Recent publications
2]Rotaxanes offer unique opportunities for studying and modulating charge separation and energy transfer, because the mechanical bond allows the robust, yet spatially dynamic tethering of photoactive groups. In this work, we synthesized [2]rotaxane triads comprising a central (aza)[10]CPP⊃C60 bis‐adduct complex and two zinc porphyrin stoppers to address how the movable nanohoop affects light‐induced charge separation and energy transfer between the rotaxane subcomponents. We found that neither the parent nanohoop [10]CPP nor its electron‐deficient analogue aza[10]CPP actively participate in charge separation. In contrast, the nanohoops completely prevented through‐space charge separation. This result is likely due to supramolecular “shielding”, because charge separation was observed in the thread that acted as reference dyad. On the other hand, the suppression of electron transfer allowed the observation of energy transfer from the porphyrin triplet to the fullerene triplet state with a lifetime of ca. 25 μs. The presence of the interlocked nanohoops therefore leads to a dramatic switch between charge separation and energy transfer. We suggest that our results explain observations made by others in photovoltaic devices comprising nanohoops and may pave the way toward strategic uses of mechanically interlocked architectures in devices that feature (triplet) energy transfer.
Study Design
Retrospective cohort study.
Objectives
To identify predictors for early mortality following traumatic spinal cord injury (TSCI), as recognition of factors associated with early mortality is essential for public resource allocation and optimized acute care.
Methods
Retrospective Analysis of SCI patients admitted to the acute SCI ward from 2003 to 2022 was performed. Days elapsing from the date of injury to date of death established the survival time. Early mortality was defined as survival time ≤ 365 days. Multivariable logistic regression was used in modeling of early death following TSCI with age, gender, neurologic deficit, type of neurologic injury, ventilation status, and count of complications as covariates.
Results
Simple logistic regression indicated a significant association of early mortality with the number of complications ( P < .0001), neurological deficit ( P < .0001), complete neurological injury ( P < .0001), ventilation status ( P < .0001), and age group ( P < .0003). After adjusting for other covariates, complete neurological injury (OR: 1.75, P < .0001), ventilation (OR: 2.80, P < .0001), and Age group (over 60 OR: 17.71, P < .0001) were significantly associated with early mortality. The multivariable model showed a good overall fit (Hosmer-Lemeshow P = .315; AUC 0.85).
Conclusions
Predictors of early mortality after TSCI are high complete spinal cord injury, age, number of complications, and the need for ventilation. Identification of high-risk patients is crucial to rationalize and improve acute care to potentially reduce mortality rates.
Nickel‐rich stoichiometries such as NMC811 have gained increasing relevance for lithium‐ion‐batteries in recent years due to their high specific capacity and reduced use of critical resources. However, low intrinsic electronic conductivity of NMC active materials makes the use of carbon‐based additives necessary. Volume fraction and distribution of the carbon‐binder‐domain (CBD) have a significant impact on the electrode performance. This work combines high‐resolution tomography and microstructure‐resolved simulations to characterize the three‐dimensional transport networks of a commercial NMC811 cathode. FIB‐SEM tomography reveals that low CBD volume fractions with suboptimal distribution cause a non‐percolating conductive network in the microstructure and thus unfavourably low electronic conductivity. Increasing the CBD content through virtual electrode design enables percolation and enhances electronic conductivity fundamentally. Simulations on both the real and virtually designed structures demonstrate how percolating CBD networks lead to a significantly improved energy density.
Polypharmacy in older adults increases the risk of adverse drug reactions (ADRs), but studying this relationship is complex. In real-world data, the high number of medications, coupled with rare drug combinations, results in high-dimensional datasets that are difficult to analyze using conventional statistical methods. This study applies horseshoe and lasso regression for analyzing rare events in polypharmacy contexts, focusing on severe ADRs such as falls and bleedings. These regression models are executed on a multi-center dataset compiling 7175 cases from the ADRED project to detect potential ADR-associated drugs among 100 most common drugs in emergency department admissions. Positive predictors are classified by using 50% and 90% credibility intervals. This study demonstrates that regression models with horseshoe or lasso priors are effective for analyzing ADRs, providing a comprehensive consideration of multiple factors in large, sparse datasets and improving signal detection in polypharmacy, addressing a significant challenge in pharmacovigilance. Both priors yielded consistent and clinically meaningful results. The horseshoe regression resulted in fewer potential positive predictors overall, which could make it suitable as a diagnostic tool. While these regressions generate valuable information, there are still challenges in setting appropriate thresholds for determining and interpreting the positive results.
