bluuebunny/crossref_metadata_2025 huggingface dataset:
Gesundheitliche Folgen sozialer Isolation: Qualitative Studie zu psychosozialen Belastungen und Ressourcen älterer Menschen im Zusammenhang mit der COVID-19-Pandemie
Authors: Welzel Franziska D. , Schladitz Katja , Förster Franziska , Löbner Margrit , Riedel-Heller Steffi G.
Published: February 2021

Hintergrund

Mit dem SARS-CoV-2-Ausbruchsgeschehen („Severe acute respiratory syndrome coronavirus type 2“, COVID-19) ist es zu einer Verunsicherung über Erkrankungsrisiko und Folgen der Virusinfektion in der Bevölkerung gekommen. Ältere Menschen gelten als Risikogruppe für schwere Infektionsverläufe und wurden im besonderen Maße zu sozialer Distanzierung aufgerufen. Gleichzeitig wurde die Sorge geäußert, dass sich Erkrankungsrisiko und soziale Isolation negativ auf die psychische Gesundheit älterer Menschen auswirken würden.

Ziele der Arbeit

Erfassung von psychosozialen Belastungen, vorhandenen Bewältigungsstrategien, Unterstützungsbedarfen und Kohärenzerleben älterer Menschen im Zusammenhang mit dem COVID-19-Ausbruchsgeschehen.

Material und Methoden

Die Studie folgt einem qualitativen Untersuchungsdesign. Zwischen Mai und Juni 2020 wurden telefonische Interviews mit 11 älteren Personen (70+) durchgeführt. Die Durchführung der Interviews erfolgte leitfadengestützt. Die Daten wurden mittels Audioaufzeichnung festgehalten, transkribiert und inhaltsanalytisch nach Mayring und Fenzl (2019) unter Nutzung von MAXQDA ausgewertet.

Ergebnisse

Die Probanden waren im Durchschnitt 74,8 Jahre alt. Bei den Befragten zeigte sich ein überwiegend stabiles Befinden und gutes Zurechtkommen mit dem COVID-19-Geschehen. Als wesentliche Ressourcen wurden Lebenserfahrung, frühere bewältigte Krisen, eine optimistische Grundhaltung und Einsicht in die Notwendigkeit der Maßnahmen genannt. Externe Unterstützungsangebote seien kaum in Anspruch genommen worden. Das Schließen seniorenspezifischer Treffpunkte wurde kritisch bewertet.

Diskussion

Ältere Menschen scheinen sich ihre psychosoziale Gesundheit trotz COVID-19-Pandemie überwiegend zu erhalten. Die Bedeutsamkeit mentaler Ressourcen älterer Menschen für die Unterstützung jüngerer Generationen bleibt bisher unerkannt.
No impact of a short-term climatic “El Niño” fluctuation on gut microbial diversity in populations of the Galápagos marine iguana (Amblyrhynchus cristatus)
Authors: Ibáñez Alejandro , Bletz Molly C. , Quezada Galo , Geffers Robert , Jarek Michael , Vences Miguel , Steinfartz Sebastian
Published: February 2021

Gut microorganisms are crucial for many biological functions playing a pivotal role in the host’s well-being. We studied gut bacterial community structure of marine iguana populations across the Galápagos archipelago. Marine iguanas depend heavily on their specialized gut microbiome for the digestion of dietary algae, a resource whose growth was strongly reduced by severe “El Niño”-related climatic fluctuations in 2015/2016. As a consequence, marine iguana populations showed signs of starvation as expressed by a poor body condition. Body condition indices (BCI) varied between island populations indicating that food resources (i.e., algae) are affected differently across the archipelago during ‘El Niño’ events. Though this event impacted food availability for marine iguanas, we found that reductions in body condition due to “El Niño”-related starvation did not result in differences in bacterial gut community structure. Species richness of gut microorganisms was instead correlated with levels of neutral genetic diversity in the distinct host populations. Our data suggest that marine iguana populations with a higher level of gene diversity and allelic richness may harbor a more diverse gut microbiome than those populations with lower genetic diversity. Since low values of these diversity parameters usually correlate with small census and effective population sizes, we use our results to propose a novel hypothesis according to which small and genetically less diverse host populations might be characterized by less diverse microbiomes. Whether such genetically depauperate populations may experience additional threats from reduced dietary flexibility due to a limited intestinal microbiome is currently unclear and calls for further investigation.
On thermal stability of piezo-flexomagnetic microbeams considering different temperature distributions
Authors: Malikan Mohammad , Wiczenbach Tomasz , Eremeyev Victor A.
Published: February 2021

By relying on the Euler–Bernoulli beam model and energy variational formula, we indicate critical temperature causes in the buckling of piezo-flexomagnetic microscale beams. The corresponding size-dependent approach is underlying as a second strain gradient theory. Small deformations of elastic solids are assessed, and the mathematical discussion is linear. Regardless of the pyromagnetic effects, the thermal loading of the thermal environment varies in three states along with the thickness, which is linear, uniform, and parabolic forms. We then establish the results by developing consistent shape functions that independently evaluate boundary conditions. Next, we analytically develop and explore the effective properties of the studied beam concerning vital factors. It was achieved that piezomagnetic-flexomagnetic microbeams are more affected by the thermal environment while the thermal loading is parabolically distributed across the thickness, particularly when the boundaries involve simple supports.
Comparable incidence of periprosthetic tibial fractures in cementless and cemented unicompartmental knee arthroplasty: a systematic review and meta-analysis
Authors: Burger Joost A. , Jager Tjeerd , Dooley Matthew S. , Zuiderbaan Hendrik A. , Kerkhoffs Gino M. M. J. , Pearle Andrew D.
Published: February 2021

Purpose

(I) To determine the incidence of periprosthetic tibial fractures in cemented and cementless unicompartmental knee arthroplasty (UKA) and (II) to summarize the existing evidence on characteristics and risk factors of periprosthetic fractures in UKA.

