bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of carbon ion and photon reirradiation for recurrent glioblastoma
Authors: Lautenschlaeger F. S. , Dumke R. , Schymalla M. , Hauswald H. , Carl B. , Stein M. , Keber U. , Jensen A. , Engenhart-Cabillic R. , Eberle F.
Published: September 2021

Purpose

Purpose of this study was to investigate overall survival in recurrent glioblastoma treated with either carbon ion reirradiation or photon reirradiation.

Materials and methods

In this retrospective study we evaluated 78 consecutive patients with recurrent IDH (Isocitrate dehydrogenase)-wildtype glioblastoma (38 patients carbon ion re-radiotherapy, 40 patients photon re-radiotherapy) treated with either carbon ion reirradiation or stereotactic photon reirradiation. 45 Gy (RBE; 15 fractions) carbon ion reirradiation (CIRT) or 39 Gy (13 fractions) photon reirradiation (FSRT) was administered, respectively. Overall survival was investigated with respect to histological, clinical, and epidemiological features. Kaplan–Meier and multivariate Cox statistics were calculated. A propensity score-matched analysis of the FSRT and CIRT groups using variables from a validated prognosis score was carried out.

Results

The type of reirradiation (CIRT vs. FSRT) significantly influenced overall survival—8.0 months vs. 6.5 months (univariate: p = 0.046)—and remained an independent prognostic factor in multivariate analysis (p = 0.017). Propensity score-adjusted analysis with CIRT versus FSRT as the dependent variable yielded a significant overall survival advantage for the CIRT group (median OS 8.9 versus 7.2 months, p = 0.041, 1‑year survival 29 versus 10%). Adverse events (AE) were evaluated for both subgroups. For the FSRT group no toxicity ≥ grade 4 occurred. For the CIRT subgroup no grade 5 AE occurred, but 1 patient developed a grade 4 radionecrosis. We encountered 4 grade 3 toxicities. One patient developed a zoster at the trunk, 2 progressed in their paresis, and 1 featured progressive dysesthesia.

Conclusion

In conclusion, carbon ion treatment is a safe and feasible treatment option for recurrent glioblastoma. Due to the retrospective nature of the study and two different dose levels for CIRT or FSRT, the improved outcome in CIRT reirradiation might be an effect of higher biological impact from carbon ions or a simple dose-escalation effect. This hypothesis needs prospective testing in larger patient cohorts. A prospective phase III randomized trial is in preparation at our center.
Innovationsunterstützung im BfArM – Erfahrungen aus den Beratungen zu digitalen Gesundheitsanwendungen (DiGA)
Authors: Löbker Wiebke , Böhmer Anne Christin , Höfgen Barbara
Published: September 2021

Seit Mai 2020 können Hersteller einen Antrag zur Aufnahme einer digitalen Gesundheitsanwendung (DiGA) in das Verzeichnis nach § 139e Fünftes Buch Sozialgesetzbuch (SGB V) beim für das Bewertungsverfahren zuständigen Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) stellen. Diesem neuen Antragsverfahren liegen spezifische Anforderungen und Bewertungsparameter zugrunde, zu denen sich herstellerseitig eine Vielzahl an Verfahrens- und wissenschaftlichen Fragestellungen an das BfArM ergibt.

Um diesem Bedarf Rechnung zu tragen, hat das BfArM seine etablierten Informations- und Beratungsangebote gezielt für diese neuen Fragestellungen erweitert. Welche dies bezogen auf DiGA im Einzelnen sind, wo entsprechende Informationen und Unterlagen zu finden sind und was diese jeweils auszeichnet, wird in diesem Beitrag dargelegt. Des Weiteren wird mit Blick auf die zwischen Mai 2020 und April 2021 durchgeführten Beratungsgespräche analysiert, welchen Einfluss diese auf das Ergebnis im jeweiligen Antragsverfahren zur Aufnahme in das DiGA-Verzeichnis haben. Dabei bestätigt sich, dass die frühzeitige Erörterung bewertungsrelevanter Parameter und die Berücksichtigung der Beratungsempfehlungen mit einem positiven Bewertungsergebnis korrelieren: Zu den im Verzeichnis gelisteten DiGA hatten 80 % der Hersteller zuvor eine Beratung durch das BfArM in Anspruch genommen. Die Quote zurückgezogener bzw. abgelehnter Anträge war dagegen deutlich höher, wenn Hersteller zuvor keine Beratung in Anspruch genommen hatten, gegenüber Herstellern, die im Vorfeld zentrale Aspekte mit dem BfArM diskutiert hatten (63 % vs. 35 %). Insgesamt profitieren alle Seiten von dem frühzeitigen, intensiven Austausch – letztendlich insbesondere die Patientinnen und Patienten durch einen unverzögerten Einzug von DiGA in die Regelversorgung aufgrund höherer Antragsqualität.
Bumblebee electric charge stimulates floral volatile emissions in Petunia integrifolia but not in Antirrhinum majus
Authors: Montgomery Clara , Vuts Jozsef , Woodcock Christine M. , Withall David M. , Birkett Michael A. , Pickett John A. , Robert Daniel
Published: September 2021