Objective
This systematic review and meta-analysis evaluates the available evidence on efficacy of social support strategies, as defined by the persuasive system design framework, in internet-based and mobile-based interventions (IMI) targeting mental health.
Design
Systematic review and meta-analysis.
Data sources
PubMed, Embase, PsycINFO and the Cochrane Central Register of Controlled Trials.
Eligibility criteria for selecting studies
Randomised controlled trials comparing IMI implementing a social support strategy for mental health symptoms to various control conditions. Publications up to June 2023 (date of search 6 June 2023) were considered.
Data extraction and synthesis
Two independent reviewers screened and extracted data in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed with the Risk of Bias Tool V.2.0. Data were pooled based on a random-effects model.
Results
After screening 6484 records, a total of 45 studies met our inclusion criteria. At 96%, social support was predominantly implemented through the strategy of social facilitation, by which users recognising others using the intervention (eg, discussion forum). IMI implementing social support strategies showed moderate effect sizes of Hedges’ g =−0.34 (95% CI −0.47 to −0.21, p<0.001) in comparison to different control conditions. Heterogeneity was considerable (I ² =73.6%; 95% CI 64.8 to 80.3). Subgroup analyses revealed a significant influence of targeted psychological condition (p<0.001), type of social support (p<0.001) and control condition (p<0.001). In k =11 component studies (ie, comparison to a disentangled version of the same intervention), IMI with social support strategies were not significantly more effective in comparison to the same IMI without social support (Hedges’ g =−0.08 (95% CI −0.22 to 0.05, p=0.19, I ² =0%). 64% (k=7) of component studies reported higher adherence rates in IMI with social support.
Conclusions
Based on a small number of component studies, implementing social support strategies in IMI that target mental health symptoms has no significant incremental benefit on effectiveness. To draw more robust conclusions, the potential of other social support strategies besides social facilitation should be exploited in future component studies.
PROSPERO registration number
CRD42020222810.
A series of high-density polyethylene and a statistical copolymer of poly(propylene-co-ethylene) blends in a wide range, namely (0, 10, 20, 30, 40, 50, 60,70, 80, 90, 100) abbreviated as HDPE/VM were systematically investigated by using a rheometer, differential scanning calorimetry (DSC) measurements, polarized optical microscopy (POM) and tensile tests. Rheometer results show that adding VM decreases dynamic viscosity, storage, and loss modulus. Han plot shows that HDPE and VM are compatible and miscible in the range from 20 to 60 VM % in the molten state. DSC results show little nucleation effect of VM on HDPE (HDPE’s melt crystallization temperature shifts 2 °C higher). Moreover, a linear composition dependence of ∆cp ∆Hc, ∆Hm shows that PE and VM are most probably compatible in the molten state in composition range from 20 to 60%. However, upon crystallization, the VM and PE domains occur distinctively. The results of the tensile tests demonstrated a decrease in elastic modulus, yield stress, and ultimate tensile strength as VM content increased. At low VM content (less than 20%), high elongation at break was detected for the blends, and very fine spherulites of HDPE were found across the sample by POM.
Zusammenfassung
Ziel der Studie Psychisch erkrankte Menschen sollten selbstbestimmt in der Gemeinde wohnen, es findet sich starke Evidenz für diese Wohnform. In dieser Arbeit wurden die Wohnsituation von Menschen mit schweren psychischen Erkrankungen, die Inanspruchnahme und der Bedarf an Versorgungsangeboten analysiert.
Methodik Es wurden Daten einer Querschnittsstudie mit 397 Menschen mit schweren psychischen Erkrankungen aus zwei bayerischen Bezirken verwendet und deskriptiv ausgewertet.
Ergebnisse 70% der Betroffenen wohnen eigenständig. 6% leben im ambulant oder stationär betreuten Wohnen. 25% der Betroffenen sind auf Hilfe beim Wohnen angewiesen, wobei 39% hiervon nicht die nötige Hilfe erhalten. Die betreuenden Wohnformen sind den meisten Betroffenen bekannt und wurden als hilfreich empfunden.
Schlussfolgerung Die meisten Betroffenen leben in einer der gesellschaftlichen Norm entsprechenden Wohnsituation. Dennoch besteht bei einem Teil der Betroffenen ein ungelöstes Wohnproblem. Die Inanspruchnahme von ambulant oder stationär betreutem Wohnen ist hilfreich, die Unterstützung wird aber kaum genutzt.
