bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of programmed cell death protein 1 inhibitor in resection transformation treatment of esophageal cancer
Authors: Fan Mengying , Dai Liang , Yan Wanpu , Yang Yongbo , Lin Yao , Chen Keneng
Published: June 2021

Background

Surgery is an important component in the treatment of esophageal cancer. For patients not eligible for R0 resection, defined as locally advanced unresectable esophageal cancer, a new approach is to transform the cancer into a resectable state by preoperative treatment. However, preoperative chemo/radiation is unsatisfactory. Therefore, the aim of this study was to assess the safety and efficacy of chemo/radiotherapy combined with a programmed cell death protein 1 (PD‐1) inhibitor in the preoperative transformation of unresectable esophageal cancer.

Methods

Patients were evaluated as having unresectable, locally advanced esophageal cancer at baseline and were re‐evaluated as possible R0 resection candidates after PD‐1 inhibitor treatment. Patient data were derived from the prospective database of Peking University Cancer Hospital Thoracic Surgery I. Preoperative chemotherapy plus PD‐1 inhibitor treatment was defined as “transformation treatment.” The objective response rate, operation rate (proportion of patients who underwent surgery), R0 rate, and treatment safety were analyzed retrospectively.

Results

A total of 36 patients were enrolled into the study, and 94.4% (34/36) completed the planned transformation treatment. The objective response rate was 71.4% (25/35), and 75% (27/36) of the patients who completed transformation treatment underwent surgery. For these surgical patients, 81.5% (22/27) obtained R0 resection, and 22.2% (6/22) had pathological complete response (pCR). During transformation treatment, 22.2% (8/36) patients had ≥ grade 3 complications. There were no reoperations or perioperative deaths. After surgery, 29.6% (8/27) had ≥ grade 3 complications.

Conclusions

Esophagectomy after immunotherapy is safe with acceptable complications. Compared with chemotherapy alone, chemotherapy combined with immunotherapy had a more favorable transformation effect for patients with unresectable esophageal cancer.
Prior pars plana vitrectomy and its association with adverse intraoperative events during cataract surgery
Authors: Mudie Lucy I. , Patnaik Jennifer L. , Lynch Anne M. , Wise Ronald E.
Published: June 2021

Purpose

To evaluate the risk of intraoperative complications during cataract surgery in eyes with a prior vitrectomy.

Methods

A retrospective review of data from our cataract surgery registry of all patients undergoing cataract surgery between 2014 and 2018 at the University of Colorado Hospital. Univariate and multivariate analyses were conducted, accounting for intra‐patient correlation in subjects who underwent two cataract surgeries. The three main outcomes of interest, zonulopathy, posterior capsule (PC) tears and dropped lens fragments, were analysed for their association with prior pars plana vitrectomy (PPV) and clinical characteristics of patients such as history of prior intravitreal injection and surgeon level of experience.

Results

10 540 eyes of 6447 patients were included in the analysis. 371 (3.5%) eyes had a prior PPV. Eyes with a prior PPV experienced more zonulopathy during cataract surgery (adjusted OR 2.2, 95% confidence interval: 1.3–3.7, p = 0.002). Combined phacoemulsification/PPV were significantly more likely to experience all 3 complications, and this effect was even greater for eyes with a prior PPV.

Conclusions

All complications were rare; however, there was a significant association with prior PPV and intraoperative zonulopathy. Cataract surgeons must be aware of a patient’s prior vitrectomy and plan accordingly for the increased risk of intraoperative complications.
Autologous versus allogeneic versus umbilical cord sera for the treatment of severe dry eye disease: a double‐blind randomized clinical trial
Authors: Rodríguez Calvo‐de‐Mora Marina , Domínguez‐Ruiz Cayetano , Barrero‐Sojo Francisco , Rodríguez‐Moreno Gustavo , Antúnez Rodríguez Cristina , Ponce Verdugo Laura , Hernández Lamas María del Carmen , Hernández‐Guijarro Luisa , Villalvilla Castillo Jacinto , Fernández‐Baca Casares Idefonso , Prat Arrojo Isidro , Borroni Davide , Alba‐Linero Carmen , Zamorano‐Martín Francisco , Moreno‐Guerrero Antonio , Rocha‐de‐Lossada Carlos
Published: June 2021

Purpose

To measure the effects of Autologous serum (AS), Allogeneic Serum (HS) and Umbilical Cord serum (CS) eye drops in severe dry eye disease (DES), as well as to characterize and quantify several molecules in the three sera (albumin, fibronectin; Vitamin A and E; IgG, IgA and IgM; Transforming growth factor β; Epithelial growth factor).

Methods

Randomized, double‐blind, single‐centre, three‐arm (AS, HS and CS) clinical trial. Sixty‐three subjects were included with severe DES, 21 in each arm of the study. Visual acuity, Schirmer test, Breakup time (BUT), lissamine green, fluorescein staining measurements and a questionnaire were performed prior to treatment, and after one‐month and three‐month follow‐up.

Results

There was a significant main effect of time on visual acuities, Schirmer and BUT tests and fluorescein and lissamine green staining measurements and questionnaire scores (p = 0.015, p = 0.002, p < 0.001, p < 0.001, p = 0.031 and p < 0.001, respectively), although there was no significant interaction between time and serum type, nor between serum type and the test performed. Regarding the concentration of molecules, in our study AS contained significantly higher concentrations of IgA, IgG and fibronectin whereas HS contained significantly higher concentration of IgM, vitamins A and E, TGF and albumin. Contrary to previous reports, CS did not show higher concentration of any of the molecules analysed.

