bluuebunny/crossref_metadata_2025 huggingface dataset:
Using a quick timed‐up‐and‐go test to predict surgical risk
Authors: Boereboom Catherine L. , McGuinness Rachel B. , Herrod Philip J. J. , Blackwell James E. M. , Sian Tanvir S. , Boyd‐Carson Hannah , Williams John P. , Lund Jonathan N. , Phillips Bethan E.
Published: March 2021

Background

Cardiorespiratory fitness (CRF) has important implications for post‐operative recovery. The timed‐up‐and‐go (TUG) test is a cheap and simple method to assess a patient's functional performance; although how well TUG correlates with results of a cardiopulmonary exercise test (CPET), the gold standard measure of CRF is unknown. Therefore, the aim of this study was to assess the correlation between CPET‐derived parameters of CRF and TUG times in a group of older adults.

Methods

Ninety‐eight independent community dwelling older adults [mean age: 72 years (range: 61–86), mean body mass index: 26.3 ± 3.1 kg/m2, 54 male] were recruited to this study; completing 180 CPET and TUG testing sessions over a 28 month period. The correlation between CPET‐derived CRF parameters and TUG time was assessed, and receiver operating characteristic curve analysis was performed to determine clinically useful cut‐off points in TUG time.

Results

Median TUG time was 7.1 s [interquartile range (IQR): 4–8.5], median VO2 peak was 24.4 mL/kg/min (IQR: 20.2–29.2), and the median anaerobic threshold (AT) was 13.4 mL/kg/min (IQR: 8.6–16.5). There was a statistically significant negative correlation between TUG time and AT (r = −0.317, P = <0.0001) and TUG time and VO2 peak (r = −0.4247, P < 0.0001). Receiver operating characteristic curve analysis determined a TUG time of ≥6.5 s to have an 82% sensitivity and 60% specificity to detect an AT <11.0 mL/kg/min, the point at below which perioperative mortality is known to increase.

Conclusions

Despite strong evidence for the utility of pre‐operative CPET in stratifying surgical risk, CPET is not universally available. Our finding of a correlation between TUG time and CPET‐derived parameters of CRF (AT/VO2 peak) suggests that TUG may be a useful surrogate in the pre‐operative setting.
Neutralising antibody escape of SARS‐CoV‐2 spike protein: Risk assessment for antibody‐based Covid‐19 therapeutics and vaccines
Authors: Focosi Daniele , Maggi Fabrizio
Published: March 2021

The Spike protein is the target of both antibody‐based therapeutics (convalescent plasma, polyclonal serum, monoclonal antibodies) and vaccines. Mutations in Spike could affect efficacy of those treatments. Hence, monitoring of mutations is necessary to forecast and readapt the inventory of therapeutics. Different phylogenetic nomenclatures have been used for the currently circulating SARS‐CoV‐2 clades. The Spike protein has different hotspots of mutation and deletion, the most dangerous for immune escape being the ones within the receptor binding domain (RBD), such as K417N/T, N439K, L452R, Y453F, S477N, E484K, and N501Y. Convergent evolution has led to different combinations of mutations among different clades. In this review we focus on the main variants of concern, that is, the so‐called UK (B.1.1.7), South African (B.1.351) and Brazilian (P.1) strains.
A Bayesian approach for estimating age‐adjusted rates for low‐prevalence diseases over space and time
Authors: Jay Melissa , Oleson Jacob , Charlton Mary , Arab Ali
Published: March 2021

Age‐adjusted rates are frequently used by epidemiologists to compare disease incidence and mortality across populations. In small geographic regions, age‐adjusted rates computed directly from the data are subject to considerable variability and are generally unreliable. Therefore, we desire an approach that accounts for the excessive number of zero counts in disease mapping datasets, which are naturally present for low‐prevalence diseases and are further innated when stratifying by age group. Bayesian modeling approaches are naturally suited to employ spatial and temporal smoothing to produce more stable estimates of age‐adjusted rates for small areas. We propose a Bayesian hierarchical spatio‐temporal hurdle model for counts and demonstrate how age‐adjusted rates can be estimated from the hurdle model. We perform a simulation study to evaluate the performance of the proposed model vs a traditional Poisson model on datasets with varying characteristics. The approach is illustrated using two applications to cancer mortality at the county level.
Application of Delafossite AgFeO2 Nanoparticles as SERS Substrate and Antimicrobial Agent
Authors: Limaye Mukta V. , Pramanik Monidipa , Singh Shashi B. , Paik Gyan Ranjan , Singh Prabhat
Published: March 2021

We have used simple chemical route to synthesize delafossite silver ferrite (AgFeO2) nanoparticles (NPs). AgFeO2 NPs were utilized as Raman substrate for detection of Rhodamine 6G (R6G) molecules. AgFeO2 NPs substrate show excellent Surface‐enhanced Raman Scattering (SERS) activity, which enables ultrasensitive detection of R6G with a concentration down to 1 picomolar (1 pM) with an enhancement factor (EF) of 1.6×1010. The observed SERS signal enhancement in this AgFeO2 NPs system is attributed to a combination of electromagnetic (EM) enhancement, charge ‐ transfer (CT) effect between R6G analyte molecules and AgFeO2 NPs surface and Resonance Raman (RR) effect. Further, AgFeO2 NPs were used to study its antibacterial activity against certain different pathogenic bacteria. The antibacterial studies showed that the AgFeO2 NPs possesses potential inhibitory effect against both Gram‐negative and Gram‐positive bacteria. In addition, AgFeO2 NPs was found cytotoxic to yeast cells. The stable aqueous colloids of AgFeO2 NPs may find potential applications in the biomedical field as a sensing platform for the trace level detection of analyte molecules and antimicrobial agent.
Copper Catalyzed N‐Arylation of Amines in Ionic Liquid Using 1‐Aryltriazenes as Aryl Surrogates
Authors: Kim Kang M. , Kim Kang Min
Published: March 2021

