julilili42/papers huggingface dataset:
39: Spectrum of interventional procedures during hybrid central line placement in pediatric intestinal rehabilitation patients with end-stage vascular access
2023-06-26

Introduction: Loss of available central vein access sites for parenteral nutrition delivery represents one of the main indications for intestinal transplantation in children with intestinal failure. Placement of central venous catheters can be challenging in advanced loss of patent venous pathways. We recently described the hybrid technique (interventional plus surgical approach) of central line placement in children. The aim of this study was to describe and analyze the interventions used during the hybrid procedures regarding feasibility, safety and outcome. Methods: We retrospectively analyzed the course of all children in our intestinal rehabilitation program undergoing hybrid central line placement. We evaluated patients’ conditions, interventional techniques and surgical peculiarities as well as outcome. Results: Between 2010 and 2021, 203 children were treated in our intestinal rehabilitation program. Due to loss of venous access, hybrid technique was performed in 53 children during 76 interventions. In 40 cases the same vessel was reused via Seldinger technique. Among the 30 ultrasound-guided new vessel punctures, 12 were performed by puncture of collateral vessels. Extended interventions due to thoracic central venous obstruction and/or thrombosis requiring additional access via a femoral vein for rehabilitation of the vascular system was performed during 29 procedures including catheter extraction (1), angioplasties (18), stent placement (1), revascularization (5) and thrombectomy (4). Placement of a central line was not possible in 6 children which eventually underwent extended thoracic/vascular surgery: in three children the previously placed catheter could not be removed, in one child, placement of a thrombectomy-catheter was not possible because of inferior vena cava occlusion, and in two children, revascularization failed. Intestinal transplantation was considered in one patient because of impending loss of vascular access. Two self-limiting minor extravasations and one intervention-associated pericardial effusion occurred. Conclusion: Hybrid interventions for central venous catheter placement and vascular rehabilitation enable a high success rate in children with intestinal failure and end-stage vascular access, circumventing the need for intestinal transplantation or advanced surgery. The relevant procedures are complex and require a foresighted and individualized approach with a wide range of interventional techniques. If performed with expertise, this combined interventional/surgical approach is feasible and safe.
The largest record of the minute beaver Euroxenomys minutus (Mammalia, Castoridae) from the early Late Miocene hominid locality Hammerschmiede (Bavaria, Southern Germany) and palaeoecological considerations
2023-06-26

In this study, we describe the dental remains of a very minute beaver from the early Late Miocene locality Hammerschmiede (MN 7/8) located at the Northern Alpine Foreland Basin (Southern Germany, Bavaria). The finds represent the so far most comprehensive (&gt;1.000 dental specimens) collection of the trogontheriine castorid <i>Euroxenomys minutus</i>. Metrically and morphologically, the large data set demonstrates an extensive intraspecific variability of this beaver from Hammerschmiede that covers most finds of other European localities and confirms previous species assignments. The subspecies <i>Euroxenomys minutus rhenanus</i> from Dorn-Dürkheim (Germany), clearly isolates from this range of variation and can thus be validated. The performed age-frequency distributions for <i>Euroxenomys minutus</i> from the local stratigraphic levels HAM 5 (rivulet) and HAM 4 (river) correspond roughly and also resemble <i>Euroxenomys</i> from the swamp deposit Rudabánya (Hungary). Since previous mortality studies on the also occurring larger beaver <i>Steneofiber depereti</i> from Hammerschmiede demonstrated dominance of behavioural or internal factors, this cross-ecosystem similarity in mortality for the small beaver species is likely explained by external factors, such as predation. Supported by a taphonomic bone analysis, a multitude of predators are finally considered to prey on <i>Euroxenomys minutus</i> and indicate a predatory bone assemblage.
Zwitterionic Carbazole Ligands Enhance the Stability and Performance of Perovskite Nanocrystals in Light-Emitting Diodes
2023-06-27

