bluuebunny/crossref_metadata_2025 huggingface dataset:
Migrating production monolithic systems to microservices using aspect oriented programming
Authors: Freire Augusto Flávio A. A. , Sampaio Américo Falcone , Carvalho Luis Heustakio L. , Medeiros Otávio , Mendonça Nabor C.
Published: March 2021

Several organizations need to address the challenge to migrate current traditional monolithic applications in production to microservices, preferably, without having to schedule maintenances to take the application offline. This article presents an approach for migrating to microservices with almost zero downtime and minimal changes in the monolithic code. The approach is based on the concepts of aspect‐oriented programming (AOP) and reflection to enable to intercept calls inside the monolith and transform them into service requests invoking the newly built microservices using the concept of around advices. The aspects do the “dirty work” of decoupling what will be refactored and which service to call and practically “zero” code changes need to be done in the original monolithic code. This enables one key novel contribution of our migration approach which is the ability to revert code and data changes without having to take the system offline. Two applications are used as proofs of concept to demonstrate that the proposed approach enables to go “forward” or “backward” among different versions of the application with minimal code or data changes. An evaluation performed in the cloud demonstrates that this work does not introduce significant performance or cost overhead when compared to the current state of the art and to the original monolith.
Cell Therapy for Critical Limb Ischemia: Advantages, Limitations, and New Perspectives for Treatment of Patients with Critical Diabetic Vasculopathy
Authors: Gu Y. , Rampin A. , Alvino V. V. , Spinetti G. , Madeddu P.
Published: March 2021

Purpose of Review

To provide a highlight of the current state of cell therapy for the treatment of critical limb ischemia in patients with diabetes.

Recent Findings

The global incidence of diabetes is constantly growing with consequent challenges for healthcare systems worldwide. In the UK only, NHS costs attributed to diabetic complications, such as peripheral vascular disease, amputation, blindness, renal failure, and stroke, average £10 billion each year, with cost pressure being estimated to get worse. Although giant leaps forward have been registered in the scope of early diagnosis and optimal glycaemic control, an effective treatment for critical limb ischemia is still lacking. The present review aims to provide an update of the ongoing work in the field of regenerative medicine. Recent advancements but also limitations imposed by diabetes on the potential of the approach are addressed. In particular, the review focuses on the perturbation of non-coding RNA networks in progenitor cells and the possibility of using emerging knowledge on molecular mechanisms to design refined protocols for personalized therapy.

The field of cell therapy showed rapid progress but has limitations. Significant advances are foreseen in the upcoming years thanks to a better understanding of molecular bottlenecks associated with the metabolic disorders.
Seize the day: opportunities and costs in the COVID-19 crisis
Authors: Bezemer Dirk J.
Published: March 2021

Non-technical summary

The thesis of this paper is that the COVID-19 crisis creates opportunities for fundamental change towards a more sustainable economy, for two reasons: structural change in the economy and a change in public opinion. The paper identifies how the COVID-19 crisis accelerates six processes of change that can be leveraged in policy making. With a focus on the Netherlands, it argues for activist government policy because of the tipping-point nature of the economic system in the crisis.

Technical summary

Structural change in the economy and a change in public opinion during the COVID-19 crisis jointly imply that government choices regarding investments, regulation and taxes can now create stronger synergies of cleaner economic growth and employment creation with ecological, social and financial sustainability. The paper details this for six areas, with examples taken from The Netherlands. High levels of private and (in some countries) public debt may become so unsustainable that this prompts a restructuring of financing systems which are more productive and more in support of ecological goals. In value chains, ICT systems and urban transport systems, forced changes such as more work from home, more cycling lanes and more local production may, once in place, be used as proof of concepts for permanently different infrastructures and organizations. Aviation and energy became dependent on public support, which created financial leverage for enforcing change.

Social media summary

COVID-19 creates opportunities for change towards sustainability as it accelerates six processes of change.
Dactinomycin induces complete remission associated with nucleolar stress response in relapsed/refractory NPM1-mutated AML
Authors: Gionfriddo Ilaria , Brunetti Lorenzo , Mezzasoma Federica , Milano Francesca , Cardinali Valeria , Ranieri Roberta , Venanzi Alessandra , Pierangeli Sara , Vetro Calogero , Spinozzi Giulio , Dorillo Erica , Wu Hsin Chieh , Berthier Caroline , Ciurnelli Raffaella , Griffin Melanie J. , Jennings Claire E. , Tiacci Enrico , Sportoletti Paolo , Falzetti Franca , de Thé Hugues , Veal Gareth J. , Martelli Maria Paola , Falini Brunangelo
Published: March 2021

Acute myeloid leukemia (AML) with mutated NPM1 accounts for one-third of newly diagnosed AML. Despite recent advances, treatment of relapsed/refractory NPM1-mutated AML remains challenging, with the majority of patients eventually dying due to disease progression. Moreover, the prognosis is particularly poor in elderly and unfit patients, mainly because they cannot receive intensive treatment. Therefore, alternative treatment strategies are needed. Dactinomycin is a low-cost chemotherapeutic agent, which has been anecdotally reported to induce remission in NPM1-mutated patients, although its mechanism of action remains unclear. Here, we describe the results of a single-center phase 2 pilot study investigating the safety and efficacy of single-agent dactinomycin in relapsed/refractory NPM1-mutated adult AML patients, demonstrating that this drug can induce complete responses and is relatively well tolerated. We also provide evidence that the activity of dactinomycin associates with nucleolar stress both in vitro and in vivo in patients. Finally, we show that low-dose dactinomycin generates more efficient stress response in cells expressing NPM1 mutant compared to wild-type cells, suggesting that NPM1-mutated AML may be more sensitive to nucleolar stress. In conclusion, we establish that dactinomycin is a potential therapeutic alternative in relapsed/refractory NPM1-mutated AML that deserves further investigation in larger clinical studies.
Altered metabolic and inflammatory transcriptomics after cardiac surgery in neonates with congenital heart disease
Authors: Jain Parag N. , Robertson Matthew , Lasa Javier J. , Shekerdemian Lara , Guffey Danielle , Zhang Yuhao , Lingappan Krithika , Checchia Paul , Coarfa Cristian
Published: March 2021

