bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of ultrasound‐assisted lumbar punctures performed by pediatric oncologists at the point of care
Authors: Shaikh Furqan , Arzola Cristian , Alexander Sarah , Carvalho Jose C. A. , Everett Tobias , Shroff Manohar , Doria Andrea S. , Trottier Luc , To Teresa , Sung Lillian
Published: March 2021

Background

Ultrasound assistance improves success rates and reduces adverse outcomes of lumbar punctures (LPs) among adult patients in the emergency room and the operating room, but has not been evaluated in pediatric patients with cancer. Our objectives were (1) to determine whether pediatric oncologists could perform ultrasound‐assisted LPs following a structured teaching curriculum, and (2) to determine the feasibility of recruiting pediatric cancer patients to a clinical trial of this procedure.

Methods

Three pediatric oncologists completed a curriculum composed of didactic teaching followed by hands‐on workshops. Each learner was evaluated during 20 attempts at three ultrasound tasks using the cumulative sum method. The three pediatric oncologists then performed ultrasound assessments prior to routinely scheduled LPs. Feasibility was defined as ability to perform at least 30 ultrasound‐assisted LPs within 6 months. Secondary outcomes were the proportion of successful, bloody, or traumatic LPs, time required, and perceived helpfulness of ultrasound.

Results

All three pediatric oncologists achieved competence in the three tasks of ultrasound scanning within 20 evaluated attempts. We recruited 62 patients within 1 month, and 58 underwent an ultrasound‐assisted LP. All LPs were successful. Two LPs (4%) had ≥500 red blood cells (RBCs)/μl, and nine (16%) had ≥10 RBCs/μl. Median time to conduct the scan was 1.9 minutes (range 0.8–4.0 minutes). In 37 (64%) of the LPs, ultrasound assistance was considered helpful or very helpful.

Conclusions

Pediatric oncologists readily achieved competence in ultrasound‐assisted LPs, and ultrasound was commonly perceived as helpful. It is feasible to proceed to a randomized trial of this procedure in pediatric cancer.
Accuracy of a single‐lead mobile smartphone electrocardiogram for QT interval measurement in patients undergoing maintenance methadone therapy
Authors: Titus‐Lay Erika N. , Jaynes Heather A. , Tomaselli Muensterman Elena , Ott Carol A. , Walroth Todd A. , Williams Gabriela , Moe Paul R. , Wilbrandt Michelle , Tisdale James E.
Published: March 2021

Study Objective

Methadone is associated with QT interval prolongation and torsades de pointes. Expert panel recommendations advocate a pre‐methadone electrocardiogram (ECG) and another ECG at 30 days of therapy in patients with risk factors. Some guidelines recommend a pre‐methadone ECG and routine ECG monitoring in all methadone patients, but this is controversial due to the resources required. Availability of a convenient, less resource‐intensive method of ECG monitoring for patients taking methadone is desirable. The objective of this study was to assess the accuracy of a handheld smartphone ECG (iECG) for QT measurement in patients on maintenance methadone therapy in an urban opioid treatment program.

Design

Prospective study.

Setting

Urban opioid treatment program.

Patients

n = 115 patients in normal sinus rhythm who were on steady‐state maintenance methadone therapy

Intervention

Patients (n = 115) underwent a simultaneous 12‐lead ECG and a single‐lead iECG.

Measurements and Main Results

The first three QT and RR intervals from lead II of the 12‐lead ECG and simulated lead I from the iECG were compared using the Bland‐Altman analysis of measurement agreement. Mean [± standard deviation) age was 34 ± 11 years; 71% were female, 75% were white. Compared to the 12‐lead ECG, the iECG was associated with a QTc bias of ‐ 0.14 ms (SD = 12 ms, 95% CI = ‐2.4 to 2.1 ms). The absolute mean difference in QTc between the two methods was 9.5 ± 7.1 ms. For identification of patients with methadone‐associated QTc prolongation, the iECG performed moderately well [c‐statistic 0.97 (95% CI 0.91–0.99); sensitivity and specificity 75% (95% CI 43–95%) and 99% (95% CI 94–99%), respectively]. The positive and negative likelihood ratios of the iECG for identifying patients with methadone‐associated QTc prolongation were 77.25 (95% CI 10.69 to 558.18) and 0.25 (95% CI 0.09 to 0.67), respectively, while the positive and negative predictive values were 90% (95% CI 56–99%) and 97% (95% CI 92–99%), respectively. The accuracy of the iECG for identifying patients with QTc prolongation was 97% (95% CI 91–99%).

Conclusion

A handheld smartphone ECG is accurate for QT interval measurement in patients taking maintenance methadone therapy, and its performance is moderately good for identifying patients with methadone‐associated QTc prolongation.
Measuring fucosylated alpha‐fetoprotein in hepatocellular carcinoma: A comparison of μTAS and parallel reaction monitoring
Authors: Kim Kwang Hoe , Lee Sang Yoon , Baek Je‐Hyun , Lee Soo‐Youn , Kim Jin Young , Yoo Jong Shin
Published: March 2021

Purpose

Fucosylation of alpha‐fetoprotein (AFP) is closely correlated with the diagnosis of patients with hepatocellular carcinoma (HCC). In current, a micro‐total analysis system (μTAS) using immunoassay has been developed for determining fucosylated AFP

Experimental Design

We compared two analytical methods, μTAS and liquid chromatography‐parallel reaction monitoring mass spectrometry (LC‐PRM MS), for the measurement of fucosylated AFP in serum to evaluate the usefulness of the results. For this purpose, serum samples were used (cirrhosis, n = 105; HCC, n = 105), and we have discussed the analytical performance of these two methods

Results

We observed a correlation (R2 = 0.84) between LC‐PRM MS and μTAS using samples where fucosylated levels were measured by both methods. The fucosylated level of AFP by LC‐PRM MS better differentiated between cirrhosis and HCC patients than those by μTAS (AUC = 0.910 vs. 0.861), particularly in subgroups with a level of total AFP < 20 ng/mL (0.973 vs. 0.874) and in early stage (I and II) patients (0.922 vs. 0.835)

Conclusions and Clinical Relevance

From this comparative study we can suggest that the LC‐PRM MS is applicable in the measurement of fucosylated AFP from human serum and is more useful for early diagnosis of HCC.

