bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent advances in fire‐retardant carbon‐based polymeric nanocomposites through fighting free radicals
Authors: Sai Ting , Ran Shiya , Guo Zhenghong , Song Pingan , Fang Zhengping
Published: June 2022

Polymeric materials are ubiquitously utilized in modern society and continuously improve quality of life. Unfortunately, most of them suffer from intrinsic flammability, significantly limiting their practical applications. Fundamentally, free‐radical reaction is a critical “trigger” for their thermal pyrolysis and following combustion process regardless of the anaerobic thermal pyrolysis in the condensed phase or aerobic combustion of polymers in the gaseous phase. The addition of free radical scavengers represents a promising and effective means to enhance the fire safety of polymeric materials. This review aims to offer a state‐of‐the‐art overview on the creation of fire‐retardant polymeric nanocomposites by adding fire retardants with an ability to trap free radicals. Their specific modes of action (condensed‐phase action, gaseous‐phase action, and dual‐phases action) and performances in some typical polymers are reviewed and discussed in detail. Following this, some key challenges associated with these free‐radical capturers are discussed, and design strategies are also proposed. This review provides some insights into the modes of action of free radical capturing agents and paves the avenue for the design of advanced fire‐retardant polymeric nanocomposites for expanded real‐world applications in industries.
Microalgal–bacterial consortia for efficient wastewater treatment: Optimization using response surface methodology
Authors: Mu Ruimin , Jia Yantian , Qi Feng , Guo Qingyang , Qin Xiaowen , Ma Guixia , Meng Qianya , Yu Gejiang
Published: June 2022

The performance of microalgal–bacterial consortia in wastewater treatment and biomass production needs to be further optimized to meet increasingly stringent effluent standards and operating costs. Besides, due to uncontrollability of ambient conditions, it is generally believed that operating conditions (e.g., aeration) respond to ambient conditions (e.g., illumination). Therefore, response surface methodology (RSM) based on Box–Behnken design was used in this study to analyze the removal of chemical oxygen demand (COD), NH3‐N and TP, and algal biomass of the microalgal–bacterial consortia within 48 h. The results showed that under medium illumination intensity (5000 lx), photoperiod (12:12) and aeration rate (0.55 L min −1), the removal efficiency of COD, NH3‐N and TP was the highest, and the maximal biomass growth rates were 95.43%, 95.49%, 89.42% and 99.63%, respectively. However, as the limited critical removal requirements of TP, the effluent standards can only be achieved within the small illumination intensity and photoperiod available range, even under medium aeration conditions, which means that under fixed operating conditions, the effective operation range will be very limited. In addition, based on RSM and differential equation analysis, the further study indicated that the effective treatment range can be greatly expanded within aeration responding, which meets the discharge standard of pollutants in China.

Practitioner points

Illumination was responded by aeration for optimizing performance of microalgal–bacterial consortium for wastewater treatment and biomass productivity.

The strategy of optimization was based on response surface methodology.

The maximum effect on wastewater treatment and biomass productivity was based on partial differential equations and quadratic inhomogeneous equations.

Limited to critical TP‐removal requirements, effluent standards can meet only in the small‐usable range of illumination, under medium aeration.
A Solvent‐free energetic coordination polymer [N, N‐(3,4‐dinitropyrazolate)Ag]: synthesis, structure and energetic performance
Authors: Zhang Xiaopeng , Wu Yige , Wang Pengcheng , Lin Qiuhan , Chen Shusen , Jin Shaohua , Xu Yuangang , Lu Ming
Published: June 2022

A novel solvent‐free energetic coordination polymer [Ag(3,4‐dnp)] was performed by dehydration. The structure was confirmed by single‐crystal X‐ray crystallography and the Ag(I) ions are coordinated in bidentate‐bridging mode. The results of thermal analysis (thermogravimetric and accelerating rate calorimeter) show that this compound has higher thermal stability than that of the traditional CHON‐containing energetic materials, RDX, HMX and CL‐20. The detonation velocity and detonation pressure of [Ag(3,4‐dnp)] are 5.532 km s−1, 15.88 GPa, respectively, which is lower than that HMX, RDX and TNT, and comparable with the 2D MOFs [Ag(Mtta)] based on the Ag ions and 5‐methyl tetrazole. The impact and friction sensitivities of this compound are infinitely close to RDX, state‐of‐the‐art explosive. The coordination polymers based on metal ions and nitropyrazole are promising potential as energetic materials.
Correction to: A Web-Based Co-Creation and User Engagement Method and Platform
Authors: Tocchetti Andrea , Corti Lorenzo , Brambilla Marco , Marco Diletta Di
Published: June 2022

Chapter “A Web-Based Co-Creation and User Engagement Method and Platform” was previously published non-open access. It has now been changed to open access under a CC BY 4.0 license and the copyright holder updated to ‘The Author(s)’. The book has also been updated with this change.
Molecular and Cellular Analyses of Breast Cancers in Real Life
Authors: Castaneda Carlos A.
Published: June 2022