The study examines the whole blood transcriptome profile before and after cardiopulmonary bypass (CPB) in neonates with hypoplastic left heart syndrome (HLHS), a severe form of congenital heart disease, that can develop low cardiac output syndrome (LCOS). Whole blood mRNA transcriptome profiles of 13 neonates with HLHS before and after their first palliative surgery were analyzed to determine differentially expressed genes and pathways. The median age and weight at surgery were 4 days and 3.2 kg, respectively. Of the 13 patients, 8 developed LCOS. There was no significant difference between CPB, aortic cross clamp, deep hypothermic cardiac arrest times between patients that develop LCOS and those that do not. Upon comparing differential gene expression profiles between patients that develop LCOS and those that do not in pre-operative samples, 1 gene was up-regulated and 13 were down regulated. In the post-operative samples, 4 genes were up-regulated, and 4 genes were down regulated when patients that develop LCOS were compared to those that do not. When comparing post-operative samples to pre-operative samples in the patients that do not develop LCOS, 1484 genes were up-regulated, and 1388 genes were down regulated; while patients that developed LCOS had 2423 up-regulated genes, and 2414 down regulated genes for the same pre to post-operative comparison. Pathway analysis revealed differential regulation of inflammatory pathways (IL signaling, PDGF, NOTCH1, NGF, GPCR) and metabolic pathways (heme metabolism, oxidative phosphorylation, protein metabolism including amino acid and derivatives, fatty acid metabolism, TCA cycle and respiratory electron transport chain). By identifying altered transcriptome profiles related to inflammation and metabolism in neonates with HLHS who develop LCOS after CPB, this study opens for exploration novel pathways and potential therapeutic targets to improve outcomes in this high-risk population.
Clogging sensitivity of flow distributors designed for radially elongated hexagonal pillar array columns: a computational modelling
Authors: Haghighi Farideh , Talebpour Zahra , Sanati-Nezhad Amir
Published: March 2021

Flow distributor located at the beginning of the micromachined pillar array column (PAC) has significant roles in uniform distribution of flow through separation channels and thus separation efficiency. Chip manufacturing artifacts, contaminated solvents, and complex matrix of samples may contribute to clogging of the microfabricated channels, affect the distribution of the sample, and alter the performance of both natural and engineered systems. An even fluid distribution must be achieved cross-sectionally through careful design of flow distributors and minimizing the sensitivity to clogging in order to reach satisfactory separation efficiency. Given the difficulty to investigate experimentally a high number of clogging conditions and geometries, this work exploits a computational fluid dynamic model to investigate the effect of various design parameters on the performance of flow distributors in equally spreading the flow along the separation channels in the presence of different degrees of clogging. An array of radially elongated hexagonal pillars was selected for the separation channel (column). The design parameters include channel width, distributor width, aspect ratio of the pillars, and number of contact zone rows. The performance of known flow distributors, including bifurcating (BF), radially interconnected (RI), and recently introduced mixed-mode (MMI) in addition to two new distributors designed in this work (MMII and MMIII) were investigated in terms of mean elution time, volumetric variance, asymmetry factors, and pressure drop between the inlet and the monitor line for each design. The results show that except for pressure drop, the channel width and aspect ratio of the pillars has no significant influence on flow distribution pattern in non-clogged distributors. However, the behavior of flow distributors in response to clogging was found to be dependent on width of the channels. Also increasing the distributor width and number of contact zone rows after the first splitting stage showed no improvement in the ability to alleviate the clogging. MMI distributor with the channel width of 3 µm, aspect ratio of the pillars equal to 20, number of exits of 8, and number of contact zones of 3 exhibited the highest stability and minimum sensitivity to different degrees of clogging.
Expansion of the mangrove species Rhizophora mucronata in the Western Indian Ocean launched contrasting genetic patterns
Authors: Triest Ludwig , Van der Stocken Tom , De Ryck Dennis , Kochzius Marc , Lorent Sophie , Ngeve Magdalene , Ratsimbazafy Hajaniaina Andrianavalonarivo , Sierens Tim , van der Ven Rosa , Koedam Nico
Published: March 2021

Estimates of population structure and gene flow allow exploring the historical and contemporary processes that determine a species’ biogeographic pattern. In mangroves, large-scale genetic studies to estimate gene flow have been conducted predominantly in the Indo-Pacific and Atlantic region. Here we examine the genetic diversity and connectivity of Rhizophora mucronata across a > 3,000 km coastal stretch in the Western Indian Ocean (WIO) including WIO islands. Based on 359 trees from 13 populations and using 17 polymorphic microsatellite loci we detected genetic breaks between populations of the (1) East African coastline, (2) Mozambique Channel Area (3) granitic Seychelles, and (4) Aldabra and northern Madagascar. Genetic structure, diversity levels, and patterns of inferred connectivity, aligned with the directionality of major ocean currents, driven by bifurcation of the South Equatorial Current, northward into the East African Coastal Current and southward into the Mozambique Channel Area. A secondary genetic break between nearby populations in the Delagoa Bight coincided with high inbreeding levels and fixed loci. Results illustrate how oceanographic processes can connect and separate mangrove populations regardless of geographic distance.
Exploring targeting peptide-shell interactions in encapsulin nanocompartments
Authors: Altenburg Wiggert J. , Rollins Nathan , Silver Pamela A. , Giessen Tobias W.
Published: March 2021

