bluuebunny/crossref_metadata_2025 huggingface dataset:
Strength in numbers: effect of protein crowding on the shape of cell membranes
Authors: Ruhoff Victoria Thusgaard , Moreno-Pescador Guillermo , Pezeshkian Weria , Bendix Poul Martin
Published: October 2022

Continuous reshaping of the plasma membrane into pleomorphic shapes is critical for a plethora of cellular functions. How the cell carries out this enigmatic control of membrane remodeling has remained an active research field for decades and several molecular and biophysical mechanisms have shown to be involved in overcoming the energy barrier associated with membrane bending. The reported mechanisms behind membrane bending have been largely concerned with structural protein features, however, in the last decade, reports on the ability of densely packed proteins to bend membranes by protein–protein crowding, have challenged prevailing mechanistic views. Crowding has now been shown to generate spontaneous vesicle formation and tubular morphologies on cell- and model membranes, demonstrating crowding as a relevant player involved in the bending of membranes. Still, current research is largely based on unnatural overexpression of proteins in non-native domains, and together with efforts in modeling, this has led to questioning the in vivo impact of crowding. In this review, we examine this previously overlooked mechanism by summarizing recent advances in the understanding of protein–protein crowding and its prevalence in cellular membrane-shaping processes.
Plastic pollution of four understudied marine ecosystems: a review of mangroves, seagrass meadows, the Arctic Ocean and the deep seafloor
Authors: Walther Bruno Andreas , Bergmann Melanie
Published: October 2022

Plastic pollution is now a worldwide phenomenon affecting all marine ecosystems, but some ecosystems and regions remain understudied. Here, we review the presence and impacts of macroplastics and microplastics for four such ecosystems: mangroves, seagrass meadows, the Arctic Ocean and the deep seafloor. Plastic production has grown steadily, and thus the impact on species and ecosystems has increased, too. The accumulated evidence also indicates that plastic pollution is an additional and increasing stressor to these already ecosystems and many of the species living in them. However, laboratory or field studies, which provide strong correlational or experimental evidence of ecological harm due to plastic pollution remain scarce or absent for these ecosystems. Based on these findings, we give some research recommendations for the future.
Hydrodynamical simulations for the common-envelope wind model for Type Ia supernovae
Authors: Cui Yingzhen , Meng Xiangcun , Podsiadlowski Philipp , Song Ren
Published: October 2022

Context. The single-degenerate (SD) model is one of the leading models for the progenitors of Type Ia supernovae (SNe Ia). Recently, a new version of the SD model, the common-envelope wind (CEW) model, has been proposed, which, in principle, has the potential to resolve most of the difficulties encountered by previous SD models. This model is still being developed and a number of open issues remain, such as the details of the mass-loss mechanism from the surface of the common envelope (CE), the main observational properties, and the spiral-in timescale of the binary inside the envelope.

Aims. In this article, we aim to address these issues by considering hydrodynamical effects on the CE.

Methods. Using the stellar evolution code MESA, we carried out a series of 1D hydrodynamical simulations of an asymptotic giant branch (AGB) star undergoing a common-envelope phase with different envelope masses (0.0007 M⊙–0.06 M⊙). The effect of the immersed binary was mimicked by changing the gravitational constant throughout the envelope and injecting an extra heating source at the location of the binary orbit.

Results. We found that the envelopes are always dynamically unstable, leading to regular mass ejection events if the envelope is more massive than the critical value of ∼0.003 M⊙. The κ mechanism can naturally explain this phenomenon. We also found that, due to the low mass of the CE, the estimated frictional luminosity caused by the spiral-in of the immersed binary is much less than the nuclear luminosity, and therefore will not affect the structure of the CE significantly.

Conclusions. Our results imply that the CE in the CEW model cannot be very massive. We also present a rough estimate for the spiral-in timescale based on a simplified model. We found that, for reasonable assumptions, the timescale may be longer than a few 105 yr; therefore, the white dwarf (WD) may have enough time to increase its mass toward the Chandrasekhar mass, avoiding a merger with the companion.
Near-infrared observations of RR Lyrae and Type II Cepheid variables in the metal-rich bulge globular cluster NGC 6441
Authors: Bhardwaj A. , Kanbur S. M. , Rejkuba M. , Marconi M. , Catelan M. , Ripepi V. , Singh H. P.
Published: October 2022

Context. NGC 6441 is a bulge globular cluster (GC) with an unusual horizontal branch morphology and a rich population of RR Lyrae (RRL) and Type II Cepheid (T2C) variables that is unexpected for its relatively high metallicity.

Aims. Our goal is to characterize the pulsation properties of the population II RRL and T2C variables in this metal-rich GC and compare them with a sample of variables in more metal-poor clusters, as well as with theoretical predictions.

Methods. We present JHKs time-series observations of 42 RRLs, eight T2Cs, and ten eclipsing binary candidate variables in NGC 6441 . The multi-epoch observations were obtained using the FLAMINGOS-2 instrument on the 8-m Gemini South telescope. Multiband data are used to investigate pulsation properties of the RRL and T2C variables, including their light curves, instability strip, period–amplitude diagrams, and period–luminosity and period–Wesenheit relations (PLRs and PWRs) in the JHKs filters.

