bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of malignant cutaneous wounds in oncologic patients
Authors: Starace Michela , Carpanese Miriam Anna , Pampaloni Francesca , Dika Emi , Pileri Alessandro , Rubino Daniela , Alessandrini Aurora , Zamagni Claudio , Baraldi Carlotta , Misciali Cosimo , Patrizi Annalisa , Bianchi Tommaso , Apalla Zoe , Piraccini Bianca Maria
Published: June 2022

Purpose

Neoplastic wounds may develop as a result of primary tumor growth in the skin, due to metastasis, or due to skin invasion by tumors emerging from deeper levels. Malignant wounds may present as a crater-like ulcer, or as raised nodules with a cauliflower-like appearance. They are associated with malodor, necrosis, pain, bleeding, and secondary infection. The aim of our study is to better characterize fungating wounds and their management.

Methods

We retrospectively reviewed the database of the Wound Care Unit of the University of Bologna in order to identify individuals affected by neoplastic wound, between January 2019 and February 2021.

Results

We identified 9 females and 2 males with a mean age of 63 years; all were referred by the Oncology Unit. Management differed depending on the characteristics of the patients and the ulcers. Complete healing of the wound, following the parallel complete remission of the lymphoproliferative neoplasia, was observed in one individual. Among the others, one died because of breast cancer, while cutaneous lesions in 2 individuals deteriorated after 1 year of follow-up. Remission/relapse of the ulcer following the treatment course administered for the lymphoma were observed in one patient.

Conclusions

Treatment of malignant fungating wounds is challenging. Considering the neoplastic nature of the wounds, complete healing or improvement cannot be expected with the application of classically prescribed dressing for wounds. A mostly palliative treatment, focusing on maintaining the patient’s quality of life, is a reasonable choice.
Reconnaissance of the Diquini and Mariani springs and insights regarding the Massif de la Selle karst aquifer of Haiti
Authors: Miner Wm Javan , Adamson James K. , Rochat Pierre-Yves
Published: June 2022

A reconnaissance was performed for Tunnel Diquini and Source Mariani in the metropolitan region of Port-au-Prince, Haiti, to address concerns of decreasing flows and to evaluate potential impacts of a proposed river diversion scheme in the study area. The tunnel and spring are the two largest water sources serving the Port-au-Prince municipal water system and discharge from the Massif de la Selle carbonate aquifer. Considering their significance and importance to the water security of the region, there are limited data or studies specific to the water sources. An introductory framework was established regarding the flow regimes, the origin of waters, and recharge dynamics of the sources. Field reconnaissance and stable-isotope, tracer, and chloride-mass-balance techniques were applied to strengthen the conceptual understanding of the water sources. Recharge to this portion of the Massif de la Selle carbonate aquifer is variable depending on monthly rainfall intensity and 3–7-year climatic cycles. Rather than a consistent long-term decreasing flow trend, a particularly intense period from 2007 through 2010 resulted in the highest flows on record, which have steadily recessed to historical norms in recent years. The recharge characteristics and catchment areas indicate that neither water source is connected to the River Momance; however, a connection to the River Froide is possible, particularly related to the tunnel. Finally, recharge rates and an estimate of renewable groundwater in the Massif de la Selle show the regional significance and importance of the carbonate aquifer for current supplies and future water development.
Efficacy and safety of ixekizumab in patients with active psoriatic arthritis with and without concomitant conventional disease-modifying antirheumatic drugs: SPIRIT-P1 and SPIRIT-P2 3-year results
Authors: Coates Laura C. , Mease Philip , Kronbergs Andris , Helt Cameron , Sandoval David , Park So Young , Combe Bernard , Nash Peter , Deodhar Atul
Published: June 2022

Introduction/objectives

To evaluate the three-year efficacy and safety of ixekizumab with and without concomitant conventional synthetic disease-modifying antirheumatic drug (csDMARD) use in patients with active psoriatic arthritis (PsA).

Method

Patients with PsA who were biologic-naïve (SPIRIT-P1, NCT01695239) or had prior inadequate response to tumor necrosis factor inhibitors (SPIRIT-P2, NCT02349295) were randomized to receive 80-mg ixekizumab every four weeks after receiving 160-mg ixekizumab at baseline. Efficacy, safety, and immunogenicity were evaluated in this post-hoc analysis in three subgroups: (1) ixekizumab monotherapy, (2) ixekizumab and methotrexate (MTX), (3) ixekizumab and any csDMARD (including MTX). Missing data were imputed using multiple imputation for continuous variables and modified non-responder imputation for categorical variables.

Results

Efficacy was similar across the three subgroups with 59.1%, 67.0%, and 66.1% of ixekizumab-treated patients achieving 20% improvement in the American College of Rheumatology scale score at week 156. Radiographic progression of structural joint damage (SPIRIT-P1 only) was similarly inhibited across the three subgroups with several outliers. No new safety signals were reported, and 91.0%, 84.1%, and 83.2% in the three subgroups reported ≥ 1 treatment-emergent adverse event. At week 156, 15.9%, 13.1%, and 11.0% in the three subgroups had antidrug antibodies; most had low titer status.

Conclusions

Ixekizumab showed sustained efficacy in treating patients with PsA for up to three years in monotherapy or in combination with MTX or any csDMARD. The three subgroups had similar safety and immunogenicity profiles, which supports that the use of concomitant MTX or csDMARDs does not seem to impact the benefit/risk profile of ixekizumab.

