Novel Estimates of Mortality Associated With Poverty in the US.

This cohort study estimated association between poverty and mortality and quantified the proportion and number of deaths associated with poverty.

Is There a Rural Penalty in Language Acquisition? Evidence From Germany's Refugee Allocation Policy.

Emerging evidence has highlighted the important role of local contexts for integration trajectories of asylum seekers and refugees. Germany's policy of randomly allocating asylum seekers across Germany may advantage some and disadvantage others in terms of opportunities for equal participation in society. This study explores the question whether asylum seekers that have been allocated to rural areas experience disadvantages in terms of language acquisition compared to those allocated to urban areas. We derive testable assumptions using a Directed Acyclic Graph (DAG) which are then tested using large-N survey data (IAB-BAMF-SOEP refugee survey). We find that living in a rural area has no negative total effect on language skills. Further the findings suggest that the "null effect" is the result of two processes which offset each other: while asylum seekers in rural areas have slightly lower access for formal, federally organized language courses, they have more regular exposure to German speakers.

The Long Arm of Prospective Childhood Income for Mature Adult Health in the United States.

Pioneering scholarship links retrospective childhood conditions to mature adult health. We distinctively provide critical evidence with prospective state-of-the-art measures of parent income observed multiple times during childhood in the 1970s to 1990s. Using the Panel Study of Income Dynamics, we analyze six health outcomes (self-rated health, heart attack, stroke, life-threatening chronic conditions, non-life-threatening chronic conditions, and psychological distress) among 40- to 65-year-olds. Parent relative income rank has statistically and substantively significant relationships with five of six outcomes. The relationships with heart attack, stroke, and life-threatening chronic conditions are particularly strong. Parent income rank performs slightly better than alternative prospective and retrospective measures. At the same time, we provide novel validation on which retrospective measures (i.e., father's education) perform almost as well as prospective measures. Furthermore, we inform several perennial debates about how relative versus absolute income and other measures of socioeconomic status and social class influence health.

The Danish metastatic melanoma database (DAMMED): A nation-wide platform for quality assurance and research in real-world data on medical therapy in Danish melanoma patients.

BACKGROUND: Clinical trials enroll patients with specific diseases based on certain pre-defined eligibility criteria. Disease registries are crucial to evaluate the efficacy and safety of new expensive oncology medicines in broad non-trial patient populations. METHODS: We provide detailed information on the structure, including variables, and the scientific results from a nation-wide Danish database covering advanced melanoma, illustrating the importance of continuous real-world data registration. Disease status and treatment-related information on all patients with American Joint Committee on Cancer (AJCC) 8th edition stage III or IV melanoma candidates to medical treatment in Denmark are prospectively registered in the Danish Metastatic Melanoma Database (DAMMED). RESULTS: By January 1st, 2021, DAMMED includes 4156 patients and 7420 treatment regimens. Response rates and survival data from published randomized clinical trial data are compared with real-world efficacy data from DAMMED and presented. Overall, nine independent manuscripts highlighting similarities and discrepancies between real-world and clinical trial results are already reported to date. CONCLUSION: Nation-wide disease registries take into consideration the complexity of daily clinical practice. We show a concrete example of how disease registries can complement clinical trials' information, improving clinical practice, and support health-related technology assessment.

Real-World Impact of Immune Checkpoint Inhibitors in Metastatic Uveal Melanoma.

Uveal melanoma (UM) is the most common intraocular malignancy in adults and shows a high rate of metastatic spread. As randomized clinical trials with immune checkpoint inhibitors (ICI) have not been performed in patients with metastatic UM, we analyzed the real-world outcomes in a nationwide population-based study. Clinical data of patients with UM were extracted from the Danish Metastatic Melanoma database, a nationwide database containing unselected records of patients diagnosed with metastatic melanoma in Denmark. Survival before (pre-ICI, n = 32) and after (post-ICI, n = 94) the approval of first-line treatment with ICI was analyzed. A partial response to first-line treatment was observed in 7% of patients treated with anti-programmed cell death protein (PD)-1 monotherapy and in 21% with combined anti-cytotoxic T lymphocyte antigen (CTLA)-4 plus anti-PD-1 therapy. Median progression-free survival was 2.5 months for patients treated in the pre-ICI era compared to 3.5 months in the post-ICI era (hazard ratio (HR) 0.43; 95% confidence interval (CI) 0.28-0.67; p < 0.001). The estimated one-year overall survival rate increased from 25.0% to 41.9% and the median overall survival improved from 7.8 months to 10.0 months, respectively (HR 0.52; 95% CI 0.34-0.79; p = 0.003). Thus, the introduction of ICI as first-line treatment appears to have significantly improved the real-world survival of patients with metastatic UM, despite relatively low response rates compared to cutaneous melanoma. With the lack of therapies proven effective in randomized trials, these data support the current treatment with ICI in patients with metastatic UM.

