bluuebunny/crossref_metadata_2025 huggingface dataset:
Atopische Keratokonjunktivitis: Pathophysiologie, Klinik und potenzielle neue Therapiekonzepte
Authors: Lapp Thabo , Mann Caroline , Jakob Thilo , Reinhard Thomas , Maier Philip Christian
Published: April 2024

Die atopische Dermatitis (AD) ist eine chronisch rezidivierende inflammatorische Hauterkrankung, die mit einer 2-gipfligen Altersverteilung sowohl im Kindes- und Jugendalter als auch im mittleren Erwachsenenalter auftritt. In bis zu 50% der AD-Patient*innen findet sich eine Augenbeteiligung, die potenziell visusbedrohend verlaufen kann. Klinisch zeigt sich in der Mehrzahl der Fälle eine atopische Blepharo(kerato)konjunktivitis (ABK) bzw. atopische Keratokonjunktivitis (engl. AKC); weitere klinische Varianten aus diesem Formenkreis der entzündlichen Augenoberflächenerkrankungen sind die Keratoconjunctivitis vernalis im Kindes- bzw. Jugendalter und die allergische Konjunktivitis. Neben der bereits erwähnten Blepharitis, Keratitis und Konjunktivitis sind bei der AD auch eine Lidbeteiligung mit konsekutiver Lidfehlstellung, einer Limbusinsuffizienz mit Ausbildung von Pseudopterygien, eine vernarbende Konjunktivitis mit Symblephara und Fornixverkürzung sowie Malignome der
Augenoberfläche wie konjunktivale intraepitheliale Neoplasien (CIN) und Plattenepithelkarzinome beschrieben. Zudem ist für den Keratokonus eine Assoziation mit der AD bzw. der AKC beschrieben. Während sich die Therapie der AD in der Dermatologie durch den Einsatz von Biologika in den letzten Jahren revolutionär weiterentwickelt hat, erfolgt der primäre Einsatz dieser Biologika bei ophthalmologischen Komplikationen noch sehr zurückhaltend. Die Behandlung erfolgt hier häufig mit Steroiden und Calcineurin-Inhibitoren in topischer Form. Der folgende Artikel fasst neuere Entwicklungen aus der dermatologischen Grundlagenforschung und der klinischen Forschung zusammen und beleuchtet diese im Kontext aktueller ophthalmologischer Therapiekonzepte.
9. Dreiländertagung Kopfschmerz
Authors: Kleinschmidt Andreas , Palla Antonella , Schankin Christoph , Bischoff Nina , Goßrau Gudrun , Kraya Torsten , Tesar Sonja-Maria , Frank Florian , Zebenholzer Karin
Published: April 2024

Gemeinsam organisiert von der Schweizerischen Kopfwehgesellschaft SKG mit der Deutschen Migräne- und Kopfschmerzgesellschaft e.V. DMKG und der Österreichischen Kopfschmerzgesellschaft ÖKSG
Bedeutung von Magnesium im Gehirnstoffwechsel
Authors: Kisters Sophia , Gröber Uwe , Kisters Klaus
Published: April 2024

Jüngste Forschungen lassen auf die Wichtigkeit eines intakten Magnesiumhaushalts
bei Vorliegen einer Demenz oder von Störungen im zentralen Nervensystem
schließen. Die pathophysiologische Bedeutung von Magnesium muss daher aufgrund
seiner guten Wirksamkeit weiter untersucht und weitere Erhebungen sollten im
Sinne der Betroffenen forciert werden. In jedem Fall gilt es,
Magnesiummangelzustände bei Risikopatienten zu vermeiden, um fortwährenden
Einschränkungen vorzubeugen. Trotz einiger Studien zum Einsatz von Magnesium bei
Demenz liegen heute jedoch nur wenige Erhebungen zur Wirkweise des Mineralstoffs
bei dieser Erkrankung vor. Bei vaskulärer Demenz sind eine gute
Blutdruckeinstellung und Senkung erhöhter Interleukin-6-Spiegel von großer
Bedeutung. Dies wird durch eine Magnesiumtherapie erreicht.
Die neue Struktur und Konzeption der ICD-11 im Bereich psychischer Störungen
Authors: Husemann Ronja , Wiegand Hauke F. , Hölzel Lars P.
Published: April 2024

Die Diagnostik psychischer Störungen ist komplex und umfangreich. Die ICD (International Statistical Classification of Diseases and Related Health Problems) erlaubte bislang nicht, wichtige Informationen bzgl. Verlauf (z. B. Chronische Depression) oder Symptomatik (z. B. Angstsymptome bei affektiven Episoden) zu kodieren. Auch erschwerte die bisherige Codestruktur das Hinzufügen weiterer, neuer Störungsbilder. Häufig gibt es keine Unterscheidung des Schweregrades, und wenn doch, beruht diese Einstufung auf der Anzahl der erfüllten Symptome und nicht den Funktionseinschränkungen, die sich als Folge der Symptomatik für den Betroffenen ergeben. Aus diesen Gründen wurde die ICD grundlegend in Struktur und Konzept überarbeitet.