Key Points• Ixekizumab treatment led to improved clinical responses over time when used as monotherapy or in combination with concomitant MTX or any concomitant csDMARD (including MTX) in patients with active PsA.• Ixekizumab monotherapy has similar radiographic efficacy as ixekizumab with MTX or ixekizumab with other csDMARDs (including MTX); similar inhibition of radiographic progression was observed between the subgroups of patients receiving ixekizumab monotherapy or ixekizumab with MTX or other csDMARDs.• The long-term safety profile of ixekizumab used as monotherapy or in combination with MTX or any other csDMARDs is consistent with what has been previously reported. The addition of MTX or any csDMARD to ixekizumab treatment did not negatively impact the favorable long-term safety profile of ixekizumab.
Metacognitive judgments can potentiate new learning: The role of covert retrieval
Authors: Kubik Veit , Koslowski Kenneth , Schubert Torsten , Aslan Alp
Published: June 2022

Interim tests of previously studied information can potentiate subsequent learning of new information, in part, because retrieval-based processes help to reduce proactive interference from previously learned information. We hypothesized that an effect similar to this forward testing effect would also occur when making judgments of (prior) learning (JOLs). Previous research showed that making JOLs likely prompts covert retrieval attempts and thereby enhances memory, specifically when providing only parts of previously studied information. This study examined the forward effect of different types of JOLs (i.e., with complete or partial prior study information available) on subsequent learning of new materials, compared to restudy and retrieval practice. In a between-subjects design, participants (N = 161) consecutively studied five lists of 20 words with the aim to recall as many of them on a final cumulative recall test. After the presentation of each of the first four lists, participants either restudied the list, made JOLs with complete words, made JOLs with word stems, or they were tested on word stems. Compared to restudy, practicing retrieval and making JOLs with word stems, but not JOLs with complete words, facilitated the List-5 interim recall performance and attenuated the number of intrusions from prior lists. The findings suggest that, similar to overt retrieval, making JOLs with incomplete information can enhance new learning to the extent that it elicits covert retrieval attempts.
Enhancing the properties of bone China ceramics by treatment with microporous SiO2 nanoparticles
Authors: Abou Elmaaty Tarek M. , Sayed-Ahmed Khaled , El Gohari Mohamed M. , Noaman Rokaya
Published: June 2022

In this study, microporous silicon dioxide nanoparticles (SiO2–NPs) were used to improve the physical, chemical, and mechanical properties of bone China ceramics. Microporous SiO2–NPs were prepared economically from sodium metasilicate (SMS) as a precursor with cetyltrimethylammonium bromide (CTAB) as a surfactant at different concentrations. The prepared SiO2–NPs were characterized using scanning electron microscopy, transmission electron microscopy, X-ray diffraction, and Raman spectroscopy to confirm the formation of microporous SiO2–NPs. The optimum concentrations of the precursor and surfactant used in the SiO2–NPs synthesis were set to be 1.5% and 2 g/200 ml, with a size range of 7–96 nm. SiO2–NPs prepared at the optimum concentrations were incorporated into bone China at different concentrations to evaluate their effect on flexural strength and elasticity. The bone China prepared using 1% SiO2–NPs (B1) had the highest flexural strength and Young's modulus values. Sample characteristics, including self-cleaning, differential scanning calorimetry, thermogravimetric analysis, bulk density (BD), apparent porosity (AP), and water absorption (WA), were investigated. The results revealed outstanding characteristic such as self-cleaning ability, remarkable increase in AP and WA, and a decrease in BD.
The impact of convexity on expansion planning in low-carbon electricity markets
Authors: Wogrin S. , Tejada-Arango D. , Delikaraoglou S. , Lamadrid A. , Botterud A.
Published: June 2022

Expansion planning models are tools frequently employed to analyze the transition to a carbon-neutral power system. Such models provide estimates for an optimal technology mix and optimal operating decisions, but they are also often used to obtain prices and subsequently calculate profits. This paper analyzes the impact of modeling assumptions on convexity for power system outcomes and, in particular, on investment cost recovery. Through a case study, we find that although there is a long-term equilibrium for producers under convex models, introducing realistic constraints, such as non-convexities/lumpiness of investments, inelastic demand or unit commitment constraints, leads to profitability challenges. We furthermore demonstrate that considering only short-term marginal costs in market-clearing may potentially create a significant missing-money problem caused by a missing-market problem and dual degeneracy in a 100 percent renewable system.
Stability Improvement of Methylammonium Lead Iodide Perovskite Thin Films by Bismuth Doping
Authors: Marí-Guaita Julia , Bouich Amal , Marí Bernabé
Published: June 2022

Perovskites have been in the spotlight in the field of solar cells due to their high efficiency and their low cost of materials and fabrication processes. Perovskite solar cells (PSCs) have shown an efficiency of up to 25%. Nevertheless, PSCs have some drawbacks such as rapid degradation in ambient conditions. To improve PSC stability, lead is usually replaced with bismuth. In this article, we report the results when doping the methylammonium lead iodide (CH3NH3)PbI3, aka MAPbI3, with different bismuth quantities. The incorporation of bismuth into the lattice leads to a remarkable change in optoelectronics and morphological structure. Substituting lead atoms with 2% bismuth improves some characteristics of MAPbI3 layers, such as removing pinholes and increasing crystallite size and optical absorption. Furthermore, bismuth doping improves the stability of pure MAPbI3 layers, which after 4 weeks exhibits higher degradation compared to bismuth-doped MAPbI3 samples, which remain stable after that period.
Muscle Protein Synthesis Responses Following Aerobic-Based Exercise or High-Intensity Interval Training with or Without Protein Ingestion: A Systematic Review
Authors: Bagheri Reza , Robinson Isabelle , Moradi Sajjad , Purcell Jessica , Schwab Elita , Silva Tharindie , Baker Brooke , Camera Donny M.
Published: June 2022

Background

Systematic investigation of muscle protein synthesis (MPS) responses with or without protein ingestion has been largely limited to resistance training.