The timing of volatile organic compound (VOC) emission by flowering plants often coincides with pollinator foraging activity. Volatile emission is often considered to be paced by environmental variables, such as light intensity, and/or by circadian rhythmicity. The question arises as to what extent pollinators themselves provide information about their presence, in keeping with their long co-evolution with flowering plants. Bumblebees are electrically charged and provide electrical stimulation when visiting plants, as measured via the depolarisation of electric potential in the stem of flowers. Here we test the hypothesis that the electric charge of foraging bumblebees increases the floral volatile emissions of bee pollinated plants. We investigate the change in VOC emissions of two bee-pollinated plants (Petunia integrifolia and Antirrhinum majus) exposed to the electric charge typical of foraging bumblebees. P. integrifolia slightly increases its emissions of a behaviorally and physiologically active compound in response to visits by foraging bumblebees, presenting on average 121 pC of electric charge. We show that for P. integrifolia, strong electrical stimulation (600–700 pC) promotes increased volatile emissions, but this is not found when using weaker electrical charges more representative of flying pollinators (100 pC). Floral volatile emissions of A. majus were not affected by either strong (600–700 pC) or weak electric charges (100 pC). This study opens a new area of research whereby the electrical charge of flying insects may provide information to plants on the presence and phenology of their pollinators. As a form of electroreception, this sensory process would bear adaptive value, enabling plants to better ensure that their attractive chemical messages are released when a potential recipient is present.
Topology optimization using PETSc: a Python wrapper and extended functionality
Authors: Smit Thijs , Aage Niels , Ferguson Stephen J. , Helgason Benedikt
Published: September 2021

This paper presents a Python wrapper and extended functionality of the parallel topology optimization framework introduced by Aage et al. (Topology optimization using PETSc: an easy-to-use, fully parallel, open source topology optimization framework. Struct Multidiscip Optim 51(3):565–572, 2015). The Python interface, which simplifies the problem definition, is intended to expand the potential user base and to ease the use of large-scale topology optimization for educational purposes. The functionality of the topology optimization framework is extended to include passive domains and local volume constraints among others, which contributes to its usability to real-world design applications. The functionality is demonstrated via the cantilever beam, bracket and torsion ball examples. Several tests are provided which can be used to verify the proper installation and for evaluating the performance of the user’s system setup. The open-source code is available at https://github.com/thsmit/, repository $$\texttt {TopOpt\_in\_PETSc\_wrapped\_in\_Python}$$

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New directions for inline inspection of automobile laser welds using non-destructive testing
Authors: Machado Miguel Araújo , Rosado Luís Filipe Soldado Granadeiro , Mendes Nuno Alberto Marques , Miranda Rosa Maria Mendes , dos Santos Telmo Jorge Gomes
Published: September 2021

An innovative pilot installation and eddy current testing (ECT) inspection system for laser-brazed joints is presented. The proposed system detects both surface and sub-surface welding defects operating autonomously and integrated with a robotized arm. Customized eddy current probes were designed and experimentally validated detecting pore defects with 0.13 mm diameter and sub-surface defects buried 1 mm deep. The integration of the system and the manufacturing process towards an Industry 4.0 quality control paradigm is also discussed.
The age distribution of business firms
Authors: Calvino Flavio , Giachini Daniele , Guerini Mattia
Published: September 2021

We investigate upon the shape and the determinants of the age distribution of business firms. By employing a novel dataset covering the population of French businesses, we highlight that a geometric law provides a reasonable approximation for the age distribution. However, relevant systematic deviations and sectoral heterogeneity appear. We develop a stochastic model of firm dynamics to explain the mechanisms behind this evidence and relate them to business dynamism. Results reveal a long-term decline in entry rates and lower survival probabilities of young firms. Our findings bear important implications for aggregate outcomes, notably employment growth.
Suizidale Gasembolie im Krankenhaus
Authors: Böckers A. , Steinhoff S. , Scholl T. , Kunz Sebastian N.
Published: September 2021

Luftembolien sind im klinischen Alltag nach traumatischen oder iatrogenen Ereignissen eine häufig zu beobachtende Entität. Fälle einer in suizidaler Absicht herbeigeführten Luftembolie sind selten. Die Konnektivität von luft- und flüssigkeitsführenden Schlauchsystemen ermöglicht die Zufuhr großer Gasmengen in kurzer Zeit mit häufig tödlichem Ausgang. Der Einsatz einer Computertomographie vor der Obduktion ist in solchen Fällen obligat und ermöglicht eine umfassende Darstellung der zugeführten Gasmengen. Wir präsentieren den ungewöhnlichen Fall einer suizidalen venösen Gaszufuhr mittels eines stationären Sauerstoffgerätes in einem Krankenhaus.
Lipschitz Bounds and Nonautonomous Integrals
Authors: De Filippis Cristiana , Mingione Giuseppe
Published: September 2021

We provide a general approach to Lipschitz regularity of solutions for a large class of vector-valued, nonautonomous variational problems exhibiting nonuniform ellipticity. The functionals considered here range from those with unbalanced polynomial growth conditions to those with fast, exponential type growth. The results obtained are sharp with respect to all the data considered and also yield new, optimal regularity criteria in the classical uniformly elliptic case. We give a classification of different types of nonuniform ellipticity, accordingly identifying suitable conditions to get regularity theorems.
Surgical Management of Patients with Snakebite‐Related Musculoskeletal Complication–A Single Institution Experience in Cambodia
Authors: Uy Kim , Heang Oy , Keo Vanna , Kim Yong June , Gollogly Jim , Lee Ling Hong
Published: September 2021

Background

Snakebite‐related injury is a serious public health issue. In Cambodia, it is estimated that up to 21,500 cases of envenoming occurs from snakebites annually. Musculoskeletal disability is a major long‐term complication associated with the injury. In this study, we aim to describe surgical management and rehabilitation in snakebite‐related musculoskeletal injuries at Children's Surgical Centre, Phnom Penh, Cambodia.