Serving [TMG][CH3COO] ionic liquid as solvent and promoter, a competent access to unsymmetrically substituted secondary amine is accomplished through a copper catalyzed mono arylation of aromatic/aliphatic amines with diverse 1‐aryltriazenes. No base, ligand, co‐catalyst, additional promoter or additives are necessary to drive the reaction. Varied functional group tolerance, shorter reaction time, better product yield, recycle and re‐use of ionic liquid highlight this reaction as a better eco‐friendly alternative for the conventional synthesis.
Sequential Pull‐Down Purification of DNA Origami Superstructures
Authors: Ye Jingjing , Teske Josephine , Kemper Ulrich , Seidel Ralf
Published: March 2021

Higher‐order superstructures of individual DNA origami building blocks are frequently used in DNA nanotechnology in order to increase the structure dimensions and complexity. Here, a purification method is presented to specifically enrich a fully assembled superstructure out of an excess of substructures. The approach is based on pull‐down reactions with magnetic beads, where superstructures are captured via an anchor strand on a specific terminus and then become separated from terminus‐free structures. By carrying out several pull‐down reactions sequentially on different termini, the full superstructures that possess all termini become finally enriched. The approach is demonstrated by purifying linear origami superstructures with up to nine monomers by two‐sided pull‐down reactions and a T‐shaped superstructure in a three‐sided pull‐down reaction. In all cases, high recovery yields and purities are obtained. A crucial prerequisite for the sequential pull‐down scheme is the establishment of highly specific, orthogonal sequence sets for capture, and anchor strands. It is expected that the introduced approach provides a useful and universal method to purify complex DNA origami superstructures with high specificity and yield and this way allows the massive parallel fabrication of nanostructures at high homogeneity.
Indirect Electrosynthesis with Halogen Ions as Mediators
Authors: Lian Fei , Xu Kun , Zeng Chengchu
Published: March 2021

Organic electrosynthesis has gained increasing research interest as it harvests electric current as redox regents, thereby providing a sustainable alternative to conventional approaches. Compared with direct electrosynthesis, indirect electrosynthesis employs mediator(s) to lower the overpotentials for substrate activation, and enhance the reaction efficiency and functional group compatibility by shifting the heterogenous electron transfer process to be homogenous. As one of the most versatile and cost‐efficient mediators, halogen mediators are always combined with an irreversible halogenation reaction. Thus, the electrochemical reaction between halogen mediators and substrates doesn't directly controlled by the two standard potentials difference. In this account, our recent developments in the area of halogen‐mediated indirect electrosynthesis are summarized. The anodically generated halogen species from halogenide salts have the abilities to undergo electron‐transfer (ET) or hydrogen‐atom‐ transfer (HAT) processes. The reaction features, scopes, limitations, and mechanistic rationalisations are discussed in this account. We hope our studies will contribute to the future developments to broaden the scope of halogen‐mediated electrosynthesis.
Factors influencing transition to care homes for people with dementia in Northern Ireland
Authors: Zafeiridi Evi , McMichael Alan J. , Passmore A. Peter , McGuinness Bernadette
Published: March 2021

Introduction

The increasing number of people with dementia (PwD) is a significant health and financial challenge for countries. PwD often transition to a care home. This study explored factors predicting transition to care homes for PwD and the place and causes of death.

Methods

Data about dementia medication, care home transitions, demographic characteristics, deaths, and hospital admissions were extracted from national databases from 2010 to 2016.

Results

PwD (n = 25,418) were identified through prescriptions of dementia medication, from which 11,930 transitioned to care homes. A logistic regression showed that increased age, female sex, living in less deprived and urban areas, and hospital admissions predicted this transition. PwD who transition to care homes are more likely to die there. The most common cause of death was dementia.

Discussion

Certain demographic characteristics are significant predictors for care home transitions and they should be considered in the development of early community‐based care services to delay transitions. In the last decades, dementia has been reported more frequently in death certificates.
AdS2 duals to ADHM quivers with Wilson lines
Authors: Lozano Yolanda , Nunez Carlos , Ramirez Anayeli , Speziali Stefano
Published: March 2021

Abstract

We discuss AdS2 × S3 × CY2 × Iρ solutions to massive Type IIA supergravity with 4 Poincaré supersymmetries. We propose explicit dual quiver quantum mechanics built out of D0 and D4 colour branes coupled to D4’ and D8 flavour branes. We propose that these quivers describe the interactions of instantons and Wilson lines in 5d gauge theories with 8 Poincaré supersymmetries. Using the RR Maxwell fluxes of the solutions, conveniently put off-shell, we construct a functional from which the holographic central charge can be derived through a geometrical extremisation principle.
Power corrections to event shapes using Eikonal dressed gluon exponentiation
Authors: Agarwal Neelima , Mukhopadhyay Ayan , Pal Sourav , Tripathi Anurag
Published: March 2021

Abstract

Event shapes are classical tools for the determination of the strong coupling and for the study of hadronization effects in electron-positron annihilation. In the context of analytical studies, hadronization corrections take the form of power-suppressed contributions to the cross section, which can be extracted from the perturbative ambiguity of Borel-resummed distributions. We propose a simplified version of the well-established method of Dressed Gluon Exponentiation (DGE), which we call Eikonal DGE (EDGE), which determines all dominant power corrections to event shapes by means of strikingly elementary calculations. We believe our method can be generalized to hadronic event shapes and jet shapes of relevance for LHC physics.
Integrating simple genus two string invariants over moduli space
Authors: Basu Anirban
Published: March 2021