Encapsulins are recently discovered protein compartments able to specifically encapsulate cargo proteins in vivo. Encapsulation is dependent on C-terminal targeting peptides (TPs). Here, we characterize and engineer TP-shell interactions in the Thermotoga maritima and Myxococcus xanthus encapsulin systems. Using force-field modeling and particle fluorescence measurements we show that TPs vary in native specificity and binding strength, and that TP-shell interactions are determined by hydrophobic and ionic interactions as well as TP flexibility. We design a set of TPs with a variety of predicted binding strengths and experimentally characterize these designs. This yields a set of TPs with novel binding characteristics representing a potentially useful toolbox for future nanoreactor engineering aimed at controlling cargo loading efficiency and the relative stoichiometry of multiple concurrently loaded cargo proteins.
Short- and midterm outcome of ruptured and unruptured intracerebral wide-necked aneurysms with microsurgical treatment
Authors: Won Sae-Yeon , Seifert Volker , Dubinski Daniel , Kashefiolasl Sepide , Dinc Nazife , Bruder Markus , Konczalla Juergen
Published: March 2021

To clip or coil has been matter of debates for several years and is the domain of interdisciplinary decision making. However, the microsurgical outcome has still been elusive concerning wide neck aneurysms (WNA). A retrospective single center study was performed with all patients with ruptured WNA (rWNA) and unruptured WNA (uWNA) admitted to author´s institute between 2007–2017. Microsurgical outcome was evaluated according to Raymond-Roy occlusion grade and follow-up angiography was performed to analyze the stability of neck/aneurysm remnants and retreatment poverty. Of 805 aneurysms, 139 were rWNA (17.3%) and 148 uWNA (18.4%). Complete occlusion was achieved in 102 of 139 rWNA (73.4%) and 112 of 148 uWNA (75.6%). Neck remnants were observed in 36 patients with rWNA (25.9%) and 30 patients with uWNA (20.3%), 1 (0.7%) and 6 (4.1%) patients had aneurysmal remnant, respectively. Overall complication rate was 11.5%. At follow-up (939/1504 months), all remnants were stable except for one, which was further conservatively treated with marginal retreatment rate under 1%. Even the risk of de-novo aneurysm was higher than the risk for remnant growth (2.6% vs 0% in rWNA; 8.7% vs 5.3% in uWNA) without significant difference. Microsurgical clipping is effective for complete occlusion of r/uWNA with low complication. Furthermore, the risk of remnant growth is marginal even lower than the risk of de-novo rate low retreatment rate.
A Japanese prospective multicenter study of urinary oxysterols in biliary atresia
Authors: Konishi Ken-ichiro , Mizuochi Tatsuki , Takei Hajime , Yasuda Ryosuke , Sakaguchi Hirotaka , Ishihara Jun , Takaki Yugo , Kinoshita Masahiro , Hashizume Naoki , Fukahori Suguru , Shoji Hiromichi , Miyano Go , Yoshimaru Koichiro , Matsuura Toshiharu , Sanada Yukihiro , Tainaka Takahisa , Uchida Hiroo , Kubo Yumiko , Tanaka Hiromu , Sasaki Hideyuki , Murai Tsuyoshi , Fujishiro Jun , Yamashita Yushiro , Nio Masaki , Nittono Hiroshi , Kimura Akihiko
Published: March 2021

Diagnosis of biliary atresia (BA) can involve uncertainties. In the present prospective multicenter study, we considered whether urinary oxysterols represent a useful marker for diagnosis of BA in Japanese children. Subjects under 6 months old at 7 pediatric centers in Japan were prospectively enrolled, including patients with cholestasis and healthy controls (HC) without liver disease. Patients with cholestasis constituted 2 groups representing BA patients and others with cholestasis from other causes (non-BA). We quantitatively analyzed 7 oxysterols including 4β-, 20(S)-, 22(S)-, 22(R)-, 24(S)-, 25-, and 27-hydroxycholesterol by liquid chromatography/electrospray ionization-tandem mass spectrometry. Enrolled subjects included 14 with BA (median age 68 days; range 26–170) and 10 non-BA cholestatic controls (59; 14–162), as well as 10 HC (57; 25–120). Total urinary oxysterols were significantly greater in BA (median, 153.0 μmol/mol creatinine; range 24.1–486.7; P < 0.001) and non-BA (36.2; 5.8–411.3; P < 0.05) than in HC (2.7; 0.8–7.6). In patients with BA, urinary 27-hydroxycholesterol (3.61; 0.42–11.09; P < 0.01) was significantly greater than in non-BA (0.71; 0–5.62). In receiver operating characteristic (ROC) curve analysis for distinguishing BA from non-BA, the area under the ROC curve for urinary 27-hydroxycholesterol was 0.83. In conclusion, this first report of urinary oxysterol analysis in patients with BA indicated that 27-hydroxycholesterol may be a useful marker for distinguishing BA from other causes of neonatal cholestasis.
Roles of anthropogenic forcings in the observed trend of decreasing late-summer precipitation over the East Asian transitional climate zone
Authors: Zhao Wei , Chen Wen , Chen Shangfeng , Gong Hainan , Ma Tianjiao
Published: March 2021