Methods

We conducted a retrospective case series analysis of patients with snakebite‐related injury who were treated between January 1, 2002 and December 31, 2018. Surgical patients were divided into the early and late presenting groups (= < one year vs. > one year, respectively) based on their time interval from snake bite to time of presentation.

Results

There were 88 patients who presented with snakebite‐related musculoskeletal injury during the cohort study period. Majority of them were male (n = 62, 71%) and had a median age of 24 years old (IQR 17–44). The injuries were all in the upper and lower limbs though lower limb injury was more common in female patients (81% vs. 48%, Fisher's test p = 0.005). The median time interval from snakebite to time of treatment was 3 years (IQR 3 months–11 years). In this study, 65 patients received surgical interventions. An ulcerated wound was the most common symptom among the early presenting group (78% vs. 24%), while scar contracture was most common among the late group (76% vs. 22%) (Fisher's test p < 0.0001). For management, surgical debridement was the most common primary intervention for the early group (52% vs. 19%), and contracture release was the most common for patients in the late group (62% vs. 15%) (Fisher's test p = 0.0004). Overall, the postoperative complication rate was highest in the late presenting group (34% vs. 3%, Fisher's test p = 0.005).

Conclusion

More than half of the patients presented with musculoskeletal injury require surgical correction. Our study demonstrated that scar contracture is the most common complaint among the late presenting group and is associated with high postoperative complication rate.
Physiological and Biochemical Effects of an Aqueous Extract of Lemna minor L. as a Potential Biostimulant for Maize
Authors: Del Buono Daniele , Bartucca Maria Luce , Ballerini Eleonora , Senizza Biancamaria , Lucini Luigi , Trevisan Marco
Published: September 2021

Biostimulants are receiving increasing attention for their beneficial effects on crops, driving interest in identifying new plant extracts that could exert such stimulatory effects. This work aimed to evaluate the potential of an aqueous extract obtained from duckweed (Lemna minor L.), a freshwater species, to act as a biostimulant in maize. For this purpose, duckweed plants were collected from a natural basin and then transferred, stabilized, and grown under controlled conditions. The duckweed extract was first characterized through untargeted profiling, which revealed an abundance of bioactive phytochemicals. A relatively high amount of low-molecular-weight secondary metabolites such as phenolics (6714.99 mg kg−1) and glucosinolates (4563.74 mg kg−1) were present in the plant extract. Maize seeds were primed with different concentrations of this extract (0.01%, 0.05%, 0.50%, and 1.00%, dry weight/water volume), and some physiological and biochemical traits of the crop were recorded. The duckweed extract improved maize germination, biomass, leaf area, pigment content, and vigor index. The most effective treatment was the 0.50% concentration, which improved the majority of the measured growth traits. The extract at concentrations of 0.05%, 0.50%, and 1.00% stimulated the assimilation of nitrogen (N), phosphorous (P), potassium (K), calcium (Ca), magnesium (Mg), sodium (Na), iron (Fe), and copper (Cu). In summary, this study revealed that duckweed is a promising species that can be cultured and grown under controlled conditions for obtaining extracts with biostimulant properties.
Vascular surgery in liver resection
Authors: Radulova-Mauersberger Olga , Weitz Jürgen , Riediger Carina
Published: September 2021

Vascular surgery in liver resection is a standard part of liver transplantation, but is also used in oncological liver surgery. Malignant liver tumors with vascular involvement have a poor prognosis without resection. Surgery is currently the only treatment to provide long-term survival in advanced hepatic malignancy. Even though extended liver resections are increasingly performed, vascular involvement with need of vascular reconstruction is still considered a contraindication for surgery in many institutions. However, vascular resection and reconstruction in liver surgery—despite being complex procedures—are safely performed in specialized centers. The improvements of the postoperative results with reduced postoperative morbidity and mortality are a result of rising surgical and anesthesiological experience and advancements in multimodal treatment concepts with preconditioning measures regarding liver function and systemic treatment options. This review focuses on vascular surgery in oncological liver resections. Even though many surgical techniques were developed and are also used during liver transplantation, this special procedure is not particularly covered within this review article. We provide a summary of vascular reconstruction techniques in oncological liver surgery according to the literature and present also our own experience. We aim to outline the current advances and standards in extended surgical procedures for liver tumors with vascular involvement established in specialized centers, since curative resection improves long-term survival and shifts palliative concepts to curative therapy.
Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital
Authors: Rauch Julia , Patrzyk Maciej , Heidecke Claus-Dieter , Schulze Tobias
Published: September 2021

Introduction

Stress ulcer prophylaxis (SUP) has been a widespread practice both in intensive care units (ICU) and internal wards at the beginning of the twenty-first century. Clinical data suggests an important overuse of acid suppressive therapy (AST) for this indication. Data on current clinical practice of SUP in surgical patients in a non-ICU setting are spares. In the light of a growing number of reports on serious side effects of AST, this study evaluates the use of AST for SUP in a normal surgical ward in a German university hospital.

Methods

Between January 2016 and June 2016, SUP was analysed retrospectively in 1132 consecutive patients of the Department of Surgery of the Universitätsmedizin Greifswald.