Methods

Pubmed, Cochrane and Embase databases were comprehensively searched. Any clinical, laboratory or case report study describing information on proportion, characteristics or risk factors of periprosthetic tibial fractures in UKA was included. Proportion meta-analysis was performed to estimate the incidence of fractures only using data from clinical studies. Information on characteristics and risk factors was evaluated and summarized.

Results

A total of 81 studies were considered to be eligible for inclusion. Based on 41 clinical studies, incidences of fractures were 1.24% (95%CI 0.64–2.41) for cementless and 1.58% (95%CI 1.06–2.36) for cemented UKAs (9451 UKAs). The majority of fractures in the current literature occurred during surgery or presented within 3 months postoperatively (91 of 127; 72%) and were non-traumatic (95 of 113; 84%). Six different fracture types were observed in 21 available radiographs. Laboratory studies revealed that an excessive interference fit (press fit), excessive tibial bone resection, a sagittal cut too deep posteriorly and low bone mineral density (BMD) reduce the force required for a periprosthetic tibial fracture to occur. Clinical studies showed that periprosthetic tibial fractures were associated with increased body mass index and postoperative alignment angles, advanced age, decreased BMD, female gender, and a very overhanging medial tibial condyle.

Conclusion

Comparable low incidences of periprosthetic tibial fractures in cementless and cemented UKA can be achieved. However, surgeons should be aware that an excessive interference fit in cementless UKAs in combination with an impaction technique may introduce an additional risk, and could therefore be less forgiving to surgical errors and patients who are at higher risk of periprosthetic tibial fractures.

Level of evidence

V.
CD30+OX40+ Treg is associated with improved overall survival in colorectal cancer
Authors: Lam Jian Hang , Hong Michelle , Koo Si-Lin , Chua Clarinda Wei Ling , Lim Kah Ling , Wee Felicia , Wan Wei Keat , Leow Wei Qiang , Yeo Joo Guan , Tan Iain Bee Huat , Yeong Joe , Lim Tony Kiat Hon , Lim Tong Seng
Published: February 2021

Regulatory T cells (Tregs) are often enriched in tumors, where their immunosuppressive function has a key role in tumor persistence and progression. In colorectal cancer (CRC), however, Tregs are frequently associated with an improved clinical outcome. Tumor-infiltrating Tregs have been shown to exhibit a distinct signature comprising the co-stimulatory molecules (OX40, 4-1BB), cytokine receptors (IL1R2, IL21R, CCR8, CD30), and co-inhibitory molecules (PD-L1, TIGIT). Here, we showed by flow cytometry that circulating CD45RO+Tregs from patients with CRC (n = 25) have elevated CD30 and OX40 expression compared to healthy subjects (n = 14). We identified co-expression of CD30 and OX40 on circulating CD45RO+Tregs using single-cell images captured by the DEPArray™system. The frequency of CD30+OX40+CD45RO+Tregs was significantly higher in CRC patients than in healthy subjects (P < 0.001). Importantly, receiver operating characteristic analysis confirmed that this CD30+OX40+Treg subset could strongly discriminate between CRC patients and healthy subjects with the highest accuracy of 92.3%, an AUC of 0.92, a sensitivity of 88%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 82.35%, and a trade-off value of 3.44%, compared to other Treg subsets. Consistently, multiplex-IHC/IF of tumor-infiltrating Tregs revealed a significant association between high densities of CD30+OX40+Tregs and improved overall survival; no such association was found for other subsets. These data suggest a potential role for CD30+OX40+Tregs as a diagnostic or prognostic biomarker in CRC.
Thymic origins of autoimmunity—lessons from inborn errors of immunity
Authors: Bacchetta Rosa , Weinberg Kenneth
Published: February 2021

During their intrathymic development, nascent T cells are empowered to protect against pathogens and to be operative for a life-long acceptance of self. While autoreactive effector T (Teff) cell progenitors are eliminated by clonal deletion, the intrathymic mechanisms by which thymic regulatory T cell (tTreg) progenitors maintain specificity for self-antigens but escape deletion to exert their regulatory functions are less well understood. Both tTreg and Teff development and selection result from finely coordinated interactions between their clonotypic T cell receptors (TCR) and peptide/MHC complexes expressed by antigen-presenting cells, such as thymic epithelial cells and thymic dendritic cells. tTreg function is dependent on expression of the FOXP3 transcription factor, and induction of FOXP3 gene expression by tTreg occurs during their thymic development, particularly within the thymic medulla. While initial expression of FOXP3 is downstream of TCR activation, constitutive expression is fixed by interactions with various transcription factors that are regulated by other extracellular signals like TCR and cytokines, leading to epigenetic modification of the FOXP3 gene. Most of the understanding of the molecular events underlying tTreg generation is based on studies of murine models, whereas gaining similar insight in the human system has been very challenging. In this review, we will elucidate how inborn errors of immunity illuminate the critical non-redundant roles of certain molecules during tTreg development, shedding light on how their abnormal development and function cause well-defined diseases that manifest with autoimmunity alone or are associated with states of immune deficiency and autoinflammation.
Effect of liquid elasticity on the behaviour of high-speed focused jets
Authors: Franco-Gómez A. , Onuki H. , Yokoyama Y. , Nagatsu Y. , Tagawa Y.
Published: February 2021