Conclusions and relevance

The three sera were effective in the treatment of severe DES. CS did not contain a higher proportion of molecules compared to AS/HS. More research is needed to assess the effect of AS in patients with DES and autoimmune diseases.
Hearing impairment among children in Sweden with foreign‐born parents and natives: A national Swedish study
Authors: Wändell Per , Li Xinjun , Carlsson Axel C. , Sundquist Jan , Sundquist Kristina
Published: June 2021

Aim

We aimed to estimate the risk of hearing impairment in children and adolescents with foreign‐born parents, compared to natives.

Methods

A nationwide study of 1,923,590 (51.4% boys) individuals aged 0–17 years of age in Sweden. Hearing impairment was defined as at least one registered diagnosis in the National Patient Register between 1 January 1998 and 31 December 2015. We used Cox regression analysis to estimate relative risk (hazard ratios with 99% confidence intervals) of incident hearing impairment in children with foreign‐born parents compared to Swedish‐born natives. Cox regression models were stratified by sex and adjusted for age, co‐morbidities and socioeconomic status.

Results

A total of 20,514 cases (53.7% boys) with extended sensorineural hearing impairment were registered, also including noise‐induced hearing impairment and that from other causes, and 6172 cases (50.0% boys) with conductive hearing impairment. The risk of extended sensorineural hearing impairment was higher in boys with parents from Asia, especially from Iraq, fully adjusted HR (99% CI) 1.30 (1.17–1.4), and lower in boys with parents from Nordic countries, South Europe, and North America.

Conclusion

The risk of extended sensorineural hearing impairment was higher in boys with parents from Asia, in particular Iraq.
Kairos care in a Chronos world: Midwifery care as model of resistance and accountability in public health settings
Authors: Niles Paulomi Mimi , Vedam Saraswathi , Witkoski Stimpfel Amy , Squires Allison
Published: June 2021

Background

In the United States (US), pregnancy‐related mortality is 2–4 times higher for Black and Indigenous women irrespective of income and education. The integration of midwifery as a fundamental component of standard maternity services has been shown to improve health outcomes and service user satisfaction, including among underserved and minoritized groups. Nonetheless, there remains limited uptake of this model in the United States. In this study, we examine a series of interdependent factors that shape how midwifery care operates in historically disenfranchised communities within the Unites States.

Methods

Using data collected from in‐depth, semi‐structured interviews, the purpose of this study was to examine the ways midwives recount, describe, and understand the relationships that drive their work in a publicly funded urban health care setting serving minoritized communities. Using a qualitative exploratory research design, guided by critical feminist theory, twenty full‐scope midwives working in a large public health care network participated. Data were thematically analyzed using Braun & Clarke's inductive thematic analysis to interpret data and inductively identify patterns in participants’ experiences.

Findings

The overarching theme “Kairos care in a Chronos World” captures the process of providing health‐promoting, individualized care in a system that centers measurement, efficiency, and pathology. Five subthemes support the central theme: (1) the politics of progress, (2) normalizing pathologies, (3) cherished connections, (4) protecting the experience, and (5) caring for the social body. Midwives used relationships to sustain their unique care model, despite the conflicting demands of dominant (and dominating) medical models.

Conclusion

This study offers important insight into how midwives use a Kairos approach to maternity care to enhance quality and safety. In order to realize equitable access to optimal outcomes, health systems seeking to provide robust services to historically disenfranchised communities should consider integration of relationship‐based strategies, including midwifery care.
Thromboembolic risk in patients with lung cancer receiving systemic therapy
Authors: Madison Cecelia J. , Melson Ryan A. , Conlin Michael J. , Gundle Kenneth R. , Thompson Reid F. , Calverley David C.
Published: June 2021

In this retrospective study, we investigated the influence of chemotherapy and immunotherapy on thromboembolic risk among United States Veterans with lung cancer during their first 6 months (180 days) following initiation of systemic therapy. Included patients received treatment with common front‐line agents that were divided into four groups: chemotherapy alone, immunotherapy alone, combination of chemo‐ and immunotherapies, and molecularly targeted therapies (control group). The cohort experienced a 7·4% overall incidence of thrombosis, but the analysis demonstrated significantly different rates among the different groups. We explored models incorporating multiple confounding variables as well as the competing risk of death, and these results indicated that both chemo‐ and immunotherapies were associated with an increased incidence of thrombosis, either alone or combined, compared with the control group (7·56%, P = 2.2 × 10–16; 10·2%, P = 2.2 × 10–16; and 7·87%, P = 2.4 × 10–14 respectively vs. 4·10%). The Khorana score was found to be associated with increased risk, as were vascular disease and metastases. We found an association between risk of thrombosis and the use of anticoagulation, accounting for several confounders, including history of thrombosis. Further study is warranted to better determine the drivers of thromboembolic risk and to identify ways to mitigate this risk for patients.
Self‐Regulatory Development in Children from Chinese Immigrant Families: Evidence for Commonality and Specificity
Authors: Chen Stephen H. , Deng Xue Fang , Zhang Emily , Wang Leslie K. , Liu Cindy H.
Published: June 2021

A central theme of acculturative specificity is the heterogeneity of the immigrant experience. This study integrated this application of the Specificity Principle with intergenerational transmission models of self‐regulation and identified both common and specific pathways in the self‐regulatory development of Chinese American children in immigrant families (N = 169, Mage = 9.2 years). Consistent with intergenerational transmission models, results indicated associations between parents’ and children’s effortful control, with the mediation of these associations via authoritarian parenting. Parental education, family income, and children’s bilingual proficiency were also uniquely associated with children’s executive function and effortful control. Together, findings provide new directions for research with ethnic minority immigrant families, and underscore the utility of within‐group approaches in advancing research on ethnic minority children’s development.
Socio‐economic inequalities in dental pain in children: A birth cohort study
Authors: Costa Francine dos Santos , Costa Caroline dos Santos , Chisini Luiz Alexandre , Wendt Andrea , Santos Iná da Silva dos , Matijasevich Alicia , Correa Marcos Britto , Demarco Flávio Fernando
Published: June 2021

Objective

To describe socio‐economic inequalities in dental pain and dental caries in 5 and 12‐year‐old children enrolled in a birth cohort.

