bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in the prognoses of patients referred to an advanced heart failure center from hospitals with different bed volumes
Authors: Narita Koichi , Amiya Eisuke , Hatano Masaru , Ishida Junichi , Maki Hisataka , Minatsuki Shun , Tsuji Masaki , Saito Akihito , Bujo Chie , Ishii Satoshi , Kakuda Nobutaka , Shimbo Mai , Hosoya Yumiko , Endo Miyoko , Kagami Yukie , Imai Hiroko , Itoda Yoshifumi , Ando Masahiko , Shimada Shogo , Kinoshita Osamu , Ono Minoru , Komuro Issei
Published: December 2020

Few reports have discussed appropriate strategies for patient referrals to advanced heart failure (HF) centers with available left ventricular assist devices (LVADs). We examined the association between the characteristics and prognoses of referred patients with advanced HF and the bed volume of the referring hospitals. This retrospective analysis evaluated 186 patients with advanced HF referred to our center for consultation about the indication of LVAD between January 1, 2015, and August 31, 2018. We divided the patients into two groups according to the bed volume of their referring hospital (high bed volume hospitals (HBHs): ≥ 500 beds in the hospital; low bed volume hospitals (LBHs): < 500 beds). We compared the primary outcome measure, a composite of LVAD implantation and all-cause death, between the patients referred from HBHs and patients referred from LBHs. The 186 patients with advanced HF referred to our hospital, who were referred from 130 hospitals (87 from LBHs and 99 from HBHs), had a mean age of 43.0 ± 12.6 years and a median left ventricular ejection fraction of 22% [15–33%]. The median follow-up duration of the patients was 583 days (119–965 days), and the primary outcome occurred during follow-up in 42 patients (43%) in the HBH group and 20 patients (23%) in the LBH group. Patients referred from HBHs tended to require catecholamine infusion on transfer more often than those referred from LBLs (36.5% (HBH), 20.2% (LBL), P = 0.021). Kaplan–Meier analysis indicates that the occurrence of the primary outcome was significantly higher in the HBH patients than in the LBH patients (log-rank P = 0.0022). Multivariate Cox proportional hazards analysis revealed that catecholamine support on transfer and long disease duration were statistically significant predictors of the primary outcome. Patients from HBHs had a greater risk of the primary outcome. However, the multivariate analysis did not indicate an association between referral from an HBH and the primary outcome. In contrast, catecholamine support on transfer, long duration of disease, and low blood pressure were independent predictors of the primary outcome. Therefore, these should be considered when determining the timing of a referral to an advanced HF center, irrespective of the bed volume of the referring hospital.
Diel-scale temporal dynamics in the abundance and composition of pollinators in the Arctic summer
Authors: Zoller Leana , Bennett Joanne M. , Knight Tiffany M.
Published: December 2020

Our understanding of how pollinator activity varies over short temporal scales is limited because most research on pollination is based on data collected during the day that is then aggregated at a larger temporal scale. To understand how environmental factors affect plant–pollinator interactions, it is critical that studies include the entire diel cycle to examine patterns and processes that cause temporal variations. Further, there is little information from the Arctic, where environmental conditions that influence pollinator activity (e.g. temperature and solar radiation), are less variable across the diel cycle during the summer compared to locations from lower latitudes. We quantified abundance, composition and foraging activity of a pollinator community in Finnish Lapland at a diel scale over two summers, one of which was an extreme heat year. Pollinators showed a robust pattern in daily foraging activity, with peak activity during the day, less to no activity at night, and an absence of typically night active Lepidoptera. Abundance and composition of pollinators differed significantly between the years, possibly in response to the extreme heat in one of the years, which may particularly harm muscid flies. Our results showing strong diel and interannual abundance patterns for several taxa of pollinators in the Arctic summer have important implications for our understanding of temporal dynamics of plant–pollinator interactions.
Dissipation kinetics and biological degradation by yeast and dietary risk assessment of fluxapyroxad in apples
Authors: Podbielska Magdalena , Książek Paulina , Szpyrka Ewa
Published: December 2020

The aim of this study was to investigate the dissipation kinetics of fluxapyroxad in apples, the influence of biological treatment with yeast, and the estimation of dietary exposure for consumers, both adults and children. The gas chromatography technique with the electron capture detector was used to analyse the fluxapyroxad residues. Samples of apples were prepared by the quick, easy, cheap, effective, rugged and safe (QuEChERS) method. The average fluxapyroxad recoveries in apple samples ranged from 107.9 to 118.4%, the relative standard deviations ranged from 4.2 to 4.7%, and the limit of quantification was 0.005 mg/kg. The dissipation half-lives in Gala and Idared varieties were 8.9 and 9.0 days, respectively. Degradation levels of the tested active substance after application of yeast included in a biological preparation Myco-Sin were 59.9% for Gala and 43.8% for Idared. The estimated dietary risk for fluxapyroxad in apples was on the acceptable safety level (below 9.8% for children and 1.9% for adults) and does not pose a danger to the health of consumers.
Resistance to insecticides and synergism by enzyme inhibitors in Aedes albopictus from Punjab, Pakistan
Authors: Khan Hafiz Azhar Ali
Published: December 2020