We investigate the effect of highly contrasting non-Newtonian liquid properties on the formation of liquid jets with a focused shape. By using two nozzle-free ejection techniques, mechanically impact- and laser-induced, fast jets of a highly elastic (sodium polyacrylate) and weakly elastic (xanthan-gum) diluted polymer solutions are generated. A unique high-speed effect is encountered at the jet ejection onset of the highly elastic solution. Its jet-tip speed is on average 1.4 times faster in comparison to a Newtonian (glycerin/water) and the weakly elastic liquids. We explain this effect occurring as a result of the high viscoelasticity of the sodium polyacrylate solution. Additionally, a ‘bungee jumper’ jet behaviour (Morrison and Harlen in Rheol Acta 49(6):619–632, 2010) is observed in a regime of high speed ($$10<V_j<40$$

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j

<
40

m/s) and high viscosity ($$\mu >20$$

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20

mPa s) not previously examined. We additionally characterise the viscoelastic non-breakup jet limit using the Bazilevskii et al. (Fluid Dyn 40(3):376–392, 2005) ejection criterion. Herein, the extensional rheological parameters are measured implementing a novel DoS-CaBER technique (Dinic et al. in Lab Chip 17(3):460–473, 2017). Our findings may influence results of inkjet printing technologies and recent nozzle-free ejection systems for ejecting liquids with non-Newtonian properties.

Graphical abstract
Prognostic significance of diastolic blood pressure in patients with heart failure with preserved ejection fraction
Authors: Fuchida Aya , Suzuki Sho , Motoki Hirohiko , Kanzaki Yusuke , Maruyama Takuya , Hashizume Naoto , Kozuka Ayako , Yahikozawa Kumiko , Kuwahara Koichiro
Published: February 2021

Although systolic blood pressure (SBP) is routinely considered when treating acute heart failure (HF), diastolic blood pressure (DBP) is hardly been assessed in the situation. There are no previous studies regarding the predictive value of DBP in elderly patients with HF with preserved ejection fraction (HFpEF) in Japan. This study aimed to investigate the prognostic significance of DBP in patients with acute decompensated HFpEF. We analyzed data of all HFpEF patients admitted to Shinonoi General Hospital for HF treatment between July 2016 and December 2018. We excluded patients with acute coronary syndrome and severe valvular disease. Patients were divided into two groups according to their median DBP; the low DBP group (DBP ≤ 77 mmHg,n = 106) and the high DBP group (DBP > 77 mmHg,n = 100). The primary outcome was HF readmission. In 206 enrolled patients (median 86 years), during a median follow-up of 302 days, the primary outcome occurred in 48 patients. The incidence of HF readmission was significantly higher in the low DBP group (33.0% vs 18.5%,p = 0.024). In Kaplan–Meier analysis, low DBP predicted HF readmission (Log-rank test,p = 0.013). In Cox proportional hazard analysis, low DBP was an independent predictor of HF readmission after adjustment for age, sex, SBP, hemoglobin, serum albumin, serum creatinine, B-type natriuretic peptide, renin-angiotensin system inhibitors, calcium channel blockers, left ventricular ejection fraction, coronary artery disease, and whether they live alone (hazard ratio, 2.229; 95% confidence interval, 1.021–4.867;p = 0.044). Low DBP predicted HF readmission in patients with HFpEF.
Pulmonary hypertension in extremely preterm infants: a call to standardize echocardiographic screening and follow-up policy
Authors: Arjaans Sanne , Zwart Elvira. A. H. , Roofthooft Marc , Kooi Elisabeth M. W. , Bos Arend F. , Berger Rolf M. F.
Published: February 2021

Pulmonary hypertension (PH) is a frequent complication in extremely preterm born infants that seriously affects outcome. We aimed to describe the prevalence of PH in extremely preterm infants and the policy on screening and follow-up in the ten Dutch intensive care units (NICUs). We performed a retrospective cohort study at the University Medical Centre Groningen on infants with gestational age < 30 weeks and/or birthweight < 1000 g, born between 2012 and 2013. Additionally, we carried out a survey among the Dutch NICUs covering questions on the awareness of PH, the perceived prevalence, and policy regarding screening and following PH in extremely preterm infants. Prevalence of early-onset PH in our study was 26% and 5% for late-onset PH. PH was associated with poor survival and early-onset PH was associated with subsequent development of bronchopulmonary dysplasia (BPD). All the NICUs completed the questionnaire and we found that no standardized policy existed regarding screening and following PH in extremely preterm infants.

Conclusion: Despite the frequent occurrence of PH and its clinically important consequences, (inter-)national standardized guidelines regarding screening and following of PH in extremely preterm infants are lacking. Standardizing screening and follow-up will enable early identification of infants with late-onset PH and allow for earlier treatment. Additionally, greater clarity is required regarding the prevalence of early PH as are new preventive treatment strategies to combat BPD.

