bluuebunny/crossref_metadata_2025 huggingface dataset:
Insights gained from computational modeling of YAP/TAZ signaling for cellular mechanotransduction
Authors: Jafarinia Hamidreza , Khalilimeybodi Ali , Barrasa-Fano Jorge , Fraley Stephanie I. , Rangamani Padmini , Carlier Aurélie
Published: August 2024

YAP/TAZ signaling pathway is regulated by a multiplicity of feedback loops, crosstalk with other pathways, and both mechanical and biochemical stimuli. Computational modeling serves as a powerful tool to unravel how these different factors can regulate YAP/TAZ, emphasizing biophysical modeling as an indispensable tool for deciphering mechanotransduction and its regulation of cell fate. We provide a critical review of the current state-of-the-art of computational models focused on YAP/TAZ signaling.
Theoretical model of donor–donor and donor–acceptor energy transfer on a nanosphere
Authors: Synak Anna , Kułak Leszek , Bojarski Piotr
Published: August 2024

In this study, we introduce a novel advancement in the field of theoretical exploration. Specifically, we investigate the transfer and trapping of electronic excitations within a two-component disordered system confined to a finite volume. The implications of our research extend to energy transfer phenomena on spherical nanoparticles, characterized by randomly distributed donors and acceptors on their surface. Utilizing the three-body Padé approximant technique, previously employed in single-component systems, we apply it to address the challenge of trapping within our system. To validate the robustness of our model, we conduct Monte Carlo simulations on a donor–acceptor system positioned on a spherical nanoparticle. In particular, very good agreement between the model and Monte Carlo simulations has been found for donor fluorescence intensity decay.
Age-associated functional healing of musculoskeletal trauma through regenerative engineering and rehabilitation
Authors: Habing Krista M. , Alcazar Cynthia A. , Duke Victoria R. , Tan Yong How , Willett Nick J. , Nakayama Karina H.
Published: August 2024

Regenerative rehabilitation facilities age-dependent healing following severe muscle injuries; young mice respond well to treatment, whereas aged mice show minimal improvement, highlighting reduced responsiveness to these therapies in aged animals.
Advances in carrier-delivered small interfering RNA based therapeutics for treatment of neurodegenerative diseases
Authors: Liang Wendanqi , Luo Yi , Xu Ajing , Chu Jianjian , Ji Wenbo , Wang Li , Gu Yuankai , Lu Xinyu , Hou Along , Liu Yan , Gao Jie , Yin You
Published: August 2024

Neurodegenerative diseases are devastating diseases that severely affect the health of people all over the world.
Enhancing the performance of organic phototransistors using a sandwich-heterostructure
Authors: Yan Chi , Wang Qi , Gong Weijie , Lu Jie , Yin Yao , Xiang Chuan , Xue Di , Wang Zi , Huang Lizhen , Chi Lifeng
Published: August 2024

A sandwich heterostructure improves organic phototransistor performance by enhancing mobility, photoresponsivity, and reducing dark current, weakening the adverse effects of traditional planar heterojunctions.
Structural descriptors and information extraction from X-ray emission spectra: aqueous sulfuric acid
Authors: Eronen E. A. , Vladyka A. , Sahle Ch. J. , Niskanen J.
Published: August 2024

We systematically benchmark structural descriptors in machine learning and study information recoverability from X-ray emission spectra of aqueous sulfuric acid.
Exploring antiviral and antiparasitic activity of gold N-heterocyclic carbenes with thiolate ligands
Authors: Oliveira Igor S. , Garcia Marcus S. A. , Cassani Natasha M. , Oliveira Ana L. C. , Freitas Lara C. F. , Bertolini Vitor K. S. , Castro Jennyfer , Clauss Gustavo , Honorato João , Gadelha Fernanda R. , Miguel Danilo C. , Jardim Ana C. G. , Abbehausen Camilla
Published: August 2024

Novel gold(i)(NHC) containing thiopyrimidines and thiazolidines with promising antiviral and antiparasitic activity.
Evidence for a kinetic FLP reaction pathway in the activation of benzyl chlorides by alkali metal–phosphine pairs
Authors: Csókás Dániel , Coles Max , Toh Zhi Hao , Young Rowan D.
Published: August 2024

The presence of Na+ is found to accelerate Bn−Cl bond cleavage by PPh3via a kinetic frustrated Lewis pair (FLP) pathway.
Trace F-doped Co3O4 nanoneedles for enhanced acidic water oxidation activity via promoting OH coverage
Authors: Hao Genyan , Zhao Tao , Fang Qiang , Jia Yunzhen , Li Dandan , Zhong Dazhong , Li Jinping , Zhao Qiang
Published: August 2024

F doping promotes the enrichment of OH on the surface of Co3O4, reduces the energy barrier of the rate-limiting step, and thus accelerates the reaction efficiency.
Copper catalyzed direct C–H double methylation of aromatic aldehydes employing methanol as an alkylating agent
Authors: Sunny Sereena , Karvembu Ramasamy
Published: August 2024

A mild sustainable protocol for the direct C–H double methylation of aromatic aldehydes has been accomplished by using un-activated methanol as a C1 source.
Photocatalytically active metal–organic derived ensembles for organic pollutant degradation
Authors: López-García Clara , Castillo-Blas Celia , Iglesias Marta , Monge M. Angeles , Gutiérrez-Puebla Enrique , Gándara Felipe
Published: August 2024

The pyrolysis process of multi-metal metal–organic frameworks produces complex ensembles with photocatalytic activity for water pollutant degradation.
Clay–polymer hybrid hydrogels in the vanguard of technological innovations for bioremediation, metal biorecovery, and diverse applications
Authors: Ruiz-Fresneda Miguel A. , González-Morales Eduardo , Gila-Vilchez Cristina , Leon-Cecilla Alberto , Merroun Mohamed L. , Medina-Castillo Antonio L. , Lopez-Lopez Modesto T.
Published: August 2024

Hybrid clay/polymer composite hydrogels immobilized with microbial cells offer a novel, green, and effective methodology for bioremediation, biorecovery, and other applications, due to their enhanced properties and functionalities.
Valley-selective carrier transfer in SnS-based van der Waals heterostructures
Authors: Sutter E. , Komsa H.-P. , Sutter P.
Published: August 2024