Breast cancer is the most common women’s malignancy. Incorporation of biomarkers of prognosis and prediction of response are needed to improve treatment management. Lectures for immunohistochemistry of estrogen, progesterone, and HER2 receptors as well as Ki67 staining in cancer cells have been incorporated, and their positive cutoffs have periodically been reviewed. Gene expression platforms in tumor lesions as well as germline and somatic mutations have also been included in the practice for treatment selection. Liquid biopsy evaluating circulating tumor cells (CTCs) and circulating DNA can also predict survival and has reached the clinical practice, although it needs better standardization. On the other side, biomarkers can also evaluate stroma cells in the tumor microenvironment, and they can predict survival and response to chemotherapy and targeted treatment. They have been incorporated in the daily practice, and new methodologies for obtaining more information are currently being developed.
Challenges in Establishing the Clinical Trials Centre at the University of Ulm
Authors: Lang Nicole
Published: June 2022

A Clinical Trials Centre (CTC) is an institution that unites experts and expertise for successful designing, conducting and publishing of clinical trials. It provides competence and the infrastructure required for conducting clinical trials in compliance with international and national regulations, guidelines and standards, ICH GCP (good clinical practice) and the Declaration of Helsinki. Mostly, the CTCs are institutions of the Medical Faculty of the University or the University Hospitals, sometimes both. In Germany, after passing an audit providing reassurance of compliance with required standards, a Clinical Trials Centre is invited to join the Network of Coordinating Centers for Clinical Trials (KKS-Network). Challenges in establishing these standards are diverse and start at the underlying IT (information technology) structure that might not be suitable for providing validated data systems and continue in generating awareness for the need of centralised structures for being compliant with regulations and guidance in conducting high-quality clinical trials.
Quality Oncology Practice Improvement (QOPI) in Brazil: A Successful Knowledge Transfer Under the Auspices of the American Society of Clinical Oncology (ASCO)
Authors: Guimaraes Rodrigo Cunha , Santos Pedro Ribeiro , Ferrari Bruno Lemos
Published: June 2022

Data suggest that the quality of care delivered to patients by a physician decreases over the years of clinical practice. In order to ensure quality care delivery, the American Society of Clinical Oncology (ASCO) has developed the Quality Oncology Practice Initiative (QOPI) and uses this program for international outreach activities. In this chapter, we describe the successful application of the quality management principles to our practice, Oncocentro, which is part of the Oncoclinicas Group.
Challenges in Running a Comprehensive Cancer Center
Authors: Seufferlein Thomas
Published: June 2022

Comprehensive Cancer Centers (CCCs) have their origins already in 1945 in France as “Centres de lutte contre le cancer.” In 1971, the USA started their program as part of the National Cancer Act. Comprehensive Cancer Centers shall provide comprehensive, multidisciplinary cancer care at the highest level but also do combine the best possible treatment with innovative basic, translational, and clinical research in order to optimize care for patients. The concept not only includes medical or surgical treatment but much more includes nutrition, psychooncology, or palliative care. This review aims at pointing out the structure of a Comprehensive Cancer Center in Germany and its major components and tasks, the benefits that shall be achieved with such a structure for improving patient care, and the challenges in running a CCC.
Challenges and Outcomes in Launching the First Board-Certified Program in Radiation Oncology in Iraq
Authors: Mula-Hussain Layth
Published: June 2022

Radiation therapy is—in many therapeutic settings—equivalent to surgery. Training in radiotherapy requires a particular infrastructure including highly trained personnel, safety training, and the necessary equipment as well as time. In this chapter, I will be describing the establishment of the first board-certified radiation oncology training in Iraq. In doing so, I will be outlining challenges specific to the region and low- and middle-income countries (LMICs) in general. I will also be describing the impact of this endeavor and its prospects.
Improving the WHO Classification of Tumours by an Evidence-Based Approach: A New Online/Blended Learning Training Program
Authors: Ruiz Blanca Iciar Indave
Published: June 2022

The WHO Classification of Tumours (WCT) is a series of authoritative and concise reference books for the histological and molecular classification of tumors that underpins treatment and care of cancer patients, as well as research into cancer epidemiology, prevention, diagnosis, and treatment, and is essential for cancer diagnosis worldwide. This classification relies traditionally on consensus of pathological expert opinions as basis for cancer classification, but the understanding of cancer at a molecular level advances in prognosis, and other related fields have moved the WCT to find ways of translating diagnostic research into evidence synthesis that can effectively inform decisions relevant to the classification. Systematic reviews represent the top of the hierarchy of scientific evidence and allow to summarize evidence from many publications to inform decisions. This evidence-based approach is the cornerstone of evidence-based medicine and well established in many medical specialties. However, uptake of these principles within pathology has been slow, and such high-quality reviews of available evidence are not easily available for authors contributing to the WCT. In an effort to overcome reluctance in the field to adopt these methods, a collaborative project between the Advanced Oncology program of the University of Ulm in Germany, the Cochrane Netherlands, the Universidad de Campinas in Brazil, and the WCT has been started. This project called Evi-Pat (Evidence-Based Pathology Training Initiative) aims to develop and evaluate an online training for oncologists and pathologists to train them in the application of evidence-based practice to pathology and related specialties, thereby addressing and overcoming challenges in this, and to pathology, novel approach. Scientific and didactic evaluation of such an effective training tool for online-educated pathologists and oncologists will improve the evidence base in pathology and hence provide a solid foundation for diagnostic and prognostic decision-making. We believe that an evidence-based approach to informing key decisions that feed into tumor classification will allow the WCT editorial board to mitigate the potential inclusion of biased decisions into the classification and also benefit authors by providing structured, transparent, and reliable methods for the synthesis of available evidence for each tumor type, as the same time training to apply these methodologies.
Getting Started in Research: What Registries Can Do for You
Authors: Alfaar Ahmad Samir
Published: June 2022