What is known? • Pulmonary hypertension (PH) substantially impairs the survival of extremely preterm infants. • PH is associated with bronchopulmonary dysplasia (BPD): Early-onset PH predicts the development of BPD. Late-onset PH is prevalent in infants with severe BPD.

What is new? • Pulmonary hypertension (PH) is prevalent in preterm infants. Its consequences for morbidity and mortality justify a standardized policy aimed at early detection to improve prevention and treatment. • No structured policy exists in the Netherlands regarding screening/follow-up for PH in extremely preterm infants.
Perianal streptococcal disease in childhood: systematic literature review
Authors: Gualtieri Renato , Bronz Gabriel , Bianchetti Mario G. , Lava Sebastiano A. G. , Giuliano Elena , Milani Gregorio P. , Jermini Luca M. M.
Published: February 2021

Group A Streptococcus has been associated with a perianal infection. We conducted a systematic review of the literature on childhood streptococcal perianitis in three databases: Excerpta Medica, National Library of Medicine, and Web of Science. The main purposes were to document the clinical features, the tendency to recur, the association with an asymptomatic streptococcal throat carriage, the accuracy of rapid streptococcal tests, and the mechanism possibly underlying the acquisition of this infection. More than 80% of cases are boys ≤7.0 years of age with defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness. Perianitis is associated with a streptococcal tonsillopharyngitis in about every fifth case. The time to diagnosis is ≥3 weeks in 65% of cases. Recurrences occur within 3½ months in about 20% of cases. An asymptomatic group A streptococcal throat carriage occurs in 63% of cases. As compared with perianal Streptococcus A culture, the rapid streptococcal tests have a positive predictive value of 80% and a negative predictive value of 96%. It is hypothesized that digital inoculation from nasopharynx to anus underlies perianitis. Many cases are likely caused directly by children, who are throat and nasal carriers of Streptococcus A. Some cases might occur in children, who have their bottoms wiped by caregivers with streptococcal tonsillopharyngitis or carriage of Streptococcus.

Conclusion: Perianitis is an infection with a distinctive presentation and a rather long time to diagnosis. There is a need for a wider awareness of this condition among healthcare professionals.What is Known:•Group A Streptococcus may cause perianitis in childhood.• Systemic antimicrobials (penicillin V, amoxycillin, or cefuroxime) are superior to topical treatment.What is New:•The clinical presentation is distinctive (defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness).• The time to diagnosis is usually ≥3 weeks.Recurrences occur in about 20% of cases.
Enhancing patient safety through the quality assured use of a low-tech video interpreting system to overcome language barriers in healthcare settings
Authors: Kletečka-Pulker Maria , Parrag Sabine , Doppler Klara , Völkl-Kernstock Sabine , Wagner Michael , Wenzel Thomas
Published: February 2021

Professional interpretation and translation are key issues in the improvement of public health and patient safety in an area of increased migration and multicultural healthcare system needs. Patient safety requires clear and reliable communication to avoid errors in diagnosis, treatment, and neglect of informed consent. Due to the range of languages to be covered, telephone and video interpretation (VI) can be expected to face up to the demands for trained interpreters available on short notice and in more remote healthcare sites.

In a pilot project, we implemented a new up to date model video interpretation unit and used a mixed methods approach integrating quantitative and qualitative data in assessing barriers encountered prior to the use of the pilot system and satisfaction with the use of video interpretation in a number of clinical settings, including inpatient and outpatient units, in Austria. Of all respondents (n = 144) 71% reported frequently encountering language barriers, only 37% reported the use of professional interpreters, 81% reported using siblings, parents or other non-professional interpreters, while a considerable percentage (66%) reported using gestures or drawings to communicate, resulting in very low overall satisfaction rate (only 12%) with the prior situation.

In the qualitative study the users observed rapid availability, data protection compliance, ability to see the interpreter despite physical distance, absence of potential external influence resulting from personal relationships, user-friendly nature of the technique, legal certainty, absence of the requirement for personal presence, and cost savings as key benefits in the use of the new technology. Of the users of the system 88% (n = 58) rated it as very good (72%) or good (16%).
A vulnerable age group: the impact of cancer on the psychosocial well-being of young adult childhood cancer survivors
Authors: van Erp L. M. E. , Maurice-Stam H. , Kremer L. C. M. , Tissing W. J. E. , van der Pal H. J. H. , de Vries A. C. H. , van den Heuvel-Eibrink M. M. , Versluys B. A. B. , van der Heiden-van der Loo M. , Huizinga G. A. , Grootenhuis M. A.
Published: February 2021

Purpose

This study aimed to increase our understanding of the psychosocial well-being of young adult childhood cancer survivors (YACCS) as well as the positive and negative impacts of cancer.

Methods

YACCS (aged 18–30, diagnosed ≤ 18, time since diagnosis ≥ 5 years) cross-sectionally filled out the “Pediatric Quality of Life Inventory Young Adults” (PedsQL-YA), “Hospital Anxiety and Depression Scale” (HADS), and “Checklist Individual Strengths” (CIS-20R) to measure fatigue and survivor-specific “Impact of Cancer - Childhood Survivors” (IOC-CS), which measures the long-term impact of childhood cancer in several domains. Descriptive statistics (IOC-CS), logistic regression (HADS, CIS-20R), and ANOVA (PedsQL-YA, HADS, CIS-20R) were performed. Associations between positive and negative impacts of childhood cancer and psychosocial outcomes were examined with linear regression analyses.

