bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of 4D combined angiography and perfusion using radial imaging and arterial spin labeling
Authors: Okell Thomas W. , Chiew Mark
Published: December 2022

Purpose

To extend and optimize a non‐contrast MRI technique to obtain whole head 4D (time‐resolved 3D) qualitative angiographic and perfusion images from a single scan.

Methods

4D combined angiography and perfusion using radial imaging and arterial spin labeling (CAPRIA) uses pseudocontinuous labeling with a 3D golden ratio (“koosh ball”) readout to continuously image the blood water as it travels through the arterial system and exchanges into the tissue. High spatial/temporal resolution angiograms and low spatial/temporal resolution perfusion images can be flexibly reconstructed from the same raw k‐space data. Constant and variable flip angle (CFA and VFA, respectively) excitation schedules were optimized through simulations and tested in healthy volunteers. A conventional sensitivity encoding (SENSE) reconstruction was compared against a locally low rank (LLR) reconstruction, which leverages spatiotemporal correlations. Comparison was also made with time‐matched time‐of‐flight angiography and multi‐delay EPI perfusion images. Differences in image quality were assessed through split‐scan repeatability.

Results

The optimized VFA schedule (2–9°) resulted in a significant (p < 0.001) improvement in image quality (up to 84% vs. CFA), particularly for the lower SNR perfusion images. The LLR reconstruction provided effective denoising without biasing the signal timecourses, significantly improving angiographic and perfusion image quality and repeatability (up to 143%, p < 0.001). 4D CAPRIA performed well compared with time‐of‐flight angiography and had better perfusion signal repeatability than the EPI‐based approach (p < 0.001).

Conclusion

4D CAPRIA optimized using a VFA schedule and LLR reconstruction can yield high quality whole head 4D angiograms and perfusion images from a single scan.
Systematic analysis of the material basis and mechanism of total saponins of mountain cultivated ginseng against doxorubicin‐induced cardiotoxicity based on integrating network pharmacology and in vivo substance profiling
Authors: Liu Hao , Zhang Haiqiang , Nie Jianing , Yu Yang , Li Qiao , Lv Chongning , Lu Jincai
Published: December 2022

Introduction

Doxorubicin‐induced cardiotoxicity (DIC) is a serious obstacle to oncologic treatment. Mountain cultivated ginseng (MCG) exhibits stronger pharmacological effects than cultivated ginseng (CG) mainly due to the differences in ginsenosides. However, the material basis and the underlying mechanism of the protective effects of total saponins of MCG (TSMCG) against DIC are unclear.

Objectives

We aimed to elucidate the material basis and the pharmacodynamic effects of TSMCG on DIC as well as the underlying mechanisms.

Methods

To comprehensively analyze the effective substances, the chemical components of TSMCG and their prototypes or metabolites in vivo were characterized through UHPLC/Q‐TOF‐MS. Then, an absorbed component–target–disease network was established to explore the mechanisms underlying the protective effects of TSMCG against DIC. H9c2 cells were employed for pharmacodynamic assays. The mechanism was verified by Western blot and molecular docking simulations.

Results

A total of 56 main ginsenosides were identified in TSMCG, including 27 ginsenosides of PPD type, 15 ginsenosides of PPT type, two ginsenosides of OA types, and 12 ginsenosides of other types. Moreover, 55 ginsenoside prototypes or metabolites in vivo were tentatively characterized. Ginsenoside Ra1, a differential compound between MCG and CG, could be metabolized by oxidation and deglycosylation. Network pharmacology showed that AKT1, p53, and STAT3 are core targets of 62 intersecting genes. Molecular docking results indicated that most of the ginsenosides have favorable affinity with these core targets. After doxorubicin exposure, TSMCG could increase cell viability and inhibit apoptosis in a dose‐dependent manner.

Conclusion

Our work reveals a novel comprehensive strategy to study the material basis of the protective effects of TSMCG against DIC and the underlying mechanisms through integrating in vivo substance identification, metabolic profiling, network pharmacology, pharmacodynamic evaluation, and mechanism verification.
Design, characterization and evaluation of homogeneous oxidized sodium alginate/polyacrylamide–gelatin composite hydrogels constructed via interpenetrating network technology
Authors: Wang Hongcai , Sun Xiuying , Shang Ting , Li Dongze , Cao Shanshan , Chen Xiuqiong , Yan Huiqiong , Lin Qiang
Published: December 2022

To improve the bio‐applicability of alginate hydrogels, a combination of interpenetrating network technology, oxidation of alginate, surface coverage of gelatin and endogenous crosslinking of hydroxyapatite/d‐glucono‐δ‐lactone complex was designed to construct homogeneous oxidized sodium alginate/polyacrylamide–gelatin (OSA/PAM‐GT) composite hydrogels. The effects of mass ratio of PAM chemical crosslinked networks and OSA ionic crosslinked networks on the microscopic morphology, mechanical properties, swellability, biodegradability and biocompatibility of the composite hydrogels were comparatively studied. Experimental results showed that porous OSA/PAM‐GT composite hydrogels with regular morphology can be prepared through the interpenetration of OSA ionic crosslinked network and PAM chemical crosslinked network via hydrogen bonds and Schiff bases, which not only enhanced the mechanical properties and thermal stability of the composite hydrogels, but also regulated their swelling and in vitro biodegradability. When the mass ratio of OSA to PAM was 1:2, the cell proliferation activity on OSA/PAM‐GT composite hydrogels was the best, but excessive PAM reduced the living space of cells and hindered their growth due to the reduction of porosity. Considering the results obtained, interpenetrating network technology in combination with surface coverage of GT would be a useful method for alginate hydrogels to broaden their applications in the field of biomedicine. © 2022 Society of Industrial Chemistry.
Low‐cost outdoor spectral irradiances determination and its application on Concentrator Photovoltaic module power rating and energy yield calculation
Authors: Steiner Marc , Martínez Juan F. , Mathur Paresh , Sarkar Subrata , Siefer Gerald
Published: December 2022

