bluuebunny/crossref_metadata_2025 huggingface dataset:
Single‐step screening and isolation of potential lipoxidase inhibitors from Trifolium repens by stepwise flow rate high‐speed countercurrent chromatography and semipreparative high‐performance liquid chromatography target‐guided by ultrafiltration‐LC‐MS
Authors: Wang Yueqi , Guo Liping , Liu Chunming , Li Sainan
Published: May 2021

An efficient method based on ultrafiltration high‐performance liquid chromatography coupled with photodiode array detector and electrospray ionization mass spectrometry for the rapid screening and identified of the ligands for activated from the extract of Trifolium repens L. Five major compounds, namely ononin, daidzein, genistein, formononetin, and biochanin A, were identified as potentially effective inhibitors. Subsequently, the specific binding ligands were separated by stepwise flow rate high‐speed countercurrent chromatography and semipreparative high‐performance liquid chromatography. This is the first report that T. repens extracts contain potent lipoxidase inhibitors. In summary, we systematically studied the active components in T. repens, evaluated their activity, separated and purified them, and identified their structure. This method is simple, fast, and efficient. It is suitable for the separation and purification of active compounds in T. repens, and provides a theoretical basis and technical platform for the development of natural medicines.
Salivary Cortisol and Alpha‐Amylase in Posttraumatic Stress Disorder and Their Potential Role in the Evaluation of Cognitive Behavioral Treatment Outcomes
Authors: Schumacher Sarah , Engel Sinha , Niemeyer Helen , Küster Annika , Burchert Sebastian , Skoluda Nadine , Rau Heinrich , Nater Urs M. , Willmund Gerd‐Dieter , Knaevelsrud Christine
Published: May 2021

Alterations in HPA‐axis and autonomic nervous system activity have been associated with posttraumatic stress disorder (PTSD) development and maintenance and are potentially associated with trauma‐focused cognitive behavioral therapy (TF‐CBT) outcomes. We examined the role of salivary cortisol (sCort) and alpha‐amylase (sAA) in PTSD and TF‐CBT outcomes in German Armed Forces service members (N = 100). Participants categorized as PTSD patients (n = 39), previously deployed healthy controls (n = 33), and nondeployed healthy controls (n = 28) provided diurnal profiles of sCort and sAA; PTSD patients provided samples before, immediately after, and 3 months after an internet‐based TF‐CBT intervention. No group differences emerged regarding total daily sCort and sAA output or daily slopes, ps = .224–.897, fs = 0.05–0.24. Participants with PTSD demonstrated a significantly attenuated sCort awakening response compared to deployed, p = .021, d = 0.59, but not nondeployed controls, p = .918, d = 0.08. Moreover, a significantly steeper sAA awakening response emerged in PTSD patients, p = .034, d = 0.67, and deployed controls, p = .014, d = 0.80, compared to nondeployed controls. From pretreatment to posttreatment (n = 21) and posttreatment to follow‐up (n = 14), stable sCort, ps = .282–.628, fs = 0.34–0.49, and sAA concentrations, ps = .068–.758, fs = 0.24–1.13 paralleled a nonsignificant treatment effect. Both PTSD and trauma exposure were associated with alterations in awakening responses, but further investigation is needed to determine whether the observed correspondence remains when PTSD symptoms significantly decline.
Not just another nasal polyp: Chondro‐osseous respiratory epithelial adenomatoid hamartomas of the sinonasal tract
Authors: Yu Yue , Tan Chien Sheng , Koh Leslie Timothy
Published: May 2021

Objectives

Chondro‐osseous respiratory epithelial adenomatoid hamartomas (COREAH) are extremely rare benign lesions in the sinonasal cavity. We aim to (a) report two cases of COREAH and (b) perform a literature review with a summary on previously published cases of COREAH till August 2019.

Methods

A literature review identified 16 cases, but only 12 cases from publications from 2005 to 2019 were included in analysis. In addition, we report two cases of COREAH from our tertiary academic medical center.

Results

COREAH is found in patients from 3 to 83 years old. It originates from various sites in the nasal cavity and sinuses but the most common location is the lateral nasal wall. Calcification on imaging is a common finding.

Conclusion

COREAH is an uncommon entity that is important to recognize and distinguish from other sinister nasal masses. It is a slow growing benign lesion which lacks aggressive features on imaging. Future studies are needed to evaluate the possibility of an underlying genetic predisposition.

Level of Evidence

4.
Nicotinamide mononucleotide ameliorates senescence in alveolar epithelial cells
Authors: Fang Tingting , Yang Jingyun , Liu Li , Xiao Hengyi , Wei Xiawei
Published: May 2021

Alveolar epithelial cells (ACEs) gradually senescent as aging, which is one of the main causes of respiratory defense and function decline. Investigating the mechanisms of ACE senescence is important for understanding how the human respiratory system works. NAD+ is reported to reduce during the aging process. Supplementing NAD+ intermediates can activate sirtuin deacylases (SIRT1–SIRT7), which regulates the benefits of exercise and dietary restriction, reduce the level of intracellular oxidative stress, and improve mitochondrial function, thereby reversing cell senescence. We showed that nicotinamide mononucleotide (NMN) could effectively mitigate age‐associated physiological decline in the lung of 8–10 months old C57BL/6 mice and bleomycin‐induced pulmonary fibrosis in young mice of 6–8 weeks. Besides, the treatment of primary ACEs with NMN can markedly ameliorate cell senescence phenotype in vitro. These findings to improve the respiratory system function and reduce the incidence and mortality from respiratory diseases in the elderly are of great significance.
Convective energy transport in a vertical porous channel: Effects of triple diffusion and Newtonian heating/cooling
Authors: Umavathi Jawali C. , Sheremet Mikhail A.
Published: May 2021

