bluuebunny/crossref_metadata_2025_split huggingface dataset:
Positive Lymph Node Counts in American Thyroid Association Low‐Risk Papillary Thyroid Carcinoma Patients
Authors: Griffin Martha J. , Baik Fred M. , Brandwein‐Weber Margaret , Qazi Muhammad , Yue Lauren E. , Osorio Marcela , Urken Mark L. 
Published: February 2020

AbstractBackgroundCurrent American Thyroid Association (ATA) guidelines state that patients with intermediate‐risk papillary thyroid cancer (PTC) may benefit from remnant ablation. One criterion for intermediate‐risk classification is >5 positive lymph nodes (LNs). We investigate whether performing step‐sectioning of LNs increases the metastatic detection rate, thereby influencing ATA risk of recurrence (ROR) classification.MethodsA retrospective review was conducted of cases in which ≥ 5 LNs were removed during thyroidectomy and ≤5 LNs were found positive for PTC. Step‐sectioning was performed on the original tissue blocks. All slides were re‐reviewed by a senior pathologist.ResultsTwenty patients met study criteria. Step‐sectioning significantly increased LN yield compared to standard sectioning. In total, we found 12 new positive lymph nodes; seven (58%) were in totally new lymph nodes, while five (42%) were in lymph nodes previously read as negative. All newly discovered metastases were classified as micrometastases (≤2 mm). Of the 15 patients originally classified as low‐risk, the step‐sectioning protocol impacted two patients (13%), increasing ROR stratification.ConclusionIntensive step‐sectioning reveals additional micrometastases. More detailed analysis did not identify clinically significant nodal disease likely to impact the clinical course of patients in this study. Our study supports current standards of pathology specimen handling related to LN assessment and the impact on ATA ROR classification. Nonetheless, it is important for clinicians to understand their institution's sectioning protocol utilized to report positive and total LN counts, which could impact ATA risk stratification and denote the comprehensive nature of the LN dissection that was performed.
Surgery for Pheochromocytoma: A Single‐Center Review of 60 Cases from South Africa
Authors: Nel D. , Panieri E. , Malherbe F. , Steyn R. , Cairncross L. 
Published: February 2020

AbstractBackgroundThere is a paucity of data on the presentation and surgical management of pheochromocytoma in developing nations, particularly in Africa.MethodsThis study was a retrospective review, which included all patients managed by the Groote Schuur Hospital/University of Cape Town Endocrine Surgery unit for pheochromocytoma and abdominal paragangliomas, from January 2002 to June 2019.ResultsSixty patients were included in the study, of which 33% were male and 67% female. The mean age was 47 years (range 14–81). The median tumor size was 6 cm, with 45% larger than 6 cm. 92% were located in the adrenal gland (87% unilateral, 5% bilateral), and 8% were extra‐adrenal. The conversion rate for laparoscopic cases was 20%, with 55% of cases overall completed laparoscopically. Eleven patients with tumors > 6 cm were initially attempted laparoscopically, of which 3 were converted to open, without any associated increased morbidity. A major adverse event was recorded for 5 cases (8%), including 1 mortality. Overall morbidity, blood loss, operating time and hospital stay were all significantly reduced in the laparoscopic group. There were 5 patients with malignant disease (8%).ConclusionThis large series, from an established academic endocrine surgery unit in Africa, can serve as a benchmark for units with similar settings and resource limitations, to compare their surgical management and perioperative outcomes.
Serum Magnesium Measurements After Parathyroidectomy for Primary Hyperparathyroidism: Should It be Routine?
Authors: Novodvorsky Peter , Lowry Andrew F. , Lim C. Beverly B. , Balasubramanian Sabapathy P. 
Published: February 2020