In this work, a method to calculate the aerosol content in the atmosphere and the prevailing spectral irradiance of the sunlight is introduced. This method does not aim for low measurement uncertainty but for cost effectiveness and does not require sophisticated equipment. The bases of the method are the clear sky direct normal irradiance (DNI) and a look‐up table calculated with the software tool SMARTS2. The ratio of clear sky DNI to the prevailing DNI in combination with the look‐up table allows the determination of aerosol optical depth (AOD), spectral matching ratios (SMR), and spectral irradiances. Besides the prevailing DNI, the following ambient condition parameters are required: Air pressure, relative humidity, and ambient temperature. This means a weather station and a pyrheliometer are sufficient for the determination of the prevailing spectral irradiance. Obviously, this method cannot guarantee the same accuracy as conventional spectral irradiance measurement methods (e.g., using a spectroradiometer). However, in this work, we demonstrate the potential of this new method as a fall‐back strategy for missing spectral irradiance data. This method is worth using when (C)PV module power output data needs to be evaluated in dependence of the composition of the spectral irradiance, but no regular spectral irradiance data are available. In this paper, the AOD and SMR values determined with the introduced method are compared to measurement data with common measurement devices demonstrating a satisfying agreement. The spectral irradiances calculated with this method are successfully tested for using as the basis for energy yield calculations and for the determination of the CPV module power output at Concentrator Standard Conditions according to IEC 62670‐1.
The effect of different cold atmospheric plasma sources and treatment modalities on the generation of reactive oxygen and nitrogen species in water
Authors: Armenise Vincenza , Veronico Valeria , Cosmai Savino , Benedetti Danilo , Gristina Roberto , Favia Pietro , Fracassi Francesco , Sardella Eloisa
Published: December 2022

Reactive oxygen and nitrogen species (RONS) can be generated in liquids by different cold plasma processes. These species can influence cell biology and pathological states, and trigger wound healing, disinfection, and cancer treatments. The optimization of plasma sources' configurations and experimental conditions is fundamental to dose‐produced RONS in liquids. This research is a case study comparing RONS generation (H2O2 and NO2−) in water, after exposure to two different atmospheric pressure cold dielectric barrier discharge (DBD) plasma sources: a plasma jet‐DBD and a planar‐DBD operating in contact with the liquid and in remote, respectively. The data demonstrate that the reactor geometry and the treatment modality strongly impact the generation of the active species in water.
A breakthrough effect of gene replacement therapy on respiratory outcomes in children with spinal muscular atrophy
Authors: AlNaimi Amal , Hamad Sara G. , Mohamed Reem B. A. , Ben‐Omran Tawfeg , Ibrahim Khalid , Osman Mahmoud F. El‐Said , Abu‐Hasan Mutasim
Published: December 2022

Introduction

Spinal muscular atrophy (SMA) is an inherited progressive neuromuscular disorder characterized by generalized hypotonia, respiratory failure and early death. The introduction of gene replacement therapy (GRT) modified the natural history of the disease. However, more data is needed to understand the long‐term effect of GRT on measurable respiratory outcomes. We report the respiratory outcomes in our cohort of patients with SMA post‐GRT in 2‐year period.

Methods

A retrospective chart‐review of genetically confirmed children with SMA who received GRT between 2019 and 2021 in Qatar. The evaluated respiratory outcomes were chronic respiratory support, respiratory hospitalizations, escalation of respiratory support and polysomnography results before and after GRT. Nonrespiratory outcomes; nutritional status, swallowing, and motor functions; were also assessed.

Results

A total of 11 patients (9 patients with SMA‐1 and 2 patients with SMA‐2) received GRT at a median age of 12 months and 22 months in patients with SMA‐1 and SMA‐2, respectively. All patients were successfully weaned off Noninvasive ventilation (NIV) except one patient who remained on mechanical ventilation through tracheostomy tube. The annualized hospitalization rate dropped by half after GRT. The average length of stay (LOS) in intensive care unit (ICU) decreased by 17.32 days/patient/year after GRT. Duration of required escalation of respiratory support during acute hospitalizations has dropped by 18.56 days/patient/year post‐GRT.

Conclusion

We report favorable respiratory outcomes of GRT in our cohort. GRT resulted in discontinuation of chronic respiratory support in majority of ventilated patients. GRT also resulted in decreased respiratory hospitalization rate, hospital‐LOS, ICU‐LOS, and need for escalation of ventilatory support.
Fast and straightforward simultaneous quantification of multiple apolipoproteins in human serum on a high‐throughput LC‐MS/MS platform
Authors: Kim Hyojin , Yang Won Suk , An Dongheui , Lee Sang‐Guk , Baek Je‐Hyun
Published: December 2022

Purpose

Apolipoprotein monitoring is useful for diagnosing cardiovascular diseases, as they are risk factors of arteriosclerosis and other neutral fat‐related diseases. Liquid chromatography‐tandem mass spectrometry (LC‐MS/MS) is advantageous for simultaneous apolipoprotein quantification, differentiation, and standardization including their isoforms. However, fast and straightforward sample preparation that retains quantification accuracy remains challenging in clinical MS.

