bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution of gestational age at birth by maternal and infant characteristics in U.S. birth certificate data: Informing gestational age assumptions when clinical estimates are not available
Authors: Margulis Andrea V. , Calingaert Brian , Kawai Alison T. , Rivero‐Ferrer Elena , Anthony Mary S.
Published: April 2023

Purpose

We aimed to describe the distribution of gestational age at birth (GAB) to inform the estimation of GAB when clinical or obstetric estimates are not available for perinatal pharmacoepidemiology studies.

Methods

We estimated GAB (median, mode, mean, and standard deviation) and percentage born at each gestational week in groups based on plurality and other variables for live births in CDC's U.S. birth data.

Results

In 2020, 3 617 213 newborns had birth certificates with nonmissing GAB. Among singletons (3 501 693), median and mode GAB were both 39 weeks. Births with lower median GAB were from women with eclampsia (37 weeks) or receiving intensive care (37 weeks); newborns receiving intensive care (37 weeks); newborns with birth weight <2500 g (35 weeks), <1500 g (28 weeks), or <1000 g (25 weeks); and newborns not discharged alive (23 weeks). Among twins (112 633), median GAB was 36 weeks (mode, 37 weeks). Additional noteworthy groups were women with 0–6 prenatal visits (median, 34 weeks) or 7–8 prenatal visits (median, 35 weeks) or aged 15–19 years (median, 35 weeks).

Conclusions

Some maternal and infant groups had distinct GAB distributions in the United States. This information can be useful in estimating GAB when individual‐level clinical estimates are not available, such as in database studies of medication use during pregnancy.
Use of CFTR modulators in special populations, part 3: Solid organ transplant
Authors: Kadouh Nour K. , Elijah Joseph , Fitzgerald Linda J. , Phan Hanna
Published: April 2023

Background

Solid organ transplant (SOT) recipients with cystic fibrosis (CF) may benefit from the pulmonary and extrapulmonary benefits associated with CF transmembrane conductance regulator modulators. Nevertheless, evolution of modulator safety and efficacy data prompts consideration.

Methods

The search terms “transplant” AND “ivacaftor"(IVA) OR "lumacaftor"(LUM) OR "tezacaftor" (TEZ) OR "elexacaftor" (ELX) were utilized to conduct a scoping review of English articles from the period of January 1, 2012 to December 31, 2022. Search results from PubMed and Embase databases were reviewed by title and abstract for relevance. Included studies reported efficacy and safety outcomes of modulators in SOT recipients.

Results

One hundred thirty‐six patients from one cohort study (90 lung transplant recipients) and eight case reports and series (29 lung transplant recipients, 16 liver transplant recipients and one lung/liver transplant patient) were included. Post‐modulator initiation, 33 patients did not necessitate tacrolimus dose adjustments, 10 required dose uptitration, and 43 required dose reductions. Moreover, LUM/IVA use with azole antifungals may lead to subtherapeutic levels but opposing effects sustained tacrolimus levels. Liver transplant recipients were more likely to experience elevations in transaminases requiring pharmacologic or medical interventions. Majority of patients experienced improvements in pulmonary function, fasting blood glucose, hemoglobin, body mass index, and rhinosinusitis symptoms. However, intolerance or lack of benefit prompted discontinuation of ELX/TEZ/IVA in over 40% of lung‐transplant recipients in one study.

Conclusion

Modulator therapy has been reported to produce pulmonary and extra‐pulmonary benefits in the CF population with SOT. Considerations for modulator therapy initiation ought to include modulator pharmacokinetics, concomitant medications, and transplant type due to the complex nature of SOT recipients.
Spirometry and respiratory oscillometry: Feasibility and concordance in schoolchildren with asthma
Authors: Domínguez‐Martín Clara , Cano Alfredo , Díez‐Monge Nuria , Alonso‐Rubio Ana María , Pérez‐García Isabel , Arroyo‐Romo María Teresa , Casares‐Alonso Irene , Barbero‐Rodríguez Ana María , Grande‐Alvarez Reyes , Martínez‐Rivera María Teresa , Sanz‐Fernández Mónica
Published: April 2023

Objective

The purpose of this study was to describe the feasibility of respiratory oscillometry (RO) in schoolchildren with asthma, and the concordance of its results with those of spirometry, to determine its clinical usefulness.

Methods

RO and spirometry were performed in 154 children (6 to 14‐year‐old) with asthma, following strict quality criteria for the tests. Their feasibility (probability of valid test, time of execution, number of maneuvers needed to achieve a valid test, and perceived difficulty) was compared. The factors that influence feasibility were analyzed with multivariate methods. FEV1, FEV1/FVC, FVC and FEF25‐75 for spirometry, and R5, AX and R5‐19 for RO, were converted into z‐scores and their concordance was investigated through intraclass correlation coefficients (ICC) and kappa indices for normal/abnormal values.

Results

There were no differences in the probability of obtaining a valid RO or spirometry (83.1% vs. 81.8%, p = 0.868). RO required a lower number of maneuvers [mean (SD) 4.2 (1.8) versus 6.0 (1.6), p < 0.001] and less execution time [5.1 (2.7) versus 7.6 (2.4) minutes, p < 0.001], and patients considered it less difficult. Age increased the probability of obtaining valid RO and spirometry. The concordance of results between RO and spirometry was low, and only between zFEV1 and zAX could it be considered moderate (ICC = 0.412, kappa = 0.427).