Results. The near-infrared (NIR) pulsation properties of RRL variables are well fitted with theoretical models that have canonical helium content and the mean-metallicity of NGC 6441 ([Fe/H] = −0.44 ± 0.07 dex). The helium-enhanced RRL models predict brighter NIR magnitudes and bluer colors than the observations of RRL in the cluster. We find that the empirical slopes of the RRL PLRs and PWRs in NGC 6441 are statistically consistent with those of RRLs in more metal-poor GCs, as well as the theoretical models. Therefore, we use theoretical calibrations of RRL period–luminosity–metallicity (PLZ) relations to simultaneously estimate the mean reddening, E(J − Ks)=0.26 ± 0.06 mag, and the distance, d = 12.67 ± 0.09 kpc, to NGC 6441. Our mean reddening value is consistent with an independent estimate from the bulge reddening map based on red clump stars. The RRL-based distance agrees well with similar literature measurements based on the PLZ relations, and the Gaia and other independent methods. Our distance and reddening values provide a very good agreement between the PLRs of T2Cs in NGC 6441 and those for RRLs and T2Cs in Galactic GCs that span a broad range of metallicity.

Conclusions. We conclude that the NIR colour-magnitude diagrams, pulsation properties, and PLRs for RRLs and T2Cs in NGC 6441 are in good agreement with the predictions of RRL pulsation models with canonical helium content. This suggests that these population II variables are either not significantly helium enhanced, as previously thought, or the impact of such enhancement is smaller in NIR than the predictions of the pulsation models.
Bewegungstherapie bei nicht-heilbaren, fortgeschrittenen
Krebserkrankungen
Authors: Jensen Wiebke , Schmidt Thorsten
Published: October 2022

Dank der Entwicklung neuer Chemotherapie-Protokolle und verbesserter
zielgerichteter Therapiestrategien hat sich das Überleben von Patienten
mit nicht-heilbaren, fortgeschrittenen Krebserkrankungen deutlich
verlängert. Durch die krankheitsbedingten Symptome und die
zusätzlichen therapiebedingten Nebenwirkungen wird die
Lebensqualität dieser Patienten aber deutlich eingeschränkt.
Übersichtsarbeiten zeigen, dass auch Patienten mit nicht-heilbaren,
fortgeschrittenen Krebserkrankungen von angepasster Bewegungstherapie
profitieren können. Es wurde eine Literaturrecherche mithilfe
elektronischer Datenbanken (PubMed, MEDLINE, EMBASE, Cochrane Library)
durchgeführt und eine Übersicht der randomisierten
kontrollierten Studien (RCTs) zur Bewegungstherapie bei nicht-heilbaren,
fortgeschrittenen Krebserkrankungen gegeben. Die dargestellten Studien zeigen,
dass eine gezielte Bewegungstherapie bei Patienten mit nicht-heilbaren,
fortgeschrittenen Krebserkrankungen sicher und durchführbar ist und
positive Effekte auf die Lebensqualität, auf krankheits- und
therapiebedingte Symptome wie Fatigue, Dyspnoe und auf den körperlichen
Funktionsstatus erzielen kann. Der Artikel beinhaltet außerdem einen
Diskurs mit einem Praxisbezug zum Thema Knochenmetastasen.
Physikalische Medizin als Teil der
Palliativ-Team-Versorgung
Authors: Uher Eva Maria , Heine Georg , Sauberer Judith
Published: October 2022

Für das PMR-Team ist sowohl im ambulanten wie auch im stationären
Bereich oberstes Ziel, das Vertrauen der PalliativpatientInnen zu
stärken, um die bestmögliche Versorgung zu erhalten. Essenziell
dafür ist die enge Kooperation sowohl multiprofessionell als auch
intradisziplinär unter Führung (therapeutischer) Case-Manager,
die eine wichtige Informationsdrehscheibe für das gesamte Team
darstellen. Die Kenntnis der Bandbreite möglicher Indikationen, deren
Kontraindikationen und der Summationseffekte mehrerer physikalischer Therapien
sollten Teil der Ausbildung und Wissensstand aller in der Palliativmedizin
arbeitenden KollegInnen sein. Abgestimmte therapeutische, pflegerische und
ärztliche Maßnahmen unterstützen PatientInnen wie
Angehörige während der palliativmedizinischen Phase der
Betreuung.
Neuevaluierung der Ribavirintherapie bei Lassafieber
Authors: Kleist Christine J. , Groger Mirjam
Published: October 2022

Ribavirin ist ein Breitspektrum-Virostatikum, das zur Therapie einer Reihe an schweren Virusinfektionen inkl. viral-hämorrhagischer Fieber (VHF) verwendet wird. Lassafieber ist ein VHF, das in weiten Teilen Westafrikas endemisch und für bis zu 300 000 Infektionen sowie 5000 Todesfälle pro Jahr verantwortlich ist. Hochdosisribavirin wird trotz eher schwacher Evidenz für die Therapie des Lassafiebers empfohlen und großflächig angewandt. In dieser Studie wurde die Pharmakokinetik der Therapie mit Hochdosisribavirin bei Lassafieberpatienten untersucht und so erste pharmakokinetische Daten für die Verwendung von Ribavirin bei VHF erhoben.
Rückenschmerzen und erhöhtes Bandscheibenvorfallrisiko bei Astronauten während und nach Raumfahrtmissionen
Authors: Swanenburg Jaap , Egli Marcel , Schweinhardt Petra
Published: October 2022