Abstract

We consider an Sp(4, ℤ) invariant expression involving two factors of the Kawazumi-Zhang (KZ) invariant each of which is a modular graph with one link, and four derivatives on the moduli space of genus two Riemann surfaces. Manipulating it, we show that the integral over moduli space of a linear combination of a modular graph with two links and the square of the KZ invariant reduces to a boundary integral. We also consider an Sp(4, ℤ) invariant expression involving three factors of the KZ invariant and six derivatives on moduli space, from which we deduce that the integral over moduli space of a modular graph with three links reduces to a boundary integral. In both cases, the boundary term is completely determined by the KZ invariant. We show that both the integrals vanish.
Relating the b ghost and the vertex operators of the pure spinor superstring
Authors: Chandia Osvaldo , Vallilo Brenno Carlini
Published: March 2021

Abstract

The OPE between the composite b ghost and the unintegrated vertex operator for massless states of the pure spinor superstring is computed and shown to reproduce the structure of the bosonic string result. The double pole vanishes in the Lorenz gauge and the single pole is shown to be equal to the corresponding integrated vertex operator.
RNA and DNA G-quadruplexes bind to human dicer and inhibit its activity
Authors: Koralewska Natalia , Szczepanska Agnieszka , Ciechanowska Kinga , Wojnicka Marta , Pokornowska Maria , Milewski Marek C. , Gudanis Dorota , Baranowski Daniel , Nithin Chandran , Bujnicki Janusz M. , Gdaniec Zofia , Figlerowicz Marek , Kurzynska-Kokorniak Anna
Published: March 2021

Guanine (G)-rich single-stranded nucleic acids can adopt G-quadruplex structures. Accumulating evidence indicates that G-quadruplexes serve important regulatory roles in fundamental biological processes such as DNA replication, transcription, and translation, while aberrant G-quadruplex formation is linked to genome instability and cancer. Understanding the biological functions played by G-quadruplexes requires detailed knowledge of their protein interactome. Here, we report that both RNA and DNA G-quadruplexes are bound by human Dicer in vitro. Using in vitro binding assays, mutation studies, and computational modeling we demonstrate that G-quadruplexes can interact with the Platform–PAZ–Connector helix cassette of Dicer, the region responsible for anchoring microRNA precursors (pre-miRNAs). Consequently, we show that G-quadruplexes efficiently and stably inhibit the cleavage of pre-miRNA by Dicer. Our data highlight the potential of human Dicer for binding of G-quadruplexes and allow us to propose a G-quadruplex-driven sequestration mechanism of Dicer regulation.
Nonlocal elastodynamics and fracture
Authors: Lipton Robert P. , Jha Prashant K.
Published: March 2021

A nonlocal field theory of peridynamic type is applied to model the brittle fracture problem. The elastic fields obtained from the nonlocal model are shown to converge in the limit of vanishing non-locality to solutions of classic plane elastodynamics associated with a running crack. We carry out our analysis for a plate subject to mode one loading. The length of the crack is prescribed a priori and is an increasing function of time.
Flug- und Schiffsverkehr während der COVID-19-Pandemie in Deutschland: Herausforderungen für den Öffentlichen Gesundheitsdienst
Authors: Kleine-Kampmann Scarlett , Schöll Meike , Ehlers Lena , Hewelt Elisabeth , Götsch Udo , Göbels Klaus , Ippisch Siegfried , Seidel Juliane , Thanheiser Marc , Schindler Bert , Kalkowski Mathias , Boldt Matthias , Dirksen-Fischer Martin , von Münster Thomas , Jeglitza Matthias , Chmielewska Justyna , Sangs André , Mouchtouri Barbara , Rexroth Ute , an der Heiden Maria
Published: March 2021

COVID-19 stellt unsere Gesellschaft seit Januar 2020 vor große Herausforderungen. Durch den globalen Reiseverkehr konnte sich das neue Coronavirus rasch weltweit ausbreiten. In diesem Artikel sollen übersichtsartig die Herausforderungen bei der Implementierung von Maßnahmen im Flug- und Schiffsverkehr aus Sicht des Öffentlichen Gesundheitsdienstes (ÖGD) dargestellt werden. Dies erfolgt anhand einer Auswahl von Ereignissen und Maßnahmen zwischen Januar und August 2020. Die gewonnenen Erkenntnisse werden diskutiert.

Während der COVID-19-Pandemie bewegt sich der ÖGD in einem Spannungsfeld, das sich aus der Dynamik wissenschaftlicher Erkenntnisse, politischer Entscheidungen und der Akzeptanz und Zustimmung in der Gesellschaft ergibt. An Grenzübergangsstellen wie Flug- und Seehäfen gibt es besondere Herausforderungen. Dazu gehören insbesondere Personalengpässe und die Notwendigkeit, Maßnahmen mit hohem organisatorischen Aufwand sehr kurzfristig umzusetzen, wie etwa gesundheitsbehördliche Passagierkontrollen direkt an Luftfahrzeugen, die Einrichtung von Testzentren an Grenzübergangsstellen sowie die Überprüfung der Einhaltung von Quarantänevorgaben. Erschwerend kommt hinzu, dass Passagierlisten, die zur effektiven Kontaktpersonennachverfolgung notwendig sind, oft fehlen oder unvollständig sind. Ebenso fehlen digitale Tools für das Kontaktpersonenmanagement, aber z. B. auch für den Austausch personenbezogener Daten innerhalb des ÖGD. Weitere Schwierigkeiten beim Ausbruchsmanagement ergeben sich durch die engen Verhältnisse an Bord von Schiffen und durch die mögliche psychische Belastung von Besatzung und Passagieren, die in den Maßnahmen noch nicht ausreichend berücksichtigt werden.

