bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Coupling Mechanism of Intercalation and Conversion Hybrid Storage in Lithium–Graphite Anode
Authors: Sun Xin , Liu He , Ren Ke‐Feng , Tang Wen‐Bo , Guo Cong , Bao Weizhai , Yu Feng , Cheng Xin‐Bing , Li Jingfa
Published: April 2024

Anodes with high capacity and long lifespan play an important role in the advanced batteries. However, none of the existing anodes can meet these two requirements simultaneously. Lithium (Li)–graphite composite anode presents great potential in balancing these two requirements. Herein, the working mechanism of Li–graphite composite anode is comprehensively investigated. The capacity decay features of the composite anode are different from those of Li ion intercalation in Li ion batteries and Li metal deposition in Li metal batteries. An intercalation and conversion hybrid storage mechanism are proposed by analyzing the capacity decay ratios in the composite anode with different initial specific capacities. The capacity decay models can be divided into four stages including Capacity Retention Stage, Relatively Independent Operation Stage, Intercalation & Conversion Coupling Stage, Pure Li Intercalation Stage. When the specific capacity is between 340 and 450 mAh g−1, its capacity decay ratio is between that of pure intercalation and conversion model. These results intensify the comprehensive understandings on the working principles in Li–graphite composite anode and present novel insights in the design of high‐capacity and long‐lifespan anode materials for the next‐generation batteries.
Encasing Few‐Layer MoS2 within 2D Ordered Cubic Graphitic Cages to Smooth Trapping‐Conversion of Lithium Polysulfides for Dendrite‐Free Lithium–Sulfur Batteries
Authors: Gao Yifan , Deng Yuwei , Xia Shenxin , Xi Xiangyun , Zhang Zhebin , Wang Yajun , Yang Dong , Li Tongtao , Dong Angang
Published: April 2024

The industrialization of lithium–sulfur (Li–S) batteries faces challenges due to the shuttling effect of lithium polysulfides (LiPSs) and the growth of lithium dendrites. To address these issues, a simple and scalable method is proposed to synthesize 2D membranes comprising a single layer of cubic graphitic cages encased with few‐layer, curved MoS2. The distinctive 2D architecture is achieved by confining the epitaxial growth of MoS2 within the open cages of a 2D‐ordered mesoporous graphitic framework (MGF), resulting in MoS2@MGF heterostructures with abundant sulfur vacancies. The experimental and theoretical studies establish that these MoS2@MGF membranes can act as a multifunctional interlayer in Li–S batteries to boost their comprehensive performance. The inclusion of the MoS2@MGF interlayer facilitates the trapping and conversion kinetics of LiPSs, preventing their shuttling effect, while simultaneously promoting uniform lithium deposition to inhibit dendrite growth. As a result, Li–S batteries with the MoS2@MGF interlayer exhibit high electrochemical performance even under high sulfur loading and lean electrolyte conditions. This work highlights the potential of designing advanced MoS2‐encased heterostructures as interlayers, offering a viable solution to the current limitations plaguing Li–S batteries.
Methyltransferase Domain‐Focused Genome Mining for Fungal Polyketide Synthases
Authors: Yan Dexiu , Matsuda Yudai
Published: April 2024

A comparison of substrate‐binding site amino acid residues in the C‐methyltransferase (MT) domains of fungal nonreducing polyketide synthases (NR‐PKSs) suggests that these residues are correlated with the methylation modes used by the PKSs. A PKS, designated as AsbPKS, with substrate‐binding site residues distinct from those of other known PKSs is focused on. The characterization of AsbPKS revealed that it yields an isocoumarin derivative, anhydrosclerotinin B (1), the biosynthesis of which involves a previously unreported methylation pattern. This study demonstrates the utility of MT domain‐focused genome mining for the discovery of PKSs with new functions.
Wide Temperature Electrolytes for Lithium Batteries: Solvation Chemistry and Interfacial Reactions
Authors: Yue Liguo , Yu Manqing , Li Xiangrong , Shen Yinlin , Wu Yingru , Fa Chang , Li Nan , Xu Jijian
Published: April 2024

Improving the wide‐temperature operation of rechargeable batteries is crucial for boosting the adoption of electric vehicles and further advancing their application scope in harsh environments like deep ocean and space probes. Herein, recent advances in electrolyte solvation chemistry are critically summarized, aiming to address the long‐standing challenge of notable energy diminution at sub‐zero temperatures and rapid capacity degradation at elevated temperatures (>45°C). This review provides an in‐depth analysis of the fundamental mechanisms governing the Li‐ion transport process, illustrating how these insights have been effectively harnessed to synergize with high‐capacity, high‐rate electrodes. Another critical part highlights the interplay between solvation chemistry and interfacial reactions, as well as the stability of the resultant interphases, particularly in batteries employing ultrahigh‐nickel layered oxides as cathodes and high‐capacity Li/Si materials as anodes. The detailed examination reveals how these factors are pivotal in mitigating the rapid capacity fade, thereby ensuring a long cycle life, superior rate capability, and consistent high‐/low‐temperature performance. In the latter part, a comprehensive summary of in situ/operational analysis is presented. This holistic approach, encompassing innovative electrolyte design, interphase regulation, and advanced characterization, offers a comprehensive roadmap for advancing battery technology in extreme environmental conditions.
Sensitive Bandgap Reduction of SrTiO3 through Incorporation of Sulfur Using Ion Implantation
Authors: Fix Thomas , Zakaria Yahya , Stoeffler Daniel , Muller Dominique , Dinia Aziz , Slaoui Abdelilah
Published: April 2024

