bluuebunny/crossref_metadata_2025_split huggingface dataset:
Viscous dark energy accretion activities : sonic speed, angular momentum and Mach number studies
Authors: Dutta Sandip , Biswas Promila , Biswas Ritabrata 
Published: April 2021

AbstractIn this present article, we study different accretion properties regarding viscous accretion of dark energy. Modified Chaplygin gas is chosen as the dark energy candidate. Viscosity is encountered with the help of Shakura–Sunyaev viscosity parameter. We study sonic speed vs radial distance curves. We compare between adiabatic and dark energy dominated cases and follow that sonic speed falls as we go nearer to the central gravitating object. As viscosity is imposed, a threshold drop in accretion sonic speed is followed. Average rate of fall in accretion sonic speed is increased with black hole’s spin. This is signifying that this kind of accretion is weakening the overall matter/energy infall. Specific angular momentum to Keplerian angular momentum ratio is found to fall as we go far from the black hole. Accretion Mach number turns high as we go towards the inner region and high wind Mach number is not allowed as we are going out. Combining, we conclude that the system weakens the feeding process of accretion.
The Real Economic Dimensions of Climate Change
Authors: Warner Koko , Zommers Zinta , Wreford Anita 
Published: April 2021

The impacts of COVID-19 and efforts to stimulate recovery from the pandemic have highlighted the need for information about how disasters affect the real economy: temporal and spatial dynamics, cascading risks of disruption to employment, debt, trade, investments, bond markets, and real estate markets, among others. This commentary explores what information on the economic dimensions of climate change is needed to inform decisions about adapting to and effectively averting, minimizing, and addressing climate risks. We review the economic information presented in special reports from the IPCC AR6 cycle (SR1.5, SROCC, and SRCCL). We find that the information presented in these reports expands beyond costs of mitigation options, and potential negative GDP effects of climate impacts to include real economic dimensions in food production and land use (forestry and agriculture), coastal areas and fisheries, among others. This reflects an emerging literature which addresses a wider spectrum of economic and financial aspects relevant to climate change and national and regional priorities. Five emerging areas of work related to climate impacts on the real economy and on financial services provide essential additional information for decisions about efforts at all levels to achieve the objectives of the Paris Agreement and the overall objective of the UNFCCC Convention. Insights from economic analysis of the coronavirus pandemic—a sustained, complex disaster with global consequences across the real economy and financial services—can help highlight useful areas of research and discussion for policy makers considering climate impacts, vulnerabilities, and risks.
Exploring Lightweight Interventions at Posting Time to Reduce the Sharing of Misinformation on Social Media
Authors: Jahanbakhsh Farnaz , Zhang Amy X. , Berinsky Adam J. , Pennycook Gordon , Rand David G. , Karger David R. 
Published: April 2021

When users on social media share content without considering its veracity, they may unwittingly be spreading misinformation. In this work, we investigate the design of lightweight interventions that nudge users to assess the accuracy of information as they share it. Such assessment may deter users from posting misinformation in the first place, and their assessments may also provide useful guidance to friends aiming to assess those posts themselves.
In support of lightweight assessment, we first develop a taxonomy of the reasons why people believe a news claim is or is not true; this taxonomy yields a checklist that can be used at posting time. We conduct evaluations to demonstrate that the checklist is an accurate and comprehensive encapsulation of people's free-response rationales.
In a second experiment, we study the effects of three behavioral nudges---1) checkboxes indicating whether headings are accurate, 2) tagging reasons (from our taxonomy) that a post is accurate via a checklist and 3) providing free-text rationales for why a headline is or is not accurate---on people's intention of sharing the headline on social media. From an experiment with 1668 participants, we find that both providing accuracy assessment and rationale reduce the sharing of false content. They also reduce the sharing of true content, but to a lesser degree that yields an overall decrease in the fraction of shared content that is false.
Our findings have implications for designing social media and news sharing platforms that draw from richer signals of content credibility contributed by users. In addition, our validated taxonomy can be used by platforms and researchers as a way to gather rationales in an easier fashion than free-response.
Implant Prosthodontic Rehabilitation after Surgical Treatment for an Oropharyngeal Malignant Tumour Using Tantalum Dental Implants
Authors: Vuletić Marko , Pelivan Ivica , Gabrić Dragana 
Published: April 2021

