multiple approaches to address potential residual confounding likely suggests a true biological effect.
Targeting Endoglin-Expressing Regulatory T Cells in the Tumor Microenvironment Enhances the Effect of PD1 Checkpoint Inhibitor Immunotherapy
Authors: Schoonderwoerd Mark J.A. , Koops Maaike F.M. , Angela Ricardo A. , Koolmoes Bryan , Toitou Melpomeni , Paauwe Madelon , Barnhoorn Marieke C. , Liu Yingmiao , Sier Cornelis F.M. , Hardwick James C.H. , Nixon Andrew B. , Theuer Charles P. , Fransen Marieke F. , Hawinkels Lukas J.A.C. 
Published: April 2020

Abstract

Purpose:
Endoglin is a coreceptor for TGFβ ligands that is highly expressed on proliferating endothelial cells and other cells in the tumor microenvironment. Clinical studies have noted increased programmed cell death (PD)-1 expression on cytotoxic T cells in the peripheral blood of patients with cancer treated with TRC105, an endoglin-targeting antibody. In this study, we investigated the combination of endoglin antibodies (TRC105 and M1043) with an anti-PD1 antibody.

Experimental Design:
The combination anti-endoglin/anti-PD1 antibodies was tested in four preclinical mouse models representing different stages of cancer development. To investigate the underlying mechanism, Fc-receptor–knockout mice were used complemented with depletion of multiple immune subsets in mice. Tumor growth and the composition of immune infiltrate were analyzed by flow cytometry. Finally, human colorectal cancer specimens were analyzed for presence of endoglin-expressing regulatory T cells (Treg).

Results:
In all models, the combination of endoglin antibody and PD1 inhibition produced durable tumor responses, leading to complete regressions in 30% to 40% of the mice. These effects were dependent on the presence of Fcγ receptors, indicating the involvement of antibody-dependent cytotoxic responses and the presence of CD8+ cytotoxic T cells and CD4+ Th cells. Interestingly, treatment with the endoglin antibody, TRC105, significantly decreased the number of intratumoral Tregs. Endoglin-expressing Tregs were also detected in human colorectal cancer specimens.

Conclusions:
Taken together, these data provide a rationale for combining TRC105 and anti-PD1 therapy and provide additional evidence of endoglin's immunomodulatory role.
The NSD2 p.E1099K Mutation Is Enriched at Relapse and Confers Drug Resistance in a Cell Context–Dependent Manner in Pediatric Acute Lymphoblastic Leukemia
Authors: Pierro Joanna , Saliba Jason , Narang Sonali , Sethia Gunjan , Saint Fleur-Lominy Shella , Chowdhury Ashfiyah , Qualls Anita , Fay Hannah , Kilberg Harrison L. , Moriyama Takaya , Fuller Tori J. , Teachey David T. , Schmiegelow Kjeld , Yang Jun J. , Loh Mignon L. , Brown Patrick A. , Zhang Jinghui , Ma Xiaotu , Tsirigos Aristotelis , Evensen Nikki A. , Carroll William L. 
Published: April 2020

Abstract

The NSD2 p.E1099K (EK) mutation is observed in 10% of acute lymphoblastic leukemia (ALL) samples with enrichment at relapse indicating a role in clonal evolution and drug resistance. To discover mechanisms that mediate clonal expansion, we engineered B-precursor ALL (B-ALL) cell lines (Reh, 697) to overexpress wildtype (WT) and EK NSD2, but observed no differences in proliferation, clonal growth, or chemosensitivity. To address whether NSD2 EK acts collaboratively with other pathways, we used short hairpin RNAs to knockdown expression of NSD2 in B-ALL cell lines heterozygous for NSD2 EK (RS4;11, RCH-ACV, SEM). Knockdown resulted in decreased proliferation in all lines, decreased clonal growth in RCH-ACV, and increased sensitivity to cytotoxic chemotherapeutic agents, although the pattern of drug sensitivity varied among cell lines implying that the oncogenic properties of NSD2 mutations are likely cell context specific and rely on cooperative pathways. Knockdown of both Type II and REIIBP EK isoforms had a greater impact than knockdown of Type II alone, suggesting that both SET containing EK isoforms contribute to phenotypic changes driving relapse. Furthermore, in vivo models using both cell lines and patient samples revealed dramatically enhanced proliferation of NSD2 EK compared with WT and reduced sensitivity to 6-mercaptopurine in the relapse sample relative to diagnosis. Finally, EK-mediated changes in chromatin state and transcriptional output differed dramatically among cell lines further supporting a cell context–specific role of NSD2 EK. These results demonstrate a unique role of NSD2 EK in mediating clonal fitness through pleiotropic mechanisms dependent on the genetic and epigenetic landscape.