Angesichts all dieser Herausforderungen ist es notwendig, den ÖGD langfristig zu stärken – allgemein und an den Grenzübergangsstellen – und den Bund-Länder-Austausch im Flug- und Schiffsverkehr zu intensivieren.
Dizziness Handicap Inventory in der Qualitätssicherung der Therapie vestibulärer Funktionsstörung
Authors: Duong Dinh T. A. , Wittenborn J. , Westhofen M.
Published: March 2021

Die Therapie peripherer vestibulärer Funktionsstörungen stellt eine Herausforderung für viele HNO-Ärzte dar. Diese besteht nicht nur in der Durchführung der differenzierten neurootologischen Diagnostik, sondern auch in der Therapie und in der Verlaufskontrolle von Patienten mit vestibulärer Funktionsstörung. Insbesondere die Qualitätssicherung solcher Therapie wird in der Regel nicht adäquat abgebildet und dokumentiert. Die deutsche, validierte Version des Dizziness Handicap Inventory (DHI) bietet eine praktikable Möglichkeit zur Evaluierung und Verlaufskontrolle der Therapieergebnisse. In einer Studie wurden die Beschwerden von Patienten, welche in der HNO-Klinik des Universitätsklinikums Aachen aufgrund einer unilateralen peripheren vestibulären Funktionsstörung behandelt wurden, prä- bzw. posttherapeutisch mittels DHI erfasst und ausgewertet. Die posttherapeutische Erhebung des DHI-Scores erfolgte telefonisch. Die Auswertung der erhobenen DHI-Scores ergab in 92 % der Fälle eine signifikante Reduzierung der Schwindelbeschwerden. Es bestätigte sich die Eignung des DHI als Instrument zur Qualitätssicherung für die Funktionsdiagnostik und die darauf folgende Therapie von vestibulären Funktionsstörungen.
CM values of higher automorphic Green functions for orthogonal groups
Authors: Bruinier Jan Hendrik , Ehlen Stephan , Yang Tonghai
Published: March 2021

Gross and Zagier conjectured that the CM values (of certain Hecke translates) of the automorphic Green function $$G_s(z_1,z_2)$$

G
s

(

z
1

,

z
2

)

for the elliptic modular group at positive integral spectral parameter s are given by logarithms of algebraic numbers in suitable class fields. We prove a partial average version of this conjecture, where we sum in the first variable $$z_1$$

z
1

over all CM points of a fixed discriminant $$d_1$$

d
1

(twisted by a genus character), and allow in the second variable the evaluation at individual CM points of discriminant $$d_2$$

d
2

. This result is deduced from more general statements for automorphic Green functions on Shimura varieties associated with the group $${\text {GSpin}}(n,2)$$

GSpin
(
n
,
2
)

. We also use our approach to prove a Gross–Kohnen–Zagier theorem for higher Heegner divisors on Kuga–Sato varieties over modular curves.
Targeted Inactivation of Rin3 Increases Trabecular Bone Mass by Reducing Bone Resorption and Favouring Bone Formation
Authors: Vallet Mahéva , Sophocleous Antonia , Törnqvist Anna E. , Azfer Asim , Hof Rob van’t , Albagha Omar ME , Ralston Stuart H.
Published: March 2021

Common genetic variants at the RIN3 locus on chromosome 14q32 predispose to Paget’s disease of bone (PDB) but the mechanisms by which they do so are unknown. Here, we analysed the skeletal phenotype of female mice with targeted inactivation of the mouse Rin3 gene (Rin3−/−) as compared with wild-type littermates. The Rin3−/− mice had higher trabecular bone volume (BV/TV%) compared with wild type. Mean ± standard deviation values at the distal femur at 8 weeks were 9.0 ± 2.5 vs. 7.0 ± 1.5 (p = 0.002) and at 52 weeks were 15.8 ± 9.5 vs. 8.5 ± 4.2 (p = 0.002). No differences were observed in femoral cortical bone parameters with the exception of marrow diameter which was significantly smaller in 52-week-old Rin3−/− mice compared to wild type: (0.43 mm ± 0.1 vs. 0.57 mm ± 0.2 (p = 0.001). Bone histomorphometry showed a lower osteoclast surface / bone surface (Oc.S/BS%) at 8 weeks in Rin3−/− mice compared to wild type (24.1 ± 4.7 vs. 29.7 ± 6.6; p = 0.025) but there were no significant differences in markers of bone formation at this time. At 52 weeks, Oc.S/BS did not differ between genotypes but single labelled perimeter (SL.Pm/B.Pm (%)) was significantly higher in Rin3−/− mice (24.4 ± 6.4 vs. 16.5 ± 3.8, p = 0.003). We conclude that Rin3 negatively regulates trabecular bone mass in mice by inhibiting osteoclastic bone resorption and favouring bone formation. Our observations also suggest that the variants that predispose to PDB in humans probably do so by causing a gain-in-function of RIN3.
Two homologs of the Cat8 transcription factor are involved in the regulation of ethanol utilization in Komagataella phaffii
Authors: Barbay Diane , Mačáková Monika , Sützl Leander , De Sonakshi , Mattanovich Diethard , Gasser Brigitte
Published: March 2021