The effect of triple diffusion on convection of viscous liquid in a vertical channel saturated with permeable material is explored subject to Robin conditions on the boundaries. Inside the duct, the salts of distinct compositions are diffused. Non‐Darcy approach is used to describe the porous material influence on transport processes. Symmetric and asymmetric heating conditions are considered for the ambient temperatures close to the vertical channel borders. Heat is exchanged between the vertical plates and the external fluid. Initially, the solutions are found without an influence of viscous dissipation and buoyancy forces. Inclusion of these two effects leads to nonlinear equations and adopting Brinkman parameter as the perturbation characteristic for the solutions is procured. Owing to the limitation on the perturbation characteristic, the conservation relations are solved numerically using the Runge–Kutta procedure combined with shooting technique. The flow patterns are depicted for the properties of the heat and mass Grashof numbers, porous parameter, inertial parameter, Brinkman number, Biot numbers, and chemical reaction characteristics. The effects of these parameters are explored on the skin frictions and Nusselt numbers. In the case of dissipations caused by viscosity and Forchheimer drag term, the perturbation results and numerical solutions are equal for low magnitudes of perturbation characteristic.
A framework for voxel‐based assessment of biological effect after proton radiotherapy in pediatric brain cancer patients using multi‐modal imaging
Authors: Skaarup Mikkel , Lundemann Michael Juncker , Darkner Sune , Jørgensen Morten , Marner Lisbeth , Mirkovic Dragan , Grosshans David , Peeler Christopher , Mohan Radhe , Vogelius Ivan Richter , Appelt Ane
Published: May 2021

Introduction

The exact dependence of biological effect on dose and linear energy transfer (LET) in human tissue when delivering proton therapy is unknown. In this study, we propose a framework for measuring this dependency using multi‐modal image‐based assays with deformable registrations within imaging sessions and across time.

Materials and Methods

3T MRI scans were prospectively collected from 6 pediatric brain cancer patients before they underwent proton therapy treatment, and every 3 months for a year after treatment. Scans included T1‐weighted with contrast enhancement (T1), T2‐FLAIR (T2) and fractional anisotropy (FA) images. In addition, the planning CT, dose distributions and Monte Carlo‐calculated LET distributions were collected.

A multi‐modal deformable image registration framework was used to create a dataset of dose, LET and imaging intensities at baseline and follow‐up on a voxel‐by‐voxel basis. We modelled the biological effect of dose and LET from proton therapy using imaging changes over time as a surrogate for biological effect.

We investigated various models to show the feasibility of the framework to model imaging changes. To account for interpatient and intrapatient variations, we used a nested generalized linear mixed regression model. The models were applied to predict imaging changes over time as a function of dose and LET for each modality.

Results

Using the nested models to predict imaging changes, we saw a decrease in the FA signal as a function of dose; however, the signal increased with increasing LET. Similarly, we saw an increase in T2 signal as a function of dose, but a decrease in signal with LET. We saw no changes in T1 voxel values as a function of either dose or LET.

Conclusions

The imaging changes could successfully model biological effect as a function of dose and LET using our proposed framework. Due to the low number of patients, the imaging changes observed for FA and T2 scans were not marked enough to draw any firm conclusions.
Suppression of artifact‐generating echoes in cine DENSE using deep learning
Authors: Abdi Mohamad , Feng Xue , Sun Changyu , Bilchick Kenneth C. , Meyer Craig H. , Epstein Frederick H.
Published: May 2021

Purpose

To use deep learning for suppression of the artifact‐generating T1‐relaxation echo in cine displacement encoding with stimulated echoes (DENSE) for the purpose of reducing the scan time.

Methods

A U‐Net was trained to suppress the artifact‐generating T1‐relaxation echo using complementary phase‐cycled data as the ground truth. A data‐augmentation method was developed that generates synthetic DENSE images with arbitrary displacement‐encoding frequencies to suppress the T1‐relaxation echo modulated for a range of frequencies. The resulting U‐Net (DAS‐Net) was compared with k‐space zero‐filling as an alternative method. Non‐phase‐cycled DENSE images acquired in shorter breath‐holds were processed by DAS‐Net and compared with DENSE images acquired with phase cycling for the quantification of myocardial strain.

Results

The DAS‐Net method effectively suppressed the T1‐relaxation echo and its artifacts, and achieved root Mean Square(RMS) error = 5.5 ± 0.8 and structural similarity index = 0.85 ± 0.02 for DENSE images acquired with a displacement encoding frequency of 0.10 cycles/mm. The DAS‐Net method outperformed zero‐filling (root Mean Square error = 5.8 ± 1.5 vs 13.5 ± 1.5, DAS‐Net vs zero‐filling, P < .01; and structural similarity index = 0.83 ± 0.04 vs 0.66 ± 0.03, DAS‐Net vs zero‐filling, P < .01). Strain data for non‐phase‐cycled DENSE images with DAS‐Net showed close agreement with strain from phase‐cycled DENSE.