Experimental Design

We developed a simultaneous assay for serum apolipoprotein A‐I (ApoA‐I), apolipoprotein B100 family, and apolipoprotein C‐III (ApoC‐III) using a high‐throughput LC‐MS/MS platform coupled with a BRAVO system. The assay was simplified by using sodium deoxycholate and trypsin/lys‐C without reduction and alkylation steps.

Results

Simple sample preparation reduced turnaround time by 1.5 h and neat goat serum was chosen as an optimal calibration matrix for accurate protein quantification. Assay precision, linearity, correlation, accuracy, limit of detection (LOD), limit of quantitation (LOQ), and carryover were validated according to CLSI guidelines over 41 days using more than 100 human serum samples. Good correlation compared with turbidimetric immunoassay (TIA) was observed by Deming regression for all analytes.

Conclusions and Clinical Relevance

A high‐throughput LC‐MS/MS and BRAVO assay for simultaneous apolipoprotein analysis was validated using a simple preparation method with a human serum calibrator in goat serum matrix. The assay is readily expandable to include other target serum proteins and/or their isoforms.
Regulatory utility of physiologically‐based pharmacokinetic modeling to support alternative bioequivalence approaches and risk assessment: A workshop summary report
Authors: Wu Fang , Mousa Youssef , Raines Kimberly , Bode Chris , Tsang Yu Chung , Cristofoletti Rodrigo , Zhang Hongling , Heimbach Tycho , Fang Lanyan , Kesisoglou Filippos , Mitra Amitava , Polli James , Kim Myong‐Jin , Fan Jianghong , Zolnik Banu S. , Sun Duxin , Zhang Yi , Zhao Liang
Published: December 2022

This report summarizes the proceedings for day 2 sessions 1 and 3 of the 2‐day public workshop entitled “Regulatory Utility of Mechanistic Modeling to Support Alternative Bioequivalence Approaches,” a jointly sponsored workshop by the US Food and Drug Administration (FDA) and the Center for Research on Complex Generics (CRCG). The aims of this workshop were: (1) to discuss how mechanistic modeling, including physiologically‐based pharmacokinetic (PBPK) modeling and simulation, can support product development, and regulatory submissions; (2) to share the current state of mechanistic modeling for bioequivalence (BE) assessment through case studies; (3) to establish a consensus on best practices for using PBPK modeling for BE assessment to help drive further investment by the generic drug industry into mechanistic modeling and simulation; and (4) to introduce the concept of a Model Master File to improve model‐sharing. The theme of day 2 covered PBPK absorption model for oral products as an alternative BE approach and a tool for supporting risk assessment and biowaiver (session 1), oral PBPK for evaluating the impact of food on BE (session 2), successful cases, and challenges for oral PBPK (session 3). This report summarizes the topics of the presentations of day 2 sessions 1 and session 3 from FDA, academia, and pharmaceutical industry, including the current status of oral PBPK, case examples as well as the challenges and opportunities in this area. In addition, panel discussions on the utility of oral PBPK in both new drugs and generic drugs from regulatory and industry perspective are also summarized.
Exploring a cobot risk assessment approach combining FMEA and PRAT
Authors: Murino Teresa , Nardo Mario Di , Pollastro Daniele , Berx Nicole , Francia Angela Di , Decré Wilm , Philips Johan , Pintelon Liliane
Published: December 2022

Collaborative robots are an emerging technology falling within the scope of Industry 4.0 and based on the concept of Human‐Robot Collaboration (HRC). Unlike traditional industrial robots, collaborative robots are used in shared workspaces with no safety fences. Hence, prospective hazardous contacts need to be avoided or mitigated through a risk assessment. The normative standards such as ISO TS 15066 suggest a list of common hazards, but do not guide the robot system user through the risk assessment process. To address this shortcoming, this paper proposes a practical eight steps risk assessment approach, resulting in a risk priority list. In order to provide an accurate, practical, quantitative and supportive tool for HRC environments, the Failure Mode and Effects Analysis (FMEA) and the Proportional Risk Assessment technique (PRAT) techniques are proposed for risk assessment. The two techniques mentioned above are combined in the suggested new methodology, highlighting both their benefits and disadvantages. The proposed methodology is applied with positive results to a collaborative brick‐lifter case study.
Large lung mass lesion with spontaneous regression in a patient with IgG4‐related lung disease
Authors: Iwasaki Kazuhiko , Araya Tomoyuki , Kita Toshiyuki , Sakai Tamami
Published: December 2022

Key message

IgG4‐related lung disease (IgG4‐RLD) may present with a variety of radiological findings, but large lung mass lesion are rare. Although steroid therapy is strongly recommended for IgG4‐RLD with or without symptoms, respirologists should be aware that some patients may not need steroid therapy.
Long future frame prediction using optical flow‐informed deep neural networks for enhancement of robotic teleoperation in high latency environments
Authors: Moniruzzaman M. D. , Rassau Alexander , Chai Douglas , Islam Syed Mohammed Shamsul
Published: December 2022

