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Akut- und Mittelzeitergebnisse von Koronar-Stents unterschiedlicher Materialien im Kaninchenmodell
(2005)
In dieser Versuchsreihe wurden drei neuartige Stent-Modelle (a-SiC:H-Stent, PHB-Stent und PTFE-Membran-Stent) mit zwei bereits in der klinischen Praxis eingesetzten Referenz-Stents (TA-Stent und be-StentTM) im Tierversuch (Arteriae femorales von New Zealand White Rabbits) getestet.
Die Studie war so konzipiert, die Stents nach drei unterschiedlichen Zeitspannen (1-10 Wochen, 11-20 Wochen und 21-30 Wochen) zu explantieren und die Parameter „verbleibendes Lumen“, „Elastica-intema-Durchmesser“, „Mediadicke“, „ Anteil elastischer Fasern“ und „Anteil kollagenen Bindegewebes“ zu bestimmen und zu vergleichen, um so indirekt Aussagen über die biomechanischen Eigenschaften, wie Auslösung einer überschiessenden Gewebereaktion oder Thrombogenität treffen zu können.
Der Vergleich der einzelnen Parameter gibt Aufschluss über die durch den Stent ausgelösten Reaktionen und damit über die Bioverträglichkeit, über die mechanischen Wirkungen, die maßgeblich vom Stent-Design abhängen und über die destruktiven Veränderungen (Durchbrechen einzelner Gefäßschichten).
Die Untersuchungen wurden in drei Hauptgruppen unterteilt:
• a-SiC:H-Stent vs. TA-Stent
• PHB-Stent vs. TA-Stent
• PTFE-Membran-Stent vs. be-Stent™
Hierbei zeigte der mit amorphen Siliziumkarbid beschichtete Stent eine designbedingt starke mechanische Gefäßwandschädigung. Dennoch muss für die Siliziumkarbid-Schicht ein protektiver Langzeiteffekt diskutiert werden.
Der bioresorbierbare Polyhydroxybutyriat-Stent (PHB) erfüllte aufgrund einer massiven vaskulären Entzündungsreaktion und der zu geringen Abbaurate bereits in der gesunden Arterie des Kaninchenmodells nicht die theoretischen Erwartungen, sodass weitere Versuche nur mit einem chemisch und technisch überarbeitetem Modell empfohlen werden können.
Die besten Ergebnisse aller Versuchsreihen zeigten sich durch eine geringe Restenoseneigung sowie eine geringe Gefäßwandreaktion für den mit einer Polytetrafluoroethylenmembran ummantelten 316L Edelstahl-Stent (PTFE).
Das Tiermodell (Kaninchen) scheint eine allgemein anerkannt qualitative Vorhersage über die Reaktion am Menschen zu treffen. Eine exakte quantitative Aussage ist jedoch nicht möglich. Eine Verlängerung des Beobachtungszeitraumes von 26 Wochen 275 auf 52 Wochen dürfte zumindest im Einzelfall die Aussagefähigkeit zur Implantat-Verträglichkeit im Tiermodell erhöhen.
Rearrangements des MLL Gens sind für 5-10% aller akuten Leukämien, biphenotypischen Leukämien und myelodysplastischen Syndrome im Kindes- und Erwachsenenalter verantwortlich. 5-10% dieser MLL Aberrationen sind wiederum therapiebedingt.
Die 43 heute schon bekannten Partnergene und die mindestens 36 noch nicht identifizierten Partnergene stellen dabei ein großes Problem für die MLL-Diagnostik dar, denn nach der zytogenetischen Analyse werden nur die am häufigsten auftretenden Partnergene MLLT2, MLLT3, MLLT1, MLLT4, ELL, und MLLT10 über RT-PCR untersucht. Dagegen werden die nicht so häufig auftretenden oder unbekannten Partnergene von einer weiteren Untersuchung ausgeschlossen.
Wenn auch alle MLL Translokationen mit einer Hochrisiko-Leukämie in Verbindung gebracht werden, bestimmt jedoch das Partnergen den Verlauf der Leukämie mit günstiger oder schlechter Prognose. Deshalb ist eine schnelle Identifizierung des Partnergens wichtig, um somit einer optimalen Behandlung beginnen zu können.