Conclusion

The DAS‐Net method provides an effective alternative approach for suppression of the artifact‐generating T1‐relaxation echo in DENSE MRI, enabling a 42% reduction in scan time compared to DENSE with phase‐cycling.
Mid‐Arm Muscle and Subcutaneous Fat Associated with All‐Cause Mortality Independent of BMI: A Prospective Cohort Study
Authors: He Liyun , Yang Na , Wang Jialu , Huang Jingyue , Li Wei , Xu Lingling , Ping Fan , Li Yuxiu , Zhang Huabing
Published: May 2021

Objective

This study aimed to systematically evaluate the association between triceps skinfold (TSF) thickness (which indicates subcutaneous fat) mid‐arm muscle circumference (MAMC; which reflects muscle mass), mid‐upper arm circumference (MUAC), and all‐cause mortality.

Methods

A total of 17,717 adults from the China Health and Nutrition Survey (1993‐2015) were included. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for all‐cause mortality. The joint effect of TSF thickness and MAMC was examined, and planned subgroup analyses were performed.

Results

The highest quartiles of TSF thickness, MAMC, and MUAC were significantly associated with low all‐cause mortality, independent of BMI (TSF thickness: HR = 0.704 [95% CI: 0.575‐0.862]; MAMC: HR = 0.729 [95% CI: 0.607‐0.876]; MUAC: HR = 0.713 [95% CI: 0.583‐0.872]). A 1‐SD increase showed comparable risk reductions for TSF thickness and MAMC (14.6% and 14.0%), with 16.1% risk reductions in MUAC. There were positive additive interactions between TSF thickness and MAMC. The inverse association existed in young, middle‐aged, and elderly participants (P‐heterogeneity > 0.05).

Conclusions

Mid‐arm muscle and subcutaneous fat were inversely associated with all‐cause mortality, independent of BMI, beyond the elderly population. Mid‐arm muscle and subcutaneous fat made comparable contributions to and had positive joint effects on all‐cause mortality.
Reduced‐toxicity conditioning regimen with busulfan, fludarabine, rATG, and 400 cGy TBI in pediatric patients undergoing hematopoietic stem cell transplant for high‐risk hematologic malignancies
Authors: Rossoff Jenna , Jacobsohn David , Kwon Soyang , Kletzel Morris , Duerst Reggie E. , Tse William T. , Schneiderman Jennifer , Chaudhury Sonali
Published: May 2021

Background

Myeloablative conditioning regimens decrease the risk of relapse in pediatric patients undergoing allogeneic hematopoietic stem cell transplant (HCT) for hematologic malignancies, but cause significant toxicities

Procedure

This prospective study evaluated the use of a reduced‐toxicity, myeloablative regimen with dose‐adjusted busulfan, fludarabine, antithymocyte globulin and 400 cGy of total body irradiation in 40 patients < 21 years of age undergoing HCT for high‐risk leukemias. Busulfan pharmacokinetics were measured to target 4000 μmol*min/day in the first 30 patients; this was increased to 5000 μmol*min/day in the subsequent 10 in efforts to further decrease relapse risk

Results

Overall survival at two‐ and five‐years post‐HCT was 67% and 51%, respectively. Relapse occurred in 11 patients (28%) at a median of seven months and was the leading cause of death. Transplant‐related mortality was 8% and 13% at 100 days and one‐year post‐HCT, respectively. Trends toward improved survival were seen in patients transplanted for myeloid disease using bone marrow as stem cell source who achieved a busulfan AUC > 4000 μmol*min/day with two‐year relapse‐free survival approaching 80%

Conclusions

This conditioning regimen is safe and effective in patients with high‐risk leukemias, particularly myeloid disease. Larger studies are needed to compare its safety and efficacy to other myeloablative regimens in this population.
Joint confidence region estimation on predictive values
Authors: Schaible Braydon J. , Yin Jingjing
Published: May 2021

For evaluating diagnostic accuracy of inherently continuous diagnostic tests/biomarkers, sensitivity and specificity are well‐known measures both of which depend on a diagnostic cut‐off, which is usually estimated. Sensitivity (specificity) is the conditional probability of testing positive (negative) given the true disease status. However, a more relevant question is “what is the probability of having (not having) a disease if a test is positive (negative)?”. Such post‐test probabilities are denoted as positive predictive value (PPV) and negative predictive value (NPV). The PPV and NPV at the same estimated cut‐off are correlated, hence it is desirable to make the joint inference on PPV and NPV to account for such correlation. Existing inference methods for PPV and NPV focus on the individual confidence intervals and they were developed under binomial distribution assuming binary instead of continuous test results. Several approaches are proposed to estimate the joint confidence region as well as the individual confidence intervals of PPV and NPV. Simulation results indicate the proposed approaches perform well with satisfactory coverage probabilities for normal and non‐normal data and, additionally, outperform existing methods with improved coverage as well as narrower confidence intervals for PPV and NPV. The Alzheimer's Disease Neuroimaging Initiative (ADNI) data set is used to illustrate the proposed approaches and compare them with the existing methods.
Balance conditions in variational data assimilation for a high‐resolution forecast model
Authors: Bannister Ross N.
Published: May 2021

