bluuebunny/crossref_metadata_2025_split huggingface dataset:
Therapie der Nierentransplantatabstoßung
Authors: Renders Lutz , Niedermayer Samuel , Hartmann Daniel , Stocker Felix , Echterdieck Fabian , Aßfalg Volker 
Published: October 2023

ZUSAMMENFASSUNGBei der Nierentransplantatabstoßung wird zwischen zellulären und humoralen Rejektionen unterschieden, gemischte Formen kommen vor. Die Indikation zur Therapie sollte bioptisch gesichert werden, da viele Differenzialdiagnosen zu verschiedenen Zeiten nach einer Transplantation unter Umständen andere Therapieansätze erfordern und eine nicht notwendige zusätzliche Immunsuppression Risiken herausfordert. Eine kalkulierte Therapie bis zum Eintreffen des Biopsieergebnisses ist allerdings häufig sinnvoll und muss mit dem individuellem Risikoprofil des Patienten vorher abgewogen und besprochen werden. Für einen Therapiewahl sind hier viele Faktoren ausschlaggebend, die auch zum Teil in den weiteren Artikeln dieser Ausgabe von „Nephrologie aktuell“ diskutiert werden. Für die zellulären Rejektionen ist primär eine Steroidgabe etabliert und häufig erfolgversprechend. Bei unzureichendem Ansprechen werden depletierende Antikörper verabreicht. Ein erfolgreiches Ansprechen ist hier naturgemäß im Vergleich zu Steroidtherapie schlechter, was natürlich auch der jeweils unterschiedlichen Ausprägung der Rejektion mit entsprechenden histologischen Veränderungen geschuldet ist. Während die frühe humorale Rejektion zum Teil behandelbar ist, ohne dass hier viel Evidenz im Sinne von klassischen AMG-Studien vorhanden ist, ist die chronische und chronisch akute humorale Rejektion vor allem im späteren Verlauf nach der Transplantation einer Therapie kaum zugänglich. Therapieversuche der akuten humoralen Rejektion auf niedrigem Evidenzlevel beinhalten hier den Plasmaaustausch oder die Immunadsorbtion zur Entfernung von Antikörpern, wie auch der Einsatz von depletierenden Antikörper und die Gabe von Immunglobulinen. Bei den chronisch humoralen Formen kann eine Immunglobulingabe wiederholt versucht werden. Aktuell werden neue Substanzen aus der Rheumatologie und Hämatoonkologie auf ihre Verwendung in diesen Indikationen getestet. Ob diese zu Verbesserungen führen, bleibt abzuwarten.
Akute Beinischämie: ein Update zu Diagnose und Management
Authors: Busch Hans Lucas , Müller Oliver 
Published: October 2023

ZusammenfassungDie akute Beinischämie ist meist durch einen embolischen Verschluss und/oder durch eine akute Thrombose einer atherosklerotischen Läsion gekennzeichnet. Kennzeichnend ist eine schlechte
Kollateralisierung mit niedrigem Kompensationsdruck. Das Amputationsrisiko kann anhand der Rutherford-Klassifikation abgeschätzt werden. Einschränkung der Motorik und/oder neurologische
Ausfälle gebieten eine sofortige Revaskularisation. Mit modernen Katheterverfahren werden gute primäre Ergebnisse erzielt.
Comparison of Efficacy and Safety of a Bevacizumab Biosimilar, in Combination with Chemotherapies, in Nonresectable Metastatic Colorectal Cancer and in Advanced Nonsquamous Non–Small Cell Lung Cancer: A Randomized, Double-Blind, Phase III Study
Authors: Kasliwal Shalu , K. Ranjith , Reddy Pramod , Maharaj Narendra , M. Gopichand , Adhav Aditya , Harsh Kamlesh , Madnoorkar Nagesh , Diwan Ashok , Gupta Mamraj , Patel Ghanshyam , J. Srinivas B. , Dvorkin Mikhail Vladimirovich 
Published: October 2023