AbstractBackgroundParathyroidectomy is the treatment of choice in primary hyperparathyroidism (PHPT). Following surgery, significant changes in bone and mineral metabolism may follow, but routine magnesium monitoring is not standard practice. The occurrence of significant clinical events linked to hypomagnesaemia in 3 patients after parathyroidectomy led to our evaluation of magnesium levels after surgery for PHPT.MethodsSerum magnesium levels before and after parathyroidectomy for PHPT were prospectively evaluated in a single centre over a year. The incidence and severity of hypomagnesaemia and its correlation with other biochemical variables were assessed.ResultsA total of 138 patients underwent parathyroidectomy for PHPT. Pre‐operative and day 1 post‐operative serum magnesium levels were available in 57/138 (41.3%) and 99/138 (71.7%) patients, respectively. Serum magnesium decreased significantly after surgery (mean ± SD of 0.85 ± 0.08 and 0.75 ± 0.11 mmol/L, respectively, p < 0.001). On the day after parathyroidectomy, 31/99 (31.3%) patients had hypomagnesaemia (<0.70 mmol/L); in 3 of whom it was severe (<0.50 mmol/L). Patients with hypomagnesaemia had lower pre‐operative magnesium (mean ± SD of 0.78 ± 0.06 and 0.87 ± 0.07 mmol/L, p < 0.001), higher pre‐operative calcium [median (IQR) of 2.83 (2.71–2.99) and 2.71 (2.63–2.80) mmol/L, p = 0.001] and higher post‐operative calcium [median (IQR) of 2.41 (2.30–2.51) and 2.35 (2.28–2.43) mmol/L, p = 0.046] compared to those with normomagnesaemia. In addition, these patients demonstrated higher drop in calcium levels after surgery (0.44 ± 0.20 and 0.35 ± 0.18 mmol/L, p = 0.033). Magnesium levels after surgery correlated positively with pre‐operative magnesium (r = 0.561, p < 0.001) and post‐operative PTH (r = 0.210, p = 0.037) and negatively with pre‐operative adjusted calcium (r = − 0.389, p < 0.001).ConclusionsSerum magnesium decreased significantly following parathyroidectomy for PHPT and nearly a third of patients developed post‐operative, mostly mild hypomagnesaemia. Whilst routine serum magnesium measurements could facilitate prompt recognition and treatment of this electrolyte disturbance, further research needs to establish the clinical importance of mild hypomagnesaemia in these clinical settings and, if indicated, to devise optimal treatment strategies.
Discordant nodal staging identifies intermediate-risk group for overall survival in patients with cT3 oesophageal adenocarcinoma
Authors: Carder Charles , Fielding Patrick , Roberts Ashley , Foley Kieran 
Published: February 2020

Abstract
Objectives
Oesophageal adenocarcinoma has a poor prognosis and relies on multi-modality assessment for accurate nodal staging. The aim of the study was to determine the prognostic significance of nodal concordance between PET/CT and EUS in oesophageal adenocarcinoma.

Methods
Consecutive patients with oesophageal adenocarcinoma staged between 2010 and 2016 were included. Groups comprising concordant node–negative (C−ve), discordant (DC), and concordant node–positive (C+ve) patients were analysed. Survival analysis using log-rank tests and Cox proportional hazards model was performed. The primary outcome was overall survival. A p value < 0.05 was considered statistically significant.

Results
In total, 310 patients (median age = 66.0; interquartile range 59.5–72.5, males = 264) were included. The median overall survival was 23.0 months (95% confidence intervals (CI) 18.73–27.29). There was a significant difference in overall survival between concordance groups (X2 = 44.91, df = 2, p < 0.001). The hazard ratios for overall survival of DC and C+ve patients compared with those of C−ve patients with cT3 tumours were 1.21 (95% CI 0.81–1.79) and 1.79 (95% CI 1.23–2.61), respectively. On multivariable analysis, nodal concordance was significantly and independently associated with overall survival (HR 1.44, 95% CI 1.12–1.83, p = 0.004) and performed better than age at diagnosis (HR 1.02, 95% CI 1.003–1.034, p = 0.016) and current cN-staging methods (HR 1.20, 95% CI 0.978–1.48, p = 0.080).

Conclusions
Patients with discordant nodal staging on PET/CT and EUS represent an intermediate-risk group for overall survival. This finding was consistent in patients with cT3 tumours. These findings will assist optimum treatment decisions based upon perceived prognosis for each patient.