This paper explores the role of balance relationships for background‐error covariance modelling as the model's grid box decreases to convective scales. Data assimilation (DA) analyses are examined from a simplified convective‐scale model and DA system (called ABC‐DA) with a grid box size of 1.5 km in a 2D 540 km (longitude), 15 km (height) domain. The DA experiments are performed with background‐error covariance matrices () modelled and calibrated by switching on/off linear balance (LB) and hydrostatic balance (HB), and by observing a subset of the ABC variables, namely (meridional wind), (scaled density, a pressure‐like variable), and (buoyancy, a temperature‐like variable). Calibration data are sourced from two methods of generating proxies of forecast errors. One uses forecasts from different latitude slices of a 3D parent model (here called the latitude slice method), and the other uses sets of differences between forecasts of different lengths but valid at the same time (the National Meteorological Center method). Root‐mean‐squared errors computed over the domain from identical twin DA experiments suggest that there is no combination of LB/HB switches that give the best analysis for all model quantities. However it is frequently found that the ‐matrices modelled with both LB and HB do perform the best. A clearer picture emerges when the errors are examined at different spatial scales. In particular it is shown that switching on HB in mostly has a neutral/positive effect on the DA accuracy at ‘large’ scales, and switching off the HB has a neutral/positive effect at ‘small’ scales. The division between ‘large’ and ‘small’ scales is between 10 and 100 km. Furthermore, one hour forecast‐error correlations computed between control parameters find that correlations are small at large scales when balances are enforced, and at small scales when balances are not enforced (ideal control parameters have zero cross‐correlations). This points the way to modelling with scale‐dependent balances.
Controllable, Self‐Powered, and High‐Performance Short‐Wavelength Infrared Photodetector Driven by Coupled Flexoelectricity and Strain Effect
Authors: Kumar Mohit , Lim Jaeseong , Park Ji‐Yong , Seo Hyungtak
Published: May 2021

Mechanical deformation‐induced strain gradients and coupled spontaneous electric polarization field in centrosymmetric materials, known as the flexoelectric effect, can generate ubiquitous mechanoelectrical functionalities, like the flexo‐photovoltaic effect. Concurrently, nano/micrometer‐scale inhomogeneous strain reengineers the electronic arrangements and in turn, could alter the fundamental limits of optoelectronic performance. Here, the flexoelectric effect‐driven self‐powered giant short‐wavelength infrared (λ ≤ 1800 nm) photoresponse from centrosymmetric bulk silicon, indeed far beyond the fundamental bandgap (λ = 1100 nm) is demonstrated. Particularly, large on/off ratio (≈105), extremely high sensitivity (2.5 × 108%), good responsivity of 96 mA W−1, decent specific detectivity of ≈1.54 × 1014 Jones, and a rapid response speed of ≈100 µs, even at nanoscale (<30 nm), are measured at λ = 1620 nm. The infrared response sensitivity is tuned in a wide range (up to 1.4 × 108%) by controlling the applied pointed force from 1 to 10 µN. These results confirm that emerging mechanoelectrical coupling not only sheds to achieve tunable optoelectronic performance beyond the fundamental limit, but also offers innovative numerous applications like mechanoptical switch, photovoltaic, sensors, and self‐driving vehicles.
Cutaneous adverse drug reaction in a dog following firocoxib treatment
Authors: Geum Migyeong , Ko Hui‐Yeon , Na Yeon‐Joo , Kim Ha‐Jung
Published: May 2021

A 9‐year‐old intact female toy poodle was presented with oedema around the neck, including pus and cutaneous necrosis, 2 days after starting firocoxib treatment and placement of a cervical collar for intervertebral disc disease. Cytology of the pus revealed predominantly mature neutrophils with fewer macrophages and lymphocytes, indicating sterile inflammation. Although a skin biopsy could have provided more diagnostic information, it was not performed at presentation. Firocoxib treatment was discontinued, and immunosuppressive therapy including cyclosporine was initiated, which significantly alleviated the skin lesions. The dog recovered fully in 7 weeks. The final diagnosis was a possible cutaneous adverse drug reaction to firocoxib based on history, clinical signs and response to therapy.
Disinfection/ammonia removal from aquaculture wastewater and disinfection of irrigation water using electrochemical flow cells: A case study in Hawaii
Authors: Qing Geletu , Foster Shelby L. , Anari Zahra , Matlock Marty , Thoma Greg , Greenlee Lauren F.
Published: May 2021

This field case study reports findings on disinfection/ammonia removal from aquaculture wastewater and disinfection of irrigation water carried out at an aquaculture farm and two irrigation locations in Hawaii. We used a flow cell incorporating PtRu/graphite anode and graphite cathode for the disinfection/ammonia removal from aquaculture wastewater, and a flow cell assembled with graphite plates as both anode and cathode for the disinfection of irrigation water. The removal of ammonia followed the indirect oxidation mechanism mediated by free chlorine electro‐generated at the PtRu/graphite anode. Ammonia removal rate increased with the increase in NaCl concentration, applied current density, or flow rate. The disinfection of aquaculture wastewater can be readily achieved due to the presence of highly germicidal free chlorine species. The disinfection of irrigation water was realized without the addition of chemicals. The disinfection mechanism was attributed to the formation of free chlorine from the anodic oxidation of chloride ions naturally occurring in the water sources. The disinfection efficiency decreased with increasing organic matter concentration. In addition to the flow cell approach, we also successfully demonstrated the disinfection of irrigation water by adding electrolyzed NaCl solution or purging with a mixture of air and chlorine gas, both of which were generated on‐site.

Practitioner points

Field case study on disinfection/ammonia removal from aquaculture wastewater and disinfection of irrigation water was carried out in Hawaii.