Methods

This prospective study was carried out with children enrolled in a birth cohort in Pelotas, Brazil. The main outcome was history of dental pain in the last six months, collected at 5 and 12 years of age. Dental caries was evaluated as a secondary outcome. Inequalities dimensions were investigated using maternal education and family income. The inequalities indicators used were the slope index of inequality (SII) and the concentration index (CIX).

Results

Some 1,114 and 990 children were included in the analyses at the 5‐ and 12‐year follow‐ups, respectively. The prevalence of dental pain was 16.5% (95% CI 14.4‐18.8) at 5 years and 31.6% (95% CI 28.7‐34.6) at 12 years. Regarding SII, the difference in the prevalence of dental pain was 14 and 11 percentage points at 5 and 12 years, respectively, when comparing the less to the more maternal schooled strata. Relative inequalities (CIX) were found for dental pain only at age 12, considering family income (−5.8 CI95% −11.0; −0.6). Absolute socio‐economic inequalities were also observed for dental caries in both ages.

Conclusion

Dental pain in the last six months and dental caries was unequally distributed. Economically disadvantaged groups had the highest prevalence of dental pain and dental caries in both dentitions. Actions to tackle socio‐economic inequalities must be designed throughout life.
Histological assessment of mandibular bone tissue after guided bone regeneration with customized computer‐aided design/computer‐assisted manufacture titanium mesh in humans: A cohort study
Authors: Dellavia Claudia , Canciani Elena , Pellegrini Gaia , Tommasato Grazia , Graziano Daniele , Chiapasco Matteo
Published: June 2021

Background

Innovative customized computer‐aided design/computer‐assisted manufacture (CAD‐CAM) titanium meshes have been proposed for guided alveolar bone regeneration. Histological confirmation on the quality of the regenerated bone is needed. Purpose of the study is to assess the integration capabilities of these innovative meshes and to evaluate the histological features of the regenerated alveolar bone.

Materials and methods

Twenty partially edentulous patients, with severe posterior mandibular atrophy, underwent a guided bone regeneration technique by means of customized CAD‐CAM titanium mesh in association with a mixture of autologous bone in chips and deproteinized bovine bone (1:1). At 9 months of healing, titanium meshes and bone samples were collected and histomorphometrically analyzed.

Results

In all patients, implants were placed according to the original plan. At histologic analysis, mesh appeared well osseointegrated, except that in sites where membrane exposure occurred. In all sites, newly formed tissue resulted highly mineralized, well‐organized, and formed by 35.88% of new lamellar bone, 16.42% of woven bone, 10.88% of osteoid matrix, 14.10% of grafted remnants, and 22.72% of medullary spaces. Blood vessels were the 4% of the tissue.

Conclusions

Data from this study support the use of customized CAD/CAM titanium mesh for regeneration of vital, well‐structured, and vascularized alveolar bone.
Auswirkungen des „dunklen Rand‐Artefakts“ in dermatoskopischen Bildern auf die diagnostische Leistungsfähigkeit eines deep learning neuronalen Netzwerkes mit Marktzulassung
Authors: Sies Katharina , Winkler Julia K. , Fink Christine , Bardehle Felicitas , Toberer Ferdinand , Kommoss Felix K. F. , Buhl Timo , Enk Alexander , Rosenberger Albert , Haenssle Holger A.
Published: June 2021

Hintergrund und Ziele

Systeme künstlicher Intelligenz (durch „deep learning“ faltende neuronale Netzwerke; engl. convolutional neural networks, CNN) erreichen inzwischen bei der Klassifikation von Hautläsionen vergleichbar gute Ergebnisse wie Dermatologen. Allerdings müssen die Limitationen solcher Systeme vor flächendeckendem klinischem Einsatz bekannt sein. Daher haben wir den Einfluss des „dunklen Rand‐Artefakts“ (engl. dark corner artefact; DCA) in dermatoskopischen Bildern auf die diagnostische Leistung eines CNN mit Marktzulassung zur Klassifikation von Hautläsionen untersucht.

Patienten und Methoden

Ein Datensatz aus 233 Bildern von Hautläsionen (60 maligne und 173 benigne) ohne DCA (Kontrolle) wurde digital so modifiziert, dass kleine, mittlere oder große DCA zu sehen waren. Alle 932 Bilder wurden dann mittels CNN mit Marktzulassung (Moleanalyzer‐Pro®, FotoFinder Systems) auf Malignitätsscores hin analysiert. Das Spektrum reichte von 0–1; ein Score von > 0,5 wurde als maligne klassifiziert.

Ergebnisse

In der Kontrollserie ohne DCA erreichte das CNN eine Sensitivität von 90,0 % (79,9 %–95,3 %), eine Spezifität von 96,5 % (92,6 %–98,4 %) sowie eine Fläche unter der Kurve (AUC, area under the curve) der „receiver operating characteristic“ (ROC) von 0,961 (0,932–0,989). In den Datensätzen mit kleinen beziehungsweise mittleren DCA war die diagnostische Leistung vergleichbar. In den Bildersätzen mit großen DCA wurden allerdings signifikant höhere Malignitätsscores erzielt. Dies führte zu einer signifikant verminderten Spezifität (87,9 % [82,2 %–91,9 %], P < 0,001) sowie einer nicht signifikant erhöhten Sensitivität (96,7 % [88,6 %–99,1 %]). Die ROC‐AUC blieb mit 0,962 (0,935–0,989) unverändert.