High latency in teleoperation has a significant negative impact on operator performance. While deep learning has revolutionized many domains recently, it has not previously been applied to teleoperation enhancement. We propose a novel approach to predict video frames deep into the future using neural networks informed by synthetically generated optical flow information. This can be employed in teleoperated robotic systems that rely on video feeds for operator situational awareness. We have used the image‐to‐image translation technique as a basis for the prediction of future frames. The Pix2Pix conditional generative adversarial network (cGAN) has been selected as a base network. Optical flow components reflecting real‐time control inputs are added to the standard RGB channels of the input image. We have experimented with three data sets of 20,000 input images each that were generated using our custom‐designed teleoperation simulator with a 500‐ms delay added between the input and target frames. Structural Similarity Index Measures (SSIMs) of 0.60 and Multi‐SSIMs of 0.68 were achieved when training the cGAN with three‐channel RGB image data. With the five‐channel input data (incorporating optical flow) these values improved to 0.67 and 0.74, respectively. Applying Fleiss' κ gave a score of 0.40 for three‐channel RGB data, and 0.55 for five‐channel optical flow‐added data. We are confident the predicted synthetic frames are of sufficient quality and reliability to be presented to teleoperators as a video feed that will enhance teleoperation. To the best of our knowledge, we are the first to attempt to reduce the impacts of latency through future frame prediction using deep neural networks.
NIR‐II Self‐Luminous Molecular Probe for In Vivo Inflammation Tracking and Cancer PDT Effect Self‐Evaluating
Authors: Yuan Meng , Fang Xiao , Liu Jianyong , Yang Kaiqiong , Xiao Shenggan , Yang Sheng , Du Wei , Song Jibin
Published: December 2022

Optical imaging in the second near‐infrared (NIR‐II, 900–1700 nm) window has been extensively investigated for bioimaging. However, a strong autofluorescence background from real‐time excitation light significantly reduces the images’ quality of NIR‐II fluorescence (FL) imaging. To resolve this issue, a NIR‐II self‐luminous small molecule (CLPD) based on bioluminescence (BL) resonance energy transfer (BRET) mechanism is first developed. The reactive oxygen species (ROS) can trigger NIR‐II BL and reduce the NIR‐II FL signals of the CLPD simultaneously, enabling ROS‐correlated ratiometric BL/FL imaging. CLPD is used for high‐contrast NIR‐II BL imaging of osteoarthritis as well as guiding the treatment process by ratiometric BL/FL imaging. Moreover, CLPD is applied for NIR‐II BL imaging of tumor triggered by the generated ROS during PDT. A correlation between the ratiometric NIR‐II BL/FL signal and tumor size is constructed, providing a trustworthy tool for early assessment of PDT effect. Overall, this study presents a novel NIR‐II self‐luminous small molecular probe for in vivo imaging and provides a strategy for design a self‐evaluation system of therapeutic effect.
Large‐scale experiments on concrete hinges under general loading
Authors: Markić Tomislav , Kaufmann Walter
Published: December 2022

The structural behavior of concrete hinges under general loading is far from being properly understood, which is to a large extent due to the lack of pertinent experimental data. This paper contributes to filling this knowledge gap by presenting and discussing the results of an experimental campaign on one‐way Freyssinet concrete hinges. Seven large‐scale concrete hinges were tested in the Large Universal Shell Element Tester, which allowed the investigation of their behavior under general loading by all six stress resultants. A combination of digital image correlation and distributed fiber optic measurements allowed a deeper insight into the structural behavior of the specimens. The tested hinges could sustain very high axial stresses exceeding 4.5 times the uniaxial concrete compressive strength, large rotations of over 60 mrad, and shear stresses in transverse and longitudinal directions up to 2.24 times the axial compressive stress. The resistance to bending moments about the strong axis and torques also proved to be significant. A moderate amount of reinforcement crossing the hinge throat considerably increased the shear resistance at low axial stresses and produced a ductile shear behavior.
Owner perspectives on the impact of veterinary surgeons upon their decision making in the management of dogs with idiopathic epilepsy
Authors: Pergande Amy E. , Belshaw Zoe , Volk Holger A. , Packer Rowena M. A.
Published: December 2022

Background

Idiopathic epilepsy is a prevalent canine condition that can be challenging to manage. A positive vet–owner relationship contributes to satisfaction and compliance, but its impact on management is unclear. The aim of this study was to investigate owner perspectives about the impact of veterinary surgeons on decision making and management.

Methods

Qualitative methods were utilised, and semi‐structured interviews were completed with 21 owners of dogs with epilepsy who lived in England. Transcripts were thematically analysed, and this study discusses the theme ‘influences of the veterinary surgeon’.

Results

Many owners felt that more precise expectations could have improved interactions with their veterinary surgeon(s), and their experiences of caring for their dog. Most owners referred to a specialist reported a positive experience, often due to specialists being perceived to have greater experience or knowledge. Owners who reported predominantly negative experiences were often less trusting of the veterinary profession, and more likely to perform self‐directed research.

Limitations

These results represent the experiences of a small subset of owners, and larger scale studies are required to support these findings.