Electrochemical flow cell assembled with PtRu/graphite anode and graphite cathode effectively removes ammonia from aquaculture wastewater.

Ammonia removal proceeds via the indirect oxidation mechanism mediated by free chlorine electro‐generated at the PtRu/graphite anode.

Electrochemical flow cell assembled with commercial graphite electrodes enables fast disinfection of coliform bacteria and E. coli.

The primary disinfection mechanism is through chlorine species electro‐generated from chloride oxidation at the graphite anode.
Alkoholprävention am Arbeitsplatz: Aktuelle Konzepte zur betrieblichen Suchtprävention und Suchthilfe
Authors: Wienemann Elisabeth , Wartmann Anja
Published: May 2021

Zur Vorbeugung von Alkoholproblemen am Arbeitsplatz und zur Hilfe bei Suchtgefährdung hat sich das Standardmodell der betrieblichen Suchtprävention und Suchthilfe bewährt. Kernelemente sind: 1) Information und Aufklärung, 2) frühzeitige Interventionen, 3) Qualifizierung und Beratung von Personalverantwortlichen und 4) Hilfeangebote für Beschäftigte. In diesem Beitrag wird zunächst die historische Entwicklung der betrieblichen Alkohol- und Suchtprävention kurz beschrieben, Forschungsergebnisse werden dargestellt und danach wird auf Maßnahmen zur Prävention, zur Intervention bei Suchtgefährdung und zur Reduzierung des Alkoholkonsums am Arbeitsplatz eingegangen.

In den 1970er-Jahren wurden betriebliche Suchtpräventionsprogramme nach US-amerikanischem Vorbild in Deutschland etabliert. Im Jahr 2006 veröffentlichte die Deutsche Hauptstelle für Suchtfragen (DHS) erstmals die „Qualitätsstandards in der betrieblichen Suchtprävention und Suchthilfe“ und ermöglichte allen Betrieben den Zugriff auf fachlich abgestimmte und rechtlich aktuelle Materialien. Das ist bedeutsam, um angemessene Maßnahmen zur Regulierung und Reduzierung des Alkoholkonsums am Arbeitsplatz zu treffen. Zum Präventionsauftrag der Führungskräfte gehört die Unterweisung der Beschäftigten zur Vermeidung gesundheitlicher Gefährdungen. Sobald Verstöße gegen die Arbeitssicherheit vorliegen, sind Vorgesetzte zudem verpflichtet einzugreifen. Generell sollten sie bei Auffälligkeiten möglichst frühzeitig intervenieren. Bei riskantem Suchtmittelgebrauch und Suchtgefährdung wird nach einer gestuften Gesprächsfolge verfahren. Unterstützungsangebote von internen oder externen Beratungsstellen werden empfohlen.

Alkohol- und Suchtprävention ist Teil des betrieblichen Gesundheitsmanagements. Besonders nachhaltig wirkt sie dort, wo das Programm in einer Betriebs- oder Dienstvereinbarung festgeschrieben wurde und verbindlich umgesetzt wird.
Telemedizin in der Schlaganfallversorgung – versorgungsrelevant für Deutschland
Authors: Barlinn J. , Winzer S. , Worthmann H. , Urbanek C. , Häusler K. G. , Günther A. , Erdur H. , Görtler M. , Busetto L. , Wojciechowski C. , Schmitt J. , Shah Y. , Büchele B. , Sokolowski P. , Kraya T. , Merkelbach S. , Rosengarten B. , Stangenberg-Gliss K. , Weber J. , Schlachetzki F. , Abu-Mugheisib M. , Petersen M. , Schwartz A. , Palm F. , Jowaed A. , Volbers B. , Zickler P. , Remi J. , Bardutzky J. , Bösel J. , Audebert H. J. , Hubert G. J. , Gumbinger C.
Published: May 2021

Hintergrund und Ziel

Telemedizinische Schlaganfall-Netzwerke tragen dazu bei, die Schlaganfallversorgung und insbesondere den Zugang zu zeitkritischen Schlaganfalltherapien in vorrangig strukturschwachen, ländlichen Regionen zu gewährleisten. Ziel ist eine Darstellung der Nutzungsfrequenz und regionalen Verteilung dieser Versorgungsstruktur.

Methoden

Die Kommission „Telemedizinische Schlaganfallversorgung“ der Deutschen Schlaganfall-Gesellschaft führte eine Umfragestudie in allen Schlaganfall-Netzwerken durch.

Ergebnisse

In Deutschland sind 22 telemedizinische Schlaganfall-Netzwerke aktiv, welche insgesamt 43 Zentren (pro Netzwerk: Median 1,5, Interquartilsabstand [IQA] 1–3) sowie 225 Kooperationskliniken (pro Netzwerk: Median 9, IQA 4–17) umfassen und an einem unmittelbaren Zugang zur Schlaganfallversorgung für 48 Mio. Menschen teilhaben. Im Jahr 2018 wurden 38.211 Telekonsile (pro Netzwerk: Median 1340, IQA 319–2758) durchgeführt. Die Thrombolyserate betrug 14,1 % (95 %-Konfidenzintervall 13,6–14,7 %), eine Verlegung zur Thrombektomie wurde bei 7,9 % (95 %-Konfidenzintervall 7,5–8,4 %) der ischämischen Schlaganfallpatienten initiiert. Das Finanzierungssystem ist uneinheitlich mit einem Vergütungssystem für die Zentrumsleistungen in nur drei Bundesländern.