Objective

This systematic review determined the capacity for aerobic-based exercise or high-intensity interval training (HIIT) to stimulate post-exercise rates of MPS and whether protein ingestion further significantly increases MPS compared with placebo.

Methods

Three separate models analysed rates of either mixed, myofibrillar, sarcoplasmic, or mitochondrial protein synthesis (PS) following aerobic-based exercise or HIIT: Model 1 (n = 9 studies), no protein ingestion; Model 2 (n = 7 studies), peri-exercise protein ingestion with no placebo comparison; Model 3 (n = 14 studies), peri-exercise protein ingestion with placebo comparison.

Results

Eight of nine studies and all seven studies in Models 1 and 2, respectively, demonstrated significant post-exercise increases in either mixed or a specific muscle protein pool. Model 3 observed significantly greater MPS responses with protein compared with placebo in either mixed or a specific muscle fraction in 7 of 14 studies. Seven studies showed no difference in MPS between protein and placebo, while three studies reported no significant increases in mitochondrial PS with protein compared with placebo.

Conclusion

Most studies reporting significant increases in MPS were confined to mixed and myofibrillar PS that may facilitate power generating capacity of working skeletal muscle with aerobic-based exercise and HIIT. Only three of eight studies demonstrated significant increases in mitochondrial PS post-exercise, with no further benefits of protein ingestion. This lack of change may be explained by the acute analysis window in most studies and apparent latency in exercise-induced stimulation of mitochondrial PS.
The functional extracellular matrix on the regulation of odontogenic differentiation of stem cells
Authors: Yang Haoqing , Fan Zhipeng
Published: June 2022

Dental defects and loss are common oral diseases that seriously affect the chewing efficiency of patients and thereby affect their health. With the development of tissue engineering technology, dental tissue regeneration has emerged as a promising technique. Cell type, extracellular matrix (ECM) environment, cytokines and other factors which affect odontogenic differentiation and dental tissue regeneration have aroused significant interest. The functional ECM consists of extracellular components that control the initiation and growth of crystal deposition and regulate the differentiation and regeneration of endogenous or exogenous stem cells in the defect site. At present, the function and regulatory mechanism of the functional ECM in this process remain poorly understood. Therefore, elucidating the effect of the functional ECM on odontogenic differentiation and its mechanism has great scientific significance and potential clinical application. This review explored functional ECM components involved in odontogenic differentiation and dental tissue regeneration.
Secondary school teacher’s conception and reflection of computer programming with Scratch
Authors: Iyamuremye Aloys , Nsabayezu Ezechiel , Habimana Jean Claude
Published: June 2022

The present study explores teachers' conception and reflection of computer programming with a Scratch in terms of technological and pedagogical aspects. A mixed research approach specifically sequential explanatory research design was used to collect quantitative and qualitative data. The population was comprised of two hundred and four in-service Mathematics, Chemistry, Physics, and Biology teachers from Kayonza district, Rwanda. However, only 34 were randomly selected to participate in the study. An achievement test and structured interview were used to collect quantitative and qualitative data, respectively. The quantitative data obtained from pre- and post-tests were analyzed using a pairedttest, and the data from the interview was analyzed by descriptive, and interpretive analyses. It was revealed that secondary school teachers have a respectable conception and constructive reflection of Scratch programming once attending scratch training. Quantitative findings showed that there was an important difference in the mean among pre- and post-tests with 0.171 learning gain and an effect size of 0.53 (df = 33,p < 0.05). It was also revealed that Scratch is an operational instructional tool for teaching and learning Mathematics and Sciences. Furthermore, teachers articulated progressive views of using scratch in teaching and learning Mathematics and Sciences as it supports them to visualize abstract content, improves students' interest and impetus, critical thinking, and problem-solving skills, and acts as an assessment tool.
Destruction, Deconstruction, and Dereliction: Music for St Thomas of Canterbury during the Reformation and Counter-Reformation, 1530-1600
Authors: Emery Katherine
Published: June 2022

Between the late-twelfth and early-sixteenth centuries, much music (both liturgical and non-liturgical) was written in honour of St Thomas of Canterbury. However, in the 1530s his cult became a major target for reformers and, in 1538, Henry VIII (1491-1547) ordered the destruction of his shrine and the obliteration of all music written in his honour. This article will examine how music composed to memorialise St Thomas was treated during the Reformation and Counter-Reformation. It explores the process of self-censorship prompted by Henry’s proclamation on the cult of St Thomas that led to his erasure from liturgical books in England. It analyses the attempts by reformers to discredit music concerning St Thomas, particularly by radical reformer John Bale (1495-1563). Finally, it examines music that was composed by Catholics for St Thomas during the Counter-Reformation and asks what it can tell us about the state of the cult in the late sixteenth century. This approach results in an overview of St Thomas’ cult during the later sixteenth century and contributes to our understanding of changing conceptions of the saint by Catholic communities in the post-Reformation world.
Tixagevimab and Cilgavimab: Can we see More Recommendations for Monoclonal Antibodies Beyond COVID-19 Vaccination
Authors: Anmar Al-Taie
Published: June 2022