Starting research without external funding seems like an unsurmountable endeavor. Nevertheless, it is possible and worthwhile. In this chapter, I describe my approach to research, mainly from an epidemiological perspective. This means, registries are the basis of my research, and I am asking clinically relevant questions that may be answered, analyzing registry data. Furthermore, I am describing my research pathway using accessible high-quality registries, like SEER, as well as analyses of registries I was involved in.
The Challenge of Our Lifetime
Authors: Aichbauer Stefan , Buchhauser Martina , Erben Agnes , Steinert Sven , Tietze Detlef , Wiking Emilia
Published: June 2022

Climate change is a real and ever-present danger to the world we know. It is an imperfect world, where profits and quick turnarounds have been favored above basic human rights, and where exploitation of natural resources takes place on a massive scale with too little regard for the long-term consequences.
Set Category Work and Suppliers in Motion
Authors: Aichbauer Stefan , Buchhauser Martina , Erben Agnes , Steinert Sven , Tietze Detlef , Wiking Emilia
Published: June 2022

Suppliers are the most powerful alliance there is. Once there has been a category assessment within the supply base, it will be clear where action is required first. Then make use of one of the many sustainability tools available to cover the basics of sustainability.
Create a Movement and Drive Transformation
Authors: Aichbauer Stefan , Buchhauser Martina , Erben Agnes , Steinert Sven , Tietze Detlef , Wiking Emilia
Published: June 2022

There are only positive outcomes to effective leadership—companies headed by the right people attract and maintain talent; they futureproof themselves and their companies against sustainability-related legislation; they are more favorable options for investors; and finally, mindful customers prefer to do business with them. All gain, no pain.
Outlook 2030 and Conclusion
Authors: Aichbauer Stefan , Buchhauser Martina , Erben Agnes , Steinert Sven , Tietze Detlef , Wiking Emilia
Published: June 2022

As we said in Sect. 10.1007/978-3-030-98640-7_1#Sec1, it is time to change the way we treat the planet and all its ecosystems. It is time to change the way some people are abused for the sake of lowering the cost of consumer goods. It is time to change the way we live, time to change the way we do business, and time to put sustainability on top of the agenda when making supply chain and procurement decisions. The world in 2030 should be a cleaner, more equitable place than it is now. This will be the case if the highly informed insights from the pioneering sustainability leaders featured above and throughout this book come true.
Introduction
Authors: Golding Brian
Published: June 2022

We outline the objectives of the book, setting them in the context of disaster risk management in a changing world and introducing the role of warnings in mitigating weather-related disasters. We describe the warning value chain, linking the needs of the decision-maker with forecasting capability; identify the blockages where information is lost, which we call the “valleys of death”; and introduce partnership as the core theme of the book. We then summarise the structure of the book and of each chapter, concluding by emphasising the importance of having a governance framework to monitor performance, inform troubleshooting and determine investment.
Connecting Warning with Decision and Action: A Partnership of Communicators and Users
Authors: Scolobig Anna , Potter Sally , Kox Thomas , Kaltenberger Rainer , Weyrich Philippe , Chasco Julia , Golding Brian , Hilderbrand Douglas , Fleischhut Nadine , Uprety Dharam , Rana Bikram
Published: June 2022

In this chapter, we explore the challenges of achieving a level of awareness of disaster risk, by each person or organisation receiving a warning, which allows them to take actions to reduce potential impacts while being consistent with the warning producer’s capabilities and cost-effectiveness considerations. Firstly we show how people respond to warnings and how the nature and delivery of the warning affects their response. We look at the aims of the person providing the warning, the constraints within which they must act and the judgement process behind the issue of a warning. Then we address the delivery of the warning, noting that warning messages need to be tailored to different groups of receivers, and see how a partnership between warner and warned can produce a more effective result. We include illustrative examples of co-design of warning systems in Argentina and Nepal, experience in communicating uncertainty in Germany and the Weather-Ready Nation initiative in the USA. We conclude with a summary of aspects of the warning that need to be considered between warner and decision-maker when designing or upgrading a warning system.
Connecting Weather and Hazard: A Partnership of Physical Scientists in Connected Disciplines
Authors: Golding Brian , Sun Jenny , Riemer Michael , Yussouf Nusrat , Titley Helen , Robbins Joanne , Ebert Beth , Pagano Tom , Lewis Huw , Dashwood Claire , Boyce Graeme , Peace Mika
Published: June 2022

Achieving consistency in the prediction of the atmosphere and related environmental hazards requires careful design of forecasting systems. In this chapter, we identify the benefits of seamless approaches to hazard prediction and the challenges of achieving them in a multi-institution situation. We see that different modelling structures are adopted in different disciplines and that these often relate to the user requirements for those hazards. We then explore the abilities of weather prediction to meet the requirements of these different disciplines. We find that differences in requirement and language can be major challenges to seamless data processing and look at some ways in which these can be resolved. We conclude with examples of partnerships in flood forecasting in the UK and wildfire forecasting in Australia.
Pulling It All Together, End-to-End
Authors: Golding Brian
Published: June 2022

In this concluding chapter, we emphasise the performance of the whole chain. We look at fire warnings as an effective system to see what we can learn from them. We see that each step in the chain is important but that the bridges are at least as important as each of the steps. Partnership is key to the effectiveness of each bridge and is also crucial for the overall chain. Understanding the way in which value propagates up and down the chain can enable improvements to be targeted in the most beneficial places. We conclude with a summary of some attributes of the “perfect” warning chain.
Mitofusins: from mitochondria to fertility
Authors: Zhao Shanjiang , Heng Nuo , Wang Huan , Wang Haoyu , Zhang Haobo , Gong Jianfei , Hu Zhihui , Zhu Huabin
Published: June 2022