Der vorliegende Artikel beschreibt und diskutiert die wichtigsten Anpassungen. Dazu gehören die Umsetzung der ICD-11 als Onlineversion, die Gruppierung von Störungsbildern auf Basis gemeinsamer Ätiologie, Pathophysiologie und Phänomenologie, die Anpassung und Erweiterung der Anwendung von Diagnosecodes, der verstärkte Einbezug dimensionaler Phänomene innerhalb des kategorialen Systems und die Reduktion der diagnostischen Kriterien auf die wesentlichen Merkmale. Diese Änderungen sollen im Rahmen der Steigerung der Nutzerfreundlichkeit und stärkeren Individualisierung in der Beschreibung von klinischen Phänomenen unter Einbezug wissenschaftlicher Evidenz eine möglichst flächendeckende Anwendung des Klassifikationssystems gewährleisten und so die internationale Vergleichbarkeit verbessern.
Is Appendectomy During Late Stages of Pregnancy Associated with an Increased Cesarean Delivery Rate? – a Retrospective Analysis of One Center During 10 Years
Authors: Kummer Julia , Koenigbauer Josefine , Peters Falko Stephan Joachim , Rickert Christian , Hellmeyer Lars
Published: April 2024

About one in 500 pregnant women requires a surgical intervention that is not pregnancy-related. One of the most common surgical interventions during pregnancy is appendectomy. The primary aim of this study was to assess surgical access of appendectomy during pregnancy and pregnancy outcome. Secondary outcomes were clinical symptoms and diagnostics as well as histopathological analysis.

This is a single-center retrospective data analysis conducted at a tertiary perinatal center. A digital search of the hospital record archive was conducted focusing on pregnant women beyond 24 0/7 weeks of pregnancy encoding appendectomy. Descriptive statistical analysis was performed.

Between January 2013 and January 2023, a total of 20 appendectomies were performed during pregnancy with gestational age beyond 24 0/7 weeks of pregnancy. All of them were performed as lower midline laparotomy. The rate of appendix perforation was 3/20 (15.0%). 19/20 patients (95.0%) delivered via cesarean. In 7/20 patients (35.0%) appendectomy was performed during cesarean delivery due to incidental finding of irritated or abnormal vermiform appendix. In the pathological work-up, only 2/7 (28.6%) of these subjects had inflammation.

In this small monocentric cohort, only open appendectomies were performed. Our data indicate that it is safe to perform open appendectomy during pregnancy if necessary. In this small patient group, there was an increase in simultaneous cesarean deliveries.
Komplementärmedizinische Basisgenetik: der
Histaminabbau
Authors: Kramer Michael , Welt Thomas , Fux Vilmos
Published: April 2024

Histamin wirkt in der Peripherie als Gewebshormon und im zentralen Nervensystem
(ZNS) als Neurotransmitter. Eine verstärkte Histaminwirkung manifestiert sich
als Histaminintoleranz mit Symptomen wie Urtikaria, Magen-Darm-Problemen und
Asthma. Im ZNS kann sie zu Schlafstörungen, Hyperaktivität und Neigung zu
psychischen Erkrankungen führen. In der vorliegenden Arbeit wird die Rolle
genetischer Varianten der histaminabbauenden Enzyme behandelt, die einen
Einfluss auf die Funktion von Histamin haben. Histamin wird in der Peripherie
extrazellulär durch das Enzym Diaminoxidase (DAO) abgebaut, und intrazellulär
durch Histamin-N-Methyl-Transferase (HNMT) und Monoaminoxidase-B (MAO-B). Im ZNS
dagegen fungieren nur die intrazellulären Abbauenzyme HNMT und die MAO-B.
Genetische Varianten dieser Enzyme mit verminderter Funktion prädisponieren zur
verstärkten Wirkung des Histamins.
A 10-Year Study of the Trend of Accidental Falls in the Elderly in a Japanese Hospital
Authors: Takekawa Toru , Obuchi Kei , Watanabe Shu , Yamada Naoki , Abo Masahiro
Published: April 2024

Elderly people are prone to falls. We established the Falls Prevention Working Group
(FPWG) at our hospital in 2015 to reduce the number of falls during hospitalization. This
study compared the trend of in-hospital falls in the elderly in two time periods (2008/9 and
2018/9) and determined the effects of FPWG-implemented measures. Using medical records, we
counted the monthly number of falls suffered by patients during hospitalization in April
2008-March 2009 and April 2018-March 2019. We also categorized the falls according to the
severity of fall-related complications.

A total of 3609 hospital falls were recorded during the 2008–2019 period (2008/9:
n = 433, 2018/9: n = 324). Falls were more common in patients aged 70–79 in 2008/9 but were
noted in those aged ≥ 80 in 2018/9. The mean number of falls/month (27.3 ± 6.4, range:
12–45) was stable throughout the year. The incidence of falls in 2018/9 (1.90/1000 per
persons per day) was significantly lower than in 2008/9 (2.30/1000, p = 0.006). Level ≥ 3b
accidents, reflecting serious accidents with complications, were encountered in 12 of 433
accidents in 2008/9 compared with significantly fewer accidents (2 of the same severity
among 324 accidents) in 2018/9 (p = 0.030).

Our results showed a decrease in in-hospital falls in 2018/9 and that the sufferers were
older relative to 10 years earlier. A multidisciplinary team should recommend measures to
prevent falls and an environment “resilient” to falls, and encourage patients to be aware of
possible falls.
ERAS-Implementierung in der Thoraxchirurgie
Authors: Neudecker Jens , Andreas Marco Nicolas , Lask Aina , Strauchmann Julia , Elsner Aron , Rückert Jens-Carsten , Dziodzio Tomasz
Published: April 2024

Dieses Manuskript gibt einen Überblick über die Prinzipien und Voraussetzungen zur Implementierung eines ERAS-Programms in der Thoraxchirurgie.