Nearly 3 years after its detection, the coronavirus disease 2019 (COVID-19) which is caused by severe acute respiratory syndrome CoV-2, is still a life-threatening global pandemic that has contributed to a high progression and mortality rate across the globe. This imposes the need for scientific research efforts in order to hold intense interest directed towards such exploration, for the development and optimization of different interventions to the COVID-19 infection. This commentary summarizes the potential clinical benefits for the recently authorized immunotherapy combination of Tixagevimab and Cilgavimab monoclonal antibodies for the prevention and treatment of COVID-19.
Cluster categories of formal DG algebras and singularity categories
Authors: Hanihara Norihiro
Published: June 2022

Given a negatively graded Calabi-Yau algebra, we regard it as a DG algebra with vanishing differentials and study its cluster category. We show that this DG algebra is sign-twisted Calabi-Yau and realise its cluster category as a triangulated hull of an orbit category of a derived category and as the singularity category of a finite-dimensional Iwanaga-Gorenstein algebra. Along the way, we give two results that stand on their own. First, we show that the derived category of coherent sheaves over a Calabi-Yau algebra has a natural cluster tilting subcategory whose dimension is determined by the Calabi-Yau dimension and thea-invariant of the algebra. Second, we prove that two DG orbit categories obtained from a DG endofunctor and its homotopy inverse are quasi-equivalent. As an application, we show that the higher cluster category of a higher representation infinite algebra is triangle equivalent to the singularity category of an Iwanaga-Gorenstein algebra, which is explicitly described. Also, we demonstrate that our results generalise the context of Keller–Murfet–Van den Bergh on the derived orbit category involving a square root of the AR translation.
A Promising Start and Frustrating End: The Rise and Fall of the Economic History Department, University of Zimbabwe
Authors: Kufakurinani Ushehwedu
Published: June 2022

The paper explores the internal dynamics of knowledge production at the University of Zimbabwe. I introduce the term epistuicide to refer to situations where a people destroy their own knowledge systems. I use this term in contrast to what have been called epistimicides—that is, the killing of a peoples’ knowledge systems by another. In this paper, I demonstrate how the history of the Economic History Department is a classic case of epistuicide, as a flipside to epistimicides. It is a history of not only unrecognized effort but also of how internal dynamics and systems derail rather than promote knowledge production. From its inception, the Department of Economic History faced onslaughts which heightened in the new millennium. Admittedly, there are pockets of successes to record, such as the expansion of the teaching of the discipline to secondary schools and growing recognition of economic historians locally.
Territorial Dynamics of Spanish Members of Parliament (1977–2020)
Authors: Domínguez Pablo , Portillo-Pérez Manuel F.
Published: June 2022

The Congress of Deputies should supposedly represent the entire Spanish population and the Spanish Constitution provides mechanisms to ensure geographic representation in the lower house. However, the mobility of the members of parliament (MPs) across constituencies can generate territorial representation imbalances. Based on the territorial component of descriptive representation, this article analyses the unequal geographic representation of autonomous communities in the Congress. A descriptive statistical assessment was conducted based on MPs’ autonomous community of birth, the autonomous community for which they have a seat, the role played by political parties, and the way in which territorial representation occurs within the hyper elite. Special attention was paid to the representation of peripheral regions and to the drivers of overrepresentation (and underrepresentation) of some regions in the Congress. It was observed that—with few exceptions—territorial peripheries include more native MPs, export fewer MPs, and are generally underrepresented in the Congress and within the hyper elite. In contrast, the Basque Country (an exception), Madrid, and other central territories are overrepresented in the Congress. Finally, four models of descriptive territorial representation were identified, which correspond to Spain’s different territorial tensions.
Laser tongue base mucosectomy is a useful diagnostic tool in the management of unknown primary cancers of the head and neck region
Authors: Olaleye O , Nassif R , Fleming B , Burrows S
Published: June 2022

Objective

Tongue base mucosectomy identified cancer in 78 per cent of cancers of unknown primary in a recent meta-analysis. The carbon dioxide laser is an alternative technique if there is no access to a robot. This study aimed to describe the steps for undertaking tongue base mucosectomy using the carbon dioxide laser and its diagnostic utility in cancers of unknown primary.

Method

This was a prospective feasibility study utilising carbon dioxide laser for tongue base mucosectomy in cancers of unknown primary. Data collected included demographic data and p16 status.

Results

There were 14 cancers of unknown primary with 86 per cent p16 positivity on immunohistochemistry. Laser tongue base mucosectomy alone identified the cancer primary in 7 of 12 (58 per cent) cancers of unknown primary among p16 positive tumours and 0 of 2 (0 per cent) among p16 negative tumours. Combining bilateral tonsillectomy with laser tongue base mucosectomy resulted in identification of the primary cancer in 8 of 12 (67 per cent) p16 positive tumours.