Schlussfolgerungen

Die Klassifizierung mittels des CNN war bei dermatoskopischen Bildern mit kleinen oder mittleren DCA nicht beeinträchtigt, das System zeigte jedoch Schwächen bei großen DCA. Wenn Ärzte solche Bilder zur Klassifikation mittels CNN einreichen, sollten sie sich dieser Grenzen der Technologie bewusst sein.
PET/CT bei Patienten mit Melanom: eine Zweiklassenversorgung? Stand der Versorgung mit PET/CT in der primären Ausbreitungsdiagnostik des Melanoms
Authors: Matiszick Antonia , Völker Charlyn , Garbe Claus , Gutzmer Ralf , Forschner Andrea , Wagner Gunnar , Franzius Christiane , Czech Norbert , Schüssler Frank , Meier Friedegund , Sachse Michael Max
Published: June 2021

Hintergrund

Patienten mit Melanom wird ab dem Tumorstadium IIC eine Schnittbildgebung zur primären Ausbreitungsdiagnostik empfohlen. Die PET/CT ist bei der Ausbreitungsdiagnostik ab Tumorstadium III den anderen Verfahren in der diagnostischen Genauigkeit überlegen. Bisher gibt es keine aussagekräftigen Daten zur bundesweiten Verfügbarkeit, Nutzung und Kostenerstattung dieser Untersuchungsmethode.

Patienten und Methodik

Allen deutschen Hautkliniken und PET/CT‐Zentren wurden im März und April 2019 Fragebögen zur Versorgungssituation im Jahr 2018 zugeschickt.

Ergebnis

61,2 % der Hautkliniken (71/115) beziehungsweise 48,2 % der PET/CT‐Zentren (77/160) beteiligten sich an der Umfrage. Diese Hautkliniken betreuten 2018 insgesamt 22 645 Patienten mit Melanom. 16,8 % der Patienten ab Stadium IIC erhielten eine PET/CT zur primären Ausbreitungsdiagnostik. Eine Kostenerstattung bei allen gesetzlich beziehungsweise privat versicherten Patienten erfolgte in 40 % beziehungsweise 68 % der Hautkliniken (20/50 beziehungsweise 34/50 Hautkliniken). 68 % aller Hautkliniken berichteten über relevante Therapieänderungen infolge der PET/CT. Mehrwöchige Prüfungszeiträume durch die Krankenversicherungen und der Zeitaufwand bei der Antragstellung stellten die häufigsten Gründe für nicht erfolgte Beantragungen einer PET/CT durch die Hautkliniken dar. 90,2 % der PET/CT‐Zentren (46/51) berichteten über relevante Nebenbefunde.

Schlussfolgerungen

Bei der Verfügbarkeit der PET/CT in der primären Ausbreitungsdiagnostik ab Stadium IIC und der Kostenerstattung durch gesetzliche und private Krankenversicherungen sind deutliche Unterschiede erkennbar, so dass von einer Zweiklassenversorgung gesprochen werden kann.
Flüssigkeits‐assoziierte Hautschäden (FAH): Eine Best Practice Empfehlung von Wund‐D.A.CH
Authors: Dissemond Joachim , Assenheimer Bernd , Gerber Veronika , Hintner Marianne , Puntigam Magareta Jukic , Kolbig Norbert , Koller Sonja , Kurz Peter , Läuchli Severin , Probst Sebastian , Protz Kerstin , Steiniger Alfred , Strohal Robert , Traber Jürg , Kottner Jan
Published: June 2021

Wund‐D.A.CH. hat sich als Dachverband deutschsprachiger Wundbehandlungs‐Fachgesellschaften in dieser Best Practice Empfehlung mit Flüssigkeits‐assoziierten Hautschäden (FAH) befasst, die im englischsprachigen Raum als moisture‐associated skin damage (MASD) bezeichnet werden. In diesem Expertenkonsens werden die Krankheitsbilder Inkontinenz‐assoziierte Dermatitis (IAD), intertriginöse Dermatitis, inklusive Intertrigo, gramnegativer Fußinfekt und toxische Kontaktdermatitis, inklusive Wundumgebungsdermatitis und peristomale Dermatitis differenziert vorgestellt. Die Krankheitsbilder haben gemeinsam, dass es infolge der Verschlechterung der Hautintegrität durch längere Exposition gegenüber Körperflüssigkeiten wie Urin, Stuhl, Schweiß oder Wundexsudat zu physikalisch‐irritativer und/oder chemischer Reizung kommt. Zudem spielen weitere Begleiterkrankungen und Kofaktoren eine wichtige Rolle.

Die Diagnostik der interdisziplinär und interprofessionell relevanten FAH gestaltet sich im klinischen Alltag schwierig, da es aktuell keine einheitlichen Definitionen und viele relevante Differenzialdiagnosen gibt. Wirksame Strategien der Prävention und Therapie sind beispielsweise Kontinenzmanagement, Verwendung leistungsfähiger aufsaugender Hilfsmittel mit guter Retention sowie konsequenter Hautschutz und adäquate Hautpflege. Ein weiterer wichtiger Aspekt ist die Edukation von Patienten und Angehörigen über die Entstehung, Behandlung und Vermeidung der FAH.
Forschen für die Praxis: Die Rolle epidermaler Proteasen in der Progression der rezessiven dystrophen Epidermolysis bullosa
Authors: Nauroy Pauline , Zingkou Eleni , Sotiropoulou Georgia , Kiritsi Dimitra
Published: June 2021

