bluuebunny/crossref_metadata_2025 huggingface dataset:
Construct Validity of the Gait Assessment and Intervention Tool (GAIT) in People With Multiple Sclerosis
Authors: Gor‐García‐Fogeda María Dolores , Cano‐de‐la‐Cuerda Roberto , Daly Janis J , Molina‐Rueda Francisco
Published: May 2020

Introduction

In clinical practice, observational scales are the most common approach used to assess gait pattern in people with neurological disorders. The Gait Assessment and Intervention Tool (GAIT) is an observational gait scale, and it has proved to be the most comprehensive, homogeneous, and objective of all the observational gait scales studied in people with neurological conditions.

Objective

To study the construct validity of the GAIT in people with multiple sclerosis (MS).

Design

An observational study was conducted.

Setting

Multiple Sclerosis Foundation in Madrid (Spain).

Patients

Thirty‐five patients with MS were assessed.

Main Outcome Measure(s)

GAIT construct validity was assessed using the following scales: Rivermead Visual Gait Assessment (RVGA), Tinetti Gait Scale (TGS), 10‐Meter Walking Test (10MWT), Timed Up&Go (TUG), Hauser Ambulatory Index (HAI), Multiple Sclerosis Walking Scale‐12 (MSWS‐12), Functional Gait Assessment (FGA), Modified Ashworth Scale (MAS), and Rivermead Mobility Index (RMI).

Results

A total of 35 subjects with MS were assessed. The correlations between the GAIT and the RVGA were excellent (r > .90) and moderate with TGS (values between ‐.62 and ‐.59). Correlations with HAI, FGA, MSWS‐12, and RMI were moderate (with values between .57 and .67). Correlations were lower for the velocity scales TUG and MAS.

Conclusions

The construct validity of the GAIT is high, as a measure of gait coordination in people with MS. Specifically, there was excellent correlation with the RVGA. There was a moderate correlation for the GAIT with measures of functional mobility, but a lesser correlation of the GAIT with measures restricted to temporal gait characteristics (speed measures) or measurements of impairments underlying gait patterns such as balance or muscle tone.
Accuracy of Wearable Devices for Measuring Heart Rate During Conventional and Nordic Walking
Authors: Baek Sora , Ha Yuncheol , Park Hee‐won
Published: May 2020

Introduction

Nordic walking is being used increasingly as an exercise method in many clinical disorders. To apply Nordic walking in cases of fragile or deconditioned patients, monitoring of exercise intensity such as heart rate (HR) measurement is required. The accuracy of wearable HR monitors during Nordic walking has not yet been reported.

Objective

To compare the accuracy of an electrocardiography (ECG)–based HR monitor (Polar H7) and a photoplethysmography (PPG)–based HR monitor (Fitbit Charge 2) during conventional and Nordic walking.

Design

Accuracy was assessed by comparing the HR values obtained using the wearable devices with those obtained via 12‐lead ECG as a reference.

Setting

Laboratory setting.

Participants

Fifteen male volunteers age 23.7 ± 3.0 years.

Interventions

None.

Main Outcomes Measures

HR was simultaneously recorded via 12‐lead ECG, the Polar H7, and the Fitbit Charge 2 during conventional and Nordic walking. Agreement between the devices was assessed by calculating Lin's concordance correlation coefficient (rc), the mean absolute difference, and the limit of agreement (LoA) from Bland‐Altman plots.

Results

Regarding HR values including Nordic and conventional walking, there was a better agreement between the Polar H7 and the reference (rc = 0.96) than between the Fitbit Charge 2 and the reference (rc = 0.84). For the Polar H7, the mean absolute difference from the reference did not differ significantly between the walking methods; for the Fitbit Charge 2, the mean absolute difference was significantly higher during Nordic walking than during conventional walking (6.60 vs. 3.68 bpm, P < .001). The Fitbit Charge 2 had a wider LoA than did the Polar H7 during both walking methods.

Conclusion

ECG‐based wearable devices may be better than PPG‐based devices for monitoring HR during Nordic walking. However, both types of devices may adequately monitor HR during conventional walking.
Continuous release of O2−/ONOO− in plasma‐exposed HEPES‐buffered saline promotes TRP channel‐mediated uptake of a large cation
Authors: Sasaki Shota , Zheng Yuexing , Mokudai Takayuki , Kanetaka Hiroyasu , Tachikawa Masanori , Kanzaki Makoto , Kaneko Toshiro
Published: May 2020

Although the externally controllable extracellular supply of the short‐lived reactive oxygen and nitrogen species, such as O2•−, •NO, and ONOO−, could potentially manipulate cellular functions, their simple administration to cells is likely to be ineffective due to their rapid deactivation. In this study, we found a method of a continuous supply of O2•−/ONOO− over a few minutes, which is triggered by irradiation of a nonequilibrium atmospheric pressure plasma to commonly used organic buffers (e.g., 4‐(2‐hydroxyethyl)‐1‐piperazineethanesulfonic acid, HEPES). In addition, a continuous low‐dose O2•−/ONOO− supply was shown to induce a physiologically relevant Ca2+ response and subsequently the uptake of a large cation mediated by transient receptor potential channel family member(s). Our results provide a novel approach to the continuous O2•−/ONOO− supply, requiring controllable and mass‐volume treatments.
Ion composition of a multicomponent beam plasma formed by electron‐beam evaporation of a boron‐containing target in medium vacuum
Authors: Yushkov Yury G. , Oks Efim M. , Tyunkov Andrey V. , Zolotukhin Denis B.
Published: May 2020