SrTiO3 (STO) is a well‐known perovskite oxide often used, among others, as a crystalline substrate for epitaxial deposition. However, its indirect bandgap of 3.25 eV is too high for solar applications. Tentative experiments to reduce its bandgap are very welcome. To this end, sulfurization of STO substrates using ion implantation is performed. The simulated profile is controlled by time‐of‐flight secondary‐ion mass spectrometry. S is at least partially inserted into the STO lattice, as evidenced by X‐ray diffraction and X‐ray photoelectron spectroscopy. UV–vis spectroscopy indicates a drastic reduction of the bandgap of S:STO from 3.25 eV (indirect) down to 2.14 eV for 10% S:STO, a trend also observed by spectroscopic ellipsometry. The results are confronted to ab initio calculations. Besides bandgap, the valence band level, that is the ionization energy, is determined by ambient‐pressure photoemission spectroscopy so that the complete energy diagrams could be plotted. This work paves the way for tuning the bandgap of perovskites in a highly controlled manner for solar energy applications.
Viability of Ecofriendly Ionic Liquids in Starch Plasticization and Modification
Authors: Agarwal Shilpi , Singhal Shailey
Published: April 2024

Ionic liquids (IL) have emerged as the potential class of solvents for various chemical processes and reactions, including gelatinization and chemical modification of starch. Through various studies it has been established that expensive nature of ILs can be counter balanced by employing the mixture of IL/water instead of pure ILs. The IL/water system has the advantage to plasticize starch more effectively due to their synchronal effect and rational viscosity. The properties of ILs can be tempered by preferring particular cations/anions according to the specific type of starch which may be helpful in convenient dissolution and modification of starch. Starch can be modified by esterification or etherification reaction in IL medium to alter their properties and to use it in various application areas. Starch dissolution is subjected to various parameters like type of starch, nature of IL, ratio of IL/water, and temperature which has been discussed elaborately in the present review paper.
Cadmium aggravates liver injury by activating ferroptosis and neutrophil extracellular traps formation in Nile tilapia (Oreochromis niloticus)
Authors: Wang Jingjing , Chen Yichun , Wang Xia , Sun Youpeng , Jiang Mingzhen , Ye Yingrong , Wu Hanpeng , Lu Yun , Zhong Huabing , Wu Yihe , Zhou Ershun , Yang Zhengtao
Published: April 2024

Cadmium (Cd) is a pervasive environmental contaminant and a significant risk factor for liver injury. The present study was undertaken to evaluate the involvement of ferroptosis and neutrophil extracellular traps (NETs) in Cd‐induced liver injury in Nile tilapia (Oreochromis niloticus), and to explore its underlying mechanism. Cd‐induced liver injury was associated with increased total iron, malondialdehyde (MDA), and Acyl‐CoA synthetase long‐chain family member 4 (ACSL4), together with reduced levels of glutathione, glutathione peroxidase‐4a (Gpx4a), and solute carrier family 7 member 11 (SLC7A11), which are all hallmarks of ferroptosis. Moreover, liver hyperemia, neutrophil infiltration, increased inflammatory factors and myeloperoxidase, as well as elevated serum DNA content in Cd‐stimulated Nile tilapia suggested that a considerable number of neutrophils were recruited to the liver. Furtherly, in vitro experiments demonstrated that Cd induced the formation of NETs, and the possible mechanism was related to the generation of reactive oxygen species and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, along with the P38 and extracellular regulated protein kinase (ERK) signaling pathways. We concluded that ferroptosis and NETs are the critical mechanisms contributing to Cd‐induced liver injury in Nile tilapia. These findings will contribute to Cd toxicological studies in aquatic animals.
Investigation of the relationship between atopic dermatitis of dogs and intestinal epithelial damage
Authors: Ekici Yusuf Emre , Ok Mahmut
Published: April 2024

Background

A significant association between atopic dermatitis and leaky gut syndrome has been demonstrated in humans. No studies have been conducted to determine whether there is an association between atopic dermatitis and intestinal damage in dogs.

Objectives

This study aimed to determine whether there is an association between canine atopic dermatitis and intestinal damage using selected intestinal‐related biomarkers.

Methods

Twenty‐six dogs with atopic dermatitis and 10 healthy dogs were included. Moderate‐to‐severe pruritus, erythema, erosion and alopecia on different parts of the body were sought in dogs to suspect atopic dermatitis. The presence of atopic dermatitis was confirmed by an allergic skin test. Serum biomarkers including intestinal fatty acid binding protein (I‐FABP), intestinal alkaline phosphatase (IAP), trefoil factor‐3 (TFF‐3), immunoglobulin E (IgE), interleukin‐4 (IL‐4) and interleukin‐13 (IL‐13) concentrations were measured from venous blood samples.

Results

Of the 26 dogs tested for allergens, 16 were found to be sensitive to mould mites, 10 to vernal grass, eight to house dust mites, five to wheat dust and five to grass pollen mix allergens. Significant increases in serum IAP, TFF‐3, IgE, IL‐4 and IL‐13 concentrations were determined.

Conclusion

It was thought that the increase in TFF‐3 and IAP concentrations may be due to the presence of intestinal epithelial damage and the repair of this damage. In addition, the development of atopic dermatitis may be predisposed to the entry of allergens into the body through sites of intestinal damage.
Zusammenfassung der Ergebnisse
Authors: Steinmeister Nicolas
Published: April 2024

Im Nachfolgenden werden die Ergebnisse der verfassungs-, unions- und DBA-rechtlichen Untersuchung noch einmal zusammenfassend dargestellt.
Ausgangslage der Krankenhausplanung in den Bundesländern
Authors: Degen Hanna
Published: April 2024