Basierend auf den ERAS-Guidelines für Thorachirurgie der ERAS Society wird das ERAS-Programm mit seinen einzelnen Maßnahmen bei elektiven Lungenoperationen dargestellt. Mit besonderem Augenmerk auf das postoperative Outcome werden die klinischen Maßnahmen anhand einer aktuellen Literaturübersicht beschrieben. Das ERAS-Programm zum optimierten perioperativen Management für elektive lungenresezierende Eingriffe besteht derzeit aus 45 Maßnahmen, die sich auf 4 perioperative Phasen verteilen. Diese Maßnahmen umfassen von der Zeit vor der Krankenhausaufnahme (Patientenaufklärung, Screening und Behandlung möglicher Risikofaktoren wie Anämie, Mangelernährung, Beendigung des Nikotin- oder Alkoholmissbrauchs, Prähabilitation, Kohlenhydratbelastung) über die unmittelbare präoperative Phase (verkürzte Nüchternheitsphase, nicht sedative Prämedikation, Prophylaxe von PONV und thromboembolischen Komplikationen), die intraoperativen Maßnahmen (Antibiotikaprophylaxe, standardisierte
Anästhesie, Normothermie, zielgerichtete Flüssigkeitstherapie, minimalinvasive Chirurgie, Vermeidung von Kathetern und Sonden) und die postoperativen Maßnahmen (frühzeitige Mobilisierung, frühzeitige Ernährung, Entfernung eines Blasenkatheters, Hyperglykämiekontrolle). Die meisten dieser Maßnahmen beruhen auf wissenschaftlichen Studien mit hohem Evidenzlevel und führen zu einer Reduktion postoperativer allgemeiner Komplikationen.

Das ERAS-Programm ist ein optimiertes perioperatives Behandlungsverfahren und kann die postoperative Genesung von Patienten bei elektiven Lungenresektionen durch eine Verringerung der allgemeinen Komplikationsrate und der Gesamtmorbidität verbessern.
Phytotherapeutische Empfehlungen in medizinischen Leitlinien zur Behandlung gastroenterologischer Erkrankungen – ein systematischer Überblick
Authors: Utz Sandra , Bittel Miriam , Langhorst Jost
Published: April 2024

Phytotherapeutika gewinnen zunehmend an Einfluss bei der Behandlung von gastroenterologischen Erkrankungen. Ihre Beliebtheit und wachsende Wirksamkeitsevidenz führen dazu, dass sie vermehrt in medizinische Leitlinien integriert werden. Ein systematisches Screening identifizierte empfohlene phytotherapeutische Ansätze. Entsprechend der aktuellen wissenschaftlichen Datenlage werden einige Empfehlungen für die Anwendung von Phytotherapeutika ausgesprochen. Bei Reizdarmsyndrom wird vor allem bei Schmerzen und Blähungen der Einsatz von Pfefferminzöl „stark empfohlen“. Weitere Phytotherapeutika wie beispielsweise STW-5, tibetanisches Padma Lax oder warme Kümmelölauflagen haben sich wirksam zur Symptomlinderung erwiesen. Es wird „empfohlen“, sie ins Behandlungskonzept zu integrieren. Bei Chronischer Obstipation werden 30g Ballaststoffe am Tag empfohlen. Die beste Datenlage existiert dabei zu Flohsamenschalen mit moderater Evidenz und für Chicorée-Inulin. Bei Colitis ulcerosa können Flohsamenschalen und die Kombination von Myrrhe, Kamillenblütenextrakt und Kaffeekohle komplementär in der remissionserhaltenden Behandlung eingesetzt werden. Ebenfalls eine „offene Empfehlung“ gibt es für Curcumin (Curcuma longa radix) sowohl für die Remissionsinduktion als auch -erhaltung. Einige Phytotherapeutika (z.B. Wermut [Artemisia absintium herba], Weihrauch [Boswellia serrata resina]) zeigen Wirksamkeitshinweise zur Behandlung von Morbus Crohn, jedoch ist die Datenlage noch nicht ausreichend für Empfehlungen. Cannabisbasierte Arzneimittel können nach nicht ausreichender Wirksamkeit oder Kontraindikation der empfohlenen Standardtherapie bei abdominellen Schmerzen und bei klinisch relevantem Appetitverlust erwogen werden, sollte jedoch nicht zur Therapie der akuten Entzündung bei aktivem Morbus Crohn eingesetzt werden. Weitere Empfehlungen für andere gastroenterologische Erkrankungen werden diskutiert. Die Sicherheit und Verträglichkeit der Phytotherapeutika wurden als überwiegend “sehr gut“ bis „tolerabel“ eingestuft. Einige klare Empfehlungen für den Einsatz von Phytotherapeutika zur Behandlung gastroenterologischer Erkrankungen zeigen das große Wirkpotenzial. Phytotherapeutika können aufgrund ihres großen Wirkspektrums bei komplexen Regulationsstörungen sehr gut komplementär zu herkömmlichen Medikamenten eingesetzt werden. Dennoch sind weitere methodisch gut durchgeführte Wirkungsstudien für weitere Empfehlungen erforderlich.
Association Between Liver Fibrosis Score and Diabetic Kidney Disease:
A Retrospective Cross-Sectional Study of Hospitalized Patients
Authors: Chen Shen , Zhang Jie , Tian Zhendong , Cao Jiarui , Jiao Yijie , Wang Bangqi , Feng Shenghui , Luo Zhanpeng , Zhang Qingfang , Deng Yuanyuan , Cai Wei , Xu Jixiong
Published: April 2024

Objectives To investigate the association between liver fibrosis score and
diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM).

Methods A total of 897 hospitalized patients with T2DM were included in
this study. Each patient completed DKD screening. Logistic regression analysis
was used to assess the predictive value of non-alcoholic fatty liver disease
fibrosis score (NAFLD-FS) and fibrosis-4 (FIB-4) for the occurrence of DKD and
risk for DKD progression, respectively.

Results The prevalence of DKD and risk for its progression significantly
increased with increasing NAFLD-FS risk category. DKD prevalence also increased
with increasing FIB-4 risk category. Multivariate logistic regression analysis
showed that the “high-risk” NAFLD-FS had a significantly higher risk of DKD
(odds ratio [OR]: 1.89, 95% confidence interval [CI]: 1.16–3.08) and risk for
DKD progression (OR: 2.88, 95% CI: 1.23–6.78), and the “intermediate-risk” FIB-4
had a significantly higher risk of DKD (OR: 1.41, 95% CI: 1.00–1.98). Subgroup
analysis showed that the association between NAFLD-FS and FIB-4 and DKD was
significant in the female subgroup, whereas the association between the
“high-risk” NAFLD-FS and risk for DKD progression was significant in the male
subgroup.