Germ cell formation and embryonic development require ATP synthesized by mitochondria. The dynamic system of the mitochondria, and in particular, the fusion of mitochondria, are essential for the generation of energy. Mitofusin1 and mitofusin2, the homologues of Fuzzy onions in yeast and Drosophila, are critical regulators of mitochondrial fusion in mammalian cells. Since their discovery mitofusins (Mfns) have been the source of significant interest as key influencers of mitochondrial dynamics, including membrane fusion, mitochondrial distribution, and the interaction with other organelles. Emerging evidence has revealed significant insight into the role of Mfns in germ cell formation and embryonic development, as well as the high incidence of reproductive diseases such as asthenospermia, polycystic ovary syndrome, and gestational diabetes mellitus. Here, we describe the key mechanisms of Mfns in mitochondrial dynamics, focusing particularly on the role of Mfns in the regulation of mammalian fertility, including spermatogenesis, oocyte maturation, and embryonic development. We also highlight the role of Mfns in certain diseases associated with the reproductive system and their potential as therapeutic targets.
Historical and current perspectives on blood endothelial cell heterogeneity in the brain
Authors: Matsuoka Ryota L. , Buck Luke D. , Vajrala Keerti P. , Quick Rachael E. , Card Olivia A.
Published: June 2022

Dynamic brain activity requires timely communications between the brain parenchyma and circulating blood. Brain–blood communication is facilitated by intricate networks of brain vasculature, which display striking heterogeneity in structure and function. This vascular cell heterogeneity in the brain is fundamental to mediating diverse brain functions and has long been recognized. However, the molecular basis of this biological phenomenon has only recently begun to be elucidated. Over the past century, various animal species and in vitro systems have contributed to the accumulation of our fundamental and phylogenetic knowledge about brain vasculature, collectively advancing this research field. Historically, dye tracer and microscopic observations have provided valuable insights into the anatomical and functional properties of vasculature across the brain, and these techniques remain an important approach. Additionally, recent advances in molecular genetics and omics technologies have revealed significant molecular heterogeneity within brain endothelial and perivascular cell types. The combination of these conventional and modern approaches has enabled us to identify phenotypic differences between healthy and abnormal conditions at the single-cell level. Accordingly, our understanding of brain vascular cell states during physiological, pathological, and aging processes has rapidly expanded. In this review, we summarize major historical advances and current knowledge on blood endothelial cell heterogeneity in the brain, and discuss important unsolved questions in the field.
Level Repulsion for Arithmetic Toral Point Scatterers in Dimension 3
Authors: Kurlberg Pär
Published: June 2022

We show that arithmetic toral point scatterers in dimension three (“Šeba billiards on $${\mathbb R}^3/{\mathbb Z}^3$$

R

3

/

Z

3

”) exhibit strong level repulsion between the set of “new” eigenvalues. More precisely, let $$\Lambda := \{ \lambda _{1}< \lambda _{2} < \ldots \}$$

Λ
:
=
{

λ
1

<

λ
2

<
…
}

denote the unfolded set of new eigenvalues. Then, given any $$\gamma >0$$

γ
>
0

, $$\begin{aligned} \frac{|\{ i \le N : \lambda _{i+1}-\lambda _{i} \le \epsilon \}|}{N} = O_{\gamma }(\epsilon ^{4-\gamma }) \end{aligned}$$

|
{
i
≤
N
:

λ

i
+
1

-

λ
i

≤
ϵ
}
|

N

=

O
γ

(

ϵ

4
-
γ

)

as $$N \rightarrow \infty $$

N
→
∞

(and $$\epsilon >0$$

ϵ
>
0

small.) To the best of our knowledge, this is the first mathematically rigorous demonstration of a level repulsion phenomena for the quantization of a deterministic system.
Die neuen Reanimationsleitlinien 2021 und der hohe Stellenwert der Laienreanimation
Authors: Horriar Lina , Rott Nadine , Böttiger Bernd W.
Published: June 2022

Die Wiederbelebung durch Laien ist eine der wichtigsten Maßnahmen, um die Überlebensrate von Patientinnen und Patienten nach außerklinischem Herz-Kreislauf-Stillstand zu erhöhen. Während in anderen europäischen Ländern, vor allem in Skandinavien, Laienreanimationsquoten von über 80 % erreicht werden, liegt die Quote in Deutschland nur bei rund 40 %. Die vom European Resuscitation Council aktualisierten Reanimationsleitlinien 2021 messen den lebensrettenden Systemen eine zentrale Bedeutung bei und legen dabei einen Fokus auf die Wiederbelebung durch Laien. Die lebensrettenden Systeme betonen das Zusammenspiel zwischen allen an der Überlebenskette beteiligten Akteurinnen und Akteuren. So wird auch die Verbindung von Rettungsdienst und der Allgemeinbevölkerung konkretisiert.