Die Krankenhausplanung hat einen besonderen Stellenwert, da sie die flächendeckende Versorgung der Bevölkerung sichern soll. Die Gesetzgebungskompetenz im Bereich der Krankenhausplanung liegt bei den Ländern, während der Bund nur begrenzte Befugnisse hat. Die Länder stellen die Krankenhauspläne nach unterschiedlichen Ansätzen auf. Eine Krankenhauszielplanung und eine Bedarfsanalyse müssen allerdings immer berücksichtigt werden. Die aktuelle Krankenhauslandschaft ist historisch gewachsen und variiert – wie die Krankenhausplanung selber – zwischen den Ländern. Erste Ideen zur Konsequenz für die Planung aufgrund der neuen Krankenhausreform lassen sich aus den Vorschlägen der „Regierungskommission für eine moderne und bedarfsgerechte Krankenhausversorgung“ und durch das gemeinsame Eckpunktepapier von Bund und Ländern ableiten: Dabei sollen Leistungsgruppen (medizinische Cluster), die von Ländern und Bund bundeseinheitlich definiert werden sollen, den Krankenhäusern durch die Landesplanungsbehörden zugewiesen werden. Die konkrete Umsetzung und Auswirkungen auf die Krankenhausplanung bleiben allerdings noch offen und werden durch das geplante Gesetz zur Krankenhausversorgungs-Reform bestimmt, das Anfang 2024 erwartet wird. Nach Veröffentlichung des Gesetzes beginnt ein arbeitsintensiver Prozess für die Länder mit den Zuweisungen der Leistungsgruppen zu den Standorten des jeweiligen Bundeslandes.
Sektorenübergreifende Planung ambulanter und ambulant erbringbarer Leistungen
Authors: Hüer Theresa , Walendzik Anke , Pilny Adam , Buchner Florian , Kleinschmidt Lara , Augurzky Boris , Wasem Jürgen
Published: April 2024

Eine stärkere Ambulantisierung der Versorgung wird politisch angestrebt. In der Konsequenz werden Leistungsbereiche zukünftig zunehmend „sektorenübergreifend“ sowohl von Krankenhäusern als auch von Vertragsärzten und medizinischen Versorgungszentren (MVZ) erbracht. Damit stellt sich die Frage nach der Notwendigkeit von Anpassungen der ambulanten vertragsärztlichen Bedarfsplanung und der Krankenhausplanung sowie nach einer möglichen eigenen „sektorenübergreifenden“ Versorgungsplanung. Die Autoren dieses Beitrags schlagen dazu ein mehrschrittiges Modell vor. Eine Richtlinie des Gemeinsamen Bundesausschusses soll zunächst die Grundlage für die sektorenübergreifende Versorgungsplanung legen. Dazu sind unter anderem die bedarfsgerechte Gesamtmenge ambulant und stationär erbringbarer Leistungen sowie der angestrebte Ambulantisierungsgrad in zu definierenden Leistungssegmenten festzulegen. Der Vorschlag identifiziert zwei Varianten einer sektorenübergreifenden Versorgungsplanung: Eine Variante erweitert den Umfang der ambulanten Bedarfsplanung, indem Leistungen aus dem sektorenübergreifenden Leistungsbereich in das bisher mit der ambulanten Bedarfsplanung beplante Leistungsvolumen überführt werden. Die andere Variante ist ein Ausschreibungsmodell, bei dem die ermittelten Bedarfe in einer Region zu passenden Leistungspaketen gebündelt und zu festen Preisen ausgeschrieben werden. Dabei sind die beiden Varianten nicht gleichermaßen für alle Leistungsbereiche geeignet, sodass sie – in einer dritten Ausgestaltungsüberlegung – parallel in unterschiedlichen Leistungssegmenten zum Einsatz kommen sollten. Das vorgeschlagene Modell bedarf umfassender konzeptioneller Vorarbeiten.
Umweltauswirkungen des Gesundheitssektors
Authors: Quitmann Claudia , Keil Mattis , Herrmann Alina , Schulz Robert , Pichler Peter-Paul
Published: April 2024

Die Gesundheit der Umwelt und der Menschheit sind untrennbar miteinander verknüpft. Klimawandel und Umweltverschmutzungen wirken sich negativ auf Gesundheit aus und der Gesundheitssektor hat die Aufgabe, dies abzufangen. Gleichzeitig hat der Gesundheitssektor selbst diverse Auswirkungen auf die Umwelt. Dazu zählen unter anderem die Freisetzung von Treibhausgasemissionen, Feinstaub und Luftschadstoffen, aber auch reaktiver Stickstoff und Arzneimittelrückstände im Wasser sowie der Verbrauch knappen Wassers. Diese Umweltauswirkungen entstehen einerseits direkt durch die Aktivitäten von Krankenhäusern und anderen Gesundheitseinrichtungen oder durch deren Abfälle. Andererseits entstehen sie indirekt entlang internationaler Lieferketten von z. B. Medizinprodukten und Medikamenten. Während die Wissensbasis zu Treibhausgasemissionen durch den Gesundheitssektor langsam wächst, ist zu anderen Umweltauswirkungen immer noch sehr wenig bekannt. Dieser Beitrag gibt einen Überblick über den aktuellen Wissensstand und diskutiert deren Auswirkungen für die medizinische Versorgung.
Ökologische Nachhaltigkeit als Herausforderung für die Krankenhäuser
Authors: Oswald Julia , Blase Nikola
Published: April 2024

Der anthropogene Klimawandel tangiert die Krankenhäuser in besonderer Weise. Einerseits ist von einer erhöhten Krankenheitslast nahezu aller Fachdisziplinen der Medizin auszugehen. Andererseits müssen Kliniken auch unter herausfordernden Wetterereignissen in Folge der globalen Erwärmung die medizinische Versorgung sicherstellen. Sie hinterlassen rund um die Prozesse der Leistungserbringung jedoch selber einen beachtlichen CO2-Fußabdruck, so dass eine umweltverträgliche Ausrichtung zur Erreichung der Klimaschutzziele zunehmend an Bedeutung gewinnen wird. Dabei stellt die Umsetzung von Maßnahmen hin zu mehr (ökologischer) Nachhaltigkeit die Krankenhäuser vor große Herausforderungen. Der Beitrag beleuchtet einerseits die sich ändernden Rahmenbedingungen, auf die sich die Krankenhäuser in Folge des Klimawandels einstellen müssen. Andererseits werden mögliche Handlungsfelder für mehr Umweltverträglichkeit der Krankenhäuser aufgezeigt und entsprechende Anforderungen an ein nachhaltigkeitsorientiertes Management ausgeführt, mit dem Ziel, durch mehr ökologische Nachhaltigkeit die klimatischen Entwicklungen abzuschwächen.
Krankenhauspolitische Chronik
Authors: Bürger Dirk , Purwins Martina
Published: April 2024