Thin boron and boron nitride films are applied in microelectronics due to their high hardness and strength, and low electrical conductivity. However, methods for fabrication of such films are limited. One promising method is electron‐beam evaporation of a boron‐containing target to form a boron‐containing plasma. In this study, we describe our investigations of the ion mass‐to‐charge composition of the multicomponent plasma generated by heating and evaporation of boron or boron nitride targets by a continuous electron beam in a helium or nitrogen atmosphere at medium vacuum pressure (about 10 Pa). We show that at beam power sufficient for intense evaporation of the boron target, there is an increase in the mass fraction of boron ions in the plasma. For the case of evaporation of a boron nitride target, the deposited coating contains both boron and nitrogen, implying incomplete dissociation of boron nitride molecules in the evaporation process. The results of our study demonstrate the utility of electron‐beam evaporation of high melting point binary compounds in medium vacuum for coating deposition.
Movement quality evaluation and its correlation with recommended functional measures in hip osteoarthritis
Authors: Olsen Aarid Liland , Magnussen Liv Heide , Skjaerven Liv Helvik , Assmus Jörg , Sundal Mary‐Anne , Ostelo Raymond , Strand Liv Inger
Published: May 2020

Objective

Hip osteoarthritis may cause compensational movement strategies that require extra physical and mental effort. Such aberrant functioning can be captured in movement quality evaluation. The objective of this study was to explore whether movement quality, evaluated as a multiperspective phenomenon, is reflected in commonly used and recommended functional measures in this group of patients.

Methods

A cross‐sectional study design was used. Baseline included 80 female and 21 male participants with hip osteoarthritis. Movement quality was evaluated by the Body Awareness Rating Scale—Movement Quality and Experience (BARS‐MQE), part one, including 12 movement items. Correlation analyses (Pearson and Spearman) were performed to explore associations between BARS‐MQE (sum score and single item scores), and scores on measures of physical capacity (Chair test, Stairs test, 6 minutes walking test; 6MWT), self‐reported activity level (UCLA), function (HOOS subscales), pain during walking (NRS), self‐efficacy (ASES) and health (EQ‐5D‐5L). Based on previous evidence, we hypothesized moderate associations between BARS‐MQE and these measures.

Results

BARS‐MQE's sum score showed moderate associations with Stairs test, 6MWT and UCLA (r = −0.425 to 0.304) and weak associations (r = 0.29 to 0.12) with ASES Pain and Symptoms, HOOS ADL, Chair test, NRS, HOOS Pain and Sports, and EQ‐5D‐5L. No association was found between BARS‐MQE and HOOS Symptoms and Quality of life. Movement quality in item 12, walking, demonstrated moderate or weak association with all included measures.

Conclusion

In this study of participants diagnosed with hip osteoarthritis, movement quality evaluated by BARS‐MQE was moderately reflected in measures of physical capacity and activity, but weakly reflected in self‐reported measures of health problems. With its particular dynamic procedure and inclusion of the whole moving person, movement quality evaluation by the BARS‐MQE was shown to provide supplementary information on functioning, scarcely captured by the commonly used and recommended measures.
Numerical and Experimental Studies on the Deformation of Missing‐Rib and Mixed Structures under Compression
Authors: Tang Cong , Li Lisa , Wang Li , Herencia Vince Zevallos , Ren James
Published: May 2020

Herein, the deformation and properties of cellular structures of missing‐rib (MR) model and mixed structures (MSs) are studied experimentally and numerically. Samples with different beam angles and lattice patterns 3D printed with thermoplastic elastomer (TPE) are tested in uniaxial compression. Parametric finite‐element models are developed and used to simulate structures of different sample dimensions and lattice patterns with a particular focus on beam–wall contacts. Structures with different sizes and aspect ratios, beam angles, and lattice patterns are comparatively studied. The numerical results show a good agreement with the experimental data on samples of various sizes/patterns. The main deformation modes and key stages of the corner edge–wall contact and structure deformation are presented, and the key mechanism is analyzed. Poisson's ratio and stability of the auxeticity of different structures are established. The link between the structural and auxeticity stabilities and the characteristic of the corner edge–wall contact in MR and MSs are discussed. The MSs with alternative MR columns at opposite orientations show a better shape stability and higher critical strain for a stable auxeticity.
Edge Mostar index of chemical structures and nanostructures using graph operations
Authors: Imran Muhammad , Akhter Shehnaz , Iqbal Zahid
Published: May 2020

Recently, a new bond‐additive molecular topological descriptor, named the Mostar index, has been put forward as a measure of peripherality in chemical graphs and networks. In this article, we determine the edge versions of the Mostar index of a corona product, Cartesian product, join, Indu‐Bala product, and subdivision vertex‐edge join of graphs and implement these outcomes to find the edge Mostar index of several classes of chemical graphs and nanostructures.
Evaluation of fall applied liquid swine manure with encapsulated nitrapyrin
Authors: Sassman Aaron M. , Barker Daniel W. , Lundvall John P. , Sawyer John E.
Published: May 2020

Fall applied liquid swine (Sus scrofa domesticus) manure (LSM) can lead to economic and environmental concerns due to potentially enhanced NO3 loss. Objectives of this study were to evaluate LSM application timing and use of Instinct nitrification inhibitor, and compare to anhydrous ammonia (AA). Treatments were a no‐N control, AA (without Instinct), and LSM with three Instinct rates applied each of 3 yr on October 1 (early fall) and November 1 (late fall). The effect of Instinct was inconsistent. Instinct increased soil NH4–N concentrations in fall (only early fall LSM application) and spring sampled LSM injection zones. However, in the late spring Instinct had no effect to minimal positive effect on soil inorganic–N, and the high rate was not more effective than the low rate. Corn (Zea mays L.) canopy normalized difference vegetative index (NDVI) was not influenced by Instinct or different between N source, and greatest with late fall N application. Across years, Instinct increased corn grain yield only when early fall applied with the low rate. However, LSM with Instinct had lower yield compared to AA. Waiting to apply N in late fall provided increased inorganic N retention, and with LSM higher corn yield. Based on this study, AA was a better fall applied N source compared to LSM with or without Instinct. A decision to use Instinct with LSM must weigh cost of the inhibitor against other options, such as delayed fall or spring application, or use of AA.
Uncertainty in the design stage of two‐stage Bayesian propensity score analysis
Authors: Liao Shirley X. , Zigler Corwin M.
Published: May 2020

