bluuebunny/crossref_metadata_2025 huggingface dataset:
Digitale Transformation deutscher Gesundheitseinrichtungen
Authors: Petzold Thomas , Steidle Oliver
Published: August 2023

Einleitung

Die digitale Transformation umfasst u. a. die Projektierung und Implementierung digitaler Anwendungen, Technologien und Maßnahmen und stellt inzwischen das Tagesgeschäft aller Organisationen und Einrichtungen im Gesundheitswesen dar. Im vorliegenden Beitrag werden die aktuellen Tätigkeitsinhalte der digitalen Transformation in Gesundheitseinrichtungen aus Sicht des Qualitätsmanagements dargestellt.

Methoden

Es erfolgte eine deutschlandweite Befragung von 141 Mitgliedern der Gesellschaft für Qualitätsmanagement in der Gesundheitsversorgung (niedergelassene Ärztinnen und Ärzte, Vertretende von Krankenhäusern, Krankenkassen sowie weiteren Einrichtungen des Gesundheitswesens) über alle Felder der digitalen Transformation, bestehende Projekte und in der Implementierung befindliche digitale Technologien. Anhand von 6 Themenblöcken bewerteten die Teilnehmenden die zeitliche Abfolge und inhaltliche Relevanz für deren Organisation.

Ergebnisse

82 % der Befragten gaben an, dass die digitale Transformation den Arbeitsalltag beeinflusst bzw. verändert. Die häufigsten Projekte umfassen Themen aus dem Prozess- und Schnittstellenmanagement (53 %) sowie zur Verbesserung der Patientensicherheit (52 %). Häufigste konkrete Vorhaben stellen die elektronische Patientenakte und Themen, die im Zuge des Krankenhauszukunftsgesetzes beauftragt wurden, dar.

Diskussion

Laut Aussage der Befragten verändert die digitale Transformation Strukturen und Prozesse von Gesundheitseinrichtungen und macht zusätzliche Kompetenzen erforderlich, damit digitale Technologien zielführend und nachhaltig implementiert werden können. Eine strukturierte Koordination der Kompetenzen aller Professionen einer Gesundheitseinrichtung ist erforderlich, um digitale Technologien im Alltag von Gesundheitseinrichtungen zu verankern.
Pädiatrische Versorgungstrukturen bei Adipositas 2023 – Wo stehen wir?
Authors: Torbahn Gabriel , Lischka Julia , Joisten Christine , Weghuber Daniel
Published: August 2023

Adipositas ist eine chronisch-rezidivierende Erkrankung, verbunden mit einer Vielzahl kardiometabolischer, orthopädischer und psychischer Komorbiditäten und hohen Belastungen für die jeweiligen Gesundheitssysteme. Bereits im Kindes- und im Jugendalter sind in Österreich und Deutschland 15–25 % von Übergewicht oder Adipositas betroffen. Daher ist eine frühzeitige, interdisziplinäre, multimodale und patientenorientierte Behandlung, bestehend aus einer Basistherapie mit Lebensstilmodifikation sowie medizinischer und psychosozialer Betreuung, dringend erforderlich. Obwohl aktuell leitliniengerechte Konzepte vorliegen, existieren nur wenige spezialisierte zertifizierte Versorgungszentren, und für leitliniengerechte Therapieprogramme erfolgt keine flächendeckende Kostenübernahme. Um insbesondere nach der COVID-19-Pandemie eine adäquate flächendeckende und durch die Sozialversicherungen finanzierte Versorgung zu gewährleisten, sind gesundheitspolitische Entscheidungsträger*innen mehr denn je aufgefordert, im Sinne der Patient*innen Lösungen zu entwickeln. Diese Maßnahmen dienen einerseits der Gesundheitsförderung und langfristigen Entlastung der Gesundheitssysteme, v. a. aber der Behandlung betroffener Kinder und Jugendlicher. Ziele dieser Arbeit sind daher, aktuelle Versorgungsempfehlungen und -strukturen bei pädiatrischer Adipositas in Österreich und Deutschland zusammenzufassen sowie rezente Fortschritte und Handlungsempfehlungen für Politik und Gesellschaft darzustellen.
Anti-predator behavior in two brown frogs: differences in the mean behaviors and in the structure of animal personality variation
Authors: Castellano Sergio , Falbo Luca , Seglie Daniele , Friard Olivier
Published: August 2023

Predation is a major source of selection and prey are known to modify their behavior depending on their past experiences and the current perceived risk. Within a species, variation in experience and in the response to perceived risk combine to explain variation in personality and individual plasticity. Between species, variation in personality and plasticity might also be the evolutionary consequence of different selective regimes. In this study, we describe the anti-predator behavior of two closely related brown frogs,Rana dalmatinaandRana latastei, and compare their structures of personality variation. We raised tadpoles in a common garden experiment with either fish, dragonfly larvae, or no predators. Tadpoles were then repeatedly tested in the presence of the three acute stimuli and their behavioral variation was described in terms of quantity and quality of movements and of path sinuosity. In these tests, tadpoles of both species and ontogenetic treatments responded flexibly to predators by moving less, faster, and with more tortuous movements, and tadpoles raised with predators tended to move even faster. Independent of the acute treatment,R. dalmatinamoved more and faster thanR. latasteiand the differences were larger without than with predators, demonstrating its higher plasticity. At the individual level, the two species showed qualitatively similar but quantitatively different structures of personality variation.R. dalmatina, more active, faster, and more plastic thanR. latastei, showed also higher repeatability and a larger behavioral variation both among and within individuals.