Diskussion

Etwa jeder 10. Schlaganfallpatient wird telemedizinisch behandelt. Die telemedizinischen Schlaganfall-Netzwerke erreichen vergleichbar hohe Lyseraten und Verlegungen zur Thrombektomie wie neurologische Stroke-Units und tragen zur Sicherstellung einer flächendeckenden Schlaganfallversorgung bei. Eine netzwerkübergreifende Sicherstellung der Finanzierung und einheitliche Erhebung von Qualitätssicherungsdaten haben das Potenzial diese Versorgungsstruktur zukünftig weiter zu stärken.
Denotational semantics of channel mobility in UTP-CSP
Authors: Ekembe Ngondi Gerard
Published: May 2021

In this paper, we present the denotational semantics for channel mobility in the Unifying Theories of Programming (UTP) semantics framework. The basis for the model is the UTP theory of reactive processes, precisely, the UTP semantics for Communicating Sequential Processes (CSP), which is extended to allow the mobility of channels—the set of channels that a process can use for communication (its interface), originally static or constant (set during the process's definition), is now made dynamic or variable: it can change during the process's execution. A channel is thus moved around by communicating it via other channels and then allowing the receiving process to extend its interface with the received channel. We introduce a new concept, thecapabilityof a process, which allows separating the ownership of channels from the knowledge of their existence. Mobile processes are then defined as having a static capability and a dynamic interface. Operations of a mobile telecommunications network, e.g., handover, load balancing, are used to illustrate the semantics. We redefine CSP operators and in particular provide the first semantics for the renaming and hiding operators in the context of channel mobility.
In-process detection of grinding burn using machine learning
Authors: Sauter Emil , Sarikaya Erkut , Winter Marius , Wegener Konrad
Published: May 2021

The improvement of industrial grinding processes is driven by the objective to reduce process time and costs while maintaining required workpiece quality characteristics. One of several limiting factors is grinding burn. Usually applied techniques for workpiece burn are conducted often only for selected parts and can be time consuming. This study presents a new approach for grinding burn detection realized for each ground part under near-production conditions. Based on the in-process measurement of acoustic emission, spindle electric current, and power signals, time-frequency transforms are conducted to derive almost 900 statistical features as an input for machine learning algorithms. Using genetic programming, an optimized combination between feature selector and classifier is determined to detect grinding burn. The application of the approach results in a high classification accuracy of about 99% for the binary problem and more than 98% for the multi-classdetection case, respectively.
Subsidizing risk prevention
Authors: Menegatti Mario
Published: May 2021

This work examines the effects of different kinds of subsidies on risk prevention from a theoretical standpoint. We show that both a subsidy on the cost of prevention activities and a subsidy on wealth have ambiguous effects on the level of present contemporaneous prevention. Similar kinds of subsidies have however increasing effects on the level of advance prevention and, under plausible assumptions, on future levels of contemporaneous prevention. We also show that social security subsidies may have decreasing effects on prevention activities while a kind of reverse social security has an increasing effects on them. This indicates that there is a trade-off between the social security aim of mitigating the negative consequences of bad events and the prevention aim of incentivizing choices which reduce the probability that these bad events occur.
Screening for adverse childhood experiences in preventive medicine settings: a scoping review
Authors: Mishra Kratika , Atkins Daniel E. , Gutierrez Brenda , Wu Jinli , Cousineau Michael R. , Hempel Susanne
Published: May 2021

Aim

Adverse childhood experiences (ACEs) are associated with numerous adverse mental and physical health outcomes. While interest in routine screening for ACEs is growing, there is still significant opposition to universal screening. This review explores the feasibility of implementing routine screening for ACEs in primary care settings.

Subject and methods

We searched PubMed, CINAHL, and PsycINFO, reference-mined relevant reviews, and consulted with key experts (June 2020). Studies from 1970 to date evaluating screening for childhood trauma, adversity, and ACEs in a routine healthcare setting, reporting quantitative or qualitative data were eligible. The project is registered in Open Science Framework (osf.io/5wef8) and reporting follows PRISMA-ScR guidelines.

Results

Searches retrieved 1402 citations. Of 246 publications screened as full text, 43 studies met inclusion criteria. Studies evaluated provider burden, familiarity with ACEs, practice characteristics, barriers to screening, frequency of ACE inquiry, reported or desired training, patient comfort, and referrals to support services.

Conclusions

This review found that the following factors increase the likelihood that ACE screenings can be successfully integrated into healthcare settings: staff trainings that increase provider confidence and competence in administering screenings, accessible and robust mental health resources, and organizational support. Further research should examine the scalability and sustainability of universal screening.
Is lifestyle change around retirement associated with better physical performance in older age?: insights from a longitudinal cohort
Authors: Robinson Sian M. , Westbury Leo D. , Ward Kate , Syddall Holly , Cooper Rachel , Cooper Cyrus , Sayer Avan A.
Published: May 2021