Valley-selective carrier transfers across interfaces in heterostructures pave the way for valleytronics with electrical readout of the valley population.
Antifouling behavior of titania–silica-reduced graphene oxide nanocomposites as coatings for marine applications
Authors: Smitha Venu Sreekala , Swargy Anson , Digilarani Malayil , Vimala Thayumani , Resmi Thoppil Ramakrishnan
Published: August 2024

A facile, low-cost, and eco-friendly method to develop antifouling coatings on glass substrates using titania–silica-reduced graphene oxide nanocomposite suitable for marine applications.
Construction of axially chiral 2-arylpyrroles using catalytic asymmetric Suzuki–Miyaura cross-coupling: an efficient approach to esaxerenone
Authors: Jia Ling , Li Bing , Wang Xi , Zhao Jinfeng , Qu Jingping , Zhou Yuhan
Published: August 2024

An efficient method has been developed to access axially chiral 2-arylpyrroles using catalytic asymmetric Suzuki–Miyaura cross-coupling. The catalytic asymmetric synthesis of esaxerenone was carried out in a faster way.
Promoting electrocatalytic water oxidation via crafting Co–O–W bridge bonds on an amorphous core/shell NiCo-ZIF@POM catalyst
Authors: Yu Tianhao , Gao Peng , Du Hong , Dong Ling
Published: August 2024

The oxygen evolution reaction (OER) requires the development of a strong and efficient electrocatalyst due to its slow mechanism and high overpotential.
Functionalization of a porous copper(ii) metal–organic framework and its capacity for loading and delivery of ibuprofen
Authors: Tella Adedibu C. , Olatunji Sunday J. , Ajibade Peter A.
Published: August 2024

A porous Cu-MOF of 4,4′,4′′-tri-tert-butyl-2,2′:6′,2′′-terpyridine and 5-nitroisophthalic acid formulated as [Cu(npd)(N3ttb)]·(DMF)(H2O) was synthesized and characterized by single crystal X-ray crystallography for loading and delivery of ibuprofen.
The backbone constitution drives passive permeability independent of side chains in depsipeptide and peptide macrocycles inspired by ent-verticilide
Authors: Thorpe Madelaine P. , Smith Abigail N. , Blackwell Daniel J. , Hopkins Corey R. , Knollmann Bjorn C. , Akers Wendell S. , Johnston Jeffrey N.
Published: August 2024

The number of peptide-like scaffolds found in late-stage drug development is increasing, but a critical unanswered question in the field is whether substituents (side chains) or the backbone drive passive permeability.
An artificial cathode-electrolyte interphase enabling one-step sulfur transition in polyethylene oxide-based solid-state lithium–sulfur batteries
Authors: Zhang Leicheng , Wang Tianshuai , Chen Junjie , Wu Maochun , Zhao Tianshou
Published: August 2024

An artificial CEI is developed for PEO-based solid-state Li–S batteries, which inhibits the cohesion and dissolution of polysulfides in PEO and enables a one-step solid-state transition of sulfur.
Exploring ortho-dianthrylbenzenes for molecular solar thermal energy storage
Authors: Baggi Nicolò , Muhammad Lidiya M. , Liasi Zacharias , Elholm Jacob Lynge , Baronas Paulius , Molins Elies , Mikkelsen Kurt V. , Moth-Poulsen Kasper
Published: August 2024

Aiming to explore anthracene-based systems for molecular solar thermal energy storage, five ortho-dianthrylbenzenes were designed, demonstrating promising properties for future development of anthracene-based photoswitches for such applications.
Collecting bidirectional flow energy through a photovoltaic thermoelectric radiative cooling hybrid system to maximize the utilization of electricity from the sun and outer space
Authors: Lv Song , Feng Mengqi , Qian Zuoqin , Guo Ying , Wu Yangyang , Deng Jingcai , Zhang Mingming , Xie Shangzhen
Published: August 2024

This study presents a photovoltaic thermoelectric radiative cooling system through an innovative photothermal design that maximizes the collection of electricity from the sun and outer space with a maximum power density of 213.1875 W m−2.
Reliability issues of amorphous oxide semiconductor-based thin film transistors
Authors: Shen Yuxuan , Zhang Meng , He Siyuan , Bian Le , Liu Jiaxin , Chen Zhengyu , Xue Shuangmei , Zhou Ye , Yan Yan
Published: August 2024

This review summarizes and discusses existing literature on reliability issues of amorphous oxide semiconductor thin-film transistors. The investigation focuses on bias stress, electro-static discharge, bending, and radiation reliability.
Distinct bulk emission properties of the hexacatenar molecules by varying the polarity of peripheral chains
Authors: Park Seongwon , Jun Jinyoung , Byun Jaeduk , Kim Ho-Joong , Cho Byoung-Ki
Published: August 2024

The molecular engineering of chain polarity in hexacatenar molecules, which are composed of an identical D–A–D chromophore leads to distinct emission properties in the bulk state.
Rational design of dimensionally matched 2D/2D COF based photocatalysts for highly efficient noble-metal-free solar energy catalysis
Authors: Hu Haijun , Sun Xiaodong , Li Hui , Huang Hongwei , Ma Tianyi
Published: August 2024

Ultrathin non-precious metal co-catalysts (WS2) were combined with a 2D COF (TP1C) through a solvothermal method, achieving excellent photocatalytic hydrogen production performance.
Augmentative and Alternative Communication Interventions in Critical and Acute Care With Mechanically Ventilated and Tracheostomy Patients: A Scoping Review
Authors: LaValley Mimi , Chavers-Edgar Tiffany , Wu Mengxuan , Schlosser Ralf , Koul Rajinder
Published: August 2024

Purpose:

Communication with nonspeaking patients is a critical challenge of person-centered care. This scoping review aimed to map the literature on augmentative and alternative communication (AAC) interventions for nonspeaking mechanically ventilated and tracheostomy patients in critical and acute care settings.