Der Deutsche Bundestag, dessen Abgeordnete im Ausschuss für Gesundheit, das Bundesgesundheitsministerium, die Landesgesundheitsminister und der Bundesrat setzen jährlich neben den gesundheits- auch die krankenhauspolitischen Rahmenbedingungen. Benannte Expertenbeiräte der Bundesregierung, die Gesundheitsexperten der Parteien, diverse Verbände, die (Sozial-)Gerichtsbarkeit und Bundesbehörden sowie politiknahe und wissenschaftliche Institute prägen dabei die öffentliche Diskussion um diese Regelungen. Die Selbstverwaltungspartner auf Bundesebene nutzen die ihnen übertragenen Aufgaben zur vertraglichen Gestaltung, um die medizinische und pflegerische Versorgung in den Krankenhäusern anhand der aktuellen Anforderungen weiterzuentwickeln. Die „Krankenhauspolitische Chronik“ liefert eine Übersicht über alle wesentlichen Entscheidungen der Akteure der deutschen Gesundheits- und Krankenhauspolitik und informiert über die Aktivitäten in den vergangenen zwölf Monaten.
Neugestaltung der deutschen Krankenhauslandschaft
Authors: Geissler Alexander , Krause Franz , Leber Wulf-Dietrich
Published: April 2024

Gesundheitsökonomische Beiträge zur Konzeption einer bedarfsnotwendigen, effizienten und qualitätsorientierten Krankenhauslandschaft sind rar. Ursächlich dafür ist die Tatsache, dass stationäre Versorgung zunehmend das Ergebnis eines (ungeplanten) Marktprozesses und zudem im Kompetenzbereich der Bundesländer verortet ist. Durch den Planungsprozess in Nordrhein-Westfalen und durch die Empfehlungen der Regierungskommission für eine moderne und bedarfsgerechte Krankenhausversorgung (Dezember 2022) ist inzwischen eine bundespolitische Debatte entstanden, zu der dieser Artikel einen Beitrag liefern soll.

Zunächst werden mögliche Bausteine einer leistungs-, bedarfs- und qualitätsorientierten Krankenhausplanung erörtert – mit einem Schwerpunkt auf Leistungsgruppen. Es schließt sich die noch wenig diskutierte Auswahlentscheidung bei Überversorgung an. Eine Reihe von Instrumenten zeigt, dass bereits heute bundesweit einheitliche Kriterien für Auswahlentscheidungen funktionieren (Sicherstellung und Förderung ländlicher Krankenhäuser, Strukturfonds, IT-Fördergelder nach KHZG, Notfallstufen).

In weiteren empiriebasierten Abschnitten werden die Folgen der bundeseinheitlichen Regulierung der Krankenhauslandschaft dargestellt. Es wird empfohlen, die Notaufnahme nicht auf Häuser mit erweiterter und umfassender Notfallversorgung zu beschränken. Nach einem umfassenderen Modell für „versorgungsrelevante“ Krankenhäuser ergeben sich insgesamt 1.247 Krankenhäuser. Mit Bezug zur Neugestaltung der Notaufnahme werden in einer Erreichbarkeitsanalyse die Standorte für integrierte Notfallzentren ermittelt. Nicht zuletzt aufgrund der Notwendigkeit gerichtsfester Auswahlentscheidungen wird empfohlen, den Weg bundesweiter Kriterien für die Krankenhausplanung algorithmengetrieben fortzusetzen.
Rotation number of 2-interval piecewise affine maps
Authors: Gaivão José Pedro , Laurent Michel , Nogueira Arnaldo
Published: April 2024

We study maps of the unit interval whose graph is made up of two increasing segments and which are injective in an extended sense. Such maps $$f_{\varvec{p}}$$

f

p

are parametrized by a quintuple $$\varvec{p}$$

p

of real numbers satisfying inequations. Viewing $$f_{\varvec{p}}$$

f

p

as a circle map, we show that it has a rotation number $$\rho (f_{\varvec{p}})$$

ρ
(

f

p

)

and we compute $$\rho (f_{\varvec{p}})$$

ρ
(

f

p

)

as a function of $$\varvec{p}$$

p

in terms of Hecke–Mahler series. As a corollary, we prove that $$\rho (f_{\varvec{p}})$$

ρ
(

f

p

)

is a rational number when the components of $$\varvec{p}$$

p

are algebraic numbers.
Aktualisierte ESAIC-Leitlinie zum postoperativen Delir beim Erwachsenen
Authors: Söhle Martin , Coburn Mark
Published: April 2024

Die aktualisierte Leitlinie der ESAIC zum postoperativen Delir (POD) umfasst insgesamt 13 Empfehlungen, darunter fünf mit dem Empfehlungsgrad „stark“: 1.) Die Erfassung der präoperativen POD-Risikofaktoren, 2.) die Optimierung des präoperativen Zustands, 3.) die Besprechung von Präventionsstrategien, 4.) die Durchführung einer nicht-pharmakologischen Multikomponenten-Intervention bei POD-Risikopatienten und 5.) die Nutzen-Risiko-Abwägung bei der prophylaktischen Gabe von Dexmedetomidin. Letzteres gilt insbesondere auf Grund der teils widersprüchlichen Datenlage und unterschiedlicher Einsatzgebiete (herzchirurgische versus nicht-herzchirurgische Patienten). Weiterhin wird die indexbasierte EEG-Überwachung der Narkosetiefe empfohlen, wobei auch weitere Parameter, wie die Burst Suppression und das Density Spectral Array mit einbezogen werden sollten. Wenn nicht-pharmakologische Maßnahmen versagen, sollte das POD mit Haloperidol therapiert werden. Hingegen wird der Einsatz von Benzodiazepinen nicht empfohlen.
Cochleaimplantatversorgung bei Autoimmunschwerhörigkeit
Authors: Armstorfer Maximilian , Weitgasser Lennart , Tschani Stefan , Rösch Sebastian
Published: April 2024