Results

YACCS (N = 151, 61.6% female, mean age 24.1 ± 3.6, mean time since diagnosis 13.6 ± 3.8) reported lower HRQOL (− .4 ≤ d ≤ − .5, p ≤ .001) and more anxiety (d = .4, p ≤ .001), depression (d = .4, p ≤ .01), and fatigue (.3 ≤ d ≤ .5, p ≤ .001) than young adults from the general Dutch population. They were at an increased risk of experiencing (sub)clinical anxiety (OR = 1.8, p = .017). YACCS reported more impact on scales representing a positive rather than negative impact of CC. Various domains of impact of childhood cancer were related to psychosocial outcomes, especially “Life Challenges” (HRQOL β = − .18, anxiety β = .36, depression β = .29) and “Body & Health” (HRQOL β = .27, anxiety β = − .25, depression β = − .26, fatigue β = − .47).

Conclusion

YACCS are vulnerable to psychosocial difficulties, but they also experience positive long-term impacts of childhood cancer. Positive and negative impacts of childhood cancer were associated with psychosocial outcomes in YACCS. Screening of psychosocial outcomes and offering targeted interventions are necessary to optimize psychosocial long-term follow-up care for YACCS.
Arrow R-CNN for handwritten diagram recognition
Authors: Schäfer Bernhard , Keuper Margret , Stuckenschmidt Heiner
Published: February 2021

We address the problem of offline handwritten diagram recognition. Recently, it has been shown that diagram symbols can be directly recognized with deep learning object detectors. However, object detectors are not able to recognize the diagram structure. We propose Arrow R-CNN, the first deep learning system for joint symbol and structure recognition in handwritten diagrams. Arrow R-CNN extends the Faster R-CNN object detector with an arrow head and tail keypoint predictor and a diagram-aware postprocessing method. We propose a network architecture and data augmentation methods targeted at small diagram datasets. Our diagram-aware postprocessing method addresses the insufficiencies of standard Faster R-CNN postprocessing. It reconstructs a diagram from a set of symbol detections and arrow keypoints. Arrow R-CNN improves state-of-the-art substantially: on a scanned flowchart dataset, we increase the rate of recognized diagrams from 37.7 to 78.6%.
Lung Nodule Classification Using Biomarkers, Volumetric Radiomics, and 3D CNNs
Authors: Mehta Kushal , Jain Arshita , Mangalagiri Jayalakshmi , Menon Sumeet , Nguyen Phuong , Chapman David R.
Published: February 2021

We present a hybrid algorithm to estimate lung nodule malignancy that combines imaging biomarkers from Radiologist’s annotation with image classification of CT scans. Our algorithm employs a 3D Convolutional Neural Network (CNN) as well as a Random Forest in order to combine CT imagery with biomarker annotation and volumetric radiomic features. We analyze and compare the performance of the algorithm using only imagery, only biomarkers, combined imagery + biomarkers, combined imagery + volumetric radiomic features, and finally the combination of imagery + biomarkers + volumetric features in order to classify the suspicion level of nodule malignancy. The National Cancer Institute (NCI) Lung Image Database Consortium (LIDC) IDRI dataset is used to train and evaluate the classification task. We show that the incorporation of semi-supervised learning by means of K-Nearest-Neighbors (KNN) can increase the available training sample size of the LIDC-IDRI, thereby further improving the accuracy of malignancy estimation of most of the models tested although there is no significant improvement with the use of KNN semi-supervised learning if image classification with CNNs and volumetric features is combined with descriptive biomarkers. Unexpectedly, we also show that a model using image biomarkers alone is more accurate than one that combines biomarkers with volumetric radiomics, 3D CNNs, and semi-supervised learning. We discuss the possibility that this result may be influenced by cognitive bias in LIDC-IDRI because malignancy estimates were recorded by the same radiologist panel as biomarkers, as well as future work to incorporate pathology information over a subset of study participants.
Impfung zur Vorbeugung der COVID-19-Erkrankung sowie Impfpriorisierung bei Epilepsie
Authors: Strzelczyk Adam , Knake Susanne , Holtkamp Martin , Schulze-Bonhage Andreas , Lemke Johannes , von Spiczak Sarah , Berkenfeld Ralf , Rosenow Felix , Brandt Christian , Schmitt Friedhelm C.
Published: February 2021

Der Vorstand der Deutschen Gesellschaft für Epileptologie und die Kommission „Epilepsie und Synkopen“ der Deutschen Gesellschaft für Neurologie haben die aktuelle Datenlage zur Impfung zur Vorbeugung der Corona-Virus-Krankheit 2019 (COVID-19) sowie zur Impfpriorisierung bei Menschen mit Epilepsie gesichtet, diese zusammengefasst und geben die unten genannten Empfehlungen ab.
Quality of life in Hungarian polio survivors
Authors: Miszory Erika Viktória , Járomi Melinda , Pakai Annamária
Published: February 2021

Aim

The number of Hungarian polio patients can be estimated at approximately 3000. Polio infection is currently affecting people 56–65 years of age. The aim of the study was to reveal the quality of life of patients living with polio virus in Hungary.

