bluuebunny/crossref_metadata_2025 huggingface dataset:
The diagnostic benefit of 16S rDNA PCR examination of infective endocarditis heart valves: a cohort study of 146 surgical cases confirmed by histopathology
Authors: Armstrong Christina , Kuhn Tim Christian , Dufner Matthias , Ehlermann Philipp , Zimmermann Stefan , Lichtenstern Christoph , Soethoff Jasmin , Katus Hugo A. , Leuschner Florian , Heininger Alexandra
Published: June 2020

Aims

Upon suspicion of infective endocarditis, the causative microorganism must be identified to optimize treatment. Blood cultures and culturing of removed valves are the mainstay of this diagnosis and should be complemented by growth-independent methods. We assessed the diagnostic benefit of examining removed endocarditis valves by broad-range bacterial PCR to detect causative bacteria in cases where culturing was not available, negative, or inconclusive because a skin commensal was detected, in patients from our clinical routine practice.

Methods and results

Patients from Heidelberg University Hospital with suspicion of endocarditis, followed by valve replacement and analysis by 16S rDNA PCR, between 2015 and 2018, were evaluated. 146 patients with definite infective endocarditis, confirmed by the valve macroscopics and/or histology, were included. Valve PCRs were compared to corresponding blood and valve culture results. Overall, valve PCR yielded an additional diagnostic benefit in 34 of 146 cases (23%) and was found to be more sensitive than valve culture. In 19 of 38 patients with both negative blood and valve cultures, valve PCR was the only method rendering a pathogen. In 23 patients with positive blood cultures detecting skin commensals, 4 patients showed discordant valve PCR results, detecting a more plausible pathogen, and in 11 of 23 cases, valve PCR confirmed commensals in blood culture as true pathogens. Only the remaining 8 patients had negative valve PCRs.

Conclusion

Valve PCR was found to be a valuable diagnostic tool in surgical endocarditis cases with negative blood cultures or positive blood cultures of unknown significance.

Trial registration

S-440/2017 on 28.08.2017 retrospectively registered.

Graphic abstract

Subdividing of all infective endocarditis patients in this study, showing that valve PCR yields valuable information for patients with skin commensals in blood cultures, which were either confirmed by the same detection in valve PCR or refuted by the detection of a different and typical pathogen in valve PCR. Additionally, benefit was determined in patients with negative or not available blood cultures and only positive detection in valve PCR. +: Positive; −: negative; n/a: not available results
Inhibition of NaV1.8 prevents atrial arrhythmogenesis in human and mice
Authors: Pabel Steffen , Ahmad Shakil , Tirilomis Petros , Stehle Thea , Mustroph Julian , Knierim Maria , Dybkova Nataliya , Bengel Philipp , Holzamer Andreas , Hilker Michael , Streckfuss-Bömeke Katrin , Hasenfuss Gerd , Maier Lars S. , Sossalla Samuel
Published: June 2020

Pharmacologic approaches for the treatment of atrial arrhythmias are limited due to side effects and low efficacy. Thus, the identification of new antiarrhythmic targets is of clinical interest. Recent genome studies suggested an involvement of SCN10A sodium channels (NaV1.8) in atrial electrophysiology. This study investigated the role and involvement of NaV1.8 (SCN10A) in arrhythmia generation in the human atria and in mice lacking NaV1.8. NaV1.8 mRNA and protein were detected in human atrial myocardium at a significant higher level compared to ventricular myocardium. Expression of NaV1.8 and NaV1.5 did not differ between myocardium from patients with atrial fibrillation and sinus rhythm. To determine the electrophysiological role of NaV1.8, we investigated isolated human atrial cardiomyocytes from patients with sinus rhythm stimulated with isoproterenol. Inhibition of NaV1.8 by A-803467 or PF-01247324 showed no effects on the human atrial action potential. However, we found that NaV1.8 significantly contributes to late Na+ current and consequently to an increased proarrhythmogenic diastolic sarcoplasmic reticulum Ca2+ leak in human atrial cardiomyocytes. Selective pharmacological inhibition of NaV1.8 potently reduced late Na+ current, proarrhythmic diastolic Ca2+ release, delayed afterdepolarizations as well as spontaneous action potentials. These findings could be confirmed in murine atrial cardiomyocytes from wild-type mice and also compared to SCN10A−/− mice (genetic ablation of NaV1.8). Pharmacological NaV1.8 inhibition showed no effects in SCN10A−/− mice. Importantly, in vivo experiments in SCN10A−/− mice showed that genetic ablation of NaV1.8 protects against atrial fibrillation induction. This study demonstrates that NaV1.8 is expressed in the murine and human atria and contributes to late Na+ current generation and cellular arrhythmogenesis. Blocking NaV1.8 selectively counteracts this pathomechanism and protects against atrial arrhythmias. Thus, our translational study reveals a new selective therapeutic target for treating atrial arrhythmias.
Structural control in micelles of alkyl acrylate-acrylate copolymers via alkyl chain length and block length
Authors: Azeri Özge , Schönfeld Dennis , Noirez Laurence , Gradzielski Michael
Published: June 2020