Rückenschmerzen zu Beginn einer Raumfahrtmission sowie ein erhöhtes Risiko für Bandscheibenvorfälle (Diskusprolaps) nach der Rückkehr ist ein seit Langem bekanntes medizinisches Problem der bemannten Raumfahrt. Mit dem Bestreben, den Mond permanent zu besiedeln, wird der Erhalt der körperlichen Gesundheit in einer für den Menschen fremden Umgebung ein zentraler Faktor. Im Vergleich zu den Apollo-Flügen zum Mond in den 1970er-Jahren sollen die Aufenthalte auf dem Mond in Zukunft nicht nur ein paar Tage dauern, sondern Monate, was neue Gesundheitsrisiken mit sich bringt. Durch die Entfernung zur Erde und den dadurch eingeschränkten Zugang zu medizinischen Leistungen wird es ferner viel schwieriger oder gar unmöglich, bei Notfällen schnell einzugreifen. Deshalb sind neue Ideen zur Bewältigung der medizinischen Herausforderungen gefragt.
Management of Enteral Feeding and Application of Probiotics in Very
Low Birth Weight Infants – A National Survey in German
NICUs
Authors: Lange Matthias , Figura Yannick , Böhne Carolin , Beske Florian , Heep Axel , Bohnhorst Bettina
Published: October 2022

Background The advantage of breast milk feeding, and supplementation of
probiotics is well known and proven. However, the lack of reliable amounts of
colostrum and/or transient breast milk during the first few postnatal
days might inhibit timely enteral nutrition.

Methods The aim of this nationwide survey in German Level-1 neonatal
intensive care units (NICUs) was to collect data regarding the management of
feeding in the first days of life in very low birth weight infants (VLBWIs,
birth weight<1500 g). In addition, we analyzed differences in
the use of probiotics. An online survey was sent to all 163 Level-1 NICUs in
Germany.

Results 110/163 (67.5%) hospitals participated in our
study. One-fifth of all participants used exclusively breast milk. The reported
incidence of necrotizing enterocolitis (NEC) was lower in NICUs that exclusively
used breast milk in VLBWIs (p=0.08). Two-thirds start enteral feeding
independent of gestational age during the first 12 hours postnatally
with either breast milk or formula. 80% of all participants checked
gastric residuals routinely. The use of probiotics differs widely concerning
duration and interruption during antibiotic therapy.

Conclusion The exclusive use of breast milk is associated with a lower
incidence of NEC. The result of our survey emphasizes the paramount importance
of nutrition with mother`s milk. In case of insufficient availability of
mother`s milk, the use of human donor milk still appears to be superior
to formula feeding. The implementation of human donor milk banks should
therefore be promoted.
Placental and Umbilical Cord Blood Oxidative Stress Level and
Telomere Homeostasis in Early Onset Severe Preeclampsia
Authors: Baser Emre , Inandiklioglu Nihal , Aydogan Kırmızı Demet , Ercan Fedi , Caniklioğlu Ayşen , Kara Mustafa , Onat Taylan , Yalvac Ethem Serdar
Published: October 2022

Objective Although the etiopathogenesis of preeclampsia (PE) is unknown,
evidence suggests that it may be associated with increased oxidative stress.
Studies have shown that oxidative stress can affect DNA fragments called
telomeres. However, the interactions of PE, oxidative stress, and telomere
length are not clearly known. This study aims to evaluate the
oxidative/anti-oxidative stress balance in the placenta and umbilical
cord and examine the effect of oxidative stress on telomeres.

Materials-Method Cord blood and placental samples were collected from 27
pregnant women with severe PE
(280/7–336/7 gestational
weeks) and 53 healthy pregnant women. Telomere length (TL) was measured by
real-time PCR in the cord blood and placenta tissue. Total antioxidant status
(TAS) and total oxidant status (TOS) levels were measured in the cord blood and
placenta tissue using a colorimetric method.

Results No significant differences were found between groups regarding
age, BMI, gravida, parity, and newborn gender (p>0.05). Cord blood and
placental TL of PE patients were significantly shorter than the control group,
while cord blood and placental TAS and TOS levels were higher (p<0.05).
The results of a multivariate logistic regression analysis showed that the level
of placental TOS in PE patients (OR=1.212, 95%
CI=1.068–1.375) was an independent risk factor affecting PE.

Conclusion This study found that oxidative stress is an independent risk
factor in the development of PE and shortens TL in both placental and umbilical
cord blood. Future research on telomere homeostasis may offer a new perspective
for the treatment of PE.
Adipocyte-Derived Exosomal LINC00968 Promotes Mouse Retina Microvascular Endothelial Cell Dysfunction in a High-Glucose Environment by Modulating the miR-361–5p/TRAF3 Axis
Authors: He Wenjing , Lin Anhua , Wang Chenxiu
Published: October 2022

As a major cause of mortality, cardiovascular disease is associated with obesity and diabetes. However, the molecular mechanism by which diabetes-obesity causes cardiovascular complications is largely unknown. In this study, the crosstalk mediated by 3T3-L1 preadipocytes and mouse retina microvascular endothelial cells (mRMECs) was determined after co-culturing performed with a Transwell system or measuring exosome uptake by mRMECs. CCK-8 assays, EdU incorporation assays, TUNEL staining, and ELISAs were used to evaluate the functions of mRMECs. Related protein markers were analyzed by western blotting. Our results showed that LINC00968 levels were significantly elevated in the exosomes derived from H-Glu-induced 3T3-L1 preadipocytes. Both H-Glu treatment and co-culture with 3T3-L1 cells damaged mRMECs, as indicated by lower rates of proliferation and higher rates of apoptosis and cell adhesion molecule expression, as well as by induced inflammation and oxidative stress, which were enhanced by combined H-Glu and co-culture treatment. Furthermore, H-Glu and co-culture treatment increased LINC00968 expression in mRMECs, and the exosomes collected from 3T3-L1 cells had a similar effect. Functionally, LINC00968 inhibition protected mRMECs against the effects of H-Glu and co-culture treatment, while LINC00968 played the opposite role. LINC00968 was found to target miR-361–5p, and TRAF3 was identified as a target gene of miR-361–5p. Finally, miR-361–5p overexpression alleviated the effects of LINC00968 on H-Glu-induced mRMEC dysfunction in vitro. In conclusion, our results indicated that in an H-glu environment, adipocyte exosomes damage microvascular endothelial cells via a LINC00968/miR-361–5p/TRAF3 signaling pathway, which could possibly serve as a target for treating diabetes-obesity-triggered microvascular complications.
Preventive Approaches in Women's Neurology: Prepartum, Pregnancy, and Postpartum
Authors: Kirkpatrick Laura , Waters Janet , O'Neal Mary Angela
Published: October 2022