Observations indicate that late-summer precipitation over the East Asian transitional climate zone (TCZ) showed a pronounced decreasing trend during 1951–2005. This study examines the relative contributions of anthropogenic [including anthropogenic aerosol (AA) and greenhouse gas (GHG)] and natural forcings to the drying trend of the East Asian TCZ based on simulations from CMIP5. The results indicate that AA forcing plays a dominant role in contributing to the drying trend of the TCZ. AA forcing weakens the East Asian summer monsoon via reducing the land-sea thermal contrast, which induces strong low-level northerly anomalies over eastern China, suppresses water vapor transport from southern oceans and results in drier conditions over the TCZ. In contrast, GHG forcing leads to a wetting trend in the TCZ by inducing southerly wind anomalies, thereby offsetting the effect of the AA forcing. Natural forcing has a weak impact on the drying trend of the TCZ due to the weak response of atmospheric anomalies.
Mice lacking PLAP-1/asporin counteracts high fat diet-induced metabolic disorder and alveolar bone loss by controlling adipose tissue expansion
Authors: Sakashita Hiromi , Yamada Satoru , Kinoshita Masaki , Kajikawa Tetsuhiro , Iwayama Tomoaki , Murakami Shinya
Published: March 2021

Adipose tissue fibrosis with chronic inflammation is a hallmark of obesity-related metabolic disorders, and the role of proteoglycans in developing adipose tissue fibrosis is of interest. Periodontal disease is associated with obesity; however, the underlying molecular mechanisms remain unclear. Here we investigated the roles of periodontal ligament associated protein-1 (PLAP-1)/asporin, a proteoglycan preferentially and highly expressed in the periodontal ligament, in obesity-related adipose tissue dysfunction and adipocyte differentiation. It was found that PLAP-1 is also highly expressed in white adipose tissues. Plap-1 knock-out mice counteracted obesity and alveolar bone resorption induced by a high-fat diet. Plap-1 knock-down in 3T3-L1 cells resulted in less lipid accumulation, and recombinant PLAP-1 enhanced lipid accumulation in 3T3-L1 cells. In addition, it was found that primary preadipocytes isolated from Plap-1 knock-out mice showed lesser lipid accumulation than the wild-type (WT) mice. Furthermore, the stromal vascular fraction of Plap-1 knock-out mice showed different extracellular matrix gene expression patterns compared to WT. These findings demonstrate that PLAP-1 enhances adipogenesis and could be a key molecule in understanding the association between periodontal disease and obesity-related metabolic disorders.
Clustering of eyes with age-related macular degeneration or pachychoroid spectrum diseases based on choroidal thickness profile
Authors: Kim Young Ho , Lee Boram , Kang Edward , Oh Jaeryung
Published: March 2021

Choroidal changes have been suggested to be involved in the pathophysiology of both age-related macular degeneration (AMD) and pachychoroid spectrum diseases (PSD). To find out the choroidal characteristics of each disease groups, various groups of AMD and PSD were classified into several clusters according to choroidal profiles based on subfoveal choroidal thickness (CT), peripapillary CT, the ratio of subfoveal CT to peripapillary CT and age. We retrospectively analyzed 661 eyes, including 190 normal controls and 471 with AMD or PSDs. In the AMD groups, eyes with soft drusen or reticular pseudodrusen were belonged to the same cluster as those with classic exudative AMD (all p < 0.001). However, eyes with pachydrusen were not clustered with eyes from other AMD groups; instead, they were classified in the same cluster as eyes from the PSD group (all p < 0.001). In the PSD group, eyes with pachychoroid neovasculopathy were grouped in the same cluster of those with polypoidal choroidal vasculopathy (p < 0.001). The cluster analysis based on the CT profiles, including subfoveal CT, peripapillary CT, and their ratio, revealed a clustering pattern of eyes with AMD and PSDs. These findings support the suggestion that pachydrusen has the common pathogenesis as PSD.
Misplacement of something inside the refrigerator is not a sign of dementia, but a probable symptom of attention deficit due to depression
Authors: Suh Jeewon , Park So Young , Park Young Ho , Pyun Jung-Min , Ryoo Na-young , Kang Min Ju , Kim SangYun
Published: March 2021

The objective of this study is to investigate the clinical significance of a specific behavior of misplacing items in a refrigerator (i.e., placing extremely unusual things such as remote control and/or cellular phone in a refrigerator) as a symptom of cognitive dysfunction. Patients with memory complaints were asked whether they ever experienced misplacing items in a refrigerator, such as placing a remote control, a cellular phone, or other extremely unusual things inside a refrigerator (referred to as the ‘fridge sign’). Among the 2172 individuals with memory complaints, 55 (2.5%) experienced symptoms of the ‘fridge sign’. We investigated the cognitive profiles of ‘fridge sign’-positive patients and performed follow-up evaluations with neuropsychological tests or telephone interviews. The ‘fridge sign’ was mostly found in individuals diagnosed as subjective cognitive decline (n = 33, 60%) or mild cognitive impairment (MCI, n = 20, 36.4%) with depressive mood and was relatively rare in dementia states (n = 2, 3.5%). Moreover, none of the ‘fridge sign’-positive patients showed significant cognitive decline over the follow-up period. We compared the cognitive profiles and the clinical progression of 20 ‘fridge sign’-positive MCI patients and 40 ‘fridge sign’-negative MCI patients. ‘Fridge sign’-positive MCI patients had worse scores on the Stroop test color reading and had higher scores on the geriatric depression scale than ‘fridge sign’-negative MCI patients, which indicates that the ‘fridge sign’ could be indicative of selective attention deficit in patients with depression rather than indicative of cognitive decline related to dementia.
Potential molecular and graphene oxide chelators to dissolve amyloid-β plaques in Alzheimer's disease: a density functional theory study
Authors: Liu Christina , Luo Xuan
Published: March 2021