Subject and methods

The quantitative cross-sectional study was conducted in January–April 2017 among polyomyelitis patients living in Hungary. In the non-random, targeted, expert sample selection, the target group was composed of patients infected with poliovirus (N = 268). We have excluded those who refused to sign the consent statement. Our data collection method was an SF-36 questionnaire. Using the IBM SPSS Statistics Version 22 program, descriptive and mathematical statistics (χ2-test) were calculated (p < 0.05).

Results

The mean age of the members of the examined population is 63.5 years; 68.1% were women and 31.90% were men. The majority of the respondents were infected by the polyovirus in 1956 (11.9%), 1957 (24.3%), and 1959 (19.5%). Polio patients, with the exception of two dimensions (mental health, social operation), on the scale of 100 do not reach the “average” quality of life (physical functioning 23 points, functional role 36 points, emotional role 47 points, body pain 48 points, general health 42 points, vitality 50 points, health change 31 points).

Conclusion

The quality of life of polio patients is far below the dimensions of physical function, while the difference in mental health compared to healthy people is minimal. It would be important to educate health professionals about the existing disease, to develop an effective rehabilitation method.
Impact Performance Comparison of Advanced Snow Sport Helmets with Dedicated Rotation-Damping Systems
Authors: DiGiacomo Gina , Tsai Stanley , Bottlang Michael
Published: February 2021

Rotational acceleration of the head is a principal cause of concussion and traumatic brain injury. Several rotation-damping systems for helmets have been introduced to better protect the brain from rotational forces. But these systems have not been evaluated in snow sport helmets. This study investigated two snow sport helmets with different rotation-damping systems, termed MIPS and WaveCel, in comparison to a standard snow sport helmet without a rotation-damping system. Impact performance was evaluated by vertical drops of a helmeted Hybrid III head and neck onto an oblique anvil. Six impact conditions were tested, comprising two impact speeds of 4.8 and 6.2 m/s, and three impact locations. Helmet performance was quantified in terms of the linear and rotational kinematics, and the predicted probability of concussion. Both rotation-damping systems significantly reduced rotational acceleration under all six impact conditions compared to the standard helmet, but their effect on linear acceleration was less consistent. The highest probability of concussion for the standard helmet was 89%, while helmets with MIPS and WaveCel systems exhibited a maximal probability of concussion of 67 and 7%, respectively. In conclusion, rotation-damping systems of advanced snow sport helmets can significantly reduce rotational head acceleration and the associated concussion risk.
Longitudinal Patterns of Ethical Organisational Culture as a Context for Leaders’ Well-Being: Cumulative Effects Over 6 Years
Authors: Huhtala Mari , Kaptein Muel , Muotka Joona , Feldt Taru
Published: February 2021

The aim of this longitudinal study was to investigate the temporal dynamics of ethical organisational culture and how it associates with well-being at work when potential changes in ethical culture are measured over an extended period of 6 years. We used a person-centred study design, which allowed us to detect both typical and atypical patterns of ethical culture stability as well as change among a sample of leaders. Based on latent profile analysis and hierarchical linear modelling we found longitudinal, concurrent relations and cumulative gain and loss cycles between different ethical culture patterns and leaders’ well-being. Leaders in the strongest ethical culture pattern experienced the highest level of work engagement and a decreasing level of ethical dilemmas and stress. Leaders who gave the lowest ratings on ethical culture which also decreased over time reported the highest level of ethical dilemmas, stress, and burnout. They also showed a continuous increase in these negative outcomes over time. Thus, ethical culture has significant cumulative effects on well-being, and these longitudinal effects can be both negative and positive, depending on the experienced strength of the culture’s ethicality.
An optimization approach for flow simulations in poro-fractured media with complex geometries
Authors: Berrone Stefano , D’Auria Alessandro , Scialò Stefano
Published: February 2021

A new discretization approach is presented for the simulation of flow in complex poro-fractured media described by means of the Discrete Fracture and Matrix Model. The method is based on the numerical optimization of a properly defined cost-functional and allows to solve the problem without any constraint on mesh generation, thus overcoming one of the main complexities related to efficient and effective simulations in realistic DFMs.
Voice Cues Influence Children’s Assessment of Adults’ Occupational Competence
Authors: Cartei Valentina , Oakhill Jane , Garnham Alan , Banerjee Robin , Reby David
Published: February 2021

The adult voice is a strong bio-social marker for masculinity and femininity. In this study we investigated whether children make gender stereotypical judgments about adults’ occupational competence on the basis of their voice. Forty-eight 8- to 10- year olds were asked to rate the competence of adult voices that varied in vocal masculinity (by artificially manipulating voice pitch) and were randomly paired with 9 occupations (3 stereotypically male, 3 female, 3 gender-neutral). In line with gender stereotypes, children rated men as more competent for the male occupations and women as more competent for the female occupations. Moreover, children rated speakers of both sexes with feminine (high-pitched) voices as more competent for the female occupations. Finally, children rated men (but not women) with masculine (low-pitched) voices as more competent for stereotypically male occupations. Our results thus indicate that stereotypical voice-based judgments of occupational competence previously identified in adults are already present in children, and likely to affect how they consider adults and interact with them in their social environment.
Improved optic disc and cup segmentation in Glaucomatic images using deep learning architecture
Authors: Mangipudi Partha Sarathi , Pandey Hari Mohan , Choudhary Ankur
Published: February 2021