The widespread use of insecticides has ecological consequences such as emergence of insecticide resistance and environmental pollution. Aedes albopictusis a major vector of dengue virus in the Punjab province, Pakistan. Control ofAe. albopictuswith insecticides along with source eradication is critical in the prevention and control of dengue fever but is threatened by the development of insecticide resistance. Here, field strains ofAe. albopictusfrom eight cities of Punjab were evaluated for resistance against temephos, deltamethrin and permethrin. For temephos, high resistance (RRLC50 > tenfold) was found in larvae of the Rawalpindi strain, moderate resistance (RRLC50 = five- to tenfold) in Multan, Faisalabad, Sialkot, Lahore and Sheikhupura strains, and low resistance (RRLC50 < fivefold) in Kasur and Sahiwal strains. In the case of deltamethrin, high resistance was seen in adults of the strain from Faisalabad, moderate resistance in the strains from Sialkot, Sheikhupura, Lahore and Kasur, and low resistance in Sahiwal, Multan and Rawalpindi strains. For permethrin, adults of all the field strains exhibited high levels of resistance. In synergism bioassays, toxicity of all the insecticides in the field strains significantly enhanced when tested in combination with piperonyl butoxide orS,S,S-tributylphosphorotrithioate, suggesting the probability of metabolic-based mechanisms of resistance. In conclusion, field strains ofAe. albopictusfrom Punjab exhibit resistance to temephos, deltamethrin and permethrin, which might be associated with metabolic mechanisms of resistance.
Evaluation of a protocol to detect malnutrition and provide nutritional care for cancer patients undergoing chemotherapy
Authors: Álvaro Sanz Elena , Abilés Jimena , Garrido Siles Marga , Rivas Ruíz Francisco , Tortajada Goitia Begoña , Domínguez Antonio Rueda
Published: December 2020

Patients with cancer frequently experience malnutrition, which is associated with higher rates of morbidity and mortality. Therefore, the implementation of strategies for its early detection and for intervention should improve the evolution of these patients. Our study aim is to design and implement a protocol for outpatients starting chemotherapy, by means of which any malnutrition can be identified and treated at an early stage. Before starting chemotherapy for patients with cancer, a complete assessment was made of their nutritional status, using the Nutriscore screening tool. When nutritional risk was detected, an interventional protocol was applied. Of 234 patients included in the study group, 84 (36%) required an individualised nutritional approach: 27 (32.1%) presented high nutritional risk, 12 had a Nutriscore result ≥ 5 and 45 experienced weight loss during chemotherapy. Among this population, the mean weight loss (with respect to normal weight) on inclusion in the study was − 3.6% ± 8.2. By the end of the chemotherapy, the mean weight gain was 0% ± 7.3 (p < 0.001) and 71.0% of the patients had experienced weight gain or maintenance, with respect to the initial weight. More than a third of cancer patients who start chemotherapy are candidates for early nutritional intervention. This finding highlights the importance of early identification of patients at risk in order to improve the efficacy of nutritional interventions, regardless of the stage of the disease.
The 20-hydroxyecdysone agonist, halofenozide, promotes anti-Plasmodium immunity in Anopheles gambiae via the ecdysone receptor
Authors: Reynolds Rebekah A. , Kwon Hyeogsun , Alves e Silva Thiago Luiz , Olivas Janet , Vega-Rodriguez Joel , Smith Ryan C.
Published: December 2020

Mosquito physiology and immunity are integral determinants of malaria vector competence. This includes the principal role of hormonal signaling inAnopheles gambiaeinitiated shortly after blood-feeding, which stimulates immune induction and promotes vitellogenesis through the function of 20-hydroxyecdysone (20E). Previous studies demonstrated that manipulating 20E signaling through the direct injection of 20E or the application of a 20E agonist can significantly impactPlasmodiuminfection outcomes, reducing oocyst numbers and the potential for malaria transmission. In support of these findings, we demonstrate that a 20E agonist, halofenozide, is able to induce anti-Plasmodiumimmune responses that limitPlasmodiumookinetes. We demonstrate that halofenozide requires the function of ultraspiracle (USP), a component of the canonical heterodimeric ecdysone receptor, to induce malaria parasite killing responses. Additional experiments suggest that the effects of halofenozide treatment are temporal, such that its application only limits malaria parasites when applied prior to infection. Unlike 20E, halofenozide does not influence cellular immune function or AMP production. Together, our results further demonstrate the potential of targeting 20E signaling pathways to reduce malaria parasite infection in the mosquito vector and provide new insight into the mechanisms of halofenozide-mediated immune activation that differ from 20E.
Human skin explant model for the investigation of topical therapeutics
Authors: Neil Jessica E. , Brown Marc B. , Williams Adrian C.
Published: December 2020

The development of in vitro and ex vivo models to mimic human illness is important not only for scientific understanding and investigating therapeutic approaches but also to mitigate animal testing and bridge the inter-species translational gap. While in vitro models can facilitate high-throughput and cost-efficient evaluation of novel therapeutics, more complex ex vivo systems can better predict both desirable and adverse in vivo effects. Here we describe an ex vivo cultured human skin explant model in which we have characterized pathological tissue integrity, barrier function and metabolic stability over time. Our findings suggest that human skin can be successfully cultured for pharmacodynamic use up to and beyond 9 days without any adverse physiological consequence.
Association between red blood cell distribution width and long-term mortality in acute respiratory failure patients
Authors: Zhang Wei , Wang Yadan , Wang Jun , Wang Shaochun
Published: December 2020