Conclusion

RO and spirometry are feasible in children with asthma. RO has some practical advantages, but the concordance of its results with spirometry is low.
Distributed Quantum Computing with Photons and Atomic Memories
Authors: Oh Eun , Lai Xuanying , Wen Jianming , Du Shengwang
Published: April 2023

The promise of universal quantum computing requires scalable single‐ and inter‐qubit control interactions. Currently, three of the leading candidate platforms for quantum computing are based on superconducting circuits, trapped ions, and neutral atom arrays. However, these systems have strong interaction with environmental and control noises that introduce decoherence of qubit states and gate operations. Alternatively, photons are well decoupled from the environment and have advantages of speed and timing for quantum computing. Photonic systems have already demonstrated capability for solving specific intractable problems like Boson sampling, but face challenges for practically scalable universal quantum computing solutions because it is extremely difficult for a single photon to “talk” to another deterministically. Here, a universal distributed quantum computing scheme based on photons and atomic‐ensemble‐based quantum memories is proposed. Taking the established photonic advantages, two‐qubit nonlinear interaction is mediated by converting photonic qubits into quantum memory states and employing Rydberg blockade for the controlled gate operation. Spatial and temporal scalability of this scheme is demonstrated further. These results show photon‐atom network hybrid approach can be a potential solution to universal distributed quantum computing.
Sex affects immune response capacity against COVID‐19 infection
Authors: Zovi Andrea , Ferrara Francesco , Langella Roberto , Cavallaro Fabiola , Vitiello Antonio
Published: April 2023

The genetic variability of each individual may lead to the identification of completely different genetic polymorphisms which are associated with a different sensitivity to infectious diseases in humans. Such genetic variability allows the immune system to respond differently to viral agents, therefore only a fraction of humans develop severe symptoms, as happened with SARS‐CoV‐2. Such knowledge is critical to enable the development of appropriate pharmacological solutions to prevent the consequences of insufficient immunity in dealing with serious viral diseases such as SARS‐CoV‐2. For instance, global epidemiological data show that male sex is a risk factor for the severe evolution of SARS‐CoV‐2 disease. Men, due to higher production of Testosterone (TLT), are more vulnerable than females. Women, due to greater expression of the TLR7 gene found on the X chromosome, a key innate immunity gene that encodes Toll‐like proteins, are able to synthesise more antiviral proteins and interferons in dendritic cells, resulting in a more robust immune system capable of preventing severe SARS‐CoV‐2 viral disease. This manuscript highlights how human genetic variability can lead to severe infectious symptoms in some individuals who must take appropriate prophylactic actions, such as vaccination, to prevent this.
Landscape features control river's confluences water quality and tributary fish composition
Authors: Bowes Rachel E. , Bergman Eva , Donadi Serena , Greenberg Larry , Sandin Leonard , Lind Lovisa
Published: April 2023

Rivers networks represent hierarchical dendritic habitats within terrestrial landscapes and differences in connectivity and land use influence dispersal, and consequently biodiversity patterns. We, therefore, measured variation in water chemistry and fish abundance and related these to a number of landscape characteristics (e.g., wetland, urban, wooded, and agricultural) in the River Klarälven and its 30 permanently flowing tributaries. We hypothesized that these environmental attributes would differ between tributary and main stem habitat and that these differences would be driven by landscape attributes including land use. We found considerable intertributary variation in temperature and nutrient levels, and between the tributaries and the main stem. Generally, water temperature was lower in the tributaries, whereas nutrient levels were higher in the tributaries. The lower water temperature has implications for coldwater fishes, and we found two fishes, burbot and lamprey, associated with coldwater tributaries. We also found an inverse relationship between water quality and anthropogenic land use. Protecting tributaries with low anthropogenic impact will likely become increasingly important with ongoing global warming as they can function as thermal refugia for coldwater fishes. Hence, this study underscores the need to evaluate water courses at regional scales to identify spatial refuges and ensure connectivity.
Different Dimensionalities, Morphological Advancements and Engineering of g‐C3N4‐Based Nanomaterials for Energy Conversion and Storage
Authors: Hayat Asif , Sohail Muhammad , El Jery Atef , Al‐Zaydi Khadijah M. , Alshammari Khaled F , Khan Javid , Ali Hamid , Ajmal Zeeshan , Taha T. A. , Ud Din Israf , Altamimi Rashid , Hussein Mahmoud Ali , Al‐Hadeethi Yas , Orooji Yasin , Ansari Mohd Zahid
Published: April 2023

Graphitic carbon nitride (g‐C3N4) has gained tremendous interest in the sector of power transformation and retention, because of its distinctive stacked composition, adjustable electronic structure, metal‐free feature, superior thermodynamic durability, and simple availability. Furthermore, the restricted illumination and extensive recombination of photoexcitation electrons have inhibited the photocatalytic performance of pure g‐C3N4. The dimensions of g‐C3N4 may impact the field of electronics confinement; as a consequence, g‐C3N4 with varying dimensions shows unique features, making it appropriate for a number of fascinating uses. Even if there are several evaluations emphasizing on the fabrication methods and deployments of g‐C3N4, there is certainly an insufficiency of a full overview, that exhaustively depicts the synthesis and composition of diverse aspects of g‐C3N4. Consequently, from the standpoint of numerical simulations and experimentation, several legitimate methodologies were employed to deliberately develop the photocatalyst and improve the optimal result, including elements loading, defects designing, morphological adjustment, and semiconductors interfacing. Herein, this evaluation initially discusses different dimensions, the physicochemical features, modifications and interfaces design development of g‐C3N4. Emphasis is given to the practical design and development of g‐C3N4 for the various power transformation and inventory applications, such as photocatalytic H2 evolution, photoreduction of CO2 source, electrocatalytic H2 evolution, O2 evolution, O2 reduction, alkali‐metal battery cells, lithium‐ion batteries, lithium–sulfur batteries, and metal‐air batteries. Ultimately, the current challenges and potential of g‐C3N4 for fuel transformation and retention activities are explored.
“Simple Tidy GeneCoEx”: A gene co‐expression analysis workflow powered by tidyverse and graph‐based clustering in R
Authors: Li Chenxin , Deans Natalie C. , Buell C. Robin
Published: April 2023