Method:

Electronic database, ancestry, and forward citation searches were conducted using eligibility criteria established a priori. Data were extracted, synthesized, and summarized according to scoping review methodology. Studies were categorized by type of intervention and summarized in terms of purpose, participants, design, quality appraisal (including validity and reliability of selected efficacy measures), and efficacy.

Results:

Small-to-large treatment effect sizes indicated demonstrable impact on patient health and communication efficacy with high-tech and no-tech visual interface–based interventions and systematic nurse training interventions. Treatment effects primarily pertained to dependent variables of patient anxiety, communication satisfaction, comfort, symptom self-reporting, and nursing practice changes.

Conclusions:

There is a paucity of high-quality AAC intervention research for mechanically ventilated and tracheostomy patients in critical and acute care settings. Emergent evidence suggests that select visual interface and nurse training interventions can impact efficacy of patient–provider communication and patients' overall health.

Supplemental Material:

https://doi.org/10.23641/asha.26506102
Targeting Phonology or Semantics to Improve Reading Aloud Response Times and Accuracy: A Case Series Investigation of Stroke Survivors With Aphasia
Authors: Boukrina Olga , Madden Elizabeth B. , Giordano Nicole , Karim Dima , Staples Ryan , Graves William W.
Published: August 2024

Purpose:

Acquired reading deficits, or alexia, affect a significant proportion of individuals with aphasia. We sought to improve treatment for alexia by targeting specific cognitive information-processing components critical to reading (i.e., phonology or semantics).

Method:

To target either phonological or semantic processing, we administered two anomia treatments, phonomotor treatment (PMT) and semantic feature analysis, modified to include a focus on reading throughout the therapy. Chronic left-hemisphere stroke survivors (
N
= 5) completed one or two 60-hr treatment rounds. Based on predictions from a computational reading model, three participants received the treatment recommended for their specific reading challenges (e.g., PMT for phonological deficits), while two participants had the nonrecommended treatment first, followed by the recommended model-matched treatment. Changes in reading aloud accuracy and response times (RTs) from before to after treatment were examined as a function of matching treatment to the deficit profile, type of treatment, therapy round, and word characteristics.

Results:

Participants' reading aloud accuracy improved after treatment relative to baseline with higher accuracy for high-frequency words and shorter words. After the first treatment round, participants' accuracy and RT improved, irrespective of whether treatment was matched to the deficit profile. Furthermore, participants who completed the second treatment round continued achieving accuracy gains. Following treatment, participants demonstrated enhanced reading efficiency and generalized improvements on the selected sections of the Woodcock Reading Mastery Test.

Conclusions:

While larger studies are needed to test for the effects of matching treatment type to the deficit profile, we conclude that treatments targeting specific information-processing components can effectively improve reading. Doubling the treatment dose offers small but significant gains.

Supplemental Material:

https://doi.org/10.23641/asha.26517319
Articulation Assessment for Tongue Cancer Patients: Using Consonant Production Performance to Capture Speech Deficits
Authors: Xie Tongtong , Li Yi , Xiao Yudong , Zheng Huayong , Liao Guiqing , Lu Shuo
Published: August 2024

Purpose:

The purpose of this study was to thoroughly analyze postoperative consonant errors by tongue cancer (TC) patients with speech disorders and also to investigate the correlation between the pathological factors and the speech performance using our Consonant-based Articulation Assessment Battery (CAAB).

Method:

The participants were 57 monolingual Mandarin TC patients (26 women, 31 men) after surgery (aged 20–80 years). All participants were literate and had normal vision and hearing, enabling them to comprehend and comply with our instructions. In order to quickly evaluate their articulation performance based on the place and manner of articulation, they were instructed to pronounce the characters in CAAB. The analysis removed speech samples impacted by speakers' dialects, while recording and documenting all other responses.

Results:

The study uncovered a significant correlation between pathological factors (e.g., size of tongue resection, specific resection site, and tumor size) and the accuracy of consonant articulation. Furthermore, tongue damage predominantly impacts the place of articulation (63.85%) than the manner of articulation (20.78%). The damage in the anterior part of the tongue has the most prominent influence on consonant production.

Conclusions:

CAAB can fast capture the idiosyncratic characteristics of speech production by TC patients, and the articulation deficits are quite different from other types of organic or nonorganic speech disorders, for example, cleft lip and cleft palate. Hence, CAAB can be designated as an assessment tool for articulation disorders caused by stomatognathic damages. Our findings also shed light on the possible oral cancer surgery plan and the postoperative speech rehabilitation training.
Impacts of Environmental Factors on Maternal Health in Low Resource Settings
Authors: Tomar Kapil , Sharma Chandra Mani , Sharma Preeti , Gupta Dhruv , Chariar V.M.
Published: August 2024

The interaction between the environment and maternal health is critical to public health. It impacts the well-being of pregnant women globally. This paper investigates the connections between multiple environmental factors and their impact on maternal health, emphasizing the challenges and potential interventions. In diverse settings, ecological conditions shape maternal health outcomes. Factors such as air and water quality, sanitation, chemical exposure, nutritional food, and climate change play pivotal roles. The disparities in environmental exposures contribute to varying risks for pregnant women, particularly in low- and middle-income countries (LMIC). The detrimental effects of environmental pollution, inadequate sanitation, a rise in temperature, and limited access to healthcare services are explored concerning maternal health outcomes. Additionally, the abstract highlights the interconnectedness of socio-economic factors, cultural influences, and healthcare-seeking behaviour in shaping the impact of the environment on expectant mothers. Recognizing the complexity of these factors is essential for designing targeted interventions to improve maternal health in low-resource settings. The abstract concludes by advocating for comprehensive strategies encompassing healthcare improvements, environmental stewardship, and community empowerment to mitigate adverse environmental impacts on maternal health. Understanding and addressing these dynamics are crucial steps toward ensuring the well-being of mothers and promoting sustainable maternal healthcare practices.
Discharge Forecasting in Monsoonal Gung Watershed: A Comparative Analysis of F. J. Mock, Markov, and ARIMA Models
Authors: Oktarini Ahya Aulia , Marselina Mariana
Published: August 2024