Amphiphilic copolymers with poly (alkyl acrylate) as hydrophobic and poly (acrylic acid) (AA) as hydrophilic block have been synthesised. The alkyl chain was varied from butyl to dodecyl, thereby varying systematically the polarity of the hydrophobic block whose length was between 35 and 70, while the PAA block had ~ 100 units. Such relatively short amphiphiles should equilibrate quickly in aqueous solution, and their corresponding self-assembly properties were characterised by means of critical micelle concentration (cmc) determination. Detailed information regarding the aggregate structures was obtained by static light scattering (SLS) and small angle neutron scattering (SANS). This could be correlated with the molecular architecture of the copolymers and the degree of ionisation of the PAA block. Generally, it is found that the aggregation numbers become smaller upon fully charging the PAA head group and only for dodecyl acrylate really well-defined micellar aggregates are formed. This means that the extent of hydrophobicity of the alkyl acrylate block and its length determine in a clear fashion the propensity for micelle formation and the mass and aggregation number of the formed micelles.
Etiologies of olfactory dysfunction in a pediatric population: based on a retrospective analysis of data from an outpatient clinic
Authors: Schriever Valentin Alexander , Hummel Thomas
Published: June 2020

Purpose

Although the prevalence of olfactory dysfunction in children is thought to be lower compared to adults, little is known about the actual frequency of etiologies of smell dysfunction in children. Aim of the study was (i) to describe the epidemiology of olfactory dysfunction in a pediatric population and (ii) to compare the distribution of etiologies to adults.

Material and methods

Data of patients consulting a smell and taste clinic between 2000 and 2017 were retrospectively analyzed. Frequency of major causes of olfactory dysfunction was examined with a focus on the pediatric population.

Results

A total of 7153 patients (164 children) were included in the analysis. Most children presented with congenital olfactory dysfunction (67%), or head-trauma (12%). In contrast, the cumulative frequency of olfactory loss associated with sinonasal disorders or acute infections of the upper airways was 6%. The frequency of etiologies of olfactory dysfunction changed with age: While the frequency of patients with congenital anosmia decreased, the frequency of causes related to infections of the upper respiratory tract and idiopathic causes increased.

Conclusion

About 2/3 of olfactory dysfunction in children are congenital while 1/3 is acquired. The frequency of etiologies causing olfactory dysfunction change significantly from children to an adult population.
Diagnostic accuracy of a smartphone bedside
test to assess the fixation suppression of the vestibulo-ocular reflex: when nothing else
matters
Authors: Gandor Florin , Tesch Manfred , Neuhauser Hannelore , Gruber Doreen , Heinze Hans-Jochen , Ebersbach Georg , Lempert Thomas
Published: June 2020

Objective

Validation of a bedside test to objectify the fixation suppression of
the vestibulo-ocular reflex (FS-VOR) in patients with a cerebellar syndrome and
healthy controls.

Methods

The vestibulo-ocular reflex and its fixation suppression were assessed
by video-nystagmography (VNG) in 20 healthy subjects (mean age 56 ± 15) and 19
patients with a cerebellar syndrome (mean age 70 ± 11). The statistical cutoff
delineating normal from pathological FS-VOR was determined at the 2.5th percentile of
the normal distribution of the healthy cohort. VNG was then compared to a bedside
test, where eye movements were recorded with a smartphone while patients were rotated
on a swivel chair at a defined speed and amplitude. These videos were rated as normal
or pathological FS-VOR by six blinded raters, and results compared to VNG.

Results

VNG in healthy controls showed FS-VOR with a reduction of nystagmus
beats by 95.0% ± 7.2 (mean ± SD). The statistical cutoff was set at 80.6%. Cerebellar
patients reduced nystagmus beats by only 26.3% ± 25.1. Inter-rater agreement of the
smartphone video ratings was 85%. The sensitivity of the video ratings to detect an
impaired FS-VOR was 99%, its specificity 92%. Inter-test agreement was 91%.

Conclusion

The smartphone bedside test is an easily performed, reliable, sensitive,
specific, and inexpensive alternative for assessing FS-VOR.
An intergrid transfer operator using radial basis functions with application to cardiac electromechanics
Authors: Salvador Matteo , Dede’ Luca , Quarteroni Alfio
Published: June 2020

In the framework of efficient partitioned numerical schemes for simulating multiphysics PDE problems, we propose using intergrid transfer operators based on radial basis functions to accurately exchange information among different PDEs defined in the same computational domain. Different (potentially non-nested) meshes can be used for the space discretization of the PDEs. The projection of the (primary) variables that are shared by the different PDEs (through the coupling terms) is carried out with Rescaled Localized Radial Basis Functions. We validate our approach by a numerical test for which we also show the scalability of the intergrid transfer operator in the framework of high performance computing. Then, we apply it to the electromechanical model for the human heart function, and simulate a heartbeat of an idealized left ventricle. We show that our approach enables the solution of large-scale multiphysics problems, especially when the individual models exhibit very different spatial scales.
Advanced pneumatic compression for treatment of lymphedema of the head and neck: a randomized wait-list controlled trial
Authors: Ridner Sheila H. , Dietrich Mary S. , Deng Jie , Ettema Sandra L. , Murphy Barbara
Published: June 2020

Purpose

Lymphedema associated with head and neck cancer (HNC) therapy causes adverse clinical outcomes. Standard treatment includes professionally administered complete decongestive therapy (CDT). Cost and availability of trained therapists are known barriers to therapy. Advanced pneumatic compression devices (APCD) may address these issues. A randomized, wait-list controlled trial was undertaken to evaluate an APCD in post-treatment HNC patients with lymphedema.

Material and methods

Eligible patients had completed treatment for HNC, were disease free, and had lymphedema at enrollment. Participants were randomized to wait-list lymphedema self-management (standard of care) or lymphedema self-management plus the use of the APCD bid. Safety (CTCAE V4.0) and feasibility were primary endpoints; secondary endpoints included efficacy measure by objective examination and patient reported outcomes (symptoms, quality of life, function), adherence barriers, and satisfaction. Assessments were conducted at baseline and weeks 4 and 8.