Conclusion

Owners appear to value the formation of partnerships of care with their veterinary surgeon, and greater availability of educational resources could further improve owner satisfaction.
To improve existing marsh bird survey protocols, we need to evaluate closure assumptions
Authors: Fournier Auriel M. V. , Bradshaw Therin M. , Hagy Heath M. , Shirkey Brendan
Published: December 2022

Our collective understanding of secretive marsh birds has increased in the past decades due to the development and implementation of the North American Standardized Marsh Bird Monitoring Protocol (hereafter, Protocol). The Protocol proposes call broadcast surveys to increase vocalization and detection rates within 3 standardized survey periods aimed at surveying peak breeding activity for a suite of secretive marsh birds. We noted a trend in the literature linking occupancy modeling with the survey design from the Protocol, despite some evidence that vocalizations decline across survey periods, which could indicate lack of population closure. An underlying assumption of occupancy modeling is closure, and the Protocol was designed to focus on only birds which will remain in an area throughout the breeding season and not migrants that may only be present in the first survey period. Including migrating marsh birds, especially if a large percentage of marsh bird detections are migrants, can bias occupancy estimates and lead to erroneous density and population size estimates that may affect conclusions about habitat resource and bird associations. We urge researchers and managers to carefully consider the analytical and field techniques when designing studies for marsh birds and to not simply pair the biweekly survey design within the Protocol with occupancy modeling and ignore closure assumptions, turnover rates, and potential differences in resource use by migrating and breeding marsh birds. Specifically, we suggest that researchers consider short survey interval times (e.g., ~2 days rather than 2 weeks) or continuous call monitoring using automated recorded devices deployed for 1–2 weeks per survey location when using occupancy analysis on secretive marsh birds. We also call for future study of turnover rates, stopover duration, and vocalization rates during migration and breeding periods to better inform study designs and increase the appropriateness of statistical analysis.
External Voting Patterns: CEE Migrants in Western Europe
Authors: Szulecki Kacper , Erdal Marta Bivand , Stanley Ben
Published: December 2022

This chapter compares external voting of CEE diasporas in Western Europe with voting patterns observed in those diasporas’ respective countries of origin. It focuses on electoral turnout, overall variation in support for parties, and variation in support for parties with respect to key ideological dimensions and issues. Using quantitative data on all parliamentary and presidential elections held in Bulgaria, Czechia, Latvia, Lithuania, Romania, and Poland, it analyzes the aggregate patterns of divergence and convergence between diaspora and origin-country electorates from the last pre-EU-accession election onward. The analysis shows that diaspora voters are less likely to turn out in elections, but that those who do vote make choices which are legible with respect to origin-country political dynamics and relatively consistent over time, with no evidence of divergence or convergence. The chapter concludes by identifying three important issues to be investigated at the individual level: the impact of election laws and infrastructure on propensity to participate in elections, the relative importance of migration experiences and socio-demographic factors in determining diaspora vote choices, and the impact of host-country society and politics on the behavior of diaspora voters.
Conclusions
Authors: Szulecki Kacper , Erdal Marta Bivand , Stanley Ben
Published: December 2022

This chapter takes stock of the evidence gathered in the empirical sections and summarizes the main findings. We discuss the differences between diaspora voting and homeland results, the ideological differences, as well as the question of low turnout and its determinants. We then move to the broader problem of legitimacy and normative consideration of external voting. Building on the interviews presented in Chap. 4, we also ask how external voting plays into the broader mechanism of political remittances and whether migrants necessarily desire to be agents of political change in their homelands. We conclude with an overview of the areas for future research, presenting both the empirical knowledge needs and normative questions to be tackled.
Remarks on q-Monotone Functions and the Bernstein polynomials
Authors: Abel Ulrich , Leviatan Dany , Raşa Ioan
Published: December 2022

We show that certain inequalities involving differences of the Bernstein basis polynomials and values of a function $$f\in C[0,1]$$

f
∈
C
[
0
,
1
]

, which is twice differentiable in [0, 1], imply that the function is q-monotone. This provides a partial answer to an open problem of the authors in a recent paper.
Schleichender demografischer Wandel und neurologische Rehabilitation – Teil 1: Situationsbeschreibung
Authors: Knecht Stefan , Reiners Harmut , Siebler Mario , Platz Thomas , Flöel Agnes , Busse Reinhard
Published: December 2022

In den nächsten zwei Jahrzehnten werden in Deutschland die Babyboomer aus dem Erwerbsleben ausscheiden. Erwerbsarbeit muss dann von der zahlenschwachen „Pillenknick“-Generation geleistet werden. Mehr ältere Personen in der Gesellschaft bedeuten trotz und teilweise wegen verbesserter medizinischer Möglichkeiten eine höhere Belastung durch Gesundheits- und Pflegeversorgung, die finanziert und personell getragen werden muss. Um mit weniger Erwerbstätigen mehr Bedürftige zu versorgen, muss das Gesundheitssystem umgebaut werden. Weil allerdings die Entwicklungen schleichend verlaufen, ist das Problembewusstsein vielerorts noch gering. Hier fokussieren wir auf den Bereich in unserem Gesundheitssystem, welcher mit am stärksten wächst und zusätzlich den größten Personalbedarf pro Betroffenem hat: die Versorgung schwerkranker und selbsthilfeeingeschränkter Menschen. Das Nebeneinander von Krankenhaus, Rehabilitationsklinik und Pflegeinstitution ist historisch bedingt und unzureichend koordiniert. Es fördert die Tendenz, selbsthilfeeingeschränkte Patient*innen in Pflegeeinrichtungen ohne Chance auf Wiederbefähigung zu entlassen, statt sie zu rehabilitieren. Mit dem weiteren demografischen Wandel droht sich diese Tendenz zu verstärken. Hier versuchen wir in einem ersten von zwei Teilen eine Beschreibung der aktuellen Situation.
Quadriceps tendon autograft with or without bone block have comparable clinical outcomes, complications and revision rate for ACL reconstruction: a systematic review
Authors: Meena Amit , D’Ambrosi Riccardo , Runer Armin , Raj Akshya , Attri Manish , Abermann Elisabeth , Hoser Christian , Fink Christian
Published: December 2022

Purpose

The purpose of this systematic review is to report complications, graft failure, fixation methods, rehabilitation protocol, clinical and patient-reported outcomes, and return to sports with the use of quadriceps tendon graft with the bone block (QT-B) and without bone block (QT-S).