Angelehnt an die BIG-FIVE-Überlebensstrategien nach Herz-Kreislauf-Stillstand werden 5 zentrale Strategien erläutert, mit denen die größte Verbesserung des Überlebens erreicht werden kann. Darunter fallen 1) die Erhöhung der Laienreanimationsquote durch Kampagnen und die schulische Ausbildung in Wiederbelebung KIDS SAVE LIVES, 2) die Implementierung der Telefonreanimation in Leitstellen, 3) Ersthelfersysteme, 4) die flächendeckende Advanced-Life-Support-Versorgung und 5) spezialisierte Kliniken, sogenannte Cardiac Arrest Centers, nach Herz-Kreislauf-Stillstand.
Efficacy and safety of systemic, high-dose glucocorticoid therapy for idiopathic sudden sensorineural hearing loss
Authors: Plontke Stefan K. , Girndt Matthias , Meisner Christoph , Böselt Iris , Ludwig-Kraus Beatrice , Richter Michael , Rahne Torsten
Published: June 2022

Background

Systemic glucocorticosteroids (“steroids”) are widely used worldwide as a standard of care for primary therapy of idiopathic sudden sensorineural hearing loss (ISSHL). The German ISSHL guideline recommends high-dose steroids without evidence from randomized controlled trials (RCTs) and refers solely to retrospective cohort studies. This RCT aims to assess the efficacy (improvement in hearing) and safety (especially systemic side effects) of high-dose steroids versus standard of care (standard dose systemic steroids) for the treatment of unilateral ISSHL, when given as a primary therapy.

Methods

The study is designed as a multicenter (approximately 40 centers), randomized, triple-blind, three-armed, parallel group, clinical trial with 312 adult patients. The interventions consist of 5 days of 250 mg/day intravenous prednisolone (intervention 1) + oral placebo, or 5 days of 40 mg/day oral dexamethasone (intervention 2) + intravenous placebo. The control intervention consists of 60 mg oral prednisolone for 5 days followed by five tapering doses + intravenous placebo. The primary efficacy endpoint is the change in hearing threshold in the three most affected contiguous frequencies between 0.25 and 8 kHz 1 month after ISSHL. Secondary endpoints include further measures of hearing improvement including speech audiometry, tinnitus, quality of life, blood pressure, and altered glucose tolerance.

Discussion

There is an unmet medical need for an effective medical therapy of ISSHL. Although sensorineural hearing impairment can be partially compensated by hearing aids or cochlear implants (CI), generic hearing is better than using hearing aids or CIs. Since adverse effects of a short course of high-dose systemic corticosteroids have not been documented with good evidence, the trial will improve knowledge on possible side effects in the different treatment arms with a focus on hyperglycemia and hypertension.

Trial registration

EudraCT (European Union Drug Regulating Authorities Clinical Trials Database) Nr. 2015-002602-36; Sponsor code: KKSH-127.
Fenestrierte und verzweigte endovaskuläre Aortenprothesen
Authors: Dachs Theresa-Marie , Hauck Sven Rudolf , Kern Maximilian , Klausenitz Catharina , Funovics Martin A.
Published: June 2022

Hintergrund

Komplexe abdominelle aortale Pathologien, welche die Abgänge der Viszeralarterien miterfassen und bei denen kein adäquater proximaler Hals gegeben ist, können heute mittels fortgeschrittener FEVAR/BEVAR-Technik („fenestrated/branched endovascular aneurysm repair“) mit ähnlicher Sicherheit und vergleichbaren Erfolgsraten behandelt werden wie infrarenale Pathologien mit konventionellem EVAR.

Methodische Innovationen und Probleme

Zur Versorgung der Viszeralarterien können Fenestrierungen (bei Abgang der Viszeralarterie aus der nichtdilatierten Aorta) oder Verzweigungen (bei Abgang aus der dilatierten Aorta) verwendet werden. Beide Arten von Öffnungen werden mit Verbindungsstentgrafts (VSG) zu den Viszeralarterien abgedichtet. Mehrere Hersteller bieten fenestrierte oder verzweigte Endoprothesen an, wobei diese nur in Einzelfällen CE-zertifiziert und überwiegend in Europa als individuelle Sonderanfertigungen patientenbezogen erhältlich sind. Dies setzt eine entsprechende Lieferzeit voraus, was die Behandlung akuter Patienten mit solchen Prothesen unmöglich macht. Es liegen allerdings zwei Produkte von vierfach verzweigten Endoprothesen vor, die einen größeren Bereich der anatomischen Gegebenheiten bei thorakoabdominellen Aneurysmen auch im Akutfall abdecken und behandelbar machen. Sämtliche FEVAR- und BEVAR-Hauptkörper benötigen VSG, die durchgehend von Fremdherstellern stammen und von denen gegenwärtig noch kein einziges Produkt für diese Anwendung zertifiziert ist.

Empfehlungen

Da Probleme an Verbindungsstentgrafts eine wesentliche Ursache für Reinterventionen sind, sollte in der Nachsorge Knickbildungen und Brüchen an diesen Verbindungsstents besonderes Augenmerk geschenkt und von der Verwendung einschichtiger Designs beim BEVAR abgesehen werden.
The Epidemiology of Major Trauma During the First Wave of COVID‐19 Movement Restriction Policies: A Systematic Review and Meta‐analysis of Observational Studies
Authors: Antonini Marcello , Hinwood Madeleine , Paolucci Francesco , Balogh Zsolt J.
Published: June 2022

Background

The objective of this systematic review is to investigate changes in the epidemiology of major trauma presentations during the implementation of movement restriction measures to manage the first wave of the SARS‐CoV‐2 (COVID‐19) pandemic.