Oropharyngeal cancer (OPC) represents a significant portion of head and neck cancers. In most cases, it is localised in the soft palate, lingual and palatine tonsils, base of the tongue, and the surrounding tissues. Alcohol and tobacco exposure are well-known evidence-based risk factors for developing OPC; however, over the last decade, there has been a rapid increase in OPC linked to human papillomavirus (HPV). Dental implant therapy faces many challenges related to immediate and long-term success, and patients who are rehabilitated with implant prosthodontic therapy often have numerous comorbidities. Tantalum is a rare transitional metal element which has high corrosion resistance and is extremely inert. Porous tantalum trabecular metal (PTTM) has high volumetric porosity, a low modulus of elasticity, and very high friction. PTTM implant surface enhancement allows “osseoincorporation,” which means the neovascularisation and formation of new bone directly onto the implant. A 65-year-old patient presented to the Department of Oral Surgery of Clinical Hospital Centre Zagreb after resection of the mandible due to OPC had oral rehabilitation. Three Zimmer Biomet Trabecular Metal™ implants (

4.1
×
10

mm

) were inserted in the area of lower left first incisor, lower left second premolar, and lower right second premolar, and after four months, a new upper partial denture and the bar-retained mandibular overdenture were made. Implant prosthodontic rehabilitation of head and neck cancer patients is usually challenging in terms of achieving an improvement in its main aim, quality of life; however, today it is a safe and reliable therapy. Although radiation therapy may negatively affect the patient’s oral condition and influence the short- and long-term success of the implant, the presented case report showed that the excellent properties of PTTM-enhanced dental implants may give great basis for future comparative researches of using these implants in the treatment of oncologic patients.
Prediction of Genotype Positivity in Patients With Hypertrophic Cardiomyopathy Using Machine Learning
Authors: Liang Lusha W. , Fifer Michael A. , Hasegawa Kohei , Maurer Mathew S. , Reilly Muredach P. , Shimada Yuichi J. 
Published: April 2021

Background:
Genetic testing can determine family screening strategies and has prognostic and diagnostic value in hypertrophic cardiomyopathy (HCM). However, it can also pose a significant psychosocial burden. Conventional scoring systems offer modest ability to predict genotype positivity. The aim of our study was to develop a novel prediction model for genotype positivity in patients with HCM by applying machine learning (ML) algorithms.

Methods:
We constructed 3 ML models using readily available clinical and cardiac imaging data of 102 patients from Columbia University with HCM who had undergone genetic testing (the training set). We validated model performance on 76 patients with HCM from Massachusetts General Hospital (the test set). Within the test set, we compared the area under the receiver operating characteristic curves (AUROCs) for the ML models against the AUROCs generated by the Toronto HCM Genotype Score (the Toronto score) and Mayo HCM Genotype Predictor (the Mayo score) using the Delong test and net reclassification improvement.

Results:

Overall, 63 of the 178 patients (35%) were genotype positive. The random forest ML model developed in the training set demonstrated an AUROC of 0.92 (95% CI, 0.85–0.99) in predicting genotype positivity in the test set, significantly outperforming the Toronto score (AUROC, 0.77 [95% CI, 0.65–0.90],
P
=0.004, net reclassification improvement:
P
<0.001) and the Mayo score (AUROC, 0.79 [95% CI, 0.67–0.92],
P
=0.01, net reclassification improvement:
P
=0.001). The gradient boosted decision tree ML model also achieved significant net reclassification improvement over the Toronto score (
P
<0.001) and the Mayo score (
P
=0.03), with an AUROC of 0.87 (95% CI, 0.75–0.99). Compared with the Toronto and Mayo scores, all 3 ML models had higher sensitivity, positive predictive value, and negative predictive value.

Conclusions:
Our ML models demonstrated a superior ability to predict genotype positivity in patients with HCM compared with conventional scoring systems in an external validation test set.
Clinical Implications of Monogenic Versus Polygenic Hypercholesterolemia: Long‐Term Response to Treatment, Coronary Atherosclerosis Burden, and Cardiovascular Events
Authors: D’Erasmo Laura , Minicocci Ilenia , Di Costanzo Alessia , Pigna Giovanni , Commodari Daniela , Ceci Fabrizio , Montali Anna , Brancato Francesca , Stanca Ilaria , Nicolucci Antonio , Ascione Andrea , Galea Nicola , Carbone Iacopo , Francone Marco , Maranghi Marianna , Arca Marcello 
Published: April 2021

Background
Familial hypercholesterolemia (FH) may arise from deleterious monogenic variants in FH‐causing genes as well as from a polygenic cause. We evaluated the relationships between monogenic FH and polygenic hypercholesterolemia in influencing the long‐term response to therapy and the risk of atherosclerosis.