Conclusions NAFLD-FS and FIB-4 are strongly associated with DKD and risk
for DKD progression in patients with T2DM. Additionally, sexual dimorphism
exists in this association.
Entwicklung der endoskopischen Enukleation der Prostata
Authors: Gross Andreas J. , Rosenbaum Clemens , Becker Benedikt , Netsch Christopher
Published: April 2024

Der Artikel befasst sich mit Lasern von deren Erstbeschreibung bis hin zu den modernsten Anwendungen im Bereich der Behandlung der gutartigen Prostatavergrößerung.
Apaydin Classification of Spreader Flaps Updated
Authors: Capelleras Marta , Saghir Meshari , Apaydin Fazil
Published: April 2024

The use of spreader flaps (SFs) is very helpful in middle vault reconstruction. The aim of the study was to evaluate the versatility of Apaydin classification of SFs on a patient population. This was a retrospective analysis which included 120 rhinoplasty cases. Thorough preoperative planning adhering to precision profileplasty principles was conducted for all patients. The study employed six primary variants of SFs. SFs' types were utilized as follows: type 1 in 41 patients (34.2%), type 2 in 2 patients (1.7%), type 3A in 38 patients (31.7%), types 3B and 3D in 10 cases each (8.3%), type 3C in 2 cases (1.7%), type 4 in 5 cases (4.2%), type 5 in 7 cases (5.8%), and type 6 in 5 cases (4.2%). This study highlights that different SF techniques should be tailored according to the need of the patient when dealing with middle vault reconstruction during reduction rhinoplasty.
Volumizing Threads (Jamber) in the Midface and Managing Side Effects: Clinical Cases
Authors: Yi Kyu-Ho , Park Soo-Yeon
Published: April 2024

The clinical application of polydioxanone (PDO) threads, traditionally utilized for tissue lifting, is now being explored for its volumizing effects in midface rejuvenation. The novel approach involves employing PDO volumizing threads to achieve physical augmentation akin to a “solid filler.” The study introduces a more convenient insertion method for these threads, prioritizing ease and efficacy. Clinical cases demonstrate the efficacy of volumizing threads in addressing midface concerns, such as nasolabial folds and midcheek grooves. Additionally, the integration of volumizing threads to provide support in sagging areas is examined for achieving natural-looking enhancements. While highlighting positive outcomes, potential side effects like thread protrusion are addressed, along with strategies for their mitigation. Volumizing threads are presented as a suitable procedure for patients wary of traditional fillers or seeking subtle enhancements, with the recommendation of combining them with cog threads for those desiring more pronounced changes in facial contour. In summary, volumizing thread offers a minimally invasive alternative with fewer side effects for midface rejuvenation.
Prenatal Diagnosis of Renal Rhabdoid Tumor: A Rare Malignant Neoplasm
Authors: Berwal Vidhika , Krishnan Vivek , Eapen Malini , Chandraprabha Vidya , Elayedatt Rinshi Abid
Published: April 2024

Rhabdoid tumors of the kidney are highly lethal malignancies of infancy. We report the prenatal detection of this renal tumor in a fetus in the third trimester of pregnancy. Ultrasonologically, the tumor appeared as a large mass in the left renal area associated with severe polyhydramnios. Though the sonographic features alone did not allow distinction from a benign lesion, tumor extension into the subcutaneous plane favored the possibility of a malignant renal tumor and this was confirmed postnatally on histopathology.
A Provider-Facing Decision Support Tool for Prostate Cancer Screening in Primary Care: A Pilot Study
Authors: Carlsson Sigrid V. , Preston Mark A. , Vickers Andrew , Malhotra Deepak , Ehdaie Behfar , Healey Michael J. , Kibel Adam S.
Published: April 2024

Objectives Our objective was to pilot test an electronic health record-embedded decision support tool to facilitate prostate-specific antigen (PSA) screening discussions in the primary care setting.

Methods We pilot-tested a novel decision support tool that was used by 10 primary care physicians (PCPs) for 6 months, followed by a survey. The tool comprised (1) a risk-stratified algorithm, (2) a tool for facilitating shared decision-making (Simple Schema), (3) three best practice advisories (BPAs: <45, 45–75, and >75 years), and (4) a health maintenance module for scheduling automated reminders about PSA rescreening.

Results All PCPs found the tool feasible, acceptable, and clear to use. Eight out of ten PCPs reported that the tool made PSA screening conversations somewhat or much easier. Before using the tool, 70% of PCPs felt confident in their ability to discuss PSA screening with their patient, and this improved to 100% after the tool was used by PCPs for 6 months. PCPs found the BPAs for eligible (45–75 years) and older men (>75 years) more useful than the BPA for younger men (<45 years). Among the 10 PCPs, 60% found the Simple Schema to be very useful, and 50% found the health maintenance module to be extremely or very useful. Most PCPs reported the components of the tool to be at least somewhat useful, with 10% finding them to be very burdensome.

Conclusion We demonstrated the feasibility and acceptability of the tool, which is notable given the marked low acceptance of existing tools. All PCPs reported that they would consider continuing to use the tool in their clinic and were likely or very likely to recommend the tool to a colleague.
Provider Perceptions of an Electronic Health Record Prostate Cancer Screening Tool
Authors: Carlsson Sigrid V. , Preston Mark , Vickers Andrew , Malhotra Deepak , Ehdaie Behfar , Healey Michael , Kibel Adam S.
Published: April 2024

Objectives We conducted a focus group to assess the attitudes of primary care physicians (PCPs) toward prostate-specific antigen (PSA)-screening algorithms, perceptions of using decision support tools, and features that would make such tools feasible to implement.