Die rezessiv dystrophe Epidermolysis bullosa (RDEB) ist eine unheilbare schwere Hautkrankheit durch den Verlust von Kollagen VII, eines extrazellulären Proteins, das die Hautkohäsion sichert. RDEB manifestiert sich mit Blasenbildung und wiederholten Wund‐ und Heilungszyklen, die zu Fibrose und früher Entwicklung aggressiver Plattenepithelkarzinome der Haut führen. Die Entzündung und die damit verbundene Fibrose spielen eine entscheidende Rolle in der Pathogenese der Erkrankung. Therapien, die diese adressieren, könnten neue Behandlungsoptionen für RDEB darstellen. Kallikreine (KLK) sind epidermal sezernierte Proteasen, die zur Desquamation und Entzündung der Haut beitragen. Sie sind nicht nur in die Pathogenese mancher entzündlicher Hautkrankheiten involviert, sondern interessanterweise auch an der Initiation und Progression verschiedener Krebsarten beteiligt. Ziel unseres Projektes ist es, die Rolle der KLK bei Entzündung, Fibrose und Tumorentwicklung bei RDEB zu entschlüsseln.
Behandlungszufriedenheit bei chronischer Urtikaria unter leitliniengerechter Therapie
Authors: Rönsch Henriette , Berndt Katja , Bauer Andrea
Published: June 2021

Hintergrund und Ziele

Patienten mit chronischer Urtikaria sind oft mit ihrer Behandlung unzufrieden. Studienziel war die Untersuchung von Patientenzufriedenheit, Kontrolle der chronischen Urtikaria, Behandlungszielen, Selbstbehandlungskompetenz, Wissen um die Erkrankung sowie Faktoren, welche die Behandlungszufriedenheit beeinflussen.

Patienten und Methodik

87 erwachsene Patienten mit chronischer Urtikaria, die zuvor nicht ausreichend mit oralen Antihistaminika behandelt werden konnten, erhielten sechs Monate lang eine leitlinienbasierte Therapie und füllten Fragebögen aus.

Ergebnisse

In diese Studie wurden Patienten mit chronischer spontaner (80 %) und/oder induzierbarer Urtikaria (CIndU, 32 %) eingeschlossen. Signifikante mediane Verbesserungen wurden mittels Urtikaria‐Kontrolltest (UCT, von 7 auf 11), Urtikaria‐Aktivitäts‐Score für Patienten mit chronischer spontaner Urtikaria (von 19 auf 10) und in der Behandlungszufriedenheit (von 5,2 auf 8,4) beobachtet. Nach sechsmonatiger Behandlungszeit wurden sechs unabhängige, signifikante Einflussfaktoren der Behandlungszufriedenheit identifiziert (negativ: männliches Geschlecht, CIndU, Schlafstörungen; positiv: UCT, Zufriedenheit mit der Behandlung zu Studienbeginn, empfundene Kompetenz der Studienärztin). Eine adäquate Kontrolle der Urtikaria (UCT ≥ 12) wurde bei 19 % der Patienten mit CIndU und 61 % der Patienten ohne CIndU erreicht.

Schlussfolgerungen

Bei Patienten mit chronischer Urtikaria, die zuvor nicht ausreichend mit Antihistaminika behandelt werden konnten, verbesserten sich Krankheitskontrolle und Behandlungszufriedenheit unter sechsmonatiger leitliniengerechter Therapie signifikant. Eine adäquate Krankheitskontrolle erfordert bei vielen Patienten mehrere Arztkonsultationen und ist für die CIndU erheblich schwieriger zu erreichen.
Mechanism, specificity, and function of FANCD2‐FANCI ubiquitination and deubiquitination
Authors: Lemonidis Kimon , Arkinson Connor , Rennie Martin L. , Walden Helen
Published: June 2021

Fanconi anemia (FA) is a rare genetic disorder caused by mutations in any of the currently 22 known FA genes. The products of these genes, along with other FA‐associated proteins, participate in a biochemical pathway, known as the FA pathway. This pathway is responsible for the repair of DNA interstrand cross‐links (ICL) and the maintenance of genomic stability in response to replication stress. At the center of the pathway is the monoubiquitination of two FA proteins, FANCD2 and FANCI, on two specific lysine residues. This is achieved by the combined action of the UBE2T ubiquitin‐conjugating enzyme and a large multicomponent E3 ligase, known as the FA‐core complex. This E2‐E3 pair specifically targets the FANCI‐FANCD2 heterodimer (ID2 complex) for ubiquitination on DNA. Deubiquitination of both FANCD2 and FANCI, which is also critical for ICL repair, is achieved by the USP1‐UAF1 complex. Recent work suggests that FANCD2 ubiquitination transforms the ID2 complex into a sliding DNA clamp. Further ubiquitination on FANCI does not alter this closed‐on‐DNA ID2 conformation. However, the resulting dimonoubiquitinated complex is highly resistant to USP1‐UAF1 deubiquitination. This review will provide an update on recent work focusing on how specificity in FANCD2 ubiquitination and deubiquitination is achieved. Recent findings shedding light to the mechanisms, molecular functions, and biological roles of FANCI/FANCD2 ubiquitination and deubiquitination will be also discussed.

Enzymes

UBA1 (6.2.1.45), UBE2T (2.3.2.23), FANCL (2.3.2.27), USP1 (3.4.19.12).
CuCrZr processed by laser powder bed fusion—Processability and influence of heat treatment on electrical conductivity, microstructure and mechanical properties
Authors: Wegener Thomas , Koopmann Julian , Richter Julia , Krooß Philipp , Niendorf Thomas
Published: June 2021

CuCrZr parts were fabricated by laser beam powder bed fusion (LB‐PBF) technique and subjected to different heat treatments. As a result, four different conditions were considered for further investigations, that is, the as‐built condition, conditions of maximum hardness (MH) and maximum electrical conductivity (MC), and a condition representing a compromise between hardness and conductivity (H&C). Microstructural evolution and performance under monotonic and cyclic loading were studied. Fracture surfaces revealed significant volume fractions of process‐induced defects such as lack‐of‐fusion (LoF) and pores, irrespective of the condition considered. The effect of these defects on the tensile behavior was found to be marginal, whereas the fatigue performance was noticeably affected due to multiple crack nucleation promoted by large LoF defects. Assessment by computed tomography (CT) revealed a strong influence of the geometry and therefore, of the scan path length, on resulting microstructure and defect population eventually rationalizing obvious discrepancies to the initial process parameter and material density optimization study.
Enhanced electrical properties in W/Cu co‐doped CaBi2Nb2O9 high‐temperature piezoelectric ceramics
Authors: Chen Axiang , Chen Zhenning , Liu Yang , Zheng Peng , Bai Wangfeng , Li Lili , Wen Fei , Zheng Liang , Zhang Yang
Published: June 2021