Gene co‐expression analysis is an effective method to detect groups (or modules) of co‐expressed genes that display similar expression patterns, which may function in the same biological processes. Here, we present “Simple Tidy GeneCoEx”, a gene co‐expression analysis workflow written in the R programming language. The workflow is highly customizable across multiple stages of the pipeline including gene selection, edge selection, clustering resolution, and data visualization. Powered by the tidyverse package ecosystem and network analysis functions provided by the igraph package, the workflow detects gene co‐expression modules whose members are highly interconnected. Step‐by‐step instructions with two use case examples as well as source code are available athttps://github.com/cxli233/SimpleTidy_GeneCoEx.
Using haplotype and QTL analysis to fix favorable alleles in diploid potato breeding
Authors: Song Lin , Endelman Jeffrey B.
Published: April 2023

At present, the potato (Solanum tuberosum L.) of international commerce is autotetraploid, and the complexity of this genetic system creates limitations for breeding. Diploid potato breeding has long been used for population improvement, and because of an improved understanding of the genetics of gametophytic self‐incompatibility, there is now sustained interest in the development of uniform F1 hybrid varieties based on inbred parents. We report here on the use of haplotype and quantitative trait locus (QTL) analysis in a modified backcrossing (BC) scheme, using primary dihaploids of S. tuberosum as the recurrent parental background. In Cycle 1, we selected XD3‐36, a self‐fertile F2 individual homozygous for the self‐compatibility gene Sli (S‐locus inhibitor). Signatures of gametic and zygotic selection were observed at multiple loci in the F2 generation, including Sli. In the BC1 cycle, an F1 population derived from XD3‐36 showed a bimodal response for vine maturity, which led to the identification of late versus early alleles in XD3‐36 for the gene CDF1 (Cycling DOF Factor 1). Greenhouse phenotypes and haplotype analysis were used to select a vigorous and self‐fertile F2 individual with 43% homozygosity, including for Sli and the early‐maturing allele CDF1.3. Partially inbred lines from the BC1 and BC2 cycles have been used to initiate new cycles of selection, with the goal of reaching higher homozygosity while maintaining plant vigor, fertility, and yield.
Mycorrhizal fungi and soil factors influence toxic element uptake in urban grown produce
Authors: Bowdish Logan , Duran Adalie , Richardson Justin , Vukicevich Eric
Published: April 2023

Despite the need for more urban‐grown produce, toxic elements contaminated soils continue to be a major barrier to food production and food sovereignty in urban areas and a continued health and environmental justice issue. Although the US EPA provides recommendations regarding levels of soil lead that are safe for gardening, soil abiotic and biotic factors as well as plant identity play a major role in determining the actual crop uptake of toxic elements. This study evaluated the role of crop identity, harvested tissue, and soil factors, including arbuscular mycorrhizal (AM) fungi on crop uptake of lead (Pb) and arsenic (As) in an urban community farm. Crop species varied in their Pb and As accumulations, both by crop identity and also by plant tissue. Crop uptake of lead increased with lower soil pH (range 5.3–6.9) and lower soil P (range 365–1771 mg kg−1 total P). For mycorrhizal crops, greater intensity of AM fungal colonization and the prevalence of arbuscules were associated with greater lead uptake, but the presence of more storage vesicles was related to less As uptake into leaves. These findings can help inform crop selection and soil management to improve soil stabilization of toxic elements in moderately contaminated soils while serving as a platform for community conversations about the importance of soil management in healthy urban food production.
Influence of birth weight, sex and disinfection on the involution of umbilical structures in calves
Authors: Lang Dorothee , Scheu Theresa , Cohrs Imke , Koch Christian , Wehrend Axel
Published: April 2023

Background

Umbilical disinfection for calves is often recommended, but scientific studies do not always show a positive effect on disease prevention. In addition, there is little to no metric data on umbilical involution or on factors influencing the size of umbilical structures. Therefore, the aim of this study was to investigate the physiological involution of umbilical structures and the effect of two different umbilical treatment methods.

Methods

After birth, calves' umbilical cord stumps were treated with either an iodine tincture (n= 43) or an antibiotic spray (n= 41) or were left untreated (n= 42). On days 0, 1, 3, 7 and 14 after birth, calves were examined and external umbilical structures were measured. In addition, on day 14 (±2 days), a sonographic examination of umbilical structures was conducted.

Results

The treatment applied had no significant effect on the size of umbilical structures during the first 14 days of life. However, the diameter of the umbilical stalk was larger in male calves and calves with a higher birth weight than in female calves and calves with a lower birth weight.

Limitation

The study was carried out on only one farm, so the generalisability of the findings may be limited.

Conclusion

Umbilical structures showed significant involution over time and were influenced by birth weight and sex.
JACIE and Quality Management in HSCT: Implications for Nursing
Authors: Charley Carole , Espada Martín Raquel , Ferrero Ivana , Babic Aleksandra , Arraut Iris Bargalló
Published: April 2023

Laboratory medicine, along with the airline industry, has a long history of utilising quality management systems. It took until 1999 for the Joint Accreditation Committee of the International Society for Cellular Therapy (ISCT) and the European Group for Blood and Marrow Transplantation (EBMT), known as JACIE, to be established as an accreditation system in the field of haematopoietic stem cell transplantation (HSCT). The aim was to create a standardised system of accreditation to be officially recognised across Europe, and it was based on the accreditation standards established by the US-based Foundation for the Accreditation of Cellular Therapy (FACT).