Methods and Results

A cohort of 370 patients with clinically diagnosed FH were screened for monogenic mutations and a low‐density lipoprotein‐rising genetic risk score >0.69 to identify polygenic cause. Medical records were reviewed to estimate the response to lipid‐lowering therapies and the occurrence of major atherosclerotic cardiovascular events during a median follow‐up of 31.0 months. A subgroup of patients (n=119) also underwent coronary computed tomographic angiography for the evaluation of coronary artery calcium score and severity of coronary stenosis as compared with 135 controls. Two hundred nine (56.5%) patients with hypercholesterolemia were classified as monogenic (FH/M+), 89 (24.1%) as polygenic, and 72 (19.5%) genetically undefined (FH/M−). The response to lipid‐lowering therapy was poorest in monogenic, whereas it was comparable in patients with polygenic hypercholesterolemia and genetically undetermined. Mean coronary artery calcium score and the prevalence of coronary artery calcium >100 units were significantly higher in FH/M+ as compared with both FH/M− and controls. Finally, after adjustments for confounders, we observed a 5‐fold higher risk of incident major atherosclerotic cardiovascular events in FH/M+ (hazard ratio, 4.8; 95% CI, 1.06–21.36;
P
adj
=0.041).

Conclusions
Monogenic cause of FH is associated with lower response to conventional cholesterol‐lowering therapies as well as with increased burden of coronary atherosclerosis and risk of atherosclerotic‐related events. Genetic testing for hypercholesterolemia is helpful in providing important prognostic information.
X-DC: Explainable Deep Clustering Based on Learnable Spectrogram Templates
Authors: Watanabe Chihiro , Kameoka Hirokazu 
Published: April 2021

Abstract
Deep neural networks (DNNs) have achieved substantial predictive performance in various speech processing tasks. Particularly, it has been shown that a monaural speech separation task can be successfully solved with a DNN-based method called deep clustering (DC), which uses a DNN to describe the process of assigning a continuous vector to each time-frequency (TF) bin and measure how likely each pair of TF bins is to be dominated by the same speaker. In DC, the DNN is trained so that the embedding vectors for the TF bins dominated by the same speaker are forced to get close to each other. One concern regarding DC is that the embedding process described by a DNN has a black-box structure, which is usually very hard to interpret. The potential weakness owing to the noninterpretable black box structure is that it lacks the flexibility of addressing the mismatch between training and test conditions (caused by reverberation, for instance). To overcome this limitation, in this letter, we propose the concept of explainable deep clustering (X-DC), whose network architecture can be interpreted as a process of fitting learnable spectrogram templates to an input spectrogram followed by Wiener filtering. During training, the elements of the spectrogram templates and their activations are constrained to be nonnegative, which facilitates the sparsity of their values and thus improves interpretability. The main advantage of this framework is that it naturally allows us to incorporate a model adaptation mechanism into the network thanks to its physically interpretable structure. We experimentally show that the proposed X-DC enables us to visualize and understand the clues for the model to determine the embedding vectors while achieving speech separation performance comparable to that of the original DC models.
Mums Go Online: Is the Internet Changing the Demand for Health Care?
Authors: Amaral-Garcia Sofia , Nardotto Mattia , Propper Carol , Valletti Tommaso 
Published: April 2021

Abstract
We study the effect of Internet diffusion on childbirth procedures performed in England between 2000 and 2011. We show that broadband Internet access increased cesarean sections (C-sections): mothers living in areas with better Internet access are 2.5% more likely to obtain a C-section. The effect is driven by first-time mothers who are 6% more likely to obtain a C-section. The increased C-section rate is not accompanied by changes in health care outcomes; thus health care costs increased with no corresponding medical benefits. We show evidence documenting the growing importance of the Internet as a source of health-related information.
Diplomatic Immunity Ratione Materiae and Crimes in International Law
Authors: Shi Xinxiang 
Published: April 2021

