bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of concurrent oral paliperidone or risperidone use with paliperidone long-acting injection
Authors: Stump Trevor A. , Nelson Leigh Anne , Liu Yifei , Kriz Carrie R. , Iuppa Courtney A. , Diefenderfer Lauren A. , Lang Shelby E. , Elliot Ellie S. R. , Sommi Roger W.
Published: January 2021

Introduction

Dosing recommendations for paliperidone long-acting injectable antipsychotic (LAIA) do not include oral antipsychotic (OAP) overlap; however, OAPs are often given concurrently despite limited evidence describing both the risks and benefits of this practice.

Methods

A retrospective chart review was conducted in patients initiated on paliperidone palmitate (PP) during a psychiatric hospitalization to compare patients who received OAP overlap versus those who did not. The primary outcome is the proportion of patients who receive prescription claims for benztropine, a medication commonly prescribed for extrapyramidal symptoms, at the time of LAIA discontinuation and 6 months postdischarge. Secondary outcomes include prescription claims for beta blockers and diphenhydramine, number of psychiatric emergency visits and hospitalizations, length of stay of the index hospitalization, frequency of LAIA discontinuation and the time to LAIA discontinuation.

Results

There is a significant difference in the proportion of benztropine prescription claims in the OAP overlap group versus the no-overlap group at the time of LAIA discontinuation (30% vs 0%, P = .046) but not at 6 months postdischarge. There are also significant differences in the number of psychiatric emergency visits (0.7 vs 0.1, P = .02) and psychiatric hospitalizations (0.6 vs 0.1, P = .029) at the time of LAIA discontinuation. No other differences are observed in defined secondary outcomes.

Discussion

Patients who receive OAP overlap while receiving PP receive more benztropine and have more psychiatric emergency visits and hospitalizations than those treated without OAP. Larger studies with better control for confounding variables are needed to confirm these results.
Successful bilateral electroconvulsive therapy in a patient with a seizure disorder taking levetiracetam, lorazepam, and zonisamide: A case report
Authors: McGrane Ian R. , Tenison Rachel E. , Bimler Dana M. , Munjal Robert C. , Molinaro Jason R.
Published: January 2021

Electroconvulsive therapy (ECT) may be considered for treatment of severe, treatment-resistant, and emergent depression associated with MDD or bipolar disorder. Patients with epilepsy usually take medications that raise the seizure threshold, which poses challenges during ECT. We report a 66-year-old male with epilepsy taking levetiracetam extended-release (XR), lorazepam, and zonisamide requiring ECT for severe MDD. After literature review, the XR form of levetiracetam was changed to higher doses of the immediate-release (IR) formulation, and zonisamide was discontinued 2 days prior to ECT in the hospital and was resumed when the patient underwent outpatient continuation ECT. The patient was treated to remission after receiving 8 acute bilateral ECT treatments before being transitioned to continuation ECT. We provide a brief review of medication management of antiepileptic drugs and other medications that increase the seizure threshold during ECT. To our knowledge, this is the first reported case describing the management of levetiracetam, lorazepam, and zonisamide concomitantly during ECT. Our case suggests that utilizing the IR formulation of levetiracetam, administering the evening dose early the day prior to the procedure, and temporarily discontinuing zonisamide prior to bilateral ECT is effective for the treatment of severe MDD while maintaining seizure prophylaxis.
Undetectable serum lithium concentrations after coadministration of liquid lithium citrate and apple juice: A case report
Authors: Awan Sundus , Abelleira Audrey , Khehra Loveleen , Hieber Robin
Published: January 2021

Lithium is a mood-stabilizing medication approved by the FDA for the treatment of acute manic or mixed episodes of bipolar disorder as well as maintenance treatment. Lithium citrate is an oral solution, and the carbonate salt is available as oral capsules or extended-release tablets. A patient with a psychiatric history of PTSD and schizoaffective disorder–bipolar type, maintained on lithium and olanzapine prior to admission, was admitted to an inpatient psychiatric unit due to destabilization, paranoia, and mania. He was started on lithium citrate, administered with apple juice, while admitted due to nonadherence. An initial serum lithium concentration was found to be undetectable. Lithium was then administered with an alternative non–apple juice liquid, at which point serum lithium concentration became detectable and patient clinically improved. Lithium concentrations may be impacted by a number of causes, such as underlying medical conditions, drug interactions, and diet. As the majority of these factors remained stable during the patient's admission and the serum lithium concentration became detectable after switching from apple juice to an alternative non–apple juice liquid, it led to the identification of a possible incompatibility.
Just‐in‐time clinical video review improves successful placement of Sengstaken‐Blakemore tube by emergency medicine resident physicians: A randomized control simulation‐based study
Authors: Bonz James W. , Pope Joshua K. , Wong Ambrose H. , Ray Jessica M. , Evans Leigh V.
Published: January 2021

Objective

Successful completion of life‐saving procedures may benefit from a concise just‐in‐time (JIT) intervention. Video is an optimal medium for JIT training, but currently available video‐based references are not optimized for a JIT format, especially in time‐pressured situations prior to high‐risk clinical contexts. We aimed to create and evaluate the efficacy of a brief video review of emergent Sengstaken‐Blakemore tube (SBT) insertion for acutely decompensating variceal hemorrhage when used just prior to clinical performance in a simulated setting.