Since the concept of JACIE was originally launched, many European centres have applied for initial accreditation with other centres gaining reaccreditation for the second, third or fourth time. Transplant units, outside of Europe, have accepted the importance of the JACIE Standards, with units in South Africa, Singapore and Saudi Arabia also gaining accreditation.

There is evidence that both donor and patient care have improved within the accredited centres (Passweg et al., Bone Marrow Transplant 47:906–923; 2012: Demiriz IS, Tekgunduz E, Altuntas F (2012) What is the most appropriate source for hematopoietic stem cell transplantation?).

Peripheral Stem Cell/Bone Marrow/Cord Blood Bone Marrow Res. (2012):Article ID 834040 (online)). However, there is a lack of published evidence demonstrating that this improvement directly results from better nursing care. Therefore, the authors conducted a survey of nursing members of the European Blood and Marrow Transplantation Nurses Group (EBMT (NG)) to identify how nurses working in the area of HSCT felt that JACIE impacted in the care they delivered and the general implications of JACIE for nurses.
Engraftment, Graft Failure, and Rejection
Authors: Hutt Daphna
Published: April 2023

Engraftment following HSCT is an essential goal for sustained long-term and effective hematopoiesis. It is the most important criteria for a better overall survival. However, stem cell engraftment may be accompanied with a clinical condition known as engraftment syndrome (ES) that could have a devastating outcome. Nurses caring for HSCT recipients must be aware of ES symptoms in order to intervene quickly and appropriately. Conversely, graft failure (GF) is a major complication and is associated with a dismal prognosis. It is classically divided into primary or secondary graft failure. The risk factors associated with GF may be related to characteristics of the graft, the patient, the donor, or the transplant procedure. The conditions that are associated with an increased occurrence of GF and the available treatment options will be thoroughly discussed in the chapter along with the nursing considerations.
Late Effects and Long-Term Follow-Up
Authors: Kenyon Michelle , Murray John , Quinn Barry , Greenfield Diana , Trigoso Eugenia
Published: April 2023

Allogeneic stem cell transplantation was successfully performed in 1968, and its use has grown significantly over the past five decades with the total number now exceeding 1.5 million patients (Niederwieser et al. Haematologica. 107:1045–1053, 2022). HSCT is a curative treatment for many haematological cancers and other disorders. Almost 40,000 HSCT procedures are performed Europe-wide per annum (Passweg et al. Bone Marrow Transplant. 51(6):786–92, 2016), and the number of transplant recipients achieving ‘long-term survival’ and with late effects directly related to their treatment (Majhail et al. Hematol Oncol Stem Cell Ther 5(1):1–30, 2012) is increasing (Penack et al. Blood Adv 4:6283–6290, 2020). This growth in survivors is the result of improvements in transplant knowledge and expertise, refinements to conditioning regimes, developments in supportive care and increased numbers of procedures due to broadening transplant indications.

The most common cause of death after transplant is relapsed disease. Yet, even without disease relapse, long-term survival is complex for many as other causes of mortality such as graft versus host disease (GvHD), infection, second malignancy, respiratory disease and cardiovascular disease (CVD) (Savani et al. Blood. 117:3002–9, 2011) prove difficult to address.

Recovery post-HSCT is challenging, lasting several months to years. These individuals are susceptible to the development of post-treatment physical and psychological sequelae years to decades after completion of treatment leading to a reduced life expectancy with greater morbidity when compared to an age-adjusted population (Socié et al. N Engl J Med 341:14–21, 1999). Survivors with late effects experience significantly poorer physical and mental health, report more unmet needs for care and have significantly greater use of health services compared with survivors without late effects (Treanor et al. Psychooncology 22(11):2428–2435, 2013).

Furthermore, as the number of survivors continues to grow, their long-term health problems and subsequent needs demand increasing resource and attention from late effects services. These services must remain agile and responsive, develop capacity to provide continuing expertise and oversight and collaborate with the other specialist services for input when needed.

The unpredictable, complex and multifactorial nature of these long-term and late effects in HSCT survivors means that patients require regular life-long assessment guided by rigorous protocols. However, it is important to remember that even using standardised protocols, these should be different for adults and children and the resulting care must be tailored to the needs of the individual. And finally, further consideration is needed for the growing number of young people and adult survivors in long-term follow-up who have been treated in childhood and transitioned into adult long-term follow-up care.
Transplant Preparation
Authors: Bompoint Caroline , Castagna Alberto , Hutt Daphna , Leather Angela , Stenvall Merja , Schröder Teija , Arjona Eugenia Trigoso , Van Boxtel Ton
Published: April 2023

HSCT is a complex procedure, which involves a long and complicated pathway for the patient and the intervention of many health professionals. Within this multidisciplinary team, the transplant coordinator, usually a nurse, is the ‘essential marrow’, the heart and the vital backbone of this procedure; they are an essential transplant ingredient facilitating a fluidity of the pathway and a good transmission of information. Written information about the procedure is beneficial for patients either prior to clinic visit or during clinic to allow the patients and relatives to reflect on conversations. Transplantation carries a significant risk of morbidity and mortality, and these should be considered regarding the ‘need’ to transplant, based upon risk of disease, versus risk of the transplant. Pre-transplant assessments must also be undertaken, and the results of these along with suitable donor medical clearance and cell availability are essential to ascertain that transplant is a valid option and can proceed safely. Dealing with fertility preservation upon diagnosis of cancer is often challenging; this issue is even more complex for paediatric patients. PDWP recommends that counselling about fertility preservation opportunities should be offered to each patient receiving HSCT.