Water resources are crucial for human needs along with their increasing demand due to rapid population growth. Nevertheless, water availability is readily limited, and disaster might also occur due to unplanned water infrastructure management. Gung watershed, as a primary water resource, is vulnerable in water availability and flood, primarily influenced by land cover degradation. Moreover, no prior research has been conducted to obtain accurate discharge forecasting in this area. In reinforcing disaster mitigation and infrastructure planning, our recent work utilizes a 10-year dataset of hydrometeorological data (2013-2022) in the monsoonal Gung watershed. A comparative study of F. J. Mock, Markov, and ARIMA models shows that all three models are excellent in forecasting discharge with more than 80% correlation to its observed value. Markov model performs best (r=0.91; NSE=0.82), followed by ARIMA and F. J. Mock models. Aside from discharge forecasting, this study offers a reference for strategic planning in water resources infrastructure and disaster mitigation efforts.
Lead release potential of stainless steel plumbing materials – An investigation using leaching experiment
Authors: Adhikari Saroj , Ng Ding-Quan
Published: August 2024

Stainless steel (SS) is considered lead-free as lead (Pb) is not one of its components. However, Pb impurities during SS production can be unintentionally introduced. Hence, this study examined the potential and extent of Pb leaching from SS plumbing materials under mild and aggressive conditions. Synthesized tap water represented mild, while an acidic solution (pH 4) of high concentration (100 mg/L) ethylenediaminetetraacetic acid (EDTA) represented aggressive conditions. Leaching experiments were performed with a three-day stagnation, simulating a long stagnation during the weekend for up to 30 days. A dump-and-fill method was used, and total Pb was measured after three days. Pb concentrations in both solutions exceeded the locally regulated standard value of 10 μg/L during initial stagnation in fittings. Pb release from the fittings in EDTA solution peaked at 27 μg/L during the first stagnation, reducing to levels below 10 μg/L after 27 days. Likewise, it reached a maximum of 14 μg/L, diminishing to below 10 μg/L after 12 days in tap water. However, the Pb release from the pipes under both conditions consistently remained below 10 μg/L. This transient release suggests that Pb was most likely a surface contaminant. The results imply that SS can be a potential source of Pb, with the extent of release varying depending on the type of SS plumbing materials used.
Utilizing Spectral Indices on UAV Multispectral Images for Paddy Healthiness Detection: A Case Study in Perlis, Malaysia
Authors: Aziz Nor Hafiza , Narashid Rohayu Haron , Razak Tajul Rosli , Anshah Siti Aminah , Talib Noorfatekah , Zainuddin KhairulAzhar , Latif Zulkiflee , Hashim Norhashila
Published: August 2024

The increasing global population has brought challenges in expanding and maintaining the productivity levels of paddy. Nowadays, the use of Unmanned Aerial Vehicles (UAV) and multispectral sensors in precision farming has become a prevalent approach in the agriculture sector to enhance efficiency, production, and sustainability in various agricultural activities, including paddy cultivation. In addition, the red edge spectral in multispectral sensor which reflects the rapid change in vegetation is the most suitable for crop studies and very significant to be applied in the computation of spectral indices. Thus, the study aims to utilize various spectral indices on UAV Multispectral Images for the detection of paddy healthiness levels. Six (6) significant Vis (Vegetation Index) i.e., Normalized Difference Red Edge Index (NDREI), Normalized Difference Vegetation Index (NDVI), Optimized Soil Adjusted Vegetation Index (OSAVI), Soil Adjusted Vegetation Index (SAVI), Nitrogen Reflectance Index (NRI) and Green Normalized Different Vegetation Index (GNDVI) were computed and analyzed to determine the affected and healthy paddy of study areas. It was found that the NDREI gave the best accuracy in classification and significant results compared to other indices. These could be due to the application of the Red-Edge band in the algorithm used by NDREI. Meanwhile, the NRI has the lowest accuracy in classifying the paddy area due to its insensitivity to infected paddy. Overall, the severeness of infected and healthy paddy plants can be detected from the computation spectral indices on UAV multispectral, particularly with the red edge spectral band which can provide a comprehensive paddy healthiness levels in the area.
Impfen bei pneumologischen Erkrankungen – was, wann und wie?
Authors: Kodde Cathrin , Sander Leif Erik
Published: August 2024

Was ist neu?

SARS-CoV-2 Im Zuge der COVID-19-Pandemie wurden erstmalig Impfstoffe zugelassen, die auf der mRNA-Technologie beruhen. Dabei kodiert die mRNA für das virale Spike-Protein und es kommt nach der Impfung zur Ausbildung von spezifischen Antikörpern und T-Zellen, welche einen sehr wirksamen Schutz gegen eine schwere Erkrankung und Tod infolge von COVID-19 bewirken. Aufgrund von genetischer Variabilität und rascher Evolution des SARS-CoV-2-Virus entstehen regelmäßig neue Virusvarianten. Die verfügbaren Impfstoffe können vergleichsweise schnell an die saisonal dominierenden Virusvarianten angepasst werden. Für die kommende Wintersaison werden mRNA-Impfstoffe gegen die SARS-CoV-2-Omicron-Sublinie JN.1 empfohlen.

Saisonale Influenza Saisonale Influenzaviren verändern sich saisonal erheblich in ihren antigenen Eigenschaften, sodass jährlich veränderte Impfstoffe zur Auffrischung gegeben werden. Die WHO trifft jeweils im Frühjahr eine Vorhersage und spricht eine Empfehlung für die Hersteller aus, welche genetischen Hämagglutinin- und Neuraminidase-Varianten für den saisonalen Influenzaimpfstoff berücksichtigt werden sollen. Bislang wurden quadrivalente Impfstoffe empfohlen. Für die Saison 2024/2025 auf der Nordhalbkugel wurden trivalente Impfstoffe empfohlen, da seit 2020 die Influenza-B-/Yamagata-Linie nicht mehr zirkuliert. Für die Altersgruppe >60 Jahre ist ein Hochdosis-Impfstoff mit der 4-fachen Antigenmenge empfohlen, der in dieser Altersgruppe eine leichtgradig verbesserte Wirksamkeit zeigt.
Frailty in der Onkologie: Neue Handlungsempfehlungen für die klinische Praxis
Authors: Goede Valentin , Wedding Ulrich
Published: August 2024

Was ist neu?