Aus diesem Grund ist eine universelle Diagnostik-Methode entwickelt worden, die es ermöglicht, alle MLL Rearrangements innerhalb der MLL Bruchpunktsregion zu ermitteln, auch wenn das Partnergen noch nicht bekannt ist. Diese Methode beruht auf der inversen Long Range PCR (LDI-PCR), einer Methode zur Amplifizierung von unbekannten DNA Sequenzen (Partnergen), die von bekannten DNA Sequenzen (MLL Gen) flankiert werden.
Mit dieser universellen Diagnostik-Methode konnten 340 Patienten aus 15 unterschiedlichen europäischen Diagnostikzentren erfolgreich untersucht werden. Die 340 Patienten setzen sich aus 238 Kindern und 102 Erwachsenen zusammen. Bei 157 Patienten (66 Kinder und 91 Erwachsene) konnte über eine Voruntersuchung ein MLL Rearrangement festgestellt werde. 183 Patienten (172 Kinder und 11 Erwachsene) sind vorher nicht auf eine MLL Aberration hin untersucht worden. Insgesamt konnten mit dieser Methode 144 Patienten mit mindestens einem MLL Rearrangement identifiziert werden. Bei diesen Rearrangements handelte es sich in den meisten Fällen um reziproke balancierte Translokationen, aber es konnten mit dieser Methode auch Deletionen, Inversionen, Insertionen und eine Tandem-Duplikation (MLL-PTD) identifiziert werden. Von den 172 vorher nicht untersuchten pädiatrischen Patienten konnten 11 (ca. 6%) mit einer MLL Aberration identifiziert werden. Dies entspricht in etwa der in der Literatur beschriebenen Häufigkeit von 10%. 12 (8%) der schon voruntersuchten Patienten konnten mit dieser Methode nicht verifiziert werden. Diese Fälle sollten weiter untersucht werden, um die Methode dieser Problematik entsprechend zu optimieren.
Während dieser Arbeit konnten auch die 6 neuen Partnergene ACACA, ARHGEF17, SMAP1, SELB und TIRAP (DCPS) identifiziert werden. Damit steigt die Zahl der charakterisierten Partnergene von 43 auf 49.
Diese Ergebnisse zeigen, dass sich diese Methode sehr gut für die Identifizierung von bekannten und unbekannten Partnergenen des MLL Gens eignet. In Verbindung mit der Split-Signal FISH Technik kann diese Methode sehr gut für eine Routinediagnostik und einen hohen Durchsatz an Proben herangezogen werden. Ein langfristiges Ziel wird die Analyse des MLL Rekombinoms sein, denn mindestens 36 Partnergene (40%) warten noch auf ihre Identifizierung.
Darüber hinaus können die patientenspezifischen chromosomalen Fusionssequenzen für das Monitoren von leukämischen Zellen über quantitative PCR Methoden herangezogen werden. Diese genomischen MRD Marker können dann in den einzelnen Zentren genutzt werden und dazu beitragen, dass in Zukunft die Therapieprotokolle und der Therapieerfolg verbessert werden. Erste Studien sind mit Hilfe der von uns generierten molekularen Marker bereits an zwei Zentren durchgeführt worden.
Dank intensiver Forschung konnte Stickstoffmonoxid (NO) innerhalb der letzten Jahrzehnte als ein gasförmiges Signalmolekül (second messenger) identifiziert werden, das innerhalb der Zelle verschiedene Signalkaskaden beeinflusst. Dabei spielt sowohl der Syntheseort als auch die synthetisierte NO-Menge eine entscheidende Rolle für die Spezifität des über NO vermittelten Signals. Dies spiegelt sich unter Anderem in den zahlreichen regulatorischen Mechanismen, denen die NO-Synthasen unterliegen, wider. In jüngster Vergangenheit konnte gezeigt werden, dass nicht nur der Aktivitätsstatus der NO-Synthasen, sondern ebenfalls deren subzelluläre Lokalisation durch solche Mechanismen entscheidend beeinflusst werden. Von besonderer Bedeutung scheinen dabei mit den NO-Synthasen interagierende Proteine zu sein. So resultiert beispielsweise eine Überexpression von NOSIP – einem eNOS interagierenden Protein – in CHO-NOS-Zellen in einer Umverteilung von eNOS von der Plasmamembran hin zu intrazellulären Kompartimenten. Diese Umverteilung führt zu einem signifikanten Aktivitätsverlust der eNOS. Die physiologische Relevanz dieser Interaktion wird sowohl durch den Interaktionsnachweis der endogenen Proteine in Endothelzellen als auch durch eine weitreichende Co-Expression in Gastro-Intestinaltrakt, Leber und Bauchspeicheldrüse der Ratte gestützt.