We introduce a new carbazole-based zwitterionic ligand (DCzGPC) synthesized via Yamaguchi esterification which enhances the efficiency of lead halide perovskite (LHP) nanocrystals (NCs) in light-emitting diodes (LED). A facile ligand exchange of the native ligand shell, monitored by nuclear magnetic resonance (NMR), ultraviolet-visible (UV-vis), and photoluminescence (PL) spectroscopy, enables more stable and efficient LHP NCs. The improved stability is demonstrated in solution and solid-state LEDs, where the NCs exhibit prolonged luminescence lifetimes and improved luminance, respectively. These results represent a promising strategy to enhance the stability of LHP NCs and to tune their optoelectronic properties for further application in LEDs or solar cells.
Characterizing personalized neuropathology in dementia and mild cognitive impairment with explainable artificial intelligence
2023-06-27

Abstract Deep learning approaches for clinical predictions based on magnetic resonance imaging data have shown great promise as a translational technology for diagnosis and prognosis in neurological disorders, but its clinical impact has been limited. This is partially attributed to the opaqueness of deep learning models, causing insufficient understanding of what underlies their decisions. To overcome this, we trained convolutional neural networks on brain scans to differentiate dementia patients from healthy controls, and applied layerwise relevance propagation to procure individual-level explanations of the model predictions. Through extensive validations we demonstrate that deviations recognized by the model corroborate existing knowledge of neuropathology in dementia. By employing the explainable dementia classifier in a longitudinal dataset of patients with mild cognitive impairment, we show that the spatially rich explanations complement the model prediction when forecasting transition to dementia and help characterize the biological manifestation of disease in the individual brain. Overall, our work exemplifies the clinical potential of explainable artificial intelligence in precision medicine.
Transition and Drivers of Elastic to Inelastic Deformation in the Abarkuh Plain From InSAR Multi‐Sensor Time Series and Hydrogeological Data
2023-06-27

Abstract Tracking the inelastic deformation of an aquifer is important to quantify the stress experienced by the aquifer system, so that the effects of the current extraction practices are put in the context of the hydrogeological settings of a region. However, transition of elastic to inelastic deformation is hard to be monitored, particularly in the Abarkuh Plain (AP) with a dry climate. In this study, we define the confined extent of aquifer system and track the spatial evolution of inelastic deformation based on the multi‐sensor Interferometric Synthetic Aperture Radar time series in the AP in central Iran from 2003 to 2020. Our results demonstrate that many locations with experiencing no significant inelastic deformation a few years ago are now deforming inelastically, leading to partially irreversible lowering of ground surface and loss of aquifer storage. Lithological data shows that total thickness of compacted clay units controls the extent and timing of observed inelastic deformation, while joint geodetic‐well data confirms that multi‐decadal dropping of head in the confined extents of aquifer system is driving the long‐term compaction. These results show that we are possibly near a tipping point between the sustainable conditions and permanent damage to underground water resources and the current decisions have the potential to permanently change the natural resources landscape.
Gender typicality of occupational aspirations among immigrant and native youth: the role of gender ideology, educational aspirations, and work values
2023-06-27

The gender typicality of adolescents' occupational aspirations helps sustain occupational segregation, ultimately contributing to maintain gender stratification. According to sociological and psychological perspectives, adolescents develop occupational aspirations by drawing on their gender beliefs and work-related values. Yet few empirical studies have examined the contribution of these value orientations specifically to the gender typicality of occupational aspirations. Moreover, although children from immigrant backgrounds make up an ever-increasing share of school-age students, there is scant evidence on the gender typicality of their occupational aspirations relative to those of their majority peers. This study investigates variations in the gender typicality of occupational aspirations among adolescents from immigrant and non-immigrant backgrounds at around age 16. It also explores how the gender typicality of different groups' aspired occupations relates to differences in gender ideologies, in educational aspirations, and in the importance attributed to three work values: the possibility to earn high income, to help others, and to think and solve problems. Drawing on a harmonized survey from England, Germany, the Netherlands and Sweden, the analysis uses a sample of 8,574 adolescents, including 1,510 girls and 1,336 boys from immigrant backgrounds. Multinomial logistic regressions estimated the associations with aspired occupations, classified as masculine, integrated, feminine or ultrafeminine based on the proportion of women working in them. Results indicate that boys and girls of immigrant origin aspired to somewhat less gender-typical occupations than their majority peers. Among girls, these differences would be even larger if they were not suppressed by the more traditional gender ideologies held by girls from immigrant backgrounds. In terms of mediating mechanisms, our findings suggest that more ambitious educational aspirations may partly explain these differences. These findings indicate that distinguishing between multiple dimensions of adolescents' work-related values hint at different underlying mechanisms in the formation of adolescents' occupational aspirations.
Pulmonary Physiology and Medicine of Diving
2023-06-27