CaBi2Nb2O9 (CBN)‐based high‐temperature piezoelectric ceramics with the formula of CaBi2Nb2−x(W3/4Cu1/4)xO9 were prepared via the traditional solid‐state reaction method. Both the bulk microstructure and the electrical performance of the W/Cu co‐doped CBN‐based ceramics were systematically investigated. The results indicated that the W/Cu incorporation into the Nb‐site altered the crystal structure, which enhanced the piezoelectricity and resistivity. The ceramic with the composition CaBi2Nb1.96(W3/4Cu1/4)0.04O9 exhibited good performance with a high d33 (~14 pC/N) and TC (~939℃). Moreover, the ceramic exhibited a good electrical resistivity (ρ) of 4.91 × 105 Ω·cm and a low dielectric loss (tanδ) of 0.1 at 600℃. Furthermore, the ceramic that was annealed at 900℃ for 2 h presented a d33 value of 13 pC/N, thus indicating good thermal stability of the piezoelectric properties. All these results confirm that the CaBi2Nb1.96(W3/4Cu1/4)0.04O9 ceramic may act as a potential promising candidate for piezoelectric device applications in high‐temperature environments.
Laboratory testing for suspected COVID‐19 vaccine–induced (immune) thrombotic thrombocytopenia
Authors: Favaloro Emmanuel J.
Published: June 2021

COVID‐19 (coronavirus disease 2019) represents a pandemic, and several vaccines have been produced to prevent infection and/or severe sequelae associated with SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2) infection. There have been several reports of infrequent post vaccine associated thrombotic events, in particular for adenovirus‐based vaccines. These have variously been termed VIPIT (vaccine‐induced prothrombotic immune thrombocytopenia), VITT (vaccine‐induced [immune] thrombotic thrombocytopenia), VATT (vaccine‐associated [immune] thrombotic thrombocytopenia), and TTS (thrombosis with thrombocytopenia syndrome). In this report, the laboratory test processes, as utilised to assess suspected VITT, are reviewed. In published reports to date, there are notable similarities and divergences in testing approaches, potentially leading to identification of slightly disparate patient cohorts. The key to appropriate identification/exclusion of VITT, and potential differentiation from heparin‐induced thrombocytopenia with thrombosis (HITT), is identification of potentially differential test patterns. In summary, testing typically comprises platelet counts, D‐dimer, fibrinogen, and various immunological and functional assays for platelet factor 4 (PF4) antibodies. In suspected VITT, there is a generally highly elevated level of D‐dimer, thrombocytopenia, and PF4 antibodies can be identified by ELISA‐based assays, but not by other immunological assays typically positive in HITT. In addition, in some functional platelet activation assays, standard doses of heparin have been identified to inhibit activation in suspected VITT, but they tend to augment activation in HITT. Conversely, it is also important to not over‐diagnose VITT, given that not all cases of thrombosis post vaccination will have an immune basis and not all PF4‐ELISA positive patients will be VITT.
The outstanding rooting1 mutation gene maintains shoot growth and grain yield through promoting root development in rice under water deficit field environments
Authors: Hasegawa Tomomi , Wainaina Cornelius Mbathi , Shibata Akihide , Lucob‐Agustin Nonawin , Makihara Daigo , Kikuta Mayumi , Menge Daniel Makori , Gichuhi Emily Waringa , Samejima Hiroaki , Kano‐Nakata Mana , Kimani John Munji , Musila Ruth Nzisa , Yamauchi Akira , Inukai Yoshiaki
Published: June 2021

Drought is one of the most serious constraints to rice cultivation, even under alternate wetting and drying (AWD), which is a water‐saving management practice. In rice, enhanced root development is essential for stable shoot growth, adaptability and productivity under water deficit environments. We identified and characterized outstanding rooting1 (our1) rice mutant using hydroponics. The present study sought to examine morphological root traits of the our1 mutant and the role of the mutation gene in shoot growth and yield under AWD. Thus, we evaluated the growth performance of the our1 rice mutant in pot experiments and under field AWD conditions in Kenya. The experiments were conducted with our1 mutant, its wild type and their progenies under both AWD and continuously waterlogged (CWL) conditions. The our1 mutant possessed a well‐developed root system and exhibited particularly enhanced thin root development, which was maintained from the early vegetative stage through the reproductive stage under both pot and field AWD management. This enhanced root development promoted shoot growth through increased water uptake during rewatered conditions between drought periods in AWD. In addition, the our1 mutant showed enhanced shoot growth during the reproductive stage, resulting in the maintenance of yield under AWD fields. Genotypes harbouring our1 mutation gene showed higher yields compared to wild‐type genotypes which was attributed to their higher photosynthetic ability as a result of enhanced root activity. These results suggest the important role of a well‐developed root system architecture and enhanced root function in stabilizing rice yields under water‐limited environments. Our findings indicate that the our1 mutation gene can serve as a novel breeding material to mitigate the impact of transient drought stress on yield under AWD.
Broadband excited Na3Tb(PO4)2:Ce3+/Eu2+ green/yellow‐emitting phosphors with high color purity for LED‐based application
Authors: Huang Shuai , Yu Lixin , Peng Kangliang , Zhao Youjun , Wang Jindi , Shang Mengmeng
Published: June 2021

