bluuebunny/crossref_metadata_2025 huggingface dataset:
Diaspora Policies, Consular Services and Social Protection for Polish Citizens Abroad
Authors: Lesińska Magdalena , Wróbel Izabela
Published: October 2020

This chapter is devoted to case of Polish diaspora and current diaspora policies and social protection of Poles abroad. The first part presents the general overview of Polish diaspora and its diversification. The second part describes the institutional framework, general strategy and concrete activities the Polish state offers its citizens and persons of Polish origin residing abroad, such as voting rights, repatriation and return, and education. The main part of the chapter focuses on diaspora policies and social protection activities in five areas: unemployment, health care, pensions, family benefits and guaranteed minimum resources. Overall, we show that the main goal of Polish diaspora policies is to consolidate the diversified and dispersed Polish communities abroad and strengthen the cultural links with the country of origin. The priority of diaspora policies is thus to maintain national identity and promotion of Polish language and culture among Poles residing in other countries.
Diaspora Policies, Consular Services and Social Protection for Slovenian Citizens Abroad
Authors: Vah Jevšnik Mojca , Cukut Krilić Sanja
Published: October 2020

This chapter explores the type and scope of Slovenian diaspora engagement policies with a focus on social protection. It shows that Slovenia’s engagement with its diaspora is mostly of political and cultural nature and primarily aims at preserving and strengthening Slovenian identity, heritage, language and culture, while less effort has been attributed to developing policies, programmes and tools to reduce exposure to social risks of its nationals abroad. This can be explained by the post-socialist nation-building process, as well as the structure of the social protection system, which is based on compulsory social insurance contributions and linked to employment in the Republic of Slovenia as the main basis for benefit entitlement. The chapter first explores the main characteristics of the Slovenian diaspora and wider institutional framework by which authorities in Slovenia engage with nationals abroad. It then reviews key engagement policies in the areas of unemployment, health, pensions, family-related benefits and economic hardship.
Diaspora Policies, Consular Services and Social Protection for Spanish Citizens Abroad
Authors: Palop-García Pau
Published: October 2020

This chapter outlines the social protection policies that Spain has adopted to target Spanish nationals abroad. First, it describes the diaspora infrastructure and the key engagement policies developed in the last years by Spain. Subsequently, the chapter focuses on five social protection policies: unemployment, health care, pensions, family-related benefits, and economic hardship. The findings reveal that Spain has adopted a diaspora strategy that targets different emigrant groups such as exiles of the Civil War and early Francoism and their descendants, Spaniards that emigrated to other European countries during the 1950s and 1960s, and new emigrants that left the country due to the consequences of the financial crisis of 2008. Findings also show that, although Spain has developed a wide array of services to target its diverse diaspora, it still lacks a comprehensive scheme of social protection abroad. Moreover, the results suggest that Spain has adopted a subsidiary social policy strategy abroad that is triggered when the social protection offered by states of reception is lacking.
Diaspora Policies, Consular Services and Social Protection for Croatian Citizens Abroad
Authors: Winland Daphne
Published: October 2020

This chapter examines the Croatian Government’s policies for Croats abroad with a focus on social protection. The history of Croatian diaspora-homeland engagement over a century culminating in the establishment of the independent state of Croatia in 1991, informs the prioritization of Croats abroad in the social policy landscape. In addition to outlining the diaspora and consular infrastructures, culture and education policies, the protection of Croats abroad in the areas of health, employment, pensions and family-related benefits is reviewed. The findings of this analysis reveal that while the Croatian government continues to profess its commitment to providing a comprehensive program of social protection for Croats abroad, policies guaranteeing substantive social protection are mainly found in those (primarily post-Yugoslav) states where Croatia has negotiated bilateral agreements for Croats identified as a minority. The provision of protection for Croats abroad in general therefore falls somewhat short in so far as a robust, concrete set of measures are concerned.
Infrastructure: Rules, Walls, Obstacles and Opportunities
Authors: Hilton Claire
Published: October 2020

This chapter discusses the organisational underpinning of the asylums during the war. The Board of Control oversaw the asylums but could neither enforce best practice nor prevent low standards. Local tiers of management ran the asylums day-to-day. Government, professionals and public influenced asylum management, but patients’ voices were barely audible or credible. The system prioritised obeying rules and stifled innovation. Twenty-four asylums (23,000 beds), one quarter of the total, were vacated for military purposes. Widespread negativity about mental disorders and their treatment discouraged expenditure on anything other than the cheapest custodial regimes. People who attempted to make improvements faced many hurdles.
Certified Insane: Concepts and Practices
Authors: Hilton Claire
Published: October 2020

This chapter explores psychiatric concepts and clinical issues relating to patients in the asylums, including classification of disorders; research; nature and nurture hypotheses; and treatment and convalescence. From medical and legal standpoints, definitions of insanity were vague, subjective and their value debated. Physical illness and mental disturbances overlapped and there was little consensus on the relative contributions of heredity, brain disease, psycho-social, spiritual and other non-medical factors to causing mental disorders. Treatment became more custodial, often relying on sedative medications, restraint and seclusion. Individually focussed treatment was an ideal but hard to implement in large impersonal, overcrowded and inadequately staffed asylums. Particularly during the war, the asylums lost the precious commodity of staff time to build therapeutic relationships and provide psycho-social treatments to assist recovery and manage the most disturbed patients humanely.
Personnel: Staffing the Asylums and Serving the Colours
Authors: Hilton Claire
Published: October 2020