Methods A multidisciplinary team (primary care, urology, behavioral sciences, bioinformatics) developed the decision support tool that was presented to a focus group of 10 PCPs who also filled out a survey. Notes and audio-recorded transcripts were analyzed using Thematic Content Analysis.

Results The survey showed that PCPs followed different guidelines. In total, 7/10 PCPs agreed that engaging in shared decision-making about PSA screening was burdensome. The majority (9/10) had never used a decision aid for PSA screening. Although 70% of PCPs felt confident about their ability to discuss PSA screening, 90% still felt a need for a provider-facing platform to assist in these discussions. Three major themes emerged: (1) confirmatory reactions regarding the importance, innovation, and unmet need for a decision support tool embedded in the electronic health record; (2) issues around implementation and application of the tool in clinic workflow and PCPs' own clinical bias; and (3) attitudes/reflections regarding discrepant recommendations from various guideline groups that cause confusion.

Conclusion There was overwhelmingly positive support for the need for a provider-facing decision support tool to assist with PSA-screening decisions in the primary care setting. PCPs appreciated that the tool would allow flexibility for clinical judgment and documentation of shared decision-making. Incorporation of suggestions from this focus group into a second version of the tool will be used in subsequent pilot testing.
12th Al Ain Symposium on Challenges in Diabetes and Endocrinology during Ramadan (Virtual Meeting), February 16 to 17, 2024
Authors: Kaabi Juma Al , Afandi Bachar
Published: April 2024

The 12th Al Ain Annual Meeting on Diabetes and Endocrine Challenges during Ramadan Fasting brings together health care professionals, researchers, and experts to address the complex interaction between diabetes management and religious fasting. The program aims to enhance understanding, share best practices, and explore innovative strategies for optimizing patient care during Ramadan fasting through engaging presentations, symposia, and discussions.
Association between Serum Lactate Dehydrogenase Level and 30-day Mortality in Patients with Intracranial Hemorrhage with Acute Leukemia in the Induction Phase: A Cohort Study
Authors: Zhang Jia-Yuan , Yan Zhang-Song , Sun Xiu-Juan , Liu Yong-Ze , Yin Yan-Ke , Su Ming-Huan , Li Qiu-Ling , Mi Ying-Chang , Li Da-Peng
Published: April 2024

Objectives This study aimed to identify the association between lactate dehydrogenase (LDH) levels and 30-day mortality in patients with intracranial hemorrhage (ICH) with acute leukemia during the induction phase.

Methods This cohort study included patients with acute leukemia with ICH during induction. We evaluated serum LDH levels upon admission. Multivariable Cox regression analyzed the LDH 30-day mortality association. Interaction and stratified analyses based on factors like age, sex, albumin, white blood cell count, hemoglobin level, and platelet count were conducted.

Results We selected 91 patients diagnosed with acute leukemia and ICH. The overall 30-day mortality rate was 61.5%, with 56 of the 91 patients succumbing. Among those with LDH levels ≥ 570 U/L, the mortality rate was 74.4% (32 out of 43), which was higher than the 50% mortality rate of the LDH < 570 U/L group (24 out of 48) (p = 0.017). In our multivariate regression models, the hazard ratios and their corresponding 95% confidence intervals for Log2 and twice the upper limit of normal LDH were 1.27 (1.01, 1.58) and 2.2 (1.05, 4.58), respectively. Interaction analysis revealed no significant interactive effect on the relationship between LDH levels and 30-day mortality.

Conclusions Serum LDH level was associated with 30-day mortality, especially in patients with LDH ≥ 570 U/L.
Social Determinants of Long-Term Opioid Use Following Total Knee Arthroplasty
Authors: Hadlandsmyth Katherine , Lund Brian C. , Gao Yubo , Strayer Andrea L. , Davila Heather , Hausmann Leslie R. M. , Schmidt Susanne , Shireman Paula K. , Jacobs Michael A. , Mader Michael J. , Tessler Robert A. , Duncan Carly A. , Hall Daniel E. , Sarrazin Mary Vaughan
Published: April 2024

Total knee arthroplasty (TKA) risks persistent pain and long-term opioid use (LTO). The role of social determinants of health (SDoH) in LTO is not well established. We hypothesized that SDoH would be associated with postsurgical LTO after controlling for relevant demographic and clinical variables. This study utilized data from the Veterans Affairs Surgical Quality Improvement Program, VA Corporate Data Warehouse, and Centers for Medicare and Medicaid Services, including Veterans aged ≥ 65 who underwent elective TKA between 2013 and 2019 with no postsurgical complications or history of significant opioid use. LTO was defined as > 90 days of opioid use beginning within 90 days postsurgery. SDoH variables included the Area Deprivation Index, rurality, and housing instability in the last 12 months identified via medical record screener or International Classification of Diseases, Tenth Revision codes. Multivariable risk adjustment models controlled for demographic and clinical characteristics. Of the 9,064 Veterans, 97% were male, 84.2% white, mean age was 70.6 years, 46.3% rural, 11.2% living in highly deprived areas, and 0.9% with a history of homelessness/housing instability. Only 3.7% (n = 336) developed LTO following TKA. In a logistic regression model of only SDoH variables, housing instability (odds ratio [OR] = 2.38, 95% confidence interval [CI]: 1.09–5.22) and rurality conferred significant risk for LTO. After adjusting for demographic and clinical variables, LTO was only associated with increasing days of opioid supply in the year prior to surgery (OR = 1.52, 95% CI: 1.43–1.63 per 30 days) and the initial opioid fill (OR = 1.07; 95% CI: 1.06–1.08 per day). Our primary hypothesis was not supported; however, our findings do suggest that patients with housing instability may present unique challenges for postoperative pain management and be at higher risk for LTO.
Just-world beliefs are associated with influenza vaccine intake intent in the United Arab Emirates: a cross-sectional study
Authors: Andrade Gabriel , Banibella Abdelmagied Elamin Ahmed , Bedewy Dalia
Published: April 2024