Methods

According to the PRISMA guidelines a comprehensive search was performed across PubMed/MEDLINE, Scopus, EMBASE, and Cochrane Library databases from inception until April 2022. Only prospective studies using quadriceps tendon autograft with a minimum of 20 patients were considered for inclusion. The outcome measures extracted from the studies were the KT-1000, Lysholm score, Subjective and Objective IKDC, Tegner, Marx Score, complications, failures and/or revision surgery, and rate of return to sports. Cochrane risk of bias and MINORS tool were used for the risk of bias assessment of all included studies.

Results

A total of 13 studies were included, consisting of 5 randomized controlled trials, 6 cohort studies, 1 case–control and 1 case series. A total of 484 patients received QT-S in 6 studies of which 224 (46.2%) were males and 212 (43.8%) females with a mean age of 21.5 ± 7.5 (range 14–58). While 243 patients received QT-B in 7 studies of which 167 (68.7%) were males and 76 (31.3%) females with a mean age of 28.9 ± 4.5 (range: 18–49). The studies analyzed had a mean MINORS score of 14.6 (range, 12–19). Both QT-B and QT-S for ACL reconstruction reported satisfactory results in terms of patient-reported outcome measures. Although, a slightly higher anterior laxity was found with the QT-S than with the QT-B.

Conclusion

Quadriceps tendon with a bone block (QT-B) or without bone block (QT-S) for ACL reconstruction is supported by current literature. Both grafts are safe and viable options for ACL reconstruction with comparable clinical outcomes, complications and revision rates.

Level of evidence

Level IV.

Registration

PROSPERO-CRD42022347134;https://www.crd.york.ac.uk/prospero/
Comparing the Efficacy of Multiple Drugs Injection for the Treatment of Hypertrophic Scars and Keloid: A Network Meta-Analysis
Authors: Wu Wenhao , Zhao Yang , Chen Yuxuan , Zhong Aimei
Published: December 2022

Background

There is no consensus regarding the choice of injected drugs for pathological scars. Although the clinical efficacy of different drug treatments was shown in many randomized controlled trials, the efficacies of many drugs are inconsistent. Therefore, this study aimed to determine how different effective drugs are for treating pathological scars. It is anticipated that the study findings may serve as guidelines for plastic surgeons.

Methods

Relevant literature was extracted from the following databases Cochrane Library, Embase, PubMed, Web of Science, CNKI, Weipu, and Wanfang until June 2022, such as randomized clinical trials (RCTs) evaluating different injected drugs for the treatment of pathological scars, including BTA, TAC, 5-Fu, VER, and BLE.

Results

This network meta-analysis of 1539 patients from 23 articles revealed that the most effective treatment for a pathological scar was TAC + BTA. The effective rate of TAC + BTA combination therapy was significantly different from that of the BTA, TAC, 5-Fu, VER, and BLM monotherapies. TAC+5-FU was more effective than TAC, 5-FU, VER, or BLM alone, and BTA was more effective than both TAC and 5-Fu. The effectiveness of VER and BLM was the same, but both were better than TAC and 5-Fu. No big differences were found between any of the other local injection therapies.

Conclusions

According to this network meta-analysis, a combination of keloid and hypertrophic scar injection treatment is recommended, especially BTA+TAC. However, this network meta-analysis has some limitations and must be further verified by larger samples and higher quality RCTs.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266
Five Year Analyses of Vegetation Response to Restoration using Rock Detention Structures in Southeastern Arizona, United States
Authors: Wilson Natalie R. , Norman Laura M.
Published: December 2022

Rock detention structures (RDS) are used in restoration of riparian areas around the world. The purpose of this study was to analyze the effect of RDS installation on vegetation in terms of species abundance and composition. We present the results from 5 years of annual vegetation sampling which focused on short term non-woody vegetation response within the riparian channel at 3 restoration sites across southeastern Arizona. We examined the potential ways that RDS can preserve native species, encourage wetland species, and/or introduce nonnative species using a Control-Impact-Paired-Series study design. Species composition and frequency were measured within quadrats and zones on an annual basis. Multivariate bootstrap analyses were performed, including Bray-Curtis dissimilarity index and non-metric multidimensional scaling ordination. We found that response to RDS was variable and could be related to the level of degradation or proximity to groundwater. The non-degraded site did not show a response to RDS and the severely degraded site showed a slight increase in vegetation frequency, but the moderately degraded site experienced a significant increase. At the moderately degraded site, located between two historic ciénegas (desert wetlands), species composition shifted and nonnative species invaded, dominating the vegetation increase at this location. At the severely degraded site, pre-existing wetland species frequency increased in response to the installation of RDS. These findings extend the understanding of RDS effects on vegetation, provide scenarios to help land and water resource managers understand potential outcomes, and can assist in optimizing success for restoration projects.
Preperitoneal Packing for Pelvic Fracture Bleeding Control: A Human Cadaver Study
Authors: Benjamin Elizabeth R. , Warriner Zachary , Demetriades Demetrios
Published: December 2022

Background

Preperitoneal packing (PPP) has been widely accepted as a damage control technique for severe bleeding from pelvic fractures. It is supposed to work by direct compression and tamponade of the bleeding source in the pelvis and it has been suggested to be effective for both venous and arterial bleeding. However, there is little evidence to support its efficacy or the ability to place the laparotomy pads in proximity of the desired location.