A vast staff served the asylums: doctors, nurses, attendants, artisans, clergy, kitchen and laundry workers, and other who maintained buildings, farm, gardens and cemetery. Ward work was particularly demanding, with long hours, and poor conditions of employment. A regimented and punitive culture and distrust between management and lower ranks of staff, contributed to “a general feeling of insecurity” among them. They had high rates of sickness and a high turnover, sometimes over 75 per cent annually, resulting in an inexperienced workforce. The asylum leadership contributed to creating a dysfunctional system in which the patients, whom the asylum was meant to serve, were far from central to it.
Food, Farm and Fuel: An Inequitable Supply Chain
Authors: Hilton Claire
Published: October 2020

Within days of war breaking out, the country faced extraordinary chaos in the food market. Many foods considered nutritious, such as meat, were prioritised for the soldiers. The large contracts for food required by the asylums became particularly vulnerable, with food diverted into military supplies. Within the asylums, food and fuel distribution was also inequitable, depending more on status than on health need. Alongside asylum managers’ goals of lowest possible expenditure, they often had little grasp of emerging nutritional science, a potentially disastrous combination. In 1919, the Times concluded: “Have we been sending some of our lunatics into the Army and starving the others?” It called for the Board of Control to account.
Derivation of a Cell-Based Mathematical Model of Excitable Cells
Authors: Jæger Karoline Horgmo , Tveito Aslak
Published: October 2020

Excitable cells are of vital importance in biology, and mathematical models have contributed significantly to understand their basic mechanisms. However, classical models of excitable cells are based on severe assumptions that may limit the accuracy of the simulation results. Here, we derive a more detailed approach to modeling that has recently been applied to study the electrical properties of both neurons and cardiomyocytes. The model is derived from first principles and opens up possibilities for studying detailed properties of excitable cells.We refer to the model as the EMI model because both the extracellular space (E), the cell membrane (M) and the intracellular space (I) are explicitly represented in the model, in contrast to classical spatial models of excitable cells. Later chapters of the present text will focus on numerical methods and software for solving the model. Also, in the next chapter, the model will be extended to account for ionic concentrations in the intracellular and extracellular spaces.
A Cell-Based Model for Ionic Electrodiffusion in Excitable Tissue
Authors: Ellingsrud Ada J. , Daversin-Catty Cécile , Rognes Marie E.
Published: October 2020

This chapter presents theKNP-EMImodel describing ion concentrations and electrodiffusion in excitable tissue. TheKNP-EMImodel extends on theEMImodel by removing the assumption that ion concentrations are constant in time and space, and may as such be more appropriate in connection with modelling e.g. spreading depression, stroke and epilepsy. TheKNP-EMImodel defines a system of time-dependent, nonlinear, mixed dimensional partial differential equations. We here detail the derivation of the system and present a numerical example illustrating how ion concentrations evolve during neuronal activity.
Operator Splitting and Finite Difference Schemes for Solving the EMI Model
Authors: Jæger Karoline Horgmo , Hustad Kristian Gregorius , Cai Xing , Tveito Aslak
Published: October 2020

We want to be able to perform accurate simulations of a large number of cardiac cells based on mathematical models where each individual cell is represented in the model. This implies that the computational mesh has to have a typical resolution of a fewµm leading to huge computational challenges. In this paper we use a certain operator splitting of the coupled equations and showthat this leads to systems that can be solved in parallel. This opens up for the possibility of simulating large numbers of coupled cardiac cells.
Introduction
Authors: Amelung Nina , Granja Rafaela , Machado Helena
Published: October 2020

This introductory chapter sets out the key themes and arguments of the book and provides a road map for the remaining chapters. It outlines the book’s ambition to contribute to the sociological and criminological literature on technological infrastructures, borders and specific visions of Europe by portraying what we call the biobordering processes at work in the EU. Relying on what Misa and Schot, reflecting on technological infrastructures, have called the ‘hidden integration’ and ‘hidden fragmentation’ of Europe, the transnational exchange of forensic DNA data organized through the Prüm system serves as an exemplary case through which to explore the different logics of biobordering dynamics at work across the European Union. We complement an EU-level analysis with country case analysis of modes of biobordering that emphasize the legal, scientific, technical, political and ethical dimensions related to the governance and uses of biometric technologies both at a national level and in a transnational collaboration.
A Brief History of the Evolution of Biometrics and Biometric Database Systems Crossing Borders in EU Law Enforcement
Authors: Amelung Nina , Granja Rafaela , Machado Helena
Published: October 2020

This chapter provides an outline of the historical evolution of biometric databases in the European Union and explores how these developments reconfigure notions of borders within this region of the world. This sets the scene for understanding how the melange of biometrical technologies and digitization has reconfigured how we think about the mobility of people, how modes of surveillance relate to human rights and ethical issues, and what modes of regulation are being enforced. This brief historical summary covers the evolution of a range of diverse biometric technologies and database systems and their use in the context of migration control and law enforcement. Furthermore, the chapter contextualizes why the Prüm system, a decentralized database system designed to facilitate the mandatory exchange of forensic DNA data amongst EU Member States to control criminality and terrorism, is of relevance to the concept of bioborders.
Biobordering as a Concept
Authors: Amelung Nina , Granja Rafaela , Machado Helena
Published: October 2020