Significance statement

Predators are a major source of selection and preys have evolved the ability to flexibly respond to them. These responses often vary among species, because of their different evolutionary histories, and among individuals, because of their different experiences. We analyzed both these sources of behavioral variation in two closely related brown frogs,Rana dalmatinaandR. latastei. We raised tadpoles either with or without predators and tested them in open field trials both with and without predators. The effects of the raising environment were similar in the two species, whereas the effects of the testing arena differed. Both species decreased activity and increased speed and sinuosity with predators, butR. dalmatinamoved always more and faster thanR. latasteiand it showed higher plasticity, larger variation among and within individuals, and relatively higher values in repeatability.
Noninvasive prediction of insufficient biochemical response after ursodeoxycholic acid treatment in patients with primary biliary cholangitis based on pretreatment nonenhanced MRI
Authors: Zhang Yun , Fan Xiaoli , Song Bin , Liu Yifeng , Chen Yidi , Zheng Tianying , Guo Yuxin , Duan Ting , Huang Zixing , Yang Li
Published: August 2023

Objectives

To explore the feasibility of pretreatment nonenhanced magnetic resonance imaging (MRI) in predicting insufficient biochemical response to ursodeoxycholic acid (UDCA) in patients with primary biliary cholangitis (PBC).

Methods

From January 2009 to April 2022, consecutive PBC patients who were treated with UDCA and underwent nonenhanced MRI within 30 days before treatment were retrospectively enrolled. All MR images were independently evaluated by two blinded radiologists. Uni- and multivariable logistic regression analyses were performed to develop a predictive model for 12-month insufficient biochemical response. Model performances were evaluated by computing the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity.

Results

A total of 74 patients (50.6 ± 11.9 years; 62 females) were included. Three pretreatment MRI features, including hepatomegaly (odds ratio [OR]: 4.580; p = 0.011), periportal hyperintensity on T2-weighted imaging (T2WI) (OR: 4.795, p = 0.008), and narrowing of the bile ducts (OR: 3.491; p = 0.027) were associated with 12-month insufficient biochemical response in the multivariable analysis. A predictive model based on the above indicators had an AUC of 0.781, sensitivity of 85.4%, and specificity of 61.5% for predicting insufficient biochemical response.

Conclusions

A noninvasive model based on three pretreatment MRI features could accurately predict 12-month insufficient biochemical response to UDCA in patients with PBC. Early identification of PBC patients at increased risk for insufficient response can facilitate the timely initiation of additional treatment.

Clinical relevance statement

A noninvasive predictive model constructed by incorporating three pretreatment MRI features may help identify patients with primary biliary cholangitis at high risk of insufficient biochemical response to ursodeoxycholic acid and facilitate the timely initiation of additional treatment.

Key Points

• Noninvasive imaging features based on nonenhanced pretreatment MRI may predict an insufficient biochemical response to UDCA in PBC patients.

• A combined model based on three MRI features (hepatomegaly, periportal hyperintensity on T2-weighted imaging, and narrowing of the bile ducts) further improved the predictive efficacy for an insufficient biochemical response to UDCA in PBC patients, with high sensitivity and specificity.

• The nomogram of the combined model showed good calibration and predictive efficacy for an insufficient biochemical response to UDCA in PBC patients. In particular, the calibration curve visualised the clinical applicability of the prediction model.
Cortical atrophy on baseline computed tomography imaging predicts clinical outcome in patients undergoing endovascular treatment for acute ischemic stroke
Authors: Brugnara Gianluca , Engel Adrian , Jesser Jessica , Ringleb Peter Arthur , Purrucker Jan , Möhlenbruch Markus A. , Bendszus Martin , Neuberger Ulf
Published: August 2023

Objective

Multiple variables beyond the extent of recanalization can impact the clinical outcome after acute ischemic stroke due to large vessel occlusions. Here, we assessed the influence of small vessel disease and cortical atrophy on clinical outcome using native cranial computed tomography (NCCT) in a large single-center cohort.

Methods

A total of 1103 consecutive patients who underwent endovascular treatment (EVT) due to occlusion of the middle cerebral artery territory were included. NCCT data were visually assessed for established markers of age-related white matter changes (ARWMC) and brain atrophy. All images were evaluated separately by two readers to assess the inter-observer variability. Regression and machine learning models were built to determine the predictive relevance of ARWMC and atrophy in the presence of important baseline clinical and imaging metrics.

Results

Patients with favorable outcome presented lower values for all measured metrics of pre-existing brain deterioration (p < 0.001). Both ARWMC (p < 0.05) and cortical atrophy (p < 0.001) were independent predictors of clinical outcome at 90 days when controlled for confounders in both regression analyses and led to a minor improvement of prediction accuracy in machine learning models (p < 0.001), with atrophy among the top-5 predictors.

Conclusion

NCCT-based cortical atrophy and ARWMC scores on NCCT were strong and independent predictors of clinical outcome after EVT.

Clinical relevance statement

Visual assessment of cortical atrophy and age-related white matter changes on CT could improve the prediction of clinical outcome after thrombectomy in machine learning models which may be integrated into existing clinical routines and facilitate patient selection.

Key Points

• Cortical atrophy and age-related white matter changes were quantified using CT-based visual scores.

• Atrophy and age-related white matter change scores independently predicted clinical outcome after mechanical thrombectomy and improved machine learning–based prediction models.