Results

Forty-nine patients were enrolled (wait-list n = 25; intervention n = 24). In total, forty-three patients completed the study. No device-related Serious Adverse Events were reported. Most patients used the APCD once per day, instead of the prescribed twice per day, citing time related factors as barriers to use. APCD use was associated with significant improvement in perceived ability to control lymphedema (p = 0.003) and visible external swelling (front view p < 0.001, right view p = 0.004, left p = 0.005), as well as less reported pain.

Conclusion

This trial supports the safety and feasibility of the APCD for the treatment of secondary lymphedema in head and neck cancer patients. In addition, preliminary data supports efficacy.
RS-HeRR: a rough set-based Hebbian rule reduction neuro-fuzzy system
Authors: Liu Feng , Sekh Arif Ahmed , Quek Chai , Ng Geok See , Prasad Dilip K.
Published: June 2020

Interpretabilty is one of the desired characteristics in various classification task. Rule-based system and fuzzy logic can be used for interpretation in classification. The main drawback of rule-based system is that it may contain large complex rules for classification and sometimes it becomes very difficult in interpretation. Rule reduction is also difficult for various reasons. Removing important rules may effect in classification accuracy. This paper proposes a hybrid fuzzy-rough set approach named RS-HeRR for the generation of effective, interpretable and compact rule set. It combines a powerful rule generation and reduction fuzzy system, called Hebbian-based rule reduction algorithm (HeRR) and a novel rough-set-based attribute selection algorithm for rule reduction. The proposed hybridization leverages upon rule reduction through reduction in partial dependency as well as improvement in system performance to significantly reduce the problem of redundancy in HeRR, even while providing similar or better accuracy. RS-HeRR demonstrates these characteristics repeatedly over four diverse practical classification problems, such as diabetes identification, urban water treatment monitoring, sonar target classification, and detection of ovarian cancer. It also demonstrates excellent performance for highly biased datasets. In addition, it competes very well with established non-fuzzy classifiers and outperforms state-of-the-art methods that use rough sets for rule reduction in fuzzy systems.
Voltammetric sensing of recombinant viral dengue virus 2 NS1 based on Au nanoparticle–decorated multiwalled carbon nanotube composites
Authors: Palomar Quentin , Xu XingXing , Gondran Chantal , Holzinger Michael , Cosnier Serge , Zhang Zhen
Published: June 2020

A homemade gold electrode is modified with a carbon nanotubes/gold nanoparticles nanocomposite to perform selective and sensitive electrochemical detection of dengue toxin. This nanostructured composite offers a large specific surface and a reactive interface allowing the immobilization of biological material. Dengue antibodies are immobilized on gold nanoparticles via covalent bonding for dengue toxin detection. The porous tridimensional network of carbon nanotubes and gold nanoparticles enhances the electrochemical signal and the overall performance of the sensor. After optimization, the system exhibits a high sensitivity of − 0.44 ± 0.01 μA per decade with wide linear range between 1 × 10−12 and 1 × 10−6 g/mL at a working potential of 0.22 V vs Ag/AgCl. The extremely low detection limit (3 × 10−13 g/mL) ranks this immunosensor as one of the most efficient reported in the literature for the detection of recombinant viral dengue virus 2 NS1. This biosensor also offers good selectivity, characterized by a low response to various non-specific targets and assays in human serum. The outstanding performances and the reproducibility of the system place the biosensor developed among the best candidates for future medical applications and for early diagnosis of dengue fever.
A note on computational approaches for the antibandwidth problem
Authors: Sinnl Markus
Published: June 2020

In this note, we consider the antibandwidth problem, also known as dual bandwidth problem, separation problem and maximum differential coloring problem. Given a labeled graph (i.e., a numbering of the vertices of a graph), the antibandwidth of a node is defined as the minimum absolute difference of its labeling to the labeling of all its adjacent vertices. The goal in the antibandwidth problem is to find a labeling maximizing the antibandwidth. The problem is NP-hard in general graphs and has applications in diverse areas like scheduling, radio frequency assignment, obnoxious facility location and map-coloring. There has been much work on deriving theoretical bounds for the problem and also in the design of metaheuristics in recent years. However, the optimality gaps between the best known solution values and reported upper bounds for the HarwellBoeing Matrix-instances, which are the commonly used benchmark instances for this problem, are often very large (e.g., up to 577%). Moreover, only for three of these 24 instances, the optimal solution is known, leading the authors of a state-of-the-art heuristic to conclude “HarwellBoeing instances are actually a challenge for modern heuristic methods”. The upper bounds reported in literature are based on the theoretical bounds involving simple graph characteristics, i.e., size, order and degree, and a mixed-integer programming (MIP) model. We present new MIP models for the problem, together with valid inequalities, and design a branch-and-cut algorithm and an iterative solution algorithm based on them. These algorithms also include two starting heuristics and a primal heuristic. We also present a constraint programming approach, and calculate upper bounds based on the stability number and chromatic number. Our computational study shows that the developed approaches allow to find the proven optimal solution for eight instances from literature, where the optimal solution was unknown and also provide reduced gaps for eleven additional instances, including improved solution values for seven instances, the largest optimality gap is now 46%.
Mediterranean wetland conservation in the context of climate and land cover change
Authors: Leberger Roxanne , Geijzendorffer Ilse R. , Gaget Elie , Gwelmami Anis , Galewski Thomas , Pereira Henrique M. , Guerra Carlos A.
Published: June 2020