Methods

We created a less than 3‐minute audio‐optional JIT training video on SBT insertion. We recruited emergency medicine resident physicians to participate in a simulation scenario in which they had to quickly place an SBT. Participants were randomized to either a 3‐minute procedure review by any media they chose (control) or review of the JIT video (intervention). Performance on a checklist created by a multidisciplinary group of SBT experts (passing score > 18 and maximum = 28) served as the primary outcome. We analyzed performance in checklist scores controlling level of training through a one‐way analysis of covariance (ANCOVA). We analyzed rates of passing scores via a chi‐square analysis.

Results

We randomized 32 participants to media review (control) or JIT video (intervention). The intervention group had an overall mean (±SD) performance of 19.8 (±9.0) and the control group had a mean (±SD) score of 6.6 (±7.4). After adjusting for postgraduate year, we found a significant difference in final checklist scores between the two groups (mean difference = 12.8, 95% confidence interval [CI] = 7.6 to 18.0). Percentages of participants reaching a minimum passing score were two of 16 (12.5%) in the control group and 10 of 16 (62.5%) in the intervention group (odds ratio = 11.7, 95% CI = 9.9 to 13.5). Cohen's kappa indicated substantial agreement (κ = 0.714) between reviewer scores.

Conclusions

A readily available, focused, audio‐optional JIT video increased performance for SBT insertion in a simulated setting. Future work may include testing of this format for more commonly performed emergency procedures and determination of effect on bedside performance in the clinical setting.
A Systematic Review of Adolescent Masculinities and Associations with Internalizing Behavior Problems and Social Support
Authors: Exner‐Cortens Deinera , Wright Alysia , Claussen Caroline , Truscott Emma
Published: January 2021

Interest in the connection between masculinities and mental health continues to grow. However, no previous systematic review has explored this association for adolescents. We present the systematic review of 29 articles that explore the connection between adherence to stereotypical male gender role norms (e.g., emotional restriction), attributes (e.g., “ambitious”), and identity (most commonly, gender “typicality”) and internalizing behavior problems and social support. A total of 24,795 adolescent boys (6th‐12th grade) were included in the reviewed studies from 1997–2017. In the quantitative articles (n = 20), associations varied by aspect of masculinity assessed. Specifically, we found that greater endorsement of “masculine” traits (e.g., ambitious, assertive) was generally associated with fewer internalizing behavior problems and greater social support. However, lower gender “typicality” and higher adherence to stereotypical gender role norms were generally associated with more internalizing behavior problems and lower social support. In the qualitative articles (n = 9), the most predominant theme was emotional restriction (i.e., a gender role norm) and consequences for mental health. While research in this area is newer for community psychologists, the connection between masculinities and mental health is directly relevant to the field. Given the focus on individual‐level conceptions of masculinity and mental health found in our review, we describe key future directions for masculinities research in community psychology.
Enhancement of Enzymatic Hydrolysis of Lignocellulose by Tetrabutylammonium Hydroxide (TBAOH) and Tetramethylammonium Hydroxide (TMAOH) Aqueous Solution Pretreatment
Authors: Zhang Qiao‐Zhi , Ding Ran , Sun Jian‐Fei , Li Xin , Luo Wen‐Ting , Yin Jian‐Zhong
Published: January 2021

BACKGROUND

Lignocellulose is usually pretreated as a raw material, and then it undergoes hydrolysis, fermentation, and other processes to produce biofuels, which is conducive to improving the utilization of agricultural and forestry wastes. However, most pretreatments, such as acid–base, CO2 explosion, and microbial degradation, could enhance the yield of enzymatically hydrolyzed (EH) sugars, but the conditions are relatively harsh, environmentally unfriendly, and economically unfeasible. Ionic liquids, in view of their excellent physical and chemical properties and strong solubility, have been proven to be an effective green solvent for pretreating lignocellulose. The aim of this study was to exploit tetrabutylammonium hydroxide (TBAOH) and tetramethylammonium hydroxide (TMAOH) aqueous solutions to pretreat corn cob under relatively mild conditions.

RESULTS

The optimal pretreatment conditions for the two solutions were 30 °C, TBAOH concentration of 20 wt%, 60 min, 5 wt/wt, and 20 °C, TMAOH concentration of 10 wt%, 60 min, 5 wt/wt, and the corresponding sugar yields were 88.9% and 92.2%, respectively. Compared with the unpretreated corn cob, the yield of EH sugar increased by about 2.7–2.8 times. Characterization results confirmed that hemicelluloses and lignin were removed from the raw material during the pretreatment process, and that the cellulose was purified. Furthermore, after 5 cycles of reuse of the TBAOH and TMAOH aqueous solutions, the pretreated corn cob could still achieve a sugar yield higher than 70%.

CONCLUSION

The pretreatment with TBAOH and TMAOH aqueous solutions significantly enhanced the enzymatic hydrolysis, which provided a green, simple, and economical new approach for the pretreatment of agricultural waste biomass. © 2021 Society of Chemical Industry
CPO‐Fe3O4@mTiO2 nanocomposite with integrated magnetic separation and enzymatic and photocatalytic activities in efficient degradation of organic contaminants in wastewater
Authors: Wang Xun , Cheng Hanping , Gao Fengqin , Wang Jing , Zhai Quanguo , Hu Mancheng , Li Shuni , Jiang Yucheng
Published: January 2021

BACKGROUND

Immobilization of enzymes on a nanocarrier can improve their stability, but is often accompanied by a reduction of the initial catalytic activity. Meanwhile, inevitable mass loss during centrifugal separation inhibits reusability. It is still a challenge to design and prepare an immobilized enzyme with both improved catalytic activity and reusability simultaneously.