Eine nähere Charakterisierung dieser Interaktion war bisher jedoch noch nicht erfolgt. Auch blieben die biochemischen Eigenschaften von endogenem NOSIP bisher unerforscht. Daher war es Ziel dieser Arbeit, endogenes NOSIP näher zu charakterisieren und dadurch die Voraussetzungen für eine physiologische Interaktion zwischen NOSIP und eNOS aufzuklären. Dabei konnte festgestellt werden, dass es sich bei NOSIP um ein überwiegend nukleär lokalisiertes Protein handelt. Diese nukleäre Lokalisation wird über ein zweiteiliges Kernlokalisationssignal (NLS = nuclear localisation signal) vermittelt. Sukzessive Mutation dieses Signals resultiert in einer zytoplasmatischen Akkumulation von NOSIP. Ferner ist das NLS nach Fusion an heterologe Proteine in der Lage, deren Lokalisation in Richtung Zellkern zu verschieben. In Heterokaryon-Assays konnte gezeigt werden, dass NOSIP zusätzlich aus dem Kern exportiert wird und daher ein zwischen Kern und Zytoplasma wanderndes Protein ist. Dieses „trafficking“ wird über ein dynamisches Gleichgewicht aus Kernimport und Kernexport reguliert. Der Kernexport von NOSIP wird durch einen ungewöhnlichen - nicht durch Leptomycin B inhibierbaren - Mechanismus bewerkstelligt. Entsprechend findet sich innerhalb der NOSIP-Sequenz kein typisches, leucinreiches Exportsignal, durch welches gewöhnlich Kernexport über Bindung an Crm1 (chromosome region maintenance 1) vermittelt wird. Das dynamische Gleichgewicht zwischen Kernimport und Kernexport, verschiebt sich in Abhängigkeit vom Zellzyklus in der G2-Phase in Richtung Export, was in einer zytoplasmatischen Akkumulation von NOSIP resultiert. Beeinflusst wird das dynamische Gleichgewicht dabei möglicherweise von einer Interaktion zwischen NOSIP und der Zellzyklus-regulatorischen Kinase CDK1 (cyclin dependent kinase 1).
In Bezug auf eNOS ist diese zytoplasmatische Lokalisation von NOSIP von entscheidender Bedeutung, wie in vergleichenden Transfektionsexperimenten mit zytoplasmatischen NOSIP-Mutanten in CHO-NOS-Zellen gezeigt werden konnte. Danach vermittelt ausschließlich Transfektion dieser Mutanten eine Translokation von eNOS an das Aktin-Zytoskelett, während natives, primär nukleär lokalisiertes NOSIP keinen Einfluss auf die eNOS-Lokalisation hat. Analog dazu resultiert die zytoplasmatische Akkumulation von endogenem NOSIP in der G2-Phase des Zellzyklus ebenfalls in einer Translokation von eNOS an das Aktin-Zytoskelett, welche eine signifikante Aktivitätsminderung der NO-Synthase zur Folge hat. Diese zellzyklusspezifischen, eNOS-regulativen Effekte erfolgen in Abhängigkeit von endogenem zytoplasmatischem NOSIP, wie mittels RNA-Interferenzexperimente belegt werden konnte. Danach können sowohl die Umverteilung von eNOS als auch die daraus resultierende Aktivitätsminderung durch eine Expressionsunterdrückung von NOSIP vollständig inhibiert werden.
Die innerhalb dieser Arbeit erhobenen Daten stellen den ersten Bericht über eine Zellzyklusabhängige Regulation einer NOS-Isoform dar. Diese negative Regulation wird durch eine Umverteilung von eNOS an ein inaktives Kompartiment erreicht, welche wiederum über eine zellzyklusabhängige Lokalisationsänderung von NOSIP bewerkstelligt wird. In der Literatur finden sich zahlreiche Berichte über die Auswirkungen von exogen verabreichtem NO auf Zellzyklus-gesteuerte Ereignisse, wie Apoptose oder Proliferation. In diesem Zusammenhang zeigen die hier erhobenen Daten, dass die endogene NO-Menge tatsächlich zellzyklusspezifisch reguliert wird. Diese Regulation könnte möglicherweise ein Teil eines endogenen, NO-abhängigen Mechanismus darstellen, der die Apoptose und/oder die Proliferation beeinflusst.