Definition von Frailty Als Frailty wird allgemein eine Altersfaktoren geschuldete, gesteigerte Anfälligkeit für Morbidität und Mortalität bezeichnet. Im Kontext onkologischer Behandlungen älterer Menschen erhöht Frailty aber nicht nur die Wahrscheinlichkeit für unerwünschte geriatrietypische Gesundheitsereignisse (z.B. pflegerische Institutionalisierung, Stürze), sondern auch das Risiko für Therapiekomplikationen wie Toxizität und Unterbrechung oder Abbruch der Tumortherapie.

Identifikation von Patienten mit Frailty In der Onkologie sind Assessment und Management von Frailty jetzt unverzichtbare Bestandteile klinischen Handelns. Mehrere prospektive, randomisiert-kontrollierte Studien (RCT) an älteren Patienten mit onkologischer Systemtherapie haben jüngst gezeigt, dass die strukturierte Erfassung von Frailty im Rahmen eines multidimensionalen geriatrischen Assessments, mit anschließender Anpassung von Therapiedosis oder -regime, sowie der Behandlung individueller Frailty-Faktoren dabei hilft, Häufigkeit und Schwere ungünstiger Endpunkte einer onkologischen Therapie zu reduzieren.

Assessment und Management von Frailty im onkologischen Behandlungskontext In neuen Leitlinien der American Society of Clinical Oncology (ASCO) bzw. der Arbeitsgemeinschaft der Medizinischen Fachgesellschaften (AWMF) wurden die Studienergebnisse unlängst aufgenommen und entsprechende Handlungsempfehlungen mit hohem Evidenz- und Empfehlungsgrad ausgesprochen. Um die Implementierung eines gezielten Frailty-Assessments und -Managements in onkologischen Kliniken und Praxen zu erleichtern, wurde von der ASCO ein neues, anwendbares „Praktisches Geriatrisches Assessment“ (PGA) vorgeschlagen.
Lagerungstherapie bei Intensivpatienten
Authors: Hermes Carsten , Nydahl Peter , Grunow Julius J. , Schaller Stefan J.
Published: August 2024

Was ist neu?

(Früh-)Mobilisation Besonders hervorzuheben ist die differenziertere Betrachtung der Frühmobilisation, die innerhalb der ersten 72 Stunden nach der Aufnahme auf die Intensivstation beginnen soll. Ein Stufenkonzept und das scorebasierte Mobilisationsschema ermöglichen eine verbesserte Rehabilitation der behandelten Personen. Mobilisation soll den Standard darstellen, d.h. eine medizinisch notwendige Immobilisation muss ärztlich angeordnet werden. Die neue Leitlinie gibt Vorschläge für die Therapiedauer und zusätzliche Mobilisationsmaßnahmen, um sicherzustellen, dass die zu behandelnden Personen so oft wie möglich stehen, aktiv vom Bett zum Stuhl transferiert werden oder gehen können. Diese Empfehlungen gelten auch während einer ECMO-Therapie, was die Bedeutung einer frühzeitigen Aktivierung und Rehabilitation betont.

Oberkörper-Hochlagerung Zu den weiteren Neuerungen gehört die Oberkörper-Hochlagerung (OKH) von mind. 40 Grad bei intubierten kritisch Kranken, wobei potenzielle Nebenwirkungen und Risiken sorgfältig abgewogen werden müssen.

Kontinuierliche laterale Rotationstherapie Die Anwendung der kontinuierlichen lateralen Rotationstherapie (KLRT) weist im Vergleich zu anderen Therapien keine bedeutsamen Vorteile auf, führt aber durch die Notwendigkeit einer tiefen Sedierung während der KLRT zu mehr Nachteilen und wird deswegen nicht mehr empfohlen.

Bauchlagerung Die Bauchlagerung ist die empfohlene Therapieoption für invasiv beatmete Personen mit ARDS und eingeschränkter arterieller Oxygenierung (PaO2/FiO2 <150mmHg) für eine Mindestdauer von 12 Stunden, idealerweise 16 Stunden. Besondere Empfehlungen gelten bspw. für COVID-19-Erkrankte mit akutem hypoxischem Lungenversagen, bei denen Bauchlagerungen im Wachzustand („awake proning“) durchgeführt werden sollten.

Hilfsmittel Die Leitlinie befasst sich neu mit Hilfsmitteln und neuromuskulärer Elektrostimulation, die im Rahmen der Lagerungstherapie und vor allem zur (Früh)Mobilisation von intensivpflichtigen Personen eingesetzt werden.
Was ist neu beim Magenkarzinom?
Authors: Masetti Michael , Lorenzen Sylvie
Published: August 2024

Was ist neu?

Therapie des lokal fortgeschrittenen Adenokarzinoms des Magens und AEG Im lokal fortgeschrittenen Stadium werden multimodale Therapien wie die perioperative Chemotherapie mit FLOT oder die neoadjuvante Radiochemotherapie in nationalen und internationalen Leitlinien empfohlen. Die Integration der Immuntherapie in diese Konzepte hat das Potenzial, die Prognose wesentlich zu verbessern. Phase-II/III-Studien wie die DANTE-, die KEYNOTE-585- und die MATTERHORN-Studie zeigen ermutigende Ergebnisse hinsichtlich verbesserter pathologischer Remissionen, jedoch sind Daten zur Überlebenszeitverlängerung für unselektionierte Patienten bislang ernüchternd.