Methods

A systematic search in six databases, as well as a search of grey literature was performed from January 2020 to August 2021. Estimates were pooled using random‐effects meta‐analysis. The certainty of evidence was rated according to the GRADE approach. The review is reported using both PRISMA guideline and the MOOSE checklist.

Results

In total, 35 studies involving 36,987 patients were included. The number of major trauma admissions overall decreased during social movement restrictions (−24%; p < 0.01; 95% CI [−0.31; −0.17]). A pooled analysis reported no evidence of a change in the severity of trauma admissions (OR:1.17; 95%CI [0.77, 1.79], I2 = 77%). There was no evidence for a change in mortality during the COVID‐19 period (OR:0.94, 95%CI [0.80,1.11], I2 = 53%). There was a statistically significant reduction in motor vehicle trauma (OR:0.70; 95%CI [0.61, 0.81], I2 = 91%) and a statistically significant increase in admissions due to firearms and gunshot wounds (OR:1.34; 95%CI [1.11, 1.61], I2 = 73%) and suicide attempts and self‐harm (OR:1.41; 95%CI [1.05, 1.89], I2 = 39%).

Conclusions and relevance

Although evidence continues to emerge, this systematic review reports some decrease in absolute major trauma volume with unchanged severity and mortality during the first wave of COVID‐19 movement restriction policies. Current evidence does not support the reallocation of highly specialised trauma professionals and trauma resources.

Registration PROSPERO ID CRD42020224827.
Evidence for trophic niche partitioning among three temperate gorgonian octocorals
Authors: Conti-Jerpe Inga E. , Pawlik Joseph R. , Finelli Christopher M.
Published: June 2022

Trophic niche theory predicts that species in competition for a limiting resource will evolve adaptations allowing them to consume alternative resources and occupy new niche space. Trophic niche partitioning is often identified by differences in the morphology of feeding structures across species; however, these differences may not always be readily observable. Due to their constrained polyp morphology, octocorals are often viewed a single functional group that contributes to benthic-pelagic coupling by feeding opportunistically on available particles. To test the hypothesis that sympatric gorgonians share the same trophic niche, feeding selectivity of three gorgonian species (Leptogorgia virgulata, Muricea pendula,andThesea nivea)was compared using a combination of flume experiments and stable isotope analysis. The tentacle length and polyp surface area ofL. virgulataandT. niveawere also measured and compared. In flume experiments, clearance of rotifers (“typical” zooplankton) and a mixture of cultured phytoplankton indicated thatL. virgulataandT. niveafed on zooplankton and not phytoplankton. Stable isotope values for all three species are consistent with distinct trophic niches, withM. pendulaoccupying a lower trophic level.Thesea niveawas found to have significantly larger polyp surface area and tentacle length; however, this did not appear to explain observed trophic differences. The results of this study provide evidence for niche partitioning, but future work is required to better understand the mechanism behind this divergence.
DBS emergency surgery for treatment of dystonic storm associated with rhabdomyolysis and acute colitis in DYT-GNAO1
Authors: Chaib Hind , Schoene-Bake Jan-Christoph , Saryyeva Assel , Jack Thomas , Hartmann Hans , Krauss Joachim K.
Published: June 2022

Introduction

Patients with variants in the GNAO1 gene may present with life-threatening dystonic storm. There is little experience using pallidal deep brain stimulation (DBS) as an emergency treatment in such cases.

Case description

We report on a 16-year-old girl with a variant in the GNAO1 gene (c.626G > T; p.(Arg209Leu)) who was admitted to the intensive care unit with medically refractory dystonic storm with secondary complications inducing rhabdomyolysis and acute colitis. Emergency pallidal DBS resulted in rapid improvement of dystonic storm and the subsidence of rhabdomyolysis and colitis. There were no further episodes of dystonic storm during follow-up of 2 years.

Conclusion

Pallidal DBS is a useful treatment option for GNAO1-related dystonic storm with secondary complications which can be performed as an emergency surgery.
Correlation between clinical severity and extent of autonomic cardiovascular impairment in the acute phase of subarachnoid hemorrhage
Authors: Borutta Matthias C. , Gerner Stefan T. , Moeser Philip , Hoelter Philip , Engelhorn Tobias , Doerfler Arnd , Huttner Hagen B. , Schwab Stefan , Kuramatsu Joji B. , Koehn Julia
Published: June 2022

Background and aim

To assess associations between clinical severity and possible dysfunction of autonomic cardiovascular modulation within the acute phase after spontaneous subarachnoid hemorrhage (SAH).

Methods

In this prospective observational study, in 51 patients with spontaneous SAH, Hunt-and-Hess scores (H&H) were assessed and cardiovascular autonomic modulation was monitored within 24 h after SAH-onset. From 5 min time-series of R–R-intervals (RRI) and blood-pressure (BP) recordings, we calculated autonomic parameters including time-domain [RRI-coefficient-of-variation (RRI-CV) and square-root-of-the-mean-squared-differences-of-successive-RRIs (RMSSD)] and frequency-domain parameters [low- and high-frequency-powers of RRI- and BP-modulation (RRI-LF-, RRI-HF-, SBP-LF-powers) and RRI-total-powers]. Data were compared to those of 20 healthy volunteers.