This paper empirically examines differences in how 50-year-olds imagine their future. It draws on answers to an open-ended survey question in a large British cohort study—the National Child Development Study. Over 6,700 written responses about respondents’ imagined future are examined using text mining methods. Results from a relative frequency analysis and a topic model reveal differences according to gender, occupational class, and educational qualification. The cohort members’ written texts reflect different lifestyles. Men are more likely to mention sport, like golf and football, whereas women are more prone to use words related to family and friends. Respondents with a degree are more likely to write about cultural activities, such as museum or theater visits. Overall, the findings reveal gendered and socially stratified patterns in individual future perceptions, contextualized in relation to leisure, health, and family.
Background: Efficacy of treatment after failure of check point inhibitors (ICI) therapy remains ill-defined in metastatic renal cell carcinoma (mRCC).
Objective: To evaluate the safety and effectiveness of cabozantinib after failure of ICI-based therapies.
Design, setting and participants: Patients with mRCC who concluded cabozantinib treatment directly after an ICI-based therapy were eligible. Data was collected retrospectively from participating sites in Germany.
Interventions: Cabozantinib was administered as a standard of care.
Outcome measurements and statistical analysis
Adverse events (AE) were reported according to CTCAE v5.0. Objective response rate according to RECIST 1.1 and Progression Free Survival (PFS) were collected from medical records. Descriptive statistics and Kaplan-Meyer-plots were utilized.
Results and limitations: About 56 eligible patients (71.4% male) with median age of 66 years and clear cell histology in 66.1% (n = 37) were analyzed. 87.5% (n = 49) had ≥ 2 previous lines. IMDC risk was intermediate or poor in 17 patients (30.4%) and missing in 66.1%. 20 patients (35.7%) started with 60 mg. 55.4% (n = 31) required dose reductions, 26.8% (n = 15) treatment delays and 1.8% (n = 1) treatment discontinuation. Partial response was reported in 10.7% (n = 6), stable and progressive disease were reported in 19.6% (n = 11) and in 12.5% (n = 7). 32 patients were not evaluable (57.1%). Median treatment duration was 6.1 months. Treatment related AE were reported in 76.8% (n = 43) and 19.6% (n = 11) had grade 3-5. Fatigue (26.8%), diarrhea (26.8%) and hand-foot-syndrome (25.0%) were the 3 most frequent AEs of any grade and causality. SAE were reported in 21.4% (n = 12), 2 were fatal. Major limitation was the retrospective data capture in our study.
Conclusions: Cabozantinib followed directly after ICI-based therapy was safe and feasible. No new safety signals were reported. A lower starting dose was frequently utilized in this real-world cohort, which was associated with a favorable tolerability profile. Our data supports the use of cabozantinib after ICI treatment.
The CP-even fractions (F+) of the decays D0→π+π−π0 and D0→K+K−π0 are measured with a quantum-correlated ψ(3770)→DD¯ data sample collected by the BESIII experiment corresponding to an integrated luminosity of 7.93 fb−1. The results are Fπ+π−π0+=0.9406±0.0036±0.0021 and FK+K−π0+=0.631±0.014±0.011, where the first uncertainties are statistical and the second systematic. These measurements are consistent with the previous determinations, and the uncertainties for Fπ+π−π0+ and FK+K−π0+ are reduced by factors of 3.9 and 2.6, respectively. The reported results provide important inputs for the precise measurement of the angle γ of the Cabibbo-Kobayashi-Maskawa matrix and indirect CP violation in charm mixing.