• Both scores could easily be integrated into existing clinical routines and prediction models.
Prognostic impact of cancer history in patients undergoing transcatheter mitral valve repair
Authors: Kalkan Alev , Metze Clemens , Iliadis Christos , Körber Maria I. , Baldus Stephan , Pfister Roman
Published: August 2023

Background

History of cancer is common in patients undergoing transcatheter mitral valve repair (TMVR).

Objectives

Aim was to examine the impact of cancer history on outcomes after TMVR.

Methods

In patients of a monocentric prospective registry of TMVR history of cancer was retrospectively assessed from records. Associations with 6-week functional outcomes and clinical outcomes during a median follow-up period of 594 days were examined.

Results

Of 661 patients (mean age 79 years; age-range 37–101 years; 56.1% men), 21.6% had a history of cancer with active disease in 4.1%. Compared with non-cancer patients, cancer patients had a similar procedural success rate (reduction of mitral regurgitation to grade 2 or lower 91.6% vs. 88%; p = 0.517) and similar relevant improvement in 6-min walking distance, NYHA class, Minnesota Living with Heart Failure Questionnaire score and Short Form 36 scores. 1-year survival (83% vs. 82%; p = 0.813) and 1-year survival free of heart failure decompensation (75% vs. 76%; p = 0.871) were comparable between cancer and non-cancer patients. Patients with an active cancer disease showed significantly higher mortality compared with patients having a history of cancer (hazard ratio 2.05 [95% CI 1.11–3.82; p = 0.023]) but similar mortality at landmark analysis of 1 year.

Conclusion

TMVR can be performed with equal efficacy in patients with and without cancer and symptomatic mitral regurgitation. Cancer patients show comparable clinical outcome and short-term functional improvement as non-cancer patients. However, longterm mortality was increased in patients with active cancer underlining the importance of patient selection within the heart-team evaluation.

Graphical abstract
High- and low-dose cyclophosphamide in Egyptian lupus nephritis patients: a multicenter retrospective analysis
Authors: Elaziz Mohamed Momtaz A. , Gamal Sherif M. , Fayed Ahmed , Abu-Zaid Mohammed Hassan , Ghoniem Shada A. , Teleb Doaa A.
Published: August 2023

Background

Lupus nephritis (LN) is a common serious presentation of systemic lupus erythematosus. Cyclophosphamide (CYC) and mycophenolate mofetil (MMF) are listed as the first-line drugs in induction therapy for LN.

Objective

This study aimed to compare high- and low-dose CYC in a cohort of Egyptian LN patients.

Patients and methods

The data of 547 patients with class III/IV active LN who received CYC as induction therapy were retrospectively analyzed. Whereas 399 patients received 6‑monthly 0.5–1 g/m2 CYC doses, 148 patients received six biweekly 500 mg CYC doses. Demographic data, laboratory test results, and disease activity index were recorded and compared at presentation and at 6, 12, 18, 24, and 48 months of follow-up.

Results

After 48 months, the proportion of patients maintaining normal creatinine levels was higher in the group receiving induction therapy with high-dose CYC (67.9%, 60.4%, p = 0.029), and these patients also had higher proteinuria remission at 36 (26.6%, 14.8%, p = 0.014) and 48 months (24.3%, 12.8%, p = 0.006). Comparison of patient outcomes according to both induction and maintenance therapy showed the best results in patients who received high-dose CYC and continued MMF as maintenance therapy.

Conclusion

High- and low-dose CYC are comparable in early phases of treatment. However, after a longer duration of follow-up, high-dose CYC was associated with higher remission rates in the current cohort.
The clinical implication of minimally invasive versus open pancreatoduodenectomy for non-pancreatic periampullary cancer: a systematic review and individual patient data meta-analysis
Authors: Uijterwijk Bas A. , Kasai Meidai , Lemmers Daniel H. L. , Chinnusamy Palanivelu , van Hilst Jony , Ielpo Benedetto , Wei Kongyuan , Song Ki Byung , Kim Song C. , Klompmaker Sjors , Jang Jin-Young , Herremans Kelly M. , Bencini Lapo , Coratti Andrea , Mazzola Michele , Menon Krishna V. , Goh Brian K. P. , Qin Renyi , Besselink Marc G. , Abu Hilal Mohammed ,   for the International Study Group on non-pancreatic periAmpullary CAncer (ISGACA), Hakeem Abdul , Burdio Fernando , Senthilnathan Palanisamy , Sánchez Patricia , Kim Hyeong Seok , Hughes Steven J. , Giani Alessandro
Published: August 2023

Background

Most studies on minimally invasive pancreatoduodenectomy (MIPD) combine patients with pancreatic and periampullary cancers even though there is substantial heterogeneity between these tumors. Therefore, this study aimed to evaluate the role of MIPD compared to open pancreatoduodenectomy (OPD) in patients with non-pancreatic periampullary cancer (NPPC).

Methods

A systematic review of Pubmed, Embase, and Cochrane databases was performed by two independent reviewers to identify studies comparing MIPD and OPD for NPPC (ampullary, distal cholangio, and duodenal adenocarcinoma) (01/2015–12/2021). Individual patient data were required from all identified studies. Primary outcomes were (90-day) mortality, and major morbidity (Clavien-Dindo 3a-5). Secondary outcomes were postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), blood-loss, length of hospital stay (LOS), and overall survival (OS).