The objective of this study was to compare the efficacy, safety, pharmacokinetics, and immunogenicity of a proposed bevacizumab biosimilar (DRL_BZ) with the innovator Avastin (reference medicinal product [RMP]) in patients with nonresectable metastatic colorectal cancer (mCRC) over a period of 9 months and advanced nonsquamous non–small cell lung cancer (NSCLC) over 6 months. The study was planned as a randomized, double-blind trial. In part A, a total of 117 mCRC patients were intended to receive 5 mg/kg of bevacizumab every 2 weeks along with mFOLFOX6 chemotherapy for a maximum of 18 cycles. In part B, 60 NSCLC patients were to receive 15 mg/kg of bevacizumab every 3 weeks along with pemetrexed and carboplatin for the initial four cycles, followed by pemetrexed for another four cycles. The primary endpoint was the progression-free survival rate at 6 months (PFS6) in both subparts. The anticipated sample size was 106 evaluable mCRC patients to achieve 85% statistical power for concluding noninferiority with a margin of half the difference (18.8%) between DRL_BZ and Avastin, along with a pilot study involving 60 evaluable NSCLC patients. Safety comparison included assessing adverse events (AEs), infusion reactions, and lab abnormalities. Immunogenicity comparison involved the incidence of antidrug antibodies (ADAs) and neutralizing antibodies (NAbs). Pharmacokinetic comparison was planned after the first and fourth dosing cycles of treatment in 24 NSCLC patients. The PFS6 for mCRC patients treated with DRL_BZ and RMP was 57.8% and 50% respectively, with a difference in efficacy of 7.8 (–8.7, 23.7). The PFS9 was 31.1% and 22.9%, with a difference of 8.2% (–6.9%, 22.9%). The objective response rate (ORR) for DRL_BZ and RMP was 28.8% and 22.4%, while the disease control rate (DCR) was 44.2% and 37.9% respectively. For NSCLC patients, the PFS6 was 44% and 45%, showing a difference of –1.0 (–4.2, 22.1). The ORR was 41.4% and 48.1%, and the DCR was 62.1% and 63%. The frequency, type, and severity of AEs were similar in both indications. Blood levels during the first and fourth dosing cycles exhibited comparable values. All NSCLC patients tested negative for ADA, while no mCRC patients on DRL_BZ tested positive for ADA. Low incidences of ADA (8%) and NAbs (4.0%) were reported in patients on RMP. Overall, the efficacy, safety, immunogenicity, and pharmacokinetic parameters of DRL_BZ and RMP were found to be comparable.Clinical Trial Registration For BZ-01-002: CTRI/2016/01/006481
A Rare Case of Fetal Hydrocolpos Secondary to Low Vaginal Atresia
Authors: Rajamma Athira , Venkataraman Megha 
Published: October 2023

AbstractFemale urogenital anomalies are often difficult to evaluate by ultrasonography, especially in late gestation. We report a case of fetal hydrocolpos detected by a fetal medicine scan at 33 weeks of gestation. Antenatal ultrasound by the fetal medicine unit showed a singleton fetus with a huge retrovesical cystic mass extending from the mid-abdomen to the perineum. Bilateral hydronephrosis was noted. Postnatal ultrasound showed the ﬁndings of a markedly dilated vagina containing thick echogenic fluid that was extended up to the umbilical level displacing the urinary bladder upwards and anteriorly and rectum posteriorly, suggesting hydrocolpos. Bilateral hydronephrosis was also noted. Postnatal examination of the neonate showed a distended abdomen with a well-defined mass arising from the pelvis extended to the umbilicus. External genitalia were of a normal female. There were no other dysmorphic features. Hydrocolpos was secondary to low vaginal atresia. Aspiration of the mass was performed on the first postnatal day.
Arthroscopic Volar Capsuloligamentous Reattachment and Reinforcement to Bone
Authors: Corella Fernando , Ocampos Montserrat , Laredo Rafeal , Tabuenca José , Larrainzar-Garijo Ricardo 
Published: October 2023