Implications:
NSD2 EK mutation leads to drug resistance and a clonal advantage in childhood B-ALL.
Medial Femoral Condyle Periosteal Free Flap for the Treatment of Talus Avascular Necrosis
Authors: Saad Adam , Jimenez Megan L. , Rogero Ryan G. , Saad Sherif , Nakashian Michael N. , Winters Brian S. 
Published: April 2020

Background: In patients with avascular necrosis (AVN) of the talus in the precollapse stage unresponsive to conservative measures, joint preservation should be considered. Good results have previously been reported for vascularized bone grafting. The medial femoral condyle (MFC) free flap has recently been introduced, which consists of corticoperiosteal bone. We present a novel surgical technique using a periosteal-only MFC (pMFC) free flap in the treatment of talus AVN. Methods: We retrospectively reviewed all pMFC free flaps performed from 2016 to 2018 in the precollapse stage of talus AVN. Surgical management included an ankle arthroscopy, talus core decompression, and ipsilateral pMFC free flap to the talus. Foot and Ankle Ability Measure (FAAM)–Activities of Daily Living (ADL) and visual analog scale (VAS) pain scores were evaluated, and pre- and postoperative imaging studies were assessed by a musculoskeletal-trained radiologist for all patients. Six pMFC free flaps in 5 patients were included in this case series. AVN etiology included idiopathic, posttraumatic, and sepsis-related treatment. All patients were female with an average age of 44.2 (range, 37-67) years. Average postoperative follow-up was 16.9 (range, 6-28) months. Results: Pre- to postoperative FAAM-ADL, ADL single assessment numeric evaluation, and VAS scores showed statistically significant improvement ( P < .039). No reoperations or flap complications were observed. There was 1 minor complication, which included postoperative paresthesias at the pMFC harvest site. Postoperative x-rays showed no subsequent collapse, and magnetic resonance imaging (MRI) illustrated progressive improvement of bone marrow edema, decreased surrounding areas of AVN, and decreased joint effusion when compared to preoperative MRI. Conclusion: The pMFC free flap is a novel modification of a previously described technique, which appears to have similar results compared to the traditional MFC free flap. It was safe and effective in the short term with excellent clinical and radiographic outcomes. Level of Evidence: Level IV, case series.
Impact of clinical pharmacy services in a hematology/oncology ward in Morocco
Authors: Moukafih Badreddine , Abahssain Halima , Mrabti Hind , Errihani Hassan , Rahali Younes , Taoufik Jamal , Chaibi Aicha 
Published: April 2020