The real-world impact of modern treatments on the survival of patients with metastatic melanoma.

Between 2010 and 2015, pivotal trials with strict enrolment criteria led to the approval of several new treatments for metastatic melanoma (MM). We sought to determine the impact of these treatments in the 'real world'. We took advantage of the Danish MM database (DAMMED), which contains data on the entire, unselected population diagnosed with MM within Denmark. All MM cases (excluding ocular MM, n = 837) diagnosed in three non-consecutive years marked by major changes in the first-line treatments (2012: interleukin-2 and BRAF inhibitors; 2014: anti-CTLA-4: Cytotoxic T-Lymphocyte Antigen 4 and 2016: anti-PD-1: programmed cell death protein 1 and MEK inhibitors) were retrieved. Patients were grouped into 'trial-like' and 'trial-excluded' based on the common trial eligibility criteria. In the 'trial-like' population (39% of all MM), the median overall survival (OS) was not reached in 2016 versus 18.8 months in 2014 (hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.35-0.75; p = 0.0005) and 16.5 months in 2012 (HR 0.41, 95% CI 0.27-0.63; p < 0.0001). In the 'trial-excluded' population (61% of all MM), 75% had brain metastases and/or (performance status) PS ≥ 2. Here, the median OS improved to 6.9 months in 2016 versus 5.2 months in 2014 (HR 0.66, 95% CI 0.52-0.84; p = 0.0008) and 4.2 months in 2012 (HR 0.66, 95% CI 0.52-0.84; p = 0.0007). Subgroup analysis of the BRAF wild-type population showed an improved 1-year survival rate in 2016 versus 2014 (35.9% vs 18.8%, p = 0.0153). In conclusion, the introduction of modern treatments has led to an improved survival of real-world patients with MM, regardless of their eligibility to clinical trials and the BRAF status. These data support the application of modern treatments to patient populations which are not represented in pivotal trials.

Propanoate grafting on (H,OH)-Si(0 0 1)-2 × 1.

We have examined the reactivity of water-covered Si(0 0 1)-2 × 1, (H,OH)-Si(0 0 1)-2 × 1, with propanoic (C2H5COOH) acid at room temperature. Using a combination of spectroscopic techniques probing the electronic structure (XPS, NEXAFS) and the vibrational spectrum (HREELS), we have proved that the acid is chemisorbed on the surface as a propanoate. Once the molecule is chemisorbed, the strong perturbation of the electronic structure of the hydroxyls, and of their vibrational spectrum, suggests that the molecule makes hydrogen bonds with the surrounding hydroxyls. As we find evidence that surface hydroxyls are involved in the adsorption reaction, we discuss how a concerted or a radical-mediated reaction (involving the surface silicon dangling bonds) could lead to water elimination and formation of the ester.

Detection of obstructive sleep apnoea by an electronic nose.

Diagnosis of obstructive sleep apnoea syndrome (OSAS) is technically demanding, cost-intensive and time-consuming. The measurement of volatile organic compounds by an electronic nose is an innovative method that determines distinct molecular patterns of exhaled breath in different patient groups. We addressed the following questions: What is the diagnostic accuracy of an electronic nose in the detection of OSAS and the ability to detect effects of standard therapy in patients with OSAS? Are these results related to changes in distinct markers of airway inflammation and extracellular remodelling? We included 40 OSAS patients and 20 healthy controls. Exhaled breath of all participants was analysed using the Cyranose 320 electronic nose. Pharyngeal washings were performed to sample the upper airway compartment. For statistical analysis linear discriminant analysis was employed. We identified a linear discriminant function separating OSAS from control (p<0.0001). The corresponding area under the receiver-operating curve was 0.85 (95% CI 0.75-0.96; sensitivity 0.93 and specificity 0.7). In pharyngeal washing fluids of OSAS patients, we observed higher levels of α1-antitrypsin and markers of extracellular remodelling compared to controls. The electronic nose can distinguish between OSAS patients and controls with high accuracy.