Methods

Bilateral PPP was performed on 10 fresh human cadavers, followed by laparotomy and measurements of resultant pad placement in relation to critical anatomic structures.

Results

A total of 20 assessments of laparotomy pad placement were performed. Following completion of PPP, a midline laparotomy was performed to determine proximity and closest distance of the laparotomy pads to sites of potential bleeding in pelvic fractures. In almost all cases, the pad placement was not contiguous with the key anatomic structure with mean placement 3.9 + 1.1 cm from the sacroiliac joint, 3.5 + 1.6 cm from the common iliac artery, 1.1 + 1.2 cm from the external iliac artery, 2.8 + 0.8 cm from the internal iliac artery, and 2.3 + 1.2 cm from the iliac bifurcation. Surgeon experience resulted in improved placement relative to the sacroiliac joint, however the pads still did not directly contact the target point.

Conclusion

This human cadaver study has shown that PPP, even in experienced hands, may not be placed in significant proximity of anatomical structures of interest. The role of PPP needs to be revisited with better clinical or human cadaver studies.
Wahrnehmung von Körpergewicht in der Behandlung von Anorexia nervosa
Authors: Behrens Simone C. , Ziser Katrin , Mack Isabelle , Giel Katrin
Published: December 2022

Hintergrund

Die Gewichtszunahme im Rahmen der stationären Behandlung von Anorexia nervosa führt typischerweise zu einer Aktualisierung von zwei Kernsymptomen: Angst vor Gewichtszunahme und hohem Stellenwert eines niedrig gewichtigen Körpers für den Selbstwert.

Ziel der Arbeit

Um den Nutzen einer biometrischen Figure-rating-Skala (FRS) für das Monitoring der Angst vor einer Gewichtszunahme und dem Körperbild während einer stationären Behandlung von Anorexia nervosa abschätzen zu können, wurden in einer Fallserie explorativ dynamische Entwicklungen in aktuell empfundenem und idealem Körpergewicht untersucht.

Material und Methoden

Es wird eine auf Unter- bis Normalgewicht optimierte biometrische FRS eingesetzt. Auf dieser Skala markierten 13 stationär behandelte Patientinnen mit der Diagnose einer typischen Anorexia nervosa wöchentlich nach dem Wiegetermin die beiden Körper, die dem aktuellen und dem idealen Körper der Patientinnen am ehesten entsprechen. Die Angaben wurden mit dem Gewichtsverlauf verglichen.

Ergebnisse

Insgesamt wurden 128 Wiegetermine ausgewertet. Es zeigten sich differenzierte, im Verlauf variierende Antworten, die drei typische Muster aufwiesen: (1) konstante Unzufriedenheit mit dem Körpergewicht und akkurate Einschätzung bei wenig Gewichtsveränderung, (2) konstante Unzufriedenheit mit dem Körpergewicht und akkurate Einschätzung bei konstanter Zunahme, (3) wechselnde Unzufriedenheit mit dem Körpergewicht und Genauigkeit, die abhängig vom Gewichtsverlauf springen.

Diskussion

Die Beobachtungen stützen die Sinnhaftigkeit von FRS für das Monitoring von Kognitionen und Affekten im Hinblick auf das eigene Körpergewicht in der stationären Behandlung von Anorexia nervosa. Die Interpretation der Skalen sollte im Einzelfall nur unter Hinzunahme weiterer Informationen erfolgen.
Diagnostik und Therapie organischer intraorbitaler Fremdkörper
Authors: Holtmann Christoph , Roth Mathias B. , Lanzman Rotem S. , Turowski Bernd , Antoch Gerald , Mackenzie Colin R. , Borrelli Maria , Geerling Gerd
Published: December 2022

Hintergrund

Orbitaverletzungen mit organischen Fremdkörpern sind eine klinische Herausforderung, da sie eine Vielzahl von Komplikationen verursachen können und manchmal zu irreversiblen Visuseinschränkungen führen.

Material und Methoden

Wir berichten über 5 konsekutive Fälle von Patienten mit organischen orbitalen Fremdkörpern, die zwischen 2012 und 2022 vorstellig wurden. Alter, Geschlecht, Zeitpunkt der Verletzung, Verletzungsmechanismus, bestkorrigierter Visus prä- und postoperativ, Vorhandensein von Schmerzen, Motilitätseinschränkungen, durchgeführte Bildgebung, Therapie sowie Komplikationen wurden ausgewertet.