Abstract Pulmonary physiology is significantly altered during underwater exposure, as immersion of the body and increased ambient pressure elicit profound effects on both the cardiovascular and respiratory systems. Thoracic blood pooling, increased breathing gas pressures, and variations in gas volumes alongside ambient pressure changes put the heart and lungs under stress. Normal physiologic function and fitness of the cardiovascular and respiratory systems are prerequisites to safely cope with the challenges of the underwater environment when freediving, or diving with underwater breathing apparatus. Few physicians are trained to understand the physiology and medicine of diving and how to recognize or manage diving injuries. This article provides an overview of the physiologic challenges to the respiratory system during diving, with or without breathing apparatus, and outlines possible health risks and hazards unique to the underwater environment. The underlying pathologic mechanisms of dive-related injuries are reviewed, with an emphasis on pulmonary physiology and pathophysiology.
TopDownApp: An open and modular platform for analysis and visualisation of top-down proteomics data
2023-06-27

Although Top-down (TD) proteomics techniques, aimed at the analysis of intact proteins and proteoforms, are becoming increasingly popular, efforts are needed at different levels to generalise its adoption. In this context, there are numerous improvements that are possible in the area of open science including the FAIR (Findability, Accessibility, Interoperability and Reusability) data principles. These include e.g. increased data sharing practices and availability of tailored open data standards. Additionally, the field would benefit from the development of open analysis workflows that can enable e.g. data reuse of public datasets, something that is increasingly common in other proteomics fields. We present an open and modular platform for the analysis and visualisation of TD proteomics data called TopDownApp. It can be used as a flexible analysis platform, through the use of a common workflow engine, common data formats for input/output, and software containerisation. It can also serve as a tool for visual inspection through its simple setup. As a key point, it can also be used as a development platform for new tools through the use of Python, a modular design, software containerisation and common data formats. TopDownApp is open source and freely available at: https://github.com/mwalzer/TopDownApp.
Delivery of gene therapy through a cerebrospinal fluid conduit to rescue hearing in adult mice
2023-06-28

Inner ear gene therapy has recently effectively restored hearing in neonatal mice, but it is complicated in adulthood by the structural inaccessibility of the cochlea, which is embedded within the temporal bone. Alternative delivery routes may advance auditory research and also prove useful when translated to humans with progressive genetic-mediated hearing loss. Cerebrospinal fluid flow via the glymphatic system is emerging as a new approach for brain-wide drug delivery in rodents as well as humans. The cerebrospinal fluid and the fluid of the inner ear are connected via a bony channel called the cochlear aqueduct, but previous studies have not explored the possibility of delivering gene therapy via the cerebrospinal fluid to restore hearing in adult deaf mice. Here, we showed that the cochlear aqueduct in mice exhibits lymphatic-like characteristics. In vivo time-lapse magnetic resonance imaging, computed tomography, and optical fluorescence microscopy showed that large-particle tracers injected into the cerebrospinal fluid reached the inner ear by dispersive transport via the cochlear aqueduct in adult mice. A single intracisternal injection of adeno-associated virus carrying solute carrier family 17, member 8 ( Slc17A8 ), which encodes vesicular glutamate transporter-3 (VGLUT3), rescued hearing in adult deaf Slc17A8 −/− mice by restoring VGLUT3 protein expression in inner hair cells, with minimal ectopic expression in the brain and none in the liver. Our findings demonstrate that cerebrospinal fluid transport comprises an accessible route for gene delivery to the adult inner ear and may represent an important step toward using gene therapy to restore hearing in humans.
The spinal cord injury-induced immune deficiency syndrome: results of the SCIentinel study
2023-06-28