RESULTS

Core–shell magnetic microspheres (Fe3O4@mTiO2) with mesoporous structure were prepared and used to construct an enzymatic nanocomposite (CPO‐Fe3O4@mTiO2). This material can combine magnetic separability, photocatalytic property of TiO2 and enzymatic activity of chloroperoxidase (CPO) when applied in the degradation of aqueous organic contaminants diphenylamine and pesticide residue isoproturon. Moreover, CPO‐Fe3O4@mTiO2 showed good stability and reusability. It can keep 78.0% and 66.8% of its initial activity after incubation at 80 and 90 °C for 1 h, respectively, while free CPO only retained 18.3% and 6.9% of its original activity for the same conditions. After being used for eight cycles, CPO‐Fe3O4@mTiO2 can retain over 82.2% of activity. When applied in the degradation of isoproturon/diphenylamine in artificial wastewater, 60 μmol L−1 isoproturon can be completely degraded in 30 min; 82.2% of diphenylamine can be degraded at a concentration of 10 μmol L−1. Compared with the removal of aqueous contaminants using a porous adsorbent, CPO‐Fe3O4@mTiO2 can be regenerated ‘online’, obviating complicated procedures for regeneration.

CONCLUSIONS

The results indicate that CPO‐Fe3O4@mTiO2 has potential for practical application in the treatment of wastewater. © 2021 Society of Chemical Industry
1H‐NMR analysis, antioxidant activity, and α‐amylase and α‐glucosidase inhibitory potential of ten common Thai edible flowers
Authors: Wongsa Prinya , Rattanapanone Nithiya
Published: January 2021

BACKGROUND

Edible flowers have been used in cooking as foods as well as medicine alternatives. The objectives were to identify a major class of organic compounds in edible flowers by applying proton nuclear magnetic resonance (1H‐NMR) metabolite fingerprinting and to evaluate bioactivity including antioxidant and α‐amylase and α‐glucosidase inhibitory activities.

RESULTS

A total of 32 metabolites including five organic acids, eight sugars, 11 amino acids and eight phenolic compounds were identified by using 1H‐NMR at 600 MHz. The aromatic proton of phenolic compounds was observed at the low‐field region ranged between δ 5.5 ppm and 10.0 ppm. Total phenolic content (TPC) of the extracts of edible flowers ranged from 6.0 mg GAE g−1 dry weight (DW) to 47.97 mg GAE g−1 DW. Antioxidant activity varied from 140.5 mmol L−1 TE g−1 DW to 985.2 mmol L−1 TE g−1 DW. The extracts from edible flowers showed dose‐dependent inhibition against enzyme. The extract of African marigold (Tagetes erecta L.) had the highest half maximal inhibitory concentration (IC50) against α‐amylase at 0.13 mg mL−1 while the extract of flower of Sesban agasta (Sesbania grandiflora Desv.) had the lowest IC50 against α‐amylase at 0.63 mg mL−1. Moderate correlation was found between IC50 values against α‐glucosidase and antioxidant activity values (R2 = 0.66) (P < 0.05).

CONCLUSION

1H‐NMR application provided metabolomic fingerprinting of edible flowers and the in vitro inhibitory potential activity against key enzymes related to diabetes indicated that specific edible flowers have a potential use for dietary management during the early stages of hyperglycaemia. © 2021 Society of Chemical Industry
Challenges in Certifying Small-Scale (IoT) Hardware Random Number Generators
Authors: Hurley-Smith Darren , Hernandez-Castro Julio
Published: January 2021

This chapter focuses on the testing and certification of Random Number Generators (RNG). Statistical testing is required to identify whether sequences produced by RNG demonstrate non-random characteristics. These can include structures within their output, repetition of sequences, and any other form of predictability. Certification of computer security systems draws on such evaluations to determine whether a given RNG implementation contributes to a secure, robust security system. Recently, small-scale hardware RNGs have been targeted at IoT devices, especially those requiring security. This, however, introduces new technical challenges; low computational resources for post-processing and evaluation of on-board RNGs being just two examples. Can we rely on the current suite of statistical tests? What other challenges are encountered when evaluating RNG?
Finding Software Bugs in Embedded Devices
Authors: Francillon Aurélien , Thomas Sam L. , Costin Andrei
Published: January 2021

The goal of this chapter is to introduce the reader to the domain of bug discovery in embedded systems which are at the core of the Internet of Things. Embedded software has a number of particularities which makes it slightly different to general purpose software. In particular, embedded devices are more exposed to software attacks but have lower defense levels and are often left unattended. At the same time, analyzing their security is more difficult because they are very “opaque”, while the execution of custom and embedded software is often entangled with the hardware and peripherals. These differences have an impact on our ability to find software bugs in such systems. This chapter discusses how software vulnerabilities can be identified, at different stages of the software life-cycle, for example during development, during integration of the different components, during testing, during the deployment of the device, or in the field by third parties.
An Account of the ISO/IEC Standardization of the Simon and Speck Block Cipher Families
Authors: Ashur Tomer , Luykx Atul
Published: January 2021