Glaucoma is an ailment causing permanent vision loss but can be prevented through the early detection. Optic disc to cup ratio is one of the key factors for glaucoma diagnosis. But accurate segmentation of disc and cup is still a challenge. To mitigate this challenge, an effective system for optic disc and cup segmentation using deep learning architecture is presented in this paper. Modified Groundtruth is utilized to train the proposed model. It works as fused segmentation marking by multiple experts that helps in improving the performance of the system. Extensive computer simulations are conducted to test the efficiency of the proposed system. For the implementation three standard benchmark datasets such as DRISHTI-GS, DRIONS-DB and RIM-ONE v3 are used. The performance of the proposed system is validated against the state-of-the-art methods. Results indicate an average overlapping score of 96.62%, 96.15% and 98.42% respectively for optic disc segmentation and an average overlapping score of 94.41% is achieved on DRISHTI-GS which is significant for optic cup segmentation.
Coherence of PRNU weighted estimations for improved source camera identification
Authors: Bruni Vittoria , Tartaglione Michela , Vitulano Domenico
Published: February 2021

This paper presents a method for Photo Response Non Uniformity (PRNU) pattern noise based camera identification. It takes advantage of the coherence between different PRNU estimations restricted to specific image regions. The main idea is based on the following observations: different methods can be used for estimating PRNU contribution in a given image; the estimation has not the same accuracy in the whole image as a more faithful estimation is expected from flat regions. Hence, two different estimations of the reference PRNU have been considered in the classification procedure, and the coherence of the similarity metric between them, when evaluated in three different image regions, is used as classification feature. More coherence is expected in case of matching, i.e. the image has been acquired by the analysed device, than in the opposite case, where similarity metric is almost noisy and then unpredictable. Presented results show that the proposed approach provides comparable and often better classification results of some state of the art methods, showing to be robust to lack of flat field (FF) images availability, devices of the same brand or model, uploading/downloading from social networks.
A cellular automata rule placing a maximal number of dominoes in the square and diamond
Authors: Hoffmann Rolf , Désérable Dominique , Seredyński Franciszek
Published: February 2021

The objective is to demonstrate that a probabilistic cellular automata rule can place reliably a maximal number of dominoes in different active area shapes, exemplarily evaluated for the square and diamond. The basic rule forms domino patterns, but the number of dominoes is not necessarily maximal and the patterns are not always stable. It works with templates derived from domino tiles. The first proposed enhancement (Rule Option 1) can form always stable patterns. The second enhancement (Rule Option 2) can maximize the number of dominoes, but the reached patterns are not always stable. All rules drive the evolution by specific noise injection.
Development and application of reverse genetic technology for the influenza virus
Authors: Li Ziquan , Zhong Liping , He Jian , Huang Yong , Zhao Yongxiang
Published: February 2021

Influenza virus is a common virus in people's daily lives, and it has certain infectivity in humans and animals. Influenza viruses have the characteristics of a high mutation rate and wide distribution. Reverse genetic technology is primarily used to modify viruses at the DNA level through targeted modification of the virus cDNA. Genetically modified influenza viruses have a unique advantage when researching the transmission and pathogenicity of influenza. With the continuous development of oncolytic viruses in recent years, studies have found that influenza viruses also have certain oncolytic activity. Influenza viruses can specifically recognize tumor cells; activate cytotoxic T cells, NK cells, dendritic cells, etc.; and stimulate the body to produce an immune response, thereby killing tumor cells. This article will review the development and application of influenza virus reverse genetic technology.
Modelling of different circular end-of-use scenarios for smartphones
Authors: Pamminger Rainer , Glaser Sebastian , Wimmer Wolfgang
Published: February 2021

Purpose

Repairing, refurbishing and remanufacturing are three strategies of the Circular Economy (CE), aiming at closing product cycles and maintaining materials and resources in the product cycle as long as possible. This paper analyses the environmental impacts of these three circular end-of-use scenarios (repairing, refurbishing and part remanufacturing) when performed on a common, “non-circular” smartphone. The underlying data used for this paper partly have been result of the Horizon 2020 project sustainablySMART, where circular product concepts have been developed and analysed in detail.

Methods

To analyse the environmental impacts of different circular end-of-use scenarios of smartphones, a Life Cycle Assessment (LCA) is performed. For considering the impact of a smartphone’s first life (e.g. materials, production), an economic allocation is used.

Since the goal of the study was to better understand the environmental impacts of processing routes that enable multiple life cycles of a product, allocation according to the economic value is applied instead of applying system expansion. As system expansion provides just an aggregated view of the first and second product life cycles and no decision support at the end of the first life regarding the relevant CE strategy can be given. The economic allocation is based on the ratio between the residual market value and the original price from the scenario’s input stream of smartphones of the respective end-of-use scenario.

To reach comparability of the results, a second-use-time-parameter is defined for each scenario. This parameter takes into account that the second use time reaches only a certain share from the average smart phone use time.

Results

This study shows that through all three circular strategies, a reduction in the investigated impact categories—Global Warming Potential (GWP) and Abiotic Depletion Potential (ADP)—can be achieved.