The red cell distribution width (RDW) has been reported to be positively correlated with short-term mortality of pulmonary disease in adults. However, it is not clear whether RDW was associated with the long-term prognosis for acute respiratory failure (ARF). Thus, an analysis was conducted to evaluate the association between RDW and 3-year mortality of patients by the Cox regression analysis, generalized additives models, subgroup analysis and Kaplan–Meier analysis. A total of 2999 patients who were first admitted to hospital with ARF were extracted from the Medical Information Mart for Intensive Care III database (MIMIC-III). The Cox regression analysis showed that the high RDW was associated with 3-year mortality (HR 1.10, 95% CI 1.07, 1.12, P < 0.0001) after adjusting for age, gender, ethnicity and even co-morbid conditions. The ROC curve illustrated the AUC of RDW was 0.651 (95% CI 0.631, 0.670) for prediction of 3-year mortality. Therefore, there is an association between the RDW and survival time of 3 years follow-up, particularly a high RDW on admission was associated with an increased risk of long-term mortality in patients with ARF. RDW may provide an alternative indicator to predict the prognosis and disease progression and more it is easy to get.
Saroglitazar in patients with non-alcoholic fatty liver disease and diabetic dyslipidemia: a prospective, observational, real world study
Authors: Goyal Omesh , Nohria Sahil , Goyal Prerna , Kaur Jaskirat , Sharma Sarit , Sood Ajit , Chhina Rajoo Singh
Published: December 2020

Saroglitazar, a dual peroxisome proliferator activated receptor α/γ agonist, approved for diabetic dyslipidemia (DD), is potential therapeutic option for non-alcoholic fatty liver disease (NAFLD). This prospective, observational, real-world study aimed to determine efficacy and safety of Saroglitazar in patients with NAFLD and DD. We included patients with DD and NAFLD who received Saroglitazar 4 mg once daily for 24 weeks. Blood investigations, liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) (FibroScan) were compared at baseline and 24 weeks. Of 163 patients screened, 107 were included, and 101 completed 24 weeks treatment (mean age 50.4 ± 12.3 years, 78.5% males, mean body mass index 28.8 ± 4.2). After 24 weeks, alanine transaminase (ALT) reduced significantly from 94 (47–122) to 39 (31–49) (p < 0.0001) and aspartate aminotransferase (AST) (U/L) from 89 (43–114) to 37 (30–47) (p < 0.0001) and LSM (kPa) from 8.4 (7.1–9.3) to 7.5 (6.4–8.4) (p = 0.0261). CAP, glycated hemoglobin and lipid parameters also improved significantly. On linear regression, there was significant association between percent change in ALT and AST with TG reduction after treatment (p = 0.024 and 0.037 respectively).We conclude that Saroglitazar leads to significant improvement in transaminases, LSM, and CAP in NAFLD patients with DD.
Facile synthesis and thermoluminescence properties of nano bio-ceramic β-Ca2P2O7:Dy phosphor irradiated with 75 meV C6+ ion beam
Authors: Gupta Karan Kumar , Dhoble S . J. , Krupski Aleksander R.
Published: December 2020

Dy3+ doped β-Ca2P2O7 phosphor has been synthesized using wet chemical method. The scanning electron microscopy (SEM) and transmission electron microscopy (TEM) analysis confirmed the formation of β-Ca2P2O7:Dy nano-phosphors. However, photoluminescence (PL) study was carried out to confirm the presence of dopant ion in the host matrix of β-Ca2P2O7:Dy material. Thermoluminescence (TL) glow curves of β-Ca2P2O7 were recorded for different concentrations of Dy3+ after exposure to various fluences of C6+ ion beam (75 meV). TL sensitivity of β-Ca2P2O7:Dy3+ (0.1 mol%) phosphor was 3.79 times more than commercially available CaSO4:Dy3+. TRIM code based on the Monte Carlo simulation was used to calculate the absorbed doses, ion range and main energy loss. Glow curve de-convolution (GCD) method was used to determine the number of TL peaks and their trapping parameters. The wide linear response of β-Ca2P2O7 nanoparticles along with high stability of TL glow curve makes this nanomaterial a good candidate for C6+ ion beam dosimetry.
Silencing lncRNA DUXAP8 inhibits lung adenocarcinoma progression by targeting miR-26b-5p
Authors: Liu Yi , Zhang Gongming , Chen Hao , Wang Hua
Published: December 2020

Lung adenocarcinoma (LUAD), a common type of lung cancer, has become a popularly aggressive cancer. Long noncoding RNAs (lncRNAs) play a critical role in the pathogenesis of human cancers, while the function of double homeobox A pseudogene 8 (DUXAP8) in LUAD remains to be fully inquired. Therefore, our study was conducted to elucidate the DUXAP8 expression in LUAD and its mechanism on the biological features of LUAD cells. Loss-of-function experiments were performed to assess the function of DUXAP8 proliferation and apoptosis of H1975 and A549 cells. Functionally, silencing DUXAP8 inhibited proliferation and induced apoptosis of LUAD cells. Mechanistically, further correlation assay indicated a negative association between miR-26b-5p and DUXAP8 expression. Subsequently, we testified that DUXAP8 exerted its role in the progression and development of LUAD through targeting miR-26b-5p. In summary, our results elucidated that that DUXAP8 promoted tumor progression in LUAD by targeting miR-26b-5p, which provide a novel therapeutic target for diagnosis and therapy of LUAD.
The role of phosphoprotein phosphatases catalytic subunit genes in pancreatic cancer
Authors: Hang Junjie , Lau Steven Yuk-Fai , Yin Ruohan , Zhu Lina , Zhou Siyuan , Yuan Xin , Wu Lixia
Published: December 2020