Simon and Speck are two block cipher families published in 2013 by the US National Security Agency (NSA). These block ciphers, targeting lightweight applications, were suggested in 2015 to be included in ISO/IEC 29192-2 Information technology—Security techniques—Lightweight cryptography—Part 2: Block ciphers. Following 3.5 years of deliberations within ISO/IEC JTC 1 they were rejected in April 2018. This chapter provides an account of the ISO/IEC standardization process for Simon and Speck.
Ultra-lightweight Authentication
Authors: Carpent Xavier , D’Arco Paolo , Prisco Roberto De
Published: January 2021

In this chapter we provide acritical lookat the state of the art in ultra-lightweight authentication protocols. We start by outlining the features of the current ubiquitous and pervasive computing environment that have motivated the development of the ultra-lightweight paradigm which uses only basic arithmetic and logical operations. We emphasize its goals and its main challenges. Then, we focus our attention on the authentication problem. We use an abstract framework for modeling the protocols proposed over the years, in order to discuss their design strategies and the security and privacy properties they aim to achieve. After that, we survey the weaknesses and the common pitfalls in both the design and the analysis of ultra-lightweight authentication protocols. Finally, we conclude the chapter by discussing some fundamental ideas and research directions.
Side Channel Assessment Platforms and Tools for Ubiquitous Systems
Authors: Fournaris Apostolos P. , Moschos Athanassios , Sklavos Nicolas
Published: January 2021

Side Channel Attacks are nowadays considered a serious risk for many security products and ubiquitous devices. Strong security solution providers need to evaluate their implementations against such attacks before publishing them on the market, thus performing a thorough assessment. However, this procedure is not straightforward and even with the appropriate equipment, it may require considerable time to provide results due to the slow process of collecting measurements (traces) and the inflexible way of controlling the tested implementation. In this chapter, we explore and overview the trace collection landscape for generic devices under test (including ubiquitous systems) highlighting and overviewing the latest trace collection toolsets and their shortcomings, but also proposing a trace collection approach that can be applied on the most recent, open source toolsets. We showcase our proposed approach on the FlexLeco project architecture, which we have developed in our lab, and manage to practically describe how an evaluator using the proposed methodology can collect traces easily and quickly without the need to completely redesign a control mechanism for the implementation under test.
Lateral Network Governance
Authors: Glückler Johannes
Published: January 2021

The author of this article goes beyond acknowledging networks as a governance mode to elaborate on the actual forms of governance that convey legitimate and acceptable coordination. He advances the concept of lateral network governance in the empirical context of organized networks, in which organizations pool resources and join their interests in the pursuit of common goals. To solve the puzzle of having independent equals commit themselves to coordinating their actions, the author aims to overcome the traditional dualism between formal and informal mechanisms of governance. Instead, he conceives lateral network governance as a structure for the legitimate delegation of decision-making. He develops a social network analytic approach to assessing the relational distribution of legitimacy. With his empirical analysis of two case studies of inter-firm network organizations, he illustrates the degree to which the actual legitimacy distribution diverges from formal governance authority. Lateral network governance has practical implications for inter-organizational networks and network managers.
Nurturing Adaptive Governance Through Environmental Monitoring: People, Practices, Politics in the Kruger to Canyons Biosphere Region, South Africa
Authors: Schultz Lisen , West Simon , Florêncio Cláudia
Published: January 2021

Adaptive governance is an approach that can potentially help societies navigate uncertainty, change, and surprise, as well as issues that span sectors and scales. In this chapter, we use this concept to refer to flexible and learning-based collaborations and decision-making processes involving both state and non-state actors, with the aim to adaptively negotiate and coordinate management of social-ecological issues. We identify critical questions in the adaptive governance literature and provide an empirical contribution to these. We draw on a case study of the Kruger to Canyons Biosphere Region in South Africa, focusing on the people, practices, and politics involved with adaptive governance in the Global South. Our findings illustrate that the practices of generating knowledge, sharing information, collaborating, and responding to change are shaped by the navigation of tensions between diverse values, norms, and routines. A lens of people, practices, and politics highlights adaptive governance as situated and involving agency, meaning, and creativity.
Let’s Join: A Pavilion Inspired by the Weaire and Phelan Space Tessellation
Authors: Valenti Graziano Mario , El Khoury Chadi
Published: January 2021

The pavilion presented in this paper is an articulation of space based on the Weaire and Phelan tessellation. In this pavilion a second generative pattern is partially engraved and cut out of the polygonal surfaces that bind the polyhedron. This pattern is made up of cubic curves that aim to spatially engage with the tessellation. The design and prototyping process was implemented and controlled using parametric and procedural models. The use of these models made it possible to define the shape, orientation, and size of each element of the pavilion: from the polyhedron and the pattern’s curves, to smaller components like the shape of the panels’ joints, holes, and the countersinks that hold the screws. This research illustrates the geometric, formal, and procedural design that was used to shape the pavilion in its current spatial configuration, to draw the pattern cut and engraved into the polyhedron’s surface, and finally, to determine the shape and scale of the joints that hold the faces of the polyhedron together and characterize the internal space. Regarding the topic ofPatterns and Spatial Organization, the paper investigates shape design methodologies, which are based on historical practices but updated using new technologies.
The pure cohomology of multiplicative quiver varieties
Authors: McGerty Kevin , Nevins Thomas
Published: January 2021

To a quiver Q and choices of nonzero scalars $$q_i$$

q
i

, non-negative integers $$\alpha _i$$

α
i

, and integers $$\theta _i$$

θ
i

labeling each vertex i, Crawley-Boevey–Shaw associate a multiplicative quiver variety$${\mathcal {M}}_\theta ^q(\alpha )$$