A growing evidence base links individual lifestyle factors to physical performance in older age, but much less is known about their combined effects, or the impact of lifestyle change. In a group of 937 participants from the MRC National Survey of Health and Development, we examined their number of lifestyle risk factors at 53 and 60–64 years in relation to their physical performance at 60–64, and the change in number of risk factors between these ages in relation to change in physical performance. At both assessments, information about lifestyle (physical activity, smoking, diet) was obtained via self-reports and height and weight were measured. Each participant’s number of lifestyle risk factors out of: obesity (body mass index ≥ 30 kg/m2); inactivity (no leisure time physical activity over previous month); current smoking; poor diet (diet quality score in bottom quarter of distribution) was determined at both ages. Physical performance: measured grip strength, chair rise and standing balance times at both ages and conditional change (independent of baseline) in physical performance outcomes from 53 to 60–64 were assessed. There were some changes in the pattern of lifestyle risk factors between assessments: 227 (24%) participants had fewer risk factors by age 60–64; 249 (27%) had more. Reductions in risk factors were associated with better physical performance at 60–64 and smaller declines over time (all p < 0.05); these associations were robust to adjustment. Strategies to support reduction in number of lifestyle risk factors around typical retirement age may have beneficial effects on physical performance in early older age.
Distribution, behavior, and erosion of uranium in vineyard soils
Authors: Campos Daniel A. , Blanché Sophia , Jungkunst Hermann F. , Philippe Allan
Published: May 2021

Phosphate fertilization contributes to an input of uranium (U) in agricultural soils. Although its accumulation and fate in agricultural soils have been previously studied, its colloidal transport and accumulation along slopes through erosion have been studied to a lesser extent in viticulture soils. To bridge this gap, the contents and potential mobility of U were investigated in vineyard model soils in the Rhineland-Palatinate region, Germany. In addition to elevated U contents, U was expected to associate with colloids and subject to erosion, thus accumulating on slope foots and in soils with fine structure, and reflecting a greater variability. Moreover, another expectation was the favorable erosion/mobility of U in areas with greater carbonate content. This was tested in three regional locations, at different slope positions and through soil horizon depths, with a total of 57 soil samples. The results show that U concentrations (0.48–1.26 ppm) were slightly higher than proximal non-agricultural soils (0.50 ppm), quite homogenous along slope positions, and slightly higher in topsoils. Assuming a homogeneous fertilization, the vertical translocation of U in soil was most probably higher than along the slope by erosion. In addition, carbonate content and soil texture correlated with U concentrations, whereas other parameters such as organic carbon and iron contents did not. The central role of carbonate and soil texture for the prediction of U content was confirmed using decision trees and elastic net, although their limited prediction power suggests that a larger sample size with a larger range of U content is required to improve the accuracy. Overall, we did not observe neither U nor colloids accumulating on slope foots, thus suggesting that soils are aggregate-stable. Lastly, we suggested considering further soil parameters (e.g., Ca2+, phosphorus, alkali metals) in future works to improve our modelling approach. Overall, our results suggest U is fortunately immobile in the studied locations.
Investigation of the effect of residual stresses in the subsurface on process forces for consecutive orthogonal cuts
Authors: Wöste F. , Kimm J. , Bergmann J. A. , Theisen W. , Wiederkehr P.
Published: May 2021

The quality and surface integrity of machined parts is influenced by residual stresses in the subsurface resulting from cutting operations. These stress characteristics can not only affect functional properties such as fatigue life, but also the process forces during machining. Especially for orthogonal cutting as an appropriate experimental analogy setup for machining operations like milling, different undeformed chip thicknesses cause specific residual stress formations in the subsurface area. In this work, the process-related depth profile of the residual stress in AISI 4140 was investigated and correlated to the resulting cutting forces. Furthermore, an analysis of the microstructure of the cut material was performed, using additional characterization techniques such as electron backscatter diffraction and nanoindentation to account for subsurface alterations. On this basis, the influence of process-related stress profiles on the process forces for consecutive orthogonal cutting strategies is evaluated and compared to the results of a numerical model. The insights obtained provide a basis for future investigations on, e. g., empirical modeling of process forces including the influence of process-specific characteristics such as residual stress.
Dual Convolution for the Affine Group of the Real Line
Authors: Choi Yemon , Ghandehari Mahya
Published: May 2021

The Fourier algebra of the affine group of the real line has a natural identification, as a Banach space, with the space of trace-class operators on $$L^2({{\mathbb {R}}}^\times , dt/ |t|)$$

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. In this paper we study the “dual convolution product” of trace-class operators that corresponds to pointwise product in the Fourier algebra. Answering a question raised in work of Eymard and Terp, we provide an intrinsic description of this operation which does not rely on the identification with the Fourier algebra, and obtain a similar result for the connected component of this affine group. In both cases we construct explicit derivations on the corresponding Banach algebras, verifying the derivation identity directly without requiring the inverse Fourier transform. We also initiate the study of the analogous Banach algebra structure for trace-class operators on $$L^p({{\mathbb {R}}}^\times , dt/ |t|)$$

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Use of the Spare-Part Strategy to Reconstruct the External Auditory Canal After Subtotal Auriculectomy for Basal Cell Carcinoma
Authors: Pignatti Marco , Sorbi Gioia , Pinto Valentina , Sorrenti Giovanni , Cipriani Riccardo
Published: May 2021

After removal of an infiltrative BCC of the auditory meatus, a soft tissue defect of the temporal-mastoid area with bone exposure, needed reconstruction. Several options have been taken into account and a simple yet effective solution has been found following the spare-parts principle. The ear lobe, preserved during cancer removal, was split and used as a thin skin flap. Adequate coverage of the bone exposure and resurfacing of the external auditory canal was obtained with minimal donor site morbidity and a short surgery in a fragile patient with several comorbidities. The spare-parts strategy can provide successful solution to difficult reconstructive cases regardless of the anatomical area.
Understanding the links between self-concept, sociocultural deviance and mental health problems in pathological social withdrawal
Authors: Wu Alison Fang-Wei , Chou Tai-Li , Catmur Caroline , Lau Jennifer Y. F.
Published: May 2021