Systemic ALys amyloidosis is a debilitating protein misfolding disease that arises from the formation of amyloid fibrils from C-type lysozyme. We here present a 2.8 Å cryo-electron microscopy structure of an amyloid fibril, which was isolated from the abdominal fat tissue of a patient who expressed the D87G variant of human lysozyme. We find that the fibril possesses a stable core that is formed by all 130 residues of the fibril precursor protein. There are four disulfide bonds in each fibril protein that connect the same residues as in the globularly folded protein. As the conformation of lysozyme in the fibril is otherwise fundamentally different from native lysozyme, our data provide a structural rationale for the need of protein unfolding in the development of systemic ALys amyloidosis.
Background
The field of interventional electrophysiology is rapidly growing. For safe and efficient procedures sedation is needed for patient comfort and immobility. However, sedative and analgesic agents can induce respiratory depression, risking hypercapnia, hypoxia, and hypotension. This study evaluates the impact of adding transcutaneous carbon-dioxide (CO2) monitoring to standard monitoring practices in electrophysiological procedures under deep sedation.
Methods
This prospective, randomized study at Ulm University Heart Center included 726 patients undergoing treatment under deep sedation between August 2019 and October 2023. Patients were randomly assigned to standard monitoring or standard monitoring with continuous transcutaneous CO2 monitoring (TCM-group). Standard monitoring involved non-invasive blood pressure, oxygen saturation (SpO2), and frequent peripheral venous blood gas analysis. The primary composite endpoint was SpO2 dips below 90% and pathological changes in venous blood gas analysis.
Results
The TCM-group included 357 patients, and the standard group had 348. The primary composite endpoint was reached by 195 patients (54.8%) in the TCM-group and 195 patients (56.5%) in the standard group (p = 0.642). However, peripheral venous CO2 partial pressure increased by more than 30% from baseline more often in the standard group than in the TCM-group (p = 0.005). Additionally, a venous pH below 7.25 was more common in the standard group (p = 0.047).
Conclusion
While transcutaneous CO2 monitoring offers no significant benefit for the primary combined endpoint over standard monitoring during electrophysiological procedures, it helps mitigate significant CO2 elevations and respiratory acidosis.
Clinical Trial Registration: ClinicalTrials.gov, NCT04038476, 29 July 2019.
Graphical abstract
Background
Individuals with maturity‐onset diabetes of the young (MODY) are often misdiagnosed as type 1 or type 2 diabetes and receive inappropriate care. We aimed to investigate the characteristics and treatment of all MODY types in a multicenter, real‐world setting.
Methods
Individuals with MODY from the diabetes prospective follow‐up (DPV) registry were studied. We compared clinical parameters during the first year of diabetes and the most recent treatment year after MODY diagnosis.
Results
A total of 1640 individuals were identified with GCK‐MODY (n = 941) and HNF1A‐MODY (n = 417) as the most frequent types. Among these, 912 individuals were available with information during the first and the most recent treatment year (median duration of follow‐up: 4.2 years [2.6–6.6]). Positive beta cell autoantibodies were present in 20.6% (15.2% IAA). Median age at diagnosis ranged from 9.9 years in GCK‐MODY (Q1–Q3: 6.2–13.1 years) and INS‐MODY (2.7–13.7 years) to 14.3 years (5.0–17.1) in KCNJ11‐MODY. Frequency of oral antidiabetic agents (OAD) use increased and insulin decreased in HNF4A‐MODY (OAD: 18% to 39%, insulin: 34% to 23%) and in HNF1A‐MODY (OAD: 18% to 31%, insulin: 35% to 25%). ABCC8‐MODY was characterized by a decrement in nonpharmacological treatment (26% to 16%) and “insulin only” treatment (53% to 42%), while the proportion of individuals treated with OAD but no insulin increased from 0% to 21%.
Conclusions
Our results indicate that some teams caring for individuals with MODY are hesitant with regard to current recommendations. Registries are an essential source of information and provide a basis for discussing treatment guidelines for MODY.
image
Background
Advanced screening technologies, particularly biospectroscopic techniques like infrared attenuated total reflection (IR-ATR) spectroscopy, are gaining significance for their potential to offer fast, reliable, and specific diagnostic methods. These techniques, combined with chemometric approaches, have been increasingly applied for identifying bacterial and viral infections, cancer screening, and are now reported as useful in the context of COVID-19 and Long-COVID. The application IR-ATR, in point-of-care settings is crucial across various contexts. The ongoing progress in deploying IR-ATR in clinical settings represents a significant advancement in infectious disease screening.
Objective
The main objective of this study is to demonstrate the efficacy of IR-ATR as a rapid, sensitive, and specific tool for pathogen detection and infection monitoring at the clinical level, in agreement with existing literature.
Methods
The present study applied IR-ATR spectroscopy as a direct screening methodology that discriminates between patients infected with the SARS-CoV-2 virus and healthy subjects via dried serum samples.