The two‐stage process of propensity score analysis (PSA) includes a design stage where propensity scores (PSs) are estimated and implemented to approximate a randomized experiment and an analysis stage where treatment effects are estimated conditional on the design. This article considers how uncertainty associated with the design stage impacts estimation of causal effects in the analysis stage. Such design uncertainty can derive from the fact that the PS itself is an estimated quantity, but also from other features of the design stage tied to choice of PS implementation. This article offers a procedure for obtaining the posterior distribution of causal effects after marginalizing over a distribution of design‐stage outputs, lending a degree of formality to Bayesian methods for PSA that have gained attention in recent literature. Formulation of a probability distribution for the design‐stage output depends on how the PS is implemented in the design stage, and propagation of uncertainty into causal estimates depends on how the treatment effect is estimated in the analysis stage. We explore these differences within a sample of commonly used PS implementations (quantile stratification, nearest‐neighbor matching, caliper matching, inverse probability of treatment weighting, and doubly robust estimation) and investigate in a simulation study the impact of statistician choice in PS model and implementation on the degree of between‐ and within‐design variability in the estimated treatment effect. The methods are then deployed in an investigation of the association between levels of fine particulate air pollution and elevated exposure to emissions from coal‐fired power plants.
PBPK Modeling of Slightly Soluble Silver Nanomaterials and Regulatory Acceptance
Authors: Klaessig Frederick C.
Published: May 2020

International efforts to promote predictive toxicology incorporate some form of modeling based on the regularities, insights, and hypotheses gained from analyzing laboratory studies compiled in databases. While there has been a broad commentary on definitions, metadata, and test methodologies, all necessary to establishing data repositories, there has been less on translating the resulting insights into computational models. The recent use of a computational model to support a recommended exposure limit for nanoparticulate silver is an opportunity to examine physiologically based toxicokinetics in terms of data availability, model verification and validation, and regulatory acceptance. The resulting suggestions align with findings from the EU–US Roadmap Nanoinformatics 2030 and the 2018 acceptance of a computational model by the European Food Safety Authority.
Rh2S3/N‐Doped Carbon Hybrids as pH‐Universal Bifunctional Electrocatalysts for Energy‐Saving Hydrogen Evolution
Authors: Zhang Chaoxiong , Liu Haoxuan , Liu Yifan , Liu Xijun , Mi Yuying , Guo Ruijie , Sun Jiaqiang , Bao Haihong , He Jia , Qiu Yuan , Ren Junqiang , Yang Xiangjun , Luo Jun , Hu Guangzhi
Published: May 2020

Using hydrazine oxidation reaction (HzOR) to replace the oxygen evolution reaction is an effective way to decrease the overpotential of the anodic reaction in overall water splitting (OWS), facilitating cost‐effective and safe hydrogen production. Herein, Rh2S3/N‐doped carbon hybrids (Rh2S3/NC) are first reported as novel and efficient bifunctional electrocatalysts for hydrazine‐assisted hydrogen generation over a wide pH range. Specifically, Rh2S3/NC exhibits low overpotentials for the hydrogen evolution reaction (HER) in alkaline (38 mV), neutral (46 mV), and acidic (21 mV) electrolytes, to reach the current density of 10 mA cm−2, and maintains the activities over 70 h. Meanwhile, Rh2S3/NC also displays competitive HzOR performance at all‐pH electrolytes. Thus, serving as a bifunctional electrocatalyst for both HER and HzOR, Rh2S3/NC shows overwhelming‐Pt/C performance in three electrolytes, and can save over 93.3%, 85.2%, and 78.3% energy consumption compared to the corresponding OWS system. Moreover, theoretical calculations confirm that Rh2S3/NC owns low free‐energy changes of the H adsorption and the dehydrogenation of adsorbed NHNH both of which are beneficial to enhance catalytic activity. This work develops a novel bifunctional electrocatalyst with free pH‐dependent condition for the hydrazine‐assisted electrolysis system to furtherly reduce the cost of massive industrial H2 production.
Fucoxanthin treatment inhibits nasopharyngeal carcinoma cell proliferation through induction of autophagy mechanism
Authors: Long Yun , Cao Xianbao , Zhao Ruiquan , Gong Sunmin , Jin Lijuan , Feng Chun
Published: May 2020