Wetlands are known to support diverse and unique species assemblages. Globally, but particularly in the Mediterranean basin, they are threatened by climate change and natural habitat loss. Despite an alarming decline of wetlands over the last century, standardised and systematic site assessments at large scale do not exist. Here, we perform an integrated assessment of Mediterranean wetlands by evaluating the combination of wetland protection and anthropogenic pressures, namely climate and land cover change, and the subsequent impact on wintering waterbirds. We used a multivariate partial triadic analysis to quantify climate and land cover change for each site between 1990 and 2005. We found that wetland sites in the southeast of the Mediterranean basin combined low or no protection cover with the highest increases in temperature and losses in natural habitats. Despite these findings, these sites also lack observation data on biodiversity, which may underestimate the resulting impacts. However, there are examples where active conservation measurements contributed positively to slow down wetlands’ reduction. Biodiversity data coverage needs to be ensured, regularly updated, and extended across sites regardless of their protection level, to allow for the assessment of biodiversity trends. This should be further extended to include current investments in remote sensing approaches.
Balanced metrics and Berezin quantization on Hartogs triangles
Authors: Bi Enchao , Su Guicong
Published: June 2020

In this paper, we study balanced metrics and Berezin quantization on a class of Hartogs domains defined by $$\varOmega _n=\{(z_1,\ldots ,z_n)\in {\mathbb {C}}^n:\vert z_1\vert<\vert z_2\vert<\cdots<\vert z_n\vert <1\}$$

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which generalize the so-called classical Hartogs triangle. We introduce a Kähler metric $$g(\nu )$$

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(
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)

associated with the Kähler potential $$\varPhi _n(z):=-\sum _{k=1}^{n-1}\nu _k\ln (\vert z_{k+1}\vert ^2-\vert z_k\vert ^2)-\nu _n\ln (1-\vert z_n\vert ^2)$$

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on $$\varOmega _n$$

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. As main contributions, on one hand we compute the explicit form for Bergman kernel of weighted Hilbert space, and then, we obtain the necessary and sufficient condition for the metric $$g(\nu )$$

g
(
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)

on the domain $$\varOmega _n$$

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to be a balanced metric. On the other hand, by using the Calabi’s diastasis function, we prove that the Hartogs triangles admit a Berezin quantization.
Breeding productivity, nest-site selection and conservation needs of the endemic Turkestan Ground-jay Podoces panderi
Authors: Burnside Robert J. , Brighten Alex L. , Collar Nigel J. , Soldatov Valentin , Koshkin Maxim , Dolman Paul M. , Ten Anna
Published: June 2020

The Turkestan Ground-jay Podoces panderi, a corvid endemic to the deserts of Central Asia, is both understudied and under-protected. Using standardised nest-monitoring protocols and nest cameras, we estimated its breeding productivity for the first time as 0.586 fledglings per nesting attempt (inter-quartile range, IQR 0.413‒0.734), strongly constrained by a diverse set of predator species (accounting for 88% of failures), supporting the broad pattern that a wide spectrum of nest predators operate in arid environments. The probability of nest success for the 35 days from the start of incubation to fledging was low, 0.186 $$\pm$$
±
0.06 se (N = 37), with no influence of season date, nest height or nest shrub species. However, pervasive shrub harvest severely limited availability of taller shrubs for nest-site selection, and thus our ability to detect any effect of height on nest survival. Mean clutch size was 4.8 $$\pm$$
±
0.8 sd while hatching probability of an egg from a clutch surviving incubation was 0.800 $$\pm$$
±
0.050 se and fledging probability was 0.824 $$\pm$$
±
0.093 se for individual chicks in successful nests (i.e. that fledged one or more chicks). Two shrub genera, saxaul Haloxylon spp. and Calligonum spp., were used for nesting more frequently than expected ($${\chi }_{15}^{2}$$

χ

15

2

= 784.02, P < 0.001), highlighting their importance to breeding habitat suitability. This near-sole reliance on these taller shrub genera, both targeted for illegal cutting, indicates that habitat degradation may lead to increased predation and declines in productivity. Habitat conservation is, therefore, likely to be the most important management strategy for the species and other components of desert systems, as management of so diverse a set of nest predators would be both impractical and inappropriate.
On the landslide tsunami uncertainty and hazard
Authors: Løvholt Finn , Glimsdal Sylfest , Harbitz Carl B.
Published: June 2020

Landslides are the second most frequent tsunami source worldwide. However, their complex and diverse nature of origin combined with their infrequent event records make prognostic modelling challenging. In this paper, we present a probabilistic framework for analysing uncertainties emerging from the landslide source process. This probabilistic framework employs event trees and is used to conduct tsunami uncertainty analysis as well as probabilistic tsunami hazard analysis (PTHA). An example study is presented for the Lyngen fjord in Norway. This application uses a mix of empirical landslide data combined with expert judgement to come up with probability maps for tsunami inundation. Based on this study, it is concluded that the present landslide tsunami hazard analysis is largely driven by epistemic uncertainties. These epistemic uncertainties can be incorporated in the probabilistic framework. Conducting a literature analysis, we further show examples of how landslide and tsunami data can be used to better constrain landslide uncertainties, combined with statistical and numerical analysis methods. We discuss how these methods, combined with the probabilistic framework, can be used to improve landslide tsunami hazard analysis in the future.
Trade and economic development: global causality and development- and openness-related heterogeneity
Authors: Gries T. , Redlin M.
Published: June 2020