This chapter also focuses on vascular access for optimal treatment of haematology patients because stem cell treatment cannot be performed without it. Constant advances in haematology have raised challenging ethical dilemmas concerning end of life, palliative care, patient information, donor concerns and impartiality and issues related to the risk we run to our patients. Nurses provide a key role in patient education, providing pre- and post-transplant advocacy and counselling, plan hospitalisations and consultations. They also act as educators and role models to nursing students and share knowledge in accordance with local policies and JACIE guidelines.
Cell Source and Apheresis
Authors: Angelica Margherita , Trigoso Eugenia
Published: April 2023

Apheresis involves the separation of whole blood into its component layers via the use of an automated blood cell separator machine and the process of continuous flow centrifugation. This allows for the isolation and collection of a variety of blood cells, including monocytes, lymphocytes, CD34 positive cells and dendritic cells, whilst simultaneously returning the other blood components back to the donor.

The transplantation of haemopoietic stem cells to facilitate the treatment of a variety of haematological and non-haematological diseases is well established (BSBMTCT, 2022) (https://bsbmtct.org/indications-table—accessed Oct 2022).

Peripheral blood stem cells have largely replaced harvested bone marrow-derived stem cells in both autologous and allogeneic transplant settings. Collection of peripheral blood stem cells generally yields a purer, less contaminated and more consistent product with a greater CD34 positive cell dose when compared to those harvested from the bone marrow. Thus shortening engraftment time, limiting infection risks and potentially enhancing the graft versus leukaemia effect in the allogeneic patient. Umbilical cord blood (UCB) provides a further stem cell source, which may be used in allogenic transplantation if appropriate.

In recent years the ability to isolate blood-derived mononuclear cells via apheresis has been instrumental in the development of individually targeted, patient -specific immunotherapies, most notably Chimeric Antigen Receptor (CAR) T cell therapy. These type of cell collections are rapidly becoming a routine activity for many collection facilities.

Successful collection of cellular blood products via apheresis has its challenges and is influenced by a multitude of variables, including patient’s clinical condition, vascular access, timing of collection, mobilisation regimes, institutional capacity, staff experience and regulations and accreditations.

Apheresis and Bone Marrow collection facility accreditation by FACT-JACIE (2021) requires compliance and rigorous validation of standards in relation to all collection, processing, storage, distribution and infusion activities.

In 2018 FACT-JACIE incorporated the administration of immune effector cells (IEC) into the scope of accreditation standards, which describes that additional training, policies for patient treatment, management of associated toxicities and maintenance of product chain of identity, additional outcome and follow-up reporting to relevant bodies are also an important requisite to fulfil compliance.
Principles of Conditioning Therapy and Cell Infusion
Authors: Zulu Sara , Kenyon Michelle
Published: April 2023

Prior to haematopoietic stem cell transplant (HSCT), conditioning therapy is used for disease eradication, creation of space for engraftment and immunosuppression. Conditioning therapy includes combinations of chemotherapy, radiotherapy and/or immunotherapy and can be administered in the immediate days leading up to, and sometimes the days immediately following, the cell infusion. Total body irradiation (TBI) is generally used as part of conditioning regimens preceding allogeneic HSCT and is able to target sanctuary sites where some drugs cannot reach. Cancer immunotherapy treatment harnesses the body’s natural defences to fight the cancer, by involving components of the immune system. Conditioning therapy can have acute and chronic side effects which vary depending on the intensity of the treatement. Nursing implications include patient education and information, toxicity assessments, close monitoring and protocolised, evidence-based action plans. Stem cell infusion is usually a safe procedure but can cause adverse reactions ranging from flushing and nausea to life-threatening anaphylaxis. There should be written policies for the administration of cellular therapy products, and nurses must have comleted training and achieved competency in order to safely administer haematopoietic stem cells.
Cell Therapy, Nursing Implications and Care
Authors: Clout Ruth , Murray John , Farrell Maria , Hutt Daphna , Kenyon Michelle
Published: April 2023

Over recent years cellular therapy has seen substantial progress across Europe, particularly cell-based immunotherapy/ immune effector cells (IECs), with the approval of autologous CD19 CAR-T products for patients with relapsed/refractory B-cell malignancies-diffuse large B cell lymphoma, acute lymphoblastic leukaemia (paediatric, teenage and young adult) and mantle cell lymphoma). Whilst this development has delivered benefit to patients with poor risk disease, there is potential for associated toxicities which require careful patient selection, assessment, monitoring, treatment and follow-up care. Nurses play a crucial role in supporting patients throughout this pathway. This chapter focuses on autologous cell-based immunotherapies (CAR-T) process, infusion, toxicities, management and the patient pathway, whilst also exploring non-cell-based immunotherapies, cell therapy in solid tumours and the role of clinical trials.
Geldwertstabilität sichern
Authors: Gischer Horst , Herz Bernhard , Menkhoff Lukas
Published: April 2023

Die Stabilität des Geldwertes ist von überragender Bedeutung für eine funktionierende Marktwirtschaft und gehört daher zu den zentralen Zielen der Wirtschaftspolitik. Wie kann die Stabilität des Geldwertes gesichert werden? Welche Rolle spielen dabei insbesondere die Notenbanken mit ihrer Geldpolitik? Und was sind die Nebeneffekte einer Politik stabiler Preise? Kann Geldwertstabilität schädlich für die „Gesundheit“ einer Volkswirtschaft sein?
Vorhaltekostenfinanzierung: Vorschläge zur zielführenden Ausgestaltung
Authors: Loeser Simon , Scheller-Kreinsen David , Jäckel Dörte , Mostert Carina
Published: April 2023