This chapter introduces the concept of ‘biobordering’. Taking the nationally grown crime control regimes into account, we argue that the proposed concept of bioborders is useful in capturing how the territorial foundations of national state autonomy are partially reclaimed (what we call rebordering) and at the same time partially purposefully suspended (what we call debordering). The concept of biobordering is particularly fruitful for understanding how modes of bordering entangle with large-scale IT database infrastructures for the exchange of biometric data in the context of crime control. It highlights in particular the legal, scientific, technical, political and ethical dimensions of data exchange across borders across the EU. The chapter reviews recent insights from border studies and continues by outlining components and dynamics of biobordering that make bioborders more or less permeable for expansive biometric data exchange.
Germany
Authors: Amelung Nina , Granja Rafaela , Machado Helena
Published: October 2020

Germany’s DNA database was established in 1998 and grew into one of the mid-sized databases in the EU. Under the leadership of its Minister of the Interior, Germany was among the countries that drove the creation of the Prüm system and was among the first signatories of the Prüm Treaty in 2005. The 2007 German Presidency of the EU, along with the European Commission, also pushed for the integration of the Convention of Prüm into an EU legal framework. In terms of bordering practices, the German situation serves to illustrate an expansive and diffusive mode of debordering. This expansiveness is documented by the country’s early involvement and comprehensive establishment of data exchange with most of the countries in the system; this diffusive character is illustrated by the string-pulling practices employed by Germany, and some other Member States’ governments, to influence transnational police collaboration in the EU.
The Netherlands
Authors: Amelung Nina , Granja Rafaela , Machado Helena
Published: October 2020

The Netherlands’ DNA database was legally established in 1994 and became operational in 1997. It represents one of the mid-sized databases in the EU. The Netherlands has a track record of ‘innovation’ regarding the regulation and practical application of genetic technologies for forensic purposes. The Netherlands was involved with the Prüm regime from its beginnings in 2005. In terms of bordering practices, the country serves as an exemplary case of an expansive and diffusive mode of debordering. This positioning derives from the fact that the Netherlands has been a front-runner in building and implementing the technical framework for Prüm in its most expansive form; it is currently one of the most active countries in the Prüm regime. In addition, the Netherlands has also proactively trained other Member States, guiding them towards effective implementation and thus diffusing the expansive mode of debordering.
Portugal
Authors: Amelung Nina , Granja Rafaela , Machado Helena
Published: October 2020

The Portuguese DNA database was established in 2008 and is one of the smallest DNA databases in the EU. Portugal has one of the most restrictive regulatory frameworks in the EU in relation to the criteria for the entry and deletion of DNA profiles. The country started connecting with the Prüm system’s genetic data exchange in 2015. In terms of bordering practices, Portugal serves as an example of latent rebordering dynamics. This is because the requirements of the EU regulations regarding Prüm have been fully implemented in Portugal in terms of techno-scientific and operational infrastructures, yet Portugal simultaneously severely restricts access to biometric data. This situation derives from particularities of Portugal’s national policy regulations on data protection and its judicial traditions as well as regulations on ethical oversight.
Large-x resummation of off-diagonal deep-inelastic parton scattering from d-dimensional refactorization
Authors: Beneke Martin , Garny Mathias , Jaskiewicz Sebastian , Szafron Robert , Vernazza Leonardo , Wang Jian
Published: October 2020

Abstract

The off-diagonal parton-scattering channels g + γ* and q + ϕ* in deep-inelastic scattering are power-suppressed near threshold x → 1. We address the next-to-leading power (NLP) resummation of large double logarithms of 1 − x to all orders in the strong coupling, which are present even in the off-diagonal DGLAP splitting kernels. The appearance of divergent convolutions prevents the application of factorization methods known from leading power resummation. Employing d-dimensional consistency relations from requiring 1/ϵ pole cancellations in dimensional regularization between momentum regions, we show that the resummation of the off-diagonal parton-scattering channels at the leading logarithmic order can be bootstrapped from the recently conjectured exponentiation of NLP soft-quark Sudakov logarithms. In particular, we derive a result for the DGLAP kernel in terms of the series of Bernoulli numbers found previously by Vogt directly from algebraic all-order expressions. We identify the off-diagonal DGLAP splitting functions and soft-quark Sudakov logarithms as inherent two-scale quantities in the large-x limit. We use a refactorization of these scales and renormalization group methods inspired by soft-collinear effective theory to derive the conjectured soft-quark Sudakov exponentiation formula.
The light sgoldstino phenomenology: explanations for the muon (g − 2) deviation and KOTO anomaly
Authors: Liu Xuewen , Li Ying , Li Tianjun , Zhu Bin
Published: October 2020

Abstract

In this work, we study the long-standing experimental anomaly in muon (g −2) and also recent anomalous excess in $$ {K}_L\to {\pi}^0+v\overline{v} $$