Nasopharyngeal carcinoma (NPC) arises from the epithelium of the nasopharyngeal mucosa. Elderly people above the age of 65 years are more susceptible to NPC. Nasopharyngectomy is the renowned treatment procedure to NPC; however, it is too risky due to its complicated surgical procedure. Other treatment methods also reported with serious side effects such brain injury; hence, the alternative anticancer drug without any side effects was needed. Fucoxanthin is a carotenoid derived from marine algae with the numerous pharmacological functions. This study aims to examine the inhibitory potential in NPC cell proliferation via apoptosis and autophagy. The cytotoxicity of fucoxanthin on C666‐1 cells was observed by the MTT assay. The expression of autophagy‐linked proteins was assessed with immunoblotting analysis. The expression of autophagy protein LC3 was estimated using immunocytochemical analysis in C666‐1 and GFP‐LC3 transfected cells. Furthermore, the fucoxanthin‐treated C666‐1 cells were analyzed with TUNEL assay. The apoptotic level in the fucoxanthin‐treated C666‐1 cells was evaluated using acridine orange staining. Fucoxanthin significantly increased the expression of autophagy‐linked proteins which is clearly depicted in the immunoblotting analysis and immunocytochemical analysis of GFP‐tagged LC3 protein. The results of TUNEL assay of fucoxanthin‐treated C666‐1 in the presence autophagy inhibitors demonstrated the induction of autophagy by fucoxanthin. Acridine orange staining results of C666‐1 confirmed fucoxanthin decreases the expression of autophagy‐linked proteins during stressed condition thereby causes apoptosis. Our overall results authentically conclude that fucoxanthin induces autophagy and apoptosis in NPC cell line, and it can be ideal agent to treat nasopharyngeal cancer in future with further investigations.
Graphene Oxide and Vermiculite Clay Combinations to Produce Enhanced Flame Retardant Polypropylene Composite with Low Magnesium Hydroxide Loading
Authors: Amador‐Noya José Victor , Sánchez‐Valdes Saul , Ramos‐de Valle Luis Francisco , Valle‐Orta Maiby , Borjas‐Ramos José Javier , Beltrán‐Ramírez Flora Itzel , Valera‐Zaragoza Mario , Rodríguez‐González José Alberto , Flores‐Flores Rodolfo , Saldivar‐Guerrero Ruben , Ibarra‐Alonso María Cristina , Cabrera‐Álvarez Edgar Nazareo
Published: May 2020

The effect of graphene oxide (GO) functionalized with 3‐amino‐propyl‐triethoxy‐silane(APTS), organo‐vermiculite(OVMT), and magnesium hydroxide (MH) combinations on mechanical, thermal, and flame retardant (FR) properties of polypropylene (PP) was studied. GO was obtained via a slight modification of the Hummers method and then chemically surface functionalized with APTS. VMT clay was modified with maleic anhydride (MA) via a chemical reaction with acetic acid to increase its inter‐laminar spacing. The results of Fourier‐transform infrared analysis, X‐ray diffraction, and transmission electron microscopy demonstrated that APTS had been successfully attached to the GO and that VMT was modified with MA. Subsequently, each functionalized filler was incorporated in combination with MH to the flame‐retardant‐polypropylene system. The performance of PP composites with each filler as well as with their combinations, including a reduced “30 wt% of MH” were compared with the reference PP composite with 55 wt% of MH as the only FR additive. PP grafted with MA (PP‐gMA) and PP grafted with amine‐alcohol(PP‐gDMAE) were used as compatibilizer agents between each filler and the polymer matrix. The results obtained confirmed a better mechanical and FR performance when using PP‐gDMAE. Composites with 30 wt% MH combined with very low contents of GO (0.5 and 1.0 wt%) showed improved FR properties, similar to the reference sample, with an evident reduction in peak of the heat release rate (pHRR) and total heat release and increased limiting oxygen index (LOI) values. The combination of MH and GO showed the best FR and mechanical properties: LOI of 22.5% and pHRR of 540 kW/m2 which were very similar to the reference sample. In addition, PP‐gDMAE improved the OVMT exfoliation with a slight increase in the intergallery spacing but OVMT and modified GO combinations did not significantly improve the FR and mechanical properties compared with the effect of MH and modified GO combinations. The combination of MH and modified GO makes it possible to reduce the total MH filler content from 55 to 30 wt% to accomplish the FR requirements and with enhanced mechanical properties. This filler combination promoted the formation of a continuous, intact residual char layer on the PP surface, which acts as an insulating barrier to protect the base material. These filler combinations offer an option to meet the FR properties using halogen‐free FR with better mechanical properties.
Mixed culture of Lactococcus lactis and Kluyveromyces marxianus isolated from kefir grains for pollutants load removal from Jebel Chakir leachate
Authors: Cherni Yasmin , Botta Cristian , Kasmi Mariam , Franciosa Irene , Cocolin Luca , Chatti Abdelwaheb , Trabelsi Ismail , Elleuch Lobna
Published: May 2020

The wastewater from the dumping site usually contains high pollutant levels. Biological process and physico‐chemical treatments are among several technologies for wastewater treatment. Using microorganisms in the treatment of landfill leachate is an emerging research issue. Furthermore, bioremediation is a feasible approach for pollutants removal from landfill leachate which would provide an efficient way to resolve the issue of landfill leachate. In this study, the performance of yeast and bacteria isolated from kefir grains was assessed for landfill leachate treatment. Kefir grains microbial composition was evaluated by molecular approaches (Rep‐PCR and 16S rRNA gene sequencing). The obtained outcomes denoted that high concentrations of lactic acid bacteria and yeast populations (over 107 CFU/ml) were found in the kefir grains and were essentially composed of Lactococcus lactis, Lactobaccillus kefirien, bacillus sp., L. lactis, and Kluyveromyces marxianus. The co‐culture with 1% of inoculum size was demonstrated as the most efficient in the degradation of different contaminants. The overall abatement rate of chemical oxygen demand (COD), ammonium nitrogen (

), and salinity were 75.8%, 85.9%, and 75.13%, respectively. The bioremediation process resulted in up of 75% removal efficiency of Ni and Cd, and a 73.45%, 68.53%, and a 58.17% removal rates of Cu, Pb, and Fe, respectively. The research findings indicate the performance of L. lactis and K. marxianus co‐culture isolated from kefir grains for the bioremediation of LFL.

Practitioner Points

Isolation and identification of microorganisms from kefir grains was carried out.