Am 06. Dezember 2022 hat die „Regierungskommission für eine moderne und bedarfsgerechte Krankenhausversorgung“ Empfehlungen für eine Reform der Krankenhausvergütung vorgelegt. In diesen liegt im Falle einer gelungenen Umsetzung die große Chance, die Krankenhauslandschaft zu modernisieren und wirtschaftlich zu stärken, den Effekt des Fachkräftemangels abzumildern und die Versorgungsqualität zu verbessern. Dieser Beitrag stellt dar, welche Aspekte im Hinblick auf die Umsetzung der Reform erfolgskritisch sind. Dabei stehen ein eindeutiger Bevölkerungsbezug von Versorgungsaufträgen und Vorhaltefinanzierung, ein sanfter Übergang in die neue Finanzierung, eine sorgfältige Vermeidung neuer Fehlanreize, eine ausreichend differenzierte Krankenhausplanung auf der Basis von Leistungsgruppen und -bereichen und der Vorschlag, eine Mindestpopulationsgröße zu etablieren, im Vordergrund. Um mögliche Auswirkungen der Reform zu verdeutlichen, wird ein Umsetzungsszenario skizziert, das aufbauend auf der Systematik der Leistungsbereiche aus Nordrhein-Westfalen exemplarisch die Vorhaltepauschalen pro Kopf und Leistungsbereich quantifiziert.
Auswirkungen der Covid-19-Pandemie im Krankenhaus: Fallzahlentwicklung und Charakteristika der Covid-19-Patienten
Authors: Hentschker Corinna , Mostert Carina , Klauber Jürgen
Published: April 2023

Die Covid-19-Pandemie hat zu großen Veränderungen des medizinischen Versorgungsgeschehens geführt. Der Beitrag beschreibt einmal mehr die Auswirkungen der Pandemie auf das Leistungsgeschehen der Krankenhäuser. Des Weiteren werden die Charakteristika der Covid-19-Patienten in den ersten fünf Pandemiewellen miteinander verglichen und die Versorgungsstrukturen dargestellt. Es zeigen sich deutliche Fallzahlrückgänge während der Pandemiejahre 2020 bis 2022 im Vergleich zum Vorpandemiejahr 2019. Die Fallzahlrückgänge gehen einher mit einem durchschnittlichen Anstieg der Fallschwere, einer Konzentration auf operative Leistungen und einem Rückgang der durchschnittlichen Verweildauer. Zudem gibt es Unterschiede bei den Fallzahlrückgängen für die einzelnen Behandlungsanlässe. Die Sterblichkeit der stationären Covid-19-Patienten bleibt, insbesondere bei den beatmeten Patienten, während des gesamten Pandemieverlaufs sehr hoch. Jedoch zeigen sich in der fünften Pandemiewelle seltener schwere Verläufe.
Statistische Krankenhausdaten: Grunddaten der Krankenhäuser 2020
Authors: Bölt Ute
Published: April 2023

Dieser Beitrag fasst die Ergebnisse der Krankenhausstatistik zu den Grunddaten der Krankenhäuser für das Berichtsjahr 2020, dem ersten Jahr der Corona-Pandemie, zusammen. Er gibt einen Überblick über die sachlichen und personellen Ressourcen (z.B. Betten, Fachabteilungen, Personal) sowie die pandemiebedingt reduzierte Inanspruchnahme von Krankenhausleistungen (Patientenbewegungen). Die Krankenhausstatistik ist eine seit 1991 bundeseinheitlich durchgeführte jährliche Vollerhebung. Auskunftspflichtig sind die Träger der Krankenhäuser.
Das „Image“ der Pflege: das Ansehen des Pflegeberufs in der Öffentlichkeit und bei Pflegefachpersonen
Authors: Maier Claudia Bettina , Ludwig Marek , Köppen Julia , Kleine Joan , Busse Reinhard
Published: April 2023

Der Beruf der Gesundheits- und Krankenpflege, deren gesellschaftlicher Status und die Arbeitsbedingungen sind – nicht zuletzt während der Covid-19-Pandemie – vermehrt in den Fokus der Öffentlichkeit gerückt. Der Fachkräftemangel ist allgegenwärtig geworden. Die Wahrnehmung des Pflegeberufs ist von unterschiedlichen, teils gegenläufigen Entwicklungen geprägt: In der Allgemeinbevölkerung besteht generell zwar ein gutes Ansehen des Pflegeberufs, der oftmals mit Respekt und sozialem Einsatz gleichgesetzt wird, jedoch ändert sich das Bild, wenn es konkret um die eigene berufliche Zukunft geht. So ist der Pflegeberuf nicht unbedingt die erste Wahl bei jungen Menschen, v. a. bei Schülerinnen und Schülern mit höherem Schulabschluss. Die mediale Berichterstattung schwankt zwischen Missstandsbeschreibung und Heldentum, insbesondere während der Covid-19-Pandemie. Es gibt wenige Beispiele in den Medien, die die Pflege als Profession realitätsgetreu abbilden. Innerhalb der Pflege wird der Beruf zwar als wichtig und sinnstiftend wahrgenommen, jedoch überschattet durch hohe Arbeitsbelastung und Stress, Fachkräftemangel und fehlende Wertschätzung. Es braucht multifaktorielle Ansätze, um einerseits das öffentliche Bild der Berufsgruppe hin zur Profession Pflege zu verbessern und andererseits deren Arbeitsumfeld und Tätigkeiten vermehrt wertzuschätzen. Dies erfordert Maßnahmen auf Politik- und Managementebene. Zusätzlich wäre es wichtig, dass die Berufsgruppe organisiert, professionalisiert und selbstbewusst auftritt, um so das Bild nach außen selbst vermehrt zu beeinflussen.
Magnet®-Krankenhäuser: Eine Chance für Deutschland?
Authors: Kleine Joan , Maier Claudia Bettina , Köppen Julia , Busse Reinhard
Published: April 2023