K
L

→

π
0

+
v

v
¯

at the J-PARC KOTO experiment with sgoldstino. After supersymmetry breaking, the interactions between quarks and sgoldstino (s) make the decays K → π + s sizable through loop diagrams, which affects the measurements of decays K → π + invisible. Furthermore, the couplings between photons and sgoldstino contribute to ∆aμ as well as the bino-slepton contribution. With satisfying all known experimental constraints such as from NA62, E949, E137, Orsay, KTEV and CHARM experiments, these two anomalies can be explained simultaneously. The mass of CP-even sgoldstino is close to the neutral pion mass which does not violate the Grossman-Nir bound. The parameter space can be further tested in future NA62, DUNE experiments, as well as experiments in the LHC.
A Complete Asymptotic Expansion for Bernstein–Chlodovsky Polynomials for Functions on $$\mathbb {R}$$
Authors: Abel Ulrich , Karsli Harun
Published: October 2020

We consider a variant of the Bernstein–Chlodovsky polynomials approximating continuous functions on the entire real line and study its rate of convergence. The main result is a complete asymptotic expansion. As a special case we obtain a Voronovskaja-type formula previously derived by Karsli [11].
Mechanisms controlling bacterial infection in myeloid cells under hypoxic conditions
Authors: Hayek Inaya , Schatz Valentin , Bogdan Christian , Jantsch Jonathan , Lührmann Anja
Published: October 2020

Various factors of the tissue microenvironment such as the oxygen concentration influence the host–pathogen interaction. During the past decade, hypoxia-driven signaling via hypoxia-inducible factors (HIF) has emerged as an important factor that affects both the pathogen and the host. In this chapter, we will review the current knowledge of this complex interplay, with a particular emphasis given to the impact of hypoxia and HIF on the inflammatory and antimicrobial activity of myeloid cells, the bacterial responses to hypoxia and the containment of bacterial infections under oxygen-limited conditions. We will also summarize how low oxygen concentrations influence the metabolism of neutrophils, macrophages and dendritic cells. Finally, we will discuss the consequences of hypoxia and HIFα activation for the invading pathogen, with a focus onPseudomonas aeruginosa,Mycobacterium tuberculosis,Coxiella burnetii,Salmonella entericaandStaphylococcus aureus. This includes a description of the mechanisms and microbial factors, which the pathogens use to sense and react to hypoxic conditions.
Evolution of public beliefs about schizophrenia and attitudes towards those afflicted in Austria over two decades
Authors: Angermeyer Matthias C. , Grausgruber Alfred , Hackl Elisabeth , Moosbrugger Robert , Prandner Dimitri
Published: October 2020

Purpose

In the recent years, it was possible to observe two trends: First, there has been a trend to greater mental health literacy, in particular towards a biological model of schizophrenia. Secondly, an increase in public acceptance of professional help and psychiatric treatment has been observed in western countries. This indicates that the societal idea about mental illness and how it can be treated has changed. However, no changes or even changes to the worse occurred regarding the attitudes towards those suffering from the illness, particularly concerning schizophrenia. Thus, the question arises as to whether similar trends can also be found in Austria.

Methods

We use data from two representative population surveys in Austria, conducted 1998 (n = 1042) and 2018 (n = 1010) using face-to-face interviews, the same sampling procedure, interview mode, and interview schedule.

Results

The data show that today Austrians tend to opt less frequently for genetic factors and chronic stress as causes of schizophrenia than 20 years ago. There were only slight changes regarding intended first help-seeking actions except for a stronger endorsement of lay help. The believe in an effective treatment of schizophrenia has increased significantly and there was a marked trend towards preference of medication over psychotherapy. Social acceptance of people with schizophrenia has increased, but also the ascription of violence.

Conclusion

In summary, the evolution of attitudes and beliefs concerning schizophrenia in Austria shows a rather inconsistent pattern and differs to some extent from what has been observed in other western countries. This is important to know when planning awareness-raising or stigma-reducing initiatives.
Evolving evidence in the treatment of primary and recurrent posterior cruciate ligament injuries, part 2: surgical techniques, outcomes and rehabilitation
Authors: Winkler Philipp W. , Zsidai Bálint , Wagala Nyaluma N. , Hughes Jonathan D. , Horvath Alexandra , Senorski Eric Hamrin , Samuelsson Kristian , Musahl Volker
Published: October 2020

Isolated and combined posterior cruciate ligament (PCL) injuries are associated with severe limitations in daily, professional, and sports activities as well as with devastating long-term effects for the knee joint. As the number of primary and recurrent PCL injuries increases, so does the body of literature, with high-quality evidence evolving in recent years. However, the debate about the ideal treatment approach such as; operative vs. non-operative; single-bundle vs. double-bundle reconstruction; transtibial vs. tibial inlay technique, continues. Ultimately, the goal in the treatment of PCL injuries is restoring native knee kinematics and preventing residual posterior and combined rotatory knee laxity through an individualized approach. Certain demographic, anatomical, and surgical risk factors for failures in operative treatment have been identified. Failures after PCL reconstruction are increasing, confronting the treating surgeon with challenges including the need for revision PCL reconstruction. Part 2 of the evidence-based update on the management of primary and recurrent PCL injuries will summarize the outcomes of operative and non-operative treatment including indications, surgical techniques, complications, and risk factors for recurrent PCL deficiency. This paper aims to support surgeons in decision-making for the treatment of PCL injuries by systematically evaluating underlying risk factors, thus preventing postoperative complications and recurrent knee laxity.