Women's neurology is the subspecialty within neurology concerned with the distinct healthcare needs of women. In this article, we review current literature and expert management strategies regarding disease-specific neurologic concerns of women, with an emphasis on issues related to contraception, pregnancy, and lactation. Health conditions that we discuss in this article include epilepsy, headache, stroke, multiple sclerosis, and Chiari I malformation. Current findings on neurologic disease in women suggest that many women with neurologic disease can safely manage their disease during pregnancy and have healthy children, though pregnancy planning is important in many conditions to mitigate risks and effective contraceptive management is important when pregnancy prevention is desired.
Long-Term Effects of Antiseizure Medications
Authors: LoPinto-Khoury Carla
Published: October 2022

Most patients with epilepsy will benefit from seizure control with one of an array of chronic antiseizure medications. Knowledge of the potential long-term effects of these medications is critical to prevent adverse consequences on overall health. Antiseizure medications vary in their capacities to affect the brain and peripheral nerves, hormones, bone mineralization, cardiovascular risk, renal health, hepatic, hematological, and dermatological systems. Understanding of pathophysiology and population risk has evolved, although most of the data available are still on older generation antiseizure medications such as phenytoin, carbamazepine, and valproic acid. The enzyme-inducing properties of some antiseizure medications make their effects on cardiovascular risk and bone health detrimental. Few clear guidelines exist for monitoring long-term effects of medication therapy for epilepsy. When selecting an antiseizure medication, consideration should be given to the individual patient's risks of adverse consequences on other organ systems. During monitoring of patients on chronic therapy, screening tools such as metabolic panels and bone density measurements can help stratify risk and guide management.
Endoscopic sphincterotomy vs papillary large balloon dilation vs combination modalities for large common bile duct stones: a network meta-analysis
Authors: Aziz Muhammad , Khan Zubair , Haghbin Hossein , Kamal Faisal , Sharma Sachit , Lee-Smith Wade , Pervez Asad , Alastal Yaseen , Nawras Ali , Thosani Nirav
Published: October 2022

Background and study aims The optimal technique for removal of large common bile duct (CBD) stones (≥ 10 mm) during endoscopic retrograde cholangiopancreatography (ERCP) remains unclear. We aimed to perform a comparative analysis between different endoscopic techniques.

Methods Adhering to PRISMA guidelines, a stringent search of the following databases through January 12, 2021, were undertaken: PubMed/Medline, Embase, Web of Science, and Cochrane. Randomized controlled trials comparing the following endoscopic techniques were included: (1) Endoscopic sphincterotomy (EST); (2) Endoscopic papillary large balloon dilation (EPLBD); and (3) EST plus large balloon dilation (ESLBD). Stone clearance rate (SCR) on index ERCP was the primary outcome/endpoint. Need for mechanical lithotripsy (ML) and adverse events were also evaluated as secondary endpoint. Random effects model and frequentist approach were used for statistical analysis.

Results A total of 16 studies with 2545 patients (1009 in EST group, 588 in EPLBD group, and 948 patients in ESLBD group) were included. The SCR was significantly higher in ESLBD compared to EST risk ratio [RR]: 1.11, [confidence interval] CI: 1.00–1.24). Lower need for ML was noted for ESLBD (RR: 0.48, CI: 0.31–0.74) and EPLBD (RR: 0.58, CI: 0.34–0.98) compared to EST. All other outcomes including bleeding, perforation, post-ERCP pancreatitis, stone recurrence, cholecystitis, cholangitis, and mortality did not show significant difference between the three groups. Based on network ranking, ESLBD was superior in terms of SCR as well as lower need for ML and adverse events (AEs).

Conclusions Based on network meta-analysis, ESLBD seems to be superior with higher SCR and lower need for ML and AEs for large CBD stones.
Subxiphoid Mediastinoscopic Autonomous Double Fenestration
Authors: Nistor Claudiu-Eduard , Cucu Anca Pati , Gavan Camelia , Ciuche Adrian
Published: October 2022

The coexistence of pleural and pericardial effusions in frail patients with or without confirmed neoplasia necessitates the use of a minimally invasive technique that has a minor impact on the patient's general status and allows for fast fluid evacuation and biopsy sampling if necessary. We present a subxiphoid mediastinoscopic autonomous (simultaneous noncommunicating) double fenestration approach for these patients with both diagnostic and therapeutic advantages in selected cases. Using the mediastinoscope alone through the subxiphoid incision can considerably reduce the duration of operation, allow for fluid evacuation, and significantly alleviate the patient's symptoms. This method enables the sampling of pleural and pericardial fluids and targeted tissue, if necessary.
Preliminary Experience of Extracorporeal Cytokine Hemoadsorption during Left Ventricular Assist Device Implantation in Cardiogenic Shock Patients
Authors: Pausch Jonas , Mersmann Julian , Bhadra Oliver D. , Barten Markus J. , Alassar Yousuf Al , Schulte-Uentrop Leonie , Reichenspurner Hermann , Bernhardt Alexander M.
Published: October 2022

Background Systemic inflammation due to cardiogenic shock is associated with vasoplegia leading to organ hypoperfusion, right heart failure, and poor clinical outcome. Extracorporeal cytokine hemoadsorption emerged to attenuate excessive levels of inflammatory cytokines, potentially improving patient outcomes. Nevertheless, its prognostic impact during high-risk left ventricular assist device (LVAD) implantation remains unknown.