Results

The patients managed with and without SUP were similar with respect to demographic data and treatment with anticoagulants, SSRI and glucocorticoids. Patients with SUP were treated more frequently by cyclooxygenase inhibiting drugs (NSAID, COX2-inhibitors), were more frequently treated in the intermediated care unit and had a longer hospital stay. Risk factors for the development of stress ulcers were similarly present in patient groups managed with and without SUP. About 85.7–99.6% of patients were given SUP without an adequate risk for stress ulcer development, depending on the method used for risk assessment.

Discussion

Still today, SUP is widely overused in non-ICU surgical patients. Information campaigns on risk factors for stress ulcer development and standard operating procedures for SUP are required to limit potential side effects and increased treatment costs.
The relation between sleep quality, sleep quantity, and gastrointestinal problems among colorectal cancer survivors: result from the PROFILES registry
Authors: Schoormans Dounya , van Es Bonita , Mols Floortje , Wasowicz Dareczka , Beijer Sandra , Ezendam Nicole P. M.
Published: September 2021

Purpose

Common residual symptoms among survivors of colorectal cancer (CRC) are sleep difficulties and gastrointestinal symptoms. Among patients with various gastrointestinal (inflammatory) diseases, sleep quality has been related to gastrointestinal symptoms. For CRC survivors, this relation is unclear; therefore, we examined the association between sleep quality and quantity with gastrointestinal symptoms among CRC survivors.

Methods

CRC survivors registered in the Netherlands Cancer Registry—Southern Region diagnosed between 2000 and 2009 received a survey on sleep quality and quantity (Pittsburgh Sleep Quality Index) and gastrointestinal symptoms (European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire-Colorectal 38, EORTC QLQ-CR38) in 2014 (≥ 4 years after diagnosis). Secondary cross-sectional data analyses related sleep quality and quantity separately with gastrointestinal symptoms by means of logistic regression analyses.

Results

In total, 1233 CRC survivors were included, of which 15% reported poor sleep quality. The least often reported gastrointestinal symptom was pain in the buttocks (15.1%) and most often reported was bloating (29.2%). CRC survivors with poor sleep quality were more likely to report gastrointestinal symptoms (p’s < 0.01). Survivors who slept < 6 h were more likely to report symptoms of bloating or flatulence, whereas survivors who slept 6–7 h reported more problems with indigestion.

Conclusions

Worse sleep quality and short sleep duration were associated with higher occurrence of gastrointestinal symptoms.

Implications for cancer survivors

Understanding the interplay between sleep quality and gastrointestinal symptoms and underlying mechanisms adds to better aftercare and perhaps reduction of residual gastrointestinal symptoms in CRC survivors by improving sleep quality.
How does a move towards a coaching approach impact the delivery of written feedback in undergraduate clinical education?
Authors: Roberts Amanda , Jellicoe Mark , Fox Kathryn
Published: September 2021

Feedback uptake relies on interactions between learners and educators Winstone (Educ Psychol 52: 17–37, 2017). Feedback that coaches using a feedforward approach, is considered to be more personal and emotionally literate Bussey (Bull R Coll Surg Engl 99: 180–182, 2017), Hattie (Rev Educ Res 77: 81–112, 2007). Many modes of feedback are employed in clinical teaching environments, however, written feedback is particularly important, as a component of feedback discourse, as significant time may elapse before a similar clinical situation is encountered. In practice, time constraints often result in brief or descriptive written feedback rather than longer coaching feedback. This study aimed to explore whether a change in ethos and staff development would encourage clinical dental tutors to utilise a coaching approach in their written feedback. Across two time-points, written feedback was categorised into either descriptive, evaluative or coaching approaches. Cross-sections of data from 2017 to 2019 were examined to determine whether changes in practice were noted and whether there were any alterations in the affective nature of the language used. Feedback moved significantly towards coaching and away from a descriptive approach. A shift towards the use of more positive language was seen overall, although this was solely driven by a change in the evaluative feedback category. Descriptive feedback generally used neutral language with coaching feedback using marginally more positive language. Both categories employed significantly lower levels of affective language than evaluative feedback. These data indicate a move towards feedback approaches and language that may support increased uptake and utilisation of feedback.
Multiprong control of glioblastoma multiforme invasiveness: blockade of pro-inflammatory signaling, anti-angiogenesis, and homeostasis restoration
Authors: Bazan Nicolas G. , Reid Madigan M. , Flores Valerie A. Cruz , Gallo Juan E. , Lewis William , Belayev Ludmila
Published: September 2021

Glioblastoma multiforme (GBM) is the most invasive type of glial tumor with poor overall survival, despite advances in surgical resection, chemotherapy, and radiation. One of the main challenges in treating GBM is related to the tumor’s location, complex and heterogeneous biology, and high invasiveness. To meet the demand for oxygen and nutrients, growing tumors induce new blood vessels growth. Antibodies directed against vascular endothelial growth factor (VEGF), which promotes angiogenesis, have been developed to limit tumor growth. Bevacizumab (Avastin), an anti-VEGF monoclonal antibody, is the first approved angiogenesis inhibitor with therapeutic promise. However, it has limited efficacy, likely due to adaptive mutations in GBM, leading to overall survival compared to the standard of care in GBM patients. Molecular connections between angiogenesis, inflammation, oxidative stress pathways, and the development of gliomas have been recognized. Improvement in treatment outcomes for patients with GBM requires a multifaceted approach due to the converging dysregulation of signaling pathways. While most GBM clinical trials focus on “anti-angiogenic” modalities, stimulating inflammation resolution is a novel host-centric therapeutic avenue. The selective therapeutic possibilities for targeting the tumor microenvironment, specifically angiogenic and inflammatory pathways expand. So, a combination of agents aiming to interfere with several mechanisms might be beneficial to improve outcomes. Our approach might also be combined with other therapies to enhance sustained effectiveness. Here, we discuss Suramab (anti-angiogenic), LAU-0901 (a platelet-activating factor receptor antagonist), Elovanoid (ELV; a novel lipid mediator), and their combination as potential alternatives to contain GBM growth and invasiveness.
Polyplexes of retinoic acid: an in vitro study of complex nanostructures against colorectal cancer cell line (HCT-15)
Authors: Ture Narayan , Desai Drashti , Shende Pravin
Published: September 2021