Clinical Relevance

Fucosylation of AFP is used for the detection of HCC. A micro‐total analysis system (μTAS) has been only developed for measuring fucosylation of AFP in clinical research. This study reports the fucosylation of AFP in human serum samples from cirrhosis and HCC patients using the μTAS and a LC‐PRM MS to evaluate fucosylation of AFP from each method. As a result, LC‐PRM MS is complementary to the conventional μTAS method. Furthermore, LC‐PRM MS provides a higher diagnostic accuracy than the μTAS in patients with low AFP levels and an early stage.
Efficacy of chemotherapy versus chemoradiotherapy for locally advanced endometrial cancer: a systematic review and meta‐analysis
Authors: Xiang Xiaoyong , Wang Jing , Ding Zhen
Published: March 2021

Objective

This meta‐analysis evaluates the efficacy of chemoradiotherapy versus chemotherapy in patients with locally advanced endometrial cancer (EC).

Methods

A systematic search in PubMed, Embase, and the Cochrane Library was performed, according to the PRISMA statement, for the past 10 years to May 28 2020 to identify studies on chemoradiotherapy versus chemotherapy in patients with locally advanced EC. Two independent observers evaluated the identified studies. The obtained data were analyzed using the RevMan 5.3 software.

Results

Five studies involving 1346 patients with locally advanced EC were identified and included in this meta‐analysis according to the inclusion criteria. All studies reported the recurrence‐free survival, and found that patients who received chemoradiotherapy had a better recurrence‐free survival than those who received chemotherapy only (hazard ratio 1.53, 95% confidence interval 1.01–2.05, P < 0. Data on overall survival were provided in three studies; the meta‐analysis showed that patients who received chemoradiotherapy had a better overall survival than those who received chemotherapy only (hazard ratio 1.80, 95% confidence interval 1.07–2.53; P < 0.001), and their difference was significant. Toxicity details were reported in the Gynecologic Oncology Group‐258 trial. In summary, constitutional symptoms, fatigue, gastrointestinal events, renal or genitourinary events, and musculoskeletal events were more frequent in patients who received chemoradiotherapy, whereas hematological adverse events were more frequent and more severe in those who received chemotherapy only.

Conclusions

The meta‐analysis showed that patients receiving chemoradiotherapy had a better overall survival and recurrence‐free survival than those who received chemotherapy only. Large‐scale randomized controlled trials are necessary for the future.
Effects of dosing frequency on the clinical efficacy of ampicillin/sulbactam in Japanese elderly patients with pneumonia: A single‐center retrospective observational study
Authors: Suzuki Tomokazu , Sugiyama Erika , Nozawa Kenji , Tajima Masataka , Takahashi Kyoka , Yoshii Masayoshi , Suzuki Hidenori , Sato Vilasinee H. , Sato Hitoshi
Published: March 2021

This study sought to investigate whether dosing frequency (the number of doses per day) affects the antimicrobial efficacy and safety of ampicillin/sulbactam (ABPC/SBT) in Japanese elderly pneumonia patients treated with ABPC/SBT at 6 g/day. This was a retrospective observational study that included hospitalized elderly patients (aged ≥75 years, 10 ml/min ≤CLcr <50 ml/min) who received 3 g every 12 h (BID; n = 61) or 1.5 g every 6 h (QID; n = 45) for the treatment of pneumonia. The primary endpoint was clinical response, assessed by measuring body temperature, white blood cell count, and C‐reactive protein levels. Pharmacokinetic and pharmacodynamic simulations were conducted in silico to rationalize the clinical findings. The clinical response rates (extremely effective and effective) in the BID and QID groups were 36.1% and 55.6%, respectively (p = .0459). QID tended to be more effective in patients with gram‐negative rods detected (p = .0563). According to the simulated minimum plasma ABPC concentrations at steady state for BID and QID were 2.5 and 7.3 μg/ml, respectively (p < .0001). Based on the simulated time above minimum inhibitory concentration (MIC), pharmacological (not clinical) efficacy was predicted to be higher with QID. Both groups had similar safety profiles. The main adverse event in both groups was liver damage. The present retrospective survey demonstrated that ABPC/SBT treatment for elderly patients with pneumonia and renal dysfunction was more effective with QID than with BID. Therefore, the QID regimen is worthy of consideration to improve the clinical outcomes of ABPC/SBT therapy in the present patient population.
Multiferroic Properties of Pure, Transition‐Metal and Rare‐Earth–Doped BaFe12O19 Nanoparticles
Authors: Apostolova Iliana N. , Apostolov Angel T. , Trimper Steffen , Wesselinowa Julia M.
Published: March 2021