Biological treatment of LFL using monoculture of (Lactoccocus lactis; Kluyveromyces marxianus) and co‐culture (5% of L. lactis and 5% K. marxianus) has been performed.

Biological treatment using co‐culture strain is an effective approach to remove organic matter,

and heavy metals.
NET-VISA from Cradle to Adulthood. A Machine-Learning Tool for Seismo-Acoustic Automatic Association
Authors: Le Bras Ronan , Arora Nimar , Kushida Noriyuki , Mialle Pierrick , Bondár Istvan , Tomuta Elena , Alamneh Fekadu Kebede , Feitio Paulino , Villarroel Marcela , Vera Beatriz , Sudakov Alexander , Laban Shaban , Nippress Stuart , Bowers David , Russell Stuart , Taylor Tammy
Published: May 2020

A research concept that was first presented on a poster at a Comprehensive Nuclear-Test-Ban Treaty (CTBT) conference in 2009 has resulted in a fully-fledged operational software product named NET-VISA (Network Processing Vertically Integrated Seismic Analysis), which performs the Network Processing step of the automatic processing at the International Data Centre (IDC). It has become one of the tools of the waveform analysts to review and improve the IDC standard automatic third Standard Events List (SEL3) bulletin and produce the Reviewed Events Bulletin (REB), the only global seismo-acoustic bulletin. The basic scientific concepts imbedded into NET-VISA are briefly summarized in this paper but the emphasis is on the process of adopting, developing, adapting, testing, and operationalizing the initial prototype. Extensive off-line testing has shown that one of the expected benefits of NET-VISA was the significant reduction in missed events rate compared to the current Network Processing software, Global Association (GA). NET-VISA also finds some events previously missed by manual review. Starting in July 2017, and as of January 2020, NET-VISA generates an automatic bulletin, called VSEL3, in parallel to SEL3, which is also used by analysts since January 2018. Tracing the origin of the REB events has confirmed the significant reduction in missed events when complementary VSEL3 events are reviewed in addition to the SEL3 events. If sufficient confidence is established, NET-VISA has the potential to replace GA in producing the standard automatic SEL3 bulletin.
Spielerische Ansätze in Prävention und Gesundheitsförderung: Serious Games und Gamification
Authors: Tolks Daniel , Lampert Claudia , Dadaczynski Kevin , Maslon Eveline , Paulus Peter , Sailer Michael
Published: May 2020

Digitale Spieleanwendungen können im Bereich Prävention und Gesundheitsförderung eingesetzt werden, um etwa gesundheitsrelevante Informationen zu vermitteln oder Verhaltensänderungen zu evozieren. Dabei sind die beiden relevantesten spielerischen Ansätze Serious Games (Spiele mit ernsthaftem Hintergrund) und Gamification (Anwendung spieltypischer Elemente in spielfremden Kontexten). Der Begriff Serious Games umschreibt Spiele, die eingesetzt werden, um ernsthafte Inhalte, wie zum Beispiel gesundheitliche Themen, zu vermitteln. Bei Gamification werden Spieldesignelemente, wie beispielsweise Punkte, Bestenlisten, Auszeichnungen, Profilgestaltung und Teamevents, eingesetzt, um eine Motivations- und Leistungssteigerung etwa in Lernumgebungen zu bewirken. Der vorliegende narrative Beitrag beleuchtet die Wirkungsweise und Studienlage sowie die Vor- und Nachteile spielerischer Anwendungen in der Prävention und Gesundheitsförderung und führt einige dieser Anwendungen exemplarisch auf.

Serious Games und Gamification zeigen in der Prävention und Gesundheitsförderung ein großes Potenzial. Insbesondere bei schwer erreichbaren und desinteressierten Zielgruppen kann ein direkter Bezug zu deren Lebenswelt hergestellt werden. Grundlagen für den wirkungsvollen Einsatz spielerischer Ansätze in der Arbeit und Ausbildung von Gesundheitsberufen sind die bereits hohe Vertrautheit mit dem Medium Spiel sowie die direkte Adressierung der psychologischen Grundbedürfnisse zur Steigerung der Motivation.
Ein strukturierter Versorgungspfad von der Pädiatrie in die Erwachsenenmedizin für Jugendliche und junge Erwachsene mit einer seltenen Erkrankung
Authors: Grasemann Corinna , Matar Nora , Bauer Jens , Manka Eva , Mundlos Christine , Krude Heiko , Grüters Annette , Hoffmann Georg F. , Choukair Daniela , Burgard Peter
Published: May 2020

Die erfolgreiche Organisation und Umsetzung des Übergangs von Jugendlichen und jungen Erwachsenen mit einer chronischen seltenen Erkrankung aus der Pädiatrie in eine Versorgungsform (Transition) und Versorgungsstruktur (Transfer) der Erwachsenenmedizin ist eine wichtige Aufgabe im dezentral aufgebauten deutschen Gesundheitssystem. Ein mittlerweile in der Praxis erprobtes Programm stellt der strukturierte Versorgungspfad des vom Innovationsfonds des gemeinsamen Bundesausschuss (G‑BA) geförderten Konsortiums TRANSLATE-NAMSE dar (Förderkennzeichen 01NVF16024 TRANSLATE-NAMSE). Grundlage des Übergangs in diesem Programm ist der qualitätsgesicherte Informations- und Kompetenztransfer vom pädiatrischen Behandlungsteam zum adoleszenten Patienten, sowie zur neuen Versorgungseinrichtung. Basierend auf einer strukturierten Epikrise und Erhebung des individuellen Beratungsbedarfs erfolgt, ab dem Alter von 16 Jahren, die strukturierte Transitionsschulung des Patienten durch den Pädiater. Nach erfolgreich absolvierten Transfersprechstunden, gemeinsam mit Vertretern der bisherigen pädiatrischen und der zukünftigen erwachsenenmedizinischen Versorgungseinrichtungen, mündet der Prozess in die Übergabe aller notwendigen medizinischen Unterlagen an den Patienten und den Weiterbehandler sowie den Wechsel des Patienten in die neue Versorgungseinrichtung. Eine abschließende Evaluation des Projekts ist für Herbst 2020 geplant.
Evidence for systematic autopsies in COVID-19 positive deceased
Authors: Fitzek A. , Sperhake J. , Edler C. , Schröder A. S. , Heinemann A. , Heinrich F. , Ron A. , Mushumba H. , Lütgehetmann M. , Püschel K.
Published: May 2020