Abstract
Diplomatic immunity ratione materiae covers not official acts in general but merely acts performed in the exercise of diplomatic functions. Consequently, crimes in international law cannot be protected by this immunity because Article 3(1) of the Vienne Convention on Diplomatic Relations (vcdr) in general should accord with international law, although certain functions under the Article do not contain a ‘legal’ element. Further, diplomatic immunity ratione materiae cannot be upheld for jus cogens violations because Article 3(1) must not contradict a jus cogens prohibition. The dividing line between the procedural rule of immunity and the substantive rule of jus cogens is blurred by the fact that the scope of diplomatic immunity ratione materiae essentially hinges upon the contents a substantive treaty provision setting out diplomatic functions.
How I incorporate novel agents into the treatment of classical Hodgkin lymphoma
Authors: Epperla Narendranath , Herrera Alex F. 
Published: April 2021

Abstract
The introduction of targeted immunotherapies specifically, brentuximab vedotin (BV) and programmed death-1 (PD-1)–blocking antibodies (nivolumab and pembrolizumab), has reshaped the therapeutic landscape of classical Hodgkin lymphoma (cHL) in the past decade. Targeting specific biologic features of cHL, these novel agents have expanded treatment options for patients with multiply R/R cHL and have increasingly been studied at earlier points in a patient’s disease course. With the plethora of studies evaluating BV and PD-1 blockade as part of cHL therapy, often in nonrandomized, controlled studies, more questions than answers have arisen about how to optimally integrate these drugs into clinical practice. In this article, we use a case-based format to offer practical guidance on how we incorporate BV and anti-PD-1 antibodies into the management of cHL and review the data supporting those recommendations.
Caplacizumab prevents refractoriness and mortality in acquired thrombotic thrombocytopenic purpura: integrated analysis
Authors: Peyvandi Flora , Cataland Spero , Scully Marie , Coppo Paul , Knoebl Paul , Kremer Hovinga Johanna A. , Metjian Ara , de la Rubia Javier , Pavenski Katerina , Minkue Mi Edou Jessica , De Winter Hilde , Callewaert Filip 
Published: April 2021

AbstractThe efficacy and safety of caplacizumab in individuals with acquired thrombotic thrombocytopenic purpura (aTTP) have been established in the phase 2 TITAN and phase 3 HERCULES trials. Integrated analysis of data from both trials was conducted to increase statistical power for assessing treatment differences in efficacy and safety outcomes. Caplacizumab was associated with a significant reduction in the number of deaths (0 vs 4; P &lt; .05) and a significantly lower incidence of refractory TTP (0 vs 8; P &lt; .05) vs placebo during the treatment period. Consistent with the individual trials, treatment with caplacizumab resulted in a faster time to platelet count response (hazard ratio, 1.65; P &lt; .001), a 72.6% reduction in the proportion of patients with the composite end point of TTP-related death, TTP exacerbation, or occurrence of at least 1 treatment-emergent major thromboembolic event during the treatment period (13.0% vs 47.3%; P &lt; .001), and a 33.3% reduction in the median number of therapeutic plasma exchange days (5.0 vs 7.5 days) vs placebo. No new safety signals were identified; mild mucocutaneous bleeding was the main safety finding. This integrated analysis provided new evidence that caplacizumab prevents mortality and refractory disease in acquired TTP and strengthened individual trial findings, with a confirmed favorable safety and tolerability profile. These trials were registered at www.clinicaltrials.gov as #NCT01151423 and #NCT02553317.
Potent preclinical activity of HexaBody-DR5/DR5 in relapsed and/or refractory multiple myeloma
Authors: van der Horst Hilma J. , Gelderloos Anne T. , Chamuleau Martine E. D. , Breij Esther C. W. , Zweegman Sonja , Nijhof Inger S. , Overdijk Marije B. , Mutis Tuna 
Published: April 2021