Hintergrund

Die Autoimmun-Innenohrerkrankung („autoimmune inner ear disease“, AIED) imponiert durch rezidivierende, fluktuierende sensorineurale Schwerhörigkeit mit assoziierten vestibulären Symptomen. Therapeutisch kommen Kortikosteroide und Immunsuppressiva zum Einsatz. Trotz Behandlung kann es zu progressiver Schwerhörigkeit bis hin zur Ertaubung kommen, sodass ein Cochleaimplantat (CI) indiziert ist. Hier wird der Fall eines 25-jährigen Patienten präsentiert, bei dem es im Rahmen der CI-Versorgung zu Impedanzschwankungen kam, welche in Abhängigkeit von der vorab begonnenen Therapie mit dem Tumornekrosefaktor(TNF)-α-Inhibitor Adalimumab standen.

Zielsetzung

Hat eine immunmodulatorische Therapie bei AIED-Patienten nach CI-Versorgung einen Einfluss auf die Versorgungsqualität?

Material und Methoden

Die Autoren dokumentierten über ein Jahr hinweg die Impedanzen und die Ergebnisse des Freiburger Sprachtests ihres Patienten in Abhängigkeit von der Adalimumab-Therapie.

Ergebnisse

Unmittelbar nach Implantation zeigten sich unauffällige Impedanzwerte. Im weiteren Verlauf nahmen diese jedoch zu, weshalb rezidivierend Anpassungen der CI-Funktion nötig waren. Nach Wiederbeginn der Therapie mit Adalimumab sanken die Impedanzen wieder ab.

Schlussfolgerung

Eine CI-Versorgung kann bei AIED-Patienten eine suffiziente Hörrehabilitation ermöglichen. Je nach Aktivität der Grunderkrankung kann es jedoch zu schwankenden Impedanzen kommen. Eine immunmodulatorische Therapie kann somit durchaus sinnvoll und nötig sein, um eine adäquate Hörrehabilitation mit dem CI zu ermöglichen.
Non-adherence to cardiometabolic medication as assessed by LC-MS/MS in urine and its association with kidney and cardiovascular outcomes in type 2 diabetes mellitus
Authors: Denicolò Sara , Reinstadler Vera , Keller Felix , Thöni Stefanie , Eder Susanne , Heerspink Hiddo J. L. , Rosivall László , Wiecek Andrzej , Mark Patrick B. , Perco Paul , Leierer Johannes , Kronbichler Andreas , Oberacher Herbert , Mayer Gert
Published: April 2024

Aims/hypothesis

Non-adherence to medication is a frequent barrier in the treatment of patients with type 2 diabetes mellitus, potentially limiting the effectiveness of evidence-based treatments. Previous studies have mostly relied on indirect adherence measures to analyse outcomes based on adherence. The aim of this study was to use LC-MS/MS in urine—a non-invasive, direct and objective measure—to assess non-adherence to cardiometabolic drugs and analyse its association with kidney and cardiovascular outcomes.

Methods

This cohort study includes 1125 participants from the PROVALID study, which follows patients with type 2 diabetes mellitus at the primary care level. Baseline urine samples were tested for 79 cardiometabolic drugs and metabolites thereof via LC-MS/MS. An individual was classified as totally adherent if markers for all drugs were detected, partially non-adherent when at least one marker for one drug was detected, and totally non-adherent if no markers for any drugs were detected. Non-adherence was then analysed in the context of cardiovascular (composite of myocardial infarction, stroke and cardiovascular death) and kidney (composite of sustained 40% decline in eGFR, sustained progression of albuminuria, kidney replacement therapy and death from kidney failure) outcomes.

Results

Of the participants, 56.3% were totally adherent, 42.0% were partially non-adherent, and 1.7% were totally non-adherent to screened cardiometabolic drugs. Adherence was highest to antiplatelet and glucose-lowering agents and lowest to lipid-lowering agents. Over a median (IQR) follow-up time of 5.10 (4.12–6.12) years, worse cardiovascular outcomes were observed with non-adherence to antiplatelet drugs (HR 10.13 [95% CI 3.06, 33.56]) and worse kidney outcomes were observed with non-adherence to antihypertensive drugs (HR 1.98 [95% CI 1.37, 2.86]).

Conclusions/interpretation

This analysis shows that non-adherence to cardiometabolic drug regimens is common in type 2 diabetes mellitus and negatively affects kidney and cardiovascular outcomes.