Abstract
Background: Injuries of the volar ligaments of the wrist are not uncommon, but their arthroscopic treatment presents a significant challenge. The objective of this paper is to introduce a technique for reattaching (in acute injuries) or reinforcing (in chronic injuries) various volar wrist ligaments to the bone, using standard wrist arthroscopic dorsal and volar portals.
Methods: There are three common steps for all the arthroscopic volar capsuloligamentous reattachments or reinforcementsStep 1 – Volar Portal Establishment: volar radial, volar ulnar and volar central portals are used depending on which structure needs to be reattached or reinforced.Step 2 – Anchor Placement: the anchor is positioned at the site where the ligament has been detached.Step 3 – Capsuloligamentous Suture and Knotting: a knot pusher is introduced inside the joint from the dorsal portal and advanced inside the volar portal where the threads of the anchor are located. The knot pusher is loaded with the threads and retrieved to the dorsal portal. A 16G Abbocath, loaded with a loop is used to pierce the volar ligaments. The loop of the Abbocath is captured from the dorsal portal and loaded with the threads. Both threads are taken to the volar portal and knotted after releasing the traction. This way the knot is placed out of the wrist and the ligaments are reattached or reinforced to the bone.
Result: This technique has been used to reinforce and reattach the scapholunate and lunotriquetral ligaments and to reattach the radiocarpal ligaments and the Poirier space. Since this procedure has been performed in various conditions and in conjunction with other ligament treatments (such as perilunate injuries, carpal bone fractures, distal radius fractures, and reinforcement or reattachment of the dorsal portions of intrinsic ligaments), specific results are not presented.
Conclusions: The described technique enables the reattachment and reinforcement of most volar ligaments to the bone using standard wrist arthroscopic portals. It can be performed in conjunction with the treatment of the dorsal portion of intrinsic ligaments or other wrist injuries.
Dual GLP-1/GIP Agonist Tirzepatide for Diabetes and Obesity: A Review of the Evidence
Authors: Wardeh Rahaf , Elbo Iswadi Tabarak Haamid , Alsharayri Hind , Rashid Fauzia , Alhashemi Nada , Bashier Alaaeldin 
Published: October 2023

Abstract
Background Tirzepatide is a novel dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) receptors agonist in management of type 2 diabetes mellitus. The aim of this literature review is to comprehensively assess its clinical, biochemical, and safety profiles.
Materials and Methods Search was conducted in several databases including PubMed from drug inception through end of 2022. Publications relevant to tirzepatide including randomized controlled trials, meta-analysis studies, post-hoc analyses, and conference proceedings were identified to examine its profile. Additional necessary references were explored and included as needed.
Results Tirzepatide is a twincretin, acting on both GLP-1 and GIP receptors. Its performance in glycemic control and weight loss was greater than that of GLP-1 receptor agonist or insulin, comparatively. It demonstrated promising positive renal outcomes and was not associated with a higher cardiovascular risk, in addition to favorable effects on lipid, hepatic and blood pressure profiles. Most common adverse events were gastrointestinal side effects and hypoglycemia.
Conclusion Novel dual GLP-1/GIP agonist Tirzepatide shows superior efficacy in glycemic control and weight loss in T2 diabetes mellitus patients. More evidence is needed to explore and compare long-term cardiovascular and renal outcomes reflecting real-world clinical practice.
Differential responses of yield and shoot traits of five tropical grasses to nitrogen and distance to trees in silvopastoral systems
Authors: Pontes Laíse da Silveira , Laca Emilio A. 
Published: October 2023

Context Light intensity and nitrogen availability are important factors influencing the growth of C4 forage species. Trade-offs may occur in the adaptive responses of species to shading and nitrogen inputs, and functional shoot traits can help to explain the consequences of these responses for species performance. Aims Our objective was to gain understanding of the mechanisms involving shoot traits of grasses that determine above-ground dry matter yield (DMY) when resources, light and nitrogen all vary. Methods Five C4 perennial forage grasses were grown in six shading conditions (full sunlight vs five positions between Eucalyptus dunnii rows) with two nitrogen levels (0 vs 300 kg N ha−1 year−1) and clipped when the canopy reached 95% light interception. Path analysis was used to explore the relationship between DMY, shading levels, nitrogen nutrition index and shoot traits. Key results Yield increased between 126 and 569 g dry matter m−2 with nitrogen fertilisation. Plant nitrogen concentration was the most important predictor of DMY. Increased shading reduced DMY by 6.94–12.5 g dry matter m−2 for each 1% increase in shading. DMY was also modulated by shoot traits such as specific leaf area, sheath length and leaf area index (via leaf area and tiller density), but with different responses according to species. Conclusions The five species compared adopted different mechanisms involving shoot traits, revealing different strategies to cope with changes in light and nitrogen availability. Implications Agroforestry practitioners may want to choose forages that are more likely to maintain biomass yield as trees grow.
Mammalian embryo culture media: now and into the future
Authors: Zander-Fox Deirdre L. , Pacella-Ince Leanne , Morgan Daniel K. , Green Mark P. 
Published: October 2023