Different properties of pure and Ni, Zr, and Sm‐doped BaFe12O19—bulk and nanoparticles—are investigated using a microscopic model and the Green's function technique. The magnetization increases whereas the coercive field decreases with increasing particle size. The doping leads to a decrease of Ms and the bandgap energy Eg with increasing Zr concentration x due to tensile strain and to an increase of Ms and Eg after Ni doping due to compressive strain as well as due to size effects. The behavior of the spontaneous polarization Ps and the real part ϵ′ of the dielectric constant is opposite. The ϵ′ of a pure nanoparticle decreases with increasing magnetic field h. The effects of Sm substitution at Ba or Fe sites on ϵ′ and Ms are also studied.
Geniposide suppresses liver injury in a mouse model of DDC‐induced sclerosing cholangitis
Authors: Wen Min , Liu Yubei , Chen Ruiying , He Ping , Wu Feihua , Li Rui , Lin Yining
Published: March 2021

Sclerosing cholangitis, characterized by biliary inflammation, fibrosis, and stricturing, remains one of the most challenging conditions of clinical hepatology. Geniposide (GE) has anti‐inflammatory, hepatoprotective, and cholagogic effects. Whether GE provides inhibition on the development of sclerosing cholangitis is unknown. Here, we investigated the role of GE in a mouse model in which mice were fed with 3,5‐diethoxycarbonyl‐1,4‐dihydrocollidine (DDC) for 4 weeks to induce sclerosing cholangitis. The results demonstrated that the increased hepatic gene expressions of pro‐inflammatory (IL‐6, VCAM‐1, MCP‐1, and F4/80) and profibrogenic markers (Col1α1, Col1α2, TGF‐β, and α‐SMA) in DDC feeding mice were reversed after treatment with GE. GE also suppressed expressions of CK19 and Ki67 in DDC‐fed mice, suggesting that GE could ameliorate DDC‐induced hepatocytes and cholangiocytes proliferation. In addition, GE significantly increased bile acids (BAs) secretion in bile, which correlated with induced expressions of hepatic FXR, BAs secretion transporters (BSEP, MRP2, MDR1, and MDR2), and reduced CYP7A1 mRNA expression. Furthermore, higher expressions of ileal FXR‐FGF15 signaling and reduced ASBT were also observed after GE treatment. Taken together, these data showed that GE could modulate inflammation, fibrosis, and BAs homeostasis in DDC‐fed mice, which lead to efficiently delay the progression of sclerosing cholangitis.
Quantum State Transfer with Seamless Frequency‐Connection Through Diamond Optomechanical Cavity
Authors: Hao He , Shan Lingxiao , Zhang Qi , Yu Xiao‐Chong , Gong Qihuang , Gu Ying
Published: March 2021

High‐fidelity quantum state transfer, lying in the heart of the scalable quantum network, requires the frequency linkage among different quantum elements. Here, a protocol of quantum state transfer with seamless frequency‐connection between the solid spin and phonon as well as between arbitrary frequency and telecom photons through the diamond optomechanical cavity is proposed. When the diamond optomechanical cavity acts as a quantum node of the network, within each node, the spin state can map to the phonon state with arbitrary frequency via the sideband transition between spins and phonons, and simultaneously such phonon state can convert to photon state without any frequency selection through optomechanical interaction. Furthermore, the communication among quantum nodes is implemented by the evanescent field of nanofiber. The scheme not only enables universal scalable quantum networks for using robust quantum spins, but also offers a paradigm of the building block for optical quantum communications.
Accelerated quantitative feedback theory interval automatic loop shaping algorithm
Authors: Martínez‐Forte Isaac , Cervera Joaquín
Published: March 2021

The quest for an efficient quantitative feedback theory (QFT) Automatic Loop Shaping algorithm is an open research problem. Different approaches have been adopted in the literature to efficiently solve this optimization problem, which is computationally hard due to its nonlinear and nonconvex nature. The first algorithms focused on different forms of simplification of the original problem, leading to faster but not accurate results. Stochastic algorithms have been another popular way of dealing with the complexity of this problem. These algorithms are faster than an exhaustive search, but do not guarantee, in general, the globally optimal solution. A third, more recent, approach, consists of using interval analysis global search algorithms, which are able to accurately solve the original problem, and are very suitable for execution speed optimization. In this work, one of these algorithms is taken as a basis to propose and develop an improved algorithm which is more efficient in terms of the execution time needed to solve a given problem. This improved efficiency is achieved by using two new information sources: Phase information and feasible boxes information. The main contribution of this work is to propose the use of these two new information sources to reduce execution time and to integrate this idea in the original algorithm. Their individual and joint associated speedups are measured by solving two classical QFT example problems: Matlab® QFT Toolbox example 2 and ACC '90 benchmark problem. The results show that the new algorithm's performance is significantly better.
Trajectory tracking control of spatial underactuated vehicles
Authors: Fetzer Karl L. , Nersesov Sergey G. , Ashrafiuon Hashem
Published: March 2021

A common approach to control of underactuated vehicles is a prelude to cooperative control of heterogeneous networks. This article presents a novel nonlinear trajectory tracking control framework for general three‐dimensional models of underactuated vehicles with twelve states and four control inputs, including underwater, air, and space vehicles. Given a desired reference trajectory for four of the six degrees of freedom, feasible state trajectories are generated using the second‐order nonholonomic constraints in the vehicle equations of motion. A novel transformation is then introduced to formulate the error dynamics in a simplified form. The error dynamics is stabilized using a traditional nonlinear control approach. The control law is shown to uniformly asymptotically stabilize all six pose states assuming bounded unknown uncertainties and disturbances. Adaptation of the method to underwater vehicles is presented along with simulation under highly nonlinear conditions. The approach is also applied to quadrotors and both simulation and experimental results are presented.
Low frequency Lagrange stabilization for pendulum‐like systems
Authors: Li Peng , Wang Yijing , Zuo Zhiqiang
Published: March 2021