Happiness inequality: Adding meaning to numbers - A reply to Veenhoven and Kalmijn.

In SSR 40 (3), we proposed two new measures for happiness inequality, which have spurred a debate. With this rebuttal we disprove the arguments of our critics and demonstrate that our recommended measure, the percent-maximum standard deviation, is a valuable tool for cross-national comparative research.

Thermal behavior of MOCVD-grown Cu-clusters on ZnO(1010).

Scanning tunnelling microscopy (STM) and X-ray photoelectron spectroscopy (XPS, AES) were used to study MOCVD of Cu-clusters on the mixed terminated ZnO(1010) surface in comparison to MBE Cu-deposition. Both deposition methods result in the same Cu cluster morphology. After annealing to 670 K the amount of Cu visible above the oxide surface is found to decrease substantially, indicating a substantial diffusion of Cu atoms inside the ZnO-bulk. The spectroscopic data do not show any evidence for changes in the Cu oxidation state during thermal treatment up to 770 K.

Adsorption of atomic hydrogen on ZnO(1010): STM study.

The adsorption of atomic hydrogen on a single crystal ZnO(1010) surface has been studied by scanning tunneling microscopy (STM) under ultrahigh vacuum conditions at room temperature and at elevated temperatures. High resolution STM images indicate that a well-ordered (1x1) H adlayer is formed on the ZnO(1010) surface. The STM data strongly indicate that the hydrogen adsorbs on top of the oxygen atoms forming hydroxyl species. Scanning tunneling spectroscopy (STS) studies reveal a H atom induced metallization at room temperature. In contrast to the clean surface for the hydrogen-covered surface distinct defects structures consisting of missing O and Zn atoms could be identified.

Massive pulmonary tumor microembolism from a hepatocellular carcinoma.

A 48-year-old patient with known alcohol abuse and long-standing liver cirrhosis presented with spontaneous bacterial peritonitis and subsequent hepato-renal syndrome. Autopsy revealed a large hepatocellular carcinoma of the right liver lobe. Histologically, pulmonary arteries, arterioles, and capillaries were occluded by numerous tumor emboli. Small tumor emboli also covered the endocardium of the right ventricle. A review of the literature shows that macroscopic as well as microscopic pulmonary tumor embolism is often diagnosed in patients with a previously unknown malignancy. Moreover, pulmonary tumor embolism radiologically mimics pneumonia, tuberculosis, or interstitial lung disease. Therefore, an autopsy should be considered in cases of fulminant or massive pulmonary embolism to exclude tumor embolism even when the patients' history is insignificant as to this point, and in cases with known malignant tumors and respiratory symptoms to exclude tumor microembolism.

Surface reactions of 3-butenenitrile on the Si(001)-2 x 1 surface at room temperature.

Using a combination of local -- scanning tunneling microscopy -- and spatially integrated, but chemically sensitive probes -- X-ray photoelectron spectroscopy and near edge X-ray absorption fine structure spectroscopy -- we have examined how 3-butenenitrile reacts with the Si(001)-2 x 1 surface at room temperature. Electron spectroscopies indicate three different nitrogen chemical bonds: a Si-C=N-Si bond, a C=C=N cumulative double bond, and a CN moiety datively bonded to a silicon atom. All molecular imprints detected by scanning tunneling microscopy (STM) involve two adjacent silicon dimers in the same row. The three geometries we propose -- a double di-sigma bonding via the CN and the C=C, a cumulative double bond formation associated with alphaC-H bond dissociation, and a di-sigma vinyl bonding plus a CN datively bonded to a silicon atom -- are all compatible with electron spectroscopies and data. Real-time Auger yield kinetic measurements show that the double di-sigma bonding geometry is unstable when exposed to a continuous flux of 3-butenenitrile molecules, as the Si-C=N-Si unit transforms into a CN moiety. A model is proposed to explain this observation.