Level of evidence

V.
Feasibility and diagnostic accuracy of using brain attenuation changes on CT to estimate time of ischemic stroke onset
Authors: Mair Grant , Alzahrani Awad , Lindley Richard I. , Sandercock Peter A. G. , Wardlaw Joanna M.
Published: October 2020

Purpose

CT attenuation of ischemic brain reduces with time after stroke onset. We aimed to quantify this relationship and test the feasibility and accuracy of estimating stroke onset time using only CT attenuation of visible ischemic lesions, the CT-Clock Tool.

Methods

We selected CT scans with ischemic lesions representing a range of stroke-onset-to-scan times (elapsed time) from a well-defined stroke trial. We measured the attenuation of ischemic lesions and contralateral normal brain to derive attenuation ratio. We assigned scans to development (75%) or test (25%) datasets. We plotted the relationship between attenuation ratio and elapsed time in the development dataset and derived a best-fit curve. We calculated estimated time in the test dataset using only the attenuation ratio curve. We compared estimated time to elapsed time and derived absolute error for estimated time. We assessed area under the receiver operating characteristic (AUROC) curve for identifying scans ≤ 4.5 h elapsed time.

Results

We included 342 scans from 200 patients (41% male, median age 83 years). Elapsed time range: 22 min to 36 days. Estimation errors were least at early elapsed times (r = 0.82, p < 0.0001): median absolute error was 23, 106, 1030 and 1933 min for scans acquired ≤ 3, > 3–9, > 9–30 and > 30 h from stroke onset, respectively. AUROC was high at 0.955.

Conclusions

It is feasible to accurately estimate stroke onset time using simple attenuation measures of ischemic brain. Our method was most accurate 0–9 h from onset and may be useful for treatment eligibility assessment, especially where imaging resources are limited.
MRI-guided breast biopsy based on diffusion-weighted imaging: a feasibility study
Authors: Montemezzi Stefania , Cardano Giuseppe , Storer Silvia , Cardobi Nicolò , Cavedon Carlo , Camera Lucia
Published: October 2020

Objectives

This study evaluated the feasibility of DWI for lesion targeting in MRI-guided breast biopsies. Furthermore, it assessed device positioning on DWI during biopsy procedures.

Methods

A total of 87 biopsy procedures (5/87 bilateral) consecutively performed between March 2019 and June 2020 were retrospectively reviewed: in these procedures, a preliminary DWI sequence (b = 1300 s/mm2) was acquired to assess lesion detectability. We included 64/87 procedures on lesions detectable at DWI; DWI sequences were added to the standard protocol to localize lesion and biopsy device and to assess the site marker correct positioning.

Results

Mass lesions ranged from 5 to 48 mm, with a mean size of 10.7 mm and a median size of 8 mm. Non-mass lesions ranged from 7 to 90 mm, with a mean size of 33.9 mm and a median size of 31 mm. Positioning of the coaxial system was confirmed on both T1-weighted and DWI sequences. At DWI, the biopsy needle was detectable in 62/64 (96.9%) cases; it was not visible in 2/64 (3.1%) cases. The site marker was always identified using T1-weighted imaging; a final DWI sequence was acquired in 44/64 cases (68.8%). In 42/44 cases (95.5%), the marker was recognizable at DWI.

Conclusions

DWI can be used as a cost-effective, highly reliable technique for targeting both mass and non-mass lesions, with a minimum size of 5 mm, detectable at pre-procedural DWI. DWI is also a feasible technique to localize the biopsy device and to confirm the deployment of the site marker.

Key Points

• MRI-guided breast biopsy is performed in referral centers by an expert dedicated staff, based on prior MR imaging; contrast agent administration is usually needed for lesion targeting.

• DWI represents a feasible, highly reliable technique for lesion targeting, avoiding contrast agent administration.

• DWI allows a precise localization of both biopsy needle device and site marker.
Reproducibility of left atrial function using cardiac magnetic resonance imaging
Authors: Alfuhied Aseel , Marrow Benjamin A. , Elfawal Sara , Gulsin Gaurav S. , Graham-Brown Mathew P. , Steadman Christopher D. , Kanagala Prathap , McCann Gerry P. , Singh Anvesha
Published: October 2020

Objectives

To determine the test-retest reproducibility and observer variability of CMR-derived LA function, using (i) LA strain (LAS) and strain rate (LASR), and (ii) LA volumes (LAV) and emptying fraction (LAEF).

Methods

Sixty participants with and without cardiovascular disease (aortic stenosis (AS) (n = 16), type 2 diabetes (T2D) (n = 28), end-stage renal disease on haemodialysis (n = 10) and healthy volunteers (n = 6)) underwent two separate CMR scans 7–14 days apart. LAS and LASR, corresponding to LA reservoir, conduit and contractile booster-pump function, were assessed using Feature Tracking software (QStrain v2.0). LAEF was calculated using the biplane area length method (QMass v8.1). Both were assessed using 4- and 2-chamber long-axis standard steady-state free precession cine images, and average values were calculated. Intra- and inter-observer variabilities were assessed in 10 randomly selected participants.