Charge-dependent two- and three-particle correlations measured in Xe-Xe collisions at sNN−−−√=5.44 TeV are presented. Results are obtained for charged particles in the pseudorapidity range |η|<0.8 and transverse momentum interval 0.2≤pT<5.0 GeV/c for different collision centralities. The three-particle correlator γαβ≡⟨cos(φα+φβ−2Ψ2)⟩, calculated for different combinations of charge sign α and β, is expected to be sensitive to the presence of the Chiral Magnetic Effect (CME). Its magnitude is similar to the one observed in Pb-Pb collisions in contrast to a smaller CME signal in Xe-Xe collisions than in Pb-Pb collisions predicted by Monte Carlo (MC) calculations including a magnetic field induced by the spectator protons. These observations point to a large non-CME contribution to the correlator. Furthermore, the charge dependence of γαβ can be described by a blast wave model calculation that incorporates background effects and by the Anomalous Viscous Fluid Dynamics model with values of the CME signal consistent with zero. The Xe-Xe and Pb-Pb results are combined with the expected CME signal dependence on the system size from the MC calculations including a magnetic field to obtain the fraction of CME contribution in γαβ, fCME. The CME fraction is compatible with zero for the 30% most central events in both systems and then becomes positive; averaging over the 0-70% centrality interval yields an upper limit of 2% (3%) and 25% (32%) at 95% (99.7%) confidence level for the CME signal contribution to γαβ in Xe-Xe and Pb-Pb collisions, respectively.
In high-energy heavy-ion collisions, the correlations between the emitted particles can be used as a probe to gain insight into the charge creation mechanisms. In this article, we report the first results of such studies using the electric charge balance function in the relative pseudorapidity \Delta\eta and azimuthal angle \Delta\phi in Pb-Pb collisions at sqrt{s_{NN}} = 2.76 TeV with the ALICE detector at the Large Hadron Collider. The width of the balance function decreases with growing centrality (i.e. for more central collisions) in both projections. This centrality dependence is not reproduced by HIJING, while AMPT, a model which incorporates strings and parton rescattering, exhibits qualitative agreement with the measured correlations in \Delta\phi but fails to describe the correlations in \Delta\eta. A thermal blast wave model incorporating local charge conservation and tuned to describe the p_T spectra and v_2 measurements reported by ALICE, is used to fit the centrality dependence of the width of the balance function and to extract the average separation of balancing charges at freeze-out. The comparison of our results with measurements at lower energies reveals an ordering with sqrt{s_{NN}}: the balance functions become narrower with increasing energy for all centralities. This is consistent with the effect of larger radial flow at the LHC energies but also with the late stage creation scenario of balancing charges. However, the relative decrease of the balance function widths in \Delta\eta and \Delta\phi with centrality from the highest SPS to the LHC energy exhibits only small differences. This observation cannot be interpreted solely within the framework where the majority of the charge is produced at a later stage in the evolution of the heavy-ion collision.
In high--energy heavy--ion collisions, the correlations between the emitted particles can be used as a probe to gain insight into the charge creation mechanisms. In this Letter, we report the first results of such studies using the electric charge balance function in the relative pseudorapidity (Δη) and azimuthal angle (Δφ) in Pb--Pb collisions at sNN−−−−√=2.76 TeV with the ALICE detector at the Large Hadron Collider. The width of the balance function decreases with growing centrality (i.e. for more central collisions) in both projections. This centrality dependence is not reproduced by HIJING, while AMPT, a model which incorporates strings and parton rescattering, exhibits qualitative agreement with the measured correlations in Δφ but fails to describe the correlations in Δη. A thermal blast--wave model incorporating local charge conservation and tuned to describe the pmT spectra and v2 measurements reported by ALICE, is used to fit the centrality dependence of the width of the balance function and to extract the average separation of balancing charges at freeze--out. The comparison of our results with measurements at lower energies reveals an ordering with sNN−−−−√:the balance functions become narrower with increasing energy for all centralities. This is consistent with the effect of larger radial flow at the LHC energies but also with the late stage creation scenario of balancing charges. However, the relative decrease of the balance function widths in Δη and \dphi with centrality from the highest SPS to the LHC energy exhibits only small differences. This observation cannot be interpreted solely within the framework where the majority of the charge is produced at a later stage in the evolution of the heavy--ion collision.