In this article, the low frequency Lagrange stabilization issue is investigated for a pendulum‐like system. To this end, an H∞ control method is developed for converting the frequency‐domain stabilization condition into an H∞ norm bound requirement in low frequency domain. With the aid of a generalized Kalman‐Yakubovich‐Popov (KYP) lemma, time‐domain matrix inequality conditions are derived to assure both pendulum‐like and low frequency Lagrange stability properties for the closed‐loop system. Furthermore, an output feedback Lagrange stabilization controller is constructed via feasible solutions of a certain set of linear matrix inequalities. An illustrative example is provided to verify the effectiveness and superiority of the proposed controller.
Gear specific catch rates and size structure of channel catfish in the Upper Mississippi River
Authors: Gainer Colby G. , Kim Hae H. , Phelps Quinton E.
Published: March 2021

Channel catfish are important to the Mississippi River (i.e., ecologically, commercially, and recreationally). The dynamic rate functions (recruitment, growth, and mortality) of the population are important to proper management. However, different gears can produce varying estimates of these vital rates (e.g., size selectivity or age selectivity). We evaluated the effectiveness of three commonly used gear types for sampling channel catfish. Sampling was completed following United States Army Corps of Engineers' Long‐Term Resource Monitoring (LTRM) element sampling protocol; pulsed direct current daytime electrofishing, baited 37 mm hoop nets (large hoop net), baited 18 mm hoop nets (small hoop net), and a tandem hoop net set that included one large and one small hoop net. A total of 65,222 channel catfish were collected from 1993 to 2017. Channel catfish catch rates were lowest using daytime electrofishing and large hoop nets, while tandem hoop nets and small hoop nets had higher catch per unit effort (CPUE). Furthermore, tandem hoop nets collected a broader size distribution of channel catfish in comparison to daytime electrofishing, large hoop nets, and small hoop nets. As such, we recommend that tandem hoop nets should be used to evaluate channel catfish populations in the Upper Mississippi River as well as other riverine systems.
Central‐Core Engineering of Dopant‐Free Hole Transport Materials for Efficient n‐i‐p Structured Perovskite Solar Cells
Authors: Chang Zhitao , Guo Jiahao , Fu Qiang , Wang Ting , Wang Rui , Liu Yongsheng
Published: March 2021

Replacing the dominating and dopant‐needing 2,2′,7,7′‐tetrakis(N,N‐di‐p‐methoxyphenylamino)‐9,9′‐spiro‐bifluorene (spiro‐OMeTAD) with dopant‐free organic hole transport materials (HTMs) in n‐i‐p structured perovskite solar cells (PSCs) is a big challenge. Herein, a class of conjugated organic semiconductor materials, namely, ZT‐H1 and ZT‐H2, with unfused and fused core units, respectively, are successfully designed and synthesized for dopant‐free HTMs. It is found that the HTM ZT‐H1 exhibits a hole mobility of 7.08 × 10−5 cm2 V−1 s−1, which is improved to 5.16 × 10−4 cm2 V−1 s−1 for HTM ZT‐H2 due to the enlarged molecular planarity of ZT‐H2, leading to efficient intermolecular π–π interaction. Further investigation indicates that ZT‐H2 is more fit to facilitating hole extraction, restraining charge recombination, and guaranteeing long‐term stability of the devices. Consequently, a planar n‐i‐p structured device using ZT‐H2 as HTM without any dopants exhibits a remarkable efficiency of 19.63%, which is much higher than that of ZT‐H1‐based devices (10.64%). Importantly, ZT‐H2‐based devices are much more stable than the control devices using ZT‐H1 or spiro‐OMeTAD as the HTM. The findings reveal that the fused central core unit with extended π‐conjugation is an efficient strategy for rationally designing dopant‐free HTMs toward stable and efficient PSCs.
Impact of early childhood education settings on the systems thinking skills of preschool children through the lens of Bronfenbrenner's theory
Authors: Feriver Şebnem , Olgan Refika , Teksöz Gaye , Barth Matthias
Published: March 2021

The new generation spend a considerable amount of their time in formal education settings. Only a small fraction of this time is allocated to equipping children with the ability to deal with sustainability issues and so empowering them to respond to the key challenges of our time. Systems thinking (ST) has been promoted as a way of responding to these challenges by facilitating the understanding of complex dilemmas and mitigating them. The aim of this multiple case study is to shed light on the impact of early childhood education (ECE) settings on the ST skills of preschool children aged between four and six. For this purpose, we developed a strategy and instruments to determine ECE setting variables that could potentially be taken into consideration in ST education. We applied this methodology to contrasting cases from Turkey and Germany. The findings have important implications for policy makers, researchers and ECE teachers.
Strength and ductility of laterally confined concrete
Authors: Chang Wei , Hao Meijing , Zheng Wenzhong
Published: March 2021