Among the studied potential molecular and graphene oxide metal chelators for Alzheimer's disease, HQFUH is a successful chelator candidate for Cu, Zn, Fe, and Al. Graphene oxide with a 12.5% oxygen concentration is a potential chelator for Al.
Matrix colorimetry for high-resolution visual detection of free cyanide with Au@Au–Ag yolk–shell nanoparticles
Authors: Wen Cong-Ying , Chen Yuzhu , Liu Rong-sheng , Huang Jiankun , Wang Dawei , Cao Zejun , Meteku Benjamin , Zeng Jingbin
Published: March 2021

Matrix colorimetry was proposed for high-resolution visual detection of free cyanide with Au@Au–Ag yolk–shell nanoparticles.
A high-capacity aqueous zinc-ion battery fiber with air-recharging capability
Authors: Liao Meng , Wang Jiawei , Ye Lei , Sun Hao , Li Pengzhou , Wang Chuang , Tang Chengqiang , Cheng Xiangran , Wang Bingjie , Peng Huisheng
Published: March 2021

A flexible aqueous zinc-ion battery fiber that can be recharged by scavenging energy from the ambient air is reported. This air-recharging process is highly reversible with a high gravimetric capacity of 371 mA h g−1.
A theoretical investigation of the frisbee motion of red blood cells in shear flow
Authors: Mignon Thierry , Mendez Simon
Published: March 2021

The dynamics of a single red blood cell in shear flow is a fluid–structure interaction problem that yields a tremendous richness of behaviors, as a function of the parameters of the problem. A low shear rates, the deformations of the red blood cell remain small and low-order models have been developed, predicting the orientation of the cell and the membrane circulation along time. They reproduce the dynamics observed in experiments and in simulations, but they do not simplify the problem enough to enable simple interpretations of the phenomena. In a process of exploring the red blood cell dynamics at low shear rates, an existing model constituted of 5 nonlinear ordinary differential equations is rewritten using quaternions to parametrize the rotations of the red blood cell. Techniques from algebraic geometry are then used to determine the steady-state solutions of the problems. These solutions are relevant to a particular regime where the red blood cell reaches a constant inclination angle, with its membrane rotating around it, and referred to as frisbee motion. Comparing the numerical solutions of the model to the steady-state solutions allows a better understanding of the transition between the most emblematic motions of red blood cells, flipping and tank-treading.
Komplikationen von Implantaten der weiblichen Brust in der MRT
Authors: Fischer Uwe , Said Hafiez
Published: March 2021

Bei Brustimplantaten unterscheidet man frühe postoperative (Nachblutung, Wundinfektion und Heilungsstörung) von späteren (Rotation, Hernierung, Kapsulitis, Kapselfibrose) und sehr späten Komplikationen (Gelbluten, intra- und extrakapsuläre Ruptur). Unabhängig davon können externe Kräfte in jeder Phase zu einer Ruptur des Implantates führen. Der MRT kommt beim Nachweis aller Veränderungen und Komplikationen eine besondere Bedeutung zu.
„Allowing the data to ‚speak for themselves‘“– Die Klassifikation psychischer Störungen und das Imaginäre der computationalen Psychiatrie
Authors: Rüppel Jonas
Published: March 2021

Im Mittelpunkt dieses Artikels stehen Hoffnungen und Erwartungen, die angesichts der gegenwärtigen „Krise der psychiatrischen Diagnostik“ diskursiv mit computationalen Technologien verknüpft werden. Auf der Grundlage von Dokumentenanalysen, qualitativen Expertinneninterviews sowie ergänzenden Labor- und Konferenzethnografien wird die Fiktion eines „unvoreingenommenen Blicks“ herausgearbeitet. Demnach haben die Verfahren der „Künstlichen Intelligenz“ das Potenzial, die Tatsachen selbst zur Sprache kommen zu lassen. Da jedoch auch die „datengetriebene“ Forschung von konzeptuellen und normativen Entscheidungen durchzogen ist, droht diese Vorstellung, epistemische Hierarchisierungen und ontologischen Priorisierungen zu verdecken. Vor diesem Hintergrund wird für eine Position argumentiert, die Abhängigkeiten und Selektivitäten nicht negiert, sondern zum Gegenstand einer offensiven Debatte macht.
Diagnostik und Therapie rund um die Uhr? Künstliche Intelligenz als Herausforderung und Chance für Psychiatrie und Psychotherapie
Authors: Schnell Knut , Stein Miriam
Published: March 2021

Ziel Der Artikel soll ein grundsätzliches Verständnis der neu entstandenen Potenziale von KI-Anwendungen und dadurch entstehende Anforderungen an Psychiaterinnen und Psychiater in der Gegenwart und für die Entwicklung der Praxisumgebung der Zukunft ermöglichen. Psychiaterinnen und Psychiater werden in ihrer zukünftigen Praxis verstehen müssen, wie KI-Systeme und personalisierte KI-Assistenten in Therapiesystemen und als Teil der normalen Lebensrealität ihrer Patienten funktionieren.