Conclusion

In centres without a robot, tongue base mucosectomy using the carbon dioxide laser is a viable alternative, especially in combination with bilateral tonsillectomy in p16 positive cases.
A Sixteenth-Century Clergyman and Physician: Timothy Bright's Dual Approach to Melancholia
Authors: Betz Emily
Published: June 2022

This article explores the nexus of healing between clergy and physicians in late sixteenth- and early seventeenth-century medicine by focusing on the disease of melancholia, and in particular on the earliest extant English monograph on that subject, A Treatise of Melancholie (1586), by Timothy Bright. Melancholia was a disease especially apt to be treated by both medical practitioners and the clergy as it was widely defined as both corporal and spiritual in origin. What makes Bright's treatise particularly noteworthy is the vocation of the author: Bright was both doctor and cleric, and his work straddled both occupations as he defined, diagnosed and attempted to cure melancholy in his reader. By examining what Bright wrote about the various aspects of the disease, this article provides further insight into the clashes, conciliations and cooperation between early modern medical practitioners.
Moral Sick Notes: Medical Exemptions to Religious Fasting in the Eighteenth-Century Spanish World
Authors: Klaeren George A.
Published: June 2022

Eighteenth-century moral theologians in Spain expressed concern that many Catholics were obtaining permission to avoid fasting and abstinence from meat by claiming that they were ill and required medical dispensations. This article examines the theological and medical debate which occurred over a series of treatises and essays in which physicians and moral theologians sought to come to a common understanding of when a Spaniard was infirm enough to be medically excused from fasting and, perhaps more importantly, who had the authority to make this decision. Throughout the eighteenth century in Spain, this responsibility continued to be shared by priests and physicians. The debate highlights the contest for medical authority, mitigated by doubt. It also suggests that any understanding of early modern medical pluralism must include members of the theological community as well as health professionals.
Nicht-antibiotische Prophylaxe von Infekten
Authors: Seneghini Marco , Albrich Werner C.
Published: June 2022

Zusammenfassung. Die zunehmende Antibiotikaresistenz verleiht der Suche nach nicht-antibiotischen Alternativen zur Behandlung und Vorbeugung vor allem von Atemwegsinfektionen und Harnwegsinfektionen entscheidende Bedeutung. Potenzielle nicht-antibiotische Ansätze umfassen Phytopharmaka (Echinacea purpurea, Pelargonium sidoides, Cranberry-Extrakt), Zink, Immunstimulanzien (OM-85 BV, OM-89) sowie Verhaltensmodifikationen. Einige dieser Ansätze sind vielversprechende Optionen; allerdings ist hochgradige Evidenz erforderlich, bevor konkrete Empfehlungen für die Anwendung abgegeben werden können.
Therapie der Herzinsuffizienz mit reduzierter Auswurffraktion: Was ist neu in den Leitlinien 2021?
Authors: Maeder Micha T. , Rickli Hans , Brenner Roman , Scheler Eva , Buser Marc
Published: June 2022

Zusammenfassung. Das Spektrum der Optionen zur Behandlung der Herzinsuffizienz mit reduzierter Auswurffraktion (Heart Failure with reduced Ejection Fraction, HFrEF) hat sich in den vergangenen Jahren deutlich erweitert. Die nun publizierten Leitlinien von 2021 der Europäischen Gesellschaft für Kardiologie haben einen neuen Therapie-Algorithmus für Personen mit HFrEF und damit den Stellenwert der verschiedenen Medikamente und Interventionen definiert. Neu ist eine Basistherapie bestehend aus vier Medikamenten mit unterschiedlichen Wirkmechanismen für alle Menschen mit HFrEF indiziert: ein ACE-Hemmer (Angiotensin-Converting Enzyme Inhibitor), ein Betablocker, ein Mineralokortikoid-Rezeptor-Antagonist und ein SGLT-2-Hemmer (Sodium Glucose Co-Transporter-2 Inhibitor). Weitere Massnahmen sollen in Abhängigkeit vom Ansprechen auf diese maximal auftitrierte 4-Säulen-Basistherapie und vom Phänotyp diskutiert und angewendet werden. Im vorliegenden Artikel diskutieren wir die verfügbaren Medikamente und Interventionen, deren Stellenwert im Behandlungsalgorithmus und relevante praktische Aspekte der modernen HFrEF-Therapie.
Ocean Waves in the South Pacific: Complementarity of SWIM and SAR Observations
Authors: Oruba L. , Hauser D. , Planes S. , Dormy E.
Published: June 2022

This study focuses on ocean waves impacting the Moorea Island in French Polynesia, where coral reefs play an essential role in the biodiversity and protection of habitations. We investigate how the innovative Surface Waves Investigation and Monitoring (SWIM) instrument of the Chinese‐French Oceanography SATellite satellite enables to document on a multi‐annual basis, the spectral properties of ocean waves reaching the coasts of the Moorea Island. Our analysis is based on comparisons with in situ measurements (wave gauges deployed on the outer slope of the coral reef), and with other satellite observations (altimeter, Synthetic Aperture Radar [SAR]). Accounting for local masking effects, we show that SWIM provides relevant information on short swell or wind waves, which is missed by the SAR observations, in particular in high sea‐state conditions, owing to the dominant propagation direction being close to the azimuth. We, nevertheless, also find that wave properties in low sea‐state conditions are better documented by SAR than by SWIM. Such results are important to accurately measure and predict the wave conditions which fragilize the coral reefs and to evaluate the impact of extreme events on tropical islands and coral reefs.
Effects of Land Reclamation on a Subterranean Estuary
Authors: Shen Chengji , Fan Yu , Wang Xibin , Song Wenjing , Li Ling , Lu Chunhui
Published: June 2022