The objective of this paper was to evaluate the strength and ductility of laterally confined concrete. To reach the purpose, the effects of the investigated parameters including concrete strength, the volumetric ratio, tensile strength, configurations of transverse reinforcements, as well as the longitudinal reinforcements ratio on the strength and the ductility of laterally confined concrete were analyzed. A three‐dimension effective confinement coefficient of confined circular and rectangular columns was proposed to evaluate the effective confinement area of core concrete in both plane and elevation, and the strength and ductility enhancement factor prediction models of confined concrete were developed to evaluate the strength and ductility of confined concrete. The results showed that concrete strength, the volumetric ratio and configurations of transverse reinforcements, and the distribution of longitudinal reinforcements had obvious influence on the strength and ductility of confined concrete and only when lateral stress exceeded the yield strength of transverse reinforcements, transverse reinforcements had significant effects on the strength and ductility of confined concrete. Furthermore, the proposed strength enhancement factor and ductility enhancement factor models of confined concrete can be utilized to evaluate the strength and ductility of laterally confined concrete.
Research on the Competitive Advantage of the Firm
Authors: Deszczyński Bartosz
Published: March 2021

This chapter introduces the notion of competitive advantage in multiple research perspectives of the dominant strategic management schools, and references the academic discourse on the fundamental issue of the locus of competitive advantage. Its first section briefly presents exemplary attempts to organize the body of knowledge on the theory of the firm, including strategic management as an associated theory, and argues why the notion of competitive advantage lies at the heart of this book’s research agenda. In the second section, the dispute between the proponents of Industrial Organization Economics and the Resource-Based View is recounted. Following this, the relationship approach is introduced as a concept that facilitates market coordination based on cooperation.
Relationship Management Maturity
Authors: Deszczyński Bartosz
Published: March 2021

This chapter introduces the notion of RM maturity. The first section clarifies the role of the maturity concepts in management science and presents the design of a systemic theoretical inquiry into RM maturity. In total, 13 RM-related themes were qualified to become the content of the RM maturity concept. The second section discusses the themes grouped in the strategic dimension of RM, including Service-Dominant Logic (SDL) as the most distinctive and consistent theme in this group. A brief theory-integrative discourse is given about the interplay between RM and SDL as permeable paradigms embedded in the RBV and dynamic capabilities theories. The third section discusses the roles of interdepartmental and departmental processes and ICT in defining RM maturity. The chapter concludes with the preliminary proposal of the RM maturity model fitted into the broad definitional basis of RM.
Erratum to: Gravitons in a Casimir box
Authors: Alessio Francesco , Barnich Glenn , Bonte Martin
Published: March 2021

The correct name of the second author is Martin Bonte. In the expression for the Pauli-Fierz Hamiltonian in equation (3.10), we missed two terms that vanish on the constraint surface.
Mathilde Ludendorff (1877–1966): Nervenärztin und völkische Philosophin
Authors: Förstl Hans
Published: March 2021

Mathilde Ludendorff (geb. Spiess, verw. von Kemnitz, gesch. Kleine) war eine der ersten Frauen, die im wilhelminischen Deutschland Medizin studierte. Sie schrieb eine feministische Dissertation; gab an, sehr früh Sigmund Freuds Psychoanalyse erfolgreich widerlegt zu haben und zu Emil Kraepelins bester Schülerin avanciert zu sein; deckte den Schwindel von Albert Schrenck-Notzings Mediumforschung auf; firmierte nach 17-monatiger Weiterbildung als Spezialärztin für Nervenheilkunde; behandelte General von Ludendorffs erste Frau und wurde alsbald seine zweite; entwickelte eine germanische Philosophie, die Adolf Hitler zu verwegen erschien; wurde 1949 in einem Spruchkammerverfahren zunächst als Hauptschuldige verurteilt und setzte sich kritisch mit dem Gutachten ihres Kollegen Georg Stertz über ihren eigenen Geisteszustand auseinander. Ihre zahlreichen Schriften werden weiter verlegt. Der von ihr begründete „Bund für Gotterkenntnis (Ludendorff)“ existiert noch und wird vom Verfassungsschutz beobachtet.
A gradient-based optimization method with functional principal component analysis for efficient structural topology optimization
Authors: Montanino Andrea , Alaimo Gianluca , Lanzarone Ettore
Published: March 2021

Structural topology optimization (STO) is usually treated as a constrained minimization problem, which is iteratively addressed by solving the equilibrium equations for the problem under consideration. To reduce the computational effort, several reduced basis approaches that solve the equilibrium equations in a reduced space have been proposed. In this work, we apply functional principal component analysis (FPCA) to generate the reduced basis, and we couple FPCA with a gradient-based optimization method for the first time in the literature. The proposed algorithm has been tested on a large STO problem with 4.8 million degrees of freedom. Results show that the proposed algorithm achieves significant computational time savings with negligible loss of accuracy. Indeed, the density maps obtained with the proposed algorithm capture the larger features of maps obtained without reduced basis, but in significantly lower computational times, and are associated with similar values of the minimized compliance.
Single-station PPP-RTK: correction latency and ambiguity resolution performance
Authors: Khodabandeh A.
Published: March 2021

Single-station PPP-RTK is a special case of PPP-RTK in that corrections are computed, instead of a network, by only one single GNSS receiver. The present contribution aims to develop a framework to generate multi-epoch, single-station corrections, thereby providing PPP-RTK users the capability to time-predict corrections that are subject to time delay or latency. By presenting analytical expressions of the user ambiguity variance matrix, we address how the ambiguity resolution performance is driven by the correction latency and therefore by the uncertainty involved in the time-prediction of single-station PPP-RTK corrections. Supported by numerical results, our analytical study shows that the number of satellites and number of frequencies work in tandem to enable one to increase the correction latency, yet ensuring successful single-receiver ambiguity resolution.
Adjoint-based optimisation of detonation initiation by a focusing shock wave
Authors: Bengoechea S. , Reiss J. , Lemke M. , Sesterhenn J.
Published: March 2021