Background Clinical pharmacists are contributing to safe medication use by providing comprehensive management to patients and medical staff. The aim of this study is to document and evaluate the role of clinical pharmacy services in oncology department. Patients and methods A prospective, descriptive, observational study was carried out from July 2018 through June 2019 at the Department of Medical Oncology at the National Institute of Oncology, Morocco. Medication reviews concerning hospitalized adult cancer patients were performed every day by the clinical pharmacist assigned to the department. Results A total of 3542 prescriptions of 526 adult cancer patients were analyzed. The pharmacist identified 450 drug-related problems (12.7% of the prescriptions) primarily related to the analgesics (31.5%). Medication problems included mostly untreated indications (31.3%), overdosing (17.1%), drug–drug interactions (12.4%), underdosing (11.1%), administration omissions (6.7%), drug not indicated (6.0%), and contraindication (5.3%). Interventions ( n = 450) led to drug additions (30.7%), drug dosing adjustments (27.1%), treatment discontinuations (20.0%), recall of the treatment (6.2%), replacement of a drug with another one (5.1%), administration optimization (4.0%), therapeutic drug monitoring (3.1%), alternate routes of administration (2.5%), and extension of treatment duration (1.3%). Most (98%) of the interventions were accepted and implemented by the medical staff—172 (38.2%) having a significant clinical impact on the patient, 88 (19.6%) as having a very significant clinical impact, and 71(15.8%) as having a potential vital impact. Conclusion This work highlights the positive clinical relevance of pharmacists’ interventions in oncology and the importance of medicopharmaceutical collaboration to prevent medication error.
Efficacy of cyclic therapy with terpinen-4-ol in Demodex blepharitis
Authors: Evren Kemer Özlem , Karaca Emine Esra , Özek Dilay 
Published: April 2020

Purpose To describe the effectiveness of cyclic treatment with terpinen-4-ol, a tea tree oil component, on Demodex blepharitis. Methods The presence of Demodex was determined by eyelash rotation as proposed by Mastrota. Schirmer test, tear breakup time, ocular surface disease index, lid margin score, meibomian gland expressibility score, and Oxford grade were performed. Patients were advised to apply heat followed by terpinen-4-ol soaked wipes to eyelids twice a day for 2 weeks. At the end of 2 weeks, treatment was interrupted for 7–10 days. The same treatment was repeated once again. The patients were examined after the first and second cycle of treatment and after 1 year. Results There was a statistically significant improvement in Schirmer test (10.37 ± 4.73 and 13.13 ± 3.44 mm/5 min), tear breakup time (6.47 ± 3.31 and 7.6 ± 2.89 s), ocular surface disease index (47.94 ± 19.77 and 34.28 ± 13.40), lid margin score (3.2 ± 0.7 and 2.63 ± 0.71), meibomian gland expressibility scores (1.93 ± 0.64 and 1.4 ± 0.67), and Oxford grade (0.9 ± 0.8 and 0.5 ± 0.63) after the first cycle of treatment ( p < 0.05). The improvement in symptoms and tear function tests of the patients after the second cycle was significantly better than in pre-treatment levels. At 12-month follow-up, symptoms of two patients (93%) relapsed. Conclusion The administration of terpinen-4-ol to the eyelid margins in a cyclic manner in Demodex blepharitis is effective against adult and hatching Demodex and breaks the vicious cycle.
Choroidal vascularity index determined by binarization of enhanced depth imaging optical coherence tomography images in eyes with intermediate age-related macular degeneration
Authors: Ozcaliskan Sehnaz , Balci Sevcan , Yenerel Nursal Melda 
Published: April 2020

Purpose To evaluate choroidal structural changes in patients with intermediate age-related macular degeneration using choroidal vascularity index. Methods The eyes of patients with intermediate age-related macular degeneration and controls were evaluated with enhanced depth imaging optical coherence tomography images. Subfoveal choroidal area was segmented into luminal area and stromal area by the binarization technique on enhanced depth imaging optical coherence tomography images using ImageJ software. Choroidal vascularity index was defined as the ratio of luminal area to total circumscribed subfoveal choroidal area. Results Fifty-seven eyes with intermediate age-related macular degeneration and 60 healthy control eyes were included in the study. The choroidal vascularity index was computed as 59.53% ± 4.9% in the intermediate age-related macular degeneration group and as 62.7% ± 4.3% in the control group ( p = 0.002). Patients with age-related macular degeneration showed significantly lower values of stromal area and higher values of luminal area compared to control subjects (0.51 ± 0.22 vs 0.87 ± 0.21, p < 0.001 and 0.74 ± 0.22 vs 0.52 ± 0.18, p < 0.001, respectively). Conclusion Eyes with intermediate age-related macular degeneration demonstrated reduced choroidal vascularity index compared to healthy eyes. Choroidal vascularity index seems to be a potential non-invasive quantitative method for studying structural changes of the choroid in patients with intermediate age-related macular degeneration.