In high-energy heavy-ion collisions, the correlations between the emitted particles can be used as a probe to gain insight into the charge creation mechanisms. In this Letter, we report the first results of such studies using the electric charge balance function in the relative pseudorapidity (Δη) and azimuthal angle (Δφ) in Pb--Pb collisions at sNN−−−√=2.76 TeV with the ALICE detector at the Large Hadron Collider. The width of the balance function decreases with growing centrality (i.e. for more central collisions) in both projections. This centrality dependence is not reproduced by HIJING, while AMPT, a model which incorporates strings and parton rescattering, exhibits qualitative agreement with the measured correlations in Δφ but fails to describe the correlations in Δη. A thermal blast-wave model incorporating local charge conservation and tuned to describe the pT spectra and v2 measurements reported by ALICE, is used to fit the centrality dependence of the width of the balance function and to extract the average separation of balancing charges at freeze-out. The comparison of our results with measurements at lower energies reveals an ordering with sNN−−−√: the balance functions become narrower with increasing energy for all centralities. This is consistent with the effect of larger radial flow at the LHC energies but also with the late stage creation scenario of balancing charges. However, the relative decrease of the balance function widths in Δη and Δφ with centrality from the highest SPS to the LHC energy exhibits only small differences. This observation cannot be interpreted solely within the framework where the majority of the charge is produced at a later stage in the evolution of the heavy--ion collision.
In high--energy heavy--ion collisions, the correlations between the emitted particles can be used as a probe to gain insight into the charge creation mechanisms. In this Letter, we report the first results of such studies using the electric charge balance function in the relative pseudorapidity (Δη) and azimuthal angle (Δφ) in Pb--Pb collisions at sNN−−−−√=2.76 TeV with the ALICE detector at the Large Hadron Collider. The width of the balance function decreases with growing centrality (i.e. for more central collisions) in both projections. This centrality dependence is not reproduced by HIJING, while AMPT, a model which incorporates strings and parton rescattering, exhibits qualitative agreement with the measured correlations in Δφ but fails to describe the correlations in Δη. A thermal blast--wave model incorporating local charge conservation and tuned to describe the pmT spectra and v2 measurements reported by ALICE, is used to fit the centrality dependence of the width of the balance function and to extract the average separation of balancing charges at freeze--out. The comparison of our results with measurements at lower energies reveals an ordering with sNN−−−−√:the balance functions become narrower with increasing energy for all centralities. This is consistent with the effect of larger radial flow at the LHC energies but also with the late stage creation scenario of balancing charges. However, the relative decrease of the balance function widths in Δη and \dphi with centrality from the highest SPS to the LHC energy exhibits only small differences. This observation cannot be interpreted solely within the framework where the majority of the charge is produced at a later stage in the evolution of the heavy--ion collision.
Measurements of the sphericity of primary charged particles in minimum bias proton--proton collisions at s√=0.9, 2.76 and 7 TeV with the ALICE detector at the LHC are presented. The observable is linearized to be collinear safe and is measured in the plane perpendicular to the beam direction using primary charged tracks with pT≥0.5 GeV/c in |η|≤0.8. The mean sphericity as a function of the charged particle multiplicity at mid-rapidity (Nch) is reported for events with different pT scales ("soft" and "hard") defined by the transverse momentum of the leading particle. In addition, the mean charged particle transverse momentum versus multiplicity is presented for the different event classes, and the sphericity distributions in bins of multiplicity are presented. The data are compared with calculations of standard Monte Carlo event generators. The transverse sphericity is found to grow with multiplicity at all collision energies, with a steeper rise at low Nch, whereas the event generators show the opposite tendency. The combined study of the sphericity and the mean pT with multiplicity indicates that most of the tested event generators produce events with higher multiplicity by generating more back-to-back jets resulting in decreased sphericity (and isotropy). The PYTHIA6 generator with tune PERUGIA-2011 exhibits a noticeable improvement in describing the data, compared to the other tested generators.
n this paper measurements are presented of π+, π−, K+, K−, p and p¯¯¯ production at mid-rapidity < 0.5, in Pb-Pb collisions at sNN−−−√=2.76 TeV as a function of centrality. The measurement covers the transverse momentum (pT) range from 100, 200, 300 MeV/c up to 3, 3, 4.6 GeV/c, for π, K, and p respectively. The measured pT distributions and yields are compared to expectations based on hydrodynamic, thermal and recombination models. The spectral shapes of central collisions show a stronger radial flow than measured at lower energies, which can be described in hydrodynamic models. In peripheral collisions, the pT distributions are not well reproduced by hydrodynamic models. Ratios of integrated particle yields are found to be nearly independent of centrality. The yield of protons normalized to pions is a factor ~1.5 lower than the expectation from thermal models.