Abstract Infections are prevalent after spinal cord injury (SCI), constitute the main cause of death and are a rehabilitation confounder associated with impaired recovery. We hypothesize that SCI causes an acquired lesion-dependent (neurogenic) immune suppression as an underlying mechanism to facilitate infections. The international prospective multicentre cohort study (SCIentinel; protocol registration DRKS00000122; n = 111 patients) was designed to distinguish neurogenic from general trauma-related effects on the immune system. Therefore, SCI patient groups differing by neurological level, i.e. high SCI [thoracic (Th)4 or higher]; low SCI (Th5 or lower) and severity (complete SCI; incomplete SCI), were compared with a reference group of vertebral fracture (VF) patients without SCI. The primary outcome was quantitative monocytic Human Leukocyte Antigen-DR expression (mHLA-DR, synonym MHC II), a validated marker for immune suppression in critically ill patients associated with infection susceptibility. mHLA-DR was assessed from Day 1 to 10 weeks after injury by applying standardized flow cytometry procedures. Secondary outcomes were leucocyte subpopulation counts, serum immunoglobulin levels and clinically defined infections. Linear mixed models with multiple imputation were applied to evaluate group differences of logarithmic-transformed parameters. Mean quantitative mHLA-DR [ln (antibodies/cell)] levels at the primary end point 84 h after injury indicated an immune suppressive state below the normative values of 9.62 in all groups, which further differed in its dimension by neurological level: high SCI [8.95 (98.3% confidence interval, CI: 8.63; 9.26), n = 41], low SCI [9.05 (98.3% CI: 8.73; 9.36), n = 29], and VF without SCI [9.25 (98.3% CI: 8.97; 9.53), n = 41, P = 0.003]. Post hoc analysis accounting for SCI severity revealed the strongest mHLA-DR decrease [8.79 (95% CI: 8.50; 9.08)] in the complete, high SCI group, further demonstrating delayed mHLA-DR recovery [9.08 (95% CI: 8.82; 9.38)] and showing a difference from the VF controls of −0.43 (95% CI: −0.66; −0.20) at 14 days. Complete, high SCI patients also revealed constantly lower serum immunoglobulin G [−0.27 (95% CI: −0.45; −0.10)] and immunoglobulin A [−0.25 (95% CI: −0.49; −0.01)] levels [ln (g/l × 1000)] up to 10 weeks after injury. Low mHLA-DR levels in the range of borderline immunoparalysis (below 9.21) were positively associated with the occurrence and earlier onset of infections, which is consistent with results from studies on stroke or major surgery. Spinal cord injured patients can acquire a secondary, neurogenic immune deficiency syndrome characterized by reduced mHLA-DR expression and relative hypogammaglobulinaemia (combined cellular and humoral immune deficiency). mHLA-DR expression provides a basis to stratify infection-risk in patients with SCI.
Sepsis and underlying comorbidities in intensive care unit patients
2023-06-28

Abstract Background There is an ongoing debate as to whether death with sepsis is primarily caused by sepsis or, more often, by the underlying disease. There are no data on the influence of a researcher’s background on such an assessment. Therefore, the aim of this analysis was to assess the cause of death in sepsis and the influence of an investigator’s professional background on such an assessment. Materials and methods We performed a retrospective observational cohort study of sepsis patients treated in the medical intensive care unit (ICU) of a tertiary care center. For deceased patients, comorbidities and severity of illness were documented. The cause of death (sepsis or comorbidities or both combined) was independently assessed by four assessors with different professional backgrounds (medical student, senior physician in the medical ICU, anesthesiological intensivist, and senior physician specialized in the predominant comorbidity). Results In all, 78 of 235 patients died in hospital. Agreement between assessors about cause of death was low (κ 0.37, 95% confidence interval 0.29–0.44). Depending on the assessor, sepsis was the sole cause of death in 6–12% of cases, sepsis and comorbidities in 54–76%, and comorbidities alone in 18–40%. Conclusions In a relevant proportion of patients with sepsis treated in the medical ICU, comorbidities contribute significantly to mortality, and death from sepsis without relevant comorbidities is a rare event. Designation of the cause of death in sepsis patients is highly subjective and may be influenced by the professional background of the assessor.
An inducible CRISPR‐Kill system for temporally controlled cell type‐specific cell ablation in Arabidopsis thaliana
2023-06-28