Results

Overall, 16 studies with 1949 patients were included, combining 928 patients with ampullary, 526 with distal cholangio, and 461 with duodenal cancer. In total, 902 (46.3%) patients underwent MIPD, and 1047 (53.7%) patients underwent OPD. The rates of 90-day mortality, major morbidity, POPF, DGE, PPH, blood-loss, and length of hospital stay did not differ between MIPD and OPD. Operation time was 67 min longer in the MIPD group (P = 0.009). A decrease in DFS for ampullary (HR 2.27, P = 0.019) and distal cholangio (HR 1.84, P = 0.025) cancer, as well as a decrease in OS for distal cholangio (HR 1.71, P = 0.045) and duodenal cancer (HR 4.59, P < 0.001) was found in the MIPD group.

Conclusions

This individual patient data meta-analysis of MIPD versus OPD in patients with NPPC suggests that MIPD is not inferior in terms of short-term morbidity and mortality. Several major limitations in long-term data highlight a research gap that should be studied in prospective maintained international registries or randomized studies for ampullary, distal cholangio, and duodenum cancer separately.

Protocol registration

PROSPERO (CRD42021277495) on the 25th of October 2021.
Development and evaluation study of FLY-Kids: a new lifestyle screening tool for young children
Authors: Krijger Anne , Schiphof-Godart Lieke , Elstgeest Liset , van Rossum Caroline , Verkaik-Kloosterman Janneke , Steenbergen Elly , ter Borg Sovianne , Lanting Caren , van Drongelen Karen , Engelse Ondine , Kindermann Angelika , Detmar Symone , Frenkel Carolien , Raat Hein , Joosten Koen
Published: August 2023

Evaluating, discussing, and advising on young children’s lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. We aimed to develop and evaluate a new lifestyle screening tool for children aged 1–3 years. The lifestyle screening tool “FLY-Kids” was developed using data from lifestyle behaviour patterns of Dutch toddlers, age-specific lifestyle recommendations, target group analyses, and a Delphi process. Through 10 items, FLY-Kids generates a dashboard with an overview of the child’s lifestyle that can be used as conversation aid. FLY-Kids was completed by parents of children aged 1–3 years attending a regular youth healthcare appointment. Youth healthcare professionals (YHCP) then used the FLY-Kids dashboard to discuss lifestyle with the parents and provided tailored advice. Parents as well as YHCP evaluated the tool after use. Descriptive and correlation statistics were used to determine the usability, feasibility, and preliminary effect of FLY-Kids. Parents (N = 201) scored an average of 3.2 (out of 9, SD 1.6) unfavourable lifestyle behaviours in their children, while 3.0% complied with all recommendations. Most unfavourable behaviours were reported in unhealthy food intake and electronic screen time behaviour. Parents and YHCP regarded FLY-Kids as usable and feasible. The number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment (r = 0.47, p < 0.001).

     Conclusion: FLY-Kids can be used to identify unhealthy lifestyle behaviour in young children and guide the conversation about lifestyle in preventive healthcare settings. End-users rated FLY-Kids as helpful and user-friendly.

What is Known:• A healthy lifestyle is important for optimal growth, development and overall health of young children (1-3 years).• Evaluating, discussing and advising on young children’s lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences.

What is New:• The new lifestyle screening tool FLY-Kids generates a dashboard with an overview of young children’s lifestyle that can be used as conversation aid between parents and youth healthcare professionals.• As parents and youth healthcare professionals rated FLY-Kids as helpful and user-friendly, and the number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment, FLY-Kids can be considered guiding the lifestyle discussion in preventive healthcare settings.
Protective effect of cryotherapy against oral mucositis among allogeneic hematopoietic stem cell transplant recipients using melphalan-based conditioning
Authors: Oku Saori , Futatsuki Toshiko , Imamura Yoshiko , Hikita Haruna , Inada Akemi , Mizutani Shinsuke , Mori Yasuo , Kashiwazaki Haruhiko
Published: August 2023

Purpose

Oral cryotherapy is an effective method to prevent oral mucositis (OM) induced by chemotherapeutic agents, such as melphalan (Mel). However, there is limited data about cryotherapy in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients; thus, the current study aimed to examine the efficacy of cryotherapy among allo-HSCT recipients treated with Mel-containing regimens.

Methods

Medical records of 78 consecutive allo-HSCT recipients were retrospectively analyzed. Baseline characteristics and clinical courses between the patients who received cryotherapy (cryotherapy group, n = 42) and those who did not (control group, n = 36) were compared, especially focusing on methotrexate (MTX) use as a part of graft-versus-host disease (GVHD) prophylaxis.

Results

Binary logistic regression analysis revealed that a higher dose of Mel (OR, 3.82; 95%CI, 1.085–13.46; P = 0.037) or MTX use (OR, 7.61; 95% CI, 2.41–23.97; P < 0.001) was associated with the incidence of OM. MTX use was also significantly associated with the duration of OM (β = 0.515; 95% CI, 9.712–21.636; P < 0.001). Among 31 patients without MTX use, cryotherapy was associated with a significant reduction of OM development (0% in the cryotherapy group vs 35% in the control group, P = 0.021). We did not find such an association in 47 patients with MTX use.