Methode Der Beitrag gibt einen Überblick über Grundkategorien und Anwendungsfelder von KI und Machine Learning in Diagnostik, Prävention und Therapie psychischer Störungen.

Ergebnisse KI-Anwendungen werden die Prävention, Diagnose und Behandlung sowie das ätiologische Grundverständnis psychischer Störungen neu prägen. Dabei ist zu beachten, dass die Therapie psychischer Störungen erheblich durch kommerzielle Produktentwicklungen und Assistenzsysteme außerhalb des medizinischen Systems geprägt wird, da hier die entsprechenden Entwicklungen auf größeren Datenmengen und deutlich geringeren Restriktionen basieren.

Schlussfolgerung Psychiaterinnen und Psychiater sollten den Einsatz von KI-Systemen aktiv mitgestalten, da sonst die Kompetenzen zum Nachteil der Patienten und langfristig auch der Behandler in ein primäres Feld außerhalb des medizinischen Systems verlagert werden könnten.
Psychotherapie mit einer autonomen Künstlichen Intelligenz – Ethische Chancen und Herausforderungen
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Authors: Kuhn Eva , Fiske Amelia , Henningsen Peter , Buyx Alena
Published: March 2021

Ziel der Studie Dieser Beitrag bietet eine Zusammenschau ethischer Aspekte, die beim Einsatz einer autonomen, virtuellen oder verkörperten Künstlichen Intelligenz (KI) in der Gesundheitsversorgung psychisch Erkrankter tangiert sind.

Methodik Die Zusammenschau basiert auf einer thematischen Literaturrecherche. Sie orientiert sich an der Prinzipienethik und wird durch das Konzept der epistemischen (Un-)Gerechtigkeit erweitert.

Ergebnis Neben der Chancen-Risiken-Abwägung sind die (digitale) Gesundheitskompetenz, Zugangsgerechtigkeit, Fragen der Unter- oder Fehlversorgung sowie eine Anpassung der informierten Einwilligung in den Blick zu nehmen.

Schlussfolgerung Die ethische Beurteilung autonomer KI in der Psychotherapie ist weiterhin ergebnisoffen; zu viele klinische, ethische, rechtliche und praktische Fragen sind noch zu klären. Vor der Implementierung müssen Gütekriterien für die KI-Anwendung sowie Leitlinien für ihren klinischen Einsatz entwickelt werden.
Ethische Aspekte co-intelligenter Assistenztechnologien in der Versorgung von Menschen mit Demenz
Authors: Schweda Mark , Schicktanz Silke
Published: March 2021

Intelligente technische Assistenzsysteme werden zunehmend als Lösung für die Versorgung von Menschen mit Demenz diskutiert. Der Beitrag betrachtet zentrale ethische Herausforderungen des Einsatzes derartiger Assistenzsysteme. Dabei konzentriert er sich auf Fragen der Privatheit und des Empowerments.
Plasma characteristics and broadband electromagnetic wave absorption in argon and helium capacitively coupled plasma*
Authors: Ouyang Wen-Chong , Liu Qi , Jin Tao , Wu Zheng-Wei
Published: March 2021

A one-dimensional self-consistent calculation model of capacitively coupled plasma (CCP) discharge and electromagnetic wave propagation is developed to solve the plasma characteristics and electromagnetic wave transmission attenuation. Numerical simulation results show that the peak electron number density of argon is about 12 times higher than that of helium, and that the electron number density increases with the augment of pressure, radio frequency (RF) power, and RF frequency. However, the electron number density first increases and then decreases as the discharge gap increases. The transmission attenuation of electromagnetic wave in argon discharge plasma is 8.5-dB higher than that of helium. At the same time, the transmission attenuation increases with the augment of the RF power and RF frequency, but it does not increase or decrease monotonically with the increase of gas pressure and discharge gap. The electromagnetic wave absorption frequency band of the argon discharge plasma under the optimal parameters in this paper can reach the Ku band. It is concluded that the argon CCP discharge under the optimal discharge parameters has great potential applications in plasma stealth.
Philosophy and neuropsychiatry
Authors: Poole Norman A. , Bolton Derek
Published: March 2021

This chapter explores the distinction between the mind and the body through the lens of empiricism in neuropsychiatry. The argument is made that, although much of our understanding of the relationship between the functioning mind and its abnormalities comes from rationalization, neuropsychiatric practices cannot be based entirely in a materialist idea of the mind and body as identical. Although the tests a neuropsychiatrist performs, such as neuroimaging, blood tests, and neuropsychology, appear more objective, the relation between their results and mental disorders is not empirically clear. By citing Daniel Dennet’s intentional stance theory, the perception that psychopathological phenomena are meaningless is questioned. Dennet’s stances are applied to clinical scenarios in order to demonstrate that while physical-level investigations may be conceptually incompatible with those on the intentional level, there is often no way to cleanly separate the two, and both must be considered in the line of a neuropsychiatrist’s work.
SARS-CoV-2 antibodies detected in human breast milk post-vaccination
Authors: Baird Jill K. , Jensen Shawn M. , Urba Walter J. , Fox Bernard A. , Baird Jason R.
Published: March 2021

Importance

The SARS-CoV-2 pandemic has infected over a hundred million people worldwide, with almost 2.5 million deaths at the date of this publication. In the United States, Pfizer-BioNTech and Moderna vaccines were first administered to the public starting in December 2020, and no lactating women were included in the initial trials of safety/efficacy. Research on SARS-CoV-2 vaccination in lactating women and the potential transmission of passive immunity to the infant through breast milk is needed to guide patients, clinicians and policy makers during the worldwide effort to curb the spread of this virus.