We present first measurements of the evolution of the differential transverse momentum correlation function, {\it C}, with collision centrality in Au+Au interactions at sNN−−−−√=200 GeV. {\it C} exhibits a strong dependence on collision centrality that is qualitatively similar to that of number correlations previously reported. We use the observed longitudinal broadening of the near-side peak of {\it C} with increasing centrality to estimate the ratio of the shear viscosity to entropy density, η/s, of the matter formed in central Au+Au interactions. We obtain an upper limit estimate of η/s that suggests that the produced medium has a small viscosity per unit entropy.
The present study examines for the first time the emission patterns and olfactory signatures of 9 complete human corpses of different stages of decomposition. Air sampling was performed inside the body bags with solid sorbents and analysed by coupled gas chromatography-mass spectrometry after thermal desorption (TD-GC-MS). Furthermore, odour-related substances were detected by gas chromatography-olfactometry (GC-O). Sulfurous compounds (mainly dimethyl di- and trisulfide) were identified as most important to the odour perception. Around 350 individual organic substances were detected by TD-GC-MS, notably sulfurous and nitrogenous substances as well as branched alkanes, aldehydes, ketones, alcohols, carboxylic acids, carboxylic acid esters and ethers. A range of terpenes was detected for the first time in a characteristic emission pattern over all decomposition stages. Concentrations of the substances varied greatly, and no correlation between the emission patterns, the stage of decomposition and the cause of death could be found. While previous studies often analysed pig cadavers or only parts of human tissue, the present study shows the importance of analysing complete human corpses over a range of decomposition stages. Moreover, it is shown that using body bags as a kind of “emission test chamber” is a very promising approach, also because it is a realistic application considering the usual transport and store of a body before autopsy.
Background: Transfusion of red blood cell concentrate can be life-saving, but requires accurate dose calculations in children. Aims: We tested the hypothesis that cognitive aids would improve identification of the correct recommended volumes and products, according to the German National Transfusion guidelines, in pediatric transfusion scenarios. Methods: Four online questionnaire-based scenarios, two with hemodynamically stable and two with hemodynamically unstable children, were sent to German and international pediatric anesthetists for completion. In the two stable scenarios, participants were given pre-filled tables that contained all required information. For the two emergency scenarios, existing algorithms were used and required calculation by the user. The results were classified into three categories of deviations from the recommended values (DRV): DRV120 (<80% or >120%), as the acceptable variation; DRV 300 (<33% or >300%), the deviation of concern for potential harm; and DRV 1000 (<10% or >1000%), the excessive deviation with a high probability of harm. Results: A total of 1.458 pediatric anesthetists accessed this simulation questionnaire, and 402 completed questionnaires were available for analysis. A pre-filled tabular aid, avoiding calculations, led to a reduction in deviation rates in the category of DRV120 by 60% for each and of DRV300 by 17% and 20%, respectively. The use of algorithms as aids for unstable emergencies led to a reduction in the deviation rate only for DRV120 (20% and 15% respectively). In contrast, the deviation rates for DRV300 and DRV1000 rose by 37% and 16%, respectively. Participants used higher transfusion thresholds for the emergency case of a 2-year-old compromised child than for the stable case with a patient of the same age (on average, 8.6 g/dL, 95% CI 8.5–8.8 versus 7.1 g/dL, 95% CI 7.0–7.2, p < 0.001) if not supported by our aids. Participants also used a higher transfusion threshold for unstable children aged 3 months than for stable children of the same age (on average, 8.9 g/dL, 95% CI 8.7–9.0 versus 7.9 g/dL, 95% CI 7.7–8.0, p < 0.001). Conclusions: The use of cognitive aids with precalculated transfusion volumes for determining transfusion doses in children may lead to improved adherence to published recommendations, and could potentially reduce dosing deviations outside those recommended by the German national transfusion guidelines.
Distinct immune patterns of hepatocellular carcinoma (HCC) may have prognostic implications in the response to transarterial chemoembolization (TACE). Thus, we aimed to exploratively analyze tumor tissue of HCC patients who do or do not respond to TACE, and to identify novel prognostic biomarkers predictive of response to TACE. We retrospectively included 15 HCC patients who had three consecutive TACE between January 2019 and November 2019. Eight patients had a response while seven patients had no response to TACE. All patients had measurable disease according to mRECIST. Corresponding tumor tissue samples were processed for differential expression profiling using NanoString nCounter® PanCancer immune profiling panel. Immune-related pathways were broadly upregulated in TACE responders. The top differentially regulated genes were the upregulated CXCL1 (log2fc 4.98, Benjamini–Hochberg (BH)-p < 0.001), CXCL6 (log2fc 4.43, BH-p = 0.016) and the downregulated MME (log2fc −4.33, BH-p 0.001). CD8/T-regs was highly increased in responders, whereas the relative number of T-regs to tumor-infiltrating lymphocytes (TIL) was highly decreased. We preliminary identified CXCL1 and CXCL6 as candidate genes that might have the potential to serve as therapeutically relevant biomarkers in HCC patients. This might pave the way to improve patient selection for TACE in HCC patients beyond expert consensus.