To enhance the display quality of light‐emitting diodes (LEDs), it is of great significance to exploit green/yellow‐emitting phosphors with narrow emission band, high quantum yield, and excellent color purity to satisfy the application. Herein, orthophosphate‐based green/yellow‐emitting Na3Tb(PO4)2:Ce3+/Eu2+ (NTPO:Ce3+/Eu2+) phosphors have been successfully synthesized by a facile solid‐state reaction method. The absorption band of NTPO samples was extended to the near‐ultraviolet region and the absorption efficiency was significantly improved owing to a highly efficient energy transfer from Ce3+/Eu2+ ion to Tb3+ ion in NTPO host certified by time‐resolved PL spectra. Upon 300 nm excitation, the NTPO:Ce3+ is characterized by ultra‐narrow‐band green emission of Tb3+ with an absolute quantum yield of 94.5%. Unexpectedly, NTPO:Eu2+ emits bright yellow light with a color purity of 73% as a result of the blending of green light emission from Tb3+ and red light emission from Eu3+. The thermal stability has been improved by controlling the stoichiometric ratio of Na+. The prototype white LED used yellow‐emitting NTPO:Eu2+ phosphor has higher color‐rendering index (Ra = 83.5), lower correlated color temperature (CCT = 5206 K), and closer CIE color coordinates (0.338, 0.3187) to the standard white point at (0.333, 0.333) than that used green‐emitting NTPO:Ce3+ phosphor, indicating the addition of the yellow light component improved the Ra of the trichromatic (RGB) materials.
Pore structure characteristics of MgO–SiO2binder
Authors: Shah Vineet , Dhandapani Yuvaraj , Scott Allan
Published: June 2021

This paper reports on an investigation into the pore structure characteristics of MgO–SiO2binders. Paste specimens were prepared using two MgO/SiO2ratios (1 and 1.5), two silica sources (Silica fume‐SF and Metakaolin‐MK), two water to binder ratios (0.5 and 0.6) and compared to a portland cement (PC) control mix. Mercury intrusion porosimetry was used to understand the evolution of pore structural features of the binder with hydration period. A continued reduction in porosity and refinement of pores was observed with the progress in hydration irrespective of the type of the silica source or the initial MgO/SiO2ratio. The MgO–MK mixes exhibited a finer and denser microstructure as compared to the equivalent MgO–SF mixes. The formation of hydrotalcite in addition to M‐S‐H in MgO–MK mixes was postulated to be the primary reason for the difference in microstructural characteristics, compared to MgO–SF mixes. The space‐filling capacity of hydration products of MgO–MK binder was found to be better than PC.
Enhanced aging behaviors and electric thermal stabilities in 0.75BiFeO3–0.25BaTiO3 piezoceramics by Mn modifications
Authors: Guo Jian , Chen Jianguo , Cheng Jinrong , Tan Qi
Published: June 2021

Lead‐free 0.75BiFeO3–0.25BaTiO3 (0.75BF–0.25BT) ceramics have been extensively studied because of their high Curie temperature. The aging behavior and thermal stability of piezoceramics play decisive roles in their device applications. In this work, effects of Mn doping on the phase structure, aging behavior, and thermal stability of 0.75BF–0.25BT ceramics were characterized and related mechanisms were investigated. With the increase in Mn content, the typical rhombohedral phase of 0.75BF–0.25BT ceramics changed to the coexistence of pseudo‐cubic and rhombohedral phases. Mn modification enhanced the aging behavior and thermal stability of ceramics obviously. The aging rates of d33 and kp for 0.75BF‐0.25BT ceramics with 1.0 mol% Mn are 1.3% and 1.1%, respectively, which are only 1/4 those values for the undoped ceramics. The variation of εr of 0.75BF‐0.25BT ceramics with 1.0 mol% Mn is half of undoped ceramics under 500℃. The depoling temperature of 0.75BF‐0.25BT ceramics with 1.0 mol% Mn was 450℃, which is about 200℃ higher than that of undoped ceramics. The enhanced aging behavior results from the decreased defect concentrations, and the better thermal stability is owing to the significantly improved poling state due to the enhanced resistivity, large grain size, and decreased crystal distortion by Mn modification. These results reflect that a proper amount of Mn doping is an effective way to enhance the aging behavior and electric thermal stability.
Analytical solutions of moisture‐chloride ion coupled transport in unsaturated concrete
Authors: Wang Yao , Bai Yu , Xi Yunping
Published: June 2021

Studies of chloride‐induced corrosion in reinforced concrete structures are performed based on the reliable predictions of chloride and moisture distributions in concrete. This paper adopted the Laplace Transformation and the inverse Laplace Transformation to obtain the analytical solutions of the moisture‐chloride two‐way coupled transport processes. Additionally, the model has involved with realistic material parameters to predict the internal distributions of relative humidity and free chloride ions in concrete samples. To illustrate the accuracy of the present model, the calculations were compared with the available experimental results, and good agreements were obtained. It indicates that the present analytical model can successfully characterize the two‐way coupling effects between chloride transport and moisture diffusion in concrete; and the model can provide the distribution profiles of both chloride and relative humidity in concrete, which are useful for predicting the service life of reinforced concrete structures.
Inventory of assessment practices in people with profound intellectual and multiple disabilities in three European countries
Authors: Wessels Marleen D. , van der Putten Annette A. J. , Paap Muirne C. S.
Published: June 2021

Background

Knowledge about the quality of assessment methods used in the support of people with profound intellectual and multiple disabilities (PIMD) is scarce. This study aimed to provide an overview of the assessment methods used in practice and to examine whether these instruments were studied for their psychometric properties for people with PIMD.

Method

Professionals (N = 148) from three European countries completed a survey on assessment practices. We performed a literature search to find information about the psychometric properties of the instruments that were identified in the survey.

Results

Of the participants, 78.1% used assessments that were not developed for people with PIMD. Documentation on psychometric properties was found for 8 out of 116 instruments.