Graphical Abstract
Die Bedeutung des subchondralen Knochens in der Behandlung von Knorpeldefekten
Authors: Ackermann Jakob , Günther Daniel , Laky Brenda , Mathis Dominic , Deichsel Adrian , Münch Lukas N. , Schüttler Karl Friedrich , Wafaisade Arasch , Eggeling Lena , Kopf Sebastian , Herbst Elmar
Published: April 2024

Der hyaline Knorpel und der subchondrale Knochen bilden zusammen eine komplexe osteochondrale Einheit, die eine enge Kommunikation und Abhängigkeit voneinander aufweist. Die Integrität des subchondralen Knochens ist sowohl im nativen Zustand als auch nach knorpelchirurgischen Eingriffen von entscheidender Bedeutung für den hyalinen Knorpel. Diese Gewebe befinden sich nicht nur in einem ständigen dynamischen biochemischen Austausch, sondern bilden gleichzeitig eine komplexe Mikroarchitektur, die dazu in der Lage ist, die alltäglichen mechanischen Belastungen optimal zu absorbieren und zu verteilen. Veränderungen in einem der beiden Gewebe, sei es im hyalinen Knorpel oder im subchondralen Knochen, führen zu signifikanten Anpassungen auf der jeweils anderen Seite. Daher ist es unerlässlich, den subchondralen Knochen bei der Bewertung und Behandlung von chondralen und osteochondralen Defekten zu evaluieren und ggf. chirurgisch zu behandeln, um ein optimales Behandlungsergebnis zu erzielen.
The formation and cosmic evolution of dust in the early Universe: I. Dust sources
Authors: Schneider Raffaella , Maiolino Roberto
Published: April 2024

Dust-obscured star formation has dominated the cosmic history of star formation, since $$z \simeq 4$$

z
≃
4

. However, the recent finding of significant amount of dust in galaxies out to $$z \simeq 8$$

z
≃
8

has opened the new frontier of investigating the origin of dust also in the earliest phases of galaxy formation, within the first 1.5 billion years from the Big Bang. This is a key and rapid transition phase for the evolution of dust, as galaxy evolutionary timescales become comparable with the formation timescales of dust. It is also an area of research that is experiencing an impressive growth, especially thanks to the recent results from cutting edge observing facilities, ground-based, and in space. Our aim is to provide an overview of the several findings on dust formation and evolution at $$z > 4$$

z
>
4

, and of the theoretical efforts to explain the observational results. We have organized the review in two parts. In the first part, presented here, we focus on dust sources, primarily supernovae and asymptotic giant branch stars, and the subsequent reprocessing of dust in the interstellar medium, through grain destruction and growth. We also discuss other dust production mechanisms, such as Red Super Giants, Wolf–Rayet stars, Classical Novae, Type Ia Supernovae, and dust formation in quasar winds. The focus of this first part is on theoretical models of dust production sources, although we also discuss the comparison with observations in the nearby Universe, which are key to put constraints on individual sources and processes. While the description has a general applicability at any redshift, we emphasize the relative role of different sources in the dust build-up in the early Universe. In the second part, which will be published later on, we will focus on the recent observational results at $$z > 4$$

z
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, discussing the theoretical models that have been proposed to interpret those results, as well as the profound implications for galaxy formation.
Animal spirits, bankruptcies, and monetary policy effectiveness in a hybrid macroeconomic agent-based financial accelerator model
Authors: Bazzana Davide
Published: April 2024

This paper develops a hybrid model with an agent-based financial accelerator framework embedded in a standard new Keynesian economy. It explores the interactions between the financial accelerator and the credit market, focusing on the effects of bankruptcy. The paper replicates credit-market relationships, modeling various credit crunch scenarios. It uncovers endogenous fluctuations and “animal spirits” in entrepreneurs’ expectations, driving investment and production decisions. Notably, higher pro-cyclical leverage can have destabilizing effects in the presence of small shocks, increasing entrepreneurs’ bankruptcies. The results suggest that monetary policy’s effectiveness in stabilizing fluctuations depends on factors such as heterogeneity, bounded rationality, and heuristic updating mechanisms. Moderate monetary policies perform better in terms of economic growth with moderate-to-low volatility, while aggressive policies on inflation assist bounded rational agents in reducing errors in investment decisions and default rates, fostering a more stable macroeconomic environment. Increasing forecasting options introduces diversification among entrepreneurs, reducing volatility and stabilizing investments. More options mitigate investment fluctuations, acting as a counterbalance to prevailing market sentiments. Over time, individuals weakly adhering to trends or adopting contrarian approaches come to dominate the population of entrepreneurs, enhancing the overall stability of investment decisions.
Synthesis and preclinical evaluation of novel 18F-vancomycin-based tracers for the detection of bacterial infections using positron emission tomography
Authors: Spoelstra G. B. , Blok S. N. , Reali Nazario L. , Noord L. , Fu Y. , Simeth N. A. , IJpma F. F. A. , van Oosten M. , van Dijl J. M. , Feringa B. L. , Szymanski W. , Elsinga P. H.
Published: April 2024

Introduction

Bacterial infections are a major problem in medicine, and the rapid and accurate detection of such infections is essential for optimal patient outcome. Bacterial infections can be diagnosed by nuclear imaging, but most currently available modalities are unable to discriminate infection from sterile inflammation. Bacteria-targeted positron emission tomography (PET) tracers have the potential to overcome this hurdle. In the present study, we compared three 18F-labelled PET tracers based on the clinically applied antibiotic vancomycin for targeted imaging of Gram-positive bacteria.

Methods

[18F]FB-NHS and [18F]BODIPY-FL-NHS were conjugated to vancomycin. The resulting conjugates, together with our previously developed [18F]PQ-VE1-vancomycin, were tested for stability, lipophilicity, selective binding to Gram-positive bacteria, antimicrobial activity and biodistribution. For the first time, the pharmacokinetic properties of all three tracers were compared in healthy animals to identify potential binding sites.

Results

[18F]FB-vancomycin, [18F]BODIPY-FL-vancomycin, and [18F]PQ-VE1-vancomycin were successfully synthesized with radiochemical yields of 11.7%, 2.6%, and 0.8%, respectively. [18F]FB-vancomycin exhibited poor in vitro and in vivo stability and, accordingly, no bacterial binding. In contrast, [18F]BODIPY-FL-vancomycin and [18F]PQ-VE1-vancomycin showed strong and specific binding to Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), which was outcompeted by unlabeled vancomycin only at concentrations exceeding clinically relevant vancomycin blood levels. Biodistribution showed renal clearance of [18F]PQ-VE1-vancomycin and [18F]BODIPY-FL-vancomycin with low non-specific accumulation in muscles, fat and bones.