Conclusions

The analysed end-of-use scenarios repairing and refurbishing show the highest potential for smartphones in terms of Circular Economy, as most of the environmental impacts can be allocated to the device production, and the impact of additional steps to perform CE-strategies (e.g. collection of discarded phones, refurbishing) is rather low.
Battle of the Java Sea: One Event, Multiple Sites, Values and Views
Authors: Manders M. R. , de Hoop R. W. , Adhityatama S. , Bismoko D. S. , Syofiadisna P. , Haryanto D.
Published: February 2021

Three Dutch naval ships, HNLMS De Ruyter, HNLMS Java and HNLMS Kortenaer, were lost during the Battle of the Java Sea on 27 February 1942, claiming the lives of 915 sailors. Although the ships were relocated in 2002, no official action was taken until 2016 when an international diving team from the Karel Doorman Foundation discovered that the warships had disappeared. This created tension between the government of Indonesia and those countries that had lost ships in the archipelago, especially the Netherlands. A three-track cooperation agreement was set up to investigate the disappearance of the three Dutch wrecks with the aim of understanding what had happened, in order to create a better basis for cooperation in the future. The management and protection of shipwrecks from WWII is very complicated, because of the different values that stakeholders attach to them. Only with the proper understanding and consideration of the different values or significance WWII shipwrecks hold for different stakeholders can new ways of managing these complex sites be developed that have long-term effectiveness. This paper argues that different stakeholder groups from both the flag and the coastal state must work together on this issue.
Reducing Inappropriate Proton Pump Inhibitors Use for Stress Ulcer Prophylaxis in Hospitalized Patients: Systematic Review of De-Implementation Studies
Authors: Orelio Claudia C. , Heus Pauline , Kroese-van Dieren Judith J , Spijker René , van Munster Barbara C. , Hooft Lotty
Published: February 2021

Background

A large proportion of proton pump inhibitor (PPI) prescriptions, including those for stress ulcer prophylaxis (SUP), are inappropriate. Our study purpose was to systematically review the effectiveness of de-implementation strategies aimed at reducing inappropriate PPI use for SUP in hospitalized, non-intensive care unit (non-ICU) patients.

Methods

We searched MEDLINE and Embase databases (from inception to January 2020). Two authors independently screened references, performed data extraction, and critical appraisal. Randomized trials and comparative observational studies were eligible for inclusion. Criteria developed by the Cochrane Effective Practice and Organisation of Care (EPOC) group were used for critical appraisal. Besides the primary outcome (inappropriate PPI prescription or use), secondary outcomes included (adverse) pharmaceutical effects and healthcare use.

Results

We included ten studies in this review. Most de-implementation strategies contained an educational component (meetings and/or materials), combined with either clinical guideline implementation (n = 5), audit feedback (n = 3), organizational culture (n = 4), or reminders (n = 1). One study evaluating the de-implementation strategy effectiveness showed a significant reduction (RR 0.14; 95% CI 0.03–0.55) of new inappropriate PPI prescriptions. Out of five studies evaluating the effectiveness of de-implementing inappropriate PPI use, four found a significant reduction (RR 0.21; 95% CI 0.18–0.26 to RR 0.76; 95% CI 0.68–0.86). No significant differences in the occurrence of pharmaceutical effects (n = 1) and in length of stay (n = 3) were observed. Adverse pharmaceutical effects were reported in two studies and five studies reported on PPI or total drug costs. No pooled effect estimates were calculated because of large statistical heterogeneity between studies.

Discussion

All identified studies reported mainly educational interventions in combination with one or multiple other intervention strategies and all interventions were targeted at providers. Most studies found a small to moderate reduction of (inappropriate) PPI prescriptions or use.
Association between blood cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women
Authors: Kim Eun-San , Shin Sangah , Lee Yoon Jae , Ha In-Hyuk
Published: February 2021

Summary

We aimed to investigate the association between cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. There was a significant positive association between cadmium levels and the risk of osteopenia and osteoporosis, but further studies for dose response are required.

Purpose

Cadmium exposure can exert detrimental effects on bone health, particularly in post-menopausal women. However, previous studies have failed to report an association in Korean post-menopausal women. We aimed to investigate the association between cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women.

Methods

In total, 5432 participants from the 4th and 5th Korean National Health and Nutrition Examination Survey (KNHANES) were randomly sampled for measurements of heavy metal concentrations in the blood, bone mass density (BMD), and nutrient intake. We analyzed data for 1031 post-menopausal women ≥50 years of age. Blood cadmium levels were categorized into quartiles, and a multinomial logistic regression model was used for analysis.

Results

There was a significant positive association between cadmium levels and the risk of osteopenia and osteoporosis, but the odds ratio (OR) at the 4th level was lower than that at the 3rd level (OR and 95% confidence interval (CI) for osteopenia: 2nd quartile: 1.24, 0.88-1.74; 3rd quartile: 3.22, 2.24-4.64; 4th quartile: 1.27, 0.87-1.85; P for trend <0.001; OR and 95% CI for osteoporosis: 2nd quartile: 1.54, 1.05-2.25; 3rd quartile: 3.63, 2.31-5.69; 4th quartile: 1.70, 1.03-2.81; P for trend <0.001). This trend was consistent in the sensitivity analysis.

Conclusion

Our findings suggest that there is an association between blood cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. However, further prospective studies are required to determine whether there is a dose-response relationship and address potential selection bias, especially in patients with femoral neck osteoporosis.