Compelling evidence suggests that phosphoprotein phosphatases (PPPs) are involved in a large spectrum of physiological and pathological processes, but little is known about their roles in pancreatic cancer. We investigated the expression level, prognostic value, and potential function of PPPs with data from Oncomine, GEPIA, THPA, and TCGA databases and an independent cohort of patients with pancreatic cancer. Among all the PPP catalytic subunits (PPPcs), the transcription levels of PPP1CA, PPP1CB, PPP3CA, PPP3CB, and PPP4C were higher in pancreatic cancer than in normal pancreas (P<0.01, fold change > 2). Kaplan–Meier analysis showed that high transcription levels of PPP1CA, PPP1CB, PPP2CA, PPP2CB, PPP3CA, and PPP4C correlated with poorer survival. In contrast, patients with high levels of PPP3CB, PPP3CC, PPP5C, PPP6C, and PPEF2 had much better prognoses. Data from THPA and patients with pancreatic cancer enrolled in our hospital also confirmed the prognostic value of PPP1CA, PPP1CB, PPP2CA, PPP2CB, PPP3CA, PPP3CB, and PPP6C at the protein level. In addition, the Pearson Chi-square test showed that PPP3CB level was significantly correlated with T and N stages. GO and KEGG analyses showed that the genes and pathways related to the pathogenesis and progression of pancreatic cancer were greatly affected by alterations in PPPcs. Results of the present study suggest that PPP1CA, PPP1CB, PPP2CA, PPP2CB, and PPP3CA have deleterious effects but PPP3CB, PPP5C, and PPP6C have beneficial effects on pancreatic cancer.
Extracellular RNA in kidney disease: moving slowly but surely from bench to bedside
Authors: Hunter Robert W. , Dhaun Neeraj
Published: December 2020

We have known for just over a decade that functional RNA is shuttled between cells (Nat. Cell Biol. (2007) 9, 654–659). In that short time, there have been countless reports of extracellular RNA (exRNA) and extracellular vesicles (EVs) participating in diverse biological processes in development (Dev. Cell (2017) 40, 95–103), homoeostasis (Nature (2017) 542, 450–455) and disease (Nature (2017) 546, 498–503). Unsurprisingly – as these disciplines are still in their infancies – most of this work is still in the ‘discovery biology’ phase. However, exRNA and EVs show promise as disease biomarkers and could be harnessed in novel therapies.
The Contribution of Frequency Discrimination Ability to Auditory Temporal Patterning Tests in Children
Authors: Flagge Ashley G. , Davis Tara , Henbest Victoria S.
Published: December 2020

Purpose

The Pitch Patterns Test (PPT) and the Duration Patterns Test (DPT) are clinical auditory processing tests that evaluate temporal patterning skills based on pitch (PPT) or duration (DPT) aspects of sound. Although temporal patterning tests are categorized under the temporal processing domain, successful performance on the PPT also relies on accurate pitch discrimination. However, the relationship between pitch discrimination ability and temporal patterning skills has not been thoroughly evaluated. This study examined the contribution of pitch discrimination ability to performance on temporal patterning in children through the use of a pitch discrimination task and the PPT. The DPT was also given as a control measure to assess temporal patterning with no pitch component.

Method

Thirty-two typically developing elementary school–age children (6;11–11;3 [years;months]) with normal hearing were given a series of three counterbalanced tasks: an adaptive psychophysical pitch discrimination task (difference limen for frequency [DLF]), the PPT, and the DPT.

Results

Correlational analysis revealed moderate correlations between DLF and PPT scores. After accounting for age, results of a linear regression analysis suggested that pitch discrimination accounts for a significant amount of variance in performance on the PPT. No significant correlation was found between DLF and DPT scores, supporting the hypothesis that the pitch task had no significant temporal patterning component contributing to the overall score.

Discussion

These findings indicate that pitch discrimination contributes significantly to performance on the PPT, but not the DPT, in a typically developing pediatric population. This is an important clinical consideration in both assessment and utilization of targeted therapy techniques for different clinical populations.
Development of a Hearing Conservation Program for Elementary Schools
Authors: Daney Samantha , Pakulski Lori A. , Diehm Emily A. , Glassman Jennifer
Published: December 2020

Purpose

Despite evidence supporting the positive implications of hearing conservation programs (HCPs) on hearing loss prevention among children, healthy hearing habits are often not taught in schools. To address the need for more hearing health education in schools, we investigated the feasibility of a teacher-implemented HCP and its impact on fourth-grade students.

Method

A speech-language pathology graduate student trained a science teacher from a local elementary school to implement a modified version of the American Speech-Language-Hearing Association's HCP,
Listen to Your Buds
, to 56 fourth-grade students. After completing a pre-intervention questionnaire, students received a 45-min interactive HCP, with posttesting occurring immediately afterward and 4 weeks later. Students answered questions to measure their hearing-related knowledge, attitudes, and behaviors as a result of participation in the HCP.

Results

Immediately following the program, students' knowledge of potentially damaging noises increased, as well as did their attitudes toward noise exposure. Students' responses remained similar one month after the HCP as well. However, few students reported behavioral changes related to potentially damaging noise exposure.

Conclusions

A single 45-min intervention did not appear to change students' intentions for future behaviors regarding healthy hearing habits; however, results indicate that students increased their knowledge and improved their attitudes, which may indeed impact future behavior when confronted with potentially damaging noise exposure. Although
Listen to Your Buds
materials are no longer accessible online, we provide recommendations for school-based speech-language pathologists and educational audiologists to develop and implement an HCP in their school.
Treatment Considerations for Adolescents Who Exhibit Cognitive/Communication Problems: A Neuroscience Perspective
Authors: Burns Martha S.
Published: December 2020

Purpose

Adolescence is a period of substantial neurophysiological and behavioral growth, representing a second sensitive period of brain development. It is a psychological and social transition period between childhood and adulthood with many beneficial changes occurring, especially with respect to potential responsiveness to clinical intervention. However, adolescent behavioral complexities introduce clinical challenges as well. The purpose of this review article is to review the current neuroimaging research on neurophysiological changes observed during adolescence and the cognitive and social behavioral counterparts, with specific attention to the clinical implications. The review article will then summarize currently available intervention tools that can be utilized by speech-language pathologists working with this population. It will conclude with available evidence-based social-communication approaches that may be applicable as well as available evidence-based supplemental technological cognitive interventions that may be useful in working with adolescents who exhibit language and communication issues.