Der bestehende Fachkräftemangel und der Wettbewerb um Fachkräfte stellen deutsche Krankenhäuser vor die immer größere Herausforderung, qualifiziertes Pflegepersonal zu gewinnen und zu halten. Die Covid-19-Pandemie rückte die Thematik der Arbeitsbedingungen und die Rolle des Gesundheitspersonals in deutschen Krankenhäusern verstärkt in den Fokus der Öffentlichkeit. Das vierjährige EU-Projekt Magnet4Europe setzt das Magnet-Konzept mit dem Ziel um, das klinische Arbeitsumfeld in über 60 Krankenhäusern in ganz Europa zu verbessern und bewertet die Wirksamkeit der Umsetzung. In Deutschland hat das Projekt in vielen teilnehmenden Krankenhäusern bereits nach kurzer Zeit erste Veränderungen erzielen können. Dieses Kapitel skizziert die Hintergründe für das Interesse an der Umsetzung des Magnet-Konzepts in Deutschland und stellt das Magnet4Europe-Projekt vor.
Probing minimal grand unification through gravitational waves, proton decay, and fermion masses
Authors: Saad Shaikh
Published: April 2023

Abstract

Motivated by the direct discovery of gravitational waves (GWs) from black holes and neutron stars, there is a growing interest in investigating GWs from other sources. Among them, GWs from cosmic strings are particularly fascinating since they naturally appear in a large class of grand unified theories (GUTs). Remarkably, a series of pulsar-timing arrays (PTAs) might have already observed GWs in the nHz regime, hinting towards forming a cosmic string network in the early universe, which could originate from phase transition associated with the seesaw scale emerging from GUT. In this work, we show that if these observations from PTAs are confirmed, GWs from cosmic strings, when combined with fermion masses, gauge coupling unification, and proton decay constraints, the parameter space of the minimal SO(10) GUT becomes exceedingly restrictive. The proposed minimal model is highly predictive and will be fully tested in a number of upcoming gravitational wave observatories.
Kaluza-Klein spectrometry beyond consistent truncations: the squashed S7
Authors: Duboeuf Bastien , Malek Emanuel , Samtleben Henning
Published: April 2023

Abstract

We show how to use Exceptional Field Theory to compute the full Kaluza-Klein spectra of 10- and 11-dimensional supergravity around deformations of backgrounds of maximal gauged supergravity by scalar modes that do not form part of the consistent truncation. This includes deformations of AdS4 × S7 and AdS5 × S5 by modes that are not part of the $$ \mathcal{N} $$
N
= 8 supermultiplet. As an application, we compute the full Kaluza-Klein spectrum of the $$ \mathcal{N} $$
N
= 1 and $$ \mathcal{N} $$
N
= 0 squashed S7. In this example, all conformal dimensions are captured by a universal formula in terms of the Casimir operators and additional quantum numbers which organise the spectrum.
Relativistic equations with singular potentials
Authors: Arcoya David , Sportelli Caterina
Published: April 2023

The first part of this paper concern with the study of the Lorentz force equation $$\begin{aligned} \left( \frac{q'}{\sqrt{1-|q'|^2}}\right) '= \overrightarrow{E}(t,q)+q'\times \overrightarrow{B}(t,q) \end{aligned}$$

q
′

1
-
|

q
′

|

2

′

=

E
→

(
t
,
q
)

+

q
′

×

B
→

(
t
,
q
)

in the relevant physical configuration where the electric field $$\overrightarrow{E}$$

E
→

has a singularity in zero. By using Szulkin’s critical point theory, we prove the existence of T-periodic solutions provided that T and the electric and magnetic fields interact properly. In the last part, we employ both a variational and a topological argument to prove that the scalar relativistic pendulum-type equation $$\begin{aligned} \left( \frac{q'}{\sqrt{1-(q')^2}}\right) ' +q = G^{\prime }(q) +h(t), \end{aligned}$$

q
′

1
-

(

q
′

)

2

′

+
q
=

G
′

(
q
)

+
h

(
t
)

,

admits at least a periodic solution when $$h\in L^1 (0, T)$$

h
∈

L
1

(
0
,
T
)

and G is singular at zero.
Who has mental health problems? Comparing individual, social and psychiatric constructions of mental health
Authors: Pescosolido Bernice A. , Green Harold D.
Published: April 2023

Purpose

The persistent gap between population indicators of poor mental health and the uptake of services raises questions about similarities and differences between social and medical/psychiatric constructions. Rarely do studies have assessments from different perspectives to examine whether and how lay individuals and professionals diverge.

Methods

Data from the Person-to-Person Health Interview Study (P2P), a representative U.S. state sample (N ~ 2700) are used to examine the overlap and correlates of three diverse perspectives—self-reported mental health, a self/other problem recognition, and the CAT-MH™ a validated, computer adaptive test for psychopathology screening. Descriptive and multinominal logit analyses compare the presence of mental health problems across stakeholders and their association with respondents’ sociodemographic characteristics.