An optimisation study of a shock-wave-focusing geometry is presented in this work. The configuration serves as a reliable and deterministic detonation initiator in a pulsed detonation engine. The combustion chamber consists of a circular pipe with one convergent–divergent axisymmetric nozzle, acting as a focusing device for an incoming shock wave. Geometrical changes are proposed to reduce the minimum shock wave strength necessary for a successful detonation initiation. For that purpose, the adjoint approach is applied. The sensitivity of the initiation to flow variations delivered by this method is used to reshape the obstacle’s form. The thermodynamics is described by a higher-order temperature-dependent polynomial, avoiding the large errors of the constant adiabatic exponent assumption. The chemical reaction of stoichiometric premixed hydrogen-air is modelled by means of a one-step kinetics with a variable pre-exponential factor. This factor is adapted to reproduce the induction time of a complex kinetics model. The optimisation results in a 5% decrease of the incident shock wave threshold for the successful detonation initiation.
Do proinflammatory cytokines play a role in clozapine-associated glycometabolism disorders?
Authors: Zhao Tongtong , Zhang Kai , Zhang Yelei , Yang Yating , Ning Xiaoshuai , Hu Yu , Li Xiaoyue , Zhang Yulong , Xia Lei , Ren Zhenhua , Liu Huanzhong
Published: March 2021

Rationale and objective

Clozapine (CLZ) is the most effective drug for treatment-resistant schizophrenia but is associated with many side effects, including glycometabolism disorders. Immunological mechanisms may be involved in the development of clozapine side effects. Research relating the immunomodulatory effects of clozapine and its early markers to clinically relevant adverse events is needed to reduce the harmful side effects of clozapine. This study aimed to investigate the role of proinflammatory cytokines in clozapine-associated glycometabolism disorders.

Methods

We measured the effect of a range of doses of clozapine on glycometabolism-related parameters and proinflammatory cytokines levels in mice peripheral blood. We also examined the differences between these indicators in the peripheral blood of clozapine-treated schizophrenia patients and healthy controls. Furthermore, we detected proinflammatory cytokines expression in mice pancreatic tissue.

Results

Following clozapine administration, glucagon significantly decreased in mouse serum, and proinflammatory cytokine IL-β levels markedly increased. Clozapine reliably increased proinflammatory cytokines (IL-1β, IL-6, and TNF-α) expression in murine pancreatic tissue. Compared with healthy controls, clozapine-treated patients’ BMI, blood glucose, and proinflammatory cytokines (IL-1β, IL-6, and TNF-α) increased significantly. In clozapine-treated patients, a higher clozapine daily dosage was associated with higher levels of the proinflammatory cytokines IL-1β and IL-6, and a significant positive correlation was observed between blood glucose levels and the proinflammatory cytokines IL-6 and TNF-α.

Conclusion

Findings from animal experiments and clinical trials have shown clear evidence that clozapine has a regulatory effect on immune-related proinflammatory cytokines and influences glycometabolism indicators.
Target, suspect and non-target screening analysis from wastewater treatment plant effluents to drinking water using collision cross section values as additional identification criterion
Authors: Hinnenkamp Vanessa , Balsaa Peter , Schmidt Torsten C.
Published: March 2021

The anthropogenic entry of organic micropollutants into the aquatic environment leads to a potential risk for drinking water resources and the drinking water itself. Therefore, sensitive screening analysis methods are needed to monitor the raw and drinking water quality continuously. Non-target screening analysis has been shown to allow for a more comprehensive investigation of drinking water processes compared to target analysis alone. However, non-target screening is challenging due to the many features that can be detected. Thus, data processing techniques to reduce the high number of features are necessary, and prioritization techniques are important to find the features of interest for identification, as identification of unknown substances is challenging as well. In this study, a drinking water production process, where drinking water is supplied by a water reservoir, was investigated. Since the water reservoir provides surface water, which is anthropogenically influenced by wastewater treatment plant (WWTP) effluents, substances originating from WWTP effluents and reaching the drinking water were investigated, because this indicates that they cannot be removed by the drinking water production process. For this purpose, ultra-performance liquid chromatography coupled with an ion-mobility high-resolution mass spectrometer (UPLC-IM-HRMS) was used in a combined approach including target, suspect and non-target screening analysis to identify known and unknown substances. Additionally, the role of ion-mobility-derived collision cross sections (CCS) in identification is discussed. To that end, six samples (two WWTP effluent samples, a surface water sample that received the effluents, a raw water sample from a downstream water reservoir, a process sample and the drinking water) were analyzed. Positive findings for a total of 60 substances in at least one sample were obtained through quantitative screening. Sixty-five percent (15 out of 23) of the identified substances in the drinking water sample were pharmaceuticals and transformation products of pharmaceuticals. Using suspect screening, further 33 substances were tentatively identified in one or more samples, where for 19 of these substances, CCS values could be compared with CCS values from the literature, which supported the tentative identification. Eight substances were identified by reference standards. In the non-target screening, a total of ten features detected in all six samples were prioritized, whereby metoprolol acid/atenolol acid (a transformation product of the two β-blockers metoprolol and atenolol) and 1,3-benzothiazol-2-sulfonic acid (a transformation product of the vulcanization accelerator 2-mercaptobenzothiazole) were identified with reference standards. Overall, this study demonstrates the added value of a comprehensive water monitoring approach based on UPLC-IM-HRMS analysis.