Conclusion

As a transition period between childhood and adulthood, adolescence represents a second sensitive period during which there is opportunity for clinically derived beneficial cognitive and communication growth.
Computer-Assisted Challenge Point Intervention for Residual Speech Errors
Authors: McAllister Tara , Hitchcock Elaine R. , Ortiz José A.
Published: December 2020

Purpose

This preliminary case series investigated the effects of biofeedback intervention for residual rhotic errors delivered within a modified challenge point framework. In the challenge point framework, practice difficulty is adaptively adjusted with the goal of enhancing generalization learning. This study more specifically evaluated the feasibility of a computer-mediated implementation of challenge point treatment for rhotic errors using a custom open-source software, the Challenge Point Program.

Method

Participants were five native English speakers, ages 7;3–15;5 (years;months), who had established but not generalized correct rhotic production in previous treatment; overall treatment duration was flexible. Treatment incorporated either electropalatographic or visual-acoustic biofeedback and was structured by challenge point principles implemented using the Challenge Point Program software.

Results

Participants were highly variable in the magnitude of generalization gains attained. However, the median overall effect size was 4.24, suggesting that participants' response in treatment tended to exceed the minimum value considered clinically significant.

Conclusion

These findings provide preliminary evidence that computer-mediated implementation of the challenge point framework can be effective in producing generalization in some participants.

Supplemental Material

https://doi.org/10.23641/asha.13244501
Present landscape of quantum computing
Authors: Hassija Vikas , Chamola Vinay , Saxena Vikas , Chanana Vaibhav , Parashari Prakhar , Mumtaz Shahid , Guizani Mohsen
Published: December 2020

Quantum computing is currently a topic of interest that harnesses the phenomena of quantum mechanics. It can address several scientific challenges and generate new business opportunities. Recently, for the first time in the history of quantum computing, the authors are starting to see practical applications. Keeping this in mind, this article is designed to explore the field without any required prerequisites. The authors start with a brief overview of the fundamentals of quantum computing and also outline several applications. The timeline for widespread adoption cannot be predicted, but quite a few organisations have built the first generation of quantum computers using various hardware technologies. The authors have briefly covered the wide landscape of hardware technologies. The first generation of quantum computers can be programmed using available software development kits and accessed using online cloud services. Furthermore, the growing trend in investments and patents in the field of quantum computing is also presented. A major reason for this trend is the threat that quantum computers pose against cryptography.
Treatment of Recurrent Epithelial Ovarian Cancer
Authors: Claussen Carlota , Rody Achim , Hanker Lars
Published: December 2020

Epithelial ovarian cancer is the most common cause of death from gynecological tumors. Most patients with advanced ovarian cancer develop recurrence after concluding first-line therapy, making further lines of therapy necessary. The choice of therapy depends on various criteria such as tumor biology, the patientʼs general condition (ECOG), toxicity, previous chemotherapy, and response to chemotherapy. The platinum-free or treatment-free interval determines the potential response to repeat platinum-based therapy. If patients have late recurrence, i.e. > 6 months after the end of the last platinum-based therapy (i.e., they were previously platinum-sensitive), then they are usually considered suitable for another round of a platinum-based combination therapy. Patients who are not considered suitable for platinum-based chemotherapy are treated with a platinum-free regimen such as weekly paclitaxel, pegylated liposomal doxorubicin (PLD), gemcitabine, or topotecan.
Treatment for the patient subgroup which is considered suitable for platinum-based therapy but cannot receive carboplatin due to uncontrollable hypersensitivity reactions may consist of trabectedin and PLD. While the use of surgery to treat recurrence has long been a controversial issue, new findings from the DESKTOP III study of the AGO working group have drawn attention to this issue again, particularly for patients with a platinum-free interval of > 6 months and a positive AGO score. Clinical studies have also shown the efficacy of angiogenesis inhibitors such as bevacizumab and the PARP inhibitors olaparib, niraparib and rucaparib. These drugs have substantially changed current treatment practice and expanded the range of available therapies. It is important to differentiate between purely maintenance therapy after completing CTX, continuous maintenance therapy during CTX, and the therapeutic use of these substances. The PARP inhibitors niraparib, olaparib and
rucaparib have already been approved for use by the FDA and the EMA. The presence of a BRCA mutation is a predictive factor for a better response to PARP inhibitors.
Aloe vera in der Onkologie
Authors: Rist Maike , Langhorst Jost
Published: December 2020

