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The sarcoma ring trial: a case-based analysis of inter-center agreement across 21 German-speaking sarcoma centers
No full textAbstract Purpose The management of soft tissue sarcoma (STS) at reference centers with specialized multidisciplinary tumor boards (MTB) improves patient survival. The German Cancer Society (DKG) certifies sarcoma centers in German-speaking countries, promoting high standards of care. This study investigated the variability in treatment recommendations for localized STS across different German-speaking tertiary sarcoma centers. Methods In this cross-sectional case-based survey study, 5 anonymized patient cases with imaging data of localized STS were presented to MTBs of 21 German-speaking tertiary referral hospitals. Centers provided recommendations on treatment sequence and modalities, along with the consensus level within their MTB. Agreement percentages were calculated, and consensus levels were rated on a scale of 1 to 10. Results Five patient cases were discussed resulting in 105 recommendations. Agreement percentages for case 1 to 5 were 14.3%, 61.9%, 33.3%, 52.4% and 9.3%, with a median agreement percentage of 33.3%. Grouping pre- and postoperative therapies as "perioperative" and including recommendations with and without regional hyperthermia raised the median agreement to 47.6%. The mean consensus level within each center across all 5 cases was 9.5. Conclusion This first case-based analysis of inter-center agreement for STS management in German-speaking countries reveals low inter-center agreement but high intra-center consensus. Our study includes nearly all tertiary sarcoma centers in German-speaking countries, affirming its strong external validity. These findings suggest potential and clinically very relevant differences in treatment standards among sarcoma centers. Enhanced case-based exchanges and collaborative efforts are needed to reduce discrepancies and standardize the management of STS patients
Anisotropic structure in a vapor-deposited Pd-based metallic glass
No full texthttp://dx.doi.org/10.13039/100010665 EU Framework Programme for Research and Innovation Marie Skłodowska-Curie Action
Measuring the impact of hospitalisation for infectious diseases on the quality of life of older patients in four European countries: the AEQUI longitudinal matched cohort study (2020-2023)
No full textFrom Extractables to Exposure Data: Sensitivity Analysis of Extrapolation Algorithms with Focus on USP 〈665〉
No full text
Sensorimotor environment but not task rule reconfigures population dynamics in rhesus monkey posterior parietal cortex
No full textPrimates excel at mapping sensory inputs flexibly onto motor outcomes. We asked if the neural dynamics to support context-sensitive sensorimotor mapping generalizes or differs between different behavioral contexts that demand such flexibility. We compared reaching under mirror-reversed vision, a case of adaptation to a modified sensorimotor environment (SE), with anti reaching, a case of applying an abstract task rule (TR). While neural dynamics in monkey posterior parietal cortex show shifted initial states and non-aligned low-dimensional neural subspaces in the SE task, remapping is achieved in overlapping subspaces in the TR task. A recurrent neural network model demonstrates how output constraints mimicking SE and TR tasks are sufficient to generate the two fundamentally different neural computational dynamics. We conclude that sensorimotor remapping to implement an abstract task rule happens within the existing repertoire of neural dynamics, while compensation of perturbed sensory feedback requires exploration of independent neural dynamics in parietal cortex
Search for the associated production of charm quarks and a Higgs boson decaying into a photon pair with the ATLAS detector
No full textA search for the production of a Higgs boson and one or more charm quarks, in which the Higgs boson decays into a photon pair, is presented. This search uses proton-proton collision data with a centre-of-mass energy of s = 13 TeV and an integrated luminosity of 140 fb−1 recorded by the ATLAS detector at the Large Hadron Collider. The analysis relies on the identification of charm-quark-containing jets, and adopts an approach based on Gaussian process regression to model the non-resonant di-photon background. The observed (expected, assuming the Standard Model signal) upper limit at the 95% confidence level on the cross-section for producing a Higgs boson and at least one charm-quark-containing jet that passes a fiducial selection is found to be 10.6 pb (8.8 pb). The observed (expected) measured cross-section for this process is 5.3 ± 3.2 pb (2.9 ± 3.1 pb)
Density-valued symplectic forms from a multisymplectic viewpoint
No full textWe give and intrinsic characterization of multisymplectic manifolds that have
the linear type of density-valued symplectic forms in each tangent space, prove
Darboux-type theorems for these forms and investigate their symmetries
No increased drought-related mortality after thinning: a meta-analysis
No full textAbstract Context Forest scientists are challenged to identify and propose evidence-based silvicultural options to mitigate the impacts of drought events induced by climate change. For example, it has been suggested that thinning increases soil water availability for individual trees by reducing stand density and stand-level transpiration. Many studies have assessed the impact of thinning on stem growth and transpiration of individual trees during and after drought events. Often, growth increases were observed, but not consistently, and their impact on tree survival following drought has rarely been addressed. Aims We aimed to assess the effect of thinning on tree mortality, the ultimate indicator of tree resistance to soil water deficit induced by drought, with a focus on dominant trees. Methods We conducted a risk ratio meta-analysis on tree mortality before and after an extreme drought event with 32 thinning experiments from nine studies in Europe and North America. Results We showed that thinning reduced the overall mortality risk of trees. However, the lower mortality rate in thinned stands relative to unthinned stands in pre-drought periods was not further reduced during and after extreme drought events (p > 0.05). This may be due to the large heterogeneity and inconsistent reporting of mortality across the studies included in our analysis. Thinning did not exacerbate mortality among dominant trees. Conclusion Since thinning did not increase mortality, its application can still be recommended for many other management objectives such as maintaining tree species richness or lower disturbance risks from windthrow. We propose better documentation of thinning trials to improve the data base for systematic reviews.Key message Our meta-analysis showed that thinning of forest stands did not increase mortality following extreme drought events. There was also no higher mortality among dominant trees that are typically more exposed to irradiance after thinning. We show that many thinning experiments lack sufficient documentation of mortality and climatic variation and urge for more comprehensive reporting to facilitate systematic reviews