Results

The test-retest reproducibility was moderate to poor for all strain and strain rate parameters. Overall, strain and strain rate corresponding to reservoir phase (LAS_r, LASR_r) were the most reproducible, yielding the smallest coefficient of variance (CoV) (29.9% for LAS_r, 28.9% for LASR_r). The test-retest reproducibility for LAVs and LAEF was good: LAVmax CoV = 19.6% ICC = 0.89, LAVmin CoV = 27.0% ICC = 0.89 and total LAEF CoV = 15.6% ICC = 0.78. The inter- and intra-observer variabilities were good for all parameters except for conduit function.

Conclusion

The test-retest reproducibility of LA strain and strain rate assessment by CMR utilising Feature Tracking is moderate to poor across disease states, whereas LA volume and emptying fraction are more reproducible on CMR. Further improvements in LA strain quantification are needed before widespread clinical application.

Key Points

• LA strain and strain rate assessment using Feature Tracking on CMR has moderate to poor test-retest reproducibility across disease states.

• The test-retest reproducibility for the biplane method of assessing LA function is better than strain assessment, with lower coefficient of variances and narrower limits of agreement on Bland-Altman plots.

• Biplane LA volumetric measurement also has better intra- and inter-observer variability compared to strain assessment.
Frequency and risk factors for major complications after stereotactic radiofrequency ablation of liver tumors in 1235 ablation sessions: a 15-year experience
Authors: Schullian Peter , Johnston Edward , Laimer Gregor , Putzer Daniel , Eberle Gernot , Amann Arno , Effenberger Maria , Maglione Manuel , Freund Martin C. , Loizides Alexander , Bale Reto
Published: October 2020

Objectives

To assess the frequency of major complications after multi-probe stereotactic radiofrequency ablation (SRFA) in a large cohort of patients over 15 years and to elucidate risk factors for adverse events.

Materials and methods

A retrospective study was carried out between July 2003 and December 2018. Seven hundred ninety-three consecutive patients (median 65.0 years (0.3–88), 241 women and 552 men, were treated in 1235 SRFA sessions for 2475 primary and metastatic liver tumors with a median tumor size of 3.0 cm (0.5–18 cm). The frequency of major complications was evaluated according to SIR guidelines and putative predictors of adverse events analyzed using simple and multivariable logistic regression.

Results

Thirty-day mortality after SRFA was 0.5% (6/1235) with an overall major complication rate of 7.4% (91/1235). The major complication rate decreased from 11.5% (36/314) (before January 2011) to 6.0% (55/921) (p = 0.001). 50.5% (46/91) of major complications were successfully treated in the same anesthetic session by angiographic coiling for hemorrhage and chest tube insertion for pneumothorax. History of bile duct surgery/intervention, number of coaxial needles, and location of tumors in segment IVa or VIII were independent prognostic factors for major complications following multivariable logistic regression analysis. Simple logistic regression revealed the number of tumors, tumor size, location close to the diaphragm, tumor conglomerate, and segment VII as other significant predictors.

Conclusion

SRFA of liver tumors is safe and can extend the treatment spectrum of conventional RFA. Adaptations over time combined with increasing experience resulted in a significant decrease in complications.

Key Points

• In 1235 ablation sessions in 793 patients over 15 years, we found a mortality rate of 0.5% (6/1235) and an overall major complication rate of 7.4%, which fell from 11.5 (36/314) to 6.0% (55/921, p = 0.001) after January 2011, likely due to procedural adaptations.

• History of bile duct surgery/intervention (p = 0.013, OR = 3.290), number of coaxial needles (p = 0.026, OR = 1.052), and location of tumors in segment IVa (p = 0.016, OR = 1.989) or VIII (p = 0.038, OR = 1.635) were found to be independent prognostic factors.

• Simple logistic regression revealed that number of tumors, tumor size, location close to the diaphragm, tumor conglomerates, and segment VII were other significant predictors of major complications.
Association between dietary patterns and prediabetes, undetected diabetes or clinically diagnosed diabetes: results from the KORA FF4 study
Authors: Pestoni Giulia , Riedl Anna , Breuninger Taylor A. , Wawro Nina , Krieger Jean-Philippe , Meisinger Christa , Rathmann Wolfgang , Thorand Barbara , Harris Carla , Peters Annette , Rohrmann Sabine , Linseisen Jakob
Published: October 2020

Purpose

Diet is one of the most important modifiable risk factors for the development of type 2 diabetes. Here, we aim to identify dietary patterns and to investigate their association with prediabetes, undetected diabetes and prevalent diabetes.

Methods

The present study included 1305 participants of the cross-sectional population-based KORA FF4 study. Oral glucose tolerance test (OGTT) measurements together with a physician-confirmed diagnosis allowed for an accurate categorization of the participants according to their glucose tolerance status into normal glucose tolerance (n = 698), prediabetes (n = 459), undetected diabetes (n = 49), and prevalent diabetes (n = 99). Dietary patterns were identified through principal component analysis followed by hierarchical clustering. The association between dietary patterns and glucose tolerance status was investigated using multinomial logistic regression models.

Results

A Prudent pattern, characterized by high consumption of vegetables, fruits, wholegrains and dairy products, and a Western pattern, characterized by high consumption of red and processed meat, alcoholic beverages, refined grains and sugar-sweetened beverages, were identified. Participants following the Western pattern had significantly higher chances of having prediabetes (odds ratio [OR] 1.92; 95% confidence interval [CI] 1.35, 2.73), undetected diabetes (OR 10.12; 95% CI 4.19, 24.43) or prevalent diabetes (OR 3.51; 95% CI 1.85, 6.67), compared to participants following the Prudent pattern.