Conclusion

Cryotherapy was useful to prevent the incidence of OM in allo-HSCT recipients in the cases without MTX for GVHD prophylaxis.
Professionalisierung in der Psychoonkologie – die Bedeutung der Fort- und Weiterbildung
Authors: Weis J. , Blettner G. , Lehmann-Laue A. , Ihrig A. , von Saalfeld S.
Published: August 2023

Trotz großer internationaler Unterschiede hat sich das Arbeitsgebiet Psychoonkologie innerhalb der letzten vier Jahrzehnte weltweit sowohl als wissenschaftliche Disziplin als auch als wichtiger Teil der onkologischen Versorgung etabliert. Um einheitliche Qualitätsstandards in der Versorgung umsetzen zu können, ist die professionelle Fort- und Weiterbildung mit einheitlichen Qualifizierungsstandards eine zentrale Aufgabe, um die Psychoonkologie als Tätigkeitsfeld für Berufsabsolvent*innen attraktiv machen zu können. Der vorliegende Überblicksartikel zeigt die Entwicklung und den aktuellen Stand der psychoonkologischen Fort- und Weiterbildung im internationalen Vergleich. Am Beispiel der Fort- und Weiterbildung für Psychosoziale Onkologie (WPO e. V.) wird die Entwicklung in Deutschland reflektiert. Schließlich werden die zukünftigen Aufgaben zur Stärkung der Professionalisierung in der Psychoonkologie aufgezeigt.
Factors influencing the acceptance of the measures for the containment of Covid-19
Authors: Kaltenhäuser Bernd
Published: August 2023

Aim

This study examines the impact of individual factors and personal experiences with Covid-19 on how one views the pandemic and the measures against it.

Subject and methods

For this, a survey was conducted and evaluated using structural equation modeling and multivariate statistics.

Results

Hereby, a higher approval was found for measures associated with a high contribution to the confinement of the pandemic but with low restrictions on the people at the same time. Furthermore, the results showed that people rating the pandemic as dangerous show a higher agreement with all measures, and likewise, these people decreasingly rate the measures as worse than the pandemic itself. Also, it could be shown that, especially personal experiences like a quarantaine and personal restrictions, increased the opinion that Covid-19 is a dangerous disease. Also, people informing themselves with alternative press rated Covid-19 as less dangerous. In contrast, age and gender had no influence on the view on the pandemic and the measures against it.

Conclusion

From the results, mainly two conclusions can be drawn: people can disinguish well between the benefits of single measures and personal experiences play an important role in their rating. Thus, when establishing measures in further pandemics, it might be wise to include the public’s opinion in all decisions.
Drag Assessment for Boundary Layer Control Schemes with Mass Injection
Authors: Fahland Georg , Atzori Marco , Frede Annika , Stroh Alexander , Frohnapfel Bettina , Gatti Davide
Published: August 2023

The present study considers uniform blowing in turbulent boundary layers as active flow control scheme for drag reduction on airfoils. The focus lies on the important question of how to quantify the drag reduction potential of this control scheme correctly. It is demonstrated that mass injection causes the body drag (the drag resulting from the stresses on the body) to differ from the wake survey drag (the momentum deficit in the wake of an airfoil), which is classically used in experiments as a surrogate for the former. This difference is related to the boundary layer control (BLC) penalty, an unavoidable drag portion which reflects the effort of a mass-injecting boundary layer control scheme. This is independent of how the control is implemented. With an integral momentum budget, we show that for the present control scheme, the wake survey drag contains the BLC penalty and is thus a measure for the inclusive drag of the airfoil, i.e. the one required to determine net drag reduction. The concept of the inclusive drag is extended also to boundary layers using the von Kàrmàn equation. This means that with mass injection the friction drag only is not sufficient to assess drag reduction also in canonical flows. Large Eddy Simulations and Reynolds-averaged Navier–Stokes simulations of the flow around airfoils are utilized to demonstrate the significance of this distinction for the scheme of uniform blowing. When the inclusive drag is properly accounted for, control scenarios previously considered to yield drag reduction actually show drag increase.
Litigation and settlement under loss aversion
Authors: Argenton Cédric , Wang Xiaoyu
Published: August 2023

In this paper, we investigate how loss aversion affects people’s behavior in private litigation. We find that a loss-averse plaintiff demands a higher settlement for intermediate claims to maintain her threat to proceed to trial following rejection compared to a loss-neutral plaintiff. For larger claims, a loss-averse plaintiff demands a lower offer to increase the settlement probability as loss pains her extra in trial. We also investigate how various policies affect loss-averse litigants’ settlement decisions. Only a reduction in the asymmetry of information about trial odds uniformly leads to higher settlement rates.
“How in God’s Name Are We Going to Navigate This?”: Parent Support for Transgender Adolescents
Authors: Dunlap Shannon L. , Goldbach Jeremy T. , Olson-Kennedy Johanna , Held Jordan
Published: August 2023

The extant literature has clearly demonstrated that transgender and nonbinary adolescents (TNBA) face extreme stress related to navigating gender identity and expression across various social environments. Additionally, parents are perhaps the most critical aspect of support for TNBA, and research has repeatedly identified the benefits of parent support for adolescent mental health. However, few studies underscore how TNBA and parents within the same family perceive parent support after adolescents disclose that they are transgender or nonbinary. The present qualitative study uses a life history calendar (LHC) interview approach with 20 TNBA-parent dyads (40 individual interviews) to explore TNBA-parent perceptions of parent support and adjustment related to TNBA gender identity and affirmation. Findings yielded three main points regarding parental support for TNBA. First, the time between disclosure to a parent and puberty mattered for parental support and adjustment processes. Second, parents who stepped into their child’s gender journey during their child’s adolescence grappled with feelings of grief and loss as they were making decisions to support their child’s gender affirmation. For many of these families, stigma-related fears and adolescent distress impacted parent support for their child’s gender journey. Third, parents lacked a familiar and affirming roadmap in their own families and communities, and although parents connected with other parents of trans kids for support, for some, these supportive resources presented challenges. Continued research can further study the complex drivers of support and the potential impact of these support processes on adolescent and parental well-being.
A Novel CDC42 Variant with Impaired Thymopoiesis, IL-7R Signaling, PAK1 Binding, and TCR Repertoire Diversity
Authors: Assing Kristian , Jørgensen Sofie E. , Sandgaard Katrine S. , De Keukeleere Kerstin , B.-Hansen Marie , Petersen Mikkel S. , Hartling Ulla B. , Vaal Thanis M. K.-de , Nielsen Christian , Jakobsen Marianne A. , Watt Eleanor , Adams Stuart , Hao Qin , Fagerberg Christina , Mogensen Trine H.
Published: August 2023