Graphical abstract
Clinical outcomes and survivorship of two-stage total hip or knee arthroplasty in septic arthritis: a retrospective analysis with a minimum five-year follow-up
Authors: Russo Antonio , Cavagnaro Luca , Chiarlone Francesco , Clemente Antonio , Romagnoli Sergio , Burastero Giorgio
Published: March 2021

Purpose

Septic arthritis of the native joint is challenging for orthopedic surgeons because it may lead to wide bone defects and severe impairment of joint function. This study aimed to analyze clinical functional outcomes, the rate of infection eradication, and survival of implants of patients who underwent two-stage arthroplasty for septic arthritis of the hip and knee.

Methods

A retrospective single-centre analysis was conducted of patients treated for septic arthritis of the hip and knee joints through a two-stage surgery between 2012 and 2015. Clinical and radiological records were gathered from the prospectively collected Institutional Arthroplasty Registry. Patients’ pre-operative Harris hip scores and Knee Society scores were compared with those obtained at the latest follow-up. Kaplan–Meier curves were generated to assess survival of implants.

Results

Forty-seven patients were included. The mean follow-up was 85.2 ± 15.4 months. The Harris hip score improved from 39.4 ± 9.9 to 84.5 ± 10.8 points (p< 0.001). The Knee Society score improved from 40.7 ± 8.4 to 86.0 ± 7.8 points (p< 0.001). Knee Society score-function increased from 25.7 ± 14.2 to 85.4 ± 23.4 points (p< 0.001). The infection eradication rates were 92.0% and 90.9% in patients who underwent hip and knee operation, respectively (p= 0.891). Overall survivorship of implants after the second stage was 93.6%.

Conclusions

Two-stage arthroplasty provides good to excellent clinical outcomes in cases of active septic arthritis of the hip and the knee, high rates of infection control, and implant survival.
Preoperative Imaging in Renal Transplant Patients with Tertiary Hyperparathyroidism
Authors: Berger Megan G. , Pandian T. K. , Lyden Melanie L. , McKenzie Travis , Drake Matthew T. , Dy Benzon M.
Published: March 2021

Background

Tertiary hyperparathyroidism following kidney transplantation is most commonly characterized by 4‐gland hyperplasia, but single and double adenomatous disease has been demonstrated in this population as well. It is unknown whether preoperative imaging can assist in identifying patients who may qualify for focused surgery for adenomatous disease.

Materials and methods

We performed a retrospective review of our patient database from 1998–2018 for patients with tertiary hyperparathyroidism following renal transplant. Patient charts were reviewed for patient demographics, laboratory values, preoperative imaging, operative findings, pathology, and complications.

Results

We identified 113 patients with tertiary hyperparathyroidism following renal transplant who underwent parathyroidectomy. There were 51 females and 62 males with a mean age of 53.4 ± 13.4 years. Median preoperative calcium and PTH were 10.9 mg/dl (IQR 10.3–11.2) and 228 pg/ml (IQR 118–305). Preoperative ultrasound was performed in 60 patients. Of these, 11 (18%) were negative, 38 (63%) showed 1–2 adenomas, and 11 (18%) showed ≥ 3 adenomas. 99mTc‐sestamibi parathyroid scintigraphy was performed in 101/113 patients. Of these, 11 (11%) were negative, 62 (61%) showed 1–2 areas of discordant sestamibi uptake, and 28 (28%) showed ≥ 3 areas of discordant uptake. Ultimately, 19 (17%) patients had a single adenoma removed, 16 (14%) had 2 adenomas removed, and (69%) had multi‐gland disease. There were 26 ectopic glands found in 21 patients, 42.3% of which were identified on preoperative imaging. 94.1% of patients were eucalcemic at last follow‐up, mean (± SD) 5.8 ± 3.6 years. Adenomas that were visualized on ultrasound were larger on pathology than those non‐visualized (997 ± 120 mg (mean ± SE) vs. 388 ± 109 mg, p = 0.0003). This was also true for parathyroid scintigraphy (647 ± 41 mg vs. 355 ± 51 mg, p = 0.0001).

Conclusion

In patients with tertiary hyperparathyroidism, preoperative imaging can aid in predicting which patients will have 1–2 gland disease. In patients with 1–2 gland disease on congruent ultrasound and nuclear medicine imaging studies, the accuracy increases to 59%. Preoperative imaging can help identify ectopic glands. Larger adenomas are more likely to be identified on both imaging modalities.
Improved detection of in-transit metastases of malignant melanoma with BSREM reconstruction in digital [18F]FDG PET/CT
Authors: Liberini Virginia , Messerli Michael , Husmann Lars , Kudura Ken , Grünig Hannes , Maurer Alexander , Skawran Stephan , Orita Erika , Pizzuto Daniele A. , Deandreis Désirée , Dummer Reinhard , Mangana Joanna , Mihic-Probst Daniela , Rupp Niels , Huellner Martin W.
Published: March 2021

Objectives

To compare block sequential regularized expectation maximization (BSREM) and ordered subset expectation maximization (OSEM) for the detection of in-transit metastasis (ITM) of malignant melanoma in digital [18F]FDG PET/CT.

Methods

We retrospectively analyzed a cohort of 100 [18F]FDG PET/CT scans of melanoma patients with ITM, performed between May 2017 and January 2020. PET images were reconstructed with both OSEM and BSREM algorithms. SUVmax, target-to-background ratio (TBR), and metabolic tumor volume (MTV) were recorded for each ITM. Differences in PET parameters were analyzed with the Wilcoxon signed-rank test. Differences in image quality for different reconstructions were tested using the Man-Whitney U test.