Despite recent advances in the treatment of human colon cancer, the chemotherapeutic efficacy against colon cancer is still unsatisfactory. The complexity in colorectal cancer treatment leads to new research in combination therapy to overcome multidrug resistance in cancer and increase apoptosis. The objective of the present research work was to develop polyplexes for co-delivery of plasmid DNA with retinoic acid against colorectal cancer cell line (HCT-15). Plain polyplexes were prepared using chitosan and hyaluronic acid solution (0.1% w/v), whereas retinoic acid polyplexes were prepared using ethanol: water (1:9 v/v) system. The particle size was observed in the order of chitosan solution > blank polyplex > retinoic acid-loaded polyplex. Encapsulation efficiency of retinoic acid was found to be 81.51 ± 4.33% for retinoic acid-loaded polyplex formulation. The drug release was observed to be in a controlled pattern with 72.23 ± 1.32% release of retenoic acid from polyplex formulation. Cell line studies of the formulation displayed better cell inhibition and low cytotoxicity for the retinoic acid-loaded polyplexes in comparison to pure retinoic acid, thus demonstrating better potential action against colorectal cancer cell line HCT-15. Retinoic acid-loaded polyplexes indicated higher potential for the delivery of the active whereas the cell line studies displayed the efficacy of the formulation against colorectal cancer cell line HCT-15.
The Effects of Parental Labor Migration on Children’s Mental Health in Rural China
Authors: Jiang Hechao , Duan Taixiang , Wang Fang
Published: September 2021

Utilizing data from the China Education Panel Survey, we investigated the effects of parental migration and its duration on children’s mental health in rural China. We obtained a sample of 3830 rural children, comprising 2769 children who lived with both parents, 512 children whose one parent had migrated, and 549 children whose both parents had migrated. The results of multiple regression and propensity score matching showed that absence of both parents was negatively correlated to children’s mental health, with the migration of one parent having little effect. The negative effects related to parental labor migration became more apparent when we considered the duration of parents’ migration. Compared with children whose parents were not absent, children who had been left behind for less than one year and those who had been left behind for more than one year both displayed poorer mental health. These findings urge us to infer that family arrangements have an important influence on children’s psychological health. The findings also showed girls’ mental health more likely to be affected than that of boys, which implied a gender difference in the impacts of parental migration. Research and policy implications are discussed.
Ventrikuläre Arrhythmien bei obstruktiver und zentraler Schlafapnoe
Authors: Brandts Paul , Arzt Michael , Fisser Christoph
Published: September 2021

Hintergrund

Ventrikuläre Arrhythmien treten mit einer hohen Prävalenz auf und sind mit einer hohen Morbidität und Mortalität assoziiert. Sowohl die obstruktive (OSA) als auch die zentrale (ZSA) Schlafapnoe können auf Grund ihrer Pathophysiologie zu vermehrten ventrikulären Arrhythmien beitragen.

Ziel

Dieser Artikel soll die komplexen Zusammenhänge und Erkenntnisse jüngster Forschungen bezüglich schlafbezogenen Atmungsstörungen (SBAS) und ventrikulärer Arrhythmien und deren Therapiemöglichkeiten beleuchten.

Material und Methoden

Es erfolgte eine Literaturrecherche basierend auf prospektiven, retrospektiven, klinischen und experimentellen Studien sowie Reviews, Metaanalysen und aktuellen Leitlinien, die seit 2014 in der Medline-Datenbank gelistet wurden.

Ergebnisse

Es besteht ein bidirektionaler Zusammenhang zwischen der SBAS und ventrikulären Arrhythmien. Intermittierende Hypoxie, oxidativer Stress, wiederkehrende Arousals, intrathorakale Druckschwankungen und kardiales Remodeling tragen im Rahmen der SBAS zu einer erhöhten ventrikulären Arrhythmieneigung bei. Der Schweregrad der OSA, gemessen mittels Apnoe-Hypopnoe-Index, ist mit der Prävalenz ventrikulärer Arrhythmien assoziiert. Ähnliche Ergebnisse liegen für Patienten mit ZSA und Herzinsuffizienz vor. Studien zu ventrikulären Arrhythmien bei ZSA-Patienten ohne Herzinsuffizienz fehlen. Eine Positivdrucktherapie (PAP) bei OSA- oder ZSA-Patienten führte in verschiedenen Studien zu einer reduzierten Anzahl an ventrikulären Arrhythmien. Dieser Zusammenhang konnte jedoch nicht in allen Studien bestätigt werden. Ventrikuläre Arrhythmien treten bei der OSA gehäuft nachts auf, bei der ZSA gleichmäßig über den Tag verteilt.