Genetic variants in cell division cycle 42 (CDC42) can manifest with dysmorphic features, autoinflammation, hemophagocytic lymphohistiocytosis, and thrombocytopenia, whereas defective thymopoiesis is a rare disease manifestation. We report a novel CDC42 missense variant (c.46A > G, p.Lys16Glu) resulting in infection and HPV-driven carcinogenesis in the mosaic mother and impaired thymopoiesis and profound T cell lymphopenia in the heterozygous daughter identified through newborn screening for SCID. We found that surface expression of IL-7Rα (CD127) was decreased, consistent with reduced IL-7-induced STAT5 phosphorylation and accelerated apoptotic T cell death. Consistent with the vital role of IL-7 in regulating thymopoiesis, both patients displayed reduced T cell receptor CDR3 repertoires. Moreover, the CDC42 variant prevented binding to the downstream effector, p21-activated kinase (PAK)1, suggesting this impaired interaction to underlie reduced IL-7Rα expression and signaling. Here, we provide the first report of severely compromised thymopoiesis and perturbed IL-7Rα signaling caused by a novel CDC42 variant and presenting with diverging clinical and immunological phenotypes in patients.
A Lipid-Structured Model of Atherosclerotic Plaque Macrophages with Lipid-Dependent Kinetics
Authors: Watson Michael G. , Chambers Keith L. , Myerscough Mary R.
Published: August 2023

Atherosclerotic plaques are fatty growths in artery walls that cause heart attacks and strokes. Plaque formation is driven by macrophages that are recruited to the artery wall. These cells consume and remove blood-derived lipids, such as modified low-density lipoprotein. Ineffective lipid removal, due to macrophage death and other factors, leads to the accumulation of lipid-loaded macrophages and formation of a necrotic lipid core. Experimental observations suggest that macrophage functionality varies with the extent of lipid loading. However, little is known about the influence of macrophage lipid loads on plaque fate. Extending work by Ford et al. (J Theor Biol 479:48–63, 2019) and Chambers et al. (A lipid-structured model of atherosclerosis with macrophage proliferation, 2022), we develop a plaque model where macrophages are structured by their ingested lipid load and behave in a lipid-dependent manner. The model considers several macrophage behaviours, including recruitment to and emigration from the artery wall; proliferation and apotosis; ingestion of plaque lipids; and secondary necrosis of apoptotic cells. We consider apoptosis, emigration and proliferation to be lipid-dependent and we model these effects using experimentally informed functions of the internalised lipid load. Our results demonstrate that lipid-dependent macrophage behaviour can substantially alter plaque fate by changing both the total quantity of lipid in the plaque and the distribution of lipid between the live cells, dead cells and necrotic core. The consequences of macrophage lipid-dependence are often unpredictable because lipid-dependent effects introduce subtle, nonlinear interactions between the modelled cell behaviours. These observations highlight the importance of mathematical modelling in unravelling the complexities of macrophage lipid accumulation during atherosclerotic plaque formation.
Equine induced pluripotent stem cells are responsive to inflammatory cytokines before and after differentiation into musculoskeletal cell types
Authors: Palomino Lago Esther , Jelbert Elizabeth R. , Baird Arabella , Lam Pak Y. , Guest Deborah J.
Published: August 2023

Persistent inflammation is associated with the poor regeneration of musculoskeletal tissues. Embryonic stem cells (ESCs) have an attenuated response to inflammatory cytokines, but there are mixed reports on the response of induced pluripotent stem cells (iPSCs) to inflammation. Horses provide a relevant large animal model for studying musculoskeletal tissue diseases and the testing of novel therapies. The aim of this study was to determine if equine iPSCs are responsive to the inflammatory cytokines IL-1β, TNFα and IFN-γ in their undifferentiated state, or following differentiation into tendon and cartilage-like cells. We demonstrated that in undifferentiated iPSCs, the cytokines induce NF-κB P65 and STAT1 nuclear translocation which leads to cell death, decreased OCT4 expression and increased expression of inflammatory genes. Following differentiation towards cartilage-like cells exposure to the cytokines resulted in STAT1 nuclear translocation, changes in cartilage gene expression and increased expression of matrix metalloproteinases (MMPs) and inflammatory genes. Exposure of iPSC-derived tendon-like cells to the cytokines resulted nuclear translocation of NF-κB P65 and STAT1, altered tendon gene expression, increased MMP expression and increased expression of inflammatory genes. Equine iPSCs are therefore capable of responding to inflammatory stimulation and this may have relevance for their future clinical application.
Methodologische Empfehlungen zur Neurowissenschaft des luziden Träumens
Authors: Adelhöfer Nico
Published: August 2023