Submarine groundwater discharge via coastal aquifers is an important pathway for land‐derived chemicals to enter the oceans. While previous studies have mostly focused on natural coastal aquifers, little attention has been paid to those modified by land reclamation. This study used laboratory experiments and numerical simulations to investigate the effects of land reclamation on flow and mixing processes in a nearshore subterranean estuary. The results show that, regardless of the permeability, the addition of reclamation soil will shift the tide‐driven upper saline plume (USP) seaward and reduce the USP size. When the aquifer is reclaimed by low‐permeability soil, the seawater intrusion length is reduced for small tidal amplitudes but extended as tidal amplitude further increases. Depending on the tidal amplitude, high‐ and low‐permeability reclamation soils prolong or shorten the average particle travel time in the USP, the freshwater discharge zone, and the saltwater wedge. Compared to the case without reclamation, high‐/low‐permeability reclamation soil enhances/weakens the water discharge rate across the aquifer‐ocean interface, narrows/expands the freshwater discharge zone, and increases the tide‐/density‐driven recirculation percent. Findings from this study highlight the complexity of nearshore groundwater systems subject to human activities, and have significant implications for better understanding the fate of terrestrially sourced chemicals in subterranean estuaries before discharging into the coastal water.
A streamlined strain engineering workflow with genome-wide screening detects enhanced protein secretion in Komagataella phaffii
Authors: Ito Yoichiro , Ishigami Misa , Terai Goro , Nakamura Yasuyuki , Hashiba Noriko , Nishi Teruyuki , Nakazawa Hikaru , Hasunuma Tomohisa , Asai Kiyoshi , Umetsu Mitsuo , Ishii Jun , Kondo Akihiko
Published: June 2022

Expression of secreted recombinant proteins burdens the protein secretion machinery, limiting production. Here, we describe an approach to improving protein production by the non-conventional yeast Komagataella phaffii comprised of genome-wide screening for effective gene disruptions, combining them in a single strain, and recovering growth reduction by adaptive evolution. For the screen, we designed a multiwell-formatted, streamlined workflow to high-throughput assay of secretion of a single-chain small antibody, which is cumbersome to detect but serves as a good model of proteins that are difficult to secrete. Using the consolidated screening system, we evaluated >19,000 mutant strains from a mutant library prepared by a modified random gene-disruption method, and identified six factors for which disruption led to increased antibody production. We then combined the disruptions, up to quadruple gene knockouts, which appeared to contribute independently, in a single strain and observed an additive effect. Target protein and promoter were basically interchangeable for the effects of knockout genes screened. We finally used adaptive evolution to recover reduced cell growth by multiple gene knockouts and examine the possibility for further enhancing protein secretion. Our successful, three-part approach holds promise as a method for improving protein production by non-conventional microorganisms.
Brain aging is faithfully modelled in organotypic brain slices and accelerated by prions
Authors: Liu Yingjun , Senatore Assunta , Sorce Silvia , Nuvolone Mario , Guo Jingjing , Gümüş Zeynep H. , Aguzzi Adriano
Published: June 2022

Mammalian models are essential for brain aging research. However, the long lifespan and poor amenability to genetic and pharmacological perturbations have hindered the use of mammals for dissecting aging-regulatory molecular networks and discovering new anti-aging interventions. To circumvent these limitations, we developed an ex vivo model system that faithfully mimics the aging process of the mammalian brain using cultured mouse brain slices. Genome-wide gene expression analyses showed that cultured brain slices spontaneously upregulated senescence-associated genes over time and reproduced many of the transcriptional characteristics of aged brains. Treatment with rapamycin, a classical anti-aging compound, largely abolished the time-dependent transcriptional changes in naturally aged brain slice cultures. Using this model system, we discovered that prions drastically accelerated the development of age-related molecular signatures and the pace of brain aging. We confirmed this finding in mouse models and human victims of Creutzfeldt-Jakob disease. These data establish an innovative, eminently tractable mammalian model of brain aging, and uncover a surprising acceleration of brain aging in prion diseases.
Hydrodynamic superradiance in wave-mediated cooperative tunneling
Authors: Papatryfonos Konstantinos , Ruelle Mélanie , Bourdiol Corentin , Nachbin André , Bush John W. M. , Labousse Matthieu
Published: June 2022

Superradiance occurs in quantum optics when the emission rate of photons from multiple atoms is enhanced by inter-atom interactions. When the distance between two atoms is comparable to the emission wavelength, the atoms become entangled and their emission rate varies sinusoidally with their separation distance due to quantum interference. We here explore a theoretical model of pilot-wave hydrodynamics, wherein droplets self-propel on the surface of a vibrating bath. When a droplet is confined to a pair of hydrodynamic cavities between which it may transition unpredictably, in certain instances the system constitutes a two-level system with well-defined ground and excited states. When two such two-level systems are coupled through an intervening cavity, the probability of transition between states may be enhanced or diminished owing to the wave-mediated influence of its neighbour. Moreover, the tunneling probability varies sinusoidally with the coupling-cavity length. We thus establish a classical analog of quantum superradiance.
Facile synthesized zinc oxide nanorod film humidity sensor based on variation in optical transmissivity
Authors: Verma Rajni , Pathak Saurabh , Dey Kajal Kumar , Sikarwar Samiksha , Yadav B. C. , Srivastava A. K.
Published: June 2022

Variation in the transmitted light intensity from zinc oxide thin films with moisture content provides a great opportunity to use them for humidity sensing.
Metal ion-intercalated layered hydrogen tri-titanate nanotubes: synthesis, characterization and their use in ultrafast and enhanced removal of hazardous contaminant fluoride from water
Authors: Biswas Anjana , C. Prathibha
Published: June 2022