For acute and chronic soft tissue infections, radical surgical debridement is required and is considered the gold standard, along with its immediate systemic antibiotic therapy. Treatment with local antibiotics and/or antibiotic-containing materials is commonly used as an additional tool in clinical practice. Spraying with fibrin and antibiotics is a newer technique that has been studied for some antibiotics. However, for gentamicin, data are not yet available on absorption, optimal application, antibiotic fate at the site and transfer of antibiotic into the blood. In an animal study involving 29 Sprague Dawley rats, 116 back wounds were sprayed with gentamicin using either gentamicin alone or one of two possible spray combinations of gentamicin and fibrin. Simultaneous application of gentamicin and fibrin via a spray system to soft tissue wounds resulted in significant antibiotic concentration over a long period of time. The technique is easy and cost-effective. The systemic crossover was significantly minimized in our study, which may have led to fewer side effects in patients. These results could lead to an improvement in local antibiotic therapy.
Background: The Rapid Upper Limb Assessment (RULA) is used for the risk assessment of workplace-related activities. Thus far, the paper and pen method (RULA-PP) has been predominantly used for this purpose. In the present study, this method was compared with an RULA evaluation based on kinematic data using inertial measurement units (RULA-IMU). The aim of this study was, on the one hand, to work out the differences between these two measurement methods and, on the other, to make recommendations for the future use of the respective method on the basis of the available findings. Methods: For this purpose, 130 (dentists + dental assistants, paired as teams) subjects from the dental profession were photographed in an initial situation of dental treatment and simultaneously recorded with the IMU system (Xsens). In order to compare both methods statistically, the median value of the difference of both methods, the weighted Cohen’s Kappa, and the agreement chart (mosaic plot) were applied. Results: In Arm and Wrist Analysis—area A—here were differences in risk scores; here, the median difference was 1, and the agreement in the weighted Cohen’s kappa test also remained between 0.07 and 0.16 (no agreement to poor agreement). In area B—Neck, Trunk, and Leg Analysis—the median difference was 0, with at least one poor agreement in the Cohen’s Kappa test of 0.23–0.39. The final score has a median of 0 and a Cohen’s Kappa value of 0.21–0.28. In the mosaic plot, it can be seen that RULA-IMU had a higher discriminatory power overall and more often reached a value of 7 than RULA-PP. Conclusion: The results indicate a systematic difference between the methods. Thus, in the RULA risk assessment, RULA-IMU is mostly one assessment point above RULA-PP. Therefore, future study results of RULA by RULA-IMU can be compared with literature results obtained by RULA-PP to further improve the risk assessment of musculoskeletal diseases.
Purpose: To evaluate the efficacy and safety of microwave ablation (MWA) as a treatment for recurrent hepatocellular carcinoma (HCC) after initial successful surgical resection. Methods: This retrospective study included 40 patients (11 women and 29 men; mean age: 62.3 ± 11.7 years) with 48 recurrent lesions of HCC after initial surgical resection that were treated by percutaneous MWA. Several parameters including complications, technical success, local tumor progression (LTP), intrahepatic distant recurrence (IDR), overall survival (OS), and progression-free survival (PFS) were evaluated in order to investigate the safety and efficacy of MWA for these recurrent HCC lesions after surgical treatment. Results: All MWA treatments were performed without complications or procedure-related deaths. Technical success was achieved in all cases. Two cases developed LTP at a rate of 5%, and IDR occurred in 23 cases at a rate of 57.5% (23/40). The 1-, 2-, 3-, 4-, and 6-year OS rates were 97%, 89.2%, 80.3%, 70.2%, and 60.2%, respectively. The 1- and 3-year PFS rates were 50.2% and 34.6%, respectively. Conclusion: MWA is effective and safe as a local treatment for recurrent HCC after initial surgical resection.