Das luzide Träumen ist ein einzigartiges Phänomen, bei dem sich eine Person während des Schlafs bewusst ist, dass sie träumt, und dadurch häufig ihre Handlungen während des Traums bewusst steuern kann. Dieser Artikel beleuchtet kritisch die methodischen Herausforderungen bei der Erforschung des luziden Träumens und bietet Strategien zu deren Bewältigung unter Berücksichtigung neuer theoretischer und empirischer Erkenntnisse. Methodische Strenge ist für den Fortschritt auf diesem Gebiet unerlässlich. Zu den Schlüsselbereichen, auf die man sich konzentrieren sollte, gehören standardisierte EEG-Vorverarbeitungen, die Berücksichtigung von nächtlichen Störfaktoren und die Untersuchung von nichtoszillatorischen Signalaspekten wie neuronalem Rauschen. Die Verwendung von Datenanalysen auf Quellenebene könnte neue neurophysiologische Marker für luzides Träumen aufdecken und so zu einem umfassenderen Verständnis des Phänomens führen. Der Artikel enthält auch Hinweise, wie sichergestellt werden kann, dass neu erhobene Daten über luzides Träumen für die vorgeschlagenen methodischen Verbesserungen geeignet sind. Obwohl der Ton dieses Artikels kritisch ist, hebt er das Potenzial hervor, das die Forschung zum luziden Träumen hat, wenn diese Herausforderungen richtig angegangen werden. Die Überwindung der hier beschriebenen Einschränkungen wird es den Forschenden ermöglichen, das breite Spektrum der Möglichkeiten, die das luzide Träumen bietet, voll auszuschöpfen – von der Erweiterung unseres Wissens über das Bewusstsein bis hin zu neuen therapeutischen Anwendungen. Indem wir unsere Methoden verfeinern und diese Probleme angehen, kann das Forschungsfeld des luziden Träumens weiter wachsen und sich entwickeln und schließlich sein volles Potenzial entfalten.
Dermoscopy-assisted prevalence of hair loss after COVID-19 vaccination among an Egyptian population: a cross-sectional study
Authors: Ammar Amr M. , Ibrahim Ibrahim S. , Mohamed Abbas N. , Elsaie Mohamed L.
Published: August 2023

Abstact

Background

Coronavirus disease (COVID-19) currently named SARS-CoV-2 is a contagious disease caused by a coronavirus; incompatible data are present on the possible relationship among COVID-19 vaccines and hair loss.

Aims

The objective of the current study was to assess dermoscopically the prevalence of hair loss among an Egyptian population following COVID-19 vaccination.

Methods

A total of 2000 participants were enrolled in this cross-sectional study. Adult males and females who received one of recognized COVID-19 vaccine were included, irrespective of the status of previous COVID-19 infection. Those who were aged less than 18 years or above 60 years were excluded. Furthermore, subjects self-reporting hair loss were assessed by dermoscopy.

Results

Among the studied cases, n = 478 (23.9%) complained of hair loss following vaccination. The majority of cases noticed their hair loss during the first 2 months post-vaccination (n = 215 after the first month and n = 158 after the 2nd month respectively).

Conclusion

We reported prevalence of post-vaccination hair fall that was confirmed by trichoscopy and which affected approximately one quarter of participants who received COVID-19 vaccines. Other factors, such as stress and infection, cannot be excluded and remain to be further investigated by larger multicenter studies.
Comparison of the outcomes between total arch replacement and nontotal arch replacement in patients with acute type A aortic dissection
Authors: Lerdpunnapongse Pichej , Slisatkorn Worawong , Wongkornrat Wanchai , Sanphasitvong Vutthipong
Published: August 2023

Objective

To compare the outcomes between total arch replacement (TAR) and nontotal arch replacement (non-TAR) in patients with acute type A aortic dissection (ATAAD).

Methods

Between 2006 and 2018, 275 ATAAD patients were divided into 2 groups, the TAR group (n = 63) and the non-TAR group (n = 212), and multiple variables were analyzed.

Results

The TAR patients were older than the non-TAR patients (61.5 ± 11.8 vs. 57.4 ± 14.5 years, p = 0.024). The TAR group had longer operative, cardiopulmonary bypass, aortic clamping, and circulatory arrest times than the non-TAR group (all p < 0.001). The overall hospital mortality rate was 8.7% with no statistically significant difference between the TAR and non-TAR groups (9.5% vs. 8.5%, p = 0.799). There was no significant difference in the incidence of acute kidney injury (AKI), intubation time, incidence of postoperative atrial fibrillation (AF), or reoperation for bleeding or reintervention rates between the TAR and non-TAR groups (68.3% vs. 65.7% (p = 0.912), 44.8% vs. 33.8% (p = 0.127), 30.2% vs. 22.6% (p = 0.222), 9.5% vs. 9.5% (p = 0.189), and 7.9% vs. 7.1% (p = 0.077), respectively). The TAR group had a higher rate of new permanent neurological deficit (PND) than the non-TAR group and longer median length of hospital stay (17.5% vs. 6.1% (p < 0.001) and 9 vs. 12 days (p = 0.049), respectively). TAR (relative risk (RR) 3.66, p = 0.005) and preoperative cardiopulmonary resuscitation (CPR) (RR 6.60, p = 0.019) were risk factors of PND. Survival rate was similar between the two groups.