Results
The chemometric analysis through PCA presented an accuracy of 99.18% with a sensitivity and specificity of 98.83% and 97.32% respectively.
Conclusions
This approach supports the potential of IR-ATR for pathogen detection -SARS-CoV-2- in clinical settings as a rapid, sensitive, specific and minimally invasive technique that could be valuable for the deployment of rapid platforms for pathogen identification and viral infection monitoring.
Diabetes has been clearly associated with hidradenitis suppurativa (HS) in the last years. HS is a chronic inflammatory skin disease that has a significant impact on patients’ quality of life. It is characterized by recurrent painful nodules, abscesses and draining tunnels in predominantly intertriginous areas. The average prevalence of HS ranges from 0.4% to 1%, with familial and sporadic forms of the disease. HS is mostly diagnosed by clinical observation and history. An emerging tool for the assessment of deep-seated lesions is ultrasound imaging. Severity grading is still enormously based on the Hurley staging system, whereas a new validated, dynamic classification, severity grading and outcome measure, the International Hidradenitis Suppurativa Severity Score System (IHS4), has been developed. Chronic symptoms or consequences of uncontrolled disease include pain, drainage, pruritus, odour, low self-esteem, sleep and sexual dysfunction, and poor mental health. The pathogenesis of HS is thought to involve follicular dyskeratosis, hyperkeratosis and dilatation, follicular rupture and chronic inflammation with architectural tissue changes. Apart from diabetes, HS is in general associated with metabolic syndrome and other cardiovascular risk factors, polycystic ovary syndrome and depression. It has also been mainly associated with other immune-mediated diseases, such as inflammatory bowel disease and spondyloarthropathy. HS has a profound negative impact on patients’ quality of life and is an under-diagnosed and under-treated disease. A multidisciplinary management approach may be required to ensure the best outcomes, given the associated comorbid disorders. Few isolated lesions (mild disease according to IHS4) might be treated by topically applied preparations, and locally limited lesions (moderate disease) can be treated by conventional surgery or laser, whereas widespread lesions (severe disease) may be better treated with systemic therapy alone or in combination with radical surgery, if scarring is prominent. Systemic therapy may include antibiotics (clindamycin and rifampicin, tetracyclines), acitretin and biologic agents (adalimumab, secukinumab – registered biologics – but also infliximab, bimekizumab, anakinra (off label)). Adjuvant measures such as pain management, treatment of superinfections, weight loss and tobacco cessation must be taken into account.
Diabetes mellitus (DM) is a debilitating, life-limiting disease. According to recent estimates, 415 million adults currently suffer from the disease. This number is expected to rise to 642 million by 2040. Skin disorders can often predict the onset of this metabolic disorder. Uncontrolled hyperglycaemia impairs the overall immunity of the diabetic patient, involving various mechanistic pathways, resulting in the diabetic skin being immunocompromised and prone to bacterial infections. Among others, diabetic foot infections are very common. There are specific microbes that are associated with each type of infection, and the presence of these microbes is an indication of the specific type of infection. In this chapter we have focused on the association of DM with different types of bacterial skin infections and resistance patterns to antimicrobial agents commonly used in the treatment of diabetes-associated infections.
Aims/hypothesis
The diagnosis of type 2 diabetes is increasing in young people worldwide. This study evaluated the frequency and clinical characteristics of young people presenting with type 2 diabetes from the multinational SWEET e.V Registry 2012–2021, including the first years of the COVID-19 pandemic.
Methods
This is a longitudinal observational study based on the SWEET Registry, which collects demographic and clinical data on children and adolescents with diabetes from centres worldwide, with the diagnosis and classification of diabetes provided locally by each centre according to International Society for Paediatric and Adolescent Diabetes definitions. By July 2022, the SWEET Registry included 96,931 individuals from 130 centres with a total of 1,154,555 visits. Data were analysed by region: Europe (EU), Australia and New Zealand (AU/NZ), South America (SA), North America (NA) and Asia/Middle East and Africa (AS/AF). Trends in proportions for the two-year periods, calculated as cases with type 2 diabetes diagnoses over all cases with diabetes diagnoses, were estimated using logistic regression models adjusted for age at onset and sex.