Methods In total, 40 consecutive patients with advanced heart failure underwent continuous-flow LVAD implantation at our institution between 2018 and 2020. Out of 25 high-risk patients in cardiogenic shock (Interagency Registry for Mechanically Assisted Circulatory Support profile 1 and 2), 9 patients (CytoSorb group) underwent LVAD implantation with and 16 patients (control group) without simultaneous cytokine hemoadsorption during cardiopulmonary bypass. Besides preoperative patient characteristics, postoperative lactate clearance, vasopressor administration and mean arterial pressure, perioperative complication, and 30-day mortality rates were retrospectively analyzed.

Results Apart from an increased rate of reoperations within the CytoSorb group, baseline characteristics including the severity of ventricular dysfunction and consecutive signs of end-organ failure were similar in both groups. Preoperative short-term mechanical circulatory support bridging was comparable (66.7 vs. 75%; p = 0.66) prior to LVAD implantation. Procedural characteristics including intraoperative volume management and postoperative vasopressor administration were similar in both groups. There was no difference regarding postoperative lactate clearance, although postoperative mean arterial pressure was significantly higher in the control group (71.3 vs. 57.4 mm Hg; p < 0.01). Furthermore, the 30-day mortality rate was significantly higher in the CytoSorb group (33.3 vs. 0.0%; p = 0.01).

Conclusion Extracorporeal cytokine hemoadsorption during high-risk LVAD implantation was not associated with a decrease of postoperative vasopressor support, improved hemodynamics, or an accelerated lactate clearance.
Coloanal Anastomosis
Authors: Johnston William Forrest
Published: October 2022

The furthest extent of restorative proctectomy involves a colon to anal anastomosis in the deep pelvis. While the anastomosis can be challenging, it can allow the patient to avoid a permanent ostomy. Patient and surgeon preparation can improve patient outcomes. This article will describe the options, technical challenges, and anecdotal tips for coloanal anastomosis.
Proximalization of Frozen Elephant Trunk Procedure: Zone 0 or 1 versus Zone 2 or 3 Arch Repair
Authors: Lee Kwok Fai Lucius , Bhatia Inderjeet , Chan Tai Leung Daniel , Au Wing Kuk Timmy , Ho Ka Lai Cally
Published: October 2022

Background Total arch replacement with the frozen elephant trunk (FET) procedure has changed the landscape of therapy for aortic arch diseases. The optimal landing zone for a FET is controversial. We sought to share our early and midterm results of the FET procedure as well as compare the clinical outcomes of proximal and distal FET anastomosis.

Methods A total of 100 patients who underwent total arch replacement using the FET technique were identified between November 2014 and August 2021. According to the FET anastomosis over the aortic arch, patients were classified into two groups (zone 0/1 vs. zone 2/3). In-hospital mortality, complications, and midterm outcomes were assessed based on patient characteristics.

Results The overall in-hospital mortality was 8%. Major complications occurred in 32% of patients, including spinal cord injury (5%), stroke (7%), and acute kidney injury requiring dialysis (7%). Zone 2/3 FET (odds ratio: 6.491, 95% confidence interval: 1.930–21.835, p = 0.003) was an independent predictor of the composite endpoint of major complications. The rate of complete false lumen thrombosis was comparable (64.3% vs. 71.4%, p = 0.567). All patients, patients with zone 0/1 FET, and patients with zone 2/3 FET had 3-year freedom from aorta-related events of 73.0, 70.2, and 75.0%, respectively. There were no significant differences (log-rank test, p = 0.500).

Conclusion Compared with zone 2/3, proximalization of FET using zone 0/1 for anastomosis was associated with better early outcomes and comparable rates of midterm aorta-related events. To substantiate its use, more research on this approach is required.
Fokus auf Nachhaltigkeit: Klare Position zur Klimaneutralität
Authors: Hohnstein Aileen
Published: October 2022

Das Gesundheitswesen trägt mit hohen Emissionen schädlicher Klimagase und erheblichen Energieverbräuchen maßgeblich zum Klimawandel bei. Vielen Spitzenmanagern in den Führungsetagen der Krankenhäuser fällt es dennoch schwer, das Thema Nachhaltigkeit zentral auf die Agenda zu setzen. Dabei sollte nicht nur aus Klimaschutzgründen gehandelt werden.
Klinikdaten: Warum externe Cloud-Dienste eine gute Alternative sind
Authors: Engberg Anna
Published: October 2022

Der Krankenhaus-IT-Experte Nils Alwardt verantwortet bei Vivantes, dem größten kommunalen Krankenhausunternehmen Deutschlands, die IT von neun Krankenhäusern. Er findet: „Cloud-Lösungen sind eine echte Option für die Zukunft.“ Im Gespräch mit kma erklärt er, wieso externe Cloud-Datenhaltung per se weder preiswerter noch unsicherer ist als in eigenen Rechenzentren.
Zeitenwende im ÖVKT: Konzentration auf die inhaltlichen Herausforderungen
Authors: Thalmayr Maria
Published: October 2022