This manuscript presents facile fabrication, in depth analysis of phase, structure, surface and optical properties of metal ions intercalated layered hydrogen trititanate nanotubes and evaluation of their applicability for fluoride adsorption.
The greenest revolution – harnessing the power of plants to help combat climate change
Authors: Busch Wolfgang , Miller Charlotte
Published: June 2022

As we continue searching for the technologies that will halt global warming, let us take a moment to think about plants. A key contributor to our climate crisis is the accumulation of carbon dioxide in the atmosphere. Plants have been capturing carbon dioxide for billions of years, making them the most tried and tested carbon capture machinery on the planet. Plants fix carbon dioxide as part of photosynthesis. After years of research, we now know the key regulators of this process and have the knowledge to start engineering plants with increased photosynthetic capacity. In addition to improving the efficiency of carbon fixation, we must also find a way to stably store the carbon captured by plants. To achieve this, we can look to the below-ground part of the plant body – the root system. Plant roots are packed full of carbon and also exude carbon-rich molecules into the soil. Engineering future plants with deeper, more extensive root systems, with enhanced chemical composition that increases carbon content and reduces the rate of biodegradation, offers a way to store atmospheric carbon fixed by plants below ground for years to come. With optimized root systems, these plants would also be better equipped to explore their surrounding soils for water and nutrients, which would ultimately improve plant performance. This approach also offers a way to replenish our carbon-depleted soils, which would increase soil quality by improving water and nutrient retention. Harnessing the plants' natural ability to capture carbon, thus provides a way to not only restore balance to the carbon cycle, but also improve soil quality and future crop performance.
Reihentestungen an Schulen können die Dunkelziffer von
COVID-19 Infektionen unter Schülern signifikant senken
Authors: Berger Ursula , Fritz Cornelius , Kauermann Göran
Published: June 2022

Ziel der Studie Die Arbeit untersucht den Effekt der
Maßnahme verpflichtender Covid-19 Tests für den
Präsenzunterricht an Schulen. In Bayern gilt diese Testpflicht seit Ende
der Osterferien 2021. Für die erste Woche nach den Osterferien ergibt
sich ein natürliches Experiment, das uns erlaubt den Effekt der
Testpflicht an Schule auf die Meldeinzidenz zu quantifizieren.
Methoden Wir vergleichen die Änderungen der
7-Tage-Meldeinzidenz von Neuinfektionen pro 100 000 Einwohner zwischen
Kreisen mit und ohne Präsenzunterricht. Für Landkreise und
kreisfreie Städte, deren Meldeinziden zum Stichtag unter 100 lag, konnte
in Kalenderwoche 15 Präsenzunterricht in geteilten Klassen bei
Testpflicht stattfinden. Dazu haben sich Schulkinder in den Klassen mit
Antigen-Schnelltest getestet. Daten zu den Testergebnissen der Schnelltests an
den Schulen liegen uns nicht vor. Bei positivem Testergebnis im
Antigen-Schnelltest wurde der Verdachtsfall mit einem PCR-Test
überprüft. Positive PCR-Testergebnisse liegen auf Kreisebene in
den betrachteten Altersgruppen als Meldeinzidenzen vor. In den Kalenderwochen 13
und 14 fand in Bayern wegen der Osterferien kein Schulunterricht an Schulen
statt. Berücksichtigt man eine Latenzzeit von etwa 3–4 Tagen und
einen Meldeverzug von 1–2 Tagen, so kann ein stärkerer Anstieg
der Meldeinzidenzen in Kreisen mit Präsenzunterricht bei Testpflicht
nicht (bzw. nur vernachlässigbar) auf Infektionen an Schulen
zurückgeführt werden, sondern spiegelt eine Reduktion der
Dunkelziffer durch die Testpflicht wider. Ergebnisse Die
Meldeinzidenz erhöht sich in Kreisen mit Präsenzunterricht und
Testpflicht an Schulen um den Faktor 6,6 bei 5–11 Jährigen bzw.
1,7 bei 12–20 Jährigen. Dieser Anstieg geht einher mit einer
Reduktion der Dunkelziffer und ist signifikant im Vergleich zu Kreisen mit
Distanzunterricht. Aufgrund der gegebenen Situation eines natürlichen
Experiments ist diese Steigerung der Meldeinzidenz in der Altersgruppe der
Schulkinder der Maßnahme den Reihentests an Schulen mit
Präsenzunterricht zuzuschreiben. Für denselben Zeitraum zeigen
sich keinerlei Unterschiede in den Meldeinzidenzen für andere
Altersgruppen.Schlussfolgerung Präsenzunterricht mit
Testpflicht ändert die Rolle der Schulen in der Pandemie. Die Analysen
zeigen, dass die Öffnung der Schulen mit einem verpflichtenden
Testkonzept aus epidemiologischer Sicht von Vorteil ist, da damit die
Dunkelziffer von COVID-19 Infektionen unter den Schülerinnen und
Schülern drastisch gesenkt werden kann.
The Portal-Venous Enhancement Ratio of the Adrenal Glands and Spleen as a Short-Term Predictor of Mortality in Intensive Care Patients
Authors: Winzer Robert , Hoffmann Ralf-Thorsten , Fedders Dieter
Published: June 2022

Background In critically ill ICU patients, initial results showed that opposite enhancement of the adrenal glands (↑) and spleen (↓) on portal venous CT scans was associated with increased mortality over the next days to a month, with short-term mortality being best predicted. The study aimed to validate the adrenal-to-spleen ratio determined in a pilot study concerning mortality prediction.