Aloe vera ist durch die antioxidativen und entzündungshemmenden Eigenschaften ein vielseitig einsetzbares Heilmittel der Naturheilkunde, das sowohl in der traditionellen Medizin weltweit als auch in der westlichen Medizin vielfach Anwendung findet. Zu den Hauptindikationen zählt die Behandlung von Wunden, Erfrierungen und Verbrennungen, Psoriasis, Colitis ulcerosa, Diabetes und Obstipation (Verstopfung) sowie Linderung chemo- und strahlentherapeutischer Nebenwirkungen. Von großer Bedeutung für die Medizin ist die Unterscheidung zwischen Aloe-vera-Gel, das sich als Wasserspeichergewebe im Inneren der Blätter befindet, und dem Blattsaft (auch Latex genannt), der sich direkt unter der Haut der Blätter befindet, da sich die Inhaltsstoffe dieser Pflanzenbestandteile grundlegend unterscheiden: Den im Blattsaft enthaltenen Anthrachinonen (wie Aloin, Aloe-Emodin u. a. ) werden eine abführende Wirkung, aber auch toxische und kanzerogene Eigenschaften zugeschrieben, wohingegen das Gel vor allem in topischer Anwendung als unbedenklich und sicher gilt. Die orale Einnahme von Aloe vera, insbesondere in Latexform, kann zu Magen-Darm-Störungen und Elektrolytanomalien führen und gilt während der Schwangerschaft und Stillzeit als kontraindiziert. In Bezug auf die Toxizität ist die Studienlage widersprüchlich und neben Daten, die für eine schädigende Wirkung der Anthrachinone sprechen, gibt es Ergebnisse, die sowohl in Tierstudien als auch in vitro eine antikanzerogene Wirkung nachweisen. Eine entscheidende Rolle könnte sowohl die verwendete Aloe-Art als auch der Anthrachinongehalt der verwendeten Produkte spielen. Qualitativ hochwertige Studien und neue Forschungsergebnisse sowie eine klare Differenzierung zwischen Aloe-vera-Gel und anthrachinonhaltigen Bestandteilen der Pflanze sind notwendig, um weitere Ergebnisse und mehr Sicherheit in Bezug auf die Toxizität wie auch auf das gesundheitsfördernde Potenzial dieser Pflanze liefern zu können.

Die Fortschritte in der Analyse der Tumor-Immunbiologie lassen hoffen, dass die antineoplastische Eigenschaft, die auf einer antiproliferativen, immunstimulierenden und antioxidativen Wirkung beruht, in naher Zukunft weiter erforscht wird.
Psychotherapie der Schlafstörungen
Authors: Junghanns Klaus
Published: December 2020

Schlafstörungen treten im Verlauf des Alterns vermehrt auf und neigen
zur Chronifizierung. Mithilfe der Kognitiven Verhaltenstherapie der Insomnie
(CBT-I) lassen sich nichtorganische Schlafstörungen in ihrer
Entstehung und Aufrechterhaltung besser verstehen und mit gezielten
Interventionen mildern oder beseitigen. Es ist oft die bessere Alternative
zur langzeitigen Verschreibung von Schlafmitteln.
Abdominal Applications of 4D Flow MRI
Authors: Riedel Christoph , Lenz Alexander , Fischer Lutz , Li Jun , Piecha Feilix , Kluwe Johannes , Adam Gerhard , Bannas Peter
Published: December 2020

Background Four-dimensional flow magnetic resonance imaging (4D flow MRI) provides volumetric and time-resolved visualization and quantification of blood flow. This review presents an overview of possible applications of 4D flow MRI for non-invasive assessment of abdominal hemodynamics.

Method This review is based on the authors’ experience and the current literature. A PubMed database literature research was performed in December 2019 focusing on abdominal applications of 4D flow MRI. We illustrated the review with exemplary figures and movies of clinical cases from our institution.

Results and Conclusion 4D flow MRI offers the possibility of comprehensive assessment of abdominal blood flows in different vascular territories and organ systems. Results of recent studies indicate that 4D flow MRI improves understanding of altered hemodynamics in patients with abdominal disease and may be useful for monitoring therapeutic response. Future studies with larger cohorts aiming to integrate 4D flow MRI in the clinical routine setting are needed.

Key Points: 

Citation Format
Die Schilddrüse – Versuch einer ganzheitlichen Einordnung als somato-emotionale Schnittstelle
Authors: Sperlich Franz
Published: December 2020

Die Schilddrüse spielt sowohl in unserer individuellen Entwicklung als auch für unsere körperliche und geistige Gesundheit als Erwachsener eine zentrale Rolle. In diesem Beitrag erfolgt eine Einordnung der Schilddrüse als somato-emotionale Schnittstelle auf Basis phylo- und ontogenetischer, anatomischer und physiologischer Fakten. Anhand des Modells Globe of Emotions® und „Bodily Maps of Emotion“ wird Ekel unter Einbeziehung erfahrungsheilkundlicher Aspekte als immunwirksame Emotion mit topografischem Bezug zur Schilddrüse sowie ein möglicher Kausalzusammenhang mit Autoimmunerkrankungen dieses Organs diskutiert.
Residual Axillary Burden After Neoadjuvant Chemotherapy (NACT) in Early Breast Cancer in Patients with a priori Clinically Occult Nodal Metastases – a transSENTINA Analysis
Authors: Kolberg Hans-Christian , Kühn Thorsten , Krajewska Maja , Bauerfeind Ingo , Fehm Tanja N. , Fleige Barbara , Helms Gisela , Lebeau Annette , Stäbler Annette , Schmatloch Sabine , Hauschild Maik , Schwentner Lukas , Schrenk Peter , Loibl Sibylle , Untch Michael , Kolberg-Liedtke Cornelia
Published: December 2020

Background Among patients with breast cancer undergoing neoadjuvant chemotherapy (NACT), the association between pathological complete remission (pCR) in the breast and clinical/pathological parameters is well established, whereas the association between these parameters and residual axillary involvement after NACT remains unclear.

Methods Patients with clinically occult nodal metastases (i.e. negative by clinical assessment but positive by SLNB prior to NACT, i.e. Arm B of the SENTINA trial) were included in the presented analysis. All patients received a second sentinel lymph node biopsy (SLNB) and axillary dissection after NACT. Univariate and multivariate analyses were carried out to evaluate the association between clinical/pathological parameters and axillary involvement after NACT.