Diskussion

Bisherige Studien weisen einen Zusammenhang zwischen der OSA bzw. der ZSA und ventrikulären Arrhythmien trotz unterschiedlicher Pathophysiologie nach. Hinsichtlich des Effektes der PAP auf ventrikuläre Arrhythmien bei Patienten mit OSA und ZSA sind weitere Studien erforderlich.
The Glasgow Prognostic Score Before Curative Resection May Predict Postoperative Complications in Patients with Gastric Cancer
Authors: Shimoda Yota , Fujikawa Hirohito , Komori Keisuke , Watanabe Hayato , Takahashi Kosuke , Kano Kazuki , Yamada Takanobu , Shiozawa Manabu , Morinaga Soichiro , Katsumata Kenji , Tsuchida Akihiko , Ogata Takashi , Oshima Takashi
Published: September 2021

Purpose

Despite improvements in surgical techniques and devices and perioperative care of gastric cancer (GC), the rate of postoperative complications still has not decreased. If patients at high risk for postoperative complications could be identified early using biomarkers, these complications might be reduced. In this study, we investigated usefulness of the preoperative Glasgow Prognostic Score (GPS) as a predictive factor for complications after surgery in patients with stage II/III GC.

Methods

This study retrospectively analyzed the outcomes of 424 patients who underwent curative surgery for pathological stage II/III GC from February 2007 to July 2019 at a single center. The GPS was assessed within 4 days before surgery. To identify independent risk factors for postoperative complications, univariate and multivariate analyses were performed using a Cox proportional hazards model.

Results

The numbers of patients with a GPS of 0, 1, and 2 were 357, 55, and 12, respectively. The rate of complications after surgery was significantly higher among patients with a GPS of 1 or 2 than among patients with a GPS of 0 (p = 0.008). Multivariate analysis identified a GPS of 1 or 2 as an independent predictive factor for postoperative complications (p = 0.037).

Conclusion

The preoperative GPS may be a useful predictive factor for postoperative complications in patients with stage II/III GC. Being aware of the risk of complications after surgery as indicated by the GPS before surgery may promote safe and minimally invasive surgery that we expect will improve outcomes in patients with a GPS of 1 or 2.
Effect of Post-Weld Heat Treatment Conditions on Mechanical Properties, Microstructures and Nonductile Fracture Behavior of SA508 Gr.1a Thick Weldments
Authors: Lee Junsang , Kim Jong Sung , Lee Bongsang , Cho Sungwoo , Kwon Dongil , Kim Jong-hyoung
Published: September 2021

This study analyzes the effects of post-weld heat treatment (PWHT) on the mechanical properties and microstructures of SA-508 Gr.1a welds and proposes a new PWHT exemption criterion based on nonductile fracture evaluation considering welding residual stress. The welding coupons were prepared with submerged-arc welding, gas-tungsten arc welding, and shielded-metal arc welding, using ferritic steel, SA-508 Gr.1a. The microstructure of the heat-affected zone (HAZ) was analyzed using optical microscopy, electron-back-scatter diffraction and Vickers hardness testing. The mechanical properties of the welds were evaluated by uniaxial tensile test, transverse side bend test, Charpy V-notch impact test and side bend test. Bainite and ferrite structures formed mainly in the HAZ, and the grain size became coarser with proximity to the surface and fusion line. The mechanical properties did not depend strongly on PWHT, weldment thickness or welding techniques, and they satisfied the welding procedure qualification test specified in the ASME Boiler & Pressure Vessel code. Welding residual stresses were considered in assessing structural integrity using nonductile fracture evaluation. A margin of safety against nonductile fracture with residual stress was calculated for Korean Standard Nuclear Power Plant steam-generator welds, using its design parameters and operating conditions, and this safety margin is suggested as an acceptance criterion for residual stress for exemption from PWHT.

Graphic abstract
Use and self-perceived effects of social media before and after the COVID-19 outbreak: a cross-national study
Authors: Thygesen Hilde , Bonsaksen Tore , Schoultz Mariyana , Ruffolo Mary , Leung Janni , Price Daicia , Geirdal Amy Østertun
Published: September 2021

To (i) examine the use of social media before and after the COVID-19 outbreak; (ii) examine the self-perceived impact of social media before and after the outbreak; and (iii) examine whether the self-perceived impacts of social media after the outbreak varied by levels of mental health. A cross-national online survey was conducted in Norway, UK, USA and Australia. Participants (n = 3810) reported which social media they used, how frequently they used them before and after the COVID-19 outbreak, and the degree to which they felt social media contributed to a range of outcomes. The participants also completed the 12-item General Health Questionnaire. The data were analyzed by chi-square tests and multiple linear regression analysis. Social media were used more frequently after the pandemic outbreak than compared to before the outbreak. Self-perceived effects from using social media increased after the COVID-19 outbreak, and in particular stress and concern for own and others’ health. Emotional distress was associated with being more affected from using social media, in particular in terms of stress and concern for own or others’ health. The use of social media has increased during the coronavirus outbreak, as well as its impacts on people. In particular, the participants reported more stress and health concerns attributed to social media use after the COVID-19 outbreak. People with poor mental health appear to be particularly vulnerable to experiencing more stress and concern related to their use of social media.
Landslide susceptibility in the Belt and Road Countries: continental step of a multi-scale approach
Authors: Titti Giacomo , Borgatti Lisa , Zou Qiang , Cui Peng , Pasuto Alessandro
Published: September 2021