Abstract

This paper reconsiders the classic relationship between trade and economic development. We examine the short-term and long-run dynamics between trade and income for 167 countries over the period 1970–2011 and assume that the effect is not homogenous for all countries but rather varies according to the development stage and the degree of trade openness. We apply panel cointegration, Granger causality and panel error correction in combination with Dynamic Ordinary Least Squares and General Method of Moments estimation to explore the causal relationship between these two variables. The results suggest a statistically significant positive short-run and long-run global relationship between trade and income. However, when splitting the panel into different income and trade openness groups, a long-run relationship is observed only for high-income countries and countries with a relatively high degree of trade openness.
Cultural Group Selection and the Evolution of Reindeer Herding in Norway
Authors: Næss Marius Warg
Published: June 2020

Herding can be characterized as a coordination game with two strategies for minimising risk: increase herd size (livestock quantity) or increase livestock body mass (livestock quality). In this paper I demonstrate that the selection of herd maximisation as a risk management strategy in the Northern parts of Norway has been influenced by a history of intra-group competition exacerbating herder conflict and lack of trust. In the South herder-farmer conflicts have increased herder coordination and trust, resulting in the selection of increasing livestock quality as the dominant risk management strategy.
Comparison of visual outcomes after implantation of AtLisa tri 839 MP and Symfony intraocular lenses
Authors: Lubiński Wojciech , Podborączyńska-Jodko Karolina , Kirkiewicz Marta , Mularczyk Maciej , Post Michał
Published: June 2020

Purpose

To compare visual outcomes after implantation of AtLisa tri 839 MP and Symfony intraocular lenses (IOLs).

Methods

All subjects underwent sequential bilateral cataract extraction with AtLisa tri 839 MP or Symfony IOL implantation. The design is prospective case series. Each group consists of 20 patients (40 eyes). At 1 year postoperatively, the following parameters were analysed: binocular uncorrected visual acuity (log MAR): for distance (UDVA) at 4 m, for intermediate distances (UIVA) at 60, 70, 80 cm and for near (UNVA) at 40 cm, defocus curve, mesopic and photopic contrast sensitivities (CSs), spectacle independence, visual function test questionnaire modified VFQ-25), photopic phenomena and postoperative complications.

Results

In the AtLisa tri 839 MP group, the mean binocular UNVA and UIVA were significantly better than in the Symfony group (UNVA: − 0.01 ± 0.04 vs. 0.21 ± 0.15; p = 0.000; 60 cm UIVA: − 0.01 ± 0.04 vs. 0.09 ± 0.09, p = 0.001; 70 cm UIVA − 0.05 ± 0.06 vs. 0.11 ± 0.08, p = 0.002; 80 cm UIVA − 0.01 ± 0.06 vs. 0.15 ± 0.08, p = 0.019). There were no significant between-group differences in the mean binocular UDVA and CS, with one exception: the mean binocular distance CS (18 cpd) under mesopic conditions was significantly better in the Symfony group than in the AtLisa tri 839 MP group (1.39 ± 0.22 vs. 1.17 ± 0.27; p = 0.015). The defocus curve analysis revealed significant between-group differences at vergences of 2.0 to − 4.0 D (p < 0.05), except for 2.0, 1.0, 0 and − 1.5. All subjects in AtLisa tri 839 MP group and 18 subjects (90%) in Symfony group were spectacle independent. Patients from both groups highly rated their overall vision quality in the VFQ-25 (1.67 ± 0.47 vs. 1.85 ± 0.5 in the Symfony and AtLisa tri 839 MP group, respectively, p = NS). The scores for daytime driving (1.00 ± 0.00 vs. 1.21 ± 0.36; p = 0.002), night driving (1.57 ± 0.55 vs. 2.13 ± 1.15; p = 0.027) and difficult situation driving (1.14 ± 0.31 vs. 1.53 ± 0.56; p = 0.049) were significantly better in the AtLisa tri 839 MP group than in the Symfony group. The incidence and perception level of halo and glare were significantly reduced (p = 0.00) in the Symfony group as compared to the AtLisa tri 839 MP group. The postoperative course was uneventful in all subjects.

Conclusions

Visual outcomes achieved with both IOLs are comparable. In both groups, 90% of patients achieved spectacle independence. Whereas the AtLisa tri 839 MP IOL implantation was associated with slightly better intermediate distance VA and significantly better near VA, photic phenomena were less perceived by patients with Symfony IOLs.
Post-buckling of web-core sandwich plates based on classical continuum mechanics: success and needs for non-classical formulations
Authors: Romanoff Jani , Jelovica Jasmin , Reddy J. N. , Remes Heikki
Published: June 2020

The paper investigates the post-buckling response of web-core sandwich plates through classical continuum mechanics assumptions. The compressive loading is assumed to be in the direction of the web plates. Equivalent Single Layer (ESL) plate formulation is used with the kinematics of the First order Shear Deformation Theory (FSDT). During the initial, membrane-dominated loading stages, it is observed that the effect of finite size of the periodic microstructure is barely influences the plate responses. At the higher loads, when bending is activated, the finite size of the microstructure activates secondary shear-induced bending moments at the unit cells of the plate. A method to capture the envelope of the maximum values of these bending moments is presented. The findings are validated with the shell element models of the actual 3D-geometry. Finally, the physical limits of the classical continuum mechanics are discussed in the present context.
A Facile and Novel Approach to Manufacture Paclitaxel-Loaded Proliposome Tablet Formulations of Micro or Nano Vesicles for Nebulization
Authors: Khan Iftikhar , Lau Katie , Bnyan Ruba , Houacine Chahinez , Roberts Matthew , Isreb Abdullah , Elhissi Abdelbary , Yousaf Sakib
Published: June 2020

Purpose

The aim of this study was to develop novel paclitaxel-loaded proliposome tablet formulations for pulmonary drug delivery.