The transcription factors Cat8 and Sip4 were described in Saccharomyces cerevisiae and Kluyveromyces lactis to have very similar DNA binding domains and to be necessary for derepression of a variety of genes under non-fermentative growth conditions via binding to the carbon source responsive elements (CSREs). The methylotrophic yeast Komagataella phaffii (syn Pichia pastoris) has two transcription factors (TFs), which are putative homologs of Cat8 based on sequence similarity, termed Cat8-1 and Cat8-2. It is yet unclear in which cellular processes they are involved and if one of them is actually the homolog of Sip4. To study the roles of the Cat8 homologs in K. phaffii, overexpression or deletion strains were generated for the two TFs. The ability of these mutant strains to grow on different carbon sources was tested, and transcript levels of selected genes from the carbon metabolism were quantified. Our experiments showed that the TFs are required for the growth of K. phaffii on C2 carbon sources, but not on glucose, glycerol or methanol. K. phaffii deleted for Cat8-1 showed impaired growth on acetate, while both Cat8-1 and Cat8-2 are involved in the growth of K. phaffii on ethanol. Correspondingly, both TFs are participating in the activation of ADH2, ALD4 and ACS1, three genes encoding enzymes important for the assimilation of ethanol. Different from S. cerevisiae and K. lactis, Cat8-1 is not regulating the transcription of the putative Sip4-family member Cat8-2 in K. phaffii. Furthermore, Cat8-1 is necessary for the activation of genes from the glyoxylate cycle, whereas Cat8-2 is necessary for the activation of genes from the carnitine shuttle. Neither Cat8-1 nor Cat8-2 are required for the activation of gluconeogenesis genes. Finally, the CAT8-2 gene is repressed by the Mig1-2 transcription factor on glucose and autorepressed by the Cat8-2 protein on all tested carbon sources. Our study identified the involvement of K. phaffii Cat8-1 and Cat8-2 in C2-metabolism, and highlighted similarities and differences to their homologs in other yeast species.
Radiomics score predicts acute respiratory distress syndrome based on the initial CT scan after trauma
Authors: Röhrich Sebastian , Hofmanninger Johannes , Negrin Lukas , Langs Georg , Prosch Helmut
Published: March 2021

Objectives

Acute respiratory distress syndrome (ARDS) constitutes a major factor determining the clinical outcome in polytraumatized patients. Early prediction of ARDS is crucial for timely supportive therapy to reduce morbidity and mortality. The objective of this study was to develop and test a machine learning–based method for the early prediction of ARDS derived from the first computed tomography scan of polytraumatized patients after admission to the hospital.

Materials and methods

One hundred twenty-three patients (86 male and 37 female, age 41.2 ± 16.4) with an injury severity score (ISS) of 16 or higher (31.9 ± 10.9) were prospectively included and received a CT scan within 1 h after the accident. The lungs, including air pockets and pleural effusions, were automatically segmented using a deep learning–based algorithm. Subsequently, we extracted radiomics features from within the lung and trained an ensemble of gradient boosted trees (GBT) to predict future ARDS.

Results

Cross-validated ARDS prediction resulted in an area under the curve (AUC) of 0.79 for the radiomics score compared to 0.66 for ISS, and 0.68 for the abbreviated injury score of the thorax (AIS-thorax). Prediction using the radiomics score yielded an f1-score of 0.70 compared to 0.53 for ISS and 0.57 for AIS-thorax. The radiomics score achieved a sensitivity and specificity of 0.80 and 0.76.

Conclusions

This study proposes a radiomics-based algorithm for the prediction of ARDS in polytraumatized patients at the time of admission to hospital with an accuracy that competes and surpasses conventional scores despite the heterogeneous, and therefore more realistic, scanning protocols.

Key Points

• Early prediction of acute respiratory distress syndrome in polytraumatized patients is possible, even when using heterogenous data.

• Radiomics-based prediction resulted in an area under the curve of 0.79 compared to 0.66 for the injury severity score, and 0.68 for the abbreviated injury score of the thorax.

• Highlighting the most relevant lung regions for prediction facilitates the understanding of machine learning–based prediction.
Glaukomversorgung in Deutschland – Ergebnisse einer Mitgliederumfrage von DOG und BVA – Teil 1: Diagnostik
Authors: Wolfram Christian , Schuster Alexander K.
Published: March 2021

Hintergrund

Die Möglichkeiten in der Glaukomversorgung sind in den letzten Jahren immer vielfältiger geworden. Unter den Mitgliedern der Deutschen Ophthalmologischen Gesellschaft (DOG) und des Berufsverbands der Augenärzte Deutschlands (BVA) wurde eine anonymisierte Befragung durchgeführt, um zu erfassen, welche Behandlungswege in der Versorgung von Glaukompatienten gewählt werden, welche diagnostischen Parameter den Augenärztinnen und Augenärzten wichtig sind und welche Rolle Behandlungsleitlinien in der Alltagspraxis zukommt.

Ziel der Arbeit

Meinungsbild unter der deutschen Augenärzteschaft über die aktuelle Glaukomversorgung, zentrale diagnostische Parameter und ihre Anwendung in der Alltagspraxis.

Material und Methoden

Die Befragung wurde durch einen Online-Fragebogen mit insgesamt 26 Fragen (107 Items) zur Versorgungspraxis in der Glaukomdiagnostik und der Glaukomtherapie durchgeführt. Vollständig ausgefüllte Fragebögen lagen von 1361 Personen vor.

Ergebnisse

Die Papillenbeurteilung an der Spaltlampe hat für Augenärzte weiterhin den höchsten diagnostischen Stellenwert. Auch der Rolle der optischen Kohärenztomographie (OCT) kommt eine sehr hohe diagnostische Bewertung zu. Bei der Interpretation verschiedener diagnostischer Parameter ergibt sich eine höhere Sicherheit für papillennahe Parameter unter den Befragten. Eine leitliniengemäße Versorgung wird nach Selbstauskunft der Augenärzte weitgehend betrieben. Etwa zwei Drittel der Befragten führen im ersten Behandlungsjahr zwei oder mehr Gesichtsfelduntersuchungen durch und ebenso eine strukturelle Papillendarstellung einmal im Jahr. Die Rolle der Gonioskopie wird kontrovers gesehen und nicht einheitlich intensiv praktiziert.