The Belt and Road Initiative is a collaboration project launched by the Chinese Government to connect more than 65 countries all over the word by developing infrastructures, facilities, and support collaborations among involved Countries. The Silk Road Disaster Risk Reduction is a sub-project of the Belt and Road Initiative focused on mitigation and prevention of natural risks in the involved countries. In this context, this work presents a method to approach landslide susceptibility zoning on a continental scale that takes into account the limitations due to the completeness of landslide inventories and the scale and data quality of causal factors. A first attempt to produce a pixel-based statistical susceptibility map is described. All the data and software used in this work are open and open source. The landslide susceptibility zoning has been carried out in south-Asia using the NASA-COOLR landslide dataset through the Weight of Evidence method and it has been evaluated and validated by means of the ROC analysis. The results reveal a good prediction capacity and highlights that slope, relative relief and annual precipitation are the causative factors that play a major role in predisposing slope instability in the study area. Based on them, the method will be applied to the rest of the Belt and Road Countries.
Loss and Efficiency Analysis of BLDC Motor and Universal Motor by Mathematical Modelling in the Mixer Grinder
Authors: Nayak Deekshitha S , Shivarudraswamy R.
Published: September 2021

The typical mixer grinders are universal motor, which operates on alternating current supply because of the higher starting torque characteristics and easy speed control. The absence of brushes in the Brushless DC (BLDC) motor and noise reduction improves its life and makes it perfectly suited for mixer grinder. The mathematical modelling and experimental demonstration of a conventional universal motor and proposed simulated model of BLDC motor was analysed using the MATLAB/Simulink. The loss and efficiency analysis of the permanent magnet BLDC and universal motor in the application of a mixer grinder are presented in this paper.
Addressing the Challenges to Sustainable Initiatives in Value Chain Flexibility: Implications for Sustainable Development Goals
Authors: Dwivedi Ashish , Agrawal Dindayal , Jha Ajay , Gastaldi Massimo , Paul Sanjoy Kumar , D’Adamo Idiano
Published: September 2021

The value chain refers to the source of competition to facilitate organizations to maximize and sustain value for their consumers. Value chain flexibility is necessary to build sustainable initiatives in addressing ambiguity. In the literature, there is a lack of framework to highlight the challenges to sustainable initiatives in value chain flexibility. This study fills this research gap by suggesting a framework for challenges to sustainable initiatives in value chain flexibility. In this study, thirteen potential challenges to sustainable initiatives in value chain flexibility are identified and an integrated model is developed. It adopts the modified Total Interpretive Structure Model and the Cross-Impact Matrix Multiplication Applied to Classification methodology. The mixed approach is used as the modified Total Interpretive Structure Model organizes the binary interactions among the challenges, while Cross-Impact Matrix Multiplication Applied to Classification analysis organizes specific precise assessments of the driving power and dependence of the challenges. The results of the study reflect that (i) lack of supplier commitment to sustainable products and (ii) lack of knowledge toward sustainability in value chains are the challenges that achieved the highest driving power. The challenge ‘inadequate communication among the suppliers in the value chain’ is at the highest level in the analysis. The proposed framework could help government and non-government bodies to formulate policies to efficiently address challenges to sustainable initiatives in value chain flexibility.
Magnetized Micropillar-Enabled Wearable Sensors for Touchless and Intelligent Information Communication
Authors: Zhou Qian , Ji Bing , Hu Fengming , Luo Jianyi , Zhou Bingpu
Published: September 2021

The wearable sensors have recently attracted considerable attentions as communication interfaces through the information perception, decoding, and conveying process. However, it is still challenging to obtain a sensor that can convert detectable signals into multiple outputs for convenient, efficient, cryptic, and high-capacity information transmission. Herein, we present a capacitive sensor of magnetic field based on a tilted flexible micromagnet array (t-FMA) as the proposed interaction interface. With the bidirectional bending capability of t-FMA actuated by magnetic torque, the sensor can recognize both the magnitude and orientation of magnetic field in real time with non-overlapping capacitance signals. The optimized sensor exhibits the high sensitivity of over 1.3 T−1 and detection limit down to 1 mT with excellent durability. As a proof of concept, the sensor has been successfully demonstrated for convenient, efficient, and programmable interaction systems, e.g., touchless Morse code and Braille communication. The distinguishable recognition of the magnetic field orientation and magnitude further enables the sensor unit as a high-capacity transmitter for cryptic information interaction (e.g., encoded ID recognition) and multi-control instruction outputting. We believe that the proposed magnetic field sensor can open up a potential avenue for future applications including information communication, virtual reality device, and interactive robotics.
Impact of process conditions on chemical solution deposited BNKT thin film electromechanical properties
Authors: Grove Kyle M. , Fox Austin , Cann David P. , Ko Song Won , Mardilovich Peter , Gibbons Brady J.
Published: September 2021