For over 70 years, since the culture of the first mammalian embryo in vitro, scientists have undertaken studies to devise and optimise media to support the manipulation and culture of gametes and embryos. This area of research became especially active in the late 1970s onwards following the successful birth of the first human in vitro fertilised embryo. This review summarises some of the key advances in mammalian embryo culture media over time based on a greater understanding of the biochemical milieu of the reproductive tract. It highlights how learnings from studies in mice and agricultural species have informed human culture media compositions, in particular the inclusion of albumin, growth factors, cytokines, and antioxidants into contemporary culture media formulations, and how these advances may then in turn help to inform and guide development of in vitro culture systems used in other arenas, in particular agriculture. Additionally, it will highlight how the introduction of new technologies, such as timelapse, can influence current trends in media composition and usage that may see a return to a single step medium.
Sm-substituted Co-Mn nanoferrites: synthesis, characterization, magnetic properties and photocatalytic degradation of methylene blue
Authors: Abu-Elsaad N I , Nawara A S 
Published: October 2023

Abstract
An investigation has been performed into the influence of Sm3+ substitution on the structural, optical, and magnetic characteristics of Co0.5Mn0.5SmxFe2–xO4 (x = 0.0-0.1 and x changes at a step of 0.02) and its prospective use as an effective photocatalyst. The examination also explored the potential use of this composition as a proficient photocatalyst. The structural results verified the production of cubic spinel structures in all compositions. The determination of crystallite size has been done via the Williamson-Hall approach, taking into account the influence of strain variables. The ferrite nanoparticles’ spherical form was identified via transmission electron microscopy (TEM) examination. The Co0.5Mn0.5Fe2O4 sample exhibited a particle size distribution of around 40 nm. The optical band gap, ascertained using UV–vis-diffuse reflectance (DRS) spectra analysis, ranged from 1.38 to 1.43 eV. Vibrating sample magnetometer (VSM) analysis revealed that the produced sample was soft magnetic with moderate magnetization (58.18 emu g−1 - 42.73 emu g−1). Methylene Blue (MB) dye’s photocatalytic degradation (PCD) was used to study the photocatalytic behavior while exposed to sunlight. The Sm-doped Co-Mn nanoferrites synthesized in this study exhibit potential for use as effective active photocatalysts in the degradation of toxic industrial dyes. This application promises to enhance safety in both the environmental and healthcare sectors.
An algebraic theory of non-relativistic spin
Authors: Bradshaw Peter T J 
Published: October 2023

Abstract
In this paper we present a new, elementary derivation of non-relativistic spin using exclusively real algebraic methods. To do this, we formulate a novel method to decompose the domain of a real endomorphism according to its algebraic properties. We reveal non-commutative multipole tensors as the primary physically meaningful observables of spin, and indicate that spin is fundamentally geometric in nature. In so doing, we demonstrate that neither dynamics nor complex numbers are essential to the fundamental description of spin.
A physical memristor-based chaotic system and its application in colour image encryption scheme
Authors: Das Parnab , Mandal Santanu 
Published: October 2023

Abstract
This work proposes a physical memristor (TaOx) based new 4D chaotic system with 3D multi-scroll, no equilibrium point, spiking behaviour, coexistence bursting oscillation and multistability. Using this physical memristor-based chaotic system, a novel and efficient colour image encryption algorithm has been developed using a unique box scrambling method and bit-wise XOR operations. Many interesting and new dynamics of a material-based memristive chaotic system are reported here, like 3D multi-scroll chaotic attractors, bursting characteristics, multistability, a neuronal system like spiking behaviours etc using Lyapunov spectrum and bifurcation plots. It is observed that the number of scrolls is changed with the total simulation time. This novel memristive chaotic system has limit cycles with controllable spikes and bursting oscillation. In addition, the system shows chaotic bursting oscillation under a different set of parameters and initial conditions. The coexistence of the bursting phenomena is studied here. The bursting and spiking characteristic is important for material-based memristors in neuromorphic applications. 3D Chaotic multi-scroll and multistability properties make the image encryption method more efficient and secure. Such characteristics are rare in physical memristor-based chaotic systems and using this, the image encryption algorithm is also rare in recent findings. Therefore, a new secure image encryption algorithm for colour images is proposed here, based on the unique box scrambling method, bitwise XOR operation and pseudo-random number generation using the proposed memristive chaotic system. Various tests like NPCR, UACI, histogram analysis, correlation study, information entropy analysis, robustness against external noise, etc have been performed to check the algorithm’s robustness and efficiency and test the capability to resist statistical and differential attacks.
Improving constraints on models addressing the Hubble tension with CMB delensing
Authors: Ange Joshua , Meyers Joel 
Published: October 2023