Neuartige Behandlungskonzepte für die palliative Therapie In der palliativen Therapie des metastasierten Magenkarzinoms bieten Immuntherapien und neue zielgerichtete Antikörpertherapien Hoffnung. Studien wie CheckMate-649 und KEYNOTE-859 zeigen eine Verbesserung des Überlebens und der Ansprechraten. Aktuell bestehen sowohl für Pembrolizumab als auch Nivolumab Zulassungen in der Erstlinienbehandlung von Tumoren mit positiver PD-L1-Expression. Bei HER2-positiven Tumoren konnte in der KEYNOTE-811-Studie gezeigt werden, dass Patienten von Kombinationstherapien mit Immuncheckpoint-Inhibition und anti-HER2-Therapien profitieren. Das Antikörper-Wirkstoff-Konjugat Trastuzumab-Deruxtecan ist eine vielversprechende Zweitlinien-Therapieoption für HER2-positive Tumore nach Therapieversagen mit Trastuzumab. Darüber hinaus zeigt der bispezifische Antikörper Zanidatamab vielversprechende Ergebnisse in der Erstlinienbehandlung. Neue zielgerichtete Therapien gegen CLDN18.2 und FGFR2b zeigen vielversprechende Daten. Der gegen Claudin 18.2 (CLDN18.2) gerichtete Antikörper Zolbetuximab führt bei Patienten mit CLDN18.2-positiver Erkrankung in der Erstlinientherapie zu einer Verbesserung des Überlebens, im Vergleich zu Chemotherapie allein, sodass eine Zulassung 2024 erwartet wird.
Herausforderungen bei der orthopädisch-unfallchirurgischen Versorgung von Kriegsflüchtlingen und Soldaten aus der Ukraine in einem Trauma Zentrum der Maximalversorgung
Authors: Prangenberg Christian , Roder Lisa Fiona , Welle Kristian , Roos Jonas , Zellner Alberto Alfieri , Ben Amar Soufian , Burger Christof , Gathen Martin
Published: August 2024

In dem seit über 14 Monaten andauernden Ukrainekrieg sind nach Angaben der Vereinten Nationen ca. 19337 Verletzte sowie über 10242 Tote auf Seite der Ukraine zu beklagen. Zur Unterstützung der Ukraine kam es zu umfangreichen humanitären Hilfsaktionen, sodass auch in Deutschland Kriegsverletzte aus der Ukraine versorgt werden. In einer retrospektiven Kohortenstudie wurden 10 Patienten untersucht, die zwischen dem 24.02.2022 und dem 24.02.2023 mittels Kleeblattsystem aus der Ukraine in der Abteilung behandelt wurden.Die durchschnittliche stationäre Behandlungsdauer betrug 53,10 Tage. Der durchschnittliche ISS (Injury Severity Score) betrug 23,7. Die Patienten wurden durchschnittlich in unserem Haus 3,3-mal operiert. Alle Patienten wurden konsiliarisch psychologisch mitbetreut. Bei allen Patienten erfolgte zunächst eine Schutzisolierung, bis Ergebnisse eines Coronatests sowie der mikrobiologischen Abstriche vorlagen. Nach vorläufiger Schutzisolierung musste in 5 Fällen
aufgrund isolationspflichtiger Keime eine weitere Isolierung durchgeführt werden. In 8 Fällen erfolgte eine Entlassung in eine staatliche Unterkunft. In 3 Fällen erfolgte auf eigenen Wunsch eine Rückverlegung in die Ukraine.Die Behandlung von kriegsverletzten Patienten aus der Ukraine stellt eine besondere Herausforderung dar. Sie erfordert zwingend ein interdisziplinäres Behandlungskonzept, das neben spezieller unfallchirurgischer und orthopädischer Expertise plastisch-rekonstruktive, mikrobiologische und nicht zuletzt psychologische Mitbetreuung voraussetzt. Durch die hohe Rate an infizierten und isolationspflichtigen Befunden wird häufig eine lange, kostenintensive Therapie mit multiplen Revisionsoperationen erforderlich.
Flexible endoskopische Evaluation des Schluckaktes (FEES) in der Geriatrie – auch in der Diagnose einer Myasthenia gravis im Alter richtungsweisend
Authors: Kowar Michael , Frackowiak Monika , Kaufhold Christiane , Jacobs Andreas H.
Published: August 2024

Anamnese Ein 76-jähriger Patient wird durch den Hausarzt eingewiesen aufgrund eines unklaren Bolusgefühls mit Gewichtsverlust seit einer Wirbelkörperoperation vor ca. 3–4 Monaten. Eine bereits internistisch durchgeführte Duodeno-Gastroskopie zeigte keinen wegweisenden Befund. Zur weiteren Diagnostik und Therapie erfolgte daher die Aufnahme in die geriatrische Abteilung.

Untersuchungsbefund Am Tag der Aufnahme zeigt sich ein unauffälliger neurologischer und internistischer Untersuchungsbefund. Auch laborchemisch zeigte sich kein wegweisender Befund. Die radiologischen Untersuchungen zeigten sich ebenfalls unauffällig. In der FEES-Untersuchung zeigten sich Retentionen, und die Schluckfrequenz nahm im Verlauf ab, wobei sich die Retentionen vermehrten. Zusätzlich gab der Patient während der Untersuchung eine Schwäche der Nackenmuskulatur an.

Therapie und Verlauf In der FEES-Untersuchung zeigte sich der V. a. eine Myasthenia gravis. Die Diagnose konnte in der weiteren laborchemischen Untersuchung mittels positiver Antikörper gegen Acetylcholinrezeptoren und in der neurologischen Untersuchung mittels repetitiver Reizung bestätigt werden. Unter Therapie mit Mestinon und Prednisolon zeigte sich ein Rückgang der Beschwerden, insbesondere des Globusgefühls. Auch die beschriebene Schwäche der Nackenmuskulatur war regredient. Die im Verlauf erneut durchgeführte FEES-Untersuchung konnte keine Retentionen oder Abnahme der Schluckfrequenz nachweisen.