Results

BSREM reconstruction led to the detection of 287 ITM (39% more than OSEM). PET parameters of ITM were significantly different between BSREM and OSEM reconstructions (p < 0.001). SUVmax and TBR were higher (76.5% and 77.7%, respectively) and MTV lower (49.5%) on BSREM. ITM missed with OSEM had significantly lower SUVmax (mean 2.03 vs. 3.84) and TBR (mean 1.18 vs. 2.22) and higher MTV (mean 2.92 vs. 1.01) on OSEM compared to BSREM (all p < 0.001).

Conclusions

BSREM detects significantly more ITM than OSEM, owing to higher SUVmax, higher TBR, and less blurring. BSREM is particularly helpful in small and less avid lesions, which are more often missed with OSEM.

Key Points

• In melanoma patients, [18F]FDG PET/CT helps to detect in-transit metastases (ITM), and their detection is improved by using BSREM instead of OSEM reconstruction.

• BSREM is particularly useful in small lesions.
Seasonal predictability of Mediterranean weather regimes in the Copernicus C3S systems
Authors: Giuntoli Ignazio , Fabiano Federico , Corti Susanna
Published: March 2021

Seasonal predictions in the Mediterranean region have relevant socio-economic implications, especially in the context of a changing climate. To date, sources of predictability have not been sufficiently investigated at the seasonal scale in this region. To fill this gap, we explore sources of predictability using a weather regimes (WRs) framework. The role of WRs in influencing regional weather patterns in the climate state has generated interest in assessing the ability of climate models to reproduce them. We identify four Mediterranean WRs for the winter (DJF) season and explore their sources of predictability looking at teleconnections with sea surface temperature (SST). In particular, we assess how SST anomalies affect the WRs frequencies during winter focussing on the two WRs that are associated with the teleconnections in which the signal is more intense: the Meridional and the Anticyclonic regimes. These sources of predictability are sought in five state-of-the-art seasonal forecasting systems included in the Copernicus Climate Change Services (C3S) suite finding a weaker signal but an overall good agreement with reanalysis data. Finally, we assess the ability of the C3S models in reproducing the reanalysis data WRs frequencies finding that their moderate skill increases during ENSO intense years, indicating that this teleconnection is well reproduced by the models and yields improved predictability in the Mediterranean region.
Challenging the gold standard: methods of sampling for microbial culture in patients with chronic rhinosinusitis
Authors: Szaleniec Joanna , Gibała Agnieszka , Hartwich Patryk , Hydzik-Sobocińska Karolina , Konior Marcin , Gosiewski Tomasz , Szaleniec Maciej
Published: March 2021

Purpose

Chronic rhinosinusitis (CRS) is a highly prevalent multifactorial disorder. Culture-directed antibiotics are frequently prescribed to patients with CRS and the middle nasal meatus (MM) is traditionally believed to be a representative sampling site of the sinuses as a whole. The purpose of our study was to reevaluate the reliability of the MM as a sampling site in patients with CRS who suffer from impaired drainage from the sinuses to the MM.

Methods

Swabs and tissue biopsies were collected from the MM, maxillary sinus and frontal sinus from 50 patients with CRS. The results of bacterial culture were compared between sampling methods and sites in relation to the patency of the sinus ostia.

Results

782 bacterial isolates were cultured from the samples. Concordant results between the MM and the sinus cavity were noted in 80% of patients for the maxillary sinus, but only 66% for the frontal sinus and 76% for the sinuses a whole. The differences were similarly prevalent in patients with open and occluded sinus ostia. Notably, swabs from all three sites provided representative information in 92% of patients and tissue biopsies did not provide additional information compared to multiple swabs.

Conclusion

The traditional method of sampling from the middle meatus provides inadequate information in 24% of patients with CRS, which may result in inadequate antibiotic therapy and contribute to increasing antibiotic resistance. Additional sampling from the sinuses should be recommended whenever possible, while invasive sampling is not necessary.
Performance and characteristics of the Newborn Hearing Screening Program in Campania region (Italy) between 2013 and 2019
Authors: Malesci Rita , Del Vecchio Valeria , Bruzzese Dario , Burattini Ernesto , Auletta Gennaro , Errichiello Monica , Fetoni Anna Rita , Franzè Annamaria , Laria Carla , Toscano Fabiana , Caso Antonio , Marciano Elio
Published: March 2021

Purpose

Universal newborn hearing screening (UNHS) in the first month of life is crucial for facilitating both early hearing detection and intervention (EHDI) of significant permanent hearing impairment (PHI). In Campania region, UNHS has been introduced in 2003 by the Regional Council Resolution and started on January 2007. The aim of this paper is to update a previous article describing the performance of the program since its implementation in the period between 2013 and 2019.

Methods

A longitudinal retrospective study was carried at the Regional Reference Center III on 350,178 babies born in the analysis period. The paper reports the main results of overall coverage, referral rate, lost-to-follow-up rate,yield for PHI and shall determine various risk factor associations with hearing impairment

Results

In Campania region, 318,878 newborns were enrolled at I level, with a coverage rate of 91.06%, 301,818 (86.18%) Well Infant Nurseries (WIN) and 17,060 (5.35%) Neonatal Intensive Care Unit (NICU) babies. PHI was identified in 413 children, 288 (69.73%) bilaterally and 125 (30.26%) unilaterally. The overall cumulative incidence rate of PHI was 1.29 per 1000 live-born infants (95% CI 1.17–1.42) with a quite steady tendency during the whole study period.

Conclusions

This study confirms the feasibility and effectiveness of UNHS in Campania region also in a setting with major socioeconomic and health organization restrictions.The program meets quality benchmarks to evaluate the progress of UNHS. Nowadays, it is possible to achieve an early diagnosis of all types of HL avoiding the consequences of hearing deprivation.