Forensic medicine and pathology involve specific health risks, whereby health workers are dealing with microorganisms, cells or parasites, which are referred to as biological agents. Biological agents are divided into four categories according to § 3 of the Biological Agents Ordinance. The newly identified coronavirus, severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2) that has spread rapidly around the world is placed into category 3 of the Biological Agents Ordinance, meaning pathogens that can cause serious illnesses in humans and may pose a risk to workers. The Robert Koch Institute, the German government’s central scientific institution in the field of biomedicine issued the announcement, that aerosol-producing measures (including autopsies) of SARS-CoV‑2 infected bodies should be avoided, despite the fact that autopsies are an important source of understanding the pathomorphological course of new diseases. The first German case of death due to a proven SARS-CoV‑2 infection is presented with global multifocal reticular consolidation in the post-mortem computed tomography (CT) scan, a macroscopic and microscopic viral pneumonia and viral RNA of SARS-CoV‑2 in pharyngeal mucosa and lung tissue.
Development of CDX-527: a bispecific antibody combining PD-1 blockade and CD27 costimulation for cancer immunotherapy
Authors: Vitale Laura A. , He Li-Zhen , Thomas Lawrence J. , Wasiuk Anna , O’Neill Thomas , Widger Jenifer , Crocker Andrea , Mills-Chen Laura , Forsberg Eric , Weidlick Jeffrey , Patterson Colleen , Hammond Russell A. , Boyer James , Sisson Crystal , Alvarado Diego , Goldstein Joel , Marsh Henry C. , Keler Tibor
Published: May 2020

CD27 is a costimulatory molecule that provides a complementary target to the PD-1/PD-L1 checkpoint axis on T cells. Combining a CD27 agonist antibody with PD-1/PD-L1 blockade has shown synergistic antitumor activity in preclinical models, which led to clinical studies of the combination in cancer patients. We theorized that coupling CD27 costimulation with PD-1/PD-L1 blockade in a bispecific antibody (BsAb) may provide greater immune activating properties than combining the individual mAbs due to enhanced CD27 activation by cross-linking through PD-L1 and Fc receptors. To test this approach, we developed CDX-527, a tetravalent PD-L1xCD27 IgG1-scFv BsAb. CDX-527 potently inhibits PD-1 signaling and induces CD27-mediated T cell costimulation through PD-L1 cross-linking. In mixed lymphocyte reaction assays, CDX-527 is more potent than the combination of the parental antibodies, suggesting that cross-linking through both Fc receptors and PD-L1 results in enhanced CD27 agonist activity. CDX-527 was shown to mediate effector function against tumor cells overexpressing either CD27 or PD-L1. In human CD27 transgenic mice, we observed that antigen-specific T cell responses to a vaccine are greatly enhanced with a surrogate PD-L1xCD27 BsAb. Furthermore, the BsAb exhibits greater antitumor activity than the combination of the parental antibodies in a syngeneic lymphoma model. A pilot study of CDX-527 in cynomolgus macaques confirmed a mAb-like pharmacokinetic profile without noted toxicities. These studies demonstrate that CDX-527 effectively combines PD-1 blockade and CD27 costimulation into one molecule that is more potent than combination of the parental antibodies providing the rationale to advance this BsAb toward clinical studies in cancer patients.
Antitumor efficacy of BAFF-R targeting CAR T cells manufactured under clinic-ready conditions
Authors: Dong Zhenyuan , Cheng Wesley A. , Smith D. Lynne , Huang Brian , Zhang Tiantian , Chang Wen-Chung , Wang Xiuli , Forman Stephen J. , Kwak Larry W. , Qin Hong
Published: May 2020

B-cell malignancies can potentially be cured by CD19 chimeric antigen receptor (CAR) T-cell therapy. Although clinical response rates can be up to 93% in acute lymphoblastic leukemia, treatment-related antigen loss and lack of therapeutic persistence contribute to disease relapse. These shortcomings of current CAR T-cell therapy indicate the need for biologically relevant target selection and for improving the efficacy and persistence of the CAR T cells, which we have addressed by developing a novel B-cell activating factor receptor (BAFF-R) CAR T-cell therapy with improved therapeutic persistence. BAFF-R is a B-cell survival receptor and highly expressed in B-cell malignancies. We developed a prototype CAR T cell that efficiently and specifically eliminated BAFF-R expressing human B-cell tumors in several xenogeneic mouse models, including models of CD19 antigen loss. We proceeded with translational development and validation of BAFF-R CAR T cells produced under current good manufacturing practices (cGMP). cGMP-grade BAFF-R CAR T cells underwent in vitro and in vivo validation in established models to confirm that the potency and efficacy of our original research modeling was replicated. Food and Drug Administration required release testing was performed to ensure our BAFF-R CAR T cells meet specifications for new drug products. Completing and exceeding these requirements, the data fully support the initiation of a first-in-human Phase 1 trial for BAFF-R-positive relapsed/refractory (r/r) B-ALL.
Energy efficiency of respiration in mature and newborn reindeer
Authors: Solberg Simon Birger Byremo , Kjelstrup Signe , Magnanelli Elisa , Kizilova Natalya , Barroso Iratxe Lorea Casado , Acquarone Mario , Folkow Lars P.
Published: May 2020