Die Mitgliederzahl des Österreichischen Verbandes der KrankenhaustechnikInnen (ÖVKT) hat sich in den letzten 10 Jahren auf 475 annähernd verdoppelt, Tagungen und Fortbildungsangebote des Verbandes erfreuen sich eines enormen Zuspruchs. Darum: Klar zur Wende!
Examining the association between health status and subjective life expectancy among older Indian adults based on the mindsponge approach
Authors: Kumar Manish , Srivastava Shobhit , Muhammad T. , Saravanakumar Priya
Published: October 2022

Gender and socioeconomic differences in subjective life expectancy (SLE) are an unexplored arena in the geriatric literature concerning low-resource settings. Information on several health outcomes that might influence the SLE could guide targeted interventions, particularly in countries with rapidly ageing populations like India. This study aimed to explore SLE and the associations of SLE with the objective and subjective health status of older Indian adults, based on the mindsponge mechanism that links the contextual factors with individuals' evaluation of health. Data from the Longitudinal Ageing Study in India were used and the final sample included 5969 older adults aged 60 years and above. Independentt-tests were used to assess the gender difference in SLE according to various health-related factors. Additionally, we used generalized linear regression models (GLMs) with a logit link and a binomial family to fulfil the study objectives. The proportion of older adults who reported a 100% probability of survival for a 1-year period was nearly 38%, compared with 12% and 6% of the respondents who reported the same for 5 and 10 years survival periods, respectively. Older men reported a greater average probability of own survival than older women for all the time periods. Older men who reported poor self-rated health had a significantly lower SLE for a 1-year period (β = −0.232, SD = 0.107) and a 5-year period (β = −0.226, SD = 0.077) than those who reported good self-rated health. On the other hand, older women with poor self-rated health had a significantly lower SLE for a 10 years time horizon than women with good self-rated health. Underweight men had significantly lower SLE for a 1-year period than men with normal BMI (β = −0.213, SD = 0.097). Further, cognitively impaired women reported significantly lower SLE for a 1-year period (β = −0.399, SD = 0.108) and 5 years period (β = −0.160, SD = 0.077). Depressed older men reported significantly lower SLE for 1-year period (β = −0.309, SD = 0.101), 5-year period (β = −0.194, SD = 0.084), and 10-year period (β = −0.129, SD = 0.071). The current findings, supporting the mindsponge mechanism, indicate that older adults base their estimation of longevity on health factors that they are aware of or not. This finding has significant implications for health professionals and public policy in planning targeted interventions that can benefit at-risk population cohorts.
Characteristics of the cylindrical reflex triode driven by a four-stage linear transformer driver
Authors: Lai Dingguo , Xu Qifu , Qiu Mengtong , Sun Fengju , Jiang Xiaofeng , Li Mo , Jiang Hongyu , Wang Zhiguo , Yang Hailiang , Wang Jinhua
Published: October 2022

A cylindrical reflex triode was designed and directly driven by a four-stage linear transformer driver to generate high intensity pulsed warm x rays. We developed a numerical model of the cylindrical reflex triode and simulated and studied the experimental electron distribution and the radiation characteristics. The working voltage of the cylindrical reflex triode is 220 kV, and the current is about 600 kA. Under the voltage pulse with a rise time of 100 ns, the electron beam spot is uniform, and the duration of the gap without short circuit reaches 200 ns. The x-ray dose is 385 rad (Si), with an irradiation area of 615 cm2 and a uniformity of less than 2:1. The radiation field distribution is basically consistent with the simulation results. Compared with the two-stage series diode on the Flash-II accelerator, the x-ray conversion efficiency of the cylindrical reflex triode is increased about 1.6 times.
A comprehensive framework for preference aggregation Parrondo’s paradox
Authors: Lai Joel Weijia , Cheong Kang Hao
Published: October 2022

Individuals can make choices for themselves that are beneficial or detrimental to the entire group. Consider two losing choices that some individuals have to make on behalf of the group. Is it possible that the losing choices combine to give a winning outcome? We show that it is possible through a variant of Parrondo’s paradox—the preference aggregation Parrondo’s paradox (PAPP). This new variant of Parrondo’s paradox makes use of an aggregate rule that combines with a decision-making heuristic that can be applied to individuals or parts of the social group. The aim of this work is to discuss this PAPP framework and exemplify it on a social network. This work enhances existing research by constructing a feedback loop that allows individuals in the social network to adapt its behavior according to the outcome of the Parrondo’s games played.
Compositional degradation of the electron blocking layers through solid-solution in GaN-based laser diodes
Authors: Li Shukun , Lei Menglai , Lang Rui , Yu Guo , Chen Huanqing , Wen Peijun , Akbar Khan Muhammad Saddique , Meng Linghai , Zong Hua , Jiang Shengxiang , Hu Xiaodong
Published: October 2022