Schlussfolgerung Bei unklarem Globusgefühl und unklarer Schluckstörung sollte an eine Myasthenia gravis gedacht werden. Eine FEES-Untersuchung kann richtungsweisend sein in der Diagnosestellung einer Myasthenia gravis mit vorwiegend pharyngealer Verlaufsform.
Prolongierte Entwöhnung nach Langzeitbeatmung aufgrund einer SARS-CoV-2-Infektion – eine multizentrische retrospektive Analyse
Authors: Geismann Florian , Braunschmidt Lucas , Mohr Arno , Hardebusch Thorsten , Westhoff Michael , Dreher Michael , Müller Tobias , Heine Alexander , Ramdatt Hemendra , Obst Anne , Ewert Ralf
Published: August 2024

Bei einem Teil der Patienten mit SARS-CoV-2-Infektion (COVID-19) erfolgte während der stationären Betreuung eine invasive Beatmung. Die Entwöhnung von der Beatmung gestaltete sich bei einigen Patienten schwierig (sog. prolongiertes Weaning).

Patienten Wir haben retrospektiv Patientencharakteristika und Outcome
von 193 Patienten mit COVID-19-assoziierter invasiver Beatmung mit prolongiertem Weaning an
vier deutschen Weaning-Zentren erfasst. Als Vergleichsgruppe wurden Patienten (n=751) mit
prolongiertem Weaning (Grund der Beatmung „Pneumonie“ und „Akutes Lungenversagen“) aus diesen
vier Zentren aus den Jahren 2011–2023 aus dem „WeanNet“-Register herangezogen.

Ergebnisse Im Median betrug die intensivmedizinische Betreuung 39 (25–68) Tage. Bei 19% (37/193) der Patienten war im Median für 27 (18–51) Tage eine ECMO-Unterstützung notwendig. Die Sterblichkeit im Krankenhaus betrug 8,3% (2,7% mit vs. 9,6% ohne ECMO) und in der Vergleichsgruppe verstarben 6,8%. Bei Entlassung waren 84% (Vergleichsgruppe 77%) komplett entwöhnt, bei 2,6% (Vergleichsgruppe 17,6%) der Patienten erfolgte eine NIV-Behandlung. Bei 7,8% (Vergleichsgruppe 15,7%) war weiterhin eine invasive Beatmung notwendig. Im Beobachtungszeitraum von 6 Monaten nach Entlassung war bei 22,4% und nach 12 Monaten bei weiteren 14,1% der Patienten eine stationäre Betreuung notwendig. Die Gesamtsterblichkeit im Follow-up nach 12 Monaten betrug 20,6% (5,6% mit vs. 24,6% ohne ECMO).

Diskussion Die Sterblichkeit von beatmeten Patienten mit COVID-19 war
in den vier untersuchten Weaning-Zentren mit 8,3% sehr gering. Die Sterblichkeit der Patienten
mit einer ECMO-Behandlung lag bei lediglich 2,7%. Die Sterblichkeit in der Vergleichsgruppe
wurde mit 7,3% ermittelt. Die geringere Sterblichkeit der Patienten mit einer ECMO-Behandlung
zeigte sich auch bei Nachbeobachtung mit bis zu 12 Monaten.

Die aufgrund von COVID-19 invasiv beatmeten Patienten mit prolongiertem Weaning zeigten sowohl hinsichtlich erfolgreicher Entwöhnung als auch im Hinblick auf die Sterblichkeit vergleichbare Ergebnisse im Vergleich zu einer Kontrollgruppe aus dem WeanNet-Register. Die Langzeitergebnisse mit einem Überleben von mehr als 80% für das erste Jahr nach Entlassung waren ermutigend.
Revolutionizing early Alzheimer's disease and mild cognitive impairment diagnosis: a deep learning MRI meta-analysis
Authors: Wang Li-xue , Wang Yi-zhe , Han Chen-guang , Zhao Lei , He Li , Li Jie
Published: August 2024

Background The early diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI) remains a significant challenge in neurology, with conventional methods often limited by subjectivity and variability in interpretation. Integrating deep learning with artificial intelligence (AI) in magnetic resonance imaging (MRI) analysis emerges as a transformative approach, offering the potential for unbiased, highly accurate diagnostic insights.

Objective A meta-analysis was designed to analyze the diagnostic accuracy of deep learning of MRI images on AD and MCI models.

Methods A meta-analysis was performed across PubMed, Embase, and Cochrane library databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focusing on the diagnostic accuracy of deep learning. Subsequently, methodological quality was assessed using the QUADAS-2 checklist. Diagnostic measures, including sensitivity, specificity, likelihood ratios, diagnostic odds ratio, and area under the receiver operating characteristic curve (AUROC) were analyzed, alongside subgroup analyses for T1-weighted and non-T1-weighted MRI.

Results A total of 18 eligible studies were identified. The Spearman correlation coefficient was -0.6506. Meta-analysis showed that the combined sensitivity and specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.84, 0.86, 6.0, 0.19, and 32, respectively. The AUROC was 0.92. The quiescent point of hierarchical summary of receiver operating characteristic (HSROC) was 3.463. Notably, the images of 12 studies were acquired by T1-weighted MRI alone, and those of the other 6 were gathered by non-T1-weighted MRI alone.

Conclusion Overall, deep learning of MRI for the diagnosis of AD and MCI showed good sensitivity and specificity and contributed to improving diagnostic accuracy.
Ground states for mass critical two coupled semi-relativistic Hartree equations with attractive interactions
Authors: Doan Thi Anh Thu
Published: August 2024

We prove the existence and nonexistence of L2(R3)-normalized solutions of two coupled semi-relativistic Hartree equations, which arise from the studies of boson stars and multi-component Bose–Einstein condensates. Under certain condition on the strength of intra-specie and inter-specie interactions, by proving some delicate energy estimates, we give a precise description on the concentration behavior of ground state solutions of the system. Furthermore, an optimal blowing up rate for the ground state solutions of the system is also proved.
Observation of ferroelectric domain walls using nonlinear spiral interferometry
Authors: Sun Xuhui , Wu Hao , Gao Bing , Wang Chenglong , Ma Yibing , Hong Xuhao , Zhang Chao , Qin Yiqiang , Zhu Yongyuan
Published: August 2024