Method

Proliposome powder formulations (i.e. F1 – F27) were prepared employing Lactose monohydrate (LMH), Microcrystalline cellulose (MCC) or Starch as a carbohydrate carriers and Soya phosphatidylcholine (SPC), Hydrogenated soya phosphatidylcholine (HSPC) or Dimyristoly phosphatidylcholine (DMPC) as a phospholipid. Proliposome powder formulations were prepared in 1:5, 1:15 or 1:25 w/w lipid phase to carrier ratio (lipid phase; comprising of phospholipid and cholesterol in 1:1 M ratio) and Paclitaxel (PTX) was used as model anticancer drug.

Results

Based on flowability studies, out of 27 formulations; F3, F6, and F9 formulations were selected as they exhibited an excellent angle of repose (AOR) (17.24 ± 0.43, 16.41 ± 0.52 and 15.16 ± 0.72°), comparatively lower size of vesicles (i.e. 5.35 ± 0.76, 6.27 ± 0.59 and 5.43 ± 0.68 μm) and good compressibility index (14.81 ± 0.36, 15.01 ± 0.35 and 14.56 ± 0.14) via Carr’s index. The selected formulations were reduced into Nano (N) vesicles via probe sonication, followed by spray drying (SD) to get a dry powder of these formulations as F3SDN, F6SDN and F9SDN, and gave high yield (>53%) and exhibited poor to very poor compressibility index values via Carr’s Index. Post tablet manufacturing, F3 tablets formulation showed uniform weight uniformity (129.40 ± 3.85 mg), good crushing strength (14.08 ± 1.95 N), precise tablet thickness (2.33 ± 0.51 mm) and a short disintegration time of 14.35 ± 0.56 min, passing all quality control tests in accordance with British Pharmacopeia (BP). Upon nebulization of F3 tablets formulation, Ultrasonic nebulizer showed better nebulization time (8.75 ± 0.86 min) and high output rate (421.06 ± 7.19 mg/min) when compared to Vibrating mesh nebulizer. PTX-loaded F3 tablet formulations were identified as toxic (60% cell viability) to cancer MRC-5 SV2 cell lines while safe to normal MRC-5 cell lines.

Conclusion

Overall, in this study LMH was identified as a superior carbohydrate carrier for proliposome tablet manufacturing in a 1:25 w/w lipid to carrier ratio for in-vitro nebulization via Ultrasonic nebulizer.
Proposal to extend the PROMIS® item bank v2.0 ‘Ability to Participate in Social Roles and Activities’: item generation and content validity
Authors: van Leeuwen Lisette M. , Tamminga Sietske J. , Ravinskaya Margarita , de Wind Astrid , Hahn Elisabeth A. , Terwee Caroline B. , Beckerman Heleen , Boezeman Edwin J. , Hoving Jan L. , Huysmans Maaike A. , Nieuwenhuijsen Karen , de Boer Angela G. E. M. , van der Beek Allard J.
Published: June 2020

Purpose

Previous research indicated that the Patient-Reported Outcomes Measurement Information System (PROMIS®) item bank v2.0 ‘Ability to Participate in Social Roles and Activities’ may miss subdomains of social participation. The purpose of this study was to generate items for these missing subdomains and to evaluate their content validity.

Methods

A three-step approach was followed: (1) Item generation for 16 International Classification of Functioning Disability and Health subdomains currently not covered by the item bank; (2) Evaluation of content validity of generated items through expert review (n = 20) and think-aloud interviews with a purposeful sample of people with and without (chronic) health conditions (n = 10), to assess item comprehensibility, relevance, and comprehensiveness; and 3) Item revision based on the results of step 2, in a consensus procedure.

Results

First, 48 items were generated. Second, overall, content experts indicated that the generated items were relevant. Furthermore, based on experts’ responses, items were simplified and ‘participation in social media’ was identified as an important additional subdomain of social participation. Additionally, ‘participating in various social roles simultaneously’ was identified as a missing item. Based on the responses of the interviewed adults items were simplified. Third, in total 17 items, covering 17 subdomains, were proposed to be added to the original item bank.

Discussion

The relevance, comprehensibility and comprehensiveness of the 17 proposed items were supported. Whether the proposed extension of the item bank leads to better psychometric properties of the item bank should be tested in a large-scale field study.
Can the provision of sexual healthcare for oncology patients be improved? A literature review of educational interventions for healthcare professionals
Authors: Albers L.F. , Palacios L.A. Grondhuis , Pelger R.C.M. , Elzevier H.W.
Published: June 2020

Purpose

Sexual health is an important quality-of-life concern for cancer patients and survivors, but a difficult discussion topic for patients and healthcare professionals. The most important barriers causing healthcare professionals to avoid the topic are lack of education and lack of knowledge. How effective education about sexual health is for oncology healthcare professionals is not clear. The aim of this review is to examine the effectiveness of interventions in improving the provision of sexual healthcare for cancer patients.