Electron leakage currents seriously hinder GaN-based blue laser diodes (LDs) from high wall-plug efficiencies. Inserting an ultra-thin AlGaN electron blocking layer (EBL) in the epitaxy structure is a major technique to suppress the leakage currents for which a high Al composition in the EBL is necessary. Despite many studies on the optimization of the compositions of EBLs, it is questionable whether they reach the designed value in real growths by metal-organic vapor phase epitaxy. We investigate the influence of the growth conditions of upper cladding layers (CLs) on the underlying EBLs. A strong composition degradation of the EBL is observed when the growth rate of the CL is low, which drastically reduces the output performance of both LEDs and LDs. A 30-nm fast-growing protecting layer can efficiently prevent the EBL from such degradation. The phenomenon cannot be explained by a composition pulling effect nor an etch effect by hydrogen, but by a mutual solid solution between the EBL and the adjacent CL. The solution process is found thermally favored by calculating the Gibbs energy where strain and entropies are considered. It is inferred that the chemically active Ga adatoms at the surface play an important role in accelerating the solution process. Based on these considerations, we introduce a random walk model to clarify the kinetic influence of CL growth rates on EBL degradation semi-quantitatively. The results help to understand the subtle process in the growth of heterostructures and the transport process of GaN-based LDs.
Deep learning-based solvability of underdetermined inverse problems in nonlinear ultrasonic characterization of micro damages
Authors: Liu Lishuai , Sun Di , Xiang Yanxun , Xuan Fu-Zhen
Published: October 2022

Detection and evaluation of micro-damages in the early stages of engineering failure are crucial for various industrial structures to ensure their safety and prevent further catastrophic accidents. The nonlinear ultrasonic technique (NUT) has gained increasing popularity and recognition for breaking through the detection sensitivity limit upon micro-damages that usually are invisible to conventional linear techniques. However, it remains an ongoing challenge to quantitatively characterize micro-damages using NUT due to great difficulties in fully modeling the complicated interaction mechanism between the nonlinear ultrasonic waves and micro-damages. This work presents a data-driven perspective for solving multiparameter underdetermined inverse problems that are at the core of NUT, while allowing by-passing the creation of high-fidelity physics-based models. Nonlinear Lamb wave measurements with group-velocity mismatching are conducted to introduce both size and localization information of damages to the assembled dataset. A nonlinearity-aware discrete wavelet transform-bidirectional long short-term memory network is proposed to directly process nonlinear ultrasonic responses to automatically model latent nonlinear dynamics, thus establishing the complex mapping between the nonlinear ultrasonic signals and the multi-dimensional damage features. In particular, an attempt is made to augment the physical explainability of the proposed deep learning approach through a frequency component importance analysis. The trained network enables accurate and explainable predictions of length and localization of closed cracks and robustness against varying degrees of noise. Our work paves a promising and practical way to promote the transformation of NUT from the qualitative analysis for accurate and efficient quantitative prediction.
Ground state solutions for Schrödinger–Poisson system with critical growth and nonperiodic potential
Authors: Kang Jin-Cai , Chen Xiao-Ping , Tang Chun-Lei
Published: October 2022

This paper is concerned with the existence of ground state solutions for the Schrödinger–Poisson system −Δu + V(x)u + ϕu = |u|4u + λ|u|p−2u in R3 and −Δϕ = u2 in R3, where λ > 0 and p ∈ [4, 6). Here, V(x)∈C(R3,R), V(x) = V1(x) for x1 > 0, and V(x) = V2(x) for x1 < 0, where V1, V2 are periodic functions in each coordinate direction. In this paper, we give a splitting lemma corresponding to the nonperiodic potential and, then, prove the existence of ground state solutions for any λ > 0 when p ∈ (4, 6). Moreover, when p = 4, the above system possesses a ground state solution for λ > 0 sufficiently large. It is worth underlining that the technique employed in this paper is also valid for the Sobolev subcritical problem studied by Cheng and Wang [Discrete Contin. Dyn. Syst., Ser. B 27, 6295 (2022)].
Effective electron–ion percolation network enabled by in situ lithiation for dendrite-free Li metal battery
Authors: Liu Qingsong , Wang Yue , Zhang Jian , Liang Jianquan , Lou Shuaifeng , Zhu Ge , An Hanwen , Song Yajie , Dai Changsong , Yan Liqin , Xie Jingying , Wang Jiajun
Published: October 2022

The development of a lithium metal anode has been hindered by the problem of lithium dendrites. The fast and homogeneous ion transport to achieve even lithium plating is challenging but still remains elusive. Improving the single conduction of ions or electrons is not enough to achieve dendrite-free and long life Li–metal composite electrodes. Herein, we use in situ lithiation and electroplating methods to construct an effective mixed electron–ion percolation network composite anode. The mixed ion–electron conductive framework can build a stable interface that provides nucleation sites for Li plating. At the same time, the 3D percolation network composed of 3D nanosheets can facilitate the fast transport of ions and electrons, enabling uniform lithium plating inside the skeleton. As a result, the composite anodes exhibit a stable dendrite-free Li stripping/plating process with low overpotential. Furthermore, the full cell using the composite anode coupled with the LiFePO4 cathode displays high cycle stability with a capacity retention rate of about 100% after 500 cycles. The present strategy of the mixed ion–electron conductive skeleton could further promote the development of the next-generation lithium metal anode.
Correlation consistent effective core potentials for late 3d transition metals adapted for plane wave calculations
Authors: Kincaid Benjamin , Wang Guangming , Zhou Haihan , Mitas Lubos
Published: October 2022

We construct a new modification of correlation consistent effective core potentials (ccECPs) for late 3d elements Cr–Zn with Ne-core that are adapted for efficiency and low energy cut-offs in plane wave calculations. The decrease in accuracy is rather minor, so that the constructions are in the same overall accuracy class as the original ccECPs. The resulting new constructions work with energy cut-offs at or below ≈400 Ry and, thus, make calculations of large systems with transition metals feasible for plane wave codes. We also provide the basic benchmarks for atomic spectra and molecular tests of this modified option that we denote as ccECP-soft.
Non-destructive depth-resolved characterization of residual strain fields in high electron mobility transistors using differential aperture x-ray microscopy
Authors: Pagan Darren C. , Rasel Md A. J. , Lim Rachel E. , Sheyfer Dina , Liu Wenjun , Haque Aman
Published: October 2022