M
θ
q

(
α
)

, a trigonometric analogue of the Nakajima quiver variety associated to Q, $$\alpha $$
α
, and $$\theta $$
θ
. We prove that the pure cohomology, in the Hodge-theoretic sense, of the stable locus $${\mathcal {M}}_\theta ^q(\alpha )^{{\text {s}}}$$

M
θ
q

(
α
)

s

is generated as a $${\mathbb {Q}}$$
Q
-algebra by the tautological characteristic classes. In particular, the pure cohomology of genus g twisted character varieties of $$GL_n$$

G

L
n

is generated by tautological classes.
Functional and directed connectivity of the cortico-limbic network in mice in vivo
Authors: Khastkhodaei Zeinab , Muthuraman Muthuraman , Yang Jenq-Wei , Groppa Sergiu , Luhmann Heiko J.
Published: January 2021

Higher cognitive processes and emotional regulation depend on densely interconnected telencephalic and limbic areas. Central structures of this cortico-limbic network are ventral hippocampus (vHC), medial prefrontal cortex (PFC), basolateral amygdala (BLA) and nucleus accumbens (NAC). Human and animal studies have revealed both anatomical and functional alterations in specific connections of this network in several psychiatric disorders. However, it is often not clear whether functional alterations within these densely interconnected brain areas are caused by modifications in the direct pathways, or alternatively through indirect interactions. We performed multi-site extracellular recordings of spontaneous activity in three different brain regions to study the functional connectivity in the BLA–NAC–PFC–vHC network of the lightly anesthetized mouse in vivo. We show that BLA, NAC, PFC and vHC are functionally connected in distinct frequency bands and determined the influence of a third brain region on this connectivity. In addition to describing mutual synchronicity, we determined the strength of functional connectivity for each region in the BLA–NAC–PFC–vHC network. We find a region-specificity in the strength of feedforward and feedback connections for each region in its interaction with other areas in the network. Our results provide insights into functional and directed connectivity in the cortico-limbic network of adult wild-type mice, which may be helpful to further elucidate the pathophysiological changes of this network in psychiatric disorders and to develop target-specific therapeutic interventions.
Investigation of the Influence of Powder Moisture on the Spreadability Using the Spreading Tester
Authors: Mitterlehner Marco , Danninger Herbert , Gierl-Mayer Christian , Gschiel Harald
Published: January 2021

Moisture is often regarded as one of the main reasons for poor processability of powders using Laser-powder bed fusion (L-PBF) processes. To determine the influence of moisture on the spreadability, a superalloy powder IN718 commonly used for L‑PBF processes has been conditioned in two different states: once in the as-received and dry condition and once in a moist condition obtained by storing the powder for four weeks in an atmosphere containing a relative humidity of 75%. Using a self-built spreading tester and a subsequent analysis method specially developed for testing the spreadability of a powder, the differently conditioned IN718 powder batches have been investigated regarding the surface roughness and flatness of the powder layers. Additionally, the formation of empty spots between the powder particles in the top layer has been studied.
Spreadability Testing of Powder for Additive Manufacturing
Authors: Hulme-Smith Christopher Neil , Hari Vignesh , Mellin Pelle
Published: January 2021

The spreading of powders into thin layers is a critical step in powder bed additive manufacturing, but there is no accepted technique to test it. There is not even a metric that can be used to describe spreading behaviour. A robust, image-based measurement procedure has been developed and can be implemented at modest cost and with minimal training. The analysis is automated to derive quantitative information about the characteristics of the spread layer. The technique has been demonstrated for three powders to quantify their spreading behaviour as a function of layer thickness and spreading speed.
Vertikale Blickparesen bei dorsalem Mittelhirnsyndrom und anderen Erkrankungen
Authors: Pemp Berthold , Koinig Sabine , Kircher Karl , Mitsch Christoph , Reitner Andreas
Published: January 2021

Hintergrund

Die vertikale Blickparese (vBP) ist ein typisches Symptom bei Läsionen des dorsalen Mittelhirns. Die klinische Ausprägung der vBP kann dabei stark variieren und im Rahmen eines dorsalen Mittelhirnsyndroms (DMS) mit zusätzlichen Symptomen wie einer Konvergenzparese, einem Konvergenzretraktionsnystagmus, einer verminderten Pupillenreaktion oder einer Skew Deviation vergesellschaftet sein. Je nach Lokalisation und Größe der Läsion kann auch eine Kombination mit weiteren zentralen Motilitätsstörungen vorliegen.

Material und Methode

Im Rahmen einer retrospektiven Studie wurden die Patientendaten unserer neuroophthalmologischen Ambulanz über einen Zeitraum von 25 Jahren nach Fällen mit Einschränkungen konjugierter vertikaler Augenbewegungen durchsucht und hinsichtlich ihrer neuroorthoptischen Befunde und Ätiologien ausgewertet.