Pathological social withdrawal (PSW), an extreme form of socially avoidant behaviour, is emerging as a global public health issue. Prior PSW theories implicate personal values that deviate from sociocultural norms resulting in inner conflict and mental health problems. Speculatively, this conflict could manifest or be embedded within a person’s cognitive and affective self-concepts (self-construal and self-esteem respectively). In this study, we tested the hypotheses that compared to those without PSW, individuals with PSW would have lower personal and collective self-esteem, and endorse independent and/or interdependent self-construals to differing degrees. 343 Taiwanese adults completed a two-step online survey, which consisted measuring their social withdrawal condition, sociocultural deviance, personal/collective self-esteem, independent/interdependent self-construal and mental health problems. As expected, data showed that the affected group had lower self-esteem than the unaffected group, but no group difference emerged in either self-construal dimension. We also found that personal self-esteem in the PSW group was (concurrently) associated with sociocultural deviance and symptoms of poor mental health. Our results tentatively supported theories of PSW, suggesting that the influences individuals’ personal self-esteem and sociocultural deviance should be considered in future studies or treatments/preventions.
Uptake and accumulation of heavy metals by water body and Azolla filiculoides in the Anzali wetland
Authors: Hassanzadeh Mahsa , Zarkami Rahmat , Sadeghi Roghayeh
Published: May 2021

The Anzali international wetland is a valuable habitat to a wide variety of aquatic flora and fauna. This wetland ecosystem is being threatened due to various pollutants particularly the heavy metals discharging from different point and non-point sources. Concentration of various heavy metals (Cr, Pb, Hg, Cu, Zn, Cd, Ag and Ti) was examined in the water body and Azolla filiculoides (an exotic fern in the Anzali wetland). The samples regarding water and A. filiculoides were randomly carried out in three parts of the wetland (eastern, central and western parts) in May 2015. After preparing and digesting the samples, the concentration of the heavy metals was measured using ICP OES method. The obtained results showed that the concentration of Zn in water and A. filiculoides samples was higher than other heavy meals in all parts of the wetland (p < 0.05). Overall, concentration of the heavy metals was significantly higher in the eastern part of the wetland than other two sampling locations (p < 0.05). Also with comparing the concentration of the heavy metals in water and A. filiculoides, it was found that all examined metals (except Cd and Ag) in A. filiculoides had significantly higher concentration than water sample, while Cd and Ag in water and A. filiculoides did not have a significant difference with each other. Based on the results, it can be concluded that A. filiculoides can effectively absorb Cr, Pb, Zn, Hg, Cu, Cd, Ag and Ti so that it might be used as a valuable species for the bioremediation and the removal of heavy metals from the wetland.
C-reactive protein and procalcitonin for antimicrobial stewardship in COVID-19
Authors: Pink Isabell , Raupach David , Fuge Jan , Vonberg Ralf-Peter , Hoeper Marius M. , Welte Tobias , Rademacher Jessica
Published: May 2021

Purpose

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory coronavirus 2 (SARS-CoV-2) has spread around the world. Differentiation between pure viral COVID-19 pneumonia and secondary infection can be challenging. In patients with elevated C-reactive protein (CRP) on admission physicians often decide to prescribe antibiotic therapy. However, overuse of anti-infective therapy in the pandemic should be avoided to prevent increasing antimicrobial resistance. Procalcitonin (PCT) and CRP have proven useful in other lower respiratory tract infections and might help to differentiate between pure viral or secondary infection.

Methods

We performed a retrospective study of patients admitted with COVID-19 between 6th March and 30th October 2020. Patient background, clinical course, laboratory findings with focus on PCT and CRP levels and microbiology results were evaluated. Patients with and without secondary bacterial infection in relation to PCT and CRP were compared. Using receiver operating characteristic (ROC) analysis, the best discriminating cut-off value of PCT and CRP with the corresponding sensitivity and specificity was calculated.

Results

Out of 99 inpatients (52 ICU, 47 Non-ICU) with COVID-19, 32 (32%) presented with secondary bacterial infection during hospitalization. Patients with secondary bacterial infection had higher PCT (0.4 versus 0.1 ng/mL; p = 0.016) and CRP (131 versus 73 mg/L; p = 0.001) levels at admission and during the hospital stay (2.9 versus 0.1 ng/mL; p < 0.001 resp. 293 versus 94 mg/L; p < 0.001). The majority of patients on general ward had no secondary bacterial infection (93%). More than half of patients admitted to the ICU developed secondary bacterial infection (56%). ROC analysis of highest PCT resp. CRP and secondary infection yielded AUCs of 0.88 (p < 0.001) resp. 0.86 (p < 0.001) for the entire cohort. With a PCT cut-off value at 0.55 ng/mL, the sensitivity was 91% with a specificity of 81%; a CRP cut-off value at 172 mg/L yielded a sensitivity of 81% with a specificity of 76%.

Conclusion

PCT and CRP measurement on admission and during the course of the disease in patients with COVID-19 may be helpful in identifying secondary bacterial infections and guiding the use of antibiotic therapy.