Abstract
The Hubble Tension is a well-known issue in modern cosmology that refers to the apparent disagreement in inferences of the Hubble constant H
0 as found through low-redshift observations and those derived from the ΛCDM model utilizing early universe observations. Several extensions to ΛCDM have been proposed to address the Hubble Tension that involve new ingredients or dynamics in the early universe. Reversing the effects of gravitational lensing on cosmic microwave background (CMB) maps produces sharper acoustic peaks in power spectra and allows for tighter constraints on cosmological parameters. We investigate the efficacy of CMB delensing for improving the constraints on parameters used in extensions of the ΛCDM model that are aimed at resolving the Hubble Tension (such as varying fundamental constants, contributions from early dark energy, and self-interacting dark radiation). We use Fisher forecasting to predict the expected constraints with and without this delensing procedure. We demonstrate that CMB delensing improves constraints on H
0 by ∼ 20% for viable models and significantly improves constraints on parameters across the board in the low-noise regime.
Aspects of Everpresent Λ. Part I. A fluctuating cosmological constant from spacetime discreteness
Authors: Das Santanu , Nasiri Arad , Yazdi Yasaman K. 
Published: October 2023

Abstract
We provide a comprehensive discussion of the Everpresent Λ cosmological model arising from fundamental principles in causal set theory and unimodular gravity. In this framework the value of the cosmological constant (Λ) fluctuates, in magnitude and in sign, over cosmic history. At each epoch, Λ stays statistically close to the inverse square root of the spacetime volume. Since the latter is of the order of H
2 today, this provides a way out of the cosmological constant puzzle without fine tuning. Our discussion includes a review of what is known about the topic as well as new motivations and insights supplementing the original arguments. We also study features of a phenomenological implementation of this model, and investigate the statistics of simulations based on it. Our results show that while the observed values of H
0 and Ω0
Λ are not typical outcomes of the model, they can be achieved through a modest number of simulations. We also confirm some expected features of Λ based on this model, such as the fact that it stays statistically close to the value of the total ambient energy density (be it matter or radiation dominated), and that it is likely to change sign roughly every Hubble timescale.
CO2-Rich Gas Conversion to Carbon Nanotube via Molten Salt Electrolysis
Authors: Prasongthum N. , Suemanotham A. , Thanmongkhon Y. , Khowattana P. , Butniam P. , Khoduangklang N. , Samart C. , Attanatho L. 
Published: October 2023

Abstract
The CO2 capture via electrolysis process is a potentially promising and attractive pathway for greenhouse gas removal and global warming reduction by converting CO2 into value-added materials. In this study, the conversion of CO2 from CO2-rich gas into value-added carbon nanomaterial was successfully achieved via molten Li2CO3 electrolysis with a NiCr anode and a stainless steel cathode. The characterization by FESEM and TEM analyses showed that the obtained carbon product was a carbon nanotube with a bamboo-like structure and an outer average diameter of 36 nm. The EDS and XRD characterization indicated the growth of carbon nanotube in electrolysis was achieved through metal nucleation points on the electrolysis cathode. In addition, the Raman analysis showed that the carbon product exhibited high quality and crystallinity. The results from the present study revealed that the molten carbonate electrolysis offered a viable approach for direct transformation of CO2 from industrial flue gas into valuable carbon product, providing an alternative solution to reduce CO2 emissions.
Competitive Relaxation Mechanisms in Strained Epitaxial InGaSb on GaSb Substrate
Authors: Boonnum Samagorn , Kiravittaya Suwit , Thainoi Supachok , Kanjanachuchai Songphol , Panyakeow Somsak 
Published: October 2023

Abstract
Hetoroepitaxial growth of III-V compounds can produce both novel structures for fundamental research and electronic/photonic devices for practical applications. Antimony-based compounds are interested since they can interact with light in longer wavelengths ranging from near-infrared to terahertz frequency domains. In this work, we present an experimental observation of step-decorated surface and dislocation lines formed in an epitaxial In0.17Ga0.83Sb layer. The growth is performed by solid-source molecular beam epitaxy on (001) GaSb substrate at 400°C with the InGaSb deposition rate of 0.12 monolayer per second. The atomic force microscopy shows that the regular atomic steps are generally misaligned with the surface dislocation lines. The average distance between the steps is about 200 nm and the presence of dislocation lines affects the subsequent growth. Zigzag step-edge structure observed near the intersection of the step-edges and the dislocation lines can be explained by simple strain-considered models. Enhanced and depleted growth areas can be related to the degree of underneath strain. The understanding of this phenomena might lead to the simple and practical realization of regular arrays of nanostructures such as quantum wires and quantum dots.