Diskussion

Die Diagnosestellung beim Glaukom ist eine große klinische Herausforderung. Die verschiedenen diagnostischen Parameter haben einen unterschiedlich hohen Wert für Augenärzte. Morphometrische Verfahren haben eine sehr hohe Bedeutung gewonnen und ermöglichen eine assistierte, jedoch keine automatisierte Diagnostik. Mehr Behandlungsleitlinien und Standards bei der Glaukomversorgung werden gewünscht und sollten in Aus- und Weiterbildung und in den Behandlungsalltag implementiert sein.
Role of legs and foot adhesion in salticid spiders jumping from smooth surfaces
Authors: Goetzke Hanns Hagen , Federle Walter
Published: March 2021

Many spiders and insects can perform rapid jumps from smooth plant surfaces. Here, we investigate how jumping spiders (Pseudeuophrys lanigeraandSitticus pubescens) avoid slipping when accelerating. Both species differed in the relative contribution of leg pairs to the jump.P. lanigeraaccelerated mainly with their long third legs, whereas their short fourth legs detached earlier. In contrast,S. pubescensaccelerated mainly with their long fourth legs, and their short third legs detached earlier. Because of the different orientation (fourth-leg tip pointing backward, third-leg tip pointing forward), the fourth-leg tarsus pushed, whereas the third-leg tarsus pulled. High-speed video recordings showed that pushing and pulling was achieved by different attachment structures. InP. lanigera, third-leg feet made surface contact with setae on their distal or lateral claw tuft, whereas fourth-leg feet engaged the proximal claw tuft, and the distal tuft was raised off the ground.S. pubescensshowed the same division of labour between proximal and distal claw tuft for pushing and pulling, but the claw tuft contact lasted longer and was more visible in the fourth than in the third legs. Experimental ablation of claw tufts caused accelerating spiders to slip, confirming that adhesion is essential for jumps from smooth substrates.
Defunctioning stoma and short- and long-term outcomes after low anterior resection for rectal cancer—a nationwide register–based cohort study
Authors: Gadan Soran , Brand Judith S. , Rutegård Martin , Matthiessen Peter
Published: March 2021

Purpose

A defunctioning stoma reduces the risk of symptomatic anastomotic leakage after low anterior resection for rectal cancer and mitigates the consequences when a leakage occurs, but the impact on mortality and oncological outcomes is unclear. The aim was to investigate the associations of a defunctioning stoma with short- and long-term outcomes in patients undergoing low anterior resection for rectal cancer.

Methods

Data from all patients who underwent curative low anterior resection for rectal cancer between 1995 and 2010 were obtained from the Swedish Colorectal Cancer Register. A total of 4130 patients, including 2563 with and 1567 without a defunctioning stoma, were studied. Flexible parametric models were used to estimate hazard ratios for all-cause mortality, 5-year local recurrence, and distant metastatic disease in relation to the use of defunctioning stoma, adjusting for confounding factors and accounting for potential time-dependent effects.

Results

During a median follow-up of 8.3 years, a total of 2169 patients died. In multivariable analysis, a relative reduction in mortality was observed up to 6 months after surgery (hazard ratio = 0.82: 95% CI 0.67–0.99), but not thereafter. After 5 years of follow-up, 4.2% (173/4130) of the patients had a local recurrence registered and 17.9% (741/4130) had developed distant metastatic disease, without difference between patients with and without defunctioning stoma.

Conclusion

A defunctioning stoma is associated with a short-term reduction in all-cause mortality in patients undergoing low anterior resection for rectal cancer without any difference in long-term mortality and oncological outcomes, and should be considered as standard of care.
SAPHO-Syndrom
Authors: Klemm Philipp , Lange Uwe
Published: March 2021

Beim SAPHO-Syndrom handelt es sich nicht um eine Entität, sondern um einen inhomogenen, nosologisch wie pathogenetisch heterogenen Symptomenkomplex. Klinisch imponieren subakute, rezidivierende und/oder chronische Krankheitsprozesse mit charakteristisch gemeinsamer Haut-Knochen-Assoziation („ski[n]bo[ne]-disease“). Die chronisch rekurrierende multifokale Osteomyelitis (CRMO) ist die häufigste „SAPHO“-Erkrankung im Jugend- und Adoleszentenalter. Im Erwachsenenalter ist die Spondarthritis hyperostotica pustulo-psoriatica mit der Trias palmoplantare Pustulose, sternokostoklavikuläre Hyperostose und ossifizierenden Wirbelsäulenmanifestationen am häufigsten und generell als „SAPHO“ bekannt. Zusätzlich gibt es jedoch abortive Krankheitsformen: das entzündliche Anterior-chest-wall-Syndrom, das sternoklavikuläre Hyperostosesyndrom, die Akne-CRMO und die Akne-Spondarthritis. Insgesamt heilen die SAPHO-Krankheitsfälle meist mit relativ günstiger Prognose aus, es gibt aber auch ungünstige Verläufe mit funktionellen Einschränkungen. Neben der typischen Klinik dienen Bildgebung (Röntgen, Szintigraphie, Magnetresonanztomographie) und/oder histologische Knochenbiopsieanalyse der Diagnosestellung. Die Therapie sollte interdisziplinär erfolgen. Eine Antibiose ist obsolet. Der vorliegende Artikel vermittelt einen Überblick über das SAPHO-Syndrom und eine klinisch-rheumatologische wie bildgebende Differenzierung sowie nosologische Klassifizierung von 35 Fällen bei Erstvorstellung.
Cardiomyocyte depolarization triggers NOS-dependent NO transient after calcium release, reducing the subsequent calcium transient
Authors: Mosqueira Matias , Konietzny Roland , Andresen Carolin , Wang Chao , H.A. Fink Rainer
Published: March 2021