Localized residual stress and elastic strain concentrations in microelectronic devices often affect the electronic performance, resistance to thermomechanical damage, and, likely, radiation tolerance. A primary challenge for the characterization of these concentrations is that they exist over sub-μm length-scales, precluding their characterization by more traditional residual stress measurement techniques. Here, we demonstrate the use of synchrotron x-ray-based differential aperture x-ray microscopy (DAXM) as a viable, non-destructive means to characterize these stress and strain concentrations in a depth-resolved manner. DAXM is used to map two-dimensional strain fields between the source and the drain in a gallium nitride (GaN) layer within high electron mobility transistors (HEMTs) with sub-μm spatial resolution. Strain fields at various positions in both pristine and irradiated HEMT specimens are presented in addition to a preliminary stress analysis to estimate the distribution of various stress components within the GaN layer. γ-irradiation is found to significantly reduce the lattice plane spacing in the GaN along the sample normal direction, which is attributed to radiation damage in transistor components bonded to the GaN during irradiation.
Exact constraints and appropriate norms in machine-learned exchange-correlation functionals
Authors: Pokharel Kanun , Furness James W. , Yao Yi , Blum Volker , Irons Tom J. P. , Teale Andrew M. , Sun Jianwei
Published: October 2022

Machine learning techniques have received growing attention as an alternative strategy for developing general-purpose density functional approximations, augmenting the historically successful approach of human-designed functionals derived to obey mathematical constraints known for the exact exchange-correlation functional. More recently, efforts have been made to reconcile the two techniques, integrating machine learning and exact-constraint satisfaction. We continue this integrated approach, designing a deep neural network that exploits the exact constraint and appropriate norm philosophy to de-orbitalize the strongly constrained and appropriately normed (SCAN) functional. The deep neural network is trained to replicate the SCAN functional from only electron density and local derivative information, avoiding the use of the orbital-dependent kinetic energy density. The performance and transferability of the machine-learned functional are demonstrated for molecular and periodic systems.
The Wigner localization of interacting electrons in a one-dimensional harmonic potential
Authors: Telleria-Allika Xabier , Escobar Azor Miguel , François Grégoire , Bendazzoli Gian Luigi , Matxain Jon M. , Lopez Xabier , Evangelisti Stefano , Berger J. Arjan
Published: October 2022

In this work, we study the Wigner localization of interacting electrons that are confined to a quasi-one-dimensional harmonic potential using accurate quantum chemistry approaches. We demonstrate that the Wigner regime can be reached using small values of the confinement parameter. To obtain physical insight in our results, we analyze them with a semi-analytical model for two electrons. Thanks to electronic-structure properties such as the one-body density and the particle–hole entropy, we are able to define a path that connects the Wigner regime to the Fermi-gas regime by varying the confinement parameter. In particular, we show that the particle–hole entropy, as a function of the confinement parameter, smoothly connects the two regimes. Moreover, it exhibits a maximum that could be interpreted as the transition point between the localized and delocalized regimes.
Effect of free stream turbulence in critical Reynolds number regime (1.6 × 105−6.1 × 105) on flow around circular cylinder
Authors: Chang Ying , Zhao Lin , Chen Lin , Xu Jun , Cui Bing , Ge Yaojun
Published: October 2022

The flow around a cylinder is a classical aerodynamic problem involving the effect of Reynolds number (Re). Thus far, the impact of turbulence has not been fully clarified despite its important practical value in engineering applications. This study mainly investigates the influence of turbulence in the critical Re regime on the smooth and turbulent flows around a cylinder. The foregoing is accomplished by conducting static pressure measurement model experiments in the Re range of 1.6 × 105–6.1 × 105 and turbulence intensity range (Iu) of 5%–13%. Consequently, a series of useful results for engineering wind resistance design is obtained. The effect of turbulence on each sub-flow regime varies. The structural response to turbulence is more dangerous under conditions such as when the wind pressure coefficients fluctuate strongly and non-Gaussianity is strong. The foregoing effects do not necessarily increase linearly with the turbulence intensity. In addition, the influence of turbulence evidently depends on the Re and corresponding flow regime. Therefore, turbulence must be cautiously managed in scaled model experiments and actual wind resistance design.
Highly conductive MXene binder enabling Ge anode for stable sodium storage
Authors: Wang Xin , Cao Bowei , Gao Qing , Cao Qian , Hu Pengfei , Zhang Yongya , Wei Wei , Wang Hua
Published: October 2022

Traditional binders and conductive agents are important electrode additives that contribute to the mechanical integrity and conductivity of sodium ion batteries (SIBs), but they affect the energy density of the batteries. In this study, Ti3C2Tx MXene was used as a conductive binder for a Ge anode owing to its high conductivity and clay-like property, which not only combined the functionality of the binders and additives but also provided additional sodium ion storage capacity. Ultra-long lifetime (high-capacity retention of 88% after 20 000 cycles) and enhanced rate performance (124.5 at 1500 mA g−1) were observed for the as-designed Ge-Ti3C2Tx anode. The Ge-Ti3C2Tx anode exhibited a specific capacity of 125.7 mA h g−1 at a current density of 100 mA g−1 after 100 cycles even at −20 °C. This Ti3C2Tx MXene conductive binder may enhance the electrode performance of the SIBs and other energy storage devices.