Resultate

Es wurden 202 Patienten mit vBP identifiziert. Das Befundspektrum reichte von einer isolierten Sakkadenstörung nur nach oben bis hin zum kompletten Ausfall aller willkürlichen und reflektorischen vertikalen Augenbewegungen. Nur 12 vBP lagen isoliert vor. Ursächlich war bei 155 Patienten ein DMS, wovon aber nur 18 Fälle dem von Parinaud geprägten Syndrombild (vBP + Konvergenzparese ± Pupillenstörung ohne weitere Symptome) entsprachen; 42 Patienten mit DMS zeigten lediglich eine Sakkadenparese. Der Aufblick war bei DMS insgesamt mehr eingeschränkt als der Abblick. Die häufigsten Begleitsymptome waren eine Konvergenzparese (49 %), Konvergenznystagmus (40 %), Pupillenstörung (32 %), Skew Deviation (21 %) und Blickrichtungsnystagmus (15 %). In 58 Fällen traten weitere zentrale Okulomotorikstörungen auf. Bis zum 18. Lebensjahr war eine vBP bei 58 % der Patienten durch Gehirntumoren bedingt, wohingegen nach dem 60. Lebensjahr neben einem DMS durch Infarkte (41 %) v. a. degenerative Erkrankungen (44 %) ursächlich waren.

Schlussfolgerungen

Langsame und schnelle Augenbewegungen nach oben und unten werden im Hirnstamm unterschiedlich generiert, geleitet und integriert und können daher bei Läsionen des Mittelhirns verschieden stark gestört sein. Die Ergebnisse verdeutlichen zudem die enge Lagebeziehung der Zentren für vertikale Augenbewegungen, Konvergenz und Pupillenreaktion im dorsalen Mittelhirn. Die Kombination einer vBP mit weiteren neuroophthalmologischen Diagnosen kann daher eine topografische und ätiologische Zuordnung erleichtern.
Synkopenabklärung bei Kindern und Jugendlichen – Handeln wir gemäß der aktuellen Leitlinie?
Authors: Landwehr Katharina , Meyer Sascha , Flotats-Bastardas Marina , Poryo Martin
Published: January 2021

Hintergrund

Synkopen im Kindes‑/Jugendalter sind häufig und meist gutartig. Mögliche kardiale Synkopen müssen durch sorgfältige Basisdiagnostik (Anamnese (I), körperliche Untersuchung (II), Elektrokardiografie (III)) und ggf. weiterführender Diagnostik ausgeschlossen werden.

Fragestellung

Wurde die Diagnostik bei Vorliegen einer Synkope entsprechend der gültigen S2k-Leitlinie durchgeführt?

Material und Methoden

Retrospektive Analyse (01/2015–12/2017), Kinderklinik des Universitätsklinikums des Saarlandes, Homburg, Deutschland. Eingeschlossen wurden alle Patienten von 1 bis 18 Jahre, die sich wegen Synkope vorstellten.

Ergebnisse

Es erlitten 262 Patienten eine Synkope (161 weiblich [61,5 %], 101 männlich [38,5 %], Alter 12,5 ± 3,9 Jahre); davon 183 (69,8 %) Reflexsynkopen, 36 (13,7 %) Präsynkopen, 35 (13,4 %) Synkopen unklarer Genese, 8 (3,1 %) kardiale Synkopen; 43/262 Patienten (16,4 %) erhielten eine vollständiger Basisdiagnostik (I–III) gemäß Leitlinie, 13/43 (30,2 %) wurden korrekt weiterführender Diagnostik zugeführt; 219/262 Patienten (83,6 %) erhielten keine ausreichende Basisdiagnostik (I–III), 135/219 (61,6 %) wurden unnötigen apparativen Untersuchungen zugeführt.

Diskussion

Die leitlinienkonforme Synkopenabklärung ist wichtig, um unnötige, aber auch nicht ausreichende Diagnostik zu vermeiden und somit Patienten mit Synkope korrekt zu diagnostizieren.
Dispersal and Land Cover Contribute to Pseudorabies Virus Exposure in Invasive Wild Pigs
Authors: Hernández Felipe A. , Carr Amanda N. , Milleson Michael P. , Merrill Hunter R. , Avery Michael L. , Parker Brandon M. , Pylant Cortney L. , Austin James D. , Wisely Samantha M.
Published: January 2021

We investigated the landscape epidemiology of a globally distributed mammal, the wild pig (Sus scrofa), in Florida (U.S.), where it is considered an invasive species and reservoir to pathogens that impact the health of people, domestic animals, and wildlife. Specifically, we tested the hypothesis that two commonly cited factors in disease transmission, connectivity among populations and abundant resources, would increase the likelihood of exposure to both pseudorabies virus (PrV) and Brucella spp. (bacterial agent of brucellosis) in wild pigs across the Kissimmee Valley of Florida. Using DNA from 348 wild pigs and sera from 320 individuals at 24 sites, we employed population genetic techniques to infer individual dispersal, and an Akaike information criterion framework to compare candidate logistic regression models that incorporated both dispersal and land cover composition. Our findings suggested that recent dispersal conferred higher odds of exposure to PrV, but not Brucella spp., among wild pigs throughout the Kissimmee Valley region. Odds of exposure also increased in association with agriculture and open canopy pine, prairie, and scrub habitats, likely because of highly localized resources within those land cover types. Because the effect of open canopy on PrV exposure reversed when agricultural cover was available, we suggest that small-scale resource distribution may be more important than overall resource abundance. Our results underscore the importance of studying and managing disease dynamics through multiple processes and spatial scales, particularly for non-native pathogens that threaten wildlife conservation, economy, and public health.
An Efficient Descent Method for Locally Lipschitz Multiobjective Optimization Problems
Authors: Gebken Bennet , Peitz Sebastian
Published: January 2021