Cardiac excitation–contraction coupling and metabolic and signaling activities are centrally modulated by nitric oxide (NO), which is produced by one of three NO synthases (NOSs). Despite the significant role of NO in cardiac Ca2+ homeostasis regulation under different pathophysiological conditions, such as Duchenne muscular dystrophy (DMD), no precise method describes the production, source or effect of NO through two NO signaling pathways: soluble guanylate cyclase-protein kinase G (NO-sGC-PKG) and S-nitrosylation (SNO). Using a novel strategy involving isolated murine cardiomyocytes loaded with a copper-based dye highly specific for NO, we observed a single transient NO production signal after each electrical stimulation event. The NO transient signal started 67.5 ms after the beginning of Rhod-2 Ca2+ transient signal and lasted for approximately 430 ms. Specific NOS isoform blockers or NO scavengers significantly inhibited the NO transient, suggesting that wild-type (WT) cardiomyocytes produce nNOS-dependent NO transients. Conversely, NO transient in mdx cardiomyocyte, a mouse model of DMD, was dependent on inducible NOS (iNOS) and endothelial (eNOS). In a consecutive stimulation protocol, the nNOS-dependent NO transient in WT cardiomyocytes significantly reduced the next Ca2+ transient via NO-sGC-PKG. In mdx cardiomyocytes, this inhibitory effect was iNOS- and eNOS-dependent and occurred through the SNO pathway. Basal NO production was nNOS- and iNOS-dependent in WT cardiomyocytes and eNOS- and iNOS-dependent in mdx cardiomyocytes. These results showed cardiomyocyte produces NO isoform-dependent transients upon membrane depolarization at the millisecond time scale activating a specific signaling pathway to negatively modulate the subsequent Ca2+ transient.
Ghrelin peptide improves glial conditioned medium effects on neuronal differentiation of human adipose mesenchymal stem cells
Authors: Russo Cristina , Mannino Giuliana , Patanè Martina , Parrinello Nunziatina Laura , Pellitteri Rosalia , Stanzani Stefania , Giuffrida Rosario , Lo Furno Debora , Russo Antonella
Published: March 2021

The influences of ghrelin on neural differentiation of adipose-derived mesenchymal stem cells (ASCs) were investigated in this study. The expression of typical neuronal markers, such as protein gene product 9.5 (PGP9.5) and Microtubule Associated Protein 2 (MAP2), as well as glial Fibrillary Acid Protein (GFAP) as a glial marker was evaluated in ASCs in different conditions. In particular, 2 µM ghrelin was added to control ASCs and to ASCs undergoing neural differentiation. For this purpose, ASCs were cultured in Conditioned Media obtained from Olfactory Ensheathing cells (OEC-CM) or from Schwann cells (SC-CM). Data on marker expression were gathered after 1 and 7 days of culture by fluorescence immunocytochemistry and flow cytometry. Results show that only weak effects were induced by the addition of only ghrelin. Instead, dynamic ghrelin-induced modifications were detected on the increased marker expression elicited by glial conditioned media. In fact, the combination of ghrelin and conditioned media consistently induced a further increase of PGP9.5 and MAP2 expression, especially after 7 days of treatment. The combination of ghrelin with SC-CM produced the most evident effects. Weak or no modifications were found on conditioned medium-induced GFAP increases. Observations on the ghrelin receptor indicate that its expression in control ASCs, virtually unchanged by the addition of only ghrelin, was considerably increased by CM treatment. These increases were enhanced by combining ghrelin and CM treatment, especially at 7 days. Overall, it can be assumed that ghrelin favors a neuronal rather than a glial ASC differentiation.
Sprint interval training (SIT) reduces serum epidermal growth factor (EGF), but not other inflammatory cytokines in trained older men
Authors: Yasar Zerbu , Elliott Bradley T. , Kyriakidou Yvoni , Nwokoma Chiazor T. , Postlethwaite Ruth D. , Gaffney Christopher J. , Dewhurst Susan , Hayes Lawrence D.
Published: March 2021

Purpose

The present study aimed to investigate the effect of age on circulating pro- and anti-inflammatory cytokines and growth factors. A secondary aim was to investigate whether a novel sprint interval training (SIT) intervention (3 × 20 s ‘all out’ static sprints, twice a week for 8 weeks) would affect inflammatory markers in older men.

Methods

Nine older men [68 (1) years] and eleven younger men [28 (2) years] comprised the younger group. Aerobic fitness and inflammatory markers were taken at baseline for both groups and following the SIT intervention for the older group.

Results

Interleukin (IL)-8, vascular endothelial growth factor (VEGF), and monocyte chemoattractant protein-1 (MCP-1) were unchanged for the older and younger groups at baseline (IL-8, p = 0.819; MCP-1, p = 0.248; VEGF, p = 0.264). Epidermal growth factor (EGF) was greater in the older group compared to the younger group at baseline [142 (20) pg mL−1 and 60 (12) pg mL−1, respectively, p = 0.001, Cohen's d = 1.64]. Following SIT, older men decreased EGF to 100 (12) pg mL−1 which was similar to that of young men who did not undergo training (p = 0.113, Cohen's d = 1.07).

Conclusion

Older aerobically trained men have greater serum EGF than younger aerobically trained men. A novel SIT intervention in older men can shift circulating EGF towards trained younger concentrations. As lower EGF has previously been associated with longevity in C. elegans, the manipulative effect of SIT on EGF in healthy ageing in the human may be of further interest.
Comparative evaluation of cardiovascular risks among nine FDA-approved VEGFR-TKIs in patients with solid tumors: a Bayesian network analysis of randomized controlled trials
Authors: Hou Wanting , Ding Mingfu , Li Xiaohua , Zhou Xiaohan , Zhu Qing , Varela-Ramirez Armando , Yi Cheng
Published: March 2021

Purpose

The present meta-analysis study was performed to identify the potential cardiotoxicity risks when using Vascular Endothelial Growth Factor Receptor Tyrosine kinase inhibitors (VEGFR-TKIs) as anticancer drugs in patients with solid tumors.