Conclusion

The mortality rates in ATAAD patients with TAR and non-TAR were similar. However, the incidence of new permanent postoperative neurological deficit was significantly higher, and the length of hospital stay was longer in patients with TAR. TAR in ATAAD should be avoided especially in patients who have experienced preoperative CPR to abate risk of PND.
A lower bound for differential uniformity by multiplicative complexity & bijective functions of multiplicative complexity 1 over finite fields
Authors: Steiner Matthias Johann
Published: August 2023

The multiplicative complexity of an S-box over a finite field is the minimum number of multiplications needed to implement the S-box as an arithmetic circuit. In this paper we fully characterize bijective S-boxes with multiplicative complexity 1 up to affine equivalence over any finite field. We show that under affine equivalence in odd characteristic there are two classes of bijective functions and in even characteristic there are three classes of bijective functions with multiplicative complexity 1. Moreover, in (Jeon et al., Cryptogr. Commun., 14(4), 849-874 (2022)) A-boxes where introduced to lower bound the differential uniformity of an S-box over $$\mathbb {F}_{2}^{n}$$

F

2

n

via its multiplicative complexity. We generalize this concept to arbitrary finite fields. In particular, we show that the differential uniformity of a (n, m)-S-box over $$\mathbb {F}_{q}$$

F
q

is at least $$q^{n - l}$$

q

n
-
l

, where $$\lfloor \frac{n - 1}{2} \rfloor + l$$

⌊

n
-
1

2

⌋
+
l

is the multiplicative complexity of the S-box.
FlASHback—personal highlights regarding myelodysplastic syndrome from the 2022 ASH meeting
Authors: Petzer Verena , Wolf Dominik
Published: August 2023

This article intends to summarize and comment on some of the highlights regarding myelodysplastic syndrome (MDS) presented at the 2022 American Society of Hematology (ASH) annual meeting. Many abstracts dealt with the validation of the two new classifications and the International Prognostic Scoring System–Molecular (IPSS-M) being among the most intensively discussed topics in the community. Moreover, for the first time, real-world data on luspatercept were presented. Long-term data from the MEDALIST trial showed which patients benefit most from therapy with luspatercept, adding important information for the use of this substance. However, except for the phase III trial Sintra-REV, practice-changing clinical reports were sparse, although earlier trials in both higher-and lower-risk MDS reported on promising agents currently in clinical development that will hopefully improve the future management of MDS patients.
Pyrotechnology and lipid biomarker variability in pine tar production
Authors: Davara Javier , Jambrina-Enríquez Margarita , Rodríguez de Vera Caterina , Herrera-Herrera Antonio V. , Mallol Carolina
Published: August 2023

Tar or pitch produced from pine resin and wood played an important role in the past as an adhesive, waterproofing and medicinal product. However, the formation and biomolecular composition of pine tar produced only from resin under different combustion conditions (i.e., temperature and oxygen availability during heating) has not been as widely investigated as pine tar produced by dry distillation of wood or birch bark tar, for which an extensive literature is available. This lack of information hampers technological interpretations of biomolecular data obtained from organic residue analyses of archaeological pine tar products. In this study, we performed controlled laboratory heating sequences with pine resin (Pinus canariensis) at 150, 250, 350 and 450 ºC under both oxygenated and oxygen-limited conditions, and analyzed the products using gas chromatography-mass spectrometry (GC-MS). A control unheated resin sample was also analysed. We found that the formation of pine tar from resin occurs around 250–350 ºC under both oxygenated and oxygen-limited atmospheres. We also present and discuss the lipid biomarkers of pine resin and its combustion products according to changes in temperature and oxygen availability. Our reference data provide new information for the biomolecular identification of archaeological pine tar products and show potential for shedding light on the conditions in which tar was manufactured by ancient populations in different contexts.
Elucidating the Mechanisms of Cell-to-Cell Crosstalk in Probiotics Co-culture: A Proteomics Study of Limosilactobacillus reuteri ZJ625 and Ligilactobacillus salivarius ZJ614
Authors: Kwoji Iliya Dauda , Aiyegoro Olayinka Ayobami , Okpeku Moses , Adeleke Matthew Adekunle
Published: August 2023

Limosilactobacillus reuteri ZJ625 and Ligilactobacillus salivarius ZJ614 are potential probiotic bacteria with improved benefits when administered to the host as a multi-strain preparation. To elucidate the mechanisms of cell-to-cell crosstalk between these two strains, we studied their intracellular and extracellular proteomes in co-culture by liquid-chromatography mass-spectrometry (LC-MS) using Dionex Nano-RSLC and fusion mass spectrometer. The experiment consisted of five biological replicates, and samples were collected during the mid-exponential growth phase. The quantitative proteomic profiles revealed several differentially expressed proteins (DEPs), which are down- or up-regulated between and within groups for both the intracellular and extracellular proteomes. These DEPs include proteins synthesising autoinducer-2, a sensor compound for cell-to-cell bacterial crosstalk during quorum sensing in mixed culture. Other important DEPs identified include enolase, phosphoglycerate kinase, and l-lactate dehydrogenase, which play roles in carbohydrate metabolism. Proteins associated with transcription, ATP production and transport across the membrane, DNA repair, and those with the potential to bind to the host epithelium were also identified. The post-translational modifications associated with the proteins include oxidation, deamidation, and ammonia loss. Importantly, this study revealed a significant expression of S-ribosylhomocysteine lyase (luxS) involved in synthesising autoinducer-2 that plays important roles in quorum sensing, aiding bacterial cell-to-cell crosstalk in co-cultures. The proteome of L. salivarius ZJ614 was most affected when co-cultured with L. reuteri ZJ625. In contrast, omitting some medium components from the defined medium exerted more effects on L. reuteri ZJ625 than L. salivarius ZJ614.