Key Points
• Clinicians are commonly faced with results of discordant nodal staging in oesophageal adenocarcinoma.
• There is a significant difference in overall survival between patients with negative, discordant, and positive lymph node staging.
• Patients with discordant lymph node staging between imaging modalities represent an intermediate-risk group for overall survival.
Mirror patterns of physical variables in the ocean
Authors: Wang Gang , Qiao Fangli 
Published: February 2020

AbstractTemperature and salinity are independent thermodynamic variables of seawater. However, it was determined from monthly Argo data that the correlation coefficient between layer-averaged temperature and salinity (T–S) time series peaks at a depth of approximately 300 m. Meanwhile, T–S patterns around that depth are consistent. Therefore, this layer is named “T–S mirror layer”. Since the major feature of the T–S mirror layer is the high similarity of temperature and salinity patterns in it, spatial correlation should be a more direct way to determine it. Following this idea we introduce another kind of “T–S mirror layer”, which resides at 100–200 m in four sets of objectively analyzed ocean data products (WOA13, EN4, Ishii and Argo). The “T–S mirror layer” derived in this way couples with the quasi-linear “slender waist” in T–S scatter diagrams; and this coupling is typical in mid- and low-latitude oceans. The slender waist in T–S scatter diagram implies that the profiles of temperature and salinity are in phase around it. We can then give a first guess for the depth of mirror patterns of two variables just according to their local profiles. Hereby, we find mirror patterns between other variable pair (e.g., temperature and sound velocity), inverse mirror patterns (i.e. the highest spatial correlation between variable pair, e.g., temperature and density, are negative), and malposed mirror patterns (spatial correlation peaks for variable patterns in different layers). This work reveals a phenomenon that bridges horizontal patterns of variable pairs in the ocean to their vertical profiles.
The evolution process of warm season intense regional rainfall events in Yaan
Authors: Hu Xuelin , Yuan Weihua , Yu Rucong , Zhang Minghua 
Published: February 2020

AbstractAccurate simulation and prediction of intense precipitation events require better understanding of their physical mechanisms. This study uses Yaan—a place with regional maximum rainfall in central China—to investigate the cause and process of intense precipitation. Hourly rain gauge records and the new ERA5 reanalysis are used to characterize the evolution process of warm season intense regional rainfall events (RREs) in Yaan and its associated three-dimensional circulation. Results show that before the start of the Yaan intense RREs, moderate rainfall amount (frequency) appears northeast of the key region. The rainfall then moves southward in the following several hours along the eastern periphery of the Tibetan Plateau where it reaches peak. It then moves to and end up in the south and southeast Sichuan Basin. The progression of the RREs is found to be associated with a counter-clockwise rotation of anomalous surface winds associated with a developing mesoscale surface low-pressure center, which is further associated with the southeastward progression of a large-scale synoptic scale wave. The easterly phase of the winds in the counter-clockwise rotation causes upslope motion perpendicularly toward the terrain that leads to maximum rainfall. The findings illustrate how large-scale circulations, mesoscale systems, and specific topographic features interact to create the RREs evolution in Yaan.
A positive influence of basal ganglia iron concentration on implicit sequence learning
Authors: Persson Jonas , Garzón Benjamín , Sitnikov Rouslan , Bäckman Lars , Kalpouzos Grégoria 
Published: February 2020

AbstractIron homeostasis is important for maintaining normal physiological brain functioning. In two independent samples, we investigate the link between iron concentration in the basal ganglia (BG) and implicit sequence learning (ISL). In Study 1, we used quantitative susceptibility mapping and task-related fMRI to examine associations among regional iron concentration measurements, brain activation, and ISL in younger and older adults. In Study 2, we examined the link between brain iron and ISL using a metric derived from fMRI in an age-homogenous sample of older adults. Three main findings were obtained. First, BG iron concentration was positively related to ISL in both studies. Second, ISL was robust for both younger and older adults, and performance-related activation was found in fronto-striatal regions across both age groups. Third, BG iron was positively linked to task-related BOLD signal in fronto-striatal regions. This is the first study investigating the relationship among brain iron accumulation, functional brain activation, and ISL, and the results suggest that higher brain iron concentration may be linked to better neurocognitive functioning in this particular task.
A good career start can open doors: the plusses and minuses of an international graduate student program—a student’s perspective
Authors: Malik Anchal 
Published: February 2020