Conclusion

To our knowledge, the present study is one of the few investigating the association between dietary patterns and prediabetes or undetected diabetes. The use of a reference group exclusively including participants with normal glucose tolerance might explain the strong associations observed in our study. These results suggest a very important role of dietary habits in the prevention of prediabetes and type 2 diabetes.
Dynamics of sheared droplets filled with non-Brownian particles
Authors: Van Ammel Helene , Moldenaers Paula , Cardinaels Ruth
Published: October 2020

The dynamics of single droplets containing non-Brownian particles are studied. The particle over droplet size ratio (r/R) is changed by using different particle sizes (r/R = 0.02–0.4). Additionally, the effect of particle concentration (5–20 vol%) is investigated. The dynamics of droplets with r/R = 0.02 show good agreement with the corresponding particle-free reference system which has a comparable viscosity ratio. Hence, this droplet phase can be considered as a homogenous medium characterized by its bulk viscosity which is governed by the particle concentration. However, droplets with r/R ≥ 0.1 show a more suppressed deformation and slower transient dynamics and, therefore, behave as a slightly more viscous medium than expected based on their bulk viscosity. These effects become more pronounced at higher particle concentrations and higher r/R. Moreover, local particle effects like asymmetric droplet shapes, oscillating droplet shapes, and tip streaming start to influence the droplet dynamics at particle concentrations around 15 vol%.
Neurofilament light is a biomarker of brain involvement in lupus and primary Sjögren’s syndrome
Authors: Tjensvoll Anne B. , Lauvsnes Maria B. , Zetterberg Henrik , Kvaløy Jan T. , Kvivik Ingeborg , Maroni Stian S. , Greve Ole J. , Beyer Mona K. , Hirohata Shunsei , Putterman Chaim , Alves Guido , Harboe Erna , Blennow Kaj , Gøransson Lasse G. , Omdal Roald
Published: October 2020

Background

To test the hypothesis that neurofilament light (NfL) in CSF is a biomarker of CNS involvement in patients with systemic lupus erythematosus (SLE) and primary Sjögren’s syndrome (pSS), we measured NfL in CSF from 52 patients with lupus and 54 with pSS and explored associations with clinical, structural, immunological and biochemical abnormalities.

Methods

In CSF, we measured NfL, anti-P antibodies, protein S100B and TWEAK by ELISA and anti-NR2 antibodies by electrochemiluminescence. Anti-phospholipid antibodies and routine immunological tests were performed in blood. IgG and albumin were measured in CSF and serum for assessment of the blood–brain barrier function (Q-albumin) and intrathecal IgG production (IgG index). Cerebral MRI and neuropsychological testing were performed.

Results

A multivariable regression model showed that increasing CSF anti-NR2 antibody levels were associated with increasing NfL levels in patients with SLE (B 1.27, 95% CI 0.88–1.65, p < 0.001). Age contributed significantly in the model (B 0.04, 95% CI 0.03–0.05, p < 0.001). Similar findings were observed in the pSS group. Adjusted for age and sex, no associations were found between NfL levels and any MRI data. In SLE patients, higher NfL concentrations were associated with impairments in psychomotor speed and motor function, and in pSS with motor dysfunction. These associations remained in multivariable regression models.

Conclusions

Increased concentration of NfL in CSF is a marker of cerebral involvement in patients with SLE and pSS, is strongly associated with the presence of anti-NR2 antibodies, and correlates with cognitive impairment in several domains.
Physical activity and ability to meet different work requirements among adult working men with or without current depressive symptoms
Authors: Päivärinne Ville , Thodén Marie , Kautiainen Hannu , Arokoski Jari , Koponen Hannu , Heinonen Ari , Kiviranta Ilkka
Published: October 2020

Purpose

To examine the relationship between leisure-time physical activity (LTPA) and ability to meet different work requirements among adult working men with or without current depressive symptoms.

Methods

We measured LTPA with the long version of the International Physical Activity Questionnaire (IPAQ). The Work Ability Index (WAI) and Beck Depression Inventory (BDI) were used to assess the work ability and depression of 921 Finnish employed male volunteers. Participants were divided into three groups according to the WAI for their work requirements: mental (MENT), physical (PHYS), and an equal amount of mental and physical work (BTH).

Results

When adjusted for age, BMI and employment years, there was a significant difference in weekly LTPA between WAI groups {p = 0.003, [F (2902) = 5.58]}, but not for depression. It appeared that participants with depressive symptoms scored lower WAI in each group regardless of LTPA. In addition, a linear relationship was found between higher LTPA and WAI in nondepressed workers in the PHYS [p = 0.011, β = 0.10 (95% CI 0.03–0.18)] and BTH [p = 0.027, β = 0.19 (95% CI 0.03–0.34)] groups. Among workers with depressive symptoms, similar linearity was found in BTH [p = 0.003, β = 0.20 (95% CI 0.03–0.55)]. In group-wise comparison, work requirements {p = 0.001, [F (2902) = 11.2]} and depressive symptoms {p < 0.001, [F (1902) = 177.0]} related with lower WAI.