Nonlinear optical methods based on second harmonic generation have been widely used to observe ferroelectric domain structures. However, most previous methods have some flaws, such as limitations in structure patterns and time-consuming scanning processes. We have developed a technique called nonlinear spiral interferometry to observe domain walls, which avoids these problems. By placing a spiral phase plate on the rear focal plane of the imaging system, the intensity of the second harmonic wave can be concentrated at 180° domain walls, while regions with homogeneous polarization appear as a dark field. This phenomenon originates from the interference of point spread functions with spiral phase, and the principle is applicable to samples with any polarized pattern. Using this method, disturbing miscellaneous peaks can be suppressed, and imaging contrast is improved due to the redistribution of energy. This technique is verified through theoretical calculations and experiments, providing an effective and convenient way to observe domain structures.
Nonlinear comparative analysis of Greenland and Antarctica ice cores data
Authors: Rojo-Garibaldi Berenice , Aguilar-Hernández Alberto Isaac , Martínez–Mekler Gustavo
Published: August 2024

We analyze the temperature time series of the EPICA Dome C ice cores in Antarctica and of the Greenland project, Summit, with durations of 800 000 and 248 000 years, respectively, with a recent mathematical tool defined through the Fourier phases of the series, known as the J-index. This data driven index can differentiate between purely random dynamics and dynamics with a deterministic component. It is sensitive to nonlinear components and robust to the presence of noise. Our J-index data analysis shows that both Greenland and Antarctica climatic fluctuations possess deterministic traits and suggests the presence of an underlying nonlinear dynamics. Furthermore, in both regions, it reveals the simultaneous occurrence of an important global event known as the “Pelukian transgression.” For Antarctica, it also detects the marine isotopic stage 11. Additionally, our calculation of the time series Hurst exponents and our detrended fluctuation analysis show the presence of long-range persistent correlations for Antarctica and anti-persistent correlations for Greenland. For the latter case, our fractal dimension determinations are indicative of a more complex climatic dynamics in Greenland with respect to Antarctica. Our results are encouraging for further development of climate variability deterministic models for these regions.
Geometry of Spin(10) symmetry breaking
Authors: Krasnov Kirill
Published: August 2024

We provide a new characterisation of the Standard Model gauge group GSM as a subgroup of Spin(10). The new description of GSM relies on the geometry of pure spinors. We show that GSM ⊂ Spin(10) is the group that stabilises a pure spinor Ψ1 and projectively stabilises another pure spinor Ψ2, with Ψ1,2 orthogonal and such that their arbitrary linear combination is still a pure spinor. Our characterisation of GSM relies on the facts that projective pure spinors describe complex structures on R10, and the product of two commuting complex structures is a what is known as a product structure. For the pure spinors Ψ1,2 satisfying the stated conditions the complex structures determined by Ψ1,2 commute and the arising product structure is R10=R6⊕R4, giving rise to a copy of Pati–Salam gauge group inside Spin(10). Our main statement then follows from the fact that GSM is the intersection of the Georgi–Glashow SU(5) that stabilises Ψ1, and the Pati–Salam Spin(6) × Spin(4) arising from the product structure determined by Ψ1,2. We have tried to make the paper self-contained and provided a detailed description of the creation/annihilation operator construction of the Clifford algebras Cl(2n) and the geometry of pure spinors in dimensions up to and including ten.
Molecular dynamics simulations of microscopic structural transition and macroscopic mechanical properties of magnetic gels
Authors: Wei Xuefeng , Junot Gaspard , Golestanian Ramin , Zhou Xin , Wang Yanting , Tierno Pietro , Meng Fanlong
Published: August 2024

Magnetic gels with embedded micro-/nano-sized magnetic particles in cross-linked polymer networks can be actuated by external magnetic fields, with changes in their internal microscopic structures and macroscopic mechanical properties. We investigate the responses of such magnetic gels to an external magnetic field, by means of coarse-grained molecular dynamics simulations. We find that the dynamics of magnetic particles are determined by the interplay of magnetic dipole–dipole interactions, polymer elasticity, and thermal fluctuations. The corresponding microscopic structures formed by the magnetic particles, such as elongated chains, can be controlled by the external magnetic field. Furthermore, the magnetic gels can exhibit reinforced macroscopic mechanical properties, where the elastic modulus increases algebraically with the magnetic moments of the particles in the form of ∝(m−mc)2 when magnetic chains are formed. This simulation work can not only serve as a tool for studying the microscopic and the macroscopic responses of the magnetic gels, but also facilitate future fabrications and practical controls of magnetic composites with desired physical properties.
AlN/Si interface engineering to mitigate RF losses in MOCVD-grown GaN-on-Si substrates
Authors: Cardinael Pieter , Yadav Sachin , Hahn Herwig , Zhao Ming , Banerjee Sourish , Kazemi Esfeh Babak , Mauder Christof , O'Sullivan Barry , Peralagu Uthayasankaran , Vohra Anurag , Langer Robert , Collaert Nadine , Parvais Bertrand , Raskin Jean-Pierre
Published: August 2024

Fabrication of low-RF loss GaN-on-Si high electron mobility transistor stacks is critical to enable competitive front-end-modules for 5G and 6G applications. The main contribution to RF losses is the interface between the III-N layer and the HR Si wafer, more specifically the AlN/Si interface. At this interface, a parasitic surface conduction layer exists in Si, which decreases the substrate effective resistivity sensed by overlying circuitry below the nominal Si resistivity. However, a clear understanding of this interface with control of the parasitic channel is lacking. In this Letter, a detailed physical and electrical description of metalorganic chemical vapor deposition-grown AlN/Si structures is presented. The presence of a SiCxNy interfacial layer is revealed, and its importance for RF losses is shown. Through C–V and I–V characterization, an increase in the C concentration of this interfacial layer is linked to the formation of negative charge at the AlN/Si interface, which counteracts the positive charge present in the 0-predose limit. The variation of the TMAl predose is shown to allow precise tuning of the C composition and, consequently, the resulting interface charge. Notably, a linear relationship between the predose and the net interface charge is observed and confirmed by the fabrication of an AlN/Si sample with close to zero net charge. In addition, a higher Dit (∼2×1012cm−2) for such compensated samples is observed and can contribute to low-RF loss. An exceptionally high effective resistivity of above 8 kΩ cm is achieved, corresponding to an RF loss below 0.3 dB/mm at 10 GHz.