Results

RRI- and BP-values did not differ between groups. Yet, parameters of sympathetic (RRI-LF-powers 141.0 (18.9–402.4) ms2 vs 442.3 (246.8–921.2) ms2, p = 0.001) and total autonomic modulation (RRI-CV 2.4 (1.2–3.7) ms2 vs 3.7 (3.1–5.3) ms2, p = 0.001) were significantly lower in patients than in controls. Subgroup analyses (patients with H&H < 3 vs H&H ≥ 3) and Spearman-rank-correlations revealed increasing loss of sympathetic (RRI-LF-powers 338.6 (179.7–710.4) ms2 vs 72.1 (10.1–175.9) ms2, p = 0.001, rho = − 0.524) and total autonomic modulation (RRI-CV 3.5 (2.3–5.4) ms2 vs 1.6 (1.0–2.8) ms2, p < 0.001, rho = − 0.519) with higher H&H-scores. Multiple-logistic-regression underlined the significant influence of H&H-scores on sympathetic (RRI-LF-powers, p = 0.033) and total autonomic modulation (RRI-CV, p = 0.040) compared to possible confounders (e.g., age, intubation).

Conclusion

Within the acute phase, spontaneous SAH induces a decrease in sympathetic and total autonomic cardiovascular modulation. Higher H&H-scores were associated with increasing autonomic dysfunction and may therefore augment the risk of cardiovascular complications and poor clinical outcome.
COVID-19 exit strategy during vaccine implementation: a balance between social distancing and herd immunity
Authors: Daher-Nashif Suhad , Al-Anany Rania , Ali Menatalla , Erradi Khadija , Farag Elmoubasher , Abdallah Abdallah M. , Emara Mohamed M.
Published: June 2022

Currently, health authorities around the world are struggling to limit the spread of COVID-19. Since the beginning of the pandemic, social distancing has been the most important strategy used by most countries to control disease spread by flattening and elongating the epidemic curve. Another strategy, herd immunity, was also applied by some countries through relaxed control measures that allow the free spread of natural infection to build up solid immunity within the population. In 2021, COVID-19 vaccination was introduced with tremendous effort as a promising strategy for limiting the spread of disease. Therefore, in this review, we present the current knowledge about social distancing, herd immunity strategies, and aspects of their implementation to control the COVID-19 pandemic in the presence of the newly developed vaccines. Finally, we suggest a short-term option for controlling the pandemic during vaccine application.
A randomized controlled trial of remote microphone listening devices to treat auditory deficits in children with neurofibromatosis type 1
Authors: Rance Gary , Maier Alice , Zanin Julien , Haebich Kristina M. , North Kathryn N. , Orsini Francesca , Dabscheck Gabriel , Delatycki Martin B. , Payne Jonathan M.
Published: June 2022

Background

A high proportion of patients with neurofibromatosis type 1 (NF1) present with functional hearing deficiency as a result of neural abnormality in the late auditory brainstem.

Methods

In this randomized, two-period crossover study, we investigated the hypothesis that remote-microphone listening devices can ameliorate hearing and communication deficits in affected school-aged children (7–17 years). Speech perception ability in background noise was evaluated in device-active and inactive conditions using the CNC-word test. Participants were then randomized to one of two treatment sequences: (1) inactive device for two weeks (placebo), followed by active device use for two weeks, or (2) active device for 2 weeks, followed by inactive device for 2 weeks. Listening and communication ratings (LIFE-R Questionnaire) were obtained at baseline and at the end of each treatment phase.

Results

Each participant demonstrated functional hearing benefits with remote-microphone use. All showed a speech perception in noise increase when the device was activated with a mean phoneme-score difference of 16.4% (p < 0.001) and reported improved listening/communication abilities in the school classroom (mean difference: 23.4%; p = 0.017).

Discussion

Conventional hearing aids are typically ineffective as a treatment for auditory neural dysfunction, making sounds louder, but not clearer for affected individuals. In this study, we demonstrate that remote-microphone technologies are acceptable/tolerable in pediatric patients with NF1 and can ameliorate their hearing deficits.

Conclusion

Remote-microphone listening systems offer a viable treatment option for children with auditory deficits associated with NF1.
Proof, Semiotics, and the Computer: On the Relevance and Limitation of Thought Experiment in Mathematics
Authors: Lenhard Johannes
Published: June 2022

This contribution defends two claims. The first is about why thought experiments are so relevant and powerful in mathematics. Heuristics and proof are not strictly and, therefore, the relevance of thought experiments is not contained to heuristics. The main argument is based on a semiotic analysis of how mathematics works with signs. Seen in this way, formal symbols do not eliminate thought experiments (replacing them by something rigorous), but rather provide a new stage for them. The formal world resembles the empirical world in that it calls for exploration and offers surprises. This presents a major reason why thought experiments occur both in empirical sciences and in mathematics. The second claim is about a looming aporia that signals the limitation of thought experiments. This aporia arises when mathematical arguments cease to be fully accessible, thus violating a precondition for experimenting in thought. The contribution focuses on the work of Vladimir Voevodsky (1966–2017, Fields medalist in 2002) who argued that even very pure branches of mathematics cannot avoid inaccessibility of proof. Furthermore, he suggested that computer verification is a feasible path forward, but only if proof is not modeled in terms of formal logic.
Evapotranspiration in hydrological models under rising CO2: a jump into the unknown
Authors: Lemaitre-Basset Thibault , Oudin Ludovic , Thirel Guillaume
Published: June 2022