We present an efficient descent method for unconstrained, locally Lipschitz multiobjective optimization problems. The method is realized by combining a theoretical result regarding the computation of descent directions for nonsmooth multiobjective optimization problems with a practical method to approximate the subdifferentials of the objective functions. We show convergence to points which satisfy a necessary condition for Pareto optimality. Using a set of test problems, we compare our method with the multiobjective proximal bundle method by Mäkelä. The results indicate that our method is competitive while being easier to implement. Although the number of objective function evaluations is larger, the overall number of subgradient evaluations is smaller. Our method can be combined with a subdivision algorithm to compute entire Pareto sets of nonsmooth problems. Finally, we demonstrate how our method can be used for solving sparse optimization problems, which are present in many real-life applications.
Psychological risk factors that characterize the trajectories of quality of life after a physical trauma: a longitudinal study using latent class analysis
Authors: Visser Eva , Oudsten Brenda Leontine Den , Gosens Taco , Lodder Paul , De Vries Jolanda
Published: January 2021

Background

The course and corresponding characteristics of quality of life (QOL) domains in trauma population are unclear. Our aim was to identify longitudinal QOL trajectories and determine and predict the sociodemographic, clinical, and psychological characteristics of trajectory membership in physical trauma patients using a biopsychosocial approach.

Methods

Patients completed a questionnaire set after inclusion, and at 3, 6, 9, and 12 months follow-up. Trajectories were identified using repeated-measures latent class analysis. The trajectory characteristics were ranked using Cohen’s d effect size or phi coefficient.

Results

Altogether, 267 patients were included. The mean age was 54.1 (SD = 16.1), 62% were male, and the median injury severity score was 5.0 [2.0—9.0]. Four latent trajectories were found for psychological health and environment, five for physical health and social relationships, and seven trajectories were found for overall QOL and general health. The trajectories seemed to remain stable over time. For each QOL domain, the identified trajectories differed significantly in terms of anxiety, depressive symptoms, acute stress disorder, post-traumatic stress disorder, Neuroticism, trait anxiety, Extraversion, and Conscientiousness.

Discussion

Psychological factors characterized the trajectories during 12 months after trauma. Health care providers can use these findings to identify patients at risk for impaired QOL and offer patient-centered care to improve QOL.
Changes in the concentration of air pollutants before and after the COVID-19 blockade period and their correlation with vegetation coverage
Authors: Zhou Manguo , Huang Yanguo , Li Guilan
Published: January 2021

In order to control the spread of COVID-19, China had implemented strict lockdown measures. The closure of cities had had a huge impact on human production and consumption activities, which had greatly reduced population mobility. This article used air pollutant data from 341 cities in mainland China and divided these cities into seven major regions based on geographic conditions and climatic environment. The impact of urban blockade on air quality during COVID-19 was studied from the perspectives of time, space, and season. In addition, this article used Normalized Difference Vegetation Index (NDVI) to systematically analyze the characteristics of air pollution in the country and used the Pearson correlation coefficient to explore the relationship between NDVI and the air pollutant concentrations during the COVID-19 period. Then, linear regression was used to find the quantitative relationship between NDVI and AQI, and the fitting effect of the model was found to be significant through t test. Finally, some countermeasures were proposed based on the analysis results, and suggestions were provided for improving air quality. This paper has drawn the following conclusions: (1) the concentration of pollutants varied greatly in different regions, and the causes of their pollution sources were also different. The region with the largest decline in AQI was the Northeast China (60.01%), while the AQI in the southwest China had the smallest change range, and its value had increased by 1.72%. In addition, after the implementation of the city blockade, the concentration of NO2 in different regions dropped the most, but the increase in O3 was more obvious. (2) Higher vegetation coverage would have a beneficial impact on the atmospheric environment. Areas with higher NDVI values have relatively low AQI. There is a negative correlation between NDVI and AQI, and an average increase of 0.1 in NDVI will reduce AQI by 3.75 (95% confidence interval). In the case of less human intervention, the higher the vegetation coverage, the lower the local pollutant concentration will be. Therefore, the degree of vegetation coverage would have a direct or indirect impact on air pollution.
Synergistic and concentration-dependent toxicity of multiple heavy metals compared with single heavy metals in Conocarpus lancifolius
Authors: Redha Amina , Al-Hasan Redha , Afzal Mohammad
Published: January 2021

While heavy metals (HMs) naturally occur in soil, anthropogenic activities can increase the level of these toxic elements. Conocarpus lancifolius Engl. (Combretaceae) was investigated as a potential phytoremediator of soils contaminated with HM containing crude oil. This study assessed the potential of C. lancifolius (CL), a locally available plant species in Kuwait, for resolving local issues of the HM-contaminated soils. The absorption, accumulation, and distribution of three toxic HMs (Cd, Ni, and Pb) and essential metals (Fe, Mg, and metalloid Se) were examined, and their role in plant toxicity and tolerance was evaluated. Conocarpus lancifolius plants were exposed to two different concentrations of single and mixed HMs for 30 days. The accumulation of HMs was determined in the roots, leaves, stems, and the soil using ICP/MS. Biomass, soil pH, proline and protein content, and bioaccumulation, extraction, and translocation factors were measured. The bioaccumulation, extraction, and transcription factors were all >1, indicating CC is a hyperaccumulator of HM. The HM accumulation in CL was concentration-dependent and depended on whether the plants were exposed to individual or mixed HMs. The C.C leaves, stems, and roots showed a significant accumulation of antioxidant constituents, such as proline, protein, Fe, Mg, and Se. There was an insignificant increase in the soil pH, and a decrease in plant biomass and a significant increase in protein, and osmoprotective-proline as a result of the interaction of mixed heavy metals that are more toxic than single heavy metals. This study indicates that C. lancifolius is a good candidate for phytoremediation of multiple HM-contaminated soils. Further studies to establish the phyto-physiological effect of multiple heavy metals are warranted.
Bisphenol A disturbs metabolism of primary rat adipocytes without affecting adipokine secretion
Authors: Szkudelska Katarzyna , Okulicz Monika , Szkudelski Tomasz
Published: January 2021