Methods

A systematic literature review was conducted according to PRISMA guidelines using the following data sources: PubMed, PsychInfo, Embase and Emcare. Quantitative research was included which contained pre-intervention and post-intervention outcomes. The assessment of the studies was conducted independently by two reviewers. A third reviewer was involved if there was no consensus.

Results

Seven studies were included. In total, 572 oncology healthcare professionals participated, including physicians, nurses and allied healthcare professionals. Interventions consisted of 6 face-to-face sessions and one online program. Primary objectives of the studies were the assessment of improvement in knowledge about sexual health, improvement of practice, frequency of discussing sexual health and comfort level and the decline of perceived barriers to discussing sexual health. Studies showed that interventions resulted in improved realization of the objectives.

Conclusions

Although improvement in the knowledge of healthcare professionals was achieved, it was not possible to give an overall recommendation for the development of interventions due to the limited number of studies and heterogeneity of the data.

Implications for Cancer Survivors

Sexual health is an important area of survivorship that is often neglected. Many oncology healthcare professionals lack training and knowledge to provide such care. More evidence-based practices are needed to improve sexual healthcare for cancer survivors.
Prognostic impact of Claudin 18.2 in gastric and esophageal adenocarcinomas
Authors: Arnold A. , Daum S. , von Winterfeld M. , Berg E. , Hummel M. , Rau B. , Stein U. , Treese C.
Published: June 2020

Introduction

The tight junction molecule Claudin 18.2 is selectively expressed in healthy and malignant gastric epithelial tissue and is a promising therapy target for high Claudin 18.2 expressing adenocarcinomas of the esophagogastric junction and stomach (AEG/S).

Methods

This study analyzed the prevalence, characteristics and prognostic impact of Claudin 18.2 expression in primary tumor, lymph node and distant metastasis in a large Caucasian AGE/S cohort with 414 patients.

Results

Claudin 18.2 was highly expressed in 17.1% of primary tumors, 26.7% of lymph node metastasis and 16.7% of distant metastasis. High Claudin 18.2 expression in lymph node metastasis and primary tumors correlated significantly (p < 0.001). High expression of Claudin 18.2 was neither associated with histomorphogical subtype, or tumor state, nor with overall survival.

Conclusion

In Caucasian AEG/S patients, 17.1% appeared to be eligible for an anti-Claudin 18.2 therapy. Claudin 18.2 expression itself has no impact on prognosis and is not related to any tumor subtype.
Energy Use Efficiency of Biogas Production Depended on Energy Crops, Nitrogen Fertilization Level, and Cutting System
Authors: Oleszek Marta , Matyka Mariusz
Published: June 2020

The paper evaluates the relation between energy input (Ei) and output (Eo) of biogas production from six energy crops: maize, sorghum, sunflower, triticale, reed canary grass (RCG), and Virginia mallow (VM), cultivated in three different nitrogen fertilization levels. Furthermore, in the case of RCG, the impact of cutting system was examined. The results showed that raised N fertilization dose (in the range of 40–120 kg ha−1and 80–160 kg ha−1, depending on the crops) increased biomass yield and methane productivity (MP) but simultaneously caused also the increase in Ei. Nonetheless, the application of higher N doses did not cause drastic decrease in energy use efficiency (EUE). The Eiwas significantly lower for perennials than for annual crops. For this reason, EUE for RCG harvested in two cuts (5.0–5.2 GJ GJ−1) was close to EUE for maize (5.7–6.8 GJ GJ−1), despite the much lower MP (2027–2903 m3 ha−1and 4409–5692 m3 ha−1, respectively) and Eo(73–105 GJ ha−1and 159–205 GJ ha−1, respectively). Furthermore, the collection of RCG in more than two cuts turned out to be unjustified, due to increase in Eiand, simultaneously, decrease in MP.
Breast-conserving surgery with intraoperative radiotherapy in recurrent breast cancer: the patient’s perspective
Authors: Elfgen Constanze , Güth U. , Gruber G. , Birrer S. , Bjelic-Radisic V. , Fleisch M. , Tausch C. J.
Published: June 2020

Purpose

When ipsilateral breast-tumor recurrence (IBTR) following breast-conserving surgery (BCS) occurs, the cure of a potentially life-threatening disease is the main goal. If, however, this is diagnosed early, prognosis is still good and patient-reported outcomes become more important. Despite the fact that many patients would prefer a further BCS, international breast cancer guidelines still recommend mastectomy, mainly because previous radiation implies limited options. Our comparative study evaluates the long-term quality-of-life and outcome in patients with IBTR who received BCS plus intraoperative radiotherapy (IORT) versus mastectomy.

Methods

Patients with IBTR were retrospectively divided into three groups according to the local treatment: group 1 (n = 26) was treated with BCS + IORT; group 2 (n = 35) received a standard mastectomy; group 3 (n = 52) had a mastectomy with subsequent reconstruction. Outcomes were analyzed after a mean follow-up of 5 years after IBTR. Quality-of-life was evaluated by the validated questionnaire BREAST-Q in 50 patients who fulfilled the inclusion criteria.

Results

Quality-of-life scores varied within the groups, ranging from 51.4 to 91.3 (out of 100 points). We observed satisfactory scores in all items, with no statistical difference within the groups. Disease-free survival of all groups did not statistically differ, and overall mortality was very low (0.9%). The postinterventional complication rate was lower after BCS (19.2% versus 34.3% after mastectomy and 30.8% after mastectomy with reconstruction).