Objective

To determine whether SARS-CoV-2 specific immunoglobins are found in breast milk post-vaccination, and to characterize the time course and types of immunoglobulins present.

Design

Prospective cohort study

Setting

Providence Portland Medical Center, Oregon, USA

Participants

Six lactating women who planned to receive both doses of the Pfizer-BioNTech or Moderna vaccine between December 2020 and January 2021. Breast milk samples were collected pre-vaccination and at 11 additional timepoints, with last sample at 14 days post 2nd dose of vaccine.

Exposure

Two doses of Pfizer-BioNTech or Moderna SARS-CoV-2 vaccine.

Main Outcome(s) and Measure(s)

Levels of SARS-CoV-2 specific IgA and IgG immunoglobulins in breast milk.

Results

In this cohort of 6 lactating women who received 2 doses of SARS-CoV-2 vaccine, we observed significantly elevated levels of SARS-CoV-2 specific IgG and IgA antibodies in breast milk beginning at Day 7 after the initial vaccine dose, with an IgG-dominant response.

Conclusions and Relevance

We are the first to show that maternal vaccination results in SARS-CoV-2 specific immunoglobulins in breast milk that may be protective for infants.
Higher Physical Fitness Regulates In Vitro Tumor Cell Growth in Older Adults with Treatment Naïve Chronic Lymphocytic Leukemia (CLL)
Authors: Sitlinger Andrea , Deal Michael A. , Garcia Erwin , Thompson Dana K. , Stewart Tiffany , MacDonald Grace A. , Devos Nicolas , Corcoran David , Staats Janet S. , Enzor Jennifer , Weinhold Kent J. , Brander Danielle M. , Weinberg J. Brice , Bartlett David B.
Published: March 2021

Chronic lymphocytic leukemia (CLL) is associated with physical dysfunction and low overall fitness that predicts poor survival following commencement of treatment. However, it remains unknown whether higher fitness in CLL patients provides anti-oncogenic effects. We identified ten fit (CLL-FIT) and ten less fit (CLL-UNFIT) treatment-naïve CLL patients from 144 CLL patients who completed a set of physical fitness and performance tests. Patient plasma was used to determine its effects on in vitro 5-day growth/viability of three B-cell cell lines (OSU-CLL, Daudi and Farage). Plasma exosomal miRNA profiles, circulating lipids, lipoproteins, inflammation levels, and immune cell phenotypes were also assessed. CLL-FIT was associated with fewer viable OSU-CLL cells at Day 1 (p=0.003), Day 4 (p=0.001) and Day 5 (p=0.009). No differences between groups were observed for Daudi and Farage cells. Of 455 distinct exosomal miRNAs identified, 32 miRNAs were significantly different between groups. Of these, 14 miRNAs had ≤-1 or ≥1 log2 fold differences. CLL-FIT patients had 5 exosomal miRNAs with lower expression and 9 miRNAs with higher expression. CLL-FIT patients had higher HDL cholesterol, lower inflammation, and lower levels of triglyceride components (all p<0.05). CLL-FIT patients had lower frequencies of low-differentiated NKG2+/CD158a/bneg (p=0.015 and p=0.014) and higher frequencies of NKG2Aneg/CD158b+ mature NK-cells (p=0.047). Absolute numbers of lymphocytes including CD19+/CD5+ CLL-cells were similar between groups (p=0.359). Higher physical fitness in CLL patients is associated with altered CLL-like cell line growth in vitro, and with altered circulating and cellular factors indicative of better immune functions and tumor control.
Capability of web-based survey software: an empirical review
Authors: Rea Alan , Marshall Kaitlin , Farrell Dan
Published: March 2021

Purpose

The purpose of this paper is twofold: first, to develop, test and validate a set of dimensions that can verify whether any specific online survey tool can be effectively developed and deployed; second, to provide a framework and working topology for web-based survey tool selection.

Design/methodology/approach

A panel comprised of five experts determined the validity of the proposed dimensions the authors compiled from extensive feature research of the top online survey software identified by Alexa and Datanyze, which allows for web survey data to be pulled in a customizable fashion over a selected period of time. The validated dimensions were then ranked via a paper survey (n = 98) in a controlled environment using a 9-point Likert scale.

Findings

There was no strong correlation between highest-ranked dimensions and the market share and use of a particular online survey tool. However, overall dimension ranking dominance did predict an online survey tool obtaining higher market implementation and use. In addition, the influence of business roles on dimension weights should be considered when selecting survey software. Finally, two additional dimensions not prevalent in existing research – data analysis and technical support – must be considered in survey tool selection.

Practical implications

Online survey tools are increasingly supplementing or replacing random telephone-based opinion and polling surveys for data collection on important social issues, political candidacies, etc. Representative samples yielding the most accurate results are more easily obtained via mixed-mode methods that incorporate online survey tools.