Results
Overall, there were 2819 of 58,170 new cases (4.8%) with type 2 diabetes: 614 in EU, 293 in AU/NZ, 79 in SA, 1211 in NA and 622 in AS/AF. The proportion of type 2 diabetes increased from 3.2% to 6.0% from 2012/2013 to 2020/2021, a relative rate of increase of 9% per two-year period (95% CI 5.9, 12.3; p<0.001). In the two-year period of the COVID-19 pandemic, type 2 diabetes continued to follow the observed trend, with a proportion of 6.0% in 2020–2021 compared with 5.4% in 2018–2019. High variability in the proportion of type 2 diabetes was observed across regions, with the lowest values observed in EU and the highest in NA. A significant increase in the proportion of type 2 diabetes was observed in EU, AU/NZ and NA. The median HbA1c was not uniform and was highest in AS/AF (85 mmol/mol [9.9%]; IQR 55–111 [7.2–12.3%]) and lowest in EU (63 mmol/mol [7.9%]; IQR 48–99 [6.5–11.2%]), and the difference between EU and NA (median value 73 mmol/mol [8.8%]; IQR 50–105 [6.7–11.8%]) was statistically significant (p=0.047). There was also a difference in BMI SD score by region: the lowest median BMI SD score was 2.2 (IQR 1.4–2.7) in AS/AF and the highest was 3.1 (IQR 2.5–3.6) in AU/NZ.
Conclusions/interpretation
The multinational SWEET data from the years 2012 to 2021 inclusive support recent findings of a worldwide increase in type 2 diabetes in young people, albeit with regional differences. This increase highlights the need for ongoing preventive measures and available advanced treatment modalities worldwide.
Graphical Abstract
The combination of chain-mapping and tensor-network techniques provides a powerful tool for the numerically exact simulation of open quantum systems interacting with structured environments. However, these methods suffer from a quadratic scaling with the physical simulation time, and therefore, they become challenging in the presence of multiple environments. This is particularly true when fermionic environments, well-known to be highly correlated, are considered. In this work, we first illustrate how a thermo-chemical modulation of the spectral density allows replacing the original fermionic environments with equivalent, but simpler, ones. Moreover, we show how this procedure reduces the number of chains needed to model multiple environments. We then provide a derivation of the fermionic Markovian closure construction, consisting of a small collection of damped fermionic modes undergoing a Lindblad-type dynamics and mimicking a continuum of bath modes. We describe, in particular, how the use of the Markovian closure allows for a polynomial reduction of the time complexity of chain-mapping based algorithms when long-time dynamics are needed.
The majority of research on magnesium (Mg) electrolytes has focused on enhancing reversible Mg deposition, often employing chloride‐containing electrolytes. However, there is a notable gap in the literature regarding the influence of chloride ions in semi‐solid Mg electrolytes. In this study, we systematically explore the impact of chloride ions on Mg deposition/dissolution on a copper (Cu) anode using a semi‐solid electrolyte composed of Mg‐based mixed metal‐organic frameworks, MgCl2 and Mg[TFSI]2. We separate the Mg deposition/dissolution process from changes in the anode's surface morphology In this respect, the morphological and compositional transformations in the electrolyte and electrode following galvanostatic cycling are meticulously investigated. Initial potential cycling reveals the feasibility of Mg deposition/dissolution on Cu electrodes, albeit with reduced reversibility in subsequent cycles. Extending the upper potential limit to 4.0 V vs. Mg/Mg²⁺ enhances Mg dissolution, attributed to chloride ions facilitating Cu surface dissolution. Our findings provide insights into optimizing semi‐solid electrolytes for advanced Magnesium battery technologies.
Background
The Erectile Function Domain of the International Index of Erectile Function (IIEF6) is inaccurate in assessing erectile function in men who are not practicing sexual intercourse. Improvement through a modification was recently tested on patients after radical prostatectomy. This study examines the application of this modification in a population-based cohort of middle-aged men.
Aim
To assess the feasibility of a modified IIEF6 in a population-based random sample of 50-year old men in Germany.
Methods
4924 men were included. IIEF6, Erection Hardness Score (EHS), and causes for the absence of sexual intercourse within the previous 4 weeks were assessed. Modified calculation (double weighting of non-intercourse IIEF6 questions) was applied in case of absence due to external circumstances.
Outcomes
Impact of the modification on erectile dysfunction (ED) prevalence and agreement between IIEF6 and EHS in ED classification.
Results
As a result of the modified calculation, ED prevalence in the overall study sample decreased by 6.2% to a rate of 27.2%. Agreement between IIEF6 and EHS was increased from 2.7% to 73.4% in men with no sexual intercourse due to external circumstances.
Clinical Implications
An additional inquiry into the reason for the absence of sexual intercourse and modified calculation enhances the accuracy of IIEF6 in evaluating erectile function of the individual man.
Strengths and Limitations
This study comprises a large population-based sample. As the study population was exclusively 50-year-old men, results may not be representative of the population average.
Conclusion
A more accurate evaluation of an individual man’s erectile function may be achieved by using a modified version of the IIEF6.
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