Summary The application of the CRISPR/Cas system as a biotechnological tool for genome editing has revolutionized plant biology. Recently, the repertoire was expanded by CRISPR‐Kill, enabling CRISPR/Cas‐mediated tissue engineering through genome elimination by tissue‐specific expression. Using the Cas9 nuclease from Staphylococcus aureus (SaCas9), CRISPR‐Kill relies on the induction of multiple double‐strand breaks (DSBs) in conserved repetitive genome regions, such as the rDNA, causing cell death of the targeted cells. Here, we show that in addition to spatial control by tissue‐specific expression, temporal control of CRISPR‐mediated cell death is feasible in Arabidopsis thaliana . We established a chemically inducible tissue‐specific CRISPR‐Kill system that allows the simultaneous detection of targeted cells by fluorescence markers. As proof of concept, we were able to eliminate lateral roots and ablate root stem cells. Moreover, using a multi-tissue promoter, we induced targeted cell death at defined time points in different organs at select developmental stages. Thus, using this system makes it possible to gain new insights into the developmental plasticity of certain cell types. In addition to enabling tissue engineering in plants, our system provides an invaluable tool to study the response of developing plant tissue to cell elimination through positional signaling and cell‐to‐cell communication.
Non-invasive estimation of split renal function from routine 68Ga-SSR-PET/CT scans
2023-06-28

Objective Patients with impaired kidney function are at elevated risk for nephrotoxicity and hematotoxicity from peptide receptor radionuclide therapy (PPRT) for advanced neuroendocrine tumors. Somatostatin receptor (SSR)-PET/CT imaging is the method of choice to identify sufficient SSR expression as a prerequisite for PRRT. Therefore, our study aimed to explore whether split renal function could be evaluated using imaging data from routine SSR-PET/CT prior to PRRT. Methods In total, 25 consecutive patients who underwent SSR-PET/CT (Siemens Biograph mCT ® ) before PRRT between June 2019 and December 2020 were enrolled in this retrospective study. PET acquisition in the caudocranial direction started at 20 ± 0.5 min after an i.v. injection of 173 ± 20 MBq [ 68 Ga]Ga-ha DOTATATE, and the kidneys were scanned at 32 ± 0.5 min p.i. The renal parenchyma was segmented semi-automatically using an SUV-based isocontour (SUV between 5 and 15). Multiple parameters including SUVmean of renal parenchyma and blood pool, as well as parenchyma volume, were extracted, and accumulation index ( ACI : renal parenchyma volume/SUVmean) and total kidney accumulation ( TKA : SUVmean x renal parenchyma volume) were calculated. All data were correlated with the reference standard tubular extraction rate (TER-MAG) from [ 99m Tc]Tc-MAG3 scintigraphy and glomerular filtration rate (GFR CDK − EPI ). Results SUVmean of the parenchymal tracer retention showed a negative correlation with TER MAG ( r : −0.519, p &amp;lt; 0.001) and GFR CDK − EPI ( r : −0.555, p &amp;lt; 0.001) at 32 min p.i. The herein-introduced ACI revealed a significant correlation ( p &amp;lt; 0.05) with the total tubular function ( r : 0.482), glomerular renal function ( r : 0.461), split renal function ( r : 0.916), and absolute single-sided renal function ( r : 0.549). The mean difference between the split renal function determined by renal scintigraphy and ACI was 1.8 ± 4.2 % points. Conclusion This pilot study indicates that static [ 68 Ga]Ga-ha DOTATATE PET-scans at 32 min p.i. may be used to estimate both split renal function and absolute renal function using the herein proposed “Accumulation Index” (ACI).