Originality/value

The paper's findings suggest which dimensions must be present for widespread acceptance and implementation of a successful web-based online survey tool. Organizations must be able to assess a particular survey tool's viability for their specific purposes. The dimensions presented here can be developed into an effective adoption heuristic to meet an organization's particular requirements. Findings suggest that when evaluating survey software, one must remain cognizant of the various business roles associated with survey software to better account for decision-maker tendencies. For example, managers place greater emphasis on overall cost whereas developers may value survey creation and integration features.
Significance of operational capabilities of suppliers on the front-end decision making in apparel product innovation in Sri Lanka
Authors: Seram Niromi , Nanayakkara Julian , Lanarolle Gamini
Published: March 2021

Purpose

The suppliers are recognized as important external sources who can significantly contribute by working together with the buyer during the innovation process. Operational capabilities of suppliers can be one of the considerable factors when selecting them to participate in the activities at the front-end of innovation. However, proper understanding of the influence of operational capabilities of suppliers on front-end decision-making in apparel product innovation is still very limited particularly in the context of the Sri Lankan apparel industry. Therefore, this study aims to explore the influence of operational capabilities of suppliers on the front-end decision making in apparel product innovation in Sri Lanka.

Design/methodology/approach

Both semi-structured interviews and a questionnaire survey were used as data collection techniques. Six senior managers for the interviews and 60 participants for the questionnaire were randomly selected. All those who participated in interviews and the questionnaire respondents have been involved in the front-end of innovation in different apparel manufacturing organizations in Sri Lanka.

Findings

The results indicated that the operational capabilities of suppliers had a direct positive influence on front-end decision-making, and the suppliers’ production flexibility was found to be the most influential. Further, the results highlighted that 27.3% of the front-end decisions associated with apparel product innovation in Sri Lanka were influenced by the factors governing operational capabilities of suppliers.

Originality/value

The findings of the research will be beneficial for both academia and industry. The findings will be useful to extend the current understanding and make a noteworthy contribution to this topic and to provide useful and practical guidance to material suppliers and supporting industries who work with Sri Lankan apparel manufacturing.
Effect of temperature and pH on the gelation, rheology, texture, and structural properties of whey protein and sugar gels based on Maillard reaction
Authors: Wen‐qiong Wang , Pei‐pei Yuan , Ji‐yang Zhou , Zhi‐hang Gu
Published: March 2021

This study aimed to determine the effect of initial pH and temperature on whey protein gel formation via the Maillard reaction, including changes in gel structure, rheological and texture properties. The color changes in the whey protein and glucose gels were not significant with increasing heat temperature. High temperature and alkaline conditions promoted exposure to hydrophobic groups such as –SH, which accelerated protein aggregation and gel formation. Moreover, the increased particle size and additional hydrophobic groups contributed to higher elastic modulus (G′) in the whey protein gel. Fluorescence measurements revealed that more tryptophan on the protein surface decreased with increasing temperature, which indicated that exposure to tryptophan could increase the hydrophobicity of the protein gels. Whey proteins formed stronger, gummier, more elastic, and more cohesive gels at 70 ℃ under initial pH 9 conditions, which also increased with the addition of fructose.
“I felt like I was left on my own”: A mixed‐methods analysis of maternal experiences of cesarean birth and mental distress in the United States
Authors: Sega Annalisa , Cozart Ashley , Cruz Andrea Ocasio , Reyes‐Foster Beatriz
Published: March 2021

Background

Postpartum depression (PPD) is the most common complication of childbearing. Understanding potential contributors, such as cesarean deliveries, is essential to improving maternal mental health. This study investigated the relationship between unplanned versus planned cesarean birth and postpartum depressive symptoms.

Methods

We employed a sequential, mixed‐methods approach wherein the Edinburgh Postnatal Depression Scale (EPDS) was first administered to participants who had experienced a cesarean birth within the previous 12 months. EPDS scores among those in the unplanned vs. planned cesarean groups were compared by means of SPSS. Twenty‐five participants with EPDS scores >8 were then interviewed to provide subjective measures of maternal well‐being. Interview data were subjected to thematic qualitative analysis using a modified grounded theory approach.

Results

The average EPDS score from 120 participants with unplanned cesareans was 10.7 ± 6.4, with 68.5% scoring >8. The average EPDS score from 93 participants with planned cesarean births was 8.96 ± 5.7, with 52.7% scoring >8. The difference in mean score was statistically significant (P < 0.05). Interview findings revealed several important themes including: support, medical interaction, stress, recovery, breastfeeding, and sleep. In several cases, participants were not properly screened, or screening tool responses were ignored. Numerous participants reported medical interactions where they felt ignored by practitioners, including one interviewee who stated, “I got my tubes tied because it was so traumatizing that I never wanted to give birth again.”

Discussion

Findings suggest that unplanned cesareans have a higher incidence and severity of postpartum depressive symptoms. Interview analyses highlight important areas for improvement and concern about the current state of postpartum mental health care and physician‐guided supports in this US sample.
Clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments
Authors: Tang Fei , Ng Chee M. , Bada Henrietta S. , Leggas Markos
Published: March 2021

In this paper, we review the management of neonatal opioid withdrawal syndrome (NOWS) and clinical pharmacology of primary treatment agents in NOWS, including morphine, methadone, buprenorphine, clonidine, and phenobarbital. Pharmacologic treatment strategies in NOWS have been mostly empirical, and heterogeneity in dosing regimens adds to the difficulty of extrapolating study results to broader patient populations. As population pharmacokinetics (PKs) of pharmacologic agents in NOWS become more well‐defined and knowledge of patient‐specific factors affecting treatment outcomes continue to accumulate, PK/pharmacodynamic modeling and simulation will be powerful tools to aid the design of optimal dosing regimens at the patient level. Although there is an increasing number of clinical trials on the comparative efficacy of treatment agents in NOWS, here, we also draw attention to the importance of optimizing the dosing regimen, which can be arguably equally important at identifying the optimal treatment agent.