AbstractApoptosis induction by death receptor (DR)-specific agonistic antibodies is a potentially effective antitumor therapy. Nonetheless, to date, all conventional DR-targeting antibodies that induce apoptosis via FcγR-dependent DR clustering failed to show clinical efficacy. HexaBody-DR5/DR5 (GEN1029) has been developed to overcome full FcγR dependence. HexaBody-DR5/DR5 is a mixture of 2 noncompeting DR5-specific immunoglobulin G1 (IgG1) antibodies, each with an E430G mutation in the Fc domain. This mutation enhances Fc-Fc interactions, resulting in antibody hexamerization, followed by FcγR-independent clustering of DR5 molecules. This unique combination of dual epitope targeting and increased IgG hexamerization resulted in potent preclinical antitumor activity in various solid cancers. In this study, we explored the preclinical activity of HexaBody-DR5/DR5 in multiple myeloma (MM), because MM cells are known to express DR5. In bone marrow samples from 48 MM patients, HexaBody-DR5/DR5 induced potent cytotoxicity of primary MM cells. Importantly, HexaBody-DR5/DR5 mediated the highest cytotoxic activity in samples from relapsed/refractory MM patients, including those who are refractory to daratumumab. This improved cytotoxic activity was observed only in patients who received their last anti-MM treatment &lt;1 month ago, suggesting that anti-MM drugs sensitized MM cells to HexaBody-DR5/DR5. Supporting this, bortezomib combined with HexaBody-DR5/DR5 synergistically increased cytotoxicity in MM cells in 7 of 11 newly diagnosed patients. Lenalidomide also synergized with HexaBody-DR5/DR5, but only via its immunomodulatory effects, presumably by enhancing the antibody-dependent cellular cytotoxicity activity of HexaBody-DR5/DR5. Daratumumab showed additive effects when combined with HexaBody-DR5/DR5. In conclusion, the results of this preclinical study indicate a therapeutic potential for HexaBody-DR5/DR5, especially in recently treated relapsed/refractory MM patients.
Efficacy and safety of prophylactic high-dose MTX in high-risk DLBCL: a treatment intent–based analysis
Authors: Jeong Hyehyun , Cho Hyungwoo , Kim Hyeyeong , Chae Heejung , Lee Jung-Bok , Lee Kyoungmin , Kim Shin , Lee Sang-wook , Ryu Jin-Sook , Kim Kyung Won , Chae Eun Jin , Huh Jooryung , Park Chan-Sik , Yoon Dok Hyun , Suh Cheolwon 
Published: April 2021

Abstract
Despite central nervous system (CNS) relapse occurring in &gt;10% of high-risk diffuse large B-cell lymphoma (DLBCL) patients, the role of CNS-directed prophylaxis is controversial in the absence of randomized controlled trials. In this retrospective study, we aimed to evaluate the safety and efficacy of prophylactic high-dose methotrexate (HD-MTX) on CNS relapse and survival outcomes in 258 newly diagnosed R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)–treated high-risk DLBCL patients, based on the initial treatment intent (ITT) of the physician on the use of prophylactic HD-MTX. Patients were classified into an ITT HD-MTX group (n = 128) and a non-ITT HD-MTX group (n = 130). The CNS relapse rate was not significantly different between these groups, with 2-year CNS relapse rates of 12.4% and 13.9%, respectively (P = 0.96). Three-year progression-free survival and overall survival rates in the ITT HD-MTX and non-ITT HD-MTX groups were 62.4% vs 64.5% (P = 0.94) and 71.7% vs 71.4% (P = 0.7), respectively. Also, propensity score–matched analyses showed no significant differences in the time-to-CNS-relapse, progression-free survival, or overall survival. The ITT HD-MTX group showed a higher incidence of grade ≥ 3 oral mucositis and elevated alanine aminotransferase. Prophylactic HD-MTX does not improve CNS relapse rate or survival outcomes in high-risk DLBCL patients, and it is accompanied by increased toxicities.
Activity of blinatumomab in lymphoblastic leukemia with impaired T-cell immunity due to congenital immunodeficiency
Authors: Ramdeny Sandheeah , Chaudhary Asima , Worth Austen , Ghorashian Sara , Slatter Mary , Lum Su Han , Vora Ajay 
Published: April 2021

Abstract
Blinatumomab, a single-chain, bispecific, T-cell–engaging antibody targeting CD19, is effective in B-precursor acute lymphoblastic leukemia (BCP-ALL), even in the context of chemotherapy-related partial T-cell immunodeficiency. We report 2 patients with BCP-ALL and congenital T-cell immunodeficiency, who obtained an excellent response to blinatumomab. The first, a 6-year-old girl with Schimke immuno-osseous dysplasia (SIOD) and combined immunodeficiency disorder (CID) obtained a minimum residual disease–negative (MRD−) remission of high hyperdiploid BCP-ALL with blinatumomab. At last follow-up, the remission had been sustained for 14 months from diagnosis. The second was a 9-year-old boy with Omenn syndrome and CID who received a mismatched bone marrow transplant from his mother at the age of 4 months and was diagnosed with t(3;11)+ (KMT2A-LARS2) BCP-ALL 9 years after his transplant. He received a 4-drug induction followed by blinatumomab for persistent MRD as a chemotherapy-sparing bridge to transplant and achieved an MRD− remission. T-lymphopenia, whether congenital or acquired, does not compromise the efficacy of blinatumomab.