Conclusion

For patients with previous surgery and radiation who demand a second BCS in the recurrent situation, this surgical technique can be offered in combination with IORT. Our long-term results imply oncological safety, lower complication rate, and good patient satisfaction.
Categorisation of building data in the digital documentation of heritage buildings
Authors: Khalil Ahmed , Stravoravdis Spyridon , Backes Dietmar
Published: June 2020

The documentation of heritage buildings is the preliminary action to deal with any problem related to the built heritage. The procedure of documentation requires a very diverse range of data (quantitative and qualitative) to be obtained and investigated in order to produce an accurate digital representation of the building. This type of work of data capture and interpretation is often conducted in isolation by different stakeholders and for a range of purposes, leading to a lack of communication between different data types, repeated effort and incomplete documentation. Heritage Building Information Modelling (H-BIM) is set to play a key role in the digital documentation of heritage buildings, as it can combine quantitative and qualitative data and facilitate the integration of different stakeholders and specialised data into the digital management of the different phases of dealing with heritage buildings. This paper aims to review the multitude of data types that could be included in the documentation and investigation process of the built heritage, in order to assess the breadth and depth by which heritage buildings can be documented. Four main categories that span the whole documentation data areas are being suggested which vary from outer geometry surveys, to subsurface materials and structural integrity investigations, to data concerning the building performance, as well as the historic records concerning the building’s morphology over time, which can help to create a more in-depth knowledge about the heritage building’s status and performance and can create a solid base for any required restoration and retrofitting processes (Khalil and Stravoravdis 2019a).
Sharks, rays and skates (Chondrichthyes, Elasmobranchii) from the Upper Marine Molasse (middle Burdigalian, early Miocene) of the Simssee area (Bavaria, Germany), with comments on palaeogeographic and ecological patterns
Authors: Villafaña Jaime A. , Marramà Giuseppe , Klug Stefanie , Pollerspöck Jürgen , Balsberger Markus , Rivadeneira Marcelo , Kriwet Jürgen
Published: June 2020

Elasmobranch remains are quite common in Miocene deposits and were the subject of numerous studies since the middle of the nineteenth century. Nevertheless, the taxonomic diversity of the Marine Molasse sharks, rays and skates is still largely unknown. Here, we describe 37 taxa from the lower Miocene of the Molasse Basin: 21 taxa could be identified at species level, whereas 15 taxa could only be assigned to genus and one taxon is left as order incertae sedis. The material was collected from deposits of the Auwiesholz Member of the Achen Formation (middle Burdigalian, middle Ottnangian age, ca. 17.8 Ma) exposed near Simssee, Upper Bavaria. This faunal assemblage is a mixture of shallow marine, near-coastal, pelagic and deep-water taxa. The fauna from Simssee displays different biogeographic dynamics at local and regional scales, possibly related to the intense climatic, oceanographic and tectonic events that occurred during the Eggenburgian–Ottnangian stages. The faunal relationships of the early Miocene chondrichthyan faunas from the Mediterranean Sea and Paratethys with others regions are established on the basis of qualitative (presence/absence) data. The beta diversity (Sørensen–Dice coefficient) of the Miocene Molasse elasmobranchs was used to characterize the taxonomic differentiation between localities and regions. According to our results, the fauna from Simssee shows close similarities with those from Switzerland, Austria, France and northern Germany. Faunal similarities and differences are mainly related to tectonic events and oceanographic variables (i.e. migration through seaway passages) or might represent collecting biases.
Modeling of the immune response in the pathogenesis of solid tumors and its prognostic significance
Authors: Zadka Łukasz , Grybowski Damian J. , Dzięgiel Piotr
Published: June 2020

Background

Tumor initiation and subsequent progression are usually long-term processes, spread over time and conditioned by diverse aspects. Many cancers develop on the basis of chronic inflammation; however, despite dozens of years of research, little is known about the factors triggering neoplastic transformation under these conditions. Molecular characterization of both pathogenetic states, i.e., similarities and differences between chronic inflammation and cancer, is also poorly defined. The secretory activity of tumor cells may change the immunophenotype of immune cells and modify the extracellular microenvironment, which allows the bypass of host defense mechanisms and seems to have diagnostic and prognostic value. The phenomenon of immunosuppression is also present during chronic inflammation, and the development of cancer, due to its duration, predisposes patients to the promotion of chronic inflammation. The aim of our work was to discuss the above issues based on the latest scientific insights. A theoretical mechanism of cancer immunosuppression is also proposed.

Conclusions

Development of solid tumors may occur both during acute and chronic phases of inflammation. Differences in the regulation of immune responses between precancerous states and the cancers resulting from them emphasize the importance of immunosuppressive factors in oncogenesis. Cancer cells may, through their secretory activity and extracellular transport mechanisms, enhance deterioration of the immune system which, in turn, may have prognostic implications.
Zielgerichtete Therapie beim metastasierten Mammakarzinom – welche molekularen Tests sind notwendig?
Authors: Schmidt Marcus
Published: June 2020

In den letzten Jahren ist die zielgerichtete Therapie beim Mammakarzinom immer mehr in den Fokus gerückt. Neben den Hormonrezeptoren und dem humanen epidermalen Wachstumsfaktor 2 (HER2) sind derzeit für die Festlegung einer gezielten Therapie vor allem der immunhistochemische Nachweis des „programmed cell death ligand 1“ (PD-L1) bei fortgeschrittenen triple-negativen Mammakarzinomen sowie der Nachweis von Mutationen im Breast-cancer-1(BRCA1)- oder BRCA2-Gen in der Keimbahn der Patientinnen und von Mutationen im Phosphatidylinositol-3-Kinase(PI3K)-Weg relevant.