Reindeer (Rangifer tarandus) have evolved elaborate nasal turbinate structures that are perfused via a complex vascular network. These are subject to thermoregulatory control, shifting between heat conservation and dissipation, according to the animal’s needs. The three-dimensional design of the turbinate structures is essential in the sense that they determine the efficiency with which heat and water are transferred between the structure and the respired air. The turbinates have already a relatively large surface area at birth, but the structures have yet not reached the complexity of the mature animal. The aim of this study was to elucidate the structure–function relationship of the heat exchange process. We have used morphometric and physiological data from newborn reindeer calves to construct a thermodynamic model for respiratory heat and water exchange and present novel results for the simulated respiratory energy losses of calves in the cold. While the mature reindeer effectively conserves heat and water through nasal counter-current heat exchange, the nose of the calf has not yet attained a similar efficiency. We speculate that this is probably related to structure-size limitations and more favourable climate conditions during early life. The fully developed structure–function relationship may serve as inspiration for engineering design. Simulations of different extents of mucosal vascularization suggest that the abundance and pattern of perfusion of veins in the reindeer nasal mucosa may contribute to the control of temperature profiles, such that nasal cavity tissue is sufficiently warm, but not excessively so, keeping heat dissipation within limits.
Long-term safety and efficacy of daclizumab beta in relapsing–remitting multiple sclerosis: 6-year results from the SELECTED open-label extension study
Authors: Gold Ralf , Radue Ernst-Wilhelm , Giovannoni Gavin , Selmaj Krzysztof , Havrdova Eva Kubala , Montalban Xavier , Stefoski Dusan , Sprenger Till , Robinson Randy R. , Fam Sami , Smith Jonathan , Chalkias Spyros , Giannattasio Giorgio , Lima Gabriel , Castro-Borrero Wanda
Published: May 2020

Objective

SELECTED, an open-label extension study, evaluated daclizumab beta treatment for up to 6 years in participants with relapsing multiple sclerosis who completed the randomized SELECT/SELECTION studies. We report final results of SELECTED.

Methods

Eligible participants who completed 1–2 years of daclizumab beta treatment in SELECT/SELECTION received daclizumab beta 150 mg subcutaneously every 4 weeks for up to 6 years in SELECTED. Safety assessments were evaluated for the SELECTED treatment period; efficacy data were evaluated from first dose of daclizumab beta in SELECT/SELECTION.

Results

Ninety percent (410/455) of participants who completed treatment in SELECTION enrolled in SELECTED. Within SELECTED, 69% of participants received daclizumab beta for > 3 years, 39% for > 4 years, and 9% for > 5 years; 87% of participants experienced an adverse event and 26% a serious adverse event (excluding multiple sclerosis relapse). No deaths occurred. Overall, hepatic events were reported in 25% of participants; serious hepatic events in 2%. There were no confirmed cases of immune-mediated encephalitis. Based on weeks from the first daclizumab beta dose in SELECT/SELECTION, adjusted annualized relapse rate (95% confidence interval) for weeks 0–24 was 0.21 (0.16–0.29) and remained low on continued treatment. Overall incidence of 24-week confirmed disability progression was 17.4%. Mean numbers of new/newly enlarging T2 hyperintense lesions remained low; percentage change in whole brain volume decreased over time.

Conclusions

The effects of daclizumab beta on clinical and radiologic outcomes were sustained for up to ~ 8 years of treatment. No new safety concerns were identified in SELECTED.

Trial registration

Clinicaltrials.gov NCT01051349; first registered on January 15, 2010.
Pretty crowds are happy crowds: the influence of attractiveness on mood perception
Authors: Mertens Alica , Hepp Johanna , Voss Andreas , Hische Amelie
Published: May 2020

Empirical findings predominantly support a happiness superiority effect in visual search and emotion categorization paradigms and reveal that social cues, like sex and race, moderate this advantage. A more recent study showed that the facial attribute attractiveness also influences the accuracy and speed of emotion perception. In the current study, we investigated whether the influence of attractiveness on emotion perception translates into a more general evaluation of moods when more than one emotional target is presented. In two experiments, we used the mood-of-the-crowd (MoC) task to investigate whether attractive crowds are perceived more positively compared to less attractive crowds. The task was to decide whether an array of faces included more angry or more happy faces. Furthermore, we recorded gaze movements to test the assumption that fixations on happy expressions occur more often in attractive crowds. Thirty-four participants took part in experiment 1 as well as in experiment 2. In both experiments, crowds presenting attractive faces were judged as being happy more frequently whereas the reverse pattern was found for unattractive crowds of faces. Moreover, participants were faster and more accurate when evaluating attractive crowds containing more happy faces as well as when judging unattractive crowds composed of more angry expressions. Additionally, in experiment 1, there were more fixations on happy compared to angry expressions in attractive crowds. Overall, the present findings support the assumption that attractiveness moderates emotion perception.
Long-term outcomes following intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 5-year treatment arm results from a prospective randomized double-blind sham-controlled multi-center study
Authors: Fischgrund Jeffrey S. , Rhyne Alfred , Macadaeg Kevin , Moore Gregory , Kamrava Evish , Yeung Christopher , Truumees Eeric , Schaufele Michael , Yuan Philip , DePalma Michael , Anderson David Greg , Buxton Douglas , Reynolds James , Sikorsky Michael
Published: May 2020

Background

Damaged or degenerated vertebral endplates are a significant cause of vertebrogenic chronic low back pain (CLBP). Modic changes are one objective MRI biomarker for these patients. Prior data from the treatment arm of a sham-controlled, RCT showed maintenance of clinical improvements at 2 years following ablation of the basivertebral nerve (BVN). This study reports 5-year clinical outcomes.