Conclusion

Here we present the synthesis and first evaluation of the vancomycin-based PET tracers [18F]BODIPY-FL-vancomycin and [18F]PQ-VE1-vancomycin for image-guided detection of Gram-positive bacteria. Our study paves the way towards real-time bacteria-targeted diagnosis of soft tissue and implant-associated infections that are oftentimes caused by Gram-positive bacteria, even after prophylactic treatment with vancomycin.
Barriers and facilitators to implementation of an exercise and education programme for osteoarthritis: a qualitative study using the consolidated framework for implementation research
Authors: Bhardwaj Avantika , FitzGerald Christine , Graham Margaret , MacFarlane Anne , Kennedy Norelee , Toomey Clodagh M.
Published: April 2024

Targeted efforts to better understand the barriers and facilitators of stakeholders and healthcare settings to implementation of exercise and education self-management programmes for osteoarthritis (OA) are needed. This study aimed to explore the barriers and facilitators to the implementation of Good Life with osteoArthritis in Denmark (GLA:D), a supervised group guideline-based OA programme, across Irish public and private healthcare settings. Interviews with 10 physiotherapists (PTs; 8 public) and 9 people with hip and knee OA (PwOA; 4 public) were coded by the Consolidated Framework for Implementation Research (CFIR) constructs in a case memo (summary, rationale, quotes). The strong positive/negative implementation determinants were identified collaboratively by rating the valence and strength of CFIR constructs on implementation. Across public and private settings, PTs and PwOA strongly perceived GLA:D Ireland as evidence-based, with easily accessible education and modifiable marketing/training materials that meet participants’ needs, improve skills/confidence and address exercise beliefs/expectations. Despite difficulties in scheduling sessions (e.g., work/caring responsibilities), PTs in public and private settings perceived advantages to implementation over current clinical practice (e.g., shortens waiting lists). Only PTs in public settings reported limited availability of internal/external funding, inappropriate space, marketing/training tools, and inadequate staffing. Across public and private settings, PwOA reported adaptability, appropriate space/equipment and coaching/supervision, autonomy, and social support as facilitators. Flexible training and tailored education for stakeholders and healthcare settings on guideline-based OA management may promote implementation. Additional support on organising (e.g., scheduling clinical time), planning (e.g., securing appropriate space, marketing/training tools), and funding (e.g., accessing dedicated internal/external grants) may strengthen implementation across public settings.
Dispersal potential does not predict recent range expansions of sub-Antarctic plant species
Authors: Mazibuko Nompilo , Greve Michelle , le Roux Peter C.
Published: April 2024

Dispersal influences many key aspects of plant ecology at both fine- and broad scales. However, dispersal events are challenging to quantify as they are difficult to observe and measure accurately, despite the importance of understanding species’ dispersal capacity. In this study, we quantified dispersal estimates for the dominant vascular flora of sub-Antarctic Marion Island, using a mechanistic model to estimate dispersal potential via anemochory and standardized experiments that simulate dispersal events via zoochory, human activity, and thalassochory, to test if dispersal capacity correlates to contemporary range expansion of the island’s native and alien species. Our results demonstrate the broad range of dispersal potential in the island’s flora and represent the first quantification of the dispersal potential (via multiple vectors) of the dominant vascular flora in the sub-Antarctic. Dispersal potential was not related to range expansion rates of native or alien species, suggesting that other mechanisms are responsible for the variation observed in species range expansion rates. Although this finding contradicts expectations and evidence from some other studies, it is consistent with research conducted in alpine regions (which may be climatically and physiognomically similar to this sub-Antarctic study site) where factors such as demography and competition are more important predictors of species range expansion than their dispersal ability, dispersal syndromes, or dispersal-related traits.
Ultrastructure and phylogenetic significance of spermatozoa in Nemertea
Authors: Bartolomaeus Thomas , Bronkars Vanessa , Adam Leon , von Döhren Jörn
Published: April 2024

Sperm ultrastructure is frequently employed as a source for phylogenetic inference due to the ease of accessing spermatozoa. Despite being unicellular, sperm cells exhibit a relatively high number of diverse characters and character states. Spermatozoa are subject to strong sexual selection as they are finely tuned for maximizing male reproductive success. Given this strong functional constraint, one might anticipate the emergence of convergent characters in line with similar modes of reproduction. As a result, it might be expected that sperm cells do not possess substantial phylogenetic signal, with functional constraints overshadowing any evolutionary heritage. To test this assumption, we conducted a study on sperm ultrastructure in 11 nemertean species, representing closely related groups and major nemertean lineages. We analyzed these data for their phylogenetic signal within the context of the most recent nemertean phylogenies. Our findings demonstrate that, at all systematic levels, functional constraints imposed by sexual selection, or the mode of reproduction do not supersede the influence of historical constraints on sperm ultrastructure.
The role of food during oncology treatment: perspectives of cancer patients, caregivers and healthcare professionals
Authors: Adamczyk Dominika , Maison Dominika , Lignou Stella , Oloyede Omobolanle O. , Clegg Miriam , Methven Lisa , Fairfield Carol , Gosney Margot , Hernando Maria José , Amézaga Javier , Caro Mercedes , Tueros Itziar
Published: April 2024

Purpose

Many cancer patients have problems eating which are usually connected to taste and smell alterations due to side effects of cancer treatment. These problems have consequences both in terms of malnutrition and reduced quality of life. In order to explore social and psychological consequences of eating problems in cancer patients, qualitative interviews were conducted with cancer patients, their caregivers and healthcare professionals.

Methods

The study was conducted in three European countries (Poland, Spain and the UK) that differed in culture, oncology care approaches and availability of nutritional products targeted to cancer patients in the market.