Methods

Pubmed, Embase, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for the randomized controlled trials. We have included 45 randomized controlled trials (RCTs) associated with nine VEGFR-TKIs Food and Drug Administration (FDA)-approved drugs used to treat patients with solid tumors. To evaluate the trials’ risk of bias, Cochrane Risk of Bias Tool was assessed. A direct comparison was assessed by RevMan5.3 software, calculating the odds ratio (OR) and 95% confidence interval (CI). Heterogeneity was tested by the I2 statistic and Chi-square test for P value. Bayesian network meta-analysis was performed using Stata 15.0 and GeMTC 0.14.3 software, calculated OR along with corresponding 95% credible interval (CrI). The model’s convergence was evaluated by the potential scale reduced factor (PSRF). Consistency between direct and indirect comparisons was assessed by the “node-splitting” method.

Results

In this network meta-analysis, a total of 20,027 patients from 45 randomized controlled trials and associated with nine FDA-approved VEGFR-TKIs (axitinib, cabozantinib, lenvatinib, nintedanib, pazopanib, regorafenib, sorafenib, sunitinib, vandetanib), were enrolled. Findings indicated that lenvatinib had the most significant probability of provoking all grades cardiovascular incident and hypertension, followed by vandetanib, cabozantinib, axitinib, pazopanib, sorafenib, sunitinib, regorafenib and nintedanib. The nine agent’s severe cardiovascular and severe hypertension risk was probably similar. The ranking probability of cardiac toxicity shows that vandetanib ranked most likely to have the highest risk for cardiotoxicity among all the VEGFR-TKIs reviewed, followed by pazopanib, axitinib, sorafenib, sunitinib. In contrast, regorafenib and nintedanib did not exhibit an increased risk of cardiac damage.

Conclusions

The association between the nine VEGFR-TKIs with potential cardiotoxicity occurrence was reviewed. Both the regorafenib and nintedanib did not display detectable signs of cardiotoxic damage. In contrast, lenvatinib and vandetanib are ranked to have the most severe cardiotoxicity side impacts. These results may provide information for clinical practice guidelines, implementing strategies in selecting the adequate VEGFR-TKIs, and understanding the cardiovascular toxicity inflicted by the VEGFR-TKIs.

PROSPERO identifier

CRD 42,020,167,307.
The dietary management of potassium in children with CKD stages 2–5 and on dialysis—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce
Authors: Desloovere An , Renken-Terhaerdt José , Tuokkola Jetta , Shaw Vanessa , Greenbaum Larry A. , Haffner Dieter , Anderson Caroline , Nelms Christina L. , Oosterveld Michiel J. S. , Paglialonga Fabio , Polderman Nonnie , Qizalbash Leila , Warady Bradley A. , Shroff Rukshana , Vande Walle Johan
Published: March 2021

Dyskalemias are often seen in children with chronic kidney disease (CKD). While hyperkalemia is common, with an increasing prevalence as glomerular filtration rate declines, hypokalemia may also occur, particularly in children with renal tubular disorders and those on intensive dialysis regimens. Dietary assessment and adjustment of potassium intake is critically important in children with CKD as hyperkalemia can be life-threatening. Manipulation of dietary potassium can be challenging as it may affect the intake of other nutrients and reduce palatability. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPRs) for the dietary management of potassium in children with CKD stages 2–5 and on dialysis (CKD2–5D). We describe the assessment of dietary potassium intake, requirements for potassium in healthy children, and the dietary management of hypo- and hyperkalemia in children with CKD2–5D. Common potassium containing foods are described and approaches to adjusting potassium intake that can be incorporated into everyday practice discussed. Given the poor quality of evidence available, a Delphi survey was conducted to seek consensus from international experts. Statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs, based on the clinical judgment of the treating physician and dietitian. These CPRs will be regularly audited and updated by the PRNT.
Acoustics on small scales
Authors: Toth Florian , Hassanpour Guilvaiee Hamideh , Jank Georg
Published: March 2021

We present a modelling strategy based on the finite element method to describe flexible, piezoelectric structures surrounded by a compressible fluid, including viscosity. Non-conforming interfaces based on the Mortar method are used to couple the different physical domains. Finally, we present an application example of a piezoelectrically actuated MEMS structure to illustrate the modeling procedure and the impact of viscous effects.
Association of early and later depressive symptoms with functional outcome after ischemic stroke
Authors: Lopatkiewicz Anna Maria , Pera Joanna , Slowik Agnieszka , Dziedzic Tomasz
Published: March 2021

Background

Post-stroke depressive symptoms (DS) can be chronic or transient, occurring shortly or long after stroke and lasting only few months. It remains unclear if the prognosis differs between patients with DS in the acute phase of stroke and those who develop DS several months later. We aimed to determine whether outcomes vary among patients with different trajectories of post-stroke depressive symptoms.

Methods

Of 698 enrolled patients with ischemic stroke, we included 335 participants (median age: 68, 48% female) who were assessed for DS both 8 days and 3 months post-stroke. We divided patients into 4 groups: without greater DS (Group 1), only earlier DS (Group 2), only later DS (Group 3), and persistent DS (Group 4). Logistic regression was used to determine the association between DS and 3- and 12-month functional outcome.

Results

Group 2 was predominantly female and had the highest rate of previous stroke or transient ischemic attack. Group 3 was more likely to suffer from delirium and more severe stroke. Group 4 had the highest frequency of vascular risk factors, pre-morbid psychiatric symptoms, and cognitive decline. In multivariate analysis, Group 3, but not Groups 2 and 4, had an increased risk of poor 3- and 12-month functional outcome (adjusted OR 2.59, 95% CI 1.64–4.07, P < 0.01 and OR 3.97, 95% CI 2.32–6.76, P < 0.01, respectively) compared with Group 1.

Conclusions

Different trajectories of post-stroke DS are related to different outcomes. Patients who only have later DS also have the worst prognosis.