Although not a prime public health concern, seasonal influenza remains a challenge in the United Arab Emirates (UAE). This problem is augmented by the fact that the percentage of the population intending to take the yearly seasonal influenza vaccine is relatively low. The purpose of this study is to assess if vaccine knowledge and just-world beliefs have an impact on willingness to receive the seasonal influenza vaccine. The methodology relies on a multivariable logistic regression analysis establishing predictors of vaccine intake intent and parametric tests comparing variables across gender and ethnicity. Results come out showing that vaccine knowledge is not a significant predictor of seasonal influenza vaccine intake intent. However, general belief in the just world is a significant predictor of vaccine intake intent. This has important implications for the role of religion in curbing seasonal influenza vaccine hesitancy in the UAE. Given that just-world beliefs are linked to religiosity, public health authorities need to consider relying on religious leaders to exhort the faithful to take the vaccines by framing their exhortations in the context of just-world beliefs.
The wake of a large wind turbine in stable atmospheric boundary layer flow, simulated in the EnFlo stratified-flow wind tunnel
Authors: Hancock Philip E. , Hayden Paul
Published: April 2024

The EnFlo stratified-flow wind tunnel is described, and the parameterization of stable atmospheric boundary layers in the context of wind turbines and stability classification is given, as are the scaling constraints for stratified-flow wind tunnel experiments. Wake measurements of mean velocity, Reynolds stresses, and turbulent heat flux were made for three mild stable states, including overlying inversion, and the neutral state. The depth of the atmospheric boundary layer was kept constant, and so the results show the effect of change in stability alone, without the change in scale that would also arise in full scale measurements, an advantage provided by wind tunnel experiments. The simulated boundary-layer wind-speed profile is the same in each case, its height slightly exceeding the blade-tip top height, and the velocity deficit at the turbine is also the same in each, implying a constant thrust coefficient. In the near wake the momentum deficit rises more rapidly in the stable cases, and stays higher further downstream where it is subsequently reduced by turbulent mixing. The wake grows less rapidly in the vertical direction in the stable cases, both above and below the hub height, the height above growing still less rapidly with an imposed inversion, while the height below is unaffected by the inversion. The wake width is largely unaffected by stability. Stability reduces the Reynolds stresses in the wake over and above the reduction in the undisturbed flow; there is not a simple superposition. In the lower part of the wake the stresses are not affected by the inversion, while they are in the upper part. Turbulent heat flux is increased in the bulk of the wake, more so with an inversion, but is reduced to the surface and unaffected by an inversion.
A Caputo fractional derivative dynamic model of hepatitis E with optimal control based on particle swarm optimization
Authors: Li Jia , Tan Xuewen , Wu Wanqin , Zou Xiufen
Published: April 2024

Hepatitis E, as a zoonotic disease, has been a great challenge to global public health. Therefore, it has important research value and practical significance for the transmission and control of hepatitis E virus (HEV). In the exploration of infectious disease transmission dynamics and optimal control, mathematical models are often applied. Among them, the fractional differential model has become an important and practical tool because of its good memory and genetic characteristics. In this paper, an HEV propagation dynamic model is constructed by the Caputo fractional derivative. First, the properties of the model are analyzed, including the existence, non-negativity, boundedness, and stability of the equilibrium points. Then, from the perspective of fractional optimal control (FOC), control measures were proposed, including improving the awareness and prevention of hepatitis E among susceptible people, strengthening the treatment of infected people, and improving environmental hygiene. Then, an FOC model of HEV was constructed. After analyzing the necessary conditions for optimality, the particle swarm optimization is introduced to optimize the control function. In addition, four control strategies are applied. Finally, the numerical simulation is completed by the fractional Adams–Bashforth–Moulton prediction correction algorithm. The four strategies and no control were compared and analyzed. The numerical simulation results of different fractional orders are also compared and analyzed. The results illustrate that the optimal strategy, compared with no control, reduces the HEV control time by nearly 60 days. Therefore, this method would contribute to the study of HEV transmission dynamics and control mechanisms, thus contributing to the development of global public health.
Collective long-lived zero-quantum coherences in aliphatic chains
Authors: Sheberstov Kirill F. , Sonnefeld Anna , Bodenhausen Geoffrey
Published: April 2024

In nuclear magnetic resonance, long-lived coherences constitute a class of zero-quantum (ZQ) coherences that have lifetimes that can be longer than the relaxation lifetimes T2 of transverse magnetization. So far, such coherences have been observed in systems with two coupled spins with spin quantum numbers I = 1/2, where a term S0T0+T0S0 in the density operator corresponds to a coherent superposition between the singlet S0 and the central triplet T0 state. Here, we report on the excitation and detection of collective long-lived coherences in AA′MM′XX′ spin systems in molecules containing a chain of at least three methylene (–CH2–) groups. Several variants of excitation by polychromatic spin-lock induced crossing (poly-SLIC) are introduced that can excite a non-uniform distribution of the amplitudes of terms such as S0S0T0S0S0T0, S0T0S0S0T0S0, and T0S0S0T0S0S0. Once the radio frequency fields are switched off, these are not eigenstates, leading to ZQ precession involving all six protons, a process that can be understood as a propagation of spin order along the chain of CH2 groups before the reconversion into observable magnetization by a second poly-SLIC pulse that can be applied to any one or several of the CH2 groups. In the resulting 2D spectra, the ω2 domain shows SQ spectra with the chemical shifts of the CH2 groups irradiated during the reconversion, while the ω1 dimension shows ZQ signals in absorption mode with linewidths on the order of 0.1 Hz that are not affected by the inhomogeneity of the static magnetic field but can be broadened by chemical exchange as occurs in drug screening. The ZQ frequencies are primarily determined by differences ΔJ between vicinal J-couplings.
Unraveling the molecular interplay of ferroptosis and immune regulation in stroke pathogenesis: A comprehensive bioinformatics analysis
Authors: Qin Yexiao , Jin Hong , Sun Xizhe , Ma Ming , Li Xiaoning , Gu Lanxin , Fu Jiaming , Li Meng , Zhong Bin
Published: April 2024