Phase pure perovskite (1-x)Bi1/2Na1/2TiO3 – xBi1/2K1/2TiO3 (BNKT) thin films were successfully prepared via an inverse mixing order chemical solution deposition method and the impact of process conditions on film properties were observed. Process conditions evaluated included crystallization temperature and time, ramp rate, pyrolysis temperature, and cation excess. Properties measured included crystal structure, dielectric constant, dielectric loss, piezoelectric response, and ferroelectric response. A few notable trends were observed. A subtle impact on piezoelectric response was observed in films prepared using different ramp rates: 100 C per second films (d33,f = 60 ± 5 pm/V at 1 kHz), 75 °C per second films (d33,f = 55 ± 5 pm/V) and 150 C per second films (d33,f = 50 ± 5 pm/V). Films prepared using a 75 °C per second ramp rate displayed slightly higher dielectric loss (tan δ = 0.09 at 1 kHz) than films prepared using a 100 °C per second ramp rate (tan δ = 0.07 at 1 kHz) or 150 °C per second ramp rate (tan δ = 0.05 at 1 kHz). Pyrolysis temperatures greater than 350 °C are necessary to burn off organics and maximize film dielectric constant. Dielectric constant increased from 450 ± 50 at 1 kHz to 600 ± 50 at 1 kHz by increasing pyrolysis temperature from 300 to 400 °C. Excess cation amounts (for compositional control) were also evaluated and it was found films with higher amounts of Na and K excess compared to bismuth excess displayed an increase in d33,f of about 10 pm/V compared to films prepared with equivalent Bi and Na and K excess amounts.

Article highlights

Impact of processing conditions on inverse mixing order chemical solution deposited bismuth based thin films.

Dielectric, piezoelectric, and ferroelectric properties of thin film bismuth sodium titanate-bismuth potassium titanate thin films.

Developing lead-free piezoelectric actuator materials.
Lion (Panthera leo) ecology and survival in protected areas of Ethiopia
Authors: Yirga Gidey , Amare Solomon , Gebresenbet Fikirte , De Iongh Hans H. , Vos Matthijs , Sillero-Zubiri Claudio , Bauer Hans
Published: September 2021

Ethiopia is renowned for its cultural and biological diversity and covers an important share of lion habitat in Africa, providing connectivity between East and Central Africa. The aim of this study was to investigate the status of lions and human–lion conflict in several protected areas of Ethiopia and to present an overview on lion distribution nationally. We used call-ups and semi-structured interviews with 809 randomly selected pastoralists to investigate human–lion conflict and pastoralist perceptions towards lions in five priority sites and collected further anecdotal information for all other known or possible lion range. We had chance encounters with six lions, but we observed no lion responses to the call-ups. We recorded 145 spotted hyaena and 23 jackal responses at, respectively, 25 and 13 of the 46 call-up stations. Overall, respondents viewed lions as dangerous carnivores, but nonetheless responded that lions should be present regionally, preferably in restricted areas. Most respondents disagreed that the killing of lions should be allowed, but we note that a small minority strongly agreed to killing. A large majority of respondents agreed that more people need to be given information about lions. Respondents mentioned spotted hyaena and leopard as the main predators on all livestock followed by jackal (shoats) and lion (mainly cattle). The impact of depredation on livestock mortality was nearly twice that of disease. Our results strongly suggest that lion densities are low and may have substantially decreased in Awash, Nechisar, Chebera-Churchura, and Mago National Parks and in Kaffa Biosphere Reserve due to conflict, habitat loss and especially ineffective protection. Anecdotal information suggests that lions are widespread but rare and that there is no stronghold in Ethiopia. Considering the unique evolutionary background of Ethiopia as the bridge between Central and East African lion populations, and the significant role of the lion in Ethiopian history and culture, we argue that more emphasis should be given to the protection of prioritized lion populations.
Examining access to care in clinical genomic research and medicine: Experiences from the CSER Consortium
Authors: Gutierrez Amanda M. , Robinson Jill O. , Outram Simon M. , Smith Hadley S. , Kraft Stephanie A. , Donohue Katherine E. , Biesecker Barbara B. , Brothers Kyle B. , Chen Flavia , Hailu Benyam , Hindorff Lucia A. , Hoban Hannah , Hsu Rebecca L. , Knight Sara J. , Koenig Barbara A. , Lewis Katie L. , Lich Kristen Hassmiller , O’Daniel Julianne M. , Okuyama Sonia , Tomlinson Gail E. , Waltz Margaret , Wilfond Benjamin S. , Ackerman Sara L. , Majumder Mary A.
Published: September 2021

Introduction:

Ensuring equitable access to health care is a widely agreed-upon goal in medicine, yet access to care is a multidimensional concept that is difficult to measure. Although frameworks exist to evaluate access to care generally, the concept of “access to genomic medicine” is largely unexplored and a clear framework for studying and addressing major dimensions is lacking.

Methods:

Comprised of seven clinical genomic research projects, the Clinical Sequencing Evidence-Generating Research consortium (CSER) presented opportunities to examine access to genomic medicine across diverse contexts. CSER emphasized engaging historically underrepresented and/or underserved populations. We used descriptive analysis of CSER participant survey data and qualitative case studies to explore anticipated and encountered access barriers and interventions to address them.

Results:

CSER’s enrolled population was largely lower income and racially and ethnically diverse, with many Spanish-preferring individuals. In surveys, less than a fifth (18.7%) of participants reported experiencing barriers to care. However, CSER project case studies revealed a more nuanced picture that highlighted the blurred boundary between access to genomic research and clinical care. Drawing on insights from CSER, we build on an existing framework to characterize the concept and dimensions of access to genomic medicine along with associated measures and improvement strategies.

Conclusions:

Our findings support adopting a broad conceptualization of access to care encompassing multiple dimensions, using mixed methods to study access issues, and investing in innovative improvement strategies. This conceptualization may inform clinical translation of other cutting-edge technologies and contribute to the promotion of equitable, effective, and efficient access to genomic medicine.