Results

Analyses reveal a set of socially constructed patterns. Two convergent patterns indicate whether there is (6.9%, The “Sick”) or is not (64.6%, The “Well”) a problem. The “Unmet Needers” (8.7%) indicates that neither respondents nor those around them recognize a problem identified by the screener. Two patterns indicate clinical need where either respondents (The “Self Deniers”, 2.9%) or others (The “Network Deniers”, 6.0%) do not. Patterns where the diagnostic indicator does not suggest a problem include The “Worried Well” (4.9%) where only the respondent does, The “Network Coerced” (4.6%) where only others do, and The “Prodromal” (1.4%) where both self and others do. Education, gender, race, and age are associated with social constructions of mental health problems.

Conclusions

The implications of these results hold the potential to improve our understanding of unmet need, mental health literacy, stigma, and treatment resistance.
Topology optimization of microwave frequency dividing multiplexers
Authors: Bokhari Ahmad H. , Hassan Emadeldeen , Wadbro Eddie
Published: April 2023

We use material-distribution-based topology optimization to design a three-port frequency dividing multiplexer at microwave frequencies. That is, by placing a good electric conductor inside the design domain, we aim to design a passive device that splits the incoming signal’s frequencies into two frequency bands and transmits them to their respective output ports. The Helmholtz equation models the time-harmonic wave propagation problem. We solve the governing equation using the finite element method. The adjoint variable method provides the required gradients, and we solve the topology optimization problem using Svanberg’s MMA algorithm. In this study, we present a technique for modeling the distribution of a good electric conductor within the design domain. In addition, we derive a power balance expression, which aids in formulating a series of three objective functions. In each successive objective function, we add more information and evaluate its impact on the results. The results show that by selecting a suitable objective function, we achieve more than $$93.7\,\%$$

93.7

%

transmission for both the frequency bands. Moreover, the numerical experiments suggest that the optimization problem is self penalized and is sensitive to the initial design.
Maternal exposure to multiple mycotoxins and adverse pregnancy outcomes: a prospective cohort study in rural Bangladesh
Authors: Kyei Nicholas N. A. , Waid Jillian L. , Ali Nurshad , Cramer Benedikt , Humpf Hans-Ulrich , Gabrysch Sabine
Published: April 2023

There is limited and inconsistent evidence, primarily from cross-sectional studies, linking mycotoxins to adverse birth outcomes. This study investigates the potential role of maternal dietary exposure to multiple mycotoxins in the development of several adverse pregnancy and birth outcomes. We analyzed data from 436 singleton pregnancies enrolled in a prospective cohort study in the rural Habiganj district, Bangladesh, between July 2018 and November 2019. Thirty-five urinary mycotoxin biomarkers were quantified using liquid chromatography coupled with tandem mass spectrometry and used to estimate dietary mycotoxin exposure. Multivariable regression models, adjusted for potential confounding and clustering, were fitted to assess the associations between maternal exposure to frequently occurring mycotoxins (ochratoxin A-OTA, citrinin- CIT, and Deoxynivalenol- DON) and pregnancy loss, preterm birth (PTB), low birth weight (LBW), born small-for-gestational-age (SGA) and small-vulnerable newborn. The results indicate that only in 16 of 436 pregnancies (4%) were urine samples free from all investigated mycotoxins. Biomarkers for six major mycotoxins were detected in the urine samples. OTA (95%), CIT (61%), and DON (6%) were most frequently detected, with at least two mycotoxins co-occurring in the majority of women (63%). There was evidence that maternal dietary intake of OTA was associated with higher odds of having an LBW baby, with the odds increasing in a dose-dependent manner. We found no evidence of associations between pregnancy loss, PTB, SGA, small-vulnerable newborns, and maternal dietary exposure to OTA, CIT, and DON, albeit with large confidence intervals, so findings are consistent with protective as well as large harmful effects. Exposure to multiple mycotoxins during pregnancy is widespread in this rural community and represents a health risk for mothers and babies. Tailored public health policies and interventions must be implemented to reduce mycotoxin exposure to the lowest possible level.
Micro-Slip-Induced Multiplicative Plasticity: Existence of Energy Minimizers
Authors: Mariano Paolo Maria , Mucci Domenico
Published: April 2023

To account for material slips at microscopic scale, we take deformation mappings asSBVfunctions$$\varphi $$φ, which are orientation-preserving outside a jump set taken to be two-dimensional and rectifiable. For their distributional derivative$$F=D\varphi $$F=Dφwe examine the common multiplicative decomposition$$F=F^{e}F^{p}$$F=FeFpinto so-called elastic and plastic factors, the latter a measure. Then, we consider a polyconvex energy with respect to$$F^{e}$$Fe, augmented by the measure$$|\textrm{curl}\,F^{p}|$$|curlFp|. For this type of energy we prove the existence of minimizers in the space ofSBVmaps. We avoid self-penetration of matter. Our analysis rests on a representation of the slip system in terms of currents (in the sense of geometric measure theory) with both$$\mathbb {Z}^{3}$$Z3and$$\mathbb {R}^{3}$$R3valued multiplicity. The two choices make sense at different spatial scales; they describe separate but not alternative modeling options. The first one is particularly significant for periodic crystalline materials at a lattice level. The latter covers a more general setting and requires to account for an energy extra term involving the slip boundary size. We include a generalized (and weak) tangency condition; the resulting setting embraces gliding and cross-slip mechanisms. The possible highly articulate structure of the jump set allows one to consider also the resulting setting even as an approximation of climbing mechanisms.