A jigsaw puzzle framework for homogenization of high porosity foams

An approach to homogenization of high porosity metallic foams is explored. The emphasis is on the \Alporas{} foam and its representation by means of two-dimensional wire-frame models. The guaranteed upper and lower bounds on the effective properties are derived by the first-order homogenization with the uniform and minimal kinematic boundary conditions at heart. This is combined with the method of Wang tilings to generate sufficiently large material samples along with their finite element discretization. The obtained results are compared to experimental and numerical data available in literature and the suitability of the two-dimensional setting itself is discussed.Comment: 11 pages, 7 figures, 3 table

Task interference and distraction efficacy in patients with fibromyalgia: an experimental investigation

Pain has the capacity to interfere with daily tasks. Although task interference by pain is largely unintentional, it can be controlled to a certain extent. Such top-down control over pain has been thought to be reduced in fibromyalgia patients. In this study, we investigated task interference and distraction efficacy in fibromyalgia patients (FM) and a matched healthy control group. Forty-nine fibromyalgia patients and 49 heathy volunteers performed as quickly as possible (a) a visual localization task in the presence of non-painful vibrating or painful electric somatic stimuli, and (b) a somatosensory localization task (using non-painful or painful stimuli). Participants reported on their experience of the somatic stimuli on some of the trials during both localisation tasks. Results indicated that pain interferes with performance of the visual task, in both FM patients and healthy individuals. Furthermore, participants experienced the pain stimulus as less intense when directing attention away from the pain than when focusing on the pain. Overall, task performance of FM patients was slower compared to the task performance in the healthy control group. In contrast to our hypotheses, FM patients and healthy volunteers did not differ in the magnitude of the interference effect and distraction-efficacy. In conclusion, current study provides support for contemporary theories claiming that attention modulates the experience of pain and vice versa. However, no evidence was however found for an altered attentional processing of pain in fibromyalgia patients. Furthermore, results indicate that task interference and distraction-efficacy are not just two sides of the same coin

Targeted molecular analysis in adrenocortical carcinomas: a strategy towards improved personalized prognostication

Context: Adrenocortical carcinoma (ACC) has a heterogeneous prognosis, and current medical therapies have limited efficacy in its advanced stages. Genome-wide multiomics studies identified molecular patterns associated with clinical outcome. Objective: Here, we aimed at identifying a molecular signature useful for both personalized prognostic stratification and druggable targets, using methods applicable in clinical routine. Design: In total, 117 tumor samples from 107 patients with ACC were analyzed. Targeted next-generation sequencing of 160 genes and pyrosequencing of 4 genes were applied to formalin-fixed, paraffin-embedded (FFPE) specimens to detect point mutations, copy number alterations, and promoter region methylation. Molecular results were combined with clinical/histopathological parameters (tumor stage, age, symptoms, resection status, and Ki-67) to predict progression-free survival (PFS). Results: In addition to known driver mutations, we detected recurrent alterations in genes not previously associated with ACC (e.g., NOTCH1, CIC, KDM6A, BRCA1, BRCA2). Best prediction of PFS was obtained integrating molecular results (more than one somatic mutation, alterations in Wnt/beta-catenin and p53 pathways, high methylation pattern) and clinical/histopathological parameters into a combined score (P <0.0001, chi(2) = 68.6). Accuracy of prediction for early disease progress was 83.3% (area under the receiver operating characteristic curve: 0.872, 95% confidence interval 0.80 to 0.94). Furthermore, 17 potentially targetable alterations were found in 64 patients (e.g., inCDK4, NOTCH1, NF1, MDM2, and EGFR and in DNA repair system). Conclusions: This study demonstrates that molecular profiling of FFPE tumor samples improves prognostication of ACC beyond clinical/histopathological parameters and identifies new potential drug targets. These findings pave the way to precision medicine in this rare disease

Development of a tablet application for the screening of receptive vocabulary skills in multilingual children: A pilot study

For professionals working with multi-lingual children, detecting language deficits in a child’s home language can present a challenge. This is largely due to the scarcity of standardised assessments in many children’s home languages and missing normative data on multilingual language acquisition. A common approach is to translate existing English language vocabulary measures into other languages. However, this approach does not take into account the cultural and linguistic differences between languages. This pilot study explored whether English and home language receptive vocabulary skills can be objectively and reliably screened using a tablet application. Preliminary data on mono- and multilingual vocabulary skills was collected from 139 children aged 6-7 years. A tablet application was designed to assess children’s receptive vocabulary in both English, and an additional eight languages using a four choice picture paradigm. Linguistically controlled and pre-recorded target items are presented orally via the tablet in each language and responses are made via the touchscreen and automatically scored. The English version of the test was administered to 67 mono- and 72 multilingual children, while 38 multilingual children also completed the test in their home language. Test criteria measures, including reliability and concurrent validity showed satisfactory results. These findings suggest that the tablet application could be a useful tool for professionals to screen receptive vocabulary skills in mono- and multilingual children. Limitations of the first version of the RVS and future steps are discussed

Associations between depressive symptoms and disease progression in older patients with chronic kidney disease: results of the EQUAL study

Background Depressive symptoms are associated with adverse clinical outcomes in patients with end-stage kidney disease; however, few small studies have examined this association in patients with earlier phases of chronic kidney disease (CKD). We studied associations between baseline depressive symptoms and clinical outcomes in older patients with advanced CKD and examined whether these associations differed depending on sex. Methods CKD patients (&gt;= 65 years; estimated glomerular filtration rate &lt;= 20 mL/min/1.73 m(2)) were included from a European multicentre prospective cohort between 2012 and 2019. Depressive symptoms were measured by the five-item Mental Health Inventory (cut-off &lt;= 70; 0-100 scale). Cox proportional hazard analysis was used to study associations between depressive symptoms and time to dialysis initiation, all-cause mortality and these outcomes combined. A joint model was used to study the association between depressive symptoms and kidney function over time. Analyses were adjusted for potential baseline confounders. Results Overall kidney function decline in 1326 patients was -0.12 mL/min/1.73 m(2)/month. A total of 515 patients showed depressive symptoms. No significant association was found between depressive symptoms and kidney function over time (P = 0.08). Unlike women, men with depressive symptoms had an increased mortality rate compared with those without symptoms [adjusted hazard ratio 1.41 (95% confidence interval 1.03-1.93)]. Depressive symptoms were not significantly associated with a higher hazard of dialysis initiation, or with the combined outcome (i.e. dialysis initiation and all-cause mortality). Conclusions There was no significant association between depressive symptoms at baseline and decline in kidney function over time in older patients with advanced CKD. Depressive symptoms at baseline were associated with a higher mortality rate in men