Results Arm B of the SENTINA study contained 360 patients, 318 of which were evaluable for this analysis. After NACT, 71/318 (22.3%) patients had involved SLNs or non-SLNs after NACT. Overall, 71/318 (22.3%) patients achieved a pCR in the breast. Associations of extranodal spread, lack of multifocality and pCR in the breast with residual axillary burden were statistically significant. In a descriptive analysis including all patients with clinically negative axilla before NACT in the SENTINA trial 1.2% of triple negative (TN) patients and 0.5% of HER/2 positive patients had residual axillary disease in case of a breast pCR.

Conclusions Patients in the SENTINA trial with clinically negative axilla and involved SLNs still carried a significant risk of nodal metastases after NACT. However, the risk of residual axillary burden was particularly low in TN and HER/2 positive tumors in case of a breast pCR.
ω-3-Fettsäuren in der Schwangerschaft – kein Frühchen und glückliche Mutter
Authors: Schmiedel Volker
Published: December 2020

Die ausreichende Versorgung mit ω-3-Fettsäuren kann neben anderen Nährstoffen zu einer komplikationslosen Schwangerschaft und zur Geburt eines gesunden Kindes beitragen: Das Risiko für Frühgeburten, perinatalen Tod, Gestationsdiabetes sowie Depression während der Gravidität und postpartal sinkt. Besonders wichtig sind die maritimen Fettsäuren Docosahexaensäure (DHA) für die Entwicklung des Nervensystems und Eicosapentaensäure (EPA) für die Prävention atopischer Erkrankungen. Empfehlenswert ist die Fettsäurenanalyse in der Erythrozytenmembran vor bzw. zu Beginn der Schwangerschaft und in deren Verlauf. Für die Substitution eignen sich hochwertiges Fisch- oder Algenöl.
Gegenseitige Unterstützung Psychiatrieerfahrener in Krisenunterkünften – ein Scoping Review
Authors: von Peter Sebastian , Schwarz Julian
Published: December 2020

Ziel Als Alternative zur psychiatrischen Versorgung gibt es v. a. im angloamerikanischen Raum sogenannte Crisis Respites (CR), in denen sich krisen- und genesungserfahrene Menschen (Peers) gegenseitig unterstützen. In dieser Arbeit wird untersucht, wie CR aufgebaut sind und mit welchen Ansätzen und Ergebnissen sie evaluiert werden.

Methodik Systematische Literaturrecherche. Studien wurden eingeschlossen, auch der „grauen“ Literatur, sofern sie empirisches Material enthielten.

Ergebnisse Auswahl von 12 Publikationen mit Bezug zu insgesamt 10 CR. Die Arbeits- und Organisationsformen von CR sind sehr heterogen. Es wurden unterschiedliche Evaluationsansätze (RCT, qualitativ, Mixed-Methods) genutzt.

Schlussfolgerung CR sind kein Ersatz für die psychiatrische Versorgung, sondern eine eigene, wirksame Unterstützungsform. Der Einfluss von Peers bei der Umsetzung und Evaluation ist von zentraler Bedeutung, damit ihre Eigenheiten erhalten bleiben.
Perspektiven von Medizinischen Fachangestellten zu teambasierter Behandlung von Patienten mit Panikstörung in der Hausarztpraxis – Eine qualitative Studie
Authors: Blank Wolfgang A. , Lukaschek Karoline , Breitbart Jörg , Hiller Thomas S. , Brettschneider Christian , Margraf Jürgen , Gensichen Jochen ,   für die PARADIES-Studiengruppe
Published: December 2020

Ziel der Studie Untersuchung der Perspektive von Medizinischen Fachangestellten (MFA) bezüglich der Mitwirkung in verhaltenstherapeutisch orientierten Interventionen in der Hausarztpraxis.

Methode 15 MFA (w, 39,5 Jahre), Case-Manager in einem hausarztpraxis-unterstützten Übungsprogramm für Patienten mit Panik- und Angststörung (ICD-10: F41.0), wurden mittels semistrukturiertem Interviewleitfaden zur Rekrutierung von und Interaktion mit Patienten, Vermittlung der Übungen und der Implementierung in den Praxisalltag befragt. Die Interviews (n = 14) wurden dokumentiert, transkribiert und inhaltsanalytisch nach Mayring qualitativ analysiert.

Ergebnisse MFA empfanden ihren Anteil an der Intervention im Rahmen der Rekrutierung und Bindung von Patienten ans Projekt durch Telefonkontakte als positiv.

Schlussfolgerung Das Einbinden der MFA kann dazu beitragen, im Rahmen einer niedrigschwelligen Intervention Patienten mit psychischen Beschwerden in der hausärztlichen Versorgung gezielt zu unterstützen und den Hausarzt zu entlasten.
Contributing to the Study of Enzymatic and Chemical Glycosyl Transfer Through the Observation and Mimicry of Glycosyl Cations
Authors: Blériot Yves
Published: December 2020

This account describes our efforts dedicated to: 1) the design of glycomimetics aimed at targeting therapeutically relevant carbohydrate processing enzymes, and 2) the observation, characterization, and exploitation of glycosyl cations as a tool for studying the glycosylation reaction. These findings have brought important data regarding this key ionic species as well as innovative strategies to access iminosugars of interest.