Neurological disorders, particularly stroke, pose significant public health challenges, prompting a comprehensive investigation into the intricate interplay between ferroptosis and immune responses. This study aims to uncover the molecular mechanisms of stroke, emphasizing the connection between ferroptosis and immune regulation. Objectives include identifying differentially expressed genes in stroke patients, assessing immune cell subtype activation, employing advanced predictive modeling to pinpoint key candidate genes such as STMN1 and ATG16L1, exploring associations with immune cell subtypes, and revealing critical pathways, such as matrix degradation and inflammatory responses, activated in stroke through Gene Set Variation Analysis (GSVA). A comprehensive approach was adopted, involving differential gene expression analysis, functional enrichment analysis, weighted gene co-expression network analysis, Lasso regularization, random forest models, and the CIBERSORT (https://cibersortx.stanford.edu) algorithm, to assess immune cell subtypes. The study pinpointed genes with significant expression differences in stroke patients, highlighting the activation of Th17 cells and the NF-κ B signaling pathway. Key candidate genes, including STMN1 and ATG16L1, were identified using advanced predictive modeling. The relative abundance of immune cell subtypes, particularly natural killer cells (NK cells) and T cell subgroups, was associated with stroke through CIBERSORT. GSVA uncovered the activation of critical biological pathways such as matrix degradation and inflammatory responses. The analysis pinpointed STMN1 and ATG16L1 as robust predictors, emphasizing their potential as therapeutic targets. Th17 cells and the NF-κ B signaling pathway emerged as pivotal contributors to stroke pathogenesis. Notably, NK cells and specific T cell subgroups demonstrated significant associations with stroke. GSVA further illuminated the activation of key pathways, providing deeper insights into the biological processes underlying stroke. This study sheds light on crucial genes and pathways implicated in stroke, emphasizing the roles of ferroptosis and immune cell subtypes. The identified genes and pathways offer promising avenues for targeted therapeutic interventions in stroke, with a broader implication for advancing neurological disorder treatments through innovative perspectives on ferroptosis and immune regulation.
Precise density measurements of refractory metals over 3000 K: Revisiting UV imaging technique at ultrahigh temperatures
Authors: Wang Lei , Cho Yong Chan , Le Nhat Thi Huu , Lee Yun-Hee , Lee Geun Woo
Published: April 2024

Precise density and thermal expansion measurements of refractory materials are extremely challenging due to the chemical reactions and thermal gradients at ultrahigh temperatures. The UV image technique has been successfully applied to the density measurements at high temperatures above 3000 K. However, intense radiation from the sample can blur the edge of the sample image, leading to uncertain measurements. In this study, we investigate the influence of the contrast between the UV background light and sample radiation (B–S) on density measurements. We find that lower B–S contrast can significantly affect the calibration factor that converts image pixels to real size, resulting in underestimated density with scattering and overestimated thermal expansion coefficients at ultrahigh temperatures. This result underscores the necessity of adequate B–S contrast to ensure the precision of density measurements using UV imaging methods for refractory materials beyond 3000 K. By considering the critical minimum value of the B–S contrast, we successfully measure the densities and thermal expansion coefficients of four refractory metal liquids (tungsten, rhenium, osmium, and tantalum) with the improved UV technique, which are crucial for high-temperature industries. This work will be valuable for other imaging methods measuring the thermophysical properties at ultrahigh temperatures.
Cold stress changes the composition and function of microbiota in the content and mucosa of the ileum and colon in piglets
Authors: Zhang Shiyu , Li Yong , Wang Jun , Zhu Run , Sun Lan , Mi Jiandui
Published: April 2024

Context Cold stress is a significant factor that contributes to the imbalance of energy in piglets during their early life. Recent studies have shown that gut microbiota plays a crucial role in maintaining energy homeostasis under cold-stress conditions. Aims This study aims to investigate the effects of cold stress on the microbiota and expression pathways in the colon and ileum of weaned piglets, providing new insights and methods for helping piglets resist cold stress. Methods In total, 10 piglets in the cold-stress group (n = 5) and room-temperature group (n = 5) were sacrificed. Intestinal contents and mucosa samples were collected for 16S rRNA analysis. Key results The results showed that cold stress increased the observed features and chao1 index in the colonic mucosa. The beta diversity of ileum, colon and ileum mucosa was significantly changed. Under cold stress, the relative abundance of Acholeplasma, Proteiniphilum, and Olsenella increased in the contents of the ileum and colon. The relative abundance of Ruminococcaceae sp., Butyricicoccus, and Lachnospiraceae FCS020 increased in the mucosa of the colon. Sphingomonas, Helicobacter, Cutibacterium, and Bradyrhizobium were significantly increased in the mucosa of the ileum. In predicted functions, after cold stress, the purine metabolism and degradation increased in the content and mucosa of the ileum and mucosa of the colon. The fat biosynthesis pathway increased in the content of the colon. Complex carbohydrate degradation increased in the mucosa of both. Conclusions These findings suggest that cold stress has a significant impact on the species richness, composition, and predicted functions of the microbiota in the ileum and colon of piglets, with these effects varying depending on the location within the gut. Implications Therefore, we can help piglets resist cold stress by modifying the structure of gut microbiota through the addition of probiotics or adjusting the composition of their diet.
Co-designing positive behaviour support (PBS+PLUS) training resources: a qualitative study of people with ABI, close-others, and clinicians’ experiences
Authors: Carminati Jao-Yue J. , Holth Kristian , Ponsford Jennie L. , Gould Kate Rachel
Published: April 2024