Methods

In total, 117 US patients were treated successfully with BVN ablation. Patient-reported outcomes of ODI, VAS, postablation treatments, and patient satisfaction were collected at a minimum of 5-years following BVN ablation. Primary outcome was mean change in ODI. Comparisons between the postablation and baseline values were made using an analysis of covariance with alpha 0.05.

Results

Of the 117 US treated patients 100 (85%) were available for review with a mean follow-up of 6.4 years (5.4–7.8 years). Mean ODI score improved from 42.81 to 16.86 at 5-year follow-up, a reduction of 25.95 points (p < 0.001). Mean reduction in VAS pain score was 4.38 points (baseline of 6.74, p < 0.001). In total, 66% of patients reported a > 50% reduction in pain, 47% reported a > 75% reduction in pain, and 34% of patients reported complete pain resolution. Composite responder rate using thresholds of ≥ 15-point ODI and ≥ 2-point VAS for function and pain at 5 years was 75%.

Conclusion

CLBP patients treated with BVN ablation exhibit sustained clinical improvements in function and pain with high responder rates at a mean of 6.4 years following treatment. BVN ablation is a durable, minimally invasive treatment for vertebrogenic CLBP.
Usefulness of fluorescence visualization-guided surgery for early-stage tongue squamous cell carcinoma compared to iodine vital staining
Authors: Ikeda Yusuke , Suzuki Taiki , Saitou Hirokazu , Ogane Satoru , Hashimoto Kazuhiko , Takano Nobuo , Nomura Takeshi
Published: May 2020

Background

In the most cases of oral squamous cell carcinoma (OSCC), oral epithelial dysplasia (OED) is found adjacent to the primary tumor. The delineation of surgical margins for OSCC is critical to minimize the risk for local recurrence. The aim of this study is to demonstrate that the fluorescence visualization (FV)- device can delineated the lesion visualizes OED of adjacent primary tumors by histopathologically comparison to conventional iodine vital staining.

Material and methods

The study involved 40 patients with superficial tongue squamous cell carcinoma treated from July 2016 to July 2018 at the Oral Cancer Center, Tokyo Dental College.

Results

Cytokeratin 13 (CK13) expression rate in the area of fluorescence visualization loss (FVL) was significantly lower than that in the area of fluorescence visualization retention (FVR). In addition, CK17, Ki-67, and p53 expression rates were significantly higher in FVL than FVR. There was no significant difference in the delineation rate or area between FVL and iodine-unstained area. High-grade dysplasia was observed most frequently at the FV and iodine-unstained boundary, but no significant pathological differences were found.

Conclusion

We strongly suggest the FV-guided surgery is a useful method for accurate resection in early-stage tongue squamous cell carcinoma.
Predictors of negotiated prices for new drugs in Germany
Authors: Gandjour Afschin , Schüßler Sofia , Hammerschmidt Thomas , Dintsios Charalabos-Markos
Published: May 2020

Introduction

In Germany, all new, innovative medicines are subject to an early benefit assessment by the German Federal Joint Committee with subsequent price negotiation and optional arbitration. The purpose of this study was to identify drivers of negotiated (including arbitrated) prices of new, non-orphan innovative medicines in Germany.

Methods

The analysis considered all non-orphan drugs that underwent a benefit appraisal between January 2011 and June 2016, and displayed a reimbursement price in the German Drug Directory (Lauer-Taxe®) in November 2017. Negotiated annual treatment costs were analyzed with respect to 11 explanatory variables in regression models.

Results

The total sample included 106 non-orphan drugs. The analysis showed a significant and positive association of log-transformed negotiated annual treatment cost of new medicines with log-transformed annual treatment cost of its comparator(s), extent of added benefit, and log-transformed size of the target population. Analyzing the effects of specific endpoints instead of the overall added benefit revealed that the single endpoint with the largest impact on price is adverse events (AEs). Surprisingly, an increase in AEs significantly increased the price. Various subgroup and sensitivity analyses demonstrated the robustness of the results. The adjusted R squared for all models was above 80%.

Conclusions

The analysis was able to confirm that variables whose consideration is mandated by law are, in fact, the key drivers of negotiated prices. Somewhat puzzling, the analysis also found an increase in AEs to move prices significantly upward.
Out-of-plane reinforcement of masonry walls using joint-embedded steel cables
Authors: Corradi Marco , Speranzini Emanuela , Bisciotti Giordano
Published: May 2020

The out-of-plane mechanism (rocking) of walls often causes fatalities and collapses of historic buildings during earthquakes. This paper addresses the problem of assessing the seismic resistance of walls subjected to out-of-plane bending, before and after reinforcement. A new retrofitting method, consisting in the use of high-strength steel cables fully embedded in the mortar bed joints was studied. An experimental investigation using full-scale brickwork specimens was therefore conducted in an attempt to assess the walls’ structural response when these are subject to out-of-plane loads. Test results demonstrated that it is possible to increase the out-of-plane capacity with the proposed method. A simplified macro-element procedure is also presented along with recommendations for the calculation of the walls’ capacity before and after the application of the steel cable reinforcement. Predictions of the magnitude of horizontal force required to cause out-of-plane failure using the proposed procedure and quasi-static analysis procedures are compared with the results of laboratory experiments.