Conclusion

Depressive symptoms were associated with lower work ability regardless of the job description. Therefore, higher levels of weekly LTPA was linked with better work ability among nondepressed working men. Workers with depressive symptoms in jobs that require extensive mental or physical work might need more than exercise to improve work ability.
Effect of electrical stimulation therapy of the lower esophageal sphincter in GERD patients with ineffective esophageal motility
Authors: Paireder Matthias , Kristo Ivan , Asari Reza , Jomrich Gerd , Steindl Johannes , Rieder Erwin , Schoppmann Sebastian F.
Published: October 2020

Background

Electrical stimulation therapy (EST) of the lower esophageal sphincter (LES) is a novel technique in antireflux surgery. Due to the minimal alteration at the LES during surgery, LES-EST is meant to be ideal for patients with gastroesophageal reflux disease (GERD) and ineffective esophageal motility (IEM). The aim of this prospective trial (NCT03476265) is to evaluate health-related quality of life and esophageal acid exposure after LES-EST in patients with GERD and IEM.

Methods

This is a prospective non-randomized open-label study. Patients with GERD and IEM undergoing LES-EST were included. Follow-up (FUP) at 12 months after surgery included health-related quality of life (HRQL) assessment with standardized questionnaires (GERD-HRQL) and esophageal functional testing.

Results

According to the study protocol, 17 patients fulfilled eligibility criteria. HRQL score for heartburn and regurgitation improved from 21 (interquartile range (IQR) 15–27) to 7.5 (1.25–19), p = 0.001 and from 17 (11–23.5) to 4 (0–12), p = 0.003, respectively. There was neither significant improvement of esophageal acid exposure nor reduction of number of reflux events in pH impedance measurement. Distal contractile integral improved from 64 (11.5–301) to 115 (IQR 10–363) mmHg s cm, p = 0.249. None of the patients showed any sign of dysphagia after LES-EST. One patient needed re-do surgery and re-implantation of the LES-EST due to breaking of the lead after one year.

Conclusion

Although patient satisfaction improved significantly after surgery, this study fails to demonstrate normalization or significant improvement of acid exposure in the distal esophagus after LES-EST.
Family caregivers’ support needs during allo-HSCT—a longitudinal study
Authors: Kisch Annika M. , Bergkvist Karin , Alvariza Anette , Årestedt Kristofer , Winterling Jeanette
Published: October 2020

Purpose

The study aimed to explore family caregivers’ support needs prior to allo-HSCT, how these change over time and whether they are associated with demographic factors and caregiver outcome.

Methods

This longitudinal repeated measure study included 87 family caregivers of allo-HSCT recipients: 63% were partners, 74% women, 65% lived with the recipient, and their mean age was 54 years. They completed the 14-item Carer Support Needs Assessment Tool (CSNAT) and caregiver outcome measures (caregiver burden, anxiety, depression, preparedness for caregiving and general health) prior to allo-HSCT and 3, 6 and 16 weeks later.

Results

The two top support needs prior to allo-HSCT were ‘knowing what to expect in the future’ (79%) and ‘dealing with your own feelings’ (70%). Several support needs were associated with younger age and not being a partner, while higher needs implied worse caregiver outcomes for at least one of the outcomes prior to transplantation. Most support needs remained the same at the last follow-up.

Conclusion

The findings that high support needs are often associated with worse caregiver outcomes and most support needs do not diminish over time indicate that more attention should be placed on the situation of family caregivers.
Efficacy, safety, and perioperative outcomes of holmium laser enucleation of the prostate—a comparison of patients with lower urinary tract symptoms and urinary retention
Authors: Trotsenko Pawel , Wetterauer Christian , Grimsehl Philipp , Möltgen Tilmann , Meierhans Susan , Manka Lukas , Seifert Helge , Wyler Stephen , Kwiatkowski Maciej
Published: October 2020

Holmium laser enucleation of the prostate (HoLEP) is a valid treatment option to relieve bladder outlet obstruction in patients with large prostate volumes (PV). Its efficacy, tolerability, and safety are comparable to the ones of other laser treatments of the prostate and resection techniques. However, safety and efficacy of HoLEP have not been compared between patients with and without preoperative urinary retention. We included 350 patients (mean age 71.2 years) who had undergone HoLEP due to lower urinary tract symptoms (LUTS) or urinary retention caused by prostatic hyperplasia. We evaluated the differences in peri- and postoperative outcomes and complications between patients with and patients without preoperative urinary retention. The mean PV was 115 cm3. PV was > 100 cm3 in 61.9% and < 100 cm3 in 38.1% of the patients. Perioperative complications occurred in 23 patients (6.6%), 15 of which (4.3%) required operative revision. We found no significant differences in terms of complication rates between patients with PV > 100 cm3 and patients with PV < 100 cm3. Mean catheterization-duration was 3.3 days. Preoperatively, 140 patients (40%) had a suprapubic or transurethral indwelling catheter; they did not differ from patients without preoperative catheter regarding postoperative catheter removal success rate, early postoperative complications, and functional outcomes. Prostate cancer was diagnosed in 43 patients (12.3%). Median postoperative PSA-decline was 6.1 ug/l (89.8% drop). HoLEP is a safe and effective treatment for patients with LUTS or urinary retention and large PV. PV > 100 cm3 was not associated with higher complication rates or successful catheter-removal. Furthermore, functional outcomes were independent of preoperative catheterization.