AbstractThere are many Ph.D. programs from various funding agencies that provide excellent starts to a scientific career. Multinational Ph.D. positions attract students because they provide students with much-required exposure to the international scientific community at an early stage of the career. For this reason, multinational Ph.D. positions can be considered as a better career opportunity over Ph.D. positions confined to a single country. In addition, these multidisciplinary research programs connect different organizations to deal with the problems of global interest. One of these multi-disciplinary research programs is the viral and bacterial adhesion network training-innovative training network (ViBrANT). ViBrANT is a multifaceted platform that develops the required skillsets in young researchers and thereby also contributes to building a multidisciplinary research community. Is this the only parameter to be considered or are there other factors that can also stimulate one’s career development? In this perspective article, I will discuss the key reasons why I chose a multinational Ph.D. program along with the merits of being part of ViBrANT. I also discuss the challenges I faced while moving from India to the United Kingdom.
Human genetics of leishmania infections
Authors: Blackwell Jenefer M. , Fakiola Michaela , Castellucci Léa C. 
Published: February 2020

AbstractIdentifying genetic risk factors for parasitic infections such as the leishmaniases could provide important leads for improved therapies and vaccines. Until recently most genetic studies of human leishmaniasis were underpowered and/or not replicated. Here, we focus on recent genome-wide association studies of visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL). For VL, analysis across 2287 cases and 2692 controls from three cohorts identified a single major peak of genome-wide significance (Pcombined = 2.76 × 10–17) at HLA-DRB1–HLA-DQA1. HLA-DRB1*1501 and DRB1*1404/DRB1*1301 were the most significant protective versus risk alleles, respectively, with specific residues at amino acid positions 11 and 13 unique to protective alleles. Epitope-binding studies showed higher frequency of basic AAs in DRB1*1404-/*1301-specific epitopes compared to hydrophobic and polar AAs in DRB1*1501-specific epitopes at anchor residues P4 and P6 which interact with residues at DRB1 positions 11 and 13. For CL, genome-wide significance was not achieved in combined analysis of 2066 cases and 2046 controls across 2 cohorts. Rather, multiple top hits at P < 5 × 10–5 were observed, amongst which IFNG-AS1 was of specific interest as a non-coding anti-sense RNA known to influence responses to pathogens by increasing IFN-γ secretion. Association at LAMP3 encoding dendritic cell lysosomal associated membrane protein 3 was also interesting. LAMP3 increases markedly upon activation of dendritic cells, localizing to the MHC Class II compartment immediately prior to translocation of Class II to the cell surface. Together these GWAS results provide firm confirmation for the importance of antigen presentation and the regulation of IFNγ in determining the outcome of Leishmania infections.
Technological and Societal Changes and Their Impacts on Resource Production and Use
Authors: Grubler Arnulf 
Published: February 2020

AbstractThe traditional narrative of continued economic growth driven by development aspirations towards material-intensive lifestyles and associated ever larger extraction and use of resources is contrasted with an alternative perspective. This alternative may lead to much lower growth, even to a “de-growth” of biogenic, energetic, and mineral resources. Disruptive innovations, above all digitalization, combined with changing consumer preferences and lifestyles as well as public policies to address climate change could challenge traditional business models and forms of service provision. Examples of such disruptive innovations in the domains of digital convergence and the sharing economy are given with their potential implications on resource use. Two contrasting scenarios, quantified to 2050, illustrate the wide divergence of potential developments in resource extraction and use over the coming decades.
Die Beprobung von Jahresschmutzfrachten in einem Mischwasser- und einem Niederschlagswasserkanal bei Regenwetter
Authors: Gruber Günter , Pichler Markus , Hofer Thomas , Maier Roman , Clara Manfred 
Published: February 2020