Bisphenol A (BPA) is an ubiquitous synthetic chemical exerting numerous adverse effects. Results of rodent studies show that BPA negatively affects adipose tissue. However, the short-term influence of this compound addressing adipocyte metabolism and adipokine secretion is unknown. In the present study, isolated rat adipocytes were exposed for 2 h to 1 and 10 nM BPA. Insulin-induced glucose conversion to lipids along with glucose transport was significantly increased in the presence of BPA. However, basal glucose conversion to lipids, glucose oxidation, and formation of lipids from acetate were unchanged in adipocytes incubated with BPA. It was also shown that BPA significantly increases lipolytic response of adipocytes to epinephrine. However, lipolysis stimulated by dibutyryl-cAMP (a direct activator of protein kinase A) and the antilipolytic action of insulin were not affected by BPA. Moreover, BPA did not influence leptin and adiponectin secretion from adipocytes. Our new results show that BPA is capable of disturbing processes related to lipid accumulation in isolated rat adipocytes. This is associated with the potentiation of insulin and epinephrine action. The effects of BPA appear already after short-term exposure to low doses of this compound. However, BPA fails to change adipokine secretion.
Dexamethasone enhances CD163 expression in porcine IPKM immortalized macrophages
Authors: Takenouchi Takato , Morozumi Takeya , Wada Emi , Suzuki Shunichi , Nishiyama Yasutaka , Sukegawa Shin , Uenishi Hirohide
Published: January 2021

In our previous study, we established a unique porcine macrophage cell line, immortalized porcine kidney-derived macrophages (IPKM). The purpose of the present study was to further elucidate the characteristics of IPKM. CD163 is a scavenger receptor for the hemoglobin-haptoglobin complex and is used as a phenotypic marker of anti-inflammatory M2 macrophages. The expression of CD163 is enhanced by dexamethasone (DEX), a potent steroidal anti-inflammatory drug, in human and rodent macrophages in vitro. Therefore, we investigated the effects of DEX on CD163 expression in porcine IPKM. Treatment with DEX markedly enhanced CD163 expression in the IPKM. In addition, we found that SB203580, a selective inhibitor of p38 mitogen-activated protein kinase (MAPK), blocked the effects of DEX, suggesting that the p38 MAPK signaling pathway is involved in the regulation of the DEX-induced enhancement of CD163 expression. Since CD163 is considered to be a putative receptor for the porcine reproductive and respiratory syndrome virus (PRRSV), the effects of DEX on the infection of IPKM by PRRSV were evaluated. Although the IPKM were susceptible to infection by the Fostera PRRSV vaccine strain, DEX treatment did not affect the propagation of the virus in the IPKM. This suggests that the DEX-induced enhancement of CD163 expression alone is not sufficient to facilitate the infection of IPKM by PRRSV.
Improved differentiable neural architecture search for single image super-resolution
Authors: Weng Yu , Chen Zehua , Zhou Tianbao
Published: January 2021

Deep learning has shown prominent superiority over other machine learning algorithms in Single Image Super-Resolution (SISR). In order to reduce the efforts and resources cost on manually designing deep architecture, we use differentiable neural architecture search (DARTS) on SISR. Since neural architecture search was originally used for classification tasks, our experiments show that direct usage of DARTS on super-resolutions tasks will give rise to many skip connections in the search architecture, which results in the poor performance of final architecture. Thus, it is necessary for DARTS to have made some improvements for the application in the field of SISR. According to characteristics of SISR, we remove redundant operations and redesign some operations in the cell to achieve an improved DARTS. Then we use the improved DARTS to search convolution cells as a nonlinear mapping part of super-resolution network. The new super-resolution architecture shows its effectiveness on benchmark datasets and DIV2K dataset.
Sublimation for Enrichment and Identification of Marker Compounds in Fruits
Authors: Gronbach Manuel , Kraußer Laura , Broese Timo , Oppermann Christina , Kragl Udo
Published: January 2021

In this article, we describe the benefits of sublimation for natural product and food chemistry. The direct sublimation of substances from dried plant powders has not received much attention in research in the past, just like the sublimation of substances from dried plant extracts. We used sublimation to study dried sea buckthorn berry powders and dried sea buckthorn berry extracts. The results of the powder sublimations were compared to that of dried chokeberry, wolfberry, and European cornel powder. 52 marker substances of which 27 are specific for sea buckthorn were found in the sea buckthorn powder sublimates using LC/MS. The majority of them are not described in the literature and were obtained by direct sublimation. Accordingly, sublimation can help to identify new plant constituents. Our identification method was validated by the analysis of four commercially available fruit powders. The sea buckthorn powder showed an almost 80% correlation with the determined marker substances, whereas the other fruit powders did not achieve more than 38% correlation. The sublimates of sea buckthorn extracts show additional marker substances compared to the fruit powder sublimate, and we think that both techniques can be used to fight food fraud.