Method 371 portal venous CT scans of 203 ICU patients (127 men, age: 68.1 ± 14.4 years) were included in the retrospective analysis. Region-of-interest (ROI)-based Hounsfield units of the adrenal glands and the spleen and their density ratio were evaluated. The Matthews correlation coefficient (MCC) and ROC analysis were used to establish a threshold for the adrenal-to-spleen ratio regarding mortality within 72 hours of imaging. The quality of the classification of survivors and deceased patients in the current collective based on the threshold determined in a pilot study and on the current threshold was determined. The precision-recall curve (PRC) was used to test the influence of the addition of patients with low vital risk on the ROC.

Results The current threshold of 1.37 for the adrenal-to-spleen ratio provides good discriminatory power between those who died and those who survived (MCC: 0.87; sensitivity: 83.7 %; specificity: 99.1 %; PPV: 93.2 %; NPV: 97.6 %) and differs only slightly from the threshold of 1.41 determined in the pilot study, which consequently has comparable discriminatory power.

Conclusion As a reproducible image-based prognostic marker, the portal venous adrenal-to-spleen ratio has a high predictive power for short-term death in ICU patients. It is, therefore, suitable as an indicator of high risk of death within 72 hours after imaging.

Key Points: 

Citation Format
Zentralisierung, Spezialisierung und Ambulantisierung der Versorgung von Kopf-Hals-Tumorpatienten
Authors: Vahl Julius Malte , Böhm Felix , Brand Matthias , von Witzleben Adrian , Hoffmann Thomas Karl , Laban Simon
Published: June 2022

Demografisch zeigt sich eine alternde, morbider werdende deutsche Bevölkerung. Gleichzeitig werden Urbanisierungstendenzen, medizinische Überkapazitäten und steigende, auch innovationsbedingte Versorgungskosten bei einem knappen Gesundheitsetat beobachtet. Zentralisierung, Spezialisierung und Ambulantisierung sollen Abhilfe verschaffen und können durch Modifikationen der Vergütung mitgesteuert werden. Dieser Umbruch birgt für Patient*innen und Ärzt*innen neue Herausforderungen, welche exemplarisch am Kopf-Hals-Tumor (KHT)-Zentrum des Universitätsklinikums Ulm analysiert wurden. Dabei handelt es sich um eine retrospektive, monozentrische Kohortenstudie zur Entwicklung des Patientenaufkommens, Einzugsgebiets, der Behandlungsmodalität und Demografie unter Einschluss von 2070 KHT-Patient*innen zwischen den Jahren 2011 und 2020 der HNO-Klinik. Es wurde beobachtet, dass die Anzahl (Neudiagnosen 2011: 134 vs. 2020: 204) und das Durchschnittsalter (2011: 61,5 Jahre vs. 2020: 65,8 Jahre; p<0,0001) der KHT-Patient*innen im zeitlichen Verlauf anstiegen. Außerdem nahmen die Patient*innen hierbei tendenziell größere Anfahrtswege auf sich (2011: 54,4km vs. 2020: 64,4km; p=0,05). Gleichzeitig wuchs die mittlere Anzahl an Konsultationen und Behandlungen pro Patient*in und 5-Jahres-Nachsorgeintervall (bei Erstdiagnose 2011: 7,8 vs. 2016: 10,4; p=0,0003), wobei sich der Anteil ambulanter Patientenkontakte von 2011–2020 von 58,9% auf 62,4% (p=0,09) erhöhte. Dementsprechend ist zu erwarten, dass klinische Zentren im Zuge der Spezialisierung, Ambulantisierung und Zentralisierung des Gesundheitssystems an Bedeutung bei der Versorgung von KHT-Patient*innen gewinnen. Daraus folgende Konsequenzen für die Patientenversorgung sollten bei Umstrukturierungsstrategien berücksichtigt werden.
Endoscopy-related injury among gastroenterology trainees
Authors: Pawa Swati , Martindale Sarah L. , Gaidos Jill K.J. , Banerjee Promila , Kothari Shivangi , D’Souza Sharlene L. , Oxentenko Amy S. , Burke Carol A.
Published: June 2022

Background and study aims Endoscopy-related injury (ERI) is widespread among practicing gastroenterologists. However, less is known about the incidence among trainees. This study assesses the rate of self-reported ERI occurrence, patterns of injury, and knowledge of preventive strategies in a nationally representative sample of gastroenterology fellows.

Methods A 38-item electronic survey was sent to members of the American College of Gastroenterology. One hundred and sixty-eight gastroenterology fellows were included in analyses. Descriptive and univariate analyses evaluated the likelihood of ERI by workload parameters and gender.

Results ERI was reported by 54.8 % of respondents. ERI was most common in the thumb (58.7 %), hand/finger (56.5 %), and wrist (47.8 %). There was no significant difference in the reported occurrence of ERI between male and female gastroenterology fellows. However, female fellows were significantly more likely to report a greater number of body areas affected by ERI, and male fellows were more likely to report elbow pain. Most respondents (85.1 %) reported discussion about, or training in, ergonomic strategies during gastroenterology fellowship.

Conclusions ERI is reported to occur as early as gastroenterology fellowship. Results of this study support this finding and highlight the need for ongoing implementation and monitoring of a formal ergonomics training program as well as development of ergonomically appropriate instruments. Implications of these findings likely extend to trainees in other procedural related specialties like orthopedics and general surgery, though further research is required. Ergonomics training in gastroenterology fellowship and monitoring of its impact on trainees reported ERI is important due to negative effects on productivity and career longevity.