1 Introduction

2 The Glycosyl Cation, A Central Species in Glycosciences

2.1 A Selection of the Strategies Developed so far to Gain Insights into Glycosyl Cations Structure

2.2 When Superacids Meet Carbohydrates

3 Chemical Probes to Gain Insights into the Pseudorotational Itinerary of Glycosides During Glycosidic Bond Hydrolysis

3.1 Conformationally Locked Glycosides

3.1.1 The Xylopyranose Case

3.1.2 The Mannopyranose Case

3.2 Conformationally Flexible Iminosugars

3.2.1 Nojirimycin Ring Homologues

3.2.2 Noeuromycin Ring Homologues

3.2.3 Seven-Membered Iminosugar C-Glycosides

4 N-Acetyl-d-glucosamine Mimics

5 Ring Contraction: A Useful Tool to Increase Iminosugar’s Structural Diversity

6 Regioselective Deprotection of Iminosugar C-Glycosides to Introduce Diversity at C2 Position

7 Conclusion
Antimicrobial Dressing versus Standard Dressing in Obese Women Undergoing Cesarean Delivery: A Randomized Controlled Trial
Authors: Saad Antonio F. , Salazar Ashley E. , Allen Lindsey , Saade George R.
Published: December 2020

Objective This study aimed to evaluate the effect of a novel antimicrobial dressing on patient satisfaction and health-related quality of life (HRQoL) following a cesarean delivery.

Study Design  This was an open-label, single-center, two-arm randomized controlled trial. This study was done at the tertiary center, maternal unit, Galveston, TX. Pregnant women with body mass indices ≥35 kg/m2 were screened for eligibility. Women were randomized to ReliaTect Post-Op Dressing (RELIATECT) or standard wound dressing (STANDARD). Primary outcome was patient satisfaction and HRQoL using validated questionnaires. Secondary outcomes were provider satisfaction, surgical site infection (SSI) rates, and wound complications.

Results In total, 160 women were randomized. Population characteristics were not significant among groups. RELIATECT dressing group had an overall higher score of satisfaction and HRQoL compared with STANDARD group. Women in the RELIATECT group reported less incision odor and incisional pain. Compared with the STANDARD group, most women in RELIATECT dressing group reported better daily activities, self-esteem, personal hygiene, body image, and sleep. Providers reported that the RELIATECT dressing allowed better assessment of the surgical incision site, allowed patients to shower early, and did observe less wound dressing leakage. No differences were found in other secondary end points.

Conclusion Postcesarean RELIATECT dressing for wound care in pregnant women with obesity had better patient and provider satisfaction as well as better HRQoL scores. Further, level 1 evidence is needed to assess its impact on SSI rates and wound complication, as this trial was not powered to accomplish this goal.

Key Points
Do You Know What Your Scribe Did Last Spring? The Impact of COVID-19 on Medical Scribe Workflow
Authors: Gold Jeffrey A. , Becton James , Ash Joan S. , Corby Sky , Mohan Vishnu
Published: December 2020

Objective To understand the impact of the shift to virtual medicine induced by coronavirus disease 2019 (COVID-19) has had on the workflow of medical scribes.

Design This is a prospective observational survey-based study.

Setting This study was conducted at academic medical center in the United States.

Participants Seventy-four scribes working in ambulatory practices within an academic medical center.

Interventions All medical scribes received a survey assessing their workflow since beginning of COVID-19 restrictions.

Primary and Secondary Outcomes To assess the current workflow of medical scribes since transition to virtual care. Secondary outcomes are to assess the equipment used and location of their new workflow.

Results Fifty-seven scribes completed the survey. Overall 42% of scribes have transitioned to remote scribing with 97% serving as remote scribes for remote visits. This workflow is conducted at home and with personal equipment. Of those not working as scribes, 46% serve in preclinic support, with a wide range of EHR-related activities being reported. The remaining scribes have been either redeployed or furloughed.

Conclusion The rapid transition to virtual care brought about by COVID-19 has resulted in a dramatic shift in scribe workflow with the adoption of a previously unreported workflow of remote scribing for virtual care. Additional work is now needed to ensure these new workflows are safe and effective and that scribes are trained to work in this new paradigm.
Knowledge, Attitudes, and Practices toward COVID-19 among Indian Residents during the Verge of Lockdown Restrictions: A Quick Online Cross-Sectional Survey
Authors: Ponnam Hima Bindu , Akondi Butchi Raju , Jagadabhi Santosh Kumar , Rompicherla Kiranmayee G.R. , Chakali Bharathi , Mohammed Irfan
Published: December 2020

Introduction Prodigious restrictions and safety measures have been adopted by the government to control the spread of wildfire coronavirus disease 2019 (COVID-19) pandemic in India. However, the effective implementation of these measures depends upon the knowledge, attitudes, and practices (KAP) of the people. In this context, a cross-sectional online survey of a sample of Indian residents for assessing their KAP toward COVID-19 has been taken up during the verge of lockdown restrictions.

Methods A self-developed online KAP questionnaire consisted of 21 questions related to clinical treatment and prevention aspects of COVID-19 including the safety measures completed by the participants. Assessments on their attitudes and practices toward COVID-19 included the confidence of people to overcome this pandemic and adapting safety measures such as wearing mask while going out in recent days.

Results and Discussion A sample of 1,043 participants participated in this online survey. The overall correct rate of the knowledge questionnaire was 90%. More than half of the respondents (53.3%) had confidence that India can win the battle against COVID-19. All the participants believed that Ayurveda, Yoga, Unani, Siddha, and Homoeopathy (AYUSH) systems of medicine that are the rich heritage of India would be helpful in combating the viral illness (95.4%). Nearly all the participants (99%) wore masks when going out in recent days. In multiple logistic regression analyses, the COVID-19 knowledge score was significantly associated with a lower likelihood of negative attitudes and preventive practices toward COVID-19.

Conclusion The Indian residents showed good knowledge toward COVID-19 and this in turn helped them to hold optimistic attitudes and have appropriate practices toward COVID-19. More community-based health education program strategies if aimed would help further. The limitation of sample representativeness restricts to generalize the findings to population of rural areas with low socioeconomic status.