Many hydrological models use the concept of potential evapotranspiration (PE) to simulate actual evapotranspiration (AE). PE formulations often neglect the effect of carbon dioxide (CO2), which challenges their relevance in a context of climate change and rapid changes in CO2 atmospheric concentrations. In this work, we implement three options from the literature to take into account the effect of CO2 on stomatal resistance in the well-known Penman–Monteith PE formulation. We assess their impact on future runoff using the Budyko framework over France. On the basis of an ensemble of Euro-Cordex climate projections using the RCP 4.5 and RCP 8.5 scenarios, we show that taking into account CO2 in PE formulations largely reduces PE values but also limits projections of runoff decrease, especially under an emissive scenario, namely, the RCP 8.5, whereas the classic Penman–Monteith formulation yields decreasing runoff projections over most of France, taking into account CO2 yields more contrasting results. Runoff increase becomes likely in the north of France, which is an energy-limited area, with different levels of runoff response produced by the three tested formulations. The results highlight the sensitivity of hydrological projections to the processes represented in the PE formulation.
Sub-linear convergence of a stochastic proximal iteration method in Hilbert space
Authors: Eisenmann Monika , Stillfjord Tony , Williamson Måns
Published: June 2022

We consider a stochastic version of the proximal point algorithm for convex optimization problems posed on a Hilbert space. A typical application of this is supervised learning. While the method is not new, it has not been extensively analyzed in this form. Indeed, most related results are confined to the finite-dimensional setting, where error bounds could depend on the dimension of the space. On the other hand, the few existing results in the infinite-dimensional setting only prove very weak types of convergence, owing to weak assumptions on the problem. In particular, there are no results that show strong convergence with a rate. In this article, we bridge these two worlds by assuming more regularity of the optimization problem, which allows us to prove convergence with an (optimal) sub-linear rate also in an infinite-dimensional setting. In particular, we assume that the objective function is the expected value of a family of convex differentiable functions. While we require that the full objective function is strongly convex, we do not assume that its constituent parts are so. Further, we require that the gradient satisfies a weak local Lipschitz continuity property, where the Lipschitz constant may grow polynomially given certain guarantees on the variance and higher moments near the minimum. We illustrate these results by discretizing a concrete infinite-dimensional classification problem with varying degrees of accuracy.
The synergetic effect of pulp chamber extension depth and occlusal thickness on stress distribution of molar endocrowns: a 3-dimensional finite element analysis
Authors: Zhang Yuejiao , Lai Hongbin , Meng Qingzhen , Gong Qimei , Tong Zhongchun
Published: June 2022

The aim of this study was to evaluate the effects of butt margin, occlusal thickness and pulp chamber extension depth on stress distributions on mandibular molar endodontically treated teeth (ETT) with EMAX endocrown restoration using 3-dimensional finite element analysis (FEA). The FEA models of endocrown with flat surface or curve surface of butt margin were firstly evaluated stress distributions, and then 9 FEA models of endocrown with 1-, 2- or 3-mm pulp chamber extension depth and 1-, 2- or 3-mm occlusal thickness were generated using curve surface of butt margin. In all of FEA models, a 200 N of vertical load or horizontal load was applied, and the von Mises stress (VMS) were evaluated. The results showed that curve surface of butt margin offered more adhesive area of enamel, though VMS on the prepared teeth was similar in flat surface and curve surface models. In 9 endocrown models, 2-mm occlusal thickness showed the lowest VMS on restorations, teeth tissue and root furcations, and 2-mm extension depth displayed the lowest VMS on root furcations under vertical load. Also, 2-mm extension depth exhibited the lowest VMS on restorations and teeth tissue under horizontal load. Within the limitations of this FEA study, the results of this study could be used as an aid for dentists to better devise endocrown restorations.
Quality of Life and Social and Psychological Outcomes in Adulthood Following Allogeneic HSCT in Childhood for Inborn Errors of Immunity
Authors: Nicholson Bethany , Goodman Rupert , Day James , Worth Austen , Carpenter Ben , Sandford Kit , Morris Emma C. , Burns Siobhan O. , Ridout Deborah , Titman Penny , Campbell Mari
Published: June 2022

Background

Hematopoietic stem cell transplant (HSCT) is well established as a corrective treatment for many inborn errors of immunity (IEIs) presenting in childhood. Due to improved techniques, more transplants are undertaken and patients are living longer. However, long-term complications can significantly affect future health and quality of life. Previous research has focused on short-term medical outcomes and little is known about health or psychosocial outcomes in adulthood.

Objective

This project aimed to ascertain the long-term social and psychological outcomes for adults who underwent HSCT for IEI during childhood.

Methods

Adult patients, who had all undergone HSCT for IEI during childhood at two specialist immunology services at least 5 years previously, were invited to participate in the study. Questionnaires and practical tasks assessed their current functioning and circumstances. Information was also gathered from medical notes. Data was compared with population norms and a control group of participant-nominated siblings or friends.

Results

Eighty-three patients and 46 matched controls participated in the study. Patients reported significantly better physical health-related quality of life than the general population norm, but significantly worse than matched controls. Patient’s self-reported physical health status and the perceived impact of their physical health on everyday life were worse than matched controls and patients reported higher levels of anxiety and lower mood than the general population. For those where their IEI diagnosis was not associated with a learning disability, cognitive function was generally within the normal range.

Conclusions

Patients who have had a HSCT in childhood report mixed psychosocial outcomes in adulthood. More research is needed to establish screening protocols and targeted interventions to maximize holistic outcomes.

Clinical Implications

Screening for holistic needs and common mental health difficulties should be part of routine follow-up. Information should be provided to patients and families in order to support decision-making regarding progression to transplant and the early identification of any difficulties.