Background Challenging behaviours are often a significant difficulty faced following acquired brain injury (ABI), for which PBS+PLUS (a Positive Behaviour Support framework) is an effective intervention. Clinicians report experiencing a range of barriers to supporting behaviour change for individuals with ABI and require tailored resources to support the implementation of PBS+PLUS. This study aimed to describe the process of co-designing a PBS+PLUS intervention guidebook and podcast series together with individuals with ABI, close-others, and clinicians, and qualitatively examine co-design experiences. Methods The Knowledge-To-Action Framework was followed to support the translation of PBS+PLUS into clinical practice. Participants with ABI (n = 4), close-others (n = 7), and clinicians (n = 3) participated in focus groups contributing to the development of a PBS+PLUS intervention guidebook and podcast series. Following completion of the groups, qualitative interviews were conducted to understand participants’ perspectives of the co-design experience. Transcripts were analysed using reflexive thematic analysis. Results Co-design processes are described, and participants provided practical suggestions for co-design and the dissemination of developed resources. Two core themes encapsulating four sub-themes were identified. Firstly, ‘Esteeming Experiences’ described the person-driven approach of co-design whereby participants felt supported and connected with other contributors and facilitators through sharing their perspectives. Secondly, ‘Empowerment’ reflected participants’ increased confidence and skills in applying PBS+PLUS. Conclusions Overall, participants endorsed the therapeutic benefits of co-design engagement and high utility of PBS+PLUS resources. This study adds to the growing literature supporting the use of co-design methodology within clinical implementation, and is inclusive of individuals with ABI, close-others, and clinicians.
Firebrand burning under wind: an experimental study
Authors: Yan Weidong , Liu Naian , Zhu Hong , Chen Haixiang , Xie Xiaodong , Gao Wei , Du Zhihao
Published: April 2024

Background Spot fires play a significant role in the rapid spread of wildland and wildland–urban interface fires. Aims This paper presents an experimental and modelling study on the flaming and smouldering burning of wood firebrands under forced convection. Methods The firebrand burning experiments were conducted with different wind speeds and firebrand sizes. Key results The burning rate of firebrands under forced convection is quantified by wood pyrolysis rate, char oxidation rate and a convective term. The firebrand projected area is correlated with firebrand diameter, char density, wind speed, and flaming or smouldering burning. A surface temperature model is derived in terms of condensed-phase energy conservation. We finally establish a simplified firebrand transport model based on the burning rate, projected area and surface temperature of firebrands. Conclusion The mass loss due to wood pyrolysis is much greater than that due to char oxidation in self-sustaining burning. The burning rate is proportional to U1/2, where U is wind speed. The projected area for flaming firebrands decreases more rapidly than that for smouldering ones. The firebrand surface temperature is mainly determined by radiation. Implications Knowledge about firebrand burning characteristics is essential for predicting the flight distance and trajectory in firebrand transport.
Hox gene–specific cellular targeting using split intein Trojan exons
Authors: Diao Fengqiu , Vasudevan Deeptha , Heckscher Ellie S. , White Benjamin H.
Published: April 2024

The Trojan exon method, which makes use of intronically inserted T2A-Gal4 cassettes, has been widely used in
Drosophila
to create thousands of gene-specific Gal4 driver lines. These dual-purpose lines provide genetic access to specific cell types based on their expression of a native gene while simultaneously mutating one allele of the gene to enable loss-of-function analysis in homozygous animals. While this dual use is often an advantage, the truncation mutations produced by Trojan exons are sometimes deleterious in heterozygotes, perhaps by creating translation products with dominant negative effects. Such mutagenic effects can cause developmental lethality as has been observed with genes encoding essential transcription factors. Given the importance of transcription factors in specifying cell type, alternative techniques for generating specific Gal4 lines that target them are required. Here, we introduce a modified Trojan exon method that retains the targeting fidelity and plug-and-play modularity of the original method but mitigates its mutagenic effects by exploiting the self-splicing capabilities of split inteins. “Split Intein Trojan exons” (siTrojans) ensure that the two truncation products generated from the interrupted allele of the native gene are trans-spliced to create a full-length native protein. We demonstrate the efficacy of siTrojans by generating a comprehensive toolkit of Gal4 and Split Gal4 lines for the segmentally expressed Hox transcription factors and illustrate their use in neural circuit mapping by targeting neurons according to their position along the anterior–posterior axis. Both the method and the Hox gene–specific toolkit introduced here should be broadly useful.
Spin-resolved counting statistics as a sensitive probe of spin correlation in transport through a quantum dot spin valve
Authors: Hu Guanjian , Hu Jing , Wang Shikuan , Li RuiQiang , Yan Yiying , Luo JunYan
Published: April 2024

We investigate the noise in spin transport through a single quantum dot (QD) tunnel coupled to ferromagnetic (FM) electrodes with noncollinear magnetizations. Based on a spin-resolved quantum master equation, auto- and cross-correlations of spin-resolved currents are analyzed to reveal the underlying spin transport dynamics and characteristics for various polarizations. We find the currents of majority and minority spins could be strongly autocorrelated despite uncorrelated charge transfer. The interplay between tunnel coupling and the Coulomb interaction gives rise to an exchange magnetic field, leading to the precession of the accumulated spin in the QD. It strongly suppresses the bunching of spin tunneling events and results in a unique double-peak structure in the noise of the net spin current. The spin autocorrelation is found to be susceptible to magnetization alignments, which may serve as a sensitive tool to measure the magnetization directions between the FM electrodes.