ZusammenfassungNiederschlagswasser- und Mischwassereinleitungen können für einige Spurenstoffe aus dem urbanen Bereich der dominierende Eintragspfad in die Gewässer sein. Im Rahmen eines österreichischen Forschungsprojekts wurden an einer Niederschlagswasserkanaleinleitungsstelle in ein Gewässer sowie an einem Mischwasserüberlauf zwei mengenproportionale Jahresmischproben generiert, um die daraus resultierenden ein- bzw. abgeleiteten Jahresschmutzfrachten an Spurenstoffen zum einen messtechnisch zu bestimmen und zum anderen nach einer detaillierten Analyse der Oberflächenbeschaffenheiten in den Einzugsgebieten und entsprechenden Stoffflussanalysen theoretisch ermittelbaren Stofffrachtpotenzialen aus der Literatur gegenüberzustellen. Die dafür gewählte Probenahmestrategie, die dabei gesammelten Erfahrungen bei der Probenahme und die erzielten Ergebnisse aus den Beprobungen werden im Beitrag beschrieben und diskutiert.
Modeling the capacitated p-cable trench problem with facility costs
Authors: Schwarze Silvia , Lalla-Ruiz Eduardo , Voß Stefan 
Published: February 2020

AbstractIn this work, two network design concepts which have been proven to be relevant with respect to telecommunication applications, are joined within a unified approach. First, the cable trench problem searches for cost-minimizing network structures that take into account two types of edge costs appearing in the installation of wire-based networks, namely trenching costs and cable costs. Second, the facility location problem considers the placement of shared telecommunication equipment, like switches or concentrators, together with an assignment of entities to demand nodes. Following practical needs, we join these concepts within the new capacitated cable trench problem with facility costs and service capacity in terms of number of customers that can be served by facilities. Within this setting, facility location decisions in wire-based networks can be taken under a more realistic cost scenario. A mixed-integer linear program and valid inequalities are proposed. Experiments indicate a positive impact of the valid inequalities on computational time and integrality gap.
Classical Schwarz reflection principle for Jenkins–Serrin type minimal surfaces
Authors: Sa Earp Ricardo , Toubiana Eric 
Published: February 2020

AbstractWe give a proof of the classical Schwarz reflection principle for Jenkins–Serrin type minimal surfaces in the homogeneous three manifolds $$\mathbb E(\kappa ,\tau )$$E(κ,τ) for $$\kappa \leqslant 0$$κ⩽0 and $$\tau \geqslant 0$$τ⩾0. In our previous paper, we proved a reflection principle in Riemannian manifolds. The statements and techniques in the two papers are distinct.
Seasonal variability of sediment controls of nitrogen cycling in an agricultural stream
Authors: Comer-Warner Sophie A. , Gooddy Daren C. , Ullah Sami , Glover Luke , Kettridge Nicholas , Wexler Sarah K. , Kaiser Jan , Krause Stefan 
Published: February 2020

AbstractAgricultural streams receive large inputs of nutrients, such as nitrate (NO3−) and ammonium (NH4+), which impact water quality and stream health. Streambed sediments are hotspots of biogeochemical reactivity, characterised by high rates of nutrient attenuation and denitrification. High concentrations of nitrous oxide (N2O) previously observed in stream sediments point to incomplete denitrification, with sediments acting as a potentially significant source of global N2O. We investigated the effect of sediment type and seasonal variation on denitrification and N2O production in the streambed of an agricultural UK stream. Denitrification was strongly controlled by sediment type, with sand-dominated sediments exhibiting potential rates of denitrification almost 10 times higher than those observed in gravel-dominated sediments (0.026 ± 0.004 N2O–N μg g−1 h−1 for sand-dominated and 0.003 ± 0.003 N2O–N μg g−1 h−1 for gravel-dominated). In-situ measurements supported this finding, with higher concentrations of NO3−, nitrite (NO2−) and N2O observed in the porewaters of gravel-dominated sediments. Denitrification varied substantially between seasons, with denitrification increasing from winter to autumn. Our results indicate highest NO3− reduction occurred in sand-dominated sediments whilst highest N2O concentrations occurred in gravel-dominated sediments. This suggests that finer-grained streambeds could play an important role in removing excess nitrogen from agricultural catchments without producing excess N2O.