Ergebnisse

Das mittlere Patientenalter betrug 62 ± 33 Jahre und das Geschlechterverhältnis war 4/1 (weiblich/männlich). In 4 Fällen war von einem Verletzungsgeschehen berichtet worden, welches im Mittel 4,6 (0/14 min/max) Tage zurücklag. Der bestkorrigierte Visus bei Erstvorstellung betrug 0,5 ± 0,2 dezimal und nach einem mittleren Follow-up von 12,7 (0,5/38 min/max) Monaten 0,67 ± 0,3 dezimal (p = 0,2). Der Grund der Erstvorstellung waren Schmerzen (n = 3) und/oder Doppelbilder (n = 2). Bei allen Patienten wurde eine Computertomographie (CT) durchgeführt. In allen 5 Fällen konnte das Fremdkörpermaterial chirurgisch vollständig entfernt werden, wobei eine Patientin wegen verbliebender Fremdkörper mehrmals operiert werden musste. Beim Fremdkörpermaterial handelte sich in 4 Fällen um Holz und einmal um Wachs.

Schlussfolgerung

Bei Orbitatraumata muss eine sorgfältige Wundexploration durchgeführt werden, insbesondere wenn der Unfallhergang anamnestisch nicht eindeutig zur klären und verbleibende Fremdkörper oder eine Perforationsverletzung nicht ausgeschlossen werden können. Die Bildgebung der Wahl ist die CT, die ggf. im postoperativen Verlauf erneut durchgeführt werden muss.
Daily life and psychosocial functioning of adults with congenital heart disease: a 40–53 years after surgery follow-up study
Authors: Pelosi C. , Kauling R. M. , Cuypers J. A. A. E. , van den Bosch A. E. , Helbing W. A. , Utens E. M. W. J. , Legerstee J. S. , Roos-Hesselink J. W.
Published: December 2022

Introduction

Nowadays, more than 90% of patients with congenital heart disease (CHD) reach adulthood. However, knowledge about their psychosocial functioning is limited.

Methods

Longitudinal cohort study of patients (n = 204, mean age: 50 years, 46.1% female) who were operated during childhood (< 15 years) between 1968 and 1980 for one of the following diagnoses: atrial septal defect, ventricular septal defect, pulmonary stenosis, tetralogy of Fallot or transposition of the great arteries. Psychosocial functioning was measured every 10 years, using standardized and validated questionnaires. Results were compared with the general Dutch population and over time.

Results

After a median follow-up of 45 [40–53] years adults with CHD had a significantly lower educational level, occupation level and employment rate, but better health-related quality of life and emotional functioning compared with normative data. Patients with moderate/severe defects reported significantly more self-perceived physical restrictions and lack of physical strength due to their CHD. Compared to 2011, in 2021 patients considered their CHD as more severe and they felt more often disadvantaged.

Conclusions

Overall, despite a lower education, occupation level and employment rate, our sample of patients with CHD had a positive perception of their life and  their psychosocial functioning was even better than the norm. Although the quality of life was very good, their view on their disease was more pessimistic than 10 years ago, especially for patients with moderate/severe CHD.

Graphic abstract
New Osia® OSI200 active transcutaneous bone-anchored hearing device: how I do it
Authors: Chew Dylan , Proctor Vicki , Ray Jaydip
Published: December 2022

Introduction

The new Osia® OSI200 implant incorporates a receiver coil and Piezo Power™ Transducer into one monolithic unit. Appropriate planning and surgical approach is needed for suitable positioning of the device.

Method

To optimise the surgical field and provide tension-free wound closure our team have adopted a versatile ‘Sheffield-S’ post-auricular incision which remains hidden within the hairline.

Conclusion

This incision provides adequate exposure for device placement and bone polishing/recessing. The soft tissue approach has resulted in improved operative efficacy particularly in those patients with irregular cortical bone or where pre-existing osseointegrated implants need to be removed or avoided.
Zopiclone versus placebo for short-term treatment of insomnia in patients with advanced cancer—a double-blind, randomized placebo-controlled clinical multicenter phase IV trial
Authors: Jakobsen Gunnhild , Sjue Karin , Paulsen Ørnulf , Kaasa Stein , Hjermstad Marianne Jensen , Klepstad Pål
Published: December 2022

Purpose

Insomnia is frequent in patients with advanced cancer, and a variety of pharmacological agents is used to treat this condition. Still, few clinical trials have investigated the effectiveness of pharmacological sleep therapies in this patient group. We aimed to study the short-term effectiveness of zopiclone on sleep quality in patients with advanced cancer who report insomnia.

Methods

A randomized, double-blind, placebo-controlled, parallel-group, multicenter, phase IV clinical trial in adult patients with metastatic malignant disease and insomnia. Patients were treated with zopiclone or placebo for six subsequent nights. Primary end point was patient-reported sleep quality during the final study night (NRS 0–10). Secondary end points were patient-reported sleep onset latency (SOL) and total sleep time (TST).

Results

Forty-one patients were randomized, with 18 being analyzed in the zopiclone group and 21 in the placebo group. Median age was 66, median Karnofsky performance score was 80, and 56% were male. Mean sleep quality at end of study was 2.9 (CI 2.3 to 3.8) in the zopiclone group and 4.5 (CI 3.6 to 5.4) in the placebo group (p = 0.021). At end of study, SOL was significantly different between the treatment groups: zopiclone 29 min (CI 13 to 51) and placebo 62 min (CI 40 to 87) (p = 0.045). TST was not significantly different across groups: zopiclone 449 min (403 to 496) and placebo 411 min (CI 380 to 440) (p = 0.167).

Conclusion

Zopiclone improved short-term patient-reported sleep quality in this cohort of patients with advanced cancer.

Trial registration

ClinicalTrials.gov Identifier: NCT02807922.