Results

Differences in the social role of eating between the three European countries were observed which subsequently influenced the impact of eating problems for cancer patients in these countries. Furthermore, the study found that problems with food affect not only the quality of life of cancer patients, but can also distress their caregivers, who are often unable to cope with such food-related problems. In addition, the study showed that commercially available nutritional products for cancer patients focus on nutritional value but tend to neglect an important aspect of eating, which is the enjoyment of food, both individually and socially.
End-to-end tire defect detection model based on transfer learning techniques
Authors: Saleh Radhwan A. A. , Konyar Mehmet Zeki , Kaplan Kaplan , Ertunç H. Metin
Published: April 2024

Visual inspection of defective tires post-production is vital for human safety, as faulty tires can lead to explosions, accidents, and loss of life. With the advancement of technology, transfer learning (TL) plays an influential role in many computer vision applications, including the tire defect detection problem. However, automatic tire defect detection is difficult for two reasons. The first is the presence of complex anisotropic multi-textured rubber layers. Second, there is no standard tire X-ray image dataset to use for defect detection. In this study, a TL-based tire defect detection model is proposed using a new dataset from a global tire company. First, we collected and labeled the dataset consisting of 3366 X-ray images of faulty tires and 20,000 images of qualified tires. Although the dataset covers 15 types of defects arising from different design patterns, our primary focus is on binary classification to detect the presence or absence of defects. This challenging dataset was split into 70, 15, and 15% for training, validation, and testing, respectively. Then, nine common pre-trained models were fine-tuned, trained, and tested on the proposed dataset. These models are Xception, InceptionV3, VGG16, VGG19, ResNet50, ResNet152V2, DenseNet121, InceptionResNetV2, and MobileNetV2. The results show that the fine-tuned VGG19, DenseNet21 and InceptionNet models achieve compatible results with the literature. Moreover, the Xception model outperformed the compared TL models and literature methods in terms of recall, precision, accuracy, and F1 score. Moreover, it achieved on the testing dataset 73.7, 88, 80.2, and 94.75% of recall, precision, F1 score, and accuracy, respectively, and on the validation dataset 73.3, 90.24, 80.9, and 95% of recall, precision, F1 score, and accuracy, respectively.
Numerical investigation of crack propagation regimes in snow fracture experiments
Authors: Bobillier Grégoire , Bergfeld Bastian , Dual Jürg , Gaume Johan , van Herwijnen Alec , Schweizer Jürg
Published: April 2024

A snow slab avalanche releases after failure initiation and crack propagation in a highly porous weak snow layer buried below a cohesive slab. While our knowledge of crack propagation during avalanche formation has greatly improved over the last decades, it still remains unclear how snow mechanical properties affect the dynamics of crack propagation. This is partly due to a lack of non-invasive measurement methods to investigate the micro-mechanical aspects of the process. Using a DEM model, we therefore analyzed the influence of snow cover properties on the dynamics of crack propagation in weak snowpack layers. By focusing on the steady-state crack speed, our results showed two distinct fracture process regimes that depend on slope angle, leading to very different crack propagation speeds. For long experiments on level terrain, weak layer fracture is mainly driven by compressive stresses. Steady-state crack speed mainly depends on slab and weak layer elastic moduli as well as weak layer strength. We suggest a semi-empirical model to predict crack speed, which can be up to 0.6 times the slab shear wave speed. For long experiments on steep slopes, a supershear regime appeared, where the crack propagation speed reached approximately 1.6 times the slab shear wave speed. A detailed micro-mechanical analysis of stresses revealed a fracture principally driven by shear. Overall, our findings provide new insight into the micro-mechanics of dynamic crack propagation in snow, and how these are linked to snow cover properties.

Graphical Abstract
Customizing ICU patient monitoring: a user-centered approach informed by nurse profiles
Authors: Bostan Idil , van Egmond René , Gommers Diederik , Özcan Elif
Published: April 2024

Intensive Care Unit (ICU) nurses are burdened by excessive number of false and irrelevant alarms generated by patient monitoring systems. Nurses rely on these patient monitoring systems for timely and relevant medical information concerning patients. However, the systems currently in place are not sensitive to the perceptual and cognitive abilities of nurses and thus fail to communicate information efficiently. An efficient communication and an effective collaboration between patient monitoring systems and ICU nurses is only possible by designing systems sensitive to the abilities and preferences of nurses. In order to design these sensitive systems, we need to gain in-depth understanding of the user group through revealing their latent individual characteristics. To this end, we conducted a survey on individual characteristics involving nurses from two IC units. Our results shed light on the personality and other characteristics of ICU nurses. Subsequently, we performed hierarchical cluster analysis to develop data-driven nurse profiles. We suggest design recommendations tailored to four distinct user profiles to address their unique needs. By optimizing the system interactions to match the natural tendencies of nurses, we aspire to alleviate the cognitive burden induced by system use to ensure that healthcare providers receive relevant information, ultimately improving patient safety.
Validation and extension of two domain-specific information privacy competency models
Authors: Soumelidou Aikaterini , Tsohou Aggeliki
Published: April 2024

The purpose of this paper is to validate two domain-specific information privacy competency models (IPCMs); the first for online consumers and the second for users of mobile applications (apps). For the validation of the competency models, we conducted qualitative research, using interviews to collect feedback by a group of nine information privacy experts. Regarding the evaluation, the experts commented largely positively for the structure and content of the IPCMs, as well as for the extent to which they achieve the intended goals. They also provided several points for improvements, which resulted in enhancing the quality of both IPCMs. The validation of the domain-specific demonstrated that this is the first study to empirically examine the privacy competencies that users of specific technological contexts should hold. The IPCMs can be used not only by educators and privacy policy makers for the design of privacy interventions, but also by e-commerce and mobile-apps providers, who could gain important insights into the way that they can be more reliable for their users. Both consumers and users of mobile-apps could benefit from IPCMs by acquiring the necessary privacy competencies through training programs for the protection of their information privacy.