Conclusions

Most of the instruments in use were not designed for people with PIMD, and information about their quality is lacking. Guidelines are needed regarding the use and development of assessment methods for people with PIMD.
The pandemic semesters: Examining public opinion regarding online learning amidst COVID‐19
Authors: Asare Andy Ohemeng , Yap Robin , Truong Ngoc , Sarpong Eric Ohemeng
Published: June 2021

The current educational disruption caused by the COVID‐19 pandemic has fuelled a plethora of investments and the use of educational technologies for Emergency Remote Learning (ERL). Despite the significance of online learning for ERL across most educational institutions, there are wide mixed perceptions about online learning during this pandemic. This study, therefore, aims at examining public perception about online learning for ERL during COVID‐19. The study sample included 31,009 English language Tweets extracted and cleaned using Twitter API, Python libraries and NVivo, from 10 March 2020 to 25 July 2020, using keywords: COVID‐19, Corona, e‐learning, online learning, distance learning. Collected tweets were analysed using word frequencies of unigrams and bigrams, sentiment analysis, topic modelling, and sentiment labeling, cluster, and trend analysis. The results identified more positive and negative sentiments within the dataset and identified topics. Further, the identified topics which are learning support, COVID‐19, online learning, schools, distance learning, e‐learning, students, and education were clustered among each other. The number of daily COVID‐19 related cases had a weak linear relationship with the number of online learning tweets due to the low number of tweets during the vacation period from April to June 2020. The number of tweets increased during the early weeks of July 2020 as a result of the increasing number of mixed reactions to the reopening of schools. The study findings and recommendations underscore the need for educational systems, government agencies, and other stakeholders to practically implement online learning measures and strategies for ERL in the quest of reopening of schools.
Prognostic value of nocturnal blood pressure dipping on cardiovascular outcomes in Chinese patients with hypertension in primary care
Authors: Lo Ling , Hung Sandra W. S. , Chan Sara S. W. , Mak Chui‐Ling , Chan Pang‐Fai , Chao David V. K.
Published: June 2021

Meta‐analyses showed that non‐dipping of nocturnal blood pressure on ambulatory blood pressure monitoring (ABPM) was associated with adverse cardiovascular prognosis. However, these prognostic studies were mainly conducted in Caucasian and Japanese populations. Whether this association applies to Chinese patients remained uninvestigated. A total of 1199 Chinese patients with hypertension undergoing ABPM between January 2012 and December 2014 were recruited retrospectively from five public hypertension referral clinics in Hong Kong. Patients were followed up for a mean 6.42 years for cardiovascular morbidity and mortality and all‐cause mortality. Time to event of different dipping patterns was compared by Kaplan‐Meier curves. Hazard ratios (HR) were obtained by Cox proportional hazard models with patient demographics and confounding factors adjusted in multivariate regression. A total of 163 end point events occurred in the period. Normal dipping was observed in 446 patients (37.2%), non‐dipping in 490 (40.9%), reverse dipping in 161 (13.4%), and extreme dipping in 102 (8.5%). Kaplan‐Meier analyses showed inferior survival in non‐dippers and reverse dippers for total cardiovascular events and coronary events but not cerebrovascular events. After adjusting for confounding factors, Cox regressions showed HRs 1.166 (CI 0.770‐1.764) and 1.173 (CI 0.681‐2.021) in non‐dippers and reverse dippers for total cardiovascular events, and HRs 1.320 (CI 0.814‐2.141) and 1.476 (CI 0.783‐2.784) for coronary events. Nocturnal blood pressure non‐dipping, and to a greater extent reverse dipping, demonstrated adverse cardiovascular prognosis in a cohort of Chinese patients with hypertension in Hong Kong. Further focused studies on cerebrovascular events and reverse dippers were warranted to refine risk stratification.
What are important predictors of perceived stigmatization in patients with psoriasis? Commentary to ‘Significance of chronic pruritus for intrapersonal burden and interpersonal experiences of stigmatization and sexuality in patients with psoriasis’ by R. Sommer et al.
Authors: Kupfer J. , Schut C.
Published: June 2021

Linked article: R. Sommer, et al. J Eur Acad Dermatol Venereol 2021; 35: 1553–1561. https://doi.org/10.1111/jdv.17188.
Thermography for performance evaluation of a compact, air disperser equipped hot air dryer
Authors: Sabat Mousumi , Kotwaliwale Nachiket , Giri Saroj K.
Published: June 2021

A hot air dryer has been developed for achieving uniform temperature distribution throughout the drying trays with the use of an air disperser. Comparative experiments were conducted with and without the use of the disperser. Then, 1 mm thick potato slices were dried at 50, 55, and 60°C and 1.5 m/s air velocity at different locales of the tray. Validation of drying rate uniformity was done by studying the temperature distribution on the drying tray using thermal imaging and measuring the chromatic, textural, and morphological properties of dried potato slices. Without the air disperser, the average temperature and average initial drying rate measured after 30 min at five different points on the bottom tray varied from 42.5 to 52.2°C and 0.086 to 0.185 g water/min, respectively, whereas the variation was only in the range of 49.0–49.6°C and 0.182 and 0.206 g water/min when the air disperser was used at a set dryer temperature of 50°C. Similarly, drying rates at all the positions in different trays were observed to be in close proximity throughout the drying period with the presence of air disperser; however, without it, the drying rate was found to be higher at the center of the tray than other four points. Similar observations were also made for all the qualitative parameters of potato slices at all drying temperatures.

Practical Applications

The dryer has provision for placement of different types of imaging devices and sensors for online monitoring of process parameters and the product being dried. It has been designed for nondestructive study of the drying progression using machine vision system. Such a dryer will be especially